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View Full Version : How many actually use SRS docs?



rohrer01
07-20-2010, 12:55 PM
I was just wondering about how many people on here actually use SRS docs to do their surgeries. I know there are many, but I would love to hear from those that have used surgeons that don't belong to the "club". The reason I ask is that there is a surgeon here where I live that does adult scoliosis surgery. He is only about an hour away vs. 18 hours for the doc that I will be seeing in August. His specialty is neurosurgery. I didn't even know he existed until my insurance denied my referral and suggested another doctor that is a provider with a competing hospital, how ironic! Well, the provider they suggested doesn't do adult scoli, but they gave me the name of another doctor that does. So I called my insurance company since he is with their competition to see if he was also on my insurance provider list, and low and behold he is! I don't know how many surgeries he does, and that really, REALLY scares me! I would much prefer to see an SRS doc just because it makes me feel safer. I know TiEd's doc isn't an SRS doctor and he did a FABULOUS job! Any other's input would be much appreciated. Thanks in advance. :)

kennedy
07-20-2010, 03:55 PM
I use Dr Gupta at Uc Davis Medical Center He a SRS surgeon.
he the best one i met during the time i need scoliosis surgery. he did my spine surgery on march 10 of this year. he really nice Dr.
He really great with me. i'm under the best hands i can ask for

Pooka1
07-20-2010, 04:00 PM
We didn't use an SRS surgeon. But our surgeon was recommended to us by an SRS surgeon. Does that count? :)

He could have recommended another SRS surgeon as there are others around here but he didn't for some reason. In fact he could have recommended an SRS surgeon at the same hospital we went to but didn't.

Judging by the results on my two kids, I think I can guess the reason he recommended who he did but I don't know the actual reason.

gmw
07-20-2010, 04:20 PM
My surgeon was not an SRS surgeon. Almost 9-weeks post-op, I couldn't be more pleased.

rohrer01
07-20-2010, 06:54 PM
Thanks everyone. You are making me feel better, although I don't know how things will turn out for me with my insurance. The guy "I think" my insurance company will make me see trained at Mayo Clinic in Rochester, MN and is affiliated with Mayo Clinic still. I find it odd that my insurance carrier would recommend or have providers through Mayo, since they are the biggest competition. Oh, well. Who am I to say?:confused: There are a large number of SRS docs in MN. Most of them are at the Twin Cities Spine Center. I've been seen there before by Joe Perra (an SRS doc), but could not return for my follow up with him due to insurance restrictions. I HATE the way insurance companies work!:mad:

Sharon, what kind of correction did your girls get? You sound very pleased with your surgeon. I'm still making the trip to see Dr. Hey. He intrigues me and I will be interested in what he has to say.

JulieBW
07-20-2010, 07:42 PM
I went to see an SRS surgeon and he wasn't helpful at all. This creditential improves your chances, but it doesn't bring a guarantee.

Confusedmom
07-20-2010, 08:01 PM
My doctor is an SRS surgeon, but I still am not ready to take the leap with him, because he only does about 25 cases per year. I want someone who does something like 100 to 150 ADULT scoliosis surgeries per year, and there just aren't enough cases to go around here in Indy. That's why I'm looking at St. Louis or Chicago.

That said, my local surgeon did recommend a practice in Minneapolis for a second opinion. I can look up the name if you like.

Evelyn

Pooka1
07-20-2010, 08:19 PM
Sharon, what kind of correction did your girls get? You sound very pleased with your surgeon. I'm still making the trip to see Dr. Hey. He intrigues me and I will be interested in what he has to say.

Kid 1: 58* and highly rotated down to ~5* and almost no rotation. Back to school full time at 3.5 weeks. Looks and feels normal since a few months out.

Kid 2: 57* and not a lot of rotation down to ~0* with absolutely no rotation but small residual curve below the fusion. Back to school at about 3 weeks full time then took two days off because of her hug injury. Absent the injury, she would have been comfortably back at school full time at 3 weeks. She was ahead of Kid 1 in her recovery at every time point other than after the injury which resolved in a few weeks. Looks and feels normal since a few months out.

The surgeon saved their lives.

Good luck with Hey. We didn't get a consult from him but I think he is amazing.

rohrer01
07-20-2010, 10:24 PM
My doctor is an SRS surgeon, but I still am not ready to take the leap with him, because he only does about 25 cases per year. I want someone who does something like 100 to 150 ADULT scoliosis surgeries per year, and there just aren't enough cases to go around here in Indy. That's why I'm looking at St. Louis or Chicago.

That said, my local surgeon did recommend a practice in Minneapolis for a second opinion. I can look up the name if you like.

Evelyn

Wow, I thought part of the criteria to be a member of the SRS was to have a high percentage of patients/surgeries be related to scoliosis. This really surprises me. The Twin Cities Spine Center in Minneapolis is chalk full of SRS docs. That's where Ogilvie came from. I've been there but am restricted by insurance from going back, not that I would. When my curve was 41* and I was not considered a surgical candidate, I still had some questions about the surgery. When I called to talk to my doctor's nurse and ask a few questions, she was REALLY rude and actually yelled at me. I'm not even going to consider going back to a place that has nurses that treat people like that. Maybe my questions WERE irrelevant at the time, but they certainly are not now. Hopefully you will get a nicer nurse.

rohrer01
07-20-2010, 10:32 PM
Kid 1: 58* and highly rotated down to ~5* and almost no rotation. Back to school full time at 3.5 weeks. Looks and feels normal since a few months out.

Kid 2: 57* and not a lot of rotation down to ~0* with absolutely no rotation but small residual curve below the fusion. Back to school at about 3 weeks full time then took two days off because of her hug injury. Absent the injury, she would have been comfortably back at school full time at 3 weeks. She was ahead of Kid 1 in her recovery at every time point other than after the injury which resolved in a few weeks. Looks and feels normal since a few months out.

The surgeon saved their lives.

Good luck with Hey. We didn't get a consult from him but I think he is amazing.

Those are some amazing results to say the least! I'm glad the girls are doing so well. Thanks for sharing the info. It makes me feel better. I'm also glad for their sake that they were able to get the surgery as teens rather than waiting until they are adults.

I just dread the day I have surgery, and ironically I want it done now. I just want it over with, that's why. I've hated always having this looming over my head my whole life. I was told at 16 I would eventually need it. I just don't know why they didn't go ahead and do it then if they were so convinced that my future held a horrible surgery. Either that or they should have kept their mouths shut about it so I didn't worry the rest of my life away...:rolleyes:

I have heard and seen some really awesome results from non-SRS docs. I will wait and see what my insurance decides to do. To be honest, I'm a little nervous about the idea of having surgery so far from home. I've traveled to NC for surgery before (lots of great docs there!) but it was minor compared to this. I don't want to be far away if problems post-op develop. Although, I have a friend from the mid-west who traveled to CA for her surgery. I think her mom lived there, though. I don't know anyone in NC. :(

Confusedmom
07-21-2010, 03:58 PM
Yes, I think (think--not positive) 25 surgeries per year is the minimum requirement for an SRS doctor. My doc does lots of other spinal surgeries, as well, but around 25 adult scoliosis. He did do his residency in deformity surgery, though.

But my point was really that it's not the membership that matters so much--it's more an issue of how many surgeries they do, what their results are and what kinds of complications they have. (Of course getting factual info about this may be harder than it should be.)

Also, I have heard that it's possible to appeal to get an "out of network" doctor treated as an "in-network" doctor for insurance purposes in certain special cases. I would think as a scoli surgery patient you would have a shot at that. After all, this is not just getting your gallbladder out or a wisdom tooth removed. It might be worth an appeal if there is a particular doctor you want to use.

