Re: Appt w/ Dr. Errico tomorrow/possible fusion to sacrum

[Guest guest]

Hi Jody,

In the Files section on the left side on this website there is a document call

questions for revision surgeons.doc that Cam put together. You should find some

good questions in there and you can modify it to tailor your situation. It is

good to bring someone with you to help remember all the responses or ask if you

can record the conversation. I've done that too. Anyway, the more information

you have the more power you have to make an informed decision. Your on the right

track. C

>

> Hi all,

>

> Wondering if you can help point me towards a list of questions to ask Dr

Errico tomorrow.

>

> I am fused T6-L4 with a Harrington Rod done 26 years ago. I now have a

herniated disc at L4-L5 and L5-S1. I have had no feeling in my foot for weeks as

it is pressing on a nerve. I saw a Neurosurgeon who doesn't see the need to do

an osteotomy or even touch the first procedure. But he does think the last 2

Vertebrae need to be fused to the sacrum to avoid future slipping. I'm nervous

that Dr. Errico is going to recommend a complete revision and fusion all the way

to sacrum as well due to Flatback. Obviously I'd like to avoid that at all

costs. I just want to make sure I have as much info going into this appt. as

possible so I can make an informed decision. Please help!

>

> Thanks,

> Jody

>

[Guest guest]

Hi Jody....

I work for a group of spine surgeons, and am frequently in the room when

patients see their surgeon. I can tell you from experience, that the patients

who come in with a group of potentially unrelated questions, are those who end

up being unhappy and really confused coming out of the appointment. While it's

not a bad idea to look at a list of questions, I actually would only pick a few

of those questions out to focus on. Instead of asking dozens of questions,

listen to what the surgeon says, and ask questions if you need more information

or don't understand what you're being told. Also, be sure to ask how you can

get additional questions answered after you leave the appointment.

Since folks have heard me say this same thing many times, I thought people might

be interested in a new study that I hope to get involved in when I return to

work. The concept is " shared decision making " and involves working with

patients prior to their appointments, to help them focus on the important

questions and goals, in an effort to make the most of their time with the

doctor.

Regards,

linda

>

> Hi all,

>

> Wondering if you can help point me towards a list of questions to ask Dr

Errico tomorrow.

>

> I am fused T6-L4 with a Harrington Rod done 26 years ago. I now have a

herniated disc at L4-L5 and L5-S1. I have had no feeling in my foot for weeks as

it is pressing on a nerve. I saw a Neurosurgeon who doesn't see the need to do

an osteotomy or even touch the first procedure. But he does think the last 2

Vertebrae need to be fused to the sacrum to avoid future slipping. I'm nervous

that Dr. Errico is going to recommend a complete revision and fusion all the way

to sacrum as well due to Flatback. Obviously I'd like to avoid that at all

costs. I just want to make sure I have as much info going into this appt. as

possible so I can make an informed decision. Please help!

>

> Thanks,

> Jody

>

[Guest guest]

Jody,

I am so glad got a chance to answer before I did. She has exactly captured

my thoughts with regard to your question about what you should be asking. I put

my own questions up so that people could understand the depth of questioning

that I developed for my own self, and to let our members know that it is not

wrong to question a doctor in depth about your condition. So understand that my

questions may have actually nothing to do with what you may need to know. It was

a list of questions that I developed for myself over the course of learning

about my condition over the course of a year. I asked the questions with enough

knowledge to ask follow up questions....because that was how I chose to prepare

myself. Taking my list of questions and using them will undoubtedly muddy the

waters for many...and I would not advise it.

Instead....as time is short....sit down and write down the things that you do

understand and are obviously worried about. For instance...you can easily ask a

question relating to the other opinion you have where the surgeon is suggesting

the decompression without extending the fusion. Ask what Errico sees as the pros

and cons of that approach. Ask how often he has handled surgery for post

Harrington patients and what the outcome has been. Ask about outcomes. Ask what

limitations the fusions have brought to his patients. The main thing is to be

able to walk out of the consult understanding the basic differences between how

your case would be handled, and also how you assessed the capabilities of the

doctor, and to some degree, the staff.

Good luck. Please let us know how it goes!

