Re: Why can't this be easy!!

[Guest guest]

Tami,

Well, I wish it was too. No doubt you face a crucial decision and in

the way you went about it...I am guessing you will now want to have a

follow up converstaion with DrHu...since I am guessing that

DrLagrones visit probably made you think of other questions to ask

DrHu since you saw her first. Is it possible to call in questions to

either surgeon now?

Do they both propose fusion to the sacrum and do they both plan to

replace discs? My lay persons understanding of why my surgeon used

both approaches had to do with the ease of getting at the discs from

the front and both Boachie and Rand said it was less bloody to do it

this way, rather than reaching around from the front.

I think Suzannes situation might be illuminating...as I understood it

her surgeon, Bridwell, did posterior only, reserving the right to go

in again in 6 months from the front if need be...for more structural

support if I understood it. Suzanne?

It stinks that there isn't a clear winner for you today...but

hopefully as you wade through this info things will come into focus.

I felt the same way deciding between surgeons...and after about a

month of dithering around I actually made one of those pro/con lists

and it worked. For me, they were both saying A/P was the way to go,

so I didn't have that tie...but I was struggling with the one day vs

two day decision.

Best of luck getting it figured out. You know how to use Pubmed?

Take Care, Cam

[Guest guest]

yes, I have only had posterior surgery so far and I hope that I don't

need the anterior surgery.

I had kinda freaked out when I read Dr Bridwell's written report that

he thought the anterior portion would be dangerous for me because of

the size of my belly (and he also mentioned the numerous anterior

scars that I already have)

If I needed the anterior surgery in order to have a successful

revision, then I didn't want the size of my stomach to be a barrier.

So, this is what prompted me to get serious about losing weight (down

43 pounds so far!)

However, Bernie said that Dr Bridwell is always refining his

technique and that he doesn't always do the anterior surgery now. As

I understand it, the anterior fusion does make the spine stronger--

at least it makes sense to me that it would be stronger fused from

both sides.

On the other hand, people have a lot of complaints about how painful

the anterior procedure is and how much their tummies pooch out

afterward (although I have a pooching out too -- I think from the

spine being pused forward to create the lordosis makes the belly

stick out. Kam assures me that I am still swollen at this point,

though.)

I also think the anterior portion of the surgery is when they do

cages if needed. I think I have gotten pretty good correction

without the addition of something from the front.

It is also possible for them to reach around and fuse the front from

a posterior incision. Dr Bridwell said he wasn't going to do this

for me, but he will re-evaluate and determine if I need an anterior

position at the 3 or 6 month checkup.

I go for my 6 week check on Monday (but it is really more like 7

weeks)

I am feeling pretty good except I have a lot of pain in my right

shoulder. It feels to me like a rotator cuff injury since it hurts

to move my arm in certain directions. I have been putting a lidoderm

patch on it at night and it has helped some. I have also continued

to take the oxycontin at bedtime. The shoulder hurts worse at night.

For the past two days, I have also had a toothache. Night before

last, I rubbed some Nassau Royale on my gum, then got up in the

middle of the night and soaked the sore parts in a capful of Nassau

Royale. I slept pretty good that night. Last night I used mouthwash

instead.

I haven't seen my PCP about my shoulder yet. I am pretty sure I need

physical therapy. I did call Bernie and tell her that it hurts very

badly, so I am hoping I can see the physical therapist there.

Otherwise, I would worry that a local PT would try to have me doing

stuff I shouldn't do. I think that I am not supposed to have PT

until 6 months out.

--- In , " cammaltby " <cammaltby@...>

>>

> I think Suzannes situation might be illuminating...as I understood

it

> her surgeon, Bridwell, did posterior only, reserving the right to

go

> in again in 6 months from the front if need be...for more

structural

> support if I understood it. Suzanne?

>

> It stinks that there isn't a clear winner for you today...but

> hopefully as you wade through this info things will come into

focus.

> I felt the same way deciding between surgeons...and after about a

> month of dithering around I actually made one of those pro/con

lists

> and it worked. For me, they were both saying A/P was the way to go,

> so I didn't have that tie...but I was struggling with the one day

vs

> two day decision.

>

> Best of luck getting it figured out. You know how to use Pubmed?

>

> Take Care, Cam

>

[Guest guest]

Tami--I just had the posterior/anterior revision with Dr. Hu in March

and I'm still recovering. I live in CA and didn't want to travel far,

and that was my main reason to choose her, but I also love Dr. Hu,

she's so kind, willing to answer any questions you have. She also

comes and visits you in the hospital even though her " fellows " do,

too. Her reasoning for doing the surgeries a week apart is usually

the patient would have to be too long on the operating table, which

makes it hard on the doctor as well as the patient. My first

posterior surgery was about 7 1/2 hours, and the second anterior a

week later was about 4 hours. They both went well. I have had no pain

from either incision. Both have healed marvelously. I have no back

pain, only a bothersome pain in my right leg that has only begun

after surgery. I'm sure everyone on this board has had some kind of

pain somewhere after surgery!

Obviously the choice is yours to make. California is obviously closer

than Texas, but that may not be your reasons.

Wishing you the best.

Carol V.

>

> Hello,

>

> Well I had my consults with Dr. Hu @ UCSF on Monday and Dr. Lagrone

> in Amarillo on Tuesday. Boy was that a long grueling trip with

alot

> of fun thrown in on Saturday & Sunday when I flew to San Francisco!

>

> I was really hoping both doctors would have the same approach and I

> would just have to chose between the two but unfortunately that is

> not the case so I have more research and brain picking to do. I

> really liked both doctors.

