Recommendation(s)?

[JJames]

I am certainly glad that I started my post (biography, diary, story, ???) under the "General Discussion > The Big File" category of the board, as I am feeling less and less optimistic that this chronicle of events will ever actually end!

I had my follow-up appointment with Dr. Yue the first week of May to review my most recent MRI and discuss what surgical options may be available for me to address spine issues. Although a very thorough account of this visit may more clearly explain my great frustration, I don't have the patience to try and type it nor would I want to put anyone through reading it all! In short, due to some confusion created by a P.A. who initially spoke with me at the start of this appointment - Dr Yue finally came in and looked at the MRI images, then stated who wonderful they were and that there was no reason I would be unable to do anything - run, jump, climb, and on and on and on. I stared blankly in a state of shock, unable to think or speak! My wife took the much more direct approach almost shouting, "What!? Are you kidding us? Why were we working so hard to get a bi-level ADR surgery approved for you to perform if there is nothing wrong?"

Only then did Dr. Yue seem to notice it may have been a decent idea to peek into my very large file / medical chart before he walked in! He quickly back-peddled trying to explain that he was only referring to the fact that the MRI shows no cause for my leg pain! Based on whatever his P.A. said or wrote, he thought that was the purpose of the visit! He then stated that due to my past discogram with concordant pain indicating my L4/5 and L5/S1 were my pain generators that we should line up a CT scan and try to move forward with getting the bi-level ADR or a hybrid procedure done! He added that I should get tested for Lyme disease as well, as my leg pain could somehow be related to an issue like that.

For me, this appointment couldn't have gone much worse. I really needed to confidently believe that a surgical intervention for my problems was the "right" thing to do, and that I had a surgeon who was also confident in that fact. Instead, I feel like he is simply going along with what I (we) are asking for.

I suppose I need to pull myself together (once more), go ahead with the CT scan, and seek out some additional surgeons for their opinions........

[pittpete]

Sorry to hear that...
It seems like Mr Yue wasn't prepared to give you a diagnosis but continue to string you along with more tests.
If it was me i would find another doctor in the city.
Anyone from TBI in your healthcare plan?

[drewrad]

Just my two cents re the 'right thing to do'. You will never get such reassurance, nor would you want it, from a doctor. You get it strictly from yourself first, and the doctor is merely a confirming echo chamber. They do not live inside your body. Only you do, and while pain can be subjective, it is your pain tolerance itself that you're either capable or incapable of living with in the end.

There's nothing predictive that you can place your chips on the table and bet on re any surgery. These are all qualitative decisions which are something that doctors are incapable of providing clear guidance on, unfortunately.

That said, there are a few outliers where this is not so by any outwardly observable means: caudal equine syndrome, bladder problems, loss of motor control of limbs(foot drop etc). Those are easy for any doctor to base a decision on since they are his liabilities also in a court of law. Short of that, us in the grey area must make these decisions alone. Sounds like you have a great wife though to help you along and confirm your own decision.

[NJ Gene]

James,

I apologize for not reading your first post carefully. Three of my spinal surgeries were done by Daveed Frazier, MD. He is the director of orthopedic surgery at St. Lukes-Roosevelt Hospital in NYC. Here is his main website: New York City Minimally Invasive Spine Surgeon | Daveed D. Frazier, MD He also works with a group based out of Northern NJ. That website is Dr. Daveed D. Frazier, MD - Spine Surgeon | Atlantic Spine Center He has a very impressive biography that on that site that you should read. Finally, he offers a free MRI review through his NY office. If you ultimately decide to see him mention that I was the patient who he talked out of going to Germany for ADR in March, 2013. I ended up getting an endoscopic foraminotomy instead. This was fully covered by insurance and I feel great.

Good luck to you!!

Gene

[Jerry5]

Not an insurance expert, but make sure you have some claim by the end of June, so you can appeal within 30 days.

I am an ADR person, and will go the distance to NOT fuse, I have had one level disctectomy/laminectomy.

Solved the disc pressure at the site, but the nerve damage and the bad disc remain.

[CDW321]

Hi JJames -
I am in the NYC area and finding any really experienced ADR surgeons here is pretty tough. I heard from a medical insider that the NorthEast tends to be much more conservative than the western States, hence all the innovative surgeons in TX, California, Washington, etc. I heard from a friend that Dr. Paul Glazer is amazing though seems to be fusion. I liked Dr. Bitan but he seems to be very picky and cautious with doing ADRs these days. Stay away from Jeffrey Goldstein. I saw him twice and he has the bedside manner of a Troll, no compassion and not that many ADRs under his belt. ( He also writes his own online reviews.). You could try HSS though my luck with them has not been great. I think Cammisa and Girardi are the most involved in ADR but would also do a really good fusion.? Also Dr. Noel Perrin at NYU. Strictly fusion but a very good surgeon from what I know. Nice guy too. That is it and why I am going into debt seeking out surgeons really far away in the US. I heard Anders Cohen in Brooklyn is a good guy too.
Best of luck to you.

[Jerry5]

I also was offered a fusion, but refuse to fuse, this is not necessary, and have had more than one doc, say they have problems 3-5 years down the road.
Not sure what level you have,

{'added' sorry, had to back up and read, yea, the Lumbar is a bad place, not to take away anything from the cervical}

but the Mobi-C is doing real well for people. Cervical.
Again, there are MANY types, just finding the experienced docs, like the Physio-L, this was one of the first types, other than the Charite, that I read about, then the M6, and the LP-ESP, I made inquiries about the LP-ESP, and no response.

...therefore, I am going with the M6. Two Level.
Go For reimbursement.

[henry4956]

Hi James, I just read this thread for the 1st time.

In a earlier post by Drew 'Drewrad' I am the guy he referred to as the one where the radiologist and surgeon arguing in german about my mri as I lied on the floor in agony. Seems to me that you are instinctively aware that you have something seriously wrong (like me) and your mri is not showing anything conclusive, ( again like me). So I am here to tell you that I am glad that I trusted my instincts and gave my surgeon the go ahead. He made his diagnosis partly based on some abnormalities on mri but more so based on physical exam and other factors. Personally I am glad my surgeon has over 20 years experience to tap into. Undoubtedly I'm sure he drew on one or more of his previous cases and made the right call with me.

The 2 discs he replaced were 'completely gone' in his words on the surgery report. 'Dried toothpaste' is how he described their condition. Sure enough I am about 10 weeks post op and the terrible 'Belt pain' I had is gone. See my signature (I was bed ridden for about 22 hrs/day for 3 years). I could not stand up for more than 30 minutes without collapsing before the surgery. I truly hope you get yourself a good experienced surgeon. My wife and I were fortunate enough to borrow the $ because we have excellent equity in our home. I know you are 'on the clock', but you do only have 1 chance to get this right. I live in Connecticut and I decided not to see Dr Yue ( 1 hour from my house) because my research on him left me with the impression that his record is spotty.

If you go the ADR route (which most of us here have chosen to do then you most likely have to pay out of pocket anyway) I suggest that IF you forego fusion then find one of the several great adr surgeons, don't settle for someone just because he's local. Just my opinion

I hope it all works out for you