Back from my appointment with Dr Bridwell

[Guest guest]

Dr Bridwell's office called a couple of days before the appointment

and asked me to bring all my old films and have the radiology report

from my most recent MRI faxed to them. They also wanted the surgical

notes from my original surgery. I also called my pain management

doctor and asked them to fax my records, since he is the person who

has been dealing with my spine the most.

The hospital where I had the original surgery said it will take

several days for them to look for my records since if they have them,

they would be on microfilm. Dr Bridwell said they would be very

useful since it would tell him what had been done originally.

Apparently, it must be difficult to identify areas of pseudoarthrosis

from xrays, CT scans, and MRI films.

The doctor's first question was whether I really wanted a second

opinion. I told him that I had seen the other doctor with the goal of

getting a referral to see him.

He was very impressed with the quality of my most recent MRI, but said

he wants me to have a CT mylegram and a throrough CT exam of my iliac

area. A pulmonary function test is also in order.

He thinks he would need to do three surgeries. The first one would be

to remove the old hardware and do the osteotomies. He is not sure

whether he would do pedicle subtraction or - osteotomies -

- it will depend on further study of the additional xrays, myelogram,

and what he sees once he gets in there. He would do a second

posterior surgery about a week later to install the new hardware. He

wants to do the posterior part in two stages so he will be able to

tell if I have pain, whether it is from the hardware, or the other

work.

Then, the anterior portion would be done a few months later, if

needed.

I asked him what he thought about Dr s suggestion of doing the

decompression and fusing just the lower two levels first, and he said

he didn't think I would be happy being fused in a bent over position

and that I might as well get it all done at one time. However, it

would be better if I could try to lose weight and get in the best

possible physical condition before the surgery.

He sent me for more xrays to get better detail of the vertebrae, and

gave me the orders for the myelogram, CT scan, and pulmonary function

test.

I went that afternoon to the physical therapists office where she had

me walk on a treadmill for 20 minutes and report on my pain, then ride

a stationary bike for 10 minutes.

I was very surprised that I was able to walk on the treadmill at all!

A doctor had wanted to do a stress test on a treadmill several years

ago when I had some chest pains, and I had not been able to manage it

at all. I guess all that walking I did in Nassau helped get me in

somewhat better shape! Just getting from the parking lot to my room

was quite a hike, and my ex-husband is a firm believer in doing lots

of walking (especially since he doesn't drive or like to ride the bus,

so he walks around the whole island and thinks it is easy), and the

island has a definite lack of parking facilities, so walking is pretty

much necessary if you don't plan to spend all your time at the beach.

I walked .6 mile during my 20 minutes on the treadmill.

The therapist said that the bike was usually harder for people, but it

wasn't bad. It did have a slight lean forward, and during part of the

test, she had me hold on to the lower part of the handle bars. I did

2.4 miles in my 20 minutes on the bike.

I wasn't feeling much pain while actually walking or riding. I was

concentrating on trying not to fall off the treadmill, and I was

imaginging that I was in the Bahamas, trying to keep up with my ex.

But after I left the office and got in the car -- OUCH!! I could not

get comfortable in the car (and this is after having travelled 6000

miles without any problem in the last month). So, I called the office

back to make sure she knew that I had a lot of pain once I had quit

moving.

I also had a long talk with Bernie, who did some patient education.

She showed me a lot of before and after pictures and xrays. Some of

them had quite dramatic improvement.

When Dr Bridwell had asked me whether I wanted him to do the surgery,

I told him that I wanted a doctor with a whole lot of experience at

doing the complete revisions. He and his residents and fellows

chuckled for a bit to imagine anybody trusting a doctor who only knew

the theory but lacked experience at doing the complete job. He said

he has done about 120 of these, and that about 10% of his patients had

some negative consequences. He said those included permanent nerve

damage of either the foot, or the quadricep. He said the ones with

foot damage were still mostly glad they had the surgery, because they

were still able to walk with the aid of a foot brace, but the ones

with quadricep damage probably were not so happy. Of the 10%, more

had dropped foot that damaged quadriceps.

They wanted to know what I hoped for the outcome of surgery --

standing up straight or reduced pain. I told them that I really don't

care about standing up straight, but I do want to be in less pain.

They seemed to think that standing up straight should be better for

reducing the pain than to be fused in a bent over position.

Bernie went over all the discharge instructions and restrictions and

talked about getting ready for the surgery. I asked her if very many

of the patients were pain free, and she said it is really hard to

judge the results of surgery on that basis since pain is so

subjective. She said it would be wonderful if they could just open

you up, see the pain, and remove it.

I told Dr Bridwell that about 100 surgeries didn't really seem like

very much to me. That is when everybody chuckled and said he probably

had done more of them than anybody else in the country.

I see somebody recently said LaGrone has done around 90. Does anybody

know how many Rand has done?

I would still like to consider Rand, but my husband seems very opposed

to traveling to Boston.

I know a lot of folks here are very satisfied with Rand's work, but I

don't know how many people have used Bridwell and how much pain they

are in a year later. I hope Bridwell's patients will speak up and let

me know how much pain they are in! Maybe not very many of them feel a

need for a support group??

Bernie offered to schedule a date 'in pencil' She said she is

scheduling into February at the moment. I told her I will probably

want to wait until the end of May / first of June. She said she is

not sure of the schedule for the summer, because she doesn't have the

schedule of conferences and speaking engagements yet. So, we will

talk again after the CT scan and myelogram.

She said I should call her if I can't find anybody who can do the

myelogram locally. I should have thought to ask if I could do it and

the follow up appointment all in one trip to St Louis. She did say

that I should plan on 3 days there if I have it done there -- a day

before since they only do them early in the morning, and I would have

to lay still for about 6 hours afterwards, and not plan to drive home

until the next day.

Yikes! How in the hell am I going to lie still for 6 hours?? I hope

they can sedate me, or I will have to plan to stay up doing something

tiring all night beforehand so I can sleep. I hope they don't mean

flat on my back.