No Surgery... Yet

[Stonewall_Boris]

Way to go Ian!

[drewrad]

Waiting on second MRI/X ray report. Hopefully will come later today, but I already know. It 'feels' like my L5/S1 has totally collapsed in there. I'm feeling micro-movements, bone on bone. And I'm not looking forward to Kaiser's approach to my problem. I can already here the cliches.

So.... I know this is subjective, but would like to have like a field poll or something for the folks here, and I know I'm going to get a ton of different answers, but I am sending all my paperwork and MRI stuff out to 1) Clavel 2) Bierstadt 3) Zeegers and 4) TBI.

Would anyone like to rank those in terms of which they feel is the best to worst?(with explanations if possible, but not necessary) It would really help me.

[ian]

I've only spoken with Drs Clavel and Bierstedt. Based on my conversations with them and several of their patients I don't think you can go wrong with either doctor. With that said, I'm having Dr. Bierstedt perform my ADR in a couple weeks. I based my decision on the aftercare/rehab program that Dr. Bierstedt's team has set up. It just seems a little more comprehensive. As far as the surgery goes, I think both doctors would be an excellent choice.

Originally Posted by drewrad

Waiting on second MRI/X ray report. Hopefully will come later today, but I already know. It 'feels' like my L5/S1 has totally collapsed in there. I'm feeling micro-movements, bone on bone. And I'm not looking forward to Kaiser's approach to my problem. I can already here the cliches.

So.... I know this is subjective, but would like to have like a field poll or something for the folks here, and I know I'm going to get a ton of different answers, but I am sending all my paperwork and MRI stuff out to 1) Clavel 2) Bierstadt 3) Zeegers and 4) TBI.

Would anyone like to rank those in terms of which they feel is the best to worst?(with explanations if possible, but not necessary) It would really help me.

[drewrad]

Originally Posted by ian

I've only spoken with Drs Clavel and Bierstedt. Based on my conversations with them and several of their patients I don't think you can go wrong with either doctor. With that said, I'm having Dr. Bierstedt perform my ADR in a couple weeks. I based my decision on the aftercare/rehab program that Dr. Bierstedt's team has set up. It just seems a little more comprehensive. As far as the surgery goes, I think both doctors would be an excellent choice.

I'm sending off my MRIs today to both as well as Zigler. Am very interested in you and will be following your progress with Bierstedt.

My MRIs kind of frightened me. Lumbar area, discs look thin and black, no light in any of them. What in the hell is wrong with me?

Kaiser's spine specialist called me finally today and gave me a bunch of cliches. She said there is mild bilateral nerve root compression at L5/S1 but it doesn't feel mild. My feet get numb throughout the day and my butt starts to hurt in the afternoon. Can't sit either.

Her advice? Kind of live with it.

[ian]

I'll definitely update my progress as I go through my surgery and recovery.

Sounds like you've got some desiccated discs going on. The 'light' represents fluid. Black means their devoid of fluid. What many doctors don't realize is that a persons films alone aren't a good indicator of why they're in so much pain. I'm becoming less and less patient with doctors in the US.

Ha! "Live with it." Classic. Makes me want to poke a doctor in the forehead repeatedly with a toothpick and each time they complain tell them to live with it.

Originally Posted by drewrad

I'm sending off my MRIs today to both as well as Zigler. Am very interested in you and will be following your progress with Bierstedt.

My MRIs kind of frightened me. Lumbar area, discs look thin and black, no light in any of them. What in the hell is wrong with me?

Kaiser's spine specialist called me finally today and gave me a bunch of cliches. She said there is mild bilateral nerve root compression at L5/S1 but it doesn't feel mild. My feet get numb throughout the day and my butt starts to hurt in the afternoon. Can't sit either.

Her advice? Kind of live with it.

[Kelly4ADR]

IAN,
Kudos to you for suggesting self referral/cash for imaging...while I have amazing insurance (just paid $62 out of pocket for my MRI, the total billed to my insurance was $1800) it's often times overlooked that we have choices.

And don't get too jealous of "amazing insurance", as I am looking at a two level cervical ADR which I'm anticipating a denial for...

[drewrad]

Originally Posted by ian

I'll definitely update my progress as I go through my surgery and recovery.

Sounds like you've got some desiccated discs going on. The 'light' represents fluid. Black means their devoid of fluid. What many doctors don't realize is that a persons films alone aren't a good indicator of why they're in so much pain. I'm becoming less and less patient with doctors in the US.

Ha! "Live with it." Classic. Makes me want to poke a doctor in the forehead repeatedly with a toothpick and each time they complain tell them to live with it.

Hardest part is how nobody relates to what you're going through. The wife, while supportive, just has no clue. And Kaiser is absolutely disappointing, from their spine 'specialist' to the PTs to my GP. They just don't even seem very educated at all.

Looked at my friend's MRIs yesterday who is my age(45) and was disappointed to see all his other discs look really bright and tall. I thought perhaps they would be deflated like mine and that mine were more the norm. Not so.

Will be nice to get the Euros to look at my MRIs/X ray and get feedback from them.

[ian]

The thing about chronic pain is, that unless a person has experienced the same thing, that have no way of relating. I love it when people tell me about the time they broke their arm, or cracked a rib and how it was the most painful thing they've ever experienced. I just roll my eyes. Unless you know what it's like to wake up with pain and go to sleep with pain, day in and day out, you have no idea what it feels like.

