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Question?

AnonymousUserAAnonymousUser Posts: 49,622
edited 06/11/2012 - 7:19 AM in Back Surgery and Neck Surgery
Sorry if this is in the wrong place but I need help.

I am scheduled for a 360 spinal fusion for my lower lumbar and am wondering as the date draws nearer if I am making the correct choice.

I have three young children and although I want to be normal and not be in pain all the time I am terrified of surgery and the what ifs,(what ifs being what if I don't make it and leave my children motherless).

A little history after seeing many doctors, just trying to figure out what was wrong and being told by my pain management doc that there was nothing further he could do, I found a orthopedic spine specialist, who I really feel comfortable with, but he is younger (which I know has it's advantages) he is not board certified but is board eligible, he is associated with many professional associations and is fellowship trained. Again I really like him and am very comfortable with him but it is coming to crunch time, and I just need to be told that I am not making the biggest mistake of my life here.

Please help and please be nice.

Sorry for the long post.
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Comments

  • "Not board certified" makes bells and whistles go off in my head, seriously. Being associated with professional associations means nothing. What is his fellowship training in? Unless it's spine surgery, that person may as well be a mailman. Many people get 2nd opinions as a way of verifying that that specific surgery is the right course of action for you, and that you are a good surgerical candidate.

    I'm not at all saying you're making a mistake and I am in no way qualified to say that b/c I don't know your history and I'm not a medical professional. Still, going into a surgery as serious as a fusion with all these doubts isn't wise. Spend some more time getting educated about your condition (why are they recomending a fusion?), what the surgery is exactly, what the expected outcome/prognosis is, etc., etc.

    If you've done all your research and feel FULLY confident in your doctor, then don't worry about making a mistake in judgement. Many people have these done daily and are fine. Lumbar surgery, while considered major surgery,is not life-threatening. Your spinal cord ends several levels up so while there are some neurological risks, the risk of paralysis or death is incredibly low.

    Again, please do lots of research so you feel like you are making an educated decision. Except in emergent cases, spine surgery is elective - it's your choice. Read around the forums more for some personal experiences, but please read the other technical info too, here on Spine-Health to learn more. :)

  • Second Opinion..... Ask your PCP for a referral to get a second opinion. You will need to get your MRI and xray films and take them with you to avoid any delays.

    Just curious- what is your diagnosis and how many levels will be fused?

    Julie
  • I basically agree with Hopey her, except that some younger board eligible surgeons with spinal surgery fellowship may have to be observed for as much as two years before they are allowed to take the board exam. Then they have to wait for the result, so there is another lag time. Find out exactly where he stands, how many similar surgeries had he performed, etc. Also, get some information about him from other doctors, nurses, and patients if possible. It is good that you trust him, and being young he may be familiar with the newest techniques, but experience and mostly skill are very important.

    Go get a second or even a third opinion, and see if you still feel most comfortable with him, then make your decision. Don't rush into anything, most likely this is not an emergency surgery you need.

    Good luck,

    Kin ;) :) ;) :)
  • I am having my L4-L5-S1 fused due to herniations and severe nerve impingement. He is fellowship trained in spines and goes to lots of seminars. He has been doing surgery for the spine for the past 3 1/2/4 years and everyone I have talked to , my pcp, and the staff in his office says he is great.

    As I said in my previous post he is board eligible. He is also the fifth doctor I have been to but the first that offered surgery, most others said I needed or would need it, but were not in the right profession. In regards to seeing a another doc I just do not know if it is foreseeable as my condition has progressively gotten worse. I am afraid if I don't have it done then I may have permanent nerve damage.

    Again, thank you for the great responses.

    P.S. My nerves are so jangled that I guess I am searching for that sign and for more support as I know that my hubby wants me to go through it.
  • Gina,
    2 level fusion is not a joke.It's not learned at seminars.With all due respect to your doctor,3 year is not very impressive when it comes to spine surgery.At least for my spine!There are many spinal surgical procedures which means he hasn't necessarily done many fusions.Just keep in mind that fusion is an irreversible procedure.
    Call him and ask "Dr.X,how many ppl you have fused?",simple as that.
    Whatever you decide,good luck!