>

> Dr. Hu wants to do both anterior and posterior 1 week apart (July 9

&

> 16) but Dr. Lagrone thinks he can get it done posterior only (July

> 16). This would mean a lot less time in the hospital, less time to

> recover, no anterior scar, less time away from work, etc... But,

is

> it the right way to get the best correction? My husband thinks

it's

> a no brainer and I should just go with Lagrone since it's easier on

> everyone but I don't think that being easier is the deciding factor

> here. Dr. Lagrone is the most experienced, right? Dr. Hu is the

> Professor and Chief of spine service at one of the 10 best hopitals

> in the nation(according US News & Worls Report), right? Dr.

Lagrone

> does it all himself. Dr. Hu has a whole team of interns to help

but

> who know which of these is better. I know I don't.

>

> So I am still undecided. I just got back from my pain management

Dr.

> who kept trying to convince me to stay in town and let Dr. Keenen

do

> the surgery (I think they are friends) but I explained to him that

> Dr. Keenen does not have the experience with this procedure that

the

> other doctors do and he finally relented and applauded my research.

>

> Any ideas on the best approach to reaching a decision. I will be

> talking to Dr. Hu to ask her why she thinks anterior and posterior

is

> best and vice versa.

>

> Thanks in advance for any and all input. I really appreciate this

> site and everybody that contributes. I would truly be lost without

> you all.

>

> Tami in Oregon.

>

[Guest guest]

I don't think the anterior surgery causes the " pooching " because I

had very little if any swelling, and I still " pooch " . The kept

thinking in the hospital that I was bloated, and I said, no, it's my

new lordosis! They finally realized it was! Yes, my stomach sticks

out more, now, but I think everyone's does who has this surgery done

whether anterior or not.

Carol V.

>

> yes, I have only had posterior surgery so far and I hope that I

don't

> need the anterior surgery.

>

> I had kinda freaked out when I read Dr Bridwell's written report

that

> he thought the anterior portion would be dangerous for me because

of

> the size of my belly (and he also mentioned the numerous anterior

> scars that I already have)

>

> If I needed the anterior surgery in order to have a successful

> revision, then I didn't want the size of my stomach to be a

barrier.

> So, this is what prompted me to get serious about losing weight

(down

> 43 pounds so far!)

>

> However, Bernie said that Dr Bridwell is always refining his

> technique and that he doesn't always do the anterior surgery now.

As

> I understand it, the anterior fusion does make the spine stronger--

> at least it makes sense to me that it would be stronger fused from

> both sides.

>

> On the other hand, people have a lot of complaints about how

painful

> the anterior procedure is and how much their tummies pooch out

> afterward (although I have a pooching out too -- I think from the

> spine being pused forward to create the lordosis makes the belly

> stick out. Kam assures me that I am still swollen at this point,

> though.)

>

> I also think the anterior portion of the surgery is when they do

> cages if needed. I think I have gotten pretty good correction

> without the addition of something from the front.

>

> It is also possible for them to reach around and fuse the front

from

> a posterior incision. Dr Bridwell said he wasn't going to do this

> for me, but he will re-evaluate and determine if I need an anterior

> position at the 3 or 6 month checkup.

>

> I go for my 6 week check on Monday (but it is really more like 7

> weeks)

>

> I am feeling pretty good except I have a lot of pain in my right

> shoulder. It feels to me like a rotator cuff injury since it hurts

> to move my arm in certain directions. I have been putting a

lidoderm

> patch on it at night and it has helped some. I have also continued

> to take the oxycontin at bedtime. The shoulder hurts worse at

night.

>

> For the past two days, I have also had a toothache. Night before

> last, I rubbed some Nassau Royale on my gum, then got up in the

> middle of the night and soaked the sore parts in a capful of Nassau

> Royale. I slept pretty good that night. Last night I used

mouthwash

> instead.

>

> I haven't seen my PCP about my shoulder yet. I am pretty sure I

need

> physical therapy. I did call Bernie and tell her that it hurts

very

> badly, so I am hoping I can see the physical therapist there.

> Otherwise, I would worry that a local PT would try to have me doing

> stuff I shouldn't do. I think that I am not supposed to have PT

> until 6 months out.

>

>

>

>

>

>

>

>

>

>

>

>

>

> --- In , " cammaltby " <cammaltby@>

> >>

> > I think Suzannes situation might be illuminating...as I

understood

> it

> > her surgeon, Bridwell, did posterior only, reserving the right to

> go

> > in again in 6 months from the front if need be...for more

> structural

> > support if I understood it. Suzanne?

> >

> > It stinks that there isn't a clear winner for you today...but

> > hopefully as you wade through this info things will come into

> focus.

> > I felt the same way deciding between surgeons...and after about a

> > month of dithering around I actually made one of those pro/con

> lists

> > and it worked. For me, they were both saying A/P was the way to

go,

> > so I didn't have that tie...but I was struggling with the one day

> vs

> > two day decision.

> >

> > Best of luck getting it figured out. You know how to use Pubmed?

> >

> > Take Care, Cam

> >

>

[Guest guest]

HI Tami,

How frustrating. One way to go is to see a third doctor with the hope that he agrees with at least one of the others. Your best bet location-wise would probably Drs Bridwell or Lenke in St Louis. Good luck with your decagon making process. Please let us know what's going on.

Bonnie

[ ] Why can't this be easy!!

