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When does it become necessary to go out of state for surgery?

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  • When does it become necessary to go out of state for surgery?

    It has been brought up more than once in this forum that a severe adult scoliosis case requires treatment by not just a "good" surgeon, but a "great" surgeon. Just how many great surgeons are there? I think we would all agree that Dr. Boachie is a great surgeon, but as much as many of us would like to schedule our surgeries with this surgeon, it's just not feasible. Thus far I have seen four surgeons in the Chicagoland area and one out of state. Of the surgeons I have seen in Chicago, two voluntarily told me that "so and so" is excellent. However, "so and so" does not recommend surgery unless you can no longer function.

    At my advanced age and if at all possible, I want to avoid the serious complications that I'm hearing about that others have experienced and I truly believe that the right surgeon and medical center can make all the difference in your surgical outcome. Does that mean that it may be necessary to look out of state?

    Chris

  • #2
    Hi Chris...

    While surgeons of Dr. Boachie's level of expertise are the very best, there are an awful lot of great surgeons all over the U.S. I would personally exhaust every single local resource before considering going out of state. There are never any guarantees that just because you choose the very best surgeon, that you won't have complications. In fact, if you're at an advanced age, one or two minor complications are almost a given. Dealing with those complications when you're away from home can be very daunting.

    If I were in your shoes, I don't think I'd consider going outside of the area.

    Regards,
    Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

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    • #3
      Chris -- I wrestled with this issue myself, as Dr. Boachie's office is about a two-hour drive from my home. He said he would hook me up with a local specialist for my first post-op appointment and have x-rays sent to him, so that will help with the distance factor. That's assuming, of course, that I'm basically doing okay.....

      I only went to one specialist in my area and didn't like him. There are a couple of local names I could have pursued but I'm so bloody scared of this surgery I only trust Boachie at this point....regardless of the inconvenience of an out-of-town operation.
      Chris
      A/P fusion on June 19, 2007 at age 52; T10-L5
      Pre-op thoracolumbar curve: 70 degrees
      Post-op curve: 12 degrees
      Dr. Boachie-adjei, HSS, New York

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      • #4
        Hi Chris,

        I didn't trust anyone in my immediate area either. I did a search within a 300 mile radius of where I am located. And I wanted a doctor that did the surgery often.

        After several doctors, I finally found one at the Cleveland Clinic. It's was worth the effort and the driving time.

        Good luck in your search,
        Shari

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        • #5
          Thanks for your responses.

          The out-of-state doctor is the one who recommends only posterior surgery for me in one operation. In fact, he is performing fewer and fewer anteriors. The doctors in Chicago recommend both front and back surgeries in two operations. I think it's a given that at my age anterior surgery presents more risk for complications. So I feel that if I want to avoid the added risk, I have no choice but to go out of state for surgery.

          Chris

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          • #6
            Chris,
            Since you're in the Chicago area, you may want to consider Dr. Tribus at the Spine Clinic (UW Hospital) in Madison, WI. He was a John Hopkin's Fellow and studied under Dr. Bradford at UCSF (a surgeon who apparently has a very good reputation). Just an idea.
            Best,
            Anya
            "You must be the change you want to see in the world."

            Previously 55 degree thoracolumbar curve
            Surgery June 5, 2007 - Dr. Clifford Tribus, University of Wisconsin Hospital
            19 degrees post-op!

            http://abhbarry.blogspot.com

            Comment


            • #7
              Hi Chris...

              I think that many surgeons feel that both anterior and posterior surgery are necessary for older individuals with scoliosