Re: choosing a surgeon - things to consider

[Guest guest]

Dear Kam,

Such a great accounting of picking a doc, so well written, and will be of great help to new members as they start through this challenge which is flatback! Lets hope this time away from work gives you the time to get well, boy you have been through it, and I soooo look forward to meeting you and the others able to attend in North Carolina!

[ ] choosing a surgeon - things to consider

It seems this has been quite a hot topic of late and that, naturally, the doctors who are mentioned regularly have more attraction than those who aren't. I know that when I started searching for someone to "fix" me, I found a wonderful local orthopaedic surgeon who had no special experience with spinal deformity, but, he was caring and straight-forward and took the time to talk through things with me. He was willing to operate on me (proposed a laminectomy/discectomy at L4-L5 and L5-S1) and I did schedule surgery with him, but scheduled it for three months from the time we discussed it. Part of this was because I didn't want to be a burden at work and wanted to wait until summer enrollment was finished, but part of it was so I could do some research and see what I found. During that time, I found many of the people here and listened and asked LOTS of questions (I am an expert question-asker). TIMING IS SIGNIFICANT IN MAKING A SURGERY DECISION.

For those of you still pondering the doctor question, please do not misread my comments below. I am not saying that Dr. Bridwell and Dr. LaGrone are the ONLY doctors that should be considered. To the contrary, I would argue that there are endless wise choices when it comes to choosing a surgeon. In fact, a wise choice could result in a terrible outcome, but life is a gamble and we all have to decide for ourselves which risks are worth it and which are not. This is just a think-aloud of how I reached my conclusion including significant factors that helped me to decide.

In the beginning, it was almost unanimous (from recommendations) that I go see Dr. LaGrone in Amarillo. At first glance, this seems rather logical because I am in Oklahoma and Amarillo doesn't *seem* that far. It is only about five hours and it's all highway, so I suppose it really isn't that far, BUT, that's TEN hours round trip times how many pre-op and post-op visits? The other option is flying, but it is a good trick to get to Amarillo from Oklahoma City at a reasonable price without changing planes. I understand it is easier to get there from other parts of the country, but not from here. EASE/ABILITY TO TRAVEL IS SIGNIFICANT IN MAKING A SURGERY DECISION.

In addition, when I began to investigate, Dr. LaGrone was not in-network on my insurance. I had, after careful calculation, opted for the low-option HMO because all things considered, it still seemed to be the most affordable option based on the previous year (which did not include surgery). I began to second-guess this decision and wonder why in the world I would have opted for such a limited insurance plan. I was frustrated and at times, fixated on this dumb mistake I had made (although surgery was not presented as an option for me when I signed up). INSURANCE AND FINANCIAL ABILITY ARE SIGNIFICANT IN MAKING A SURGERY DECISION.

Then, I received an email suggesting that I look at St. Louis as a possibility. I had never been to St. Louis, but it wasn't that much further than Amarillo (I think it's about seven hours, but I've never driven it) and definitely had an excellent reputation regarding hospital and doctors. REPUTATION OF BOTH DOCTOR AND HOSPITAL ARE SIGNIFICANT IN MAKING A SURGERY DECISION.

So, I called my insurance and learned that Dr. Bridwell was in-network and that the co-pay for surgery was $250. Additionally, I discovered that a ticket to St. Louis via Southwest is generally $49 each way. Hmmmmm. Couldn't hurt, might help. So, I went for my first appointment with Dr. Bridwell on July 15ish, 2005 just TWO WEEKS before I was scheduled to have my surgery locally. When I returned home, I canceled that surgery, but still had a lot of thinking to do about surgeons and travel.

Dr. Bridwell is not warm and fuzzy. He does not make you feel like you are his only patient and he has all the time in the world. If you are looking for this in a surgeon, I would recommend his partner, Dr. Lenke (Bridwell trained Lenke), or another surgeon. I, however, am much more concerned about skill and attention to detail. There was no question about Dr. Bridwell's attention to detail when I first met him. He studied my films with laser focus and you could almost see the wheels turning as he thought through how to fix the problem and double-checked pertinent details. I honestly felt no reason to quiz him about his skill or ability because I had done the research before I got there and knew that he, too, had done an astronomical amount of research in his lifetime. I liked the teaching hospital environment. I liked that others were learning from this man and would someday be more prepared to help their own patients who were feeling as hopeless as I had. More importantly, I liked Bernie, Dr. Bridwell's nurse. She answered all of my questions and spent lots of time with us. If Dr. Bridwell had a nurse with his same demeanor, I am certain I would not have been as comfortable. But, he is a smart man and knows that he needs Bernie and the rest of his staff to excel at what he does. PEACE OF MIND WITH YOUR SURGEON AND HIS STAFF IS SIGNIFICANT IN MAKING A SURGERY DECISION.

I did schedule surgery, but still wasn't certain that I had made my final choice. I still needed a second opinion. A SECOND OPINION IS SIGNIFICANT IN MAKING A WISE SURGICAL DECISION. My husband was ready to sign up with Dr. B and be done with it, but I knew I wouldn't be peaceful unless I got another opinion. PEACE IS PARAMOUNT IN MAKING A SURGICAL DECISION. So, just before Labor Day weekend, mom and I headed to Amarillo to see Dr. LaGrone. I had to pay cash for this consult since my insurance wouldn't cover it, but that was insignificant compared to the peace of mind that trip provided. Dr. LaGrone is in private practice in a small office fairly close to a country club in Amarillo. It is an unassuming office complex with sufficient parking in one of the prettier areas of Amarillo (Amarillo is NOT pretty - no offense to anyone). He did make me feel like I was his only patient (I was the last one of the day)and as if he had all the time in the world. He told me what he would do and how he would do it. He answered my questions and as it turned out, his plan was almost identical to Dr. Bridwell's (except he'd do it all at once instead of in two stages).

So, then I had to weigh all of the factors. This was not an easy decision, but honestly came down to preference. ly, I like St. Louis better than Amarillo. I like traveling to (via plane) and through (via public train and bus) St. Louis better than Amarillo (via automobile or multiple planes). I like teaching hospitals over private hospitals (I am an educator). I wasn't put off by Dr. Bridwell's shy and focused demeanor (I am more matter-of-fact than sentimental). I believed I could have had a great outcome with either surgeon or either hospital, but for me, Dr. Bridwell and were the best choice. Any other person could have had my exact same experiences and made a better choice with Dr. LaGrone based on their preferences. Please note, I stated that all of these factors are SIGNIFICANT, not that you must feel 100% positive about all of them. Some may be more important to you than others, but I think it is important to ask questions aobut all of them. If your answer is that it really doesn't matter, then so be it.

I am so glad to be on this side of revision. I'm not perfect and there are still things about my experience that I question and wonder if they should have been handled differently (like why my shoulder still gives me grief), but it's done and my quality of life is far greater without chronic disabling pain than with it.

I wish you all the best decision for you and peace about it once it's been made.

kam