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mashkine
01-16-2013, 10:47 AM
Hi there!
I'm 31, have had scoliosis since I was a teenager. When I was diagnosed at 14 I already had a double curve, with over 40 in the thoracic. At the time we went for the Copes brace, which I wore religiously in high school and even a bit into college years. In retrospect I really wish I was braced with a different brace like Cheneau, because the Copes brace did not keep my spine from worsening. By the time I was out of college I had 55T, 46L, but a surgeon did not recommend surgery. I hardly thought about my back in my 20s, traveling a lot, keeping fairly active, going on hiking trips, including two-week trekking in the mountains with a heavy backpack (which may have made my lumbar worse but it was beautiful..). Over the past year or so, my low back has been giving me increasing trouble, so I went to take new x-rays and see another surgeon. My thoracic was at 57 and my lumbar at 53 - a perfect S. So the curves did not progress tremendously over the decade, despite the fact that I was doing pretty much nothing for my back. The new surgeon - he operates on adult patients, mostly with degrees of 70 and over, really surprised me by saying he still does not recommend surgery, and that he is glad that I never had it done. This partly was a relief because I dread having the operation performed - I have had nightmares and panic attacks about it - but also made me extremely confused. With all this emotional stress after seeing the doctor, my back has been acting up even more, and I am obsessed with it, noticing the little aches that I probably ignored in the past. One night I could not sleep because I felt that my leg is going numb - which it wasn't.
Are there people out there with curves like mine and trying to treat their condition in some way that is not surgery? I am ready to commit the time and money for therapy that will treat the pain symptoms (which at least in part are psychological, I think), and I would sure love to keep my curve from progressing further. If I pull this off, I am certain I could live with my scoliosis and not have the operation - the appearance does not bother me as I am perfectly centered, and I am not very self-conscious about it, maybe a little bit when I am at the beach, but that's it.
I am planning to start massage treatments, and Schroth treatments, just to try them out. I really don't want to lose hope that surgery can be avoided, especially after a surgeon advised not to have it done, but reading this forum makes me very pessimistic.

Cheers,
Maria

jrnyc
01-16-2013, 06:03 PM
Maria, did the doctor say WHY it was a good thing that you
didn't have the surgery....? specifically why?
what levels were supposed to need fusing...??

jess

jackieg412
01-16-2013, 06:03 PM
Hi Maria,
I think you have a great attitude. Yes do all things that may help. You have nothing to loose. Be as conservitive as you can because surgery can really change things. There are a ton of possibilities. New things are always happening and you are young yet.Kepp a watch as you are!

Pooka1
01-16-2013, 08:01 PM
I really don't want to lose hope that surgery can be avoided, especially after a surgeon advised not to have it done, but reading this forum makes me very pessimistic.

Hi Maria.

I can't imagine that there is anything on this forum that would trump the opinion of an experienced orthopedic surgeon specializing in scoliosis. If you doubt his opinion, get another opinion from another experienced scoliosis guy, not an online forum of lay people. People only know their own cases and even then only on a subjective level. Only a surgeon can tell you about your case on an objective level.

You can have hope to avoid surgery because you have made it this far and you have an opinion from a surgeon that you don't need surgery now. Your are progressing at a very slow pace. We have had other adults here make it to about 50* and hang there, sometimes for decades (gin and tonic therapy). You may not progress much more or only very slowly. I am guessing that is why the opinion was you don't need surgery now but I can't know what the actual reason was.

As far as I know, surgeons refer adults to PT for pain because it has a chance of working for that purpose. You can hope it will work for your pain... that is not crazy.

Good luck.

LindaRacine
01-16-2013, 09:00 PM
Hi...

I totally agree that you should try to avoid surgery if possible. You might want to check out http://www.yogaforscoliosis.com. It would be a good place to start.

Regards,
Linda

mashkine
01-17-2013, 01:47 AM
Maria, did the doctor say WHY it was a good thing that you
didn't have the surgery....? specifically why?
what levels were supposed to need fusing...??

jess I was shocked to hear it when I met him - he said, basically - you are very well aligned (i.e. pelvis/neck are centered due to the symmetry of the "S", you look great, you might have problems when you have children or when you reach 60, which is when you can have a DNA test to see whether only the thoracic can be fused while the lumbar can straighten by itself. Until then I didn't know about such technology. Until then, he said basically, throw your x-rays in the closet and lead a normal life. Due to my confusion I later called the doctor's nurse, who said that the advise was due to the risk of the operation, that they don't do it for pain relief but when the condition threatens vital organs like heart and lungs, or when the pain goes down to the legs. Most likely both my low back and the thoracic would be fused, i.e. no flexibility at all - which is no picnic...