Hello,Well I had my consults with Dr. Hu @ UCSF on Monday and Dr. Lagrone in Amarillo on Tuesday. Boy was that a long grueling trip with alot of fun thrown in on Saturday & Sunday when I flew to San Francisco!I was really hoping both doctors would have the same approach and I would just have to chose between the two but unfortunately that is not the case so I have more research and brain picking to do. I really liked both doctors.Dr. Hu wants to do both anterior and posterior 1 week apart (July 9 & 16) but Dr. Lagrone thinks he can get it done posterior only (July 16). This would mean a lot less time in the hospital, less time to recover, no anterior scar, less time away from work, etc... But, is it the right way to get the best correction? My husband thinks it's a no brainer and I should just go with Lagrone since it's easier on everyone but I don't think that being easier is the deciding factor here. Dr. Lagrone is the most experienced, right? Dr. Hu is the Professor and Chief of spine service at one of the 10 best hopitals in the nation(according US News & Worls Report), right? Dr. Lagrone does it all himself. Dr. Hu has a whole team of interns to help but who know which of these is better. I know I don't.So I am still undecided. I just got back from my pain management Dr. who kept trying to convince me to stay in town and let Dr. Keenen do the surgery (I think they are friends) but I explained to him that Dr. Keenen does not have the experience with this procedure that the other doctors do and he finally relented and applauded my research.Any ideas on the best approach to reaching a decision. I will be talking to Dr. Hu to ask her why she thinks anterior and posterior is best and vice versa.Thanks in advance for any and all input. I really appreciate this site and everybody that contributes. I would truly be lost without you all.Tami in Oregon.

[Guest guest]

Hi Tami, as usual I´ve been " away " , and it seems every time I check

in, someone from Oregon is writing. Odd since we are/were so few and

far between,m maybe it´s some sort of physic Oregon energy, or maybe

it´s just that it´s raining here in Spain and I´m remebering Eugene!!

I saw Dr. Berven ( or Breven, I never get it right), Dr. LaGrone, and

talked to Dr. Rand. Dr. LaGrone was the only one who proposed

posterior only. He has done a lot of A/P, but feels he gets the same

correction from posterior only,for some patients. I don´t know what

criteria he uses, it might be a good question. I also had one cage put

in. I´m 2+ years post op and so far, so good, although I am overdue

for a checkup. I felt enough confidence in him to go with his

assessment and was relieved that the operation would be posterior, one

day only. Surgery was 9 1/2 hours and he did it all.

I personally was more comfortable with Dr. LaGrone (I didn´t see Hu)

and with the hospital in Amarillo, although it was tricky getting

there and back. I guess if I were you, I´d try to get specifics of the

actual procedures and why exactly Dr. LaGrone proposes only posterior,

because he certainly has experience in both, and likewise, why Hu does

A/P. Interesting that Suzanne´s doctor is also tending towards

posterior???

It´s the pits making the decision, isn´t it? Good luck, Jo Ann

[Guest guest]

Hi Tami,

Perhaps one of your questions to Dr. Hu could be whether she ever does posterior only. If she doesn't, I'd question her expertise since , I think, more surgeons seem to be doing that, at least sometimes. If the answer is yes, then I would ask her why she doesn't think you are a candidate for posterior only.

Bonnie

[ ] Re: Why can't this be easy!!

Hi Tami, as usual I´ve been "away", and it seems every time I checkin, someone from Oregon is writing. Odd since we are/were so few andfar between,m maybe it´s some sort of physic Oregon energy, or maybeit´s just that it´s raining here in Spain and I´m remebering Eugene!!I saw Dr. Berven ( or Breven, I never get it right), Dr. LaGrone, andtalked to Dr. Rand. Dr. LaGrone was the only one who proposedposterior only. He has done a lot of A/P, but feels he gets the samecorrection from posterior only,for some patients. I don´t know whatcriteria he uses, it might be a good question. I also had one cage putin. I´m 2+ years post op and so far, so good, although I am overduefor a checkup. I felt enough confidence in him to go with hisassessment and was relieved that the operation would be posterior, oneday only. Surgery was 9 1/2 hours and he did it all. I personally was more comfortable with Dr. LaGrone (I didn´t see Hu)and with the hospital in Amarillo, although it was tricky gettingthere and back. I guess if I were you, I´d try to get specifics of theactual procedures and why exactly Dr. LaGrone proposes only posterior,because he certainly has experience in both, and likewise, why Hu doesA/P. Interesting that Suzanne´s doctor is also tending towardsposterior???It´s the pits making the decision, isn´t it? Good luck, Jo Ann

[Guest guest]

Hi Cam,

I am working on my new list of questions for the good Dr.'s this

weekend. The list seems to get longer by the minute. I will

probably either fax or e-mail the questions since the list is so

long. I thought I asked alot of questions during the consults but

apparently not enough. I wish I had a crystal ball or something to

help me out here. I am already fused to the sacrum with the

exception of L4/L5. Dr. Lagrone says: " Although a combined anterior

and posterior approach would certainly be reasonable, I think she can

be adequately treated with a poserior only approach. This would

involve removal of the steffee implants, (I had HR removed in 1988),

decompression and fusion at L4-L5 with a TLIF procedure followed by a

pedicle subtraction osteotomy at L2 or L3 to restore sagittal balance

w/ reinstrumentation of her spine from the lower thoracic area to the

sacrum. If her L5-S1 fusion is solid, we should have adequate distal

fixation to avoid iliac fixation. If there is a pseudoarthrosis at

L5-S1, this would have to be refused and fixation extended into the

ilium. "

I really hope we can avoid the fixation into the ilium!!

Dr. Hu said nothing about this so that will be another question.

Thank you so much.

Tami

[Guest guest]

It sounds like your still doing really well and I really hope you don't

have to go back for anterior surgery in the future. With the way you

are healing I have a feeling that you won't. I hope I recover as

quickly as you seem to be. Keep up the good work.

Tami

[Guest guest]

Oh great! As if my tummy doesn't pooch enough .