Evelyn

Back-out
07-21-2010, 04:22 PM
Yes, I think (think--not positive) 25 surgeries per year is the minimum requirement for an SRS doctor. My doc does lots of other spinal surgeries, as well, but around 25 adult scoliosis. He did do his residency in deformity surgery, though.

But my point was really that it's not the membership that matters so much--it's more an issue of how many surgeries they do, what their results are and what kinds of complications they have. (Of course getting factual info about this may be harder than it should be.)

Evelyn

I'm wondering what goes into qualifying for SRS membership. I assume that any doctor able to win membership would do so but this may not be true, for all I know. Maybe there is a certain amount of bowing and scraping that goes into it, or a ton of paperwork all of which may make some highly qualified mavericks not want to go through the process.

Yes, it's a known quantity that they all need to devote at least 20% of their practice to the treatment of scoliosis to qualify.

As you said, I certainly wouldn't want a surgeon who doesn't specialize in deformity surgery and who hasn't got a certain number of years of experience under his belt.

Beyond that, though, we return to my original question - assuming two surgeons both have that minimum amount of experience and on-going practice, what differentiates between members and non-members? I was just reviewing with royi, an Israeli surgeon who (falsely) represented himself as a regular member and we're wondering why he did it. There ARE three Israeli surgeons who are regular SRS members, unlike this one who is a "corresponding fellow" .

I wonder what they have to do not only to be elected to regular membership, but to continue to qualify (There must, I assume, be some requirements to maintain membership - no?).

To decide that it doesn't matter, i.e., to go with a non-SRS member - it seems to me ideally we'd know what it takes to qualify for election. How else can we understand the difference? I.e., why do some excellent surgeons evidently not choose to apply for membership - or whatever is involved in the process of qualifying? Not everyone is a "joiner" but what DOES it mean?

I wonder too if among those who meet the % practice requirements, there may be aspects of some surgeons' practices or educational backgrounds, which disbar them from election? Extreme situations are self-evident, but what about others? I've gotten curious now!

loves to skate
07-21-2010, 04:43 PM
It wasn't until after I had surgery with Dr. Rand that I found out he was an SRS Doctor. I didn't even know of the existence of SRS or of this Forum. He came very highly recommended to me, his examination of me was very thorough, and it was love a first meeting.:D. I probably should have gotten a second opinion, but I didn't because I felt in my gut that this was the Doctor for me. Actually, I had previously seen a Neurosurgeon whose recommendation was to wait for surgery until I was in a wheelchair.:eek:
Sally

Back-out
07-21-2010, 04:57 PM
Actually, I had previously seen a Neurosurgeon whose recommendation was to wait for surgery until I was in a wheelchair.:eek:
Sally

It's just such radical differences that make my blood run cold. Right now we have at least two members undergoing surgery (or scheduling) who were told in no uncertain terms that they did NOT qualify for surgery - in fact, that surgery was apt to make things worst, even if they survived.

Then too there are others (like you) who've had successful surgery after being dissuaded in the strongest terms by other doctors.

It's one thing for there to be a difference of opinion about fusion length, having P/A (or not). It's quite another for such major absolute differences to exist. I am all for "thinking for oneself" and these instances are certainly living proof of the nccessity flying in the face of medical opinion.

What in the WORLD goes into such surgeons coming across with such uniequivocal "advice" (=edicts) without leaving any wiggle room at all - not even recommending getting more opinions?

When are we "doctor shopping" (bad, tantamount to looking for someone to agree with us when, in fact, there is a good reason for doctors' opposing us) ? When are we courageously searching for that brilliant out-lier who IS capable of solving what for others is the insoluble problem of our spine?

titaniumed
07-21-2010, 06:51 PM
One of the things that impressed me about my surgeon was the fact that he studied at Twin Cities for years... he also has extra training in the cervical spine, and he is a fellow. With a total of 19 years of study and training under his belt, meant that he spent 11 years after becoming an MD honing his skills.....

Only my oral surgeon has that amount of training. They work on the head, not just teeth. Extremely scary.....
http://en.wikipedia.org/wiki/Oral_and_maxillofacial_surgery

Any surgeon who spends 10-14 years in specialty training, and at a credible institution, deserves high praise, SRS member or not.

Funny, SRS was started at Twin Cities. I think Dr Menmuir would know about it? I never asked him about it. I didnít think it was necessary since that would be his personal decision. It made no sense to further question the quality of his training.....

Any astronaut that has been to the moon, can fly a plane for me anytime.

Ed

rohrer01
07-21-2010, 06:52 PM
So far I've had one very good neurosurgeon tell me that I needed the surgery, but he was not qualified to do it. He referred my to an SRS doctor that refuses to do it until the curve reaches a 60* magnitude. How absurd is that? I'm already in debilitating pain!

ShariMSU
07-22-2010, 07:20 PM
I did not use an SRS doctor and had not heard of this organization until after my surgery. My surgeon, Dr. Harry Herkowitz, in Michigan, is awesome. He has written text books that medical professionals and students use to perform adult spinal surgeries. He is Chairman of Orthopaedic Surgery at Beaumont Hospital, and on the board for American Orthopaedic Surgery. He only does adult spinal surgery and has spent his career reconstructing adult spines. I'm not sure qualifications that are needed to be an SRS doctor, but from my experience this was not a determining factor for me.
I would highly recommend anyone who lives in or near Michigan checkout Dr. Herkowitz. A truly skilled and compassionate surgeon!

rohrer01
07-25-2010, 09:31 PM
Thanks Shari, it's definitely worth considering. Michigan is a little far, but then again so is North Carolina. I'm just fighting with my insurance company who doesn't have a single provider that can help me. They want me to only see one out of network doc, and he won't help me.:(

twinsmom
07-26-2010, 03:41 PM
My daughters' surgeon is SRS and we ran into mutiple problems. We are going for a consult with a non SRS surgeon with a Peds Fellowship under his belt who works in tandem with another experienced Peds Ortho. Our first Consult was with a SRS and long time Peds Ortho. We saw hiim when we were in the middle of all of this. Insurance was an issue but he also talked down to us and didn't have the medical records I had worked so hard with the hospital to be sent. It was a complete waste of time and money.
However the new doc is friends with our old one. Could be an issue here. We are also having an ID consult as well, just in case we decide to follow through with this new hospital.
It seems as if our old doc is running into problems. My daughter's case is well known now.If she were to go back to him, it would help him out alot. He said he would make her back look beautiful. I am finally at peace with this doc. But I would be very open to the other hospital as well. It is much further away from home so that would make it a hardship. I think a two to three hour consult will help all of us debrief from the awfulness we went through earlier this year. To put the past to rest and have closure with a good understanding of what happened would be so wonderful.

Back-out
07-26-2010, 07:07 PM
So far I've had one very good neurosurgeon tell me that I needed the surgery, but he was not qualified to do it. He referred my to an SRS doctor that refuses to do it until the curve reaches a 60* magnitude. How absurd is that? I'm already in debilitating pain!
rohrer, I am struck today by your painful dilemma (after getting yet MORE - different - Cobb readings) by the fact that you"re unable to get relief because of a few degrees in your Cobb - if I remember right. Let's suppose the angle problem were suddenly resolved - do you know what you would want to do? I'm finding it so hard to compartmentalize decision-making - in my case, to simultaneously plan for surgery ("as if") and on the other, to try to retain objectivity and use the time for decision-making ("as if there were NO pressure"). It's not working.

If you suddenly found this "thresh-hold Cobb" weren't a problem, do you really know what you would choose to do? Are you truly 100% convinced you're ready to say "yes"?

I ask this because a) based on my wacko variable readings, I'm increasingly thinking the Cobb reading is a much more variable quantity than thought (and wondering if you couldn't find a way to "Fudge" a difference of a few degrees - all it would take for you AFAIR. Aren't you under by at most five degrees?).

Also, asking because b) I wonder if you are able to process your wishes (for or against surgery) while focusing on something you see as currently out of your control. Again, relating it to my own experience.

Maybe you've already asked and answered this question in spades - and you KNOW you're rarin' to go, on account of your pain level (which I realize is pure hell).

My "Cobb" is coming out so different (a range of 17 degrees including my local hospital - dubious, perhaps - but also a difference now of 9 degrees between two top facilities)! I am starting to think it's as much or more a function of different Xrays, as the readers (and human factors). (Heh, go to the Xray facilities I've been to and have your readings done all over and you may find your Cobb "qualifies you" - and then some - tomorrow! NOT trying to be frivolous about this - at all)

Just sayin'... :)

rohrer01
07-26-2010, 11:31 PM
Amanda,
I've had two SRS docs measure my cobb angle. They were only off by 1/2*. I am at 46 and 38. I have a painful, progressive curve. I would definitely go for the surgery! I have tried everything. Sadly, today my doc put me back on all the meds I was on, plus one. I'm now on fentanyl, percocet, klonopin, and now gabapentin. I've gotten this weird phenomenon happen to my upper lumbar spine. I get these strange swellings in the skin above the spinous process. The first time it happened, it was only one HUGE swelling, which I attributed to a bug bite. The next time (this weekend) it spanned about 4 or 5 vertebrae (so maybe lower thoracic/upper lumbar region). My doc thinks it may be something to do with the sympathetic nervous system and the nerve pathway that is associated with some of my pain. It was really scary when that happened. I'm to the point that I don't care if I see an SRS doctor or not. I just need someone to help me. PT doesn't help anymore and I can only take so many drugs. I feel like my life is on hold until I can get off the drugs again. Sadly, I may just have to accept the fact that I may NEVER be drug free again. :( I just wished that someone who could actually help would believe me. All the docs that can't help me believe me, why not the ones who can?:confused:

Back-out
07-27-2010, 12:02 AM
I'm so sorry to hear all this, rohrer. I don't know which is the saddest - the business with the pain meds (the ones you weaned yourself from with so much courage), the strange and horrible new affair with the swellings, or just your sad resignation.

I want to point out FWIW that there is a neurosurgeon I'm planning to see (if I can get there - a five hour drive) . He's a Dr. Chris Shaffrey at the U VA - board certified in neurosurgery AND orthopedic surgery, specializing in deformity work

He is reputedly very cautious and very good - I think he does a lot of revisions which makes him even more cautious than otherwise, I'm sure. I don't know if it would work for me within my time line ("Deadline" is starting to have two meanings to me :(). He might be someone for YOU to keep in mind, though, because of his dual certification. His CV and resume are also non pareil! , A very fine human being too. Don't accidentally miss his first name as his brother is a neurosurgeon too!

If anyone deserves a break it's certainly you, dear sweet rohrer! I hope and pray you get it. Don't forget all the stories we've followed here of suffering patients who finally DID find their right doctor and everything fell into place. Don't give up. I do NOT believe you will always be forced to rely on narcotics. I believe this for many reasons, including your attitude towards them but also - why NOT? Why should you not find relief as so many have?

Not yet. No, but your turn will come. It's such a shame you have to wait in pain as you are, but don't let the pain beat your fighting spirit into the ground!!!