I am very flexible now, I do Iyengar Yoga and am more flexible than the average, I would say, of any class - most scoliosis people are, as far as I know, hyperflexible, and maybe that's part of the reason for the problem. I wish the research and science would be more advanced on this disease - it seems like the surgery is so "nuts and bolts" - pretty unchanged since 50 years ago!

mashkine
01-17-2013, 01:56 AM
Hi Maria.

I can't imagine that there is anything on this forum that would trump the opinion of an experienced orthopedic surgeon specializing in scoliosis. If you doubt his opinion, get another opinion from another experienced scoliosis guy, not an online forum of lay people. People only know their own cases and even then only on a subjective level. Only a surgeon can tell you about your case on an objective level.

You can have hope to avoid surgery because you have made it this far and you have an opinion from a surgeon that you don't need surgery now. Your are progressing at a very slow pace. We have had other adults here make it to about 50* and hang there, sometimes for decades (gin and tonic therapy). You may not progress much more or only very slowly. I am guessing that is why the opinion was you don't need surgery now but I can't know what the actual reason was.

As far as I know, surgeons refer adults to PT for pain because it has a chance of working for that purpose. You can hope it will work for your pain... that is not crazy.

Good luck.

A pediatric orthopedist looked at me ten years ago, but the latest doctor was technically a neurosurgeon, which maybe can explain his hesitation to jump to surgery on a relatively healthy young patient. Reading this forum I see a lot of people in their 20s who go ahead with it despite having no pain and with curves similar to mine - that always surprised me. I trust the doctor I saw after speaking with his nurse later who explained to me more in detail why surgery is not recommended in my case. A big concern right now is drastic deterioration after childbirth - I don't have kids yet, but I hope to have at least one in the next five years. I also live outside the US now, and don't have American insurance - also a big issue, obviously, because if I have surgery I would have to quit my job move to the US and start a new life, because surgery where I am is not as advanced and I wouldn't want to up the risk of complications.

mashkine
01-17-2013, 02:00 AM
Hi...

I totally agree that you should try to avoid surgery if possible. You might want to check out http://www.yogaforscoliosis.com. It would be a good place to start.

Regards,
Linda

Thanks Linda. I have this woman's CD, which I didnt really like because it was too slow and rudimentary - I have been doing Iyengar yoga for a couple of years now and it does seem to help with the pain. It's just so confusing as to what works and what makes the curvature worse. I know that Schroth does not advise many of the twists and backbends common in yoga practice (I have yet to try Schroth, but I do have their book on three-dimentional treatment). It's really a shame no real studies have been done on how adults with severe curves fare in later life, and what treatments are recommended.

Pooka1
01-17-2013, 06:38 AM
when you reach 60, which is when you can have a DNA test to see whether only the thoracic can be fused while the lumbar can straighten by itself. Until then I didn't know about such technology.

Are you sure you got this right? Whether or not the lumbar is structural and therefore needs to be fused is determined by bending radiographs as far as I know. Nobody has found the gene or genes for whether the lumbar in an apparent double major curve is structural. There is something called a false double major where it looks like two structural curves but the lumbar bends out and so it isn't structural. My one daughter had this and indeed was fused only through the thorax and her lumbar corrected on its own to match the corrected T curve. Not structural. There is a paper showing that all the patients in a small study who had selective T fusion of a false double were stable about 20 years out. There has also been some work on just fusing the T curve when it is known the lumbar is structural because surgeons try to avoid fusing into the lumbar. Because you are young, a surgeon might opt for this if you need surgery or only fuse part of your lumbar.

The only genetic test associated with scoliosis besides the syndromic cases like Marfans or CMT is Scoliscore to my knowledge which is a test for certain kids to see whether or not they will be above or below 40* at maturity.


I am very flexible now, I do Iyengar Yoga and am more flexible than the average, I would say, of any class - most scoliosis people are, as far as I know, hyperflexible, and maybe that's part of the reason for the problem. I wish the research and science would be more advanced on this disease - it seems like the surgery is so "nuts and bolts" - pretty unchanged since 50 years ago!

