Re: I got a copy of my records from Dr Bridwell today

[Guest guest]

Suzanne, were these ungentlemanly comments made by Dr. Bridwell? I know you're considering having surgery with him, not dating him, but, -- really!

So there were some discrepancies on the x-ray readings and shuffling about as to how he would approach helping you. Dr. Rand also made changes in his plans for me; that wouldn't bother me as much as Dr. Bridwell's apparent attitude toward you. Of course it's clothed as concern for your ability to come through surgery unharmed, but gee, am I thin-skinned or was that downright insulting? Of course we look older when we're bent over like little old ladies. So you've put on some pounds -- it's danged hard to take them off when you can barely get around and go to work, let alone diet and exercise.

I think it would be wise to ask him about the discrepancies. It's your call of curse, but I think I'd lose the dreads some time before surgery. You can grow 'em back later, but it will make after-care way easier. I still wish I had cut my hair before mine because it was just an awful mess with not being able to shower for at least a week each time. I don't imagine your dreads are actually dirty, but cutting them will ease his mind, and doc psychology is important too.

Sharon

[ ] I got a copy of my records from Dr Bridwell today

and I am a bit frustrated and curious how one page can say one thing and another page can say something else entirely.first -- a review of the standing xrays by the radiologist in julythere is moderate rotatory levoscoliosis centered in the upper lumbar spine, as well as a mile dextroscoliosis of the thoracic spine. In the sagittal plane, there is straightening of the lumbar spine, leading to a kyphosis at the thoracolumbar junction and straightenting of the thoracic spine. Because of this, the cervicothoracic junction is displaced anteriorly relative to the lumbar sacral junction.The vertebral body heights and disc spaces are normal, and there is no evidence of degenerative disease.then -- a review of prone xrays in october -- with comparison to the earlier standing xraysthere is unchanged moderate rotatory levoscoliosis centered at L#, as well as a mild dextroscoliosis of the thoracic spine. Attempted posterior fusion from T10 through L5. Degenerative dis disease is seen at L5-S1 with vacuum phenomenon. In the sagittal plane, there is lumbar hypolordosis and decreased thoracic kyphosis is prone positioning. The vertebral body heights are normal. Motion is present at L5-S1moderate thoracolumbar scoliosis does not change with prone possitioning, while thoracic kyphosis is partly reduced in the prone positionThe doctor's notes in julyheavy and overweight. Cornal balance not too bad. Pitched forward in the saggital plane. Has a CT and MRI study -- suspicious for nonunion at L1-L2. Definitely a nonunion with Grade II spondyloloisthesis and a vacuum disc at L5-S1.talked about potentially a three stage apporach -- first stage, take out the implants, get fixation points, do whatever decompression. Second staage do either mulitple smith-petersen or a single pedicle subtraction procedure and instrumented fusion T10 to the sacrum and pelvis. Thrid stage four months later, anterior fusion at L5-S1. Whether we do the anteriorr fusion at 5-1 down the road or more recent would depend on whether it appeared that her leg pain was foraminal stenosis or more central stenosis. On the MRI, some places you can see her canal very well and other places there is some scatter. Talked to her about aerobic conditioning and weight loss as well.doctor's note in octoberher abdomen is absolutely huge when she is in a supine position. I do not think doing any kind of anterior operation on her would be wise. (and I weighed less on that visit!)looks 10-15 years older than her stated age. Has a component of fixed sagittal imbalance. Seems neurologically intact.CT-myelogram shows some stenosis at L5-S1. She does not have an MRI (!!) We reviewed each and every one of a huge quantity of films.surgery would probably be a two stager. First stage removing the harrington implants and getting fixation points and the like. Second stage pedicle subtraction osteotomy at L3 and instrumented fusion T10 to the sacrum and pelvis. A 10-15% risk of weak quadriceps or weak foot on one side and roughly 1 in 1000 to 1 in 500 of paraplegia and 3-5% risk of major wound infection. She should have a thallium stress test because she is clearly much older than her stated age. I am a little concerned about her overall hygiene as well. She seems to be a fairly nice and friendly person. Ideally we would want to structurally graft 5-1 anteriorly, but her 5-1 disc is very collapsed. I don not think it is a very good disc for a TLIF and I do not think doing an anterior of any sort on her would be advisable at all.it looks like when she is prone, her spondylolisthesis reduces at L5-S1. When she is standing upright there is a 6mm or so sppondylolistthesis at L5-S1 and I think she has had a laminectomy there before.