[Guest guest]

Hi Carol,

I really liked Dr. Hu too. I know I could probably find this info but

if you don't mind, how far off was your sagittal balance? Mine is only

about 14 cm. How many osteotomies? Were they PSO's or SPO's? I still

have not received my surgical consult write up from Dr. Hu yet and I

don't remember (and didn't write down) what type she intended to use

but I did remember she said 2 to 3. I am so glad to hear you have no

back pain. I don't remember what that's like. You must be very happy

about that!

If it was just a choice of where I would go I would definintely go to

San Francisco. I love that city. Amarillo, not so much .

Thank you so much for your input.

Tami

[Guest guest]

Hi Bonnie,

I did get a local opinion for what it's worth. He wanted to do

posterior only also but with an SPO. He also said my sagittal

balance was off by only 4 to 5 cm and both Dr. Lagrone and Dr. Hu

say, um, no, more like 14 to 15 cm. My local ortho says he's done 20

or 30 of these types of operations in his career but was not

forthcoming with references and I would definately rather have

someone with alot more experience. If it was a simple disc repair or

something I would probably go to him but for this I think not.

Thanks,

Tami

>

> HI Tami,

>

> How frustrating. One way to go is to see a third doctor with the

hope that he agrees with at least one of the others. Your best bet

location-wise would probably Drs Bridwell or Lenke in St Louis. Good

luck with your decagon making process. Please let us know what's

going on.

>

> Bonnie

>

>

> [ ] Why can't this be easy!!

>

>

> Hello,

>

> Well I had my consults with Dr. Hu @ UCSF on Monday and Dr.

Lagrone

> in Amarillo on Tuesday. Boy was that a long grueling trip with

alot

> of fun thrown in on Saturday & Sunday when I flew to San

Francisco!

>

> I was really hoping both doctors would have the same approach and

I

> would just have to chose between the two but unfortunately that

is

> not the case so I have more research and brain picking to do. I

> really liked both doctors.

>

> Dr. Hu wants to do both anterior and posterior 1 week apart (July

9 &

> 16) but Dr. Lagrone thinks he can get it done posterior only

(July

> 16). This would mean a lot less time in the hospital, less time

to

> recover, no anterior scar, less time away from work, etc... But,

is

> it the right way to get the best correction? My husband thinks

it's

> a no brainer and I should just go with Lagrone since it's easier

on

> everyone but I don't think that being easier is the deciding

factor

> here. Dr. Lagrone is the most experienced, right? Dr. Hu is the

> Professor and Chief of spine service at one of the 10 best

hopitals

> in the nation(according US News & Worls Report), right? Dr.

Lagrone

> does it all himself. Dr. Hu has a whole team of interns to help

but

> who know which of these is better. I know I don't.

>

> So I am still undecided. I just got back from my pain management

Dr.

> who kept trying to convince me to stay in town and let Dr. Keenen

do

> the surgery (I think they are friends) but I explained to him

that

> Dr. Keenen does not have the experience with this procedure that

the

> other doctors do and he finally relented and applauded my

research.

>

> Any ideas on the best approach to reaching a decision. I will be

> talking to Dr. Hu to ask her why she thinks anterior and

posterior is

> best and vice versa.

>

> Thanks in advance for any and all input. I really appreciate this

> site and everybody that contributes. I would truly be lost

without

> you all.

>

> Tami in Oregon.

>

[Guest guest]

Hi Tami,

My flatback was approximately as severe as yours...did you realize that 15

centimeters is

almost 6 inches? That's a pretty hefty forward lean. It didn't strike me until I

did the

conversion. Then I realized that my entire lower body was trying to compensate

for an off

balance of 6 inches for at least 6 years, probably even longer. Look at it on a

ruler, and it

may hit you how hard your core, hips and legs are working to keep you standing.

Not to

mention the strain a forward lean of 6 inches will put on your neck muscles.

Good luck with your decision. The bottom line is that you need to go with a

surgeon that

you have absolute confidence in, and we all wish there were easier answers,

trust me. But

you can certainly get a lot of first-hand info about both of your excellent

doctor choices

on this board. Carol's a perfect person to ask in regards to Dr. Hu, and, like

myself, is one

of the more recent revisionees here.

Best to you,

Edie

>

> Hi Carol,

>

> I really liked Dr. Hu too. I know I could probably find this info but

> if you don't mind, how far off was your sagittal balance? Mine is only

> about 14 cm. How many osteotomies? Were they PSO's or SPO's? I still

> have not received my surgical consult write up from Dr. Hu yet and I

> don't remember (and didn't write down) what type she intended to use

> but I did remember she said 2 to 3. I am so glad to hear you have no

> back pain. I don't remember what that's like. You must be very happy

> about that!

>

> If it was just a choice of where I would go I would definintely go to

> San Francisco. I love that city. Amarillo, not so much .

>

> Thank you so much for your input.

>

> Tami

>

[Guest guest]

Hi Jo Ann,

Rain? In Oregon? Why would rain remind you of Eugene? Just Kidding.

I am so glad to hear you are doing so well. It makes me feel

confident in my (almost) decision so go with Dr. Lagrone. I am 90%

sure that that's what I'm going to do unless Dr. Hu can give me a

real good reason for her surgical plan. I liked both Dr.s and I

really like San Francisco alot better than Amarillo but I'm not going

for a vacation and my family, if they want to come visit, will just

have to live with Amarillo. I think posterior is probably a good

idea since I only need one TLIF at L4/L5. I'm sure that makes

matters alot easier.?.? I have confidence that Dr. Lagrone knows

what he's doing.

Thank you so much for you input,

Tami

>

> Hi Tami, as usual I´ve been " away " , and it seems every time I check

> in, someone from Oregon is writing. Odd since we are/were so few and

> far between,m maybe it´s some sort of physic Oregon energy, or maybe

> it´s just that it´s raining here in Spain and I´m remebering

Eugene!!