Both my daughters have some connective tissue issue that makes them hypermobile. I agree it is a fairly common trait among folks with scoliosis.

Pooka1
01-17-2013, 06:44 AM
A pediatric orthopedist looked at me ten years ago, but the latest doctor was technically a neurosurgeon, which maybe can explain his hesitation to jump to surgery on a relatively healthy young patient. Reading this forum I see a lot of people in their 20s who go ahead with it despite having no pain and with curves similar to mine - that always surprised me. I trust the doctor I saw after speaking with his nurse later who explained to me more in detail why surgery is not recommended in my case. A big concern right now is drastic deterioration after childbirth - I don't have kids yet, but I hope to have at least one in the next five years. I also live outside the US now, and don't have American insurance - also a big issue, obviously, because if I have surgery I would have to quit my job move to the US and start a new life, because surgery where I am is not as advanced and I wouldn't want to up the risk of complications.

You might want to get a consult with a Scoliosis Research Society guy in addition to the neurosurgeon.

http://www.srs.org/find/

Some surgeons will operate with the thought of tying to save levels in the lumbar. But if the entire lumbar is in a structural curve then I guess the only indication to operate would be unremitting nerve pain or other pain that is not amenable to PT. Only an experienced orthopedic surgeon specializing in scoliosis can say. They are the only real game in town.

mashkine
01-17-2013, 10:20 AM
Are you sure you got this right? Whether or not the lumbar is structural and therefore needs to be fused is determined by bending radiographs as far as I know. Nobody has found the gene or genes for whether the lumbar in an apparent double major curve is structural. There is something called a false double major where it looks like two structural curves but the lumbar bends out and so it isn't structural. My one daughter had this and indeed was fused only through the thorax and her lumbar corrected on its own to match the corrected T curve. Not structural. .

I'm pretty sure he meant DNA as he was talking about a saliva swab. But since I'm not getting surgery right now, I didn't really press him on it. I did bending x-rays a long time ago, when I was still in school, and I don't remember what they show. That is pretty cool that the lumbar could correct by itself in your daughter! I doubt that it would in an adult like myself though, and being fused to the pelvis scares me more than anything - exponentially more limiting!

The doc is not on the srs list you gave, but I know he does scoliosis surgery, and I have no doubt in his credentials due to his place of work and the way he was recommended to me. I notice the SRS corporate supporters are all companies making surgical equipment. Not to get into any can of worms, but I'd prefer a more distanced approach at a point where I am not sure whether surgery is the answer, rather than see a trigger-happy ortho surgeon. When I do feel like I'm ready for surgery, I will pick the surgeon from the list. They might be the only game in town for surgery, but they might also be a bit more willing to do it, even when it is not 100 percent needed.

Pooka1
01-17-2013, 10:46 AM
I'm pretty sure he meant DNA as he was talking about a saliva swab. But since I'm not getting surgery right now, I didn't really press him on it.

That sounds like Scoliscore which is only given to young kids to determine if they will be above or below 40* at maturity. The answer with you is known. It might be he is asking you to submit DNA to help calibrate the test since your outcome is known. No need to do the test. This test has nothing to do with whether or not a lumbar curve is structural.


I did bending x-rays a long time ago, when I was still in school, and I don't remember what they show. That is pretty cool that the lumbar could correct by itself in your daughter! I doubt that it would in an adult like myself though, and being fused to the pelvis scares me more than anything - exponentially more limiting!

In both my daughters, the lumbar corrected itself to match the corrected T curve. Two-of-Two's T curve was corrected to ~25* and that's what the lumbar went to. Her twin, One-of-Two's T curve was corrected to single digits and her lumbar corrected itself to single digits. It is my understanding the lumbar does this in adults also if the lumbar is not structural and if the spine has not stiffened.


The doc is not on the srs list you gave, but I know he does scoliosis surgery, and I have no doubt in his credentials due to his place of work and the way he was recommended to me. I notice the SRS corporate supporters are all companies making surgical equipment. Not to get into any can of worms, but I'd prefer a more distanced approach at a point where I am not sure whether surgery is the answer, rather than see a trigger-happy ortho surgeon. When I do feel like I'm ready for surgery, I will pick the surgeon from the list. They might be the only game in town for surgery, but they might also be a bit more willing to do it, even when it is not 100 percent needed.

What is the evidence that "trigger happy" ortho surgeons exist? Maybe it is pure mythology.

mashkine
01-17-2013, 11:15 AM
What is the evidence that "trigger happy" ortho surgeons exist? Maybe it is pure mythology.

Logically, surgeons like to increase the number of surgeries performed - that does make them more experienced and attractive doctors. But even a successful fusion is a fusion, which the patient, not the doctor, has to live with for the rest of their life.
I'm sure the vast majority of surgeons in the US are ethical and cautious, but right now I work in a country where fusion is also performed, and websites for some respected scoliosis treatment centers (performing the same type of fusion as in the US) basically say that you must operate once you are past 40 degrees, otherwise you won't live to be 40. I'm not joking! So the tendency to be trigger-happy is out there, hopefully in the US there are enough checks and balances of the medical community that prevent such misinformation.
Anyway, I don't want this to turn into a long argument about surgical ethics, it's not why I posted in the first place. Everyone who responded has been incredibly helpful, thank you.

jrnyc
01-17-2013, 03:28 PM
i do not know what they do in whatever country you are living
in right now....
i do know that in the States, i have never seen a "trigger happy"
surgeon in the field of scoliosis....
i have curves of 42T and 70L....but the decision, as in
every patient, is MINE....and MINE ALONE!!
no surgeon ever tried to pressure me....
they have lots of patients...they do not need to advertise
or talk patients into surgery....
i am not sure where you got that idea...
i see forum members trying to give you the advice you
requested, but your posts sound...resistant and almost
argumentative...
i did not read anyone saying you must have the surgery....
they seem to be trying to give you their experiences....
and perhaps save you from some grief...

i am not trying to sound harsh...
just telling you the way your posts are reading to me...
and no surgeon on the SRS list tried to talk me into any
particular materials in the surgery they suggested to me.
i thought you requested advice and benefit of others' experience?
jess

mashkine
01-17-2013, 07:28 PM
i do not know what they do in whatever country you are living
in right now....
i do know that in the States, i have never seen a "trigger happy"
surgeon in the field of scoliosis....
i have curves of 42T and 70L....but the decision, as in
every patient, is MINE....and MINE ALONE!!
no surgeon ever tried to pressure me....
they have lots of patients...they do not need to advertise
or talk patients into surgery....
i am not sure where you got that idea...
i see forum members trying to give you the advice you
requested, but your posts sound...resistant and almost
argumentative...
i did not read anyone saying you must have the surgery....
they seem to be trying to give you their experiences....
and perhaps save you from some grief...

i am not trying to sound harsh...
just telling you the way your posts are reading to me...
and no surgeon on the SRS list tried to talk me into any
particular materials in the surgery they suggested to me.
i thought you requested advice and benefit of others' experience?


I expressed my gratitude to everyone who replied. Sorry if you were offended by something I wrote. How do you cope with your 70 degrees? Do you do exercises or massage, when your back bothers you?

jrnyc
01-17-2013, 08:05 PM
no...not offended...and i wrote it before your last post...
but i just meant that it seems that you didn't want to open
your mind to what others have experienced and tried to offer
you...of course you have the right to believe what you wish...
and it can be so tough to accept any of it...
tough to hear about, tough to live with at times...
just my opinion...i did not mean to be hard on you...
sorry if it came off that way....

i am sending you a PM to answer your question....

jess...& Sparky

hdugger
01-20-2013, 12:07 PM
There is definitely a difference between surgeons likelihood of operating - some, like Dr. Hey, seem to usually recommend immediate surgery and others, like my son's doctor, seem to prefer to delay surgery. I think it's a difference in deciding where the biggest risk lies - there's a fundamental argument about whether to perform surgery as soon as possible in order to prevent further curving, or whether to delay it in order to delay the onset of degenerative problems brought on by the surgery. Some doctors fall on one side, and some fall on the other.

My son is likewise young (25) and healthy with little pain but a largish (60 degree) curve. His doctor told us to just continue follow-up and not do surgery unless there was a serious issue (progression or pain). He also suggested 'around 60' as a serious re-evaluation time.

If your curve isn't progressing, there's no reason to rush into surgery. The surgery is really just meant to stop the progression and/or to address severe pain.

LindaRacine
01-20-2013, 12:36 PM
Good post Gayle.

Mashkine... If there was a genetic test other than ScoliScore for scoliosis, I'm about 99.9% certain that I would have heard of it.

