Re: I finally met Dr today

[Guest guest]

I forgot to mention that Dr says he has a chapter in one of the

scoliosis books.

Do you know anything about him, ??

[Guest guest]

Suzanne, all I can say is you're a trooper. Definitely get that second opinion.

Sharon

[ ] I finally met Dr today

I went in for the MRI first and thought I was not going to be able to make it through the whole thing because I was on my back for about an hour. It started hurting very badly fairly early on.When I got to the doctor's office, I saw the PA first again. He showed me on the MRI films that my L5/S1 disc is totally shot -- it appears to be non-existent with the bone rubbing against bone. The hole for the nerve root to pass through is extremely small.The PA thought the doctor would want to remove my hardware since it is broken anyway and that I probably have lots of pseudarthrosis and so the hardware hasn't done anything for me anyway. He was confident they could get it out. He also thought they might want to fuse L5/S1 and put the little rods and screws in.I asked him how many of these procedures have they done and expressed my skeptism that a small fusion would be sufficient. He said they have done 5 or 6 this year and he pulled out some xrays of patients who had very severe kyphosis that they have fixed recently (and the xrays were pretty impressive).So, I said, ok, but you are the PA. How do you know what the doctor would say. So, he told me that Dr is a very good surgeon and that he trained with Dr DeWalt in Chicago and that he had gotten a lot of practice doing revision surgery there. After leaving Chicago, he was based in Loma where he also did a lot of complex spine surgery until his wife's rear view mirror got shot out while driving down the freeway. At that point, she urged him to accept the invitation of one of his former colleagues to move to Oklahoma. He has been here for 8 years and the PA has worked with him for 7 years.So, he calls Dr in to look at my films. He said he would do an A/P procedure, separated by about 7 days and put a bone wedge at the front of L5/S1 and also at L4 and the little rods and screws. He would also like to take out all of my old hardware, but it might not be necessary since it doesn't seem to have a function anyway. He thinks that putting the bone wedge in MAY eliminate the need for an ostetomy, but that if it didn't, I would be in much better shape for the full blown revision surgery after the fusion and the six screws had a chance to set well. He also said that if I have surgery with him, he would insist that I cut off all my hair first. (He said this as I showed him that I could almost touch the floor -- and I actually did touch the floor today). He was quite serious and stern when he told me to cut my hair. Of course, I asked why, wondering if he was going to say my back hurts because my hair is so heavy, but he said it poses a significant risk of infection since I have dreadlocks down to my butt. Ok, I can live with that as a good reason for getting a hair cut.The PA then told him that I had actually come in to get a letter for my insurance so I could go see a doctor out of town. He asked who and I mentioned Dr Rand. He said he had never heard of him, and that of all the spine specialists in America, only about 10-15% of them were qualified to do what I needed done.I asked him what he would recommend if I were his wife or daughter, and he said he would send me to Dr Bridwell. He and trained together, but that has about 10 years more experience and has the top spinal practice for flatback revision.He gave me the MRI films and my xrays, and said he would write a referral to Dr Bridwell and that I should definitely at least get a second opinion. I am supposed to call back in about 10 days and get a copy of the notes to send to my insurance, but the insurance company would already have it in their records.I actually thought he made a very good case for using the bone wedge instead of cages -- he said that it is difficult to deal with the cages if you get an infection in them and that it is harder to tell if you have a good fusion. When I told him that I had been reading flatback forums for about 5 years and was under the impression that osteotomies were necessary to get good correction, he had me walk across the room and stand up. I was wearing shorts, so it was easy for him to see how far pitched over I am when I straighten my knees. That is the point when he decided he should totally remove the hardware in case the bone wedge doesn't restore enough lordosis and I have to have more surgery later.His thinking was that the smaller surgery might actually work pretty well. He said he had done surgery on a woman in Chicago when he was a fellow, and that they had gotten about 70% correction and about a 70% reduction in pain. The woman wasn't satisfied, so they tried to achieve perfection and ended up causing a much bigger mess that couldn't be fixed.He said it is always possible to go back in and fuse some more and cut some wedges, but that once you do the big surgery, there is no going backwards. I was surprised to find myself actually considering scheduling a date. But, he thinks I should see Bridwell first, especially since I am planning a trip to the Bahamas next month. He said I should plan on at least 3 to 6 months off work.The PA thought I should have surgery instead of vacation, but giving up my vacation is not an option. I had been thinking about having surgery next summer and taking a one year of absence (unpaid). Quite technically, if I were going to ask for a leave of absence, I should have done that before April 20. I also asked about insurance. Obviously, he accepts my insurance, but my husband is changing jobs on June 26. My husband will be going to work for Saint 's hospital, which is part of the Saints network, which is (I believe) nationwide. So, his insurance will be better.I asked him if I should wait until I can get on my husband's insurance -- perhaps as secondary insurance and keep my free insurance from my job. The PA said the more insurance, the better.I asked the doctor if he was part of the Saints Network, and he said not yet. Apparently, the big thing in the medical field now is to provide incentives to stay within your medical group -- they pay at a higher percentage if you do. We will just have to see how much it will cost to add me to my husband's insurance and I assume he will have a three month probation period before he is eligible.I didn't get a chance to ask the doctor about pain management. I have an appointment for Monday, but I see that the hospital billing office has left a few messages on my machine that they need to speak with me about my upcoming appointment. I wonder if there is a problem since they have turned me over to collections.The PA looked a bit horrified when I told him how many times I had been for injections and that I had gotten SI joint injections, L5/L4 injections, and facet injections. He said it was overkill and that three times a year was the recommended dose.But, I told him I plan to spend at least 7 nights dancing all night (or at least attempting to) next month and it has been about 4 months since my last treatment. He shrugged and said the decision was up to me, but that pain management was not a good long term solution. DUH!I was surprised to find myself telling him that I am tired of always being in pain and that it seems to be getting worse fairly quickly. I still hurt even when floating in the hot tub and when sleeping. They said if I decide to have surgery with them, to let them know. But, that I should make an appointment to see Bridwell and get a second opinion.

