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Second opinion?

2

Comments

  • I have thought about calling the hospital, and trying to ask nurses who they think is best. Unfortunately I don't know any nurses. Is it possible to call the hospital, ask for the neurosurgery floor, or orthopedic floor? Or what department should I ask for?

    I keep going back and forth, trying to decide if I need to have surgery sooner or later. Admittedly my pain is around a 4-5 now, with medication. My surgeon did say that normally the patients he does surgery on have pain that is more like 8.

    It is such a hard decision to make. And I know that it's difficult to judge success rates from the forum, since people who have successfully recovered are no longer posting here. So most of what I see are the people who have either not had pain relief following surgery or those that are even worse off.

    It is so stressful.
  • Cathy,

    Here's a strange-sounding alternative for you ... check with your local Red Cross office to see if they can recommend a good spinal surgeon in your area.

    When I went to my local Red Cross to donate a unit of blood for myself (in prep for my surgery at the surgeon's request), two of the nurses commented that my surgeon was really good. One even said that he is the doctor in my area that other doctors go to see when they have back problems.

    Even though I already knew a bit about my surgeon, those comments made me feel much better about my decision and put me completely at ease.
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  • My story is very similar to Mark's, options were -
    -medications and cortisone shots
    -discectomy (if my back pain was manageable)
    -disc replacement (which my surgeon would neither do or recommend but he would refer me to another surgeon if I requested)
    -ALIF

    Surgeon would only do ALIF if I said I was ready, it was my choice. He said "let pain be your guide" and I decided I would not do it until my quality of life was compromised. When I did decide to do it, surgeon would not schedule it until I spoke the words "I am ready to schedule the surgery" not "yes I guess so" or "I think so". He is THAT conservative. He's never "pushed" surgery.

    I've been through a previous surgery with him, and in that situation, I actually called some of his patients who had recently been through the surgery to hear their experience. If that is an option, I highly recommend for a number of obvious reasons.

    So no, I did not get a 2nd opinion, I could see on the MRI for myself, we have been conservatively treating for a year, and my gut tells me that my options are what they are. He's also very honest about why he chose ALIF versus PLIF/TLIF and the risks if he can't get all of the disc matter.

    Jan 2009 L5-S1 ALIF
    May 2017 ALIF L4-L5 with PLF rods added L4-L5-S1
  • That's an interesting idea Mark.
  • One of the questions I have for my surgeon, when he calls me, is can I talk to any patients who have had similar surgeries. I do hope that I can talk to some of his patients, I think that is really important.
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  • Hello Cathy,

    YES, do call the hospital and talk with the nurses there. Ask them who they would select as their surgeon for spinal surgery. You may have to "push" them a bit to get a answer, but do it.

    Also, may I suggest that if you live in an area with a professional sports team that you give them a call. Find out which spinal surgeon they use for their valuable players. Then make an appointment to see their recommended doctor(s). I have done this several times and the team trainer is always more than willing to share the name of the doctor they use for spinal issues, AND whether they are pleased with the doc.

    Yep, like Paul, I have been to eight spinal surgeons. Result - they have different opinions on what should or should not be done. Though my back is a mess, the majority have recommended that I not have surgery at this time. Over and over again is the response "surgery is your LAST option". It took awhile for that to sink into my brain. Now I totally agree.

    "It is such a hard decison to make." I totally agree. It took me several months to work through my mind what seemed best for me. To decide which compromises to my life I could accept before going with the knife.

    "I keep going back and forth, trying to decide if I need to have surgery sooner or later." Oh boy Cathy, have I ever dealt with that, and frankly still do. One spinal surgeon said in the summer of '07 that I needed spinal fusion at two places, etc. by the end of the year. The ESIs were working from Apr '07 through Dec '07. In December I saw that same spinal surgeon. After some examination, etc. he said "continue with the ESIs being they are working". I celebrated that evening.

    Another spinal surgeon I saw looked at the same MRIs all the surgeons have seen. Did the usual bend this way and that. His response "NO WAY do you need surgery now. Surgery is the LAST option." I asked him how I would know when to have surgery. His response "When you can't walk across your living room." His words are my guide.

    My "thing" is gardening. I mean serious gardening with heavy lifting twisting bending and all. For me Cathy, as long as I can dig a hole in the ground and plant a tree I'll stay away from the knife.

    ALSO, there are new technologies/devices in clinical studies at this time in which you retain your motion (bending, twisting, etc.). Current "traditional" techniques of fusion do NOT permit the back to move as freely, AND if you do bend too much you will just stress the vertibrae above and below the fusion resulting in the need for more surgery. A lady from our church told me just very recently that since her one level surgery about two years ago she now finds she cannot and should not bend because of concerns about the condition of the vertibrae above and below the fusion. For me, I will try to wait for the new devices to be approved by the FDA.

    Decisions - Each one of us has to make the decision that is best for us. No one, not even a doctor can do that for us. That is why in my mind one needs several "2nd opinions" to help one determine what is the best road to travel.

    AND Cathy, DO have that ESI. They have worked for me since Apr '07 and continue to do so. The first ESI took care of my leg pain (and still does), and subsequent ESIs do help in reducing the inflammation of my lower back with the resulting much lower back pain.

    I wish you the very best as your travel on this road. Many of us have been and still are there with you.

    Take care.

    RichT

    P.S. - I forgot to mention I'm 72. Two medical publications in which the authors reviewed the literature regarding the effect of age on the success or failure of back surgery concluded that age was not a factor.



  • Thanks Rich,

    I have tried ESI's, have had 3 of them plus 1 facet joint injection. None has worked for any more than a week. When I see my PM doc in Jan, I will ask if I should go for another. If there is a possibility, that even though the others did not work, that the next one might, then I will go for it.

    I live in the Raleigh/Durham, NC area, so I could find out what surgeons the University teams go to. I also work at Duke University, and I'm sure that there are top notch surgeons there.

    So, what departments/floors in the hospital do you think I should ask to talk to? Where would patients who are recovering from back surgery be located?
  • I consulted with 2 orthopedic surgeons and 2 neurosurgeons before making my decision to have a fusion..and because of some nerve stuff going on in my right leg, I chose to go with the second neurosurgeon that I met with for my operation next month..and all four said the same for me
  • It was actually his idea - between diagnosis and surgery for my discectomy, it was about 4 weeks. I had no time to do homework, my condition deteriorated SO fast. When he suggested it I jumped at the chance and after talking to them, I knew that not only had I made the right decision re: surgery, but it stepped up my confidence in my surgeon (whom I had just met a couple of weeks prior!) Hope you are able to do the same. Who knows, maybe one of those patients you call will be one of us! :O That would be really ironic.
    Jan 2009 L5-S1 ALIF
    May 2017 ALIF L4-L5 with PLF rods added L4-L5-S1
  • Hello Cathy,

    You are welcome.

    In my opinion the best nurses to talk to are the OR nurses. In other words, the Operating Room nurses. They are the ones who see the doctors in action. They are the ones that to me would be the most knowlegable. If you can't "connect" with an OR nurse, then try to speak with a nurse on the "floor" where the post-op spineys are going to be. Even for that matter ask the nurse/person who originally answers the phone. The important thing is not to say "should I ask this person or that person", but rather ASK. Oh yes, you may need to do a little "gentle" politicaly correct HARD arm twisting. Its a fun game to play.

    Okay, so the lady on the phone won't tell you anything. Then show up at the info desk at the hospital and ask which floor/location the post-op spine patients are located. Zip up there, and start your "conversation" at the nurses "desk" area. Always come across as though you know where you are going. I'm sure you understand what I am trying to say. Oh, and if someone says "Who are you going to see?", or "Why do you want to go there?", just say "I'm considering having spinal surgery here and would like to just see the area in which the patients will be" or something to that effect.

    Back to the ESI injections - Sorry to read that you received no reduction in pain from the previous injections. Did the doctor making the injection use a fluoroscope. If so GREAT, but if no find another doctor. Also ask your doc what his "success" rate is. Yes, yes, find out if the PM unit is certified. If not, find another PM unit/doctor.

    RichT

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