>

> I saw Dr. Berven ( or Breven, I never get it right), Dr. LaGrone,

and

> talked to Dr. Rand. Dr. LaGrone was the only one who proposed

> posterior only. He has done a lot of A/P, but feels he gets the same

> correction from posterior only,for some patients. I don´t know what

> criteria he uses, it might be a good question. I also had one cage

put

> in. I´m 2+ years post op and so far, so good, although I am overdue

> for a checkup. I felt enough confidence in him to go with his

> assessment and was relieved that the operation would be posterior,

one

> day only. Surgery was 9 1/2 hours and he did it all.

>

> I personally was more comfortable with Dr. LaGrone (I didn´t see Hu)

> and with the hospital in Amarillo, although it was tricky getting

> there and back. I guess if I were you, I´d try to get specifics of

the

> actual procedures and why exactly Dr. LaGrone proposes only

posterior,

> because he certainly has experience in both, and likewise, why Hu

does

> A/P. Interesting that Suzanne´s doctor is also tending towards

> posterior???

>

> It´s the pits making the decision, isn´t it? Good luck, Jo Ann

>

[Guest guest]

Hi Carol, I believe you are right. I always had a pooch but since

my revision it is bigger. Mine in fact has just gone down some more

afterr 1 yr & 11 months.

Love,

Diane

Love,

> >

> > yes, I have only had posterior surgery so far and I hope that I

> don't

> > need the anterior surgery.

> >

> > I had kinda freaked out when I read Dr Bridwell's written report

> that

> > he thought the anterior portion would be dangerous for me because

> of

> > the size of my belly (and he also mentioned the numerous anterior

> > scars that I already have)

> >

> > If I needed the anterior surgery in order to have a successful

> > revision, then I didn't want the size of my stomach to be a

> barrier.

> > So, this is what prompted me to get serious about losing weight

> (down

> > 43 pounds so far!)

> >

> > However, Bernie said that Dr Bridwell is always refining his

> > technique and that he doesn't always do the anterior surgery

now.

> As

> > I understand it, the anterior fusion does make the spine stronger-

-

> > at least it makes sense to me that it would be stronger fused

from

> > both sides.

> >

> > On the other hand, people have a lot of complaints about how

> painful

> > the anterior procedure is and how much their tummies pooch out

> > afterward (although I have a pooching out too -- I think from the

> > spine being pused forward to create the lordosis makes the belly

> > stick out. Kam assures me that I am still swollen at this point,

> > though.)

> >

> > I also think the anterior portion of the surgery is when they do

> > cages if needed. I think I have gotten pretty good correction

> > without the addition of something from the front.

> >

> > It is also possible for them to reach around and fuse the front

> from

> > a posterior incision. Dr Bridwell said he wasn't going to do

this

> > for me, but he will re-evaluate and determine if I need an

anterior

> > position at the 3 or 6 month checkup.

> >

> > I go for my 6 week check on Monday (but it is really more like 7

> > weeks)

> >

> > I am feeling pretty good except I have a lot of pain in my right

> > shoulder. It feels to me like a rotator cuff injury since it

hurts

> > to move my arm in certain directions. I have been putting a

> lidoderm

> > patch on it at night and it has helped some. I have also

continued

> > to take the oxycontin at bedtime. The shoulder hurts worse at

> night.

> >

> > For the past two days, I have also had a toothache. Night before

> > last, I rubbed some Nassau Royale on my gum, then got up in the

> > middle of the night and soaked the sore parts in a capful of

Nassau

> > Royale. I slept pretty good that night. Last night I used

> mouthwash

> > instead.

> >

> > I haven't seen my PCP about my shoulder yet. I am pretty sure I

> need

> > physical therapy. I did call Bernie and tell her that it hurts

> very

> > badly, so I am hoping I can see the physical therapist there.

> > Otherwise, I would worry that a local PT would try to have me

doing

> > stuff I shouldn't do. I think that I am not supposed to have PT

> > until 6 months out.

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > --- In , " cammaltby " <cammaltby@>

> > >>

> > > I think Suzannes situation might be illuminating...as I

> understood

> > it

> > > her surgeon, Bridwell, did posterior only, reserving the right

to

> > go

> > > in again in 6 months from the front if need be...for more

> > structural

> > > support if I understood it. Suzanne?

> > >

> > > It stinks that there isn't a clear winner for you today...but

> > > hopefully as you wade through this info things will come into

> > focus.

> > > I felt the same way deciding between surgeons...and after about

a

> > > month of dithering around I actually made one of those pro/con

> > lists

> > > and it worked. For me, they were both saying A/P was the way to

> go,

> > > so I didn't have that tie...but I was struggling with the one

day

> > vs

> > > two day decision.

> > >

> > > Best of luck getting it figured out. You know how to use

Pubmed?

> > >

> > > Take Care, Cam

> > >

> >

>

[Guest guest]

Hi Tami,

I can't remember how long you have been reading, but I might suggest

you search for posts from Alpine (gouldianlady). DrLaGrone was her

surgeon and performed her surgery within the last year. Although

her " details " were not exactly the same as you, she first underwent

posterior only revision, and 6 months later needed the anterior

portion as well. I know it can happen, and I would want to clarify

with the doctor what would/will happen in the off chance that the

posterior fusion was not going to do the trick. I just think it's

best to plan for the worst and hope for the best with this surgery!