    Cheers,G.
  • Gina,

    I agree with the others here. Spinal fusion should be a last resort procedure. Fusing for just disc herniations seems a little extreme to me. Do you have DDD (Disc Degenerative Disease)? Do you have loss of disc height? Again, fusion surgery for a disc herniation is a very aggressive approach. You may be better off starting with a discectomy and a partial laminectomy. You really need to see a board certified surgeon (maybe see an NS if your current doctor is not one) for another opinion.

    I am recovering from a 2 level fusion at the same levels, and I only opted for the procedure because one of my discs was completely gone and the other one was following the same path. Fusion surgery is a much longer recovery period and IMHO you should determine if there are other less invasive procedures you can do.

    I wish you all the best in your decision.

    Dave
  • Hi Gina, I understand your nerves. I have them too. My surgery is scheduled for Aug 5, and I am already a wreck. I watched a fusion surgery video today, and that was a mistake, don't do it. I too am questioning my decision to have fusion L4-5. My surgeon too is board eligible, not board certified. (I was led to believe that it is just as good?). If this was March, I would have been ready to go cause I was in sooo much pain, but I actually feel a little better now after 4 months of water therapy. I still am limping when I walk from the pain down my left leg and my back crunches whenever I move. I am afraid to have surgery and afraid not to have surgery. What if it gets suddenly worse again? I don't think I'll ever feel fully committed to my decision. I just keep praying about it. I do know my surgeon is the best this town has to offer, but there may be better at UCSF or UC Davis, but then there is the commute and I am pretty much on my own in this, except for my teenagers. So, well I guess this isn't helpful, but just know you are not the only one questioning your decision. A second opinion might make you feel a lot better, even though it may be a time consuming process to get it, perhaps it would be worth it. Take care, and good luck with your decision. Sue
  • Hi Gina & Cali Sue as well,
    Yes i agree that a second opinion is a good idea and of all that has been said.
    Now I also want to add that it is also important to trust your gut instinct with your surgeon.
    7 yrs ago I was sent to 'THE best of the best" and had a laminectomy/discectomy. I went in for 4 days and stayed for 4 weeks. :jawdrop: I didn't like or feel comfortable with this Dr but everyone kept telling me how wonderful he was. I should have listened to MYSELF not everyone else.

    This time around I saw a different surgeon and from the first word I knew he was perfect, just the Dr I wanted to be operating on me. I went in to see him with an A4 sheet of questions and he very patiently answered each one. :) Yes he was qualified etc and he was younger then most but I now know I made the right choice and I couldn't be happier with it.
    So listen to yourself as much as everyone else.
    Blessings Sara
  • How do you feel about the surgeon? Are you comfortable with him? I had a doctor that is young, spine ortho, board certified. I could be wrong but I think that being board eligible is that they have fulfilled the requirements (hours and such) to sit for the boards. Check with the organization that gives the designation and see exactly what it means. I also asked my surgeon how many fusions he and done and he said hundreds. I was comfortable with him and only heard good things from the hospital staff when I called around and asked about him.
    I know how you feel regarding the mortality. I was a wreck when I had my fusion for the same reason. I wanted everything to be OK for my kids. If you ever need to talk about all that feel free to PM me. I spent many sleepless nights worrying about that.
    Good luck with your decision. Making the decision was the hardest part for me.
  • I do feel really comfortable with him and he has done hundreds of fusions from what his nurse said.

    Yes, along with the herniations I have DDD, and some instability (walk with cane), nerves are severely impinged (can't even walk to the mailbox without leg and foot swelling) and there is some loss of height in both disc segments. So all those combined I opted for the fusion rather than starting a downward spiral with the other options (he said if I had a discectomy I would be back in the next year or so anyway)

    I am young (30 1/2) and a mother and just want to have "my" life back now not later.
  • Here is some interesting information I found hopefully it will help others also…

    A surgeon who has passed the Part I written examination and is practicing while awaiting admission to Part II (oral examination) is deemed “Board Eligible”.