My girlfriend, who is a national caliber professional mountain biker, has had 4 knee surgeries and her ankle is basically fused. She eats pain like candy. Seriously, I don't know anyone who can absorb more pain. But she also deals with constant pain off the bike and wakes up every morning limping. She understands what I deal with, and it helps to have someone who doesn't dismiss what I'm going through as being all in my head

I've been racing mountain bikes for a while, and cyclist like to talk about suffering on the bike during a hard ride or race like it's a badge of honor. I just walk away from these discussions because it'll just piss me off if I have to explain to them that I'm in pain before I get on the bike and 30 minutes into a ride I can't feel my left foot. They think enduring pain is fun because as soon as they get off the bike the pain stops. When in my case the pain really begins after the ride is over.

But enough of my whining. Keep searching, Drewad, you'll find relief at some point. Just don't give up.

Originally Posted by drewrad

Hardest part is how nobody relates to what you're going through. The wife, while supportive, just has no clue. And Kaiser is absolutely disappointing, from their spine 'specialist' to the PTs to my GP. They just don't even seem very educated at all.

Looked at my friend's MRIs yesterday who is my age(45) and was disappointed to see all his other discs look really bright and tall. I thought perhaps they would be deflated like mine and that mine were more the norm. Not so.

Will be nice to get the Euros to look at my MRIs/X ray and get feedback from them.

[drewrad]

Waiting for Zeegers 'perfect diagnosis'. In the meantime, he gave me a little taste of it which shows multi-segmental lower lumbar DDD, the bottom two showing the most damage.

Malte got back to me yesterday. He is recommending a two level M6 at the L4/L5 which is basically gone as well as the L5/S1 ditto.

Here's his own words:

Dr. Bierstedt reviewed and commented your medical data.

Findings/diagnosis
Severe Degenerative disc disease L4/5, L5/S1
Moderate DDD at L2/3 and L3/4

Here's their recommendation.

Surgical decompression of the spinal canal by total discectomy, removal of osteophytes and artificial disc replacement L4/5 and L5/S1

Pre-operative discussion on disc replacement L2/3 and L3/4.
Assumption: these levels are clinically irrelevant. If symptoms develop in the future, additional disc replacements can be offered by lateral or posterior surgical approach.
For now these findings could be ignored.

I responded back to Malte and asked this.

I was curious about this....

" If symptoms develop in the future, additional disc replacements can be offered by lateral or posterior surgical approach.For now these findings could be ignored."

If I needed these two levels later on, do you mean you couldn't approach from the anterior like you would be this time? And if so, why? I never knew you could do an ADR from the posterior.

He responded back thusly.

The surgery will be performed by Dr. Bierstedt.
Ref disc replacement in high lumbar levels:
The anterior access to L2/3 is complicated due to the vessels. or higher leels Dr. Bierstedt uses a posterior approach

referencing this, the Triumph. Was wondering if anyone heard of it?

TRIUMPH® Lumbar Disc, posterolateral approach - Spine

However, what I want input on is that some here have received a 3 level ADR and vessels weren't an issue with you I assume so it is possible. Did Biersdadt or any other doctor mention higher lumber levels being a contraindication from an anterior approach?

[ian]

I've only heard of three level ADR from L3/L4 to L5/S1, but I'm unfamiliar with complications concerning vessels at L2/L3. I've read that Dr. B is one of the few doctors who performs ADR higher up, especially in thoracic vertebrae.

Ask to speak with Dr. B over the phone. I was able to clear up all my questions in one conversation that would have taken countless back and forth emails.

While he primarily uses the M6, he also uses the disc that he feels works best on a particular patient, or in a particular area of the spine. With that said, I've never heard of the Triumph disc.

Originally Posted by drewrad

Waiting for Zeegers 'perfect diagnosis'. In the meantime, he gave me a little taste of it which shows multi-segmental lower lumbar DDD, the bottom two showing the most damage.

Malte got back to me yesterday. He is recommending a two level M6 at the L4/L5 which is basically gone as well as the L5/S1 ditto.

Here's his own words:

Dr. Bierstedt reviewed and commented your medical data.

Findings/diagnosis
Severe Degenerative disc disease L4/5, L5/S1
Moderate DDD at L2/3 and L3/4

Here's their recommendation.

Surgical decompression of the spinal canal by total discectomy, removal of osteophytes and artificial disc replacement L4/5 and L5/S1

Pre-operative discussion on disc replacement L2/3 and L3/4.
Assumption: these levels are clinically irrelevant. If symptoms develop in the future, additional disc replacements can be offered by lateral or posterior surgical approach.
For now these findings could be ignored.

I responded back to Malte and asked this.

I was curious about this....

" If symptoms develop in the future, additional disc replacements can be offered by lateral or posterior surgical approach.For now these findings could be ignored."

If I needed these two levels later on, do you mean you couldn't approach from the anterior like you would be this time? And if so, why? I never knew you could do an ADR from the posterior.

He responded back thusly.

The surgery will be performed by Dr. Bierstedt.
Ref disc replacement in high lumbar levels:
The anterior access to L2/3 is complicated due to the vessels. or higher leels Dr. Bierstedt uses a posterior approach

referencing this, the Triumph. Was wondering if anyone heard of it?

TRIUMPH® Lumbar Disc, posterolateral approach - Spine

However, what I want input on is that some here have received a 3 level ADR and vessels weren't an issue with you I assume so it is possible. Did Biersdadt or any other doctor mention higher lumber levels being a contraindication from an anterior approach?