[Guest guest]

"It's your call of course"!, not "of curse". Eesh!

[ ] I got a copy of my records from Dr Bridwell today

and I am a bit frustrated and curious how one page can say one thing and another page can say something else entirely.first -- a review of the standing xrays by the radiologist in julythere is moderate rotatory levoscoliosis centered in the upper lumbar spine, as well as a mile dextroscoliosis of the thoracic spine. In the sagittal plane, there is straightening of the lumbar spine, leading to a kyphosis at the thoracolumbar junction and straightenting of the thoracic spine. Because of this, the cervicothoracic junction is displaced anteriorly relative to the lumbar sacral junction.The vertebral body heights and disc spaces are normal, and there is no evidence of degenerative disease.then -- a review of prone xrays in october -- with comparison to the earlier standing xraysthere is unchanged moderate rotatory levoscoliosis centered at L#, as well as a mild dextroscoliosis of the thoracic spine. Attempted posterior fusion from T10 through L5. Degenerative dis disease is seen at L5-S1 with vacuum phenomenon. In the sagittal plane, there is lumbar hypolordosis and decreased thoracic kyphosis is prone positioning. The vertebral body heights are normal. Motion is present at L5-S1moderate thoracolumbar scoliosis does not change with prone possitioning, while thoracic kyphosis is partly reduced in the prone positionThe doctor's notes in julyheavy and overweight. Cornal balance not too bad. Pitched forward in the saggital plane. Has a CT and MRI study -- suspicious for nonunion at L1-L2. Definitely a nonunion with Grade II spondyloloisthesis and a vacuum disc at L5-S1.talked about potentially a three stage apporach -- first stage, take out the implants, get fixation points, do whatever decompression. Second staage do either mulitple smith-petersen or a single pedicle subtraction procedure and instrumented fusion T10 to the sacrum and pelvis. Thrid stage four months later, anterior fusion at L5-S1. Whether we do the anteriorr fusion at 5-1 down the road or more recent would depend on whether it appeared that her leg pain was foraminal stenosis or more central stenosis. On the MRI, some places you can see her canal very well and other places there is some scatter. Talked to her about aerobic conditioning and weight loss as well.doctor's note in octoberher abdomen is absolutely huge when she is in a supine position. I do not think doing any kind of anterior operation on her would be wise. (and I weighed less on that visit!)looks 10-15 years older than her stated age. Has a component of fixed sagittal imbalance. Seems neurologically intact.CT-myelogram shows some stenosis at L5-S1. She does not have an MRI (!!) We reviewed each and every one of a huge quantity of films.surgery would probably be a two stager. First stage removing the harrington implants and getting fixation points and the like. Second stage pedicle subtraction osteotomy at L3 and instrumented fusion T10 to the sacrum and pelvis. A 10-15% risk of weak quadriceps or weak foot on one side and roughly 1 in 1000 to 1 in 500 of paraplegia and 3-5% risk of major wound infection. She should have a thallium stress test because she is clearly much older than her stated age. I am a little concerned about her overall hygiene as well. She seems to be a fairly nice and friendly person. Ideally we would want to structurally graft 5-1 anteriorly, but her 5-1 disc is very collapsed. I don not think it is a very good disc for a TLIF and I do not think doing an anterior of any sort on her would be advisable at all.it looks like when she is prone, her spondylolisthesis reduces at L5-S1. When she is standing upright there is a 6mm or so sppondylolistthesis at L5-S1 and I think she has had a laminectomy there before.