I would agree that you can have confidence in DrLaGrone. If I was

going to make a broad sweeping generalization it seems that DrLaG

feels posterior only is preferable, and perhaps feels that in the few

where further support is necessary it can happen at a later date,

such as Suzannes surgeon planned. I guess I would want to have this

all outlined for me before the surgery. What DrHu is proposing is

closer to what the " mainstream " revision would include. I suppose by

going both ways the surgeons may feel that they are increasing the

odds that they will " get it in one go " ...but perhaps there is an

evolving thinking on this point now as well.

Hearing from Alpine may shed some light on how that all went for her.

I am not suggesting that her surgeon failed her in any way. It is a

tricky surgery and even the best can need to take a second swing at

bat. (on balance, DrHu needed to go back in and clean up an MSRA

infection and related problems from other members). As my son often

reminds me, nothing is perfect.

I am guessing Alpine will answer you privately, she hasn't posted

much here since her second surgery, but perhaps she is busy with her

life now that she has had this last surgery. At least that is always

my hope when we don't hear from a member in awhile!

Hopefully when you get the copies of your office visit notes you will

have more informtion to proceed on.

Good luck, Cam

[Guest guest]

I have been feeling amazingly well this past week. Unfortunately, I

forgot yesterday that I wasn't supposed to bend until I reached forward

to feel something. OUCH!!! My son said he heard a loud pop. I don't

recall hearing anything except me yelling F***

It quit hurting pretty quickly and the groin pain I had been having

went away. I sure hope I didn't pull anything loose. I didn't make it

all the way to what I was trying to touch.

My washing machine sprang a leak and I had asked my son to get a big

photograph and my classroom posters off the floor. The posters were

taped up inside two science fair project cardboard things and he put it

on top of the picture. I was going to check to see if they were wet

and then tell him to get it off my huge beach picture that I always put

in the best spot of my classroom for me to see all day.

I went to bed for about an hour, then I got up and went with my husband

and daughter to the laundromat. We left the daughter at the laundromat

and we went for an almost 2 mile walk! It was kinda cool to walk on

the sidewalk along the busy street where we could see that we went

almost mile to mile.

It also reminded me that if I turn right instead of left when I take my

walks around the neighborhood, I could end up at Braums (a delicious

ice cream store)

>

> It sounds like your still doing really well and I really hope you

don't

> have to go back for anterior surgery in the future. With the way you

> are healing I have a feeling that you won't. I hope I recover as

> quickly as you seem to be. Keep up the good work.

>

> Tami

>

[Guest guest]

Hi Tami,

I think you might have misunderstood my point. I was thinking about your getting a third opinion from one of the top docs who are on par with Dr. Hu and Dr. LaGrone, not from an inexperienced doc. I wouldn't even count that local doc as a consult. That's why I mentioned Drs. Lenke or Bridwell. Whatever you decide to do, I wish you the best possible outcome.

Bonnie

[ ] Why can't this be easy!!> > > Hello,> > Well I had my consults with Dr. Hu @ UCSF on Monday and Dr. Lagrone > in Amarillo on Tuesday. Boy was that a long grueling trip with alot > of fun thrown in on Saturday & Sunday when I flew to San Francisco!> > I was really hoping both doctors would have the same approach and I > would just have to chose between the two but unfortunately that is > not the case so I have more research and brain picking to do. I > really liked both doctors.> > Dr. Hu wants to do both anterior and posterior 1 week apart (July 9 & > 16) but Dr. Lagrone thinks he can get it done posterior only (July > 16). This would mean a lot less time in the hospital, less time to > recover, no anterior scar, less time away from work, etc... But, is > it the right way to get the best correction? My husband thinks it's > a no brainer and I should just go with Lagrone since it's easier on > everyone but I don't think that being easier is the deciding factor > here. Dr. Lagrone is the most experienced, right? Dr. Hu is the > Professor and Chief of spine service at one of the 10 best hopitals > in the nation(according US News & Worls Report), right? Dr. Lagrone > does it all himself. Dr. Hu has a whole team of interns to help but > who know which of these is better. I know I don't.> > So I am still undecided. I just got back from my pain management Dr. > who kept trying to convince me to stay in town and let Dr. Keenen do > the surgery (I think they are friends) but I explained to him that > Dr. Keenen does not have the experience with this procedure that the > other doctors do and he finally relented and applauded my research.> > Any ideas on the best approach to reaching a decision. I will be > talking to Dr. Hu to ask her why she thinks anterior and posterior is > best and vice versa.> > Thanks in advance for any and all input. I really appreciate this > site and everybody that contributes. I would truly be lost without > you all.> > Tami in Oregon.>

[Guest guest]

Dr. Hu is like a regular person--she really just cares for her

patients. One Saturday when I was in there she came in my room in

casual clothes and she had her 6 yr old daughter with her and she was

checking on me, and introduced her daughter to me. I thought that was

kinda neat.

I can't remember now exactly what cm I was, but I think it was 9 cm.

I had been compensating all these years my bending my knees so it

would appear I was upright. I didn't really lean all that far forward

compared to some....especially like some on this site that were very

far bent forward. (check pictures in file area) Dr. Hu did 4

osteotomies in my first surgery. She did -'s on L2-3, L3-

4, L4-5, L5-S-1. I was originally fused T5-L4. She also did posterior

spinal fusion L2-S1. (I'm reading my medical records here!) She

removied the bottom section of my H Rod. She did laminectomy &

decompression of 3 vertebrae, She did Bilateral Foraminotomies of 3

areas (trying to keep it simple here) She also installed the

instrumentation from T12 to the sacrum. This sounds like a LOT of

work for one day! When they removed the lower portion of my Hrod,

there was a dural tear, and they had to remove that. That had nothing

to do with Dr. Hu or her skill, but that THING had gotten so

overgrown with bone and stuck in there, even tho they were very

careful, they couldn't help it. For the second surgery a week later,

they did anterior lumbar interbody fusion on L3-4, L4-5, L5-S-1. It

mentions more osteotomies which I don't understand, but the main

thing done on this day was the installation of the cage containing a

little of my bone, but mostly BMP.