Back-out
07-27-2010, 12:08 AM
BTW they are doing work at the Cleveland Clinic I think, on the premise that back pain and arthritis can be caused by an infectious agent. High level antibiotics are used in treatment. Have you had a CBC and sed rate checked recently - not to mention "the usual": ANA and LE tests?

rohrer01
07-27-2010, 12:13 AM
I haven't had anything checked lately. I haven't even had a physical in over two years. It's like "let's add ANOTHER doctor's appointment" to me weekly (or at least it seems so) regimen. :rolleyes:

gmw
07-27-2010, 08:13 PM
Rohrer--your mention of sympathetic nerve pain sparked an interest. i have had an issue with my left foot since surgery. i had a stress fracture in it several years ago and initially thought pain was just settling there. Then it started to swell, turn red, sore and warm to the touch. My PCP gave me a shot of Toradol and it did get a good bit better. My surgeon says he thinks it is a sympathetic response to the nerves severed in my lower abdomen during the surgery and it will get better over time. It is better, the swelling has gone down, but is still pink, warm to the touch and a little sore. Has anyone else heard of this or experienced anything like it?

Glenda

rohrer01
07-27-2010, 11:55 PM
Rohrer--your mention of sympathetic nerve pain sparked an interest. i have had an issue with my left foot since surgery. i had a stress fracture in it several years ago and initially thought pain was just settling there. Then it started to swell, turn red, sore and warm to the touch. My PCP gave me a shot of Toradol and it did get a good bit better. My surgeon says he thinks it is a sympathetic response to the nerves severed in my lower abdomen during the surgery and it will get better over time. It is better, the swelling has gone down, but is still pink, warm to the touch and a little sore. Has anyone else heard of this or experienced anything like it?

Glenda

Yeah, that's strange. It is "below" your surgery. I have upper thoracic and mid-thoracic curves and the swelling is below them. Maybe I am getting some pinched nerves in there. I know this is off topic, but since I started the thread I don't really care. Maybe someone will chime in or I will just start a new thread. I would really like to know if anyone else has experienced this as well.

rohrer01
07-27-2010, 11:58 PM
I want to point out FWIW that there is a neurosurgeon I'm planning to see (if I can get there - a five hour drive) . He's a Dr. Chris Shaffrey at the U VA - board certified in neurosurgery AND orthopedic surgery, specializing in deformity work

He is reputedly very cautious and very good - I think he does a lot of revisions which makes him even more cautious than otherwise, I'm sure.

If he's cautious, he probably won't help me. I'm finding that at every turn, I have to fight, fight, fight with my insurance company as it is AND they have some very good neurosurgeons that can't help me. I'm SURE they don't want me to have surgery because they don't want to PAY for it. So very frustrating!

Back-out
07-28-2010, 12:27 AM
I haven't had anything checked lately. I haven't even had a physical in over two years. It's like "let's add ANOTHER doctor's appointment" to me weekly (or at least it seems so) regimen. :rolleyes:
I know, I know. Poor, rohrer.

The thing abt this lab work, tho, is they're the first things to check to see if you're having an inflammatory response to infection and or/autoimmune processes.

gmw
07-28-2010, 05:10 AM
Yeah, that's strange. It is "below" your surgery. I have upper thoracic and mid-thoracic curves and the swelling is below them. Maybe I am getting some pinched nerves in there. I know this is off topic, but since I started the thread I don't really care. Maybe someone will chime in or I will just start a new thread. I would really like to know if anyone else has experienced this as well.

Rohrer --Glad you started a new thread. Will be interested to hear what folks know about it.

I am so sorry you are having such a hard time getting doctors and your insurance company to take you seriously. I finally had a meltdown in my PCP's office as I felt I wasn't being taken seriously and he was able to get my insurance company to move. Emory Spine Center was in my HMO's network, but they wanted me to stay in Tallahassee. My PCP had to convince the HMO the drs in Tallahassee could not help me.

rohrer01
07-28-2010, 11:30 PM
I'm to the point that I don't care if I have to fly to Timbuktu. I just want someone to help me.:(

Back-out
07-28-2010, 11:45 PM
You WILL find that help, rohrer. Have faith. I am sure you will. Look how Sharon S recently resolved her problems in finding "Dr Right"" for a revision she had been told was flat out impossible!

rohrer01
07-29-2010, 11:22 AM
I know I can find a doctor that can help. It's just getting my insurance to pay for it. I don't have a half a million dollars just laying around.