--Linda

titaniumed
01-20-2013, 02:23 PM
Hi Maria

Since I have been posting here, you are the 1st Copes patient to post. I also went to Baton Rouge and had him make a brace for me in his early days, for skiing. I was afraid that a devastating skiing crash would be the end..... Art went to jail for insurance fraud a few years back.

We have a similar story, with similar curves and I delayed for 34 years, and made it to age 49 with twin 70’s. My pain could no longer be controlled and lumbar degeneration became an issue.

I never met any surgeon that was gung ho, at least in my case. It was pretty much the same story as you, just hang as long as you can, and wait until you cant take the pain anymore...I had a few Chiros that kept me going, it was effective for pain for many years.....

If you still have your de-rotation cliffs, are you using them? Remember those?

I am wondering where you live? Do you have access to a warm ocean?

We are glad you posted!

Ed

mashkine
01-20-2013, 03:10 PM
Hi Maria

Since I have been posting here, you are the 1st Copes patient to post. I also went to Baton Rouge and had him make a brace for me in his early days, for skiing. I was afraid that a devastating skiing crash would be the end..... Art went to jail for insurance fraud a few years back.

Ed

Hi Ed. I salute another Copes survivor! Copes really made my life miserable when I was a teenager. We went to him after a pediatric orthopedist told me it was too late to brace a 14-year old. He was a nasty guy, even though I can't say with certainty that his brace did nothing- maybe I'd be at 70 degrees now without it? Plus it taught me a lot of discipline-all those other aspects of the treatment took so much time and required good planning skills... I've read that he's in jail, though I understand it's for insurance fraud rather than being a "quack" - not sure if such a charge exists anyway )
How fast did your curves progress in adulthood? Are you pleased with the surgery? I myself am terrified of being fused...
I have a lot of Copes gear left over, but it's sitting at my parents house in the US while I live far away now, in Russia - I'm an international journalist. So, to answer your question about a warm ocean... I do take a lot of baths though - they really seem to relax my muscles.
I'm surprised there are so few Copes ex-patients, he seemed to have quite a business going at the time.

mashkine
01-20-2013, 03:26 PM
There is definitely a difference between surgeons likelihood of operating - some, like Dr. Hey, seem to usually recommend immediate surgery and others, like my son's doctor, seem to prefer to delay surgery. I think it's a difference in deciding where the biggest risk lies - there's a fundamental argument about whether to perform surgery as soon as possible in order to prevent further curving, or whether to delay it in order to delay the onset of degenerative problems brought on by the surgery. Some doctors fall on one side, and some fall on the other.

My son is likewise young (25) and healthy with little pain but a largish (60 degree) curve. His doctor told us to just continue follow-up and not do surgery unless there was a serious issue (progression or pain). He also suggested 'around 60' as a serious re-evaluation time.

If your curve isn't progressing, there's no reason to rush into surgery. The surgery is really just meant to stop the progression and/or to address severe pain.

What is your son leaning toward? I'm just wondering how people handle this ticking time bomb. I read a lot about younger adults in their 20s-30s with degrees around 60 with no pain who go ahead with the surgery, it really surprises me, especially women who have to fuse the lumbar - what if you have a child and the equipment down there goes bust during labor?
Anyway, that's clearly not going to happen to your son :) Is he doing anything besides the ubiquitous "waiting and watching"?
I've decided, I think, that I'll hold off as long as possible, and do the max work I can right now to delay progression, anything to avoid fusion for as long as I can. I cannot imagine being unable to flex my spine... It seems like surgery technology has advanced enough that even people in their 70s can have surgery and achieve decent correction, so I'm definitely going to try to delay it. I don't have much pain now, not the kind of pain that makes me non-functional anyway. I only take advil once on a blue moon, otherwise I go swim hard 2-3 km in the pool or hang head down from my bed, that seems to help with the low back pain.

titaniumed
01-20-2013, 05:23 PM
I was 50T 50L when I was diagnosed in 1974. By the time I visited Copes, I was 58T, 66L in 1991. I was 70T, 70L in 2007. I progressed slowly as an adult as you can see.

I started having major pain “events” in 2000. In Jan 2002, the sciatica kicked in...Man-o-man! This was after a series of high ski jumps.
CT’s were shot, 4 herniations were verified, and my non-scoli ortho shook his head for 2 minutes speechless. He had me pointed in the direction of USCF since there was no scoli qualified in Reno at that time. I took Celebrex and recovered by swimming in the ocean in Hawaii.