It's hard to compare yourself EXACTLY to anyone on this board because

everyone is different. I mean that in the sense of a surgical plan.

In the chosing of a Dr., that's different. My reasons for chosing Dr.

Hu is I had known several people that had operations from her and

they just loved her, and had creditied her with helping them get over

previous serious problems that other surgeons had caused. She is an

excellent surgeon, and both were so pleased at how much she had

helped them. (My daughter just measured me, and I am now back up to 5

ft. 6 inches, and I had been measured around 5'4 " . Mostly because of

bending the knees.)

I had my original surgery over 32 yrs. ago in Oakland Children's

hospital. I live 4 hours from either SF or Oakland. It's a long

drive, but I feel it's worth it. If you want Dr. Hu's e-mail address,

I can give it to you. She always answers her e-mails. You can write

me privately for that.

If you have any other questions, feel free to ask.

If I can get some decent copies of my x-rays, I will post them.

Carol V.

>

> Hi Carol,

>

> I really liked Dr. Hu too. I know I could probably find this info

but

> if you don't mind, how far off was your sagittal balance? Mine is

only

> about 14 cm. How many osteotomies? Were they PSO's or SPO's? I

still

> have not received my surgical consult write up from Dr. Hu yet and

I

> don't remember (and didn't write down) what type she intended to

use

> but I did remember she said 2 to 3. I am so glad to hear you have

no

> back pain. I don't remember what that's like. You must be very

happy

> about that!

>

> If it was just a choice of where I would go I would definintely go

to

> San Francisco. I love that city. Amarillo, not so much .

>

> Thank you so much for your input.

>

> Tami

>

[Guest guest]

Tami, I'm sure Dr. Hu could do two of these a week, but she limits

herself to 20-30 per year! Alot more that that local Ortho! Dr. Hu

only operates on Tues. and Thurs., see patients in clinic on Mon and

Wed.

Carol V.

> >

> > HI Tami,

> >

> > How frustrating. One way to go is to see a third doctor with the

> hope that he agrees with at least one of the others. Your best

bet

> location-wise would probably Drs Bridwell or Lenke in St Louis.

Good

> luck with your decagon making process. Please let us know what's

> going on.

> >

> > Bonnie

> >

> >

> > [ ] Why can't this be easy!!

> >

> >

> > Hello,

> >

> > Well I had my consults with Dr. Hu @ UCSF on Monday and Dr.

> Lagrone

> > in Amarillo on Tuesday. Boy was that a long grueling trip with

> alot

> > of fun thrown in on Saturday & Sunday when I flew to San

> Francisco!

> >

> > I was really hoping both doctors would have the same approach

and

> I

> > would just have to chose between the two but unfortunately that

> is

> > not the case so I have more research and brain picking to do. I

> > really liked both doctors.

> >

> > Dr. Hu wants to do both anterior and posterior 1 week apart

(July

> 9 &

> > 16) but Dr. Lagrone thinks he can get it done posterior only

> (July

> > 16). This would mean a lot less time in the hospital, less time

> to

> > recover, no anterior scar, less time away from work, etc...

But,

> is

> > it the right way to get the best correction? My husband thinks

> it's

> > a no brainer and I should just go with Lagrone since it's

easier

> on

> > everyone but I don't think that being easier is the deciding

> factor

> > here. Dr. Lagrone is the most experienced, right? Dr. Hu is the

> > Professor and Chief of spine service at one of the 10 best

> hopitals

> > in the nation(according US News & Worls Report), right? Dr.

> Lagrone

> > does it all himself. Dr. Hu has a whole team of interns to help

> but

> > who know which of these is better. I know I don't.

> >

> > So I am still undecided. I just got back from my pain

management

> Dr.

> > who kept trying to convince me to stay in town and let Dr.

Keenen

> do

> > the surgery (I think they are friends) but I explained to him

> that

> > Dr. Keenen does not have the experience with this procedure

that

> the

> > other doctors do and he finally relented and applauded my

> research.

> >

> > Any ideas on the best approach to reaching a decision. I will

be

> > talking to Dr. Hu to ask her why she thinks anterior and

> posterior is

> > best and vice versa.

> >

> > Thanks in advance for any and all input. I really appreciate

this

> > site and everybody that contributes. I would truly be lost

> without

> > you all.

> >

> > Tami in Oregon.

> >

>

[Guest guest]

also had Dr. Hu.

Carol V.

-- In , " edie_scratch "

<edie_scratch@...> wrote:

>

> Hi Tami,

>

> My flatback was approximately as severe as yours...did you realize

that 15 centimeters is

> almost 6 inches? That's a pretty hefty forward lean. It didn't

strike me until I did the

> conversion. Then I realized that my entire lower body was trying to

compensate for an off

> balance of 6 inches for at least 6 years, probably even longer.

Look at it on a ruler, and it

> may hit you how hard your core, hips and legs are working to keep

you standing. Not to

> mention the strain a forward lean of 6 inches will put on your neck

muscles.

>

> Good luck with your decision. The bottom line is that you need to

go with a surgeon that

> you have absolute confidence in, and we all wish there were easier

answers, trust me. But

> you can certainly get a lot of first-hand info about both of your

excellent doctor choices

> on this board. Carol's a perfect person to ask in regards to Dr.

Hu, and, like myself, is one

> of the more recent revisionees here.