Take Care, Cam

[Guest guest]

Pamela,

I had two opinions of two top surgeons in the northesat, one in Boston, one in

NYC. They both said there was an " interim option " that might be possible.

However, in my case, they both recommended against it because they felt that the

surgery was still quite signifigant and the recovery time comparable...and that

I would probably then be back for fusion to the sacrum within a few years. They

both advised strongly in favor of doing the whole procedure at once.

If you want to read about someone who pursued the alternate option I would read

all Edie Scratchs posts...whom interestingly, had surgeries with DrBendo. I am

sure she would be glad to talk to you after you have done some background

reading...let me know if you want to get in touch with her.

Another member, Kam down in OKC had a consultation with Dr LaGrone in Amarrillo

and asked about doing the decompression first. He was quite adamant that in her

case that had she pursued that option with the local ortho, or neuro...cant

remember...that there would not have been sufficient bone left to later perform

the surgery necessary to correct her flatback and she would have foreclosed the

possibility of getting her flatback addressed ever.

I think that the take away thought you should have is that each of us are

unique, and the " fix " for this surgery is very technical...and letting anyone

perform a quick fix that doesnt have the technical expertise or big picture fix

in mind might make your situation worse. So my advise is to pick your doctor

with care, get a good second opinion, and then decide what is best for you and

your personal health and situation.

And it certainly is a question that I wanted answered in full by both surgeons

before I chose the doctor and the route I would follow!

Take Care, Cam

[Guest guest]

Hi Pamela...

A decompression below a long fusion would only serve to further destabilize the

area, so is not an option.

Regards,

>

>

> I read something in Cam's response...is there an opinion out there on another

approach instead of full fusion. My last two vertebrae are kinda broke down but

if I could get decompression without the whole shabang of rotating my saggital

planes and mesh cages and fusion and especially a full year in recovery I would

opt for that...has anyone had decompression surgery? Is it simple?

>

> Pamela

>

>

>

>

>

>

> From: cammaltby@...

> Date: Thu, 17 Mar 2011 18:36:40 +0000

> Subject: [ ] Re: Appt w/ Dr. Errico tomorrow/possible fusion to

sacrum

>

>

>

>

>

>

> Jody,

>

> I am so glad got a chance to answer before I did. She has exactly

captured my thoughts with regard to your question about what you should be

asking. I put my own questions up so that people could understand the depth of

questioning that I developed for my own self, and to let our members know that

it is not wrong to question a doctor in depth about your condition. So

understand that my questions may have actually nothing to do with what you may

need to know. It was a list of questions that I developed for myself over the

course of learning about my condition over the course of a year. I asked the

questions with enough knowledge to ask follow up questions....because that was

how I chose to prepare myself. Taking my list of questions and using them will

undoubtedly muddy the waters for many...and I would not advise it.

>

> Instead....as time is short....sit down and write down the things that you do

understand and are obviously worried about. For instance...you can easily ask a

question relating to the other opinion you have where the surgeon is suggesting

the decompression without extending the fusion. Ask what Errico sees as the pros

and cons of that approach. Ask how often he has handled surgery for post

Harrington patients and what the outcome has been. Ask about outcomes. Ask what

limitations the fusions have brought to his patients. The main thing is to be

able to walk out of the consult understanding the basic differences between how

your case would be handled, and also how you assessed the capabilities of the

doctor, and to some degree, the staff.

>

> Good luck. Please let us know how it goes!

> Take Care, Cam

>

[Guest guest]

Hi Pamela,

Unfortunately, there is nothing simple about our backs.

I've been part of this group for several years, from its inception,

and from what I've read here over the years, just getting a

decompression is nothing more than a short term stop gap measure on

the way to a full revision. I'm not saying that everyone who

eventually had a full revision was sorry they bothered with a

decompression or short fusion first, but you should be aware that it

is not the final surgery to get the lifestyle you want. Of course, I

am just a patient, so discuss this with your doctor. If your doctor

truly believes that decompression alone will solve your problems, I

strongly suggest you get a second opinion from a surgeon who is more

familiar with Flatback and patients with long fusions and a Harrington

Rod.

Bonnie