[Guest guest]

I am thoroughly impressed. How did you remember all that? You have

to love a surgeon that insists on a second opinion, especially with

Bridwell. Best of luck. Oh, ya, have a coolatta for me

>

> I went in for the MRI first and thought I was not going to be able

> to make it through the whole thing because I was on my back for

> about an hour. It started hurting very badly fairly early on.

>

> When I got to the doctor's office, I saw the PA first again. He

> showed me on the MRI films that my L5/S1 disc is totally shot --

it

> appears to be non-existent with the bone rubbing against bone.

The

> hole for the nerve root to pass through is extremely small.

>

> The PA thought the doctor would want to remove my hardware since

it

> is broken anyway and that I probably have lots of pseudarthrosis

and

> so the hardware hasn't done anything for me anyway. He was

> confident they could get it out. He also thought they might want

to

> fuse L5/S1 and put the little rods and screws in.

>

> I asked him how many of these procedures have they done and

> expressed my skeptism that a small fusion would be sufficient. He

> said they have done 5 or 6 this year and he pulled out some xrays

of

> patients who had very severe kyphosis that they have fixed

recently

> (and the xrays were pretty impressive).

>

> So, I said, ok, but you are the PA. How do you know what the

doctor

> would say. So, he told me that Dr is a very good surgeon

and

> that he trained with Dr DeWalt in Chicago and that he had gotten a

> lot of practice doing revision surgery there. After leaving

> Chicago, he was based in Loma where he also did a lot of

> complex spine surgery until his wife's rear view mirror got shot

out

> while driving down the freeway. At that point, she urged him to

> accept the invitation of one of his former colleagues to move to

> Oklahoma. He has been here for 8 years and the PA has worked with

> him for 7 years.

>

> So, he calls Dr in to look at my films. He said he would

do

> an A/P procedure, separated by about 7 days and put a bone wedge

at

> the front of L5/S1 and also at L4 and the little rods and screws.

> He would also like to take out all of my old hardware, but it

might

> not be necessary since it doesn't seem to have a function anyway.

>

> He thinks that putting the bone wedge in MAY eliminate the need

for

> an ostetomy, but that if it didn't, I would be in much better

shape

> for the full blown revision surgery after the fusion and the six

> screws had a chance to set well.

>

> He also said that if I have surgery with him, he would insist that

I

> cut off all my hair first. (He said this as I showed him that I

> could almost touch the floor -- and I actually did touch the floor

> today). He was quite serious and stern when he told me to cut my

> hair. Of course, I asked why, wondering if he was going to say my

> back hurts because my hair is so heavy, but he said it poses a

> significant risk of infection since I have dreadlocks down to my

> butt. Ok, I can live with that as a good reason for getting a

hair

> cut.

>

> The PA then told him that I had actually come in to get a letter

for

> my insurance so I could go see a doctor out of town. He asked who

> and I mentioned Dr Rand. He said he had never heard of him, and

> that of all the spine specialists in America, only about 10-15% of

> them were qualified to do what I needed done.

>

> I asked him what he would recommend if I were his wife or

daughter,

> and he said he would send me to Dr Bridwell. He and trained

> together, but that has about 10 years more experience and

has

> the top spinal practice for flatback revision.

>

> He gave me the MRI films and my xrays, and said he would write a

> referral to Dr Bridwell and that I should definitely at least get

a

> second opinion. I am supposed to call back in about 10 days and

get

> a copy of the notes to send to my insurance, but the insurance

> company would already have it in their records.

>

> I actually thought he made a very good case for using the bone

wedge

> instead of cages -- he said that it is difficult to deal with the

> cages if you get an infection in them and that it is harder to

tell

> if you have a good fusion.

>

> When I told him that I had been reading flatback forums for about

5

> years and was under the impression that osteotomies were necessary

> to get good correction, he had me walk across the room and stand

> up. I was wearing shorts, so it was easy for him to see how far

> pitched over I am when I straighten my knees. That is the point

> when he decided he should totally remove the hardware in case the

> bone wedge doesn't restore enough lordosis and I have to have more

> surgery later.