[Guest guest]

I did wonder if the hygiene comment was about my hair and I have

been thinking of cutting it -- the alternative would be to wrap it

up and leave it wrapped up for about a month until the incision is

fully healed, and I bet it would itch like heck. Last week, I

managed to wash it without bending forward, but then I couldn't

figure out how to wrap it up in the towel while drying it.

I just loved the comments about how huge my stomach was, too. He

told me he was concerned about the scar tissue (and I even had the

OB/GYN fax him a report about how surprised he was at the lack of

internal scar tissue given the number of surgeries that I have had)

I think the discrpancies about whether or not I have degenerative

disc disease and the bit about no MRI but having reviewed EVERY film

were the ones that bothered me (other than, yes, feeling insulted by

being fat and dirty.) The old part didn't bother me as much, but he

was much more tactful to my face. In the written report, it almost

sounds like he thought I was lying about my age.

Of curse sounded good to me

I am glad I got the report BEFORE seeing him on Monday -- I was

hoping it would be suitable for sending to my insurance company and

for applying for the sick leave bank, but it looks like I will have

to ask for a separate letter.

[Guest guest]

Do you have any way of getting to another revision surgeon for a second opinion? If you don't trust Dr. Bridwell to keep his facts straight, you would certainly be right to consider going with someone else. If it turned out to be someone who didn't insult you, so much the better! Then the thing about your age -- doesn't he have records from your first surgery? Don't they give your birth date and age? Wouldn't he have to be incapable of simple arithmetic to really think you're lying about your age?

Sharon

[ ] Re: I got a copy of my records from Dr Bridwell today

I did wonder if the hygiene comment was about my hair and I have been thinking of cutting it -- the alternative would be to wrap it up and leave it wrapped up for about a month until the incision is fully healed, and I bet it would itch like heck. Last week, I managed to wash it without bending forward, but then I couldn't figure out how to wrap it up in the towel while drying it. I just loved the comments about how huge my stomach was, too. He told me he was concerned about the scar tissue (and I even had the OB/GYN fax him a report about how surprised he was at the lack of internal scar tissue given the number of surgeries that I have had)I think the discrpancies about whether or not I have degenerative disc disease and the bit about no MRI but having reviewed EVERY film were the ones that bothered me (other than, yes, feeling insulted by being fat and dirty.) The old part didn't bother me as much, but he was much more tactful to my face. In the written report, it almost sounds like he thought I was lying about my age.Of curse sounded good to me :)I am glad I got the report BEFORE seeing him on Monday -- I was hoping it would be suitable for sending to my insurance company and for applying for the sick leave bank, but it looks like I will have to ask for a separate letter.

[Guest guest]

Hi Suzanne...

It’s hard to tell without looking at the full report, but I wondered if he was talking about seeing DDD in one part of your spine, but not the other.

--

On 12/16/06 4:48 AM, " SB " <bahadreama@...> wrote:

I think the discrpancies about whether or not I have degenerative

disc disease

[Guest guest]

Sharon,

Actually when I read DrBridwells notes about SB's age I didn't think

he was alluding to her not being honest about her chronological age, I

thought he was talking about her " skelatal age " ....or if her

chronological age matched the health he would be expecting in someone

her age. I think SB has told us in the past that she went through

periods as a young women where she was not nourished properly, some

time during which she was bearing children. That may have had an

affect on her body. Since signs of malnourishment are probably fairly

rare in this country he may have just been questioning for himself

what he was seeing. Each woman also begins losing bone mass beginning

in her 30's...and this certainly would be something that DrB would try

to evaluate before getting out the hammer and drill!

Take Care, Cam

Then the thing about your age -- doesn't he have records from your

first surgery? Don't they give your birth date and age? Wouldn't he

have to be incapable of simple arithmetic to really think you're lying

about your age?