    The American Board of Orthopedic Surgery (ABOS) is a separate organization from the American Academy of Orthopedic Surgery (AAOS), with a different purpose. Although many surgeons have held leadership positions in both organizations, they are not allowed to serve both simultaneously. You must be Board certified to become a fellow of the Academy, but AAOS membership is not a requirement to become Board certified.
    One major function of the Academy is to provide continuing medical education and training to orthopedic surgeons. The Board’s role is to evaluate the knowledge, skills and practice of individual surgeons for the good of the public. To have the same organization providing both of these functions would be an obvious conflict of interest.
    (I found this interesting as he holds a position in the Academy)

    I also learned that being Board Certified is not mandatory but voluntary so kudos to him trying at least, right.
  • I certianly know that the pain can be awful, but a second opinion can't hurt. I definitely agree that a gut instict counts for a lot, but take the time to be sure that not only is this surgeon above board (so to speak :) ), but also the technique and surgery is agreed upon by another surgeon (maybe in a university setting, or someone who is older and has been in practice longer--just for the oposite end of the spectrum). As for his staff raving about him, that's natural, they aren't going to say anything negative about their physician. They can't be objetive enough, and any patients they give you to talk to will be fans as well. Take the time to be sure that this is the right thing because there is no going back. I don't say this to scare you, just to emphasize the importance. Every surgery has the risk of death from anesthesia, unexpected circumstances or infection....but there's a risk of death from getting in your car or walking down the street. As a parent it's a hard not to think about the risk, but it can overwhelm you on top of everything else that's going on. Just be sure that you aren't in such a hurry to end the pain (which we can all understand!), that you sacrifice taking every opportunity to be sure that this is the best option for you. It will give you more peace of mind going into that OR. Best of luck! -Andrea
  • i had a 360 2 level fusion, i had a nuero surgeon, ortho surgeon and a vascular surgeon all work on me. before I even decided yes to this, i had a list of their patients and called about 20 of them and thats how i made up my mind. ask for a list of patients he has done this surgery on and definitely find out who is doing the incision in the front cause tehre is alot entailed with that! good luck
  • just wanted to throw in my 2 cents here.

    I realize the tremendous pain that you must be experiencing and how anxious you are for relief. But, that being said, a spinal fusion is major surgery and should not be taken lightly. I suggest you try to find another opinion before your surgery. I did and i feel so much better about my upcomin PLIF. also a side benefit was that i actually learned some more things about the procedure and my condition.

  • Can you really call his patients? How do you even get that information?

    As for the Dr opening me up in the front he is board certified and has 25 years experience (I have done my research).

    I went ahead and made a appointment for a 2nd opinion with another spine surgeon but am now terrified that they will say I don't need it.

    Everything is riding on me doing it but as the day draws nearer I get more and more scared and look for ways to get out of it (although at this time I have no plan of canceling). Hubby has scheduled off, I have made many lists, am starting to prep my crib, my mil is coming to watch kiddos so as not to disrupt their school schedule, and so on. As I write this I am near to tears because of my anxiety and my fears but I fear not being there for my babies the most and that goes both ways (having the surgery or not having the surgery and living with the pain).

    Something I forgot to mention earlier is that I am showing signs of caudal equine (?sp) (numbness in lower pelvic area that comes and goes) and so my doc put me on strict BLT.
  • Forgot to thank you all so far for dealing with my ranting and my questions I truly appreciate it. As I have no one to talk with at home.
  • Good luck Gina-

    I understand about getting it done so you can move on with your life. I could do the L5/S1 fusion this year and next year he said I would be back to get L4 added in. In terms of recovery time it is actually less to do it all at once- plus less chance of scar tissue.

    Julie
  • This is a very serious surgery, I would never go to an ortho spine specialist only a NS and one that is not board certified no way!!!! This isn't a broken leg this is your spine with tons of nerves that control so many things in our body, one wrong move and so many things could go wrong, not trying to scare you hun but this is serious stuff!
    image
  • my doctor gave me a list of his patients who had the same surgery i ws about to have and similar ones (mostly fusions). The had no problem talking to me, actually it put me more at ease. They did not sugar coat anything they were very honest. The vascular doc did the cutting in the front and moved all the "stuff " out of the way, the ortho removed the discs and put the cages in, then the vascualr doc put my "stuff" back and close dup the front. the nuero moved all the nerves out of the way in the back for the ortho to put in the rods and screws. I guess each praticew is different. My doc does not work alone and he does not like to mess with the nerves, especially since this was my 4th surgery.

    You really have nothing to loose by just makin gthe appt for the second opinion.

    A matter of saying you don't need it, the mri is what it is. Just be careful...we are only looking out for you!!!
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