The battles continued on and off with the sciatica and I set massage and hot soak records.....By 2007, the pain was out of control. Degeneration had run its course, and the alarm bells were ringing LOUD. DDD does lead to vertebral end plate damage, it doesn’t bleed, and that had to be cut out. Without blood, its all downhill, before and after....

I always knew that I would be operated on. Everyone including my Chiro’s told me this, it was pretty much a given and prepared for all those years. I called down to the ortho’s office, he retired and was replaced by my current surgeon. We talked for a few years and in Oct 2007, I made the decision. I ran out of time. He did ask why I waited so long? I should have had surgery many years ago, now it made things quite difficult. I had to have an extensive anterior work done and they ground out good portions of my lower spine.

I was told that it would feel like I was run over by a train.....and they kept me out for a few days after in ICU. Of course, you don’t feel a thing when you are out, its when they wake you up, and the weaning process starts from then on. All the “old” aches and pains were replaced by surgical pain which you eventually heal from. My recovery took 1 year to get to 90%. I was off work for 18 months....

I am pretty much pain free now....and had forgotten what being pain free was like. I will have a gripping feeling in the thoracic spine when winter storms enter the area, when the atmospheric pressure drops. Its not really pain, it’s a tight feeling......its common.

I would love to hear what they do about scoliosis in Russia....We have Irene who came over to the US years ago, but am interested in what you have to say about any methods used, and so forth. Do you have to travel to a large city? How many scoli surgeons are over there? What awareness or Russian forums are there? Do they have Chiro’s over there? Etc.....What area or city are you in? Do you hum the theme from Dr Shivago? (smiley face)

I survived a long period living with scoliosis....pain is very subjective, we build up high tolerances and have trouble knowing and remembering what being pain free is like. I least I forgot....Surgery saved my life. I wouldn’t be here without it.
Ed

jrnyc
01-20-2013, 07:05 PM
i would just venture a guess that it is the syrinx and not the kyphosis
that has surgeons hesitating..
others with scoli and kyphosis...hyper and hypo...are posted all over
forum as having no shortage of surgeons volunteering to operate on them...
me included...

i think waiting is a risk...but well understandable...
there are risks in surgery and in not having it, as someone else
pointed out,....
but i do know that healing for an older person is NOT as easy as for
a younger person...and that has been well documented by many...
doctors and patients alike....i am not saying it isn't possible...
just more difficult..and generally slower.

jess

SpineTime
01-20-2013, 09:22 PM
I was 50T 50L when I was diagnosed in 1974. By the time I visited Copes, I was 58T, 66L in 1991. I was 70T, 70L in 2007.

I survived a long period living with scoliosis....pain is very subjective, we build up high tolerances and have trouble knowing and remembering what being pain free is like. I least I forgot....Surgery saved my life. I wouldn’t be here without it.
Ed

Hi Ed, maybe you've talked about it before and I missed it, but can I ask how surgery saved your life? Were you having heart/lung issues because of your curves, or something like that? My gosh.

Lisa

mashkine
01-21-2013, 06:26 AM
I would love to hear what they do about scoliosis in Russia....We have Irene who came over to the US years ago, but am interested in what you have to say about any methods used, and so forth. Do you have to travel to a large city? How many scoli surgeons are over there? What awareness or Russian forums are there? Do they have Chiro’s over there? Etc.....What area or city are you in? Do you hum the theme from Dr Shivago? (smiley face)
Ed

I think here the approach is more or less the same, with more attention given to physical therapy. Good surgeons use the same hardware as American ones, however there are some local products are not as good. Adolescents used to have these horrible scoliosis camps as well - like summer camps of sorts but for kids with deformed spines - I would guess that there is even more exercise, massage, swimming, etc at those, but I never really looked into it, and maybe they don't exist any more. Most old school doctors here have spectacularly nasty attitudes, both toward parents and kids, and often scare people, but that can be said about the entire public medical sphere here..
Also I think the medical world here is not as drastically separated from the world of alternative medicine - I know at least two MDs who finished top universities, one an orthopedist and another neurologist, who have gone into "alternative" medicine later in life, went to China to learn their techniques, etc. Basically, unlike in the US where there are chiropractic schools separate from medical schools, here these doctors come from one community and go to the same schools, and then branch out. But there are no chiropractors here in the American sense, there are the so-called "manual therapists" who do somewhat similar adjustments, but work more with muscle tissues.