>

> His thinking was that the smaller surgery might actually work

pretty

> well. He said he had done surgery on a woman in Chicago when he

was

> a fellow, and that they had gotten about 70% correction and about

a

> 70% reduction in pain. The woman wasn't satisfied, so they tried

to

> achieve perfection and ended up causing a much bigger mess that

> couldn't be fixed.

>

> He said it is always possible to go back in and fuse some more and

> cut some wedges, but that once you do the big surgery, there is no

> going backwards.

>

> I was surprised to find myself actually considering scheduling a

> date. But, he thinks I should see Bridwell first, especially

since

> I am planning a trip to the Bahamas next month. He said I should

> plan on at least 3 to 6 months off work.

>

> The PA thought I should have surgery instead of vacation, but

giving

> up my vacation is not an option. I had been thinking about having

> surgery next summer and taking a one year of absence (unpaid).

> Quite technically, if I were going to ask for a leave of absence,

I

> should have done that before April 20.

>

> I also asked about insurance. Obviously, he accepts my insurance,

> but my husband is changing jobs on June 26. My husband will be

> going to work for Saint 's hospital, which is part of the

> Saints network, which is (I believe) nationwide. So, his

insurance

> will be better.

>

> I asked him if I should wait until I can get on my husband's

> insurance -- perhaps as secondary insurance and keep my free

> insurance from my job. The PA said the more insurance, the better.

>

> I asked the doctor if he was part of the Saints Network, and he

said

> not yet. Apparently, the big thing in the medical field now is

to

> provide incentives to stay within your medical group -- they pay

at

> a higher percentage if you do. We will just have to see how much

it

> will cost to add me to my husband's insurance and I assume he will

> have a three month probation period before he is eligible.

>

> I didn't get a chance to ask the doctor about pain management. I

> have an appointment for Monday, but I see that the hospital

billing

> office has left a few messages on my machine that they need to

speak

> with me about my upcoming appointment. I wonder if there is a

> problem since they have turned me over to collections.

>

> The PA looked a bit horrified when I told him how many times I had

> been for injections and that I had gotten SI joint injections,

L5/L4

> injections, and facet injections. He said it was overkill and

that

> three times a year was the recommended dose.

>

> But, I told him I plan to spend at least 7 nights dancing all

night

> (or at least attempting to) next month and it has been about 4

> months since my last treatment. He shrugged and said the decision

> was up to me, but that pain management was not a good long term

> solution. DUH!

>

> I was surprised to find myself telling him that I am tired of

always

> being in pain and that it seems to be getting worse fairly

quickly.

> I still hurt even when floating in the hot tub and when sleeping.

>

> They said if I decide to have surgery with them, to let them

know.

> But, that I should make an appointment to see Bridwell and get a

> second opinion.

>

[Guest guest]

Sorry, I don't, and I couldn't find any chapter authored by him in any

of the books I have (I only did a quick scan however.)

--

>

> I forgot to mention that Dr says he has a chapter in one of the

> scoliosis books.

>

> Do you know anything about him, ??

>

[Guest guest]

Suzanne,

Sounds like Dr hit all the right notes...and I am glad to hear

he is also recommending a second opinion, 5 or 6 such surgeries a year

is a long way from what DrBridwell is doing!

No matter what you do, I hope you will also get Dr to provide

you with patient references of folks who have had very similar

surgeries/issues.

I don't see vacation and surgery as mutually exclusive propositions in

your case...aren't you taking your trip to the Bahamas over your

summer break? Wouldn't your surgery require the use of sick time

and/or Family Medical Leave?

Take Care, Cam

[Guest guest]

We only get 10 days per sick leave per year, and I used every bit of

mine the year that I taught first grade. I think I ended this year

with maybe 3 or 4 days that will carry over for next year.

I think the PA thought I might want to have the surgery as soon as

possible so I could be ready to go back to work in the fall. I had

actually been thinking of taking a one year medical leave of absence

without pay.

My husband likes the idea of doing the smaller surgery and doing it

here locally. Dr made a good case for the benefits of doing

the smaller surgery first and seems to do a lot of procedures

similar to what he is proposing. If that is the way I decide to go,

I may do it in January and February and just be off half a year. I

will have to check and see how feasible that is with my job. Since

I work 10 months but get my paychecks spread out over 12 months, I

would want to make sure that I wouldn't end up owing them money.

I am planning to go ahead and call Dr Bridwell's office on Monday

after I get back from pain management (well, maybe Tuesday if I am

sleepy) and see how far ahead he is booking.

>

> Suzanne,

>

> Sounds like Dr hit all the right notes...and I am glad to

hear

> he is also recommending a second opinion, 5 or 6 such surgeries a

year

> is a long way from what DrBridwell is doing!

>

> No matter what you do, I hope you will also get Dr to

provide

> you with patient references of folks who have had very similar

> surgeries/issues.

>

> I don't see vacation and surgery as mutually exclusive

propositions in

> your case...aren't you taking your trip to the Bahamas over your

> summer break? Wouldn't your surgery require the use of sick time

> and/or Family Medical Leave?

>

> Take Care, Cam

>