>

>

> Best to you,

>

> Edie

>

>

> >

> > Hi Carol,

> >

> > I really liked Dr. Hu too. I know I could probably find this

info but

> > if you don't mind, how far off was your sagittal balance? Mine

is only

> > about 14 cm. How many osteotomies? Were they PSO's or SPO's? I

still

> > have not received my surgical consult write up from Dr. Hu yet

and I

> > don't remember (and didn't write down) what type she intended to

use

> > but I did remember she said 2 to 3. I am so glad to hear you

have no

> > back pain. I don't remember what that's like. You must be very

happy

> > about that!

> >

> > If it was just a choice of where I would go I would definintely

go to

> > San Francisco. I love that city. Amarillo, not so much .

> >

> > Thank you so much for your input.

> >

> > Tami

> >

>

[Guest guest]

<<<<<<It also reminded me that if I turn right instead of left when I take my walks around the neighborhood, I could end up at Braums (a delicious ice cream store>>>>>>>

Hi Suzanne,

Your note about turning right instead of left reminded me of how I started driving after my first surgery, when I was encased in that 25 lb cast, in '77. It was very hard to turn my head to the left, so I managed to get where I needed to go in the neighborhood by right turns only. Memories. We're lucky we don't have to deal with those casts this time around.

Bonnie

[ ] Re: Why can't this be easy!!

I have been feeling amazingly well this past week. Unfortunately, I forgot yesterday that I wasn't supposed to bend until I reached forward to feel something. OUCH!!! My son said he heard a loud pop. I don't recall hearing anything except me yelling F***It quit hurting pretty quickly and the groin pain I had been having went away. I sure hope I didn't pull anything loose. I didn't make it all the way to what I was trying to touch.My washing machine sprang a leak and I had asked my son to get a big photograph and my classroom posters off the floor. The posters were taped up inside two science fair project cardboard things and he put it on top of the picture. I was going to check to see if they were wet and then tell him to get it off my huge beach picture that I always put in the best spot of my classroom for me to see all day.I went to bed for about an hour, then I got up and went with my husband and daughter to the laundromat. We left the daughter at the laundromat and we went for an almost 2 mile walk! It was kinda cool to walk on the sidewalk along the busy street where we could see that we went almost mile to mile.It also reminded me that if I turn right instead of left when I take my walks around the neighborhood, I could end up at Braums (a delicious ice cream store)>> It sounds like your still doing really well and I really hope you don't > have to go back for anterior surgery in the future. With the way you > are healing I have a feeling that you won't. I hope I recover as > quickly as you seem to be. Keep up the good work.> > Tami>

[Guest guest]

even though I did not have anterior surgery, I did have two posterior

surgeries.

>

> Hi Tami,

and perhaps feels that in the few

> where further support is necessary it can happen at a later date,

> such as Suzannes surgeon planned. I guess I would want to have this

> all outlined for me before the surgery. What DrHu is proposing is

> closer to what the " mainstream " revision would include. I suppose by

> going both ways the surgeons may feel that they are increasing the

> odds that they will " get it in one go " ...but perhaps there is an

> evolving thinking on this point now as well.

[Guest guest]

OUCH!- That is probably an understatement. I pray you did no

damage. Probably OK since the pain stopped so quickly. I was

telling my husband just this morning that we could really use a new

washer and dryer and that maybe he and the kids could put their heads

and money together and get me one of those new front loader sets that

you can put on pedestals. I reminded him that bending is not

something that I will be doing for a long, long time and it would

really help to have them up higher. We'll see! I'm glad you had a

good walk and in the future, TURN RIGHT! haha.

Tami

> >

> > It sounds like your still doing really well and I really hope you

> don't

> > have to go back for anterior surgery in the future. With the way

you

> > are healing I have a feeling that you won't. I hope I recover as

> > quickly as you seem to be. Keep up the good work.

> >

> > Tami

> >

>

[Guest guest]

Thanks Carol,

I have Dr. Hu's e-mail I think and plan on sending a list of

questions tonight or tomorrow. I did really like her and can see her

doing something like that. Before I saw Dr. Lagrone I had actually

told my husband that I thought I had found my surgeon. Then I felt

the same way about Dr. Lagrone. He too is a very nice and caring

person. It would be easier if they both had the same approach and I

hated one of them (haha). It has been exacty 30 years since my first

surgery at Shriners Hospital here in Portland. As it turns out, Dr.

Lagrone knows and sometimes plays golf with my original surgeon, Dr.

Carr. Dr. Carr is long since retired though. I too have been

compensating by bending my knees and when Dr. Hu told me to walk and

then just stand she said something like, " You stand like that? " and

my husband said yes and have for a couple of years. She said no

wonder my knees were hurting too.

Boy does that sound like alot of work doesn't it? I realize that no

two of us are the same but it does help to hear of others

experiences. They measured me at 5'2 which is right back where I was

before my first surgery. I was 5'4 after. I look forward to

standing tall again as an extra from this surgery. I look forward to

seeing your x-rays. I need to try to get pictures of mine too.

Thanks,

Tami

> >

> > Hi Carol,

> >

> > I really liked Dr. Hu too. I know I could probably find this

info

> but

> > if you don't mind, how far off was your sagittal balance? Mine

is

> only

> > about 14 cm. How many osteotomies? Were they PSO's or SPO's? I

> still

> > have not received my surgical consult write up from Dr. Hu yet

and

> I

> > don't remember (and didn't write down) what type she intended to

> use

> > but I did remember she said 2 to 3. I am so glad to hear you

have

> no

> > back pain. I don't remember what that's like. You must be very

> happy

> > about that!

> >

> > If it was just a choice of where I would go I would definintely

go

> to

> > San Francisco. I love that city. Amarillo, not so much .

> >

> > Thank you so much for your input.

> >

> > Tami

> >

>