Guest guest Posted November 23, 2001 Report Share Posted November 23, 2001 I am looking into revision surgery due to a HNP at L5-S1. I had my first spinal surgery by the Dr. Winter in Minnesota. In l974 I had the Harrington rod instrumentation for scoliosis. They fused C7-L4-5, that's right! As far as I know I have the longest fusion in history, unless anyone out there can top that, and I sincerely hope not. I would not wish this disease on anyone. I had a laminectomy in l983 for bone spurs in my thoracic area. In l996 I fell on Mexican tile breaking the lower hook off the rod and scraping my spinal cord causing L3-4 thru S1 damage. I live with chronic lbp with bilateral radicular pain. I had the rod removed in l996. I had to undergo a diskectomy in 2000 with a titanium plate and screws to fuse C3-C7. I now can add chronic migraine H/A's, neck and bilateral upper arm pain to my list of problems. I just found out after weeks of increasing low back pain and bilat leg pain which became just excruciating last weekend, that I have a HNP at L5-S1. I will have yet another MRI done and more nerve studies done next week to find out the extent of the herniation. OH JOY! I am becoming increasingly aware that because of this dreadful scoliosis that I am basically crumbing. I have been disabled for 5 years. I have a wonderful supportive husband and teenage son. I am feeling very sad, angry, and discouraged. I have been researching the revision surgery treatment. I would love to hear from anyone else who has been thru this horrendous sounding surgery, and has had a positive story to pass on. Of course I would love to hear some words of kindness and support as well. You are all very courageous persons out there!! Thank God for this group. Sincerely Londa funinthekeys@... wrote: Elissa, I went to Dr. Errico, New York University Hospital, New York City. He is kind, knowledgable, very experienced and was recommended to me by a retired scoliosis surgeon who said, " you will do no better than this doctor. " His assistant is Rose and she is wonderful too. Their phone number is (212) 263-7182 . I traveled from Florida to see him. Best wishes on all your research. Barbara Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 12, 2008 Report Share Posted January 12, 2008 In a message dated 1/12/08 4:34:22 PM, neumandiane@... writes: > Her Dr is on the list- should I still go for a second opinion? > YES and 3rd opinion, too, especially if surgery is on the horizon. ************** Start the year off right. Easy ways to stay in shape. http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2009 Report Share Posted February 9, 2009 I had mine done that way at Cedars Sinai in Los Angeles, California in 2004 (I think). They are the only place in the US that apparently does them that way. I was a mess before, losing weight and couldn't even drink water. Now I eat everything, bread, meat, salad. I do wash down with water at the end of the meal. IT is a controversial subject here, I'll warn you. There are other surgeons that use this method, but for other things. For years the research has been more in favor, in general, of lap w/ a wrap. My surgeons feel the wrap can cause more problems by being too tight or too loose. Most lap patients require PPI's the rest of their lives. I don't take any and have no reflux. I've stayed in touch w/ several patients that also had the same surgery. They all eat almost normally, drink water after a meal and are about the same as me, no meds etc. All that I know have had similar success. There is one here, that has to take PPI's Deborah, she also has other health issues. My advice... don't be concerned with the method as much as getting to the surgeon that is most feasible for you financially and physically. None of us that post here are experts in surgical techniques. The experience of the surgeon is absolutely the most important. I wouldn't ask a lap surgeon to do it VATS and vice versa. The VATS (videoassisted thorascopically Surgery) method can be more painful at first, it can be a longer hospital stay and you may be on higher level of meds afterward. I'm talking a day's difference in stay, usually, stronger meds for a few days... not a huge difference. If the opinions differ, ask each surgeon why, if you see them again. I'm guessing the VATS surgeon will say it is because VATS doesn't need a wrap. The lap surgeon, they usually fall back on old research. Many years ago, both techniques were tried and lap was found to be better and less hospital time and less technical training was required, because VATS surgeons go through the chest cavity. Go with the surgeon w/ the most experience. Ask if each surgeon can and does do other kinds of surgeries and if so why they think either method is better. At the end, go to the surgeon that does the most successful surgeries at location that is feasible to you physically and financially. http://www.cedars-sinai.edu/1526.html This link explains the use of VATS at Cedars, but for lung surgery. In general, this is the same discussion they have told me and others for using VATS for achalasia. This will give you some information if you speak to the surgeons again. This is the link to their esophageal center... http://www.csmc.edu/5862.html they don't go into the discussion nearly as much... probably a difference in department heads, marketing or something. http://www.csmc.edu/5865.html Again... the surgeon and the experience level are most important. Think of what you do in life, remember the first few times you did it and how much you learned. If you do it all the time or just some of the time now... say even mowing the lawn... are you better at it when you do it only every 3 months or when you do it every day? All lap surgeries aren't the same, you want the surgeon who does the most heller myotomies. > > > Our meeting was with a thoracic surgeon who does *all* the myotomies at > this hospital - so he has experience. He does open myotomies > thoracoscopically. > > He said we had two options with him: open myotomy or lower > oesophagectomy. > > All the reading I've done is related to laparoscopic Heller-dor > operation. > > So this thoracic surgeon is going to refer us to an abdominal surgeon in > another city for a second opinion. > > This will take a few weeks. > > Thoracic surgeon says he will put us in touch with a person who has had > both ops (we are assuming he will choose people who've had successful > outcomes!) which may be helpful. > > I've obviously got more reading to do because I've hardly come across > any thoracoscopic open myotomy research articles - probably because I've > assumed the op would be laparoscopic. > > He says there is no need for a fundoplication or anti-reflux procedure > when the surgery is entered via the thoracic route. > > This is from his own research: > http://ejcts.ctsnetjournals.org/cgi/content/abstract/34/2/423 > <http://ejcts.ctsnetjournals.org/cgi/content/abstract/34/2/423> > > This is from a separate article: > > " Although greater experience is required, the preliminary results of > this study suggest that robot-assisted thoracoscopic Heller Myotomy > without an antireflux procedure may represent an excellent alternative > to laparoscopic myotomy with an antireflux procedure. " > > http://meeting.chestjournal.org/cgi/content/abstract/132/4/660 > <http://meeting.chestjournal.org/cgi/content/abstract/132/4/660> > > Any ideas, please? > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2009 Report Share Posted February 9, 2009 ... I reread your post. Are you confusing open myotomy vs. VATS? You mentioned Video-Assisted, which is minimally invasive, just some holes. (I say JUST because it has been 5 years and we forget the pain)... or do you mean an open myotomy, which is a LONG cut from the rib cage all the way around to the back? That is where they cut you wide open and stick their hands in you? The esophageal removal can be open or minimally invasive also, I think. VATS and lap methods are minimally invasive w/ cameras. It is confusing and the surgeons expect that we understand the differences. My surgeon kept pointing to rib area, and I didn't get it until I woke up from surgery with holes in my ribs, armpit and chest, and back. If you need help there are diagrams here and there. Don't be afraid to ask questions. > > > Our meeting was with a thoracic surgeon who does *all* the myotomies at > this hospital - so he has experience. He does open myotomies > thoracoscopically. > > He said we had two options with him: open myotomy or lower > oesophagectomy. > > All the reading I've done is related to laparoscopic Heller-dor > operation. > > So this thoracic surgeon is going to refer us to an abdominal surgeon in > another city for a second opinion. > > This will take a few weeks. > > Thoracic surgeon says he will put us in touch with a person who has had > both ops (we are assuming he will choose people who've had successful > outcomes!) which may be helpful. > > I've obviously got more reading to do because I've hardly come across > any thoracoscopic open myotomy research articles - probably because I've > assumed the op would be laparoscopic. > > He says there is no need for a fundoplication or anti-reflux procedure > when the surgery is entered via the thoracic route. > > This is from his own research: > http://ejcts.ctsnetjournals.org/cgi/content/abstract/34/2/423 > <http://ejcts.ctsnetjournals.org/cgi/content/abstract/34/2/423> > > This is from a separate article: > > " Although greater experience is required, the preliminary results of > this study suggest that robot-assisted thoracoscopic Heller Myotomy > without an antireflux procedure may represent an excellent alternative > to laparoscopic myotomy with an antireflux procedure. " > > http://meeting.chestjournal.org/cgi/content/abstract/132/4/660 > <http://meeting.chestjournal.org/cgi/content/abstract/132/4/660> > > Any ideas, please? > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2009 Report Share Posted February 10, 2009 Thank you for your help. When I say open myotomy I meant without a wrap, I wasn't refering to the surgical incisions. This thoracic surgeon aims to do the myotomy thoracoscopically - so yes, holes in chest area. The abdominal surgeon we'll see for his viewpoint would also aim to do the op laparoscopically but if they have to open him up, then that's what they'll have to do. Hubby gives his permission to open him up (long scar) if need be and do the ectomy if it comes to that. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2009 Report Share Posted February 10, 2009 Hi Who is your surgeon and where does she/he propose to do the surgery? Is it far from where you live? Good Luck on your 2nd opinion. Keep us all informed. ________________________________ From: melanie32uk <melanie32uk@...> achalasia Sent: Monday, February 9, 2009 5:47:14 PM Subject: 2nd opinion Our meeting was with a thoracic surgeon who does *all* the myotomies at this hospital - so he has experience. He does open myotomies thoracoscopically. He said we had two options with him: open myotomy or lower oesophagectomy. All the reading I've done is related to laparoscopic Heller-dor operation. So this thoracic surgeon is going to refer us to an abdominal surgeon in another city for a second opinion. This will take a few weeks. Thoracic surgeon says he will put us in touch with a person who has had both ops (we are assuming he will choose people who've had successful outcomes!) which may be helpful. I've obviously got more reading to do because I've hardly come across any thoracoscopic open myotomy research articles - probably because I've assumed the op would be laparoscopic. He says there is no need for a fundoplication or anti-reflux procedure when the surgery is entered via the thoracic route. This is from his own research: http://ejcts. ctsnetjournals. org/cgi/content/ abstract/ 34/2/423 <http://ejcts. ctsnetjournals. org/cgi/content/ abstract/ 34/2/423> This is from a separate article: " Although greater experience is required, the preliminary results of this study suggest that robot-assisted thoracoscopic Heller Myotomy without an antireflux procedure may represent an excellent alternative to laparoscopic myotomy with an antireflux procedure. " http://meeting. chestjournal. org/cgi/content/ abstract/ 132/4/660 <http://meeting. chestjournal. org/cgi/content/ abstract/ 132/4/660> Any ideas, please? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2009 Report Share Posted February 10, 2009 Hi , The thoracic surgeon is , Royal Infirmary, Edinburgh. The 2nd opinion surgeon will be in Glasgow which is about 45min - 1 hour drive depending on which part of Glasgow. We don't know who or where exactly the 2nd opinion is yet. Just waiting on an appointment letter..... <christine.hulmes@...> wrote: > > Hi > Who is your surgeon and where does she/he propose to do the surgery? Is it far from where you live? Good Luck on your 2nd opinion. Keep us all informed. > Quote Link to comment Share on other sites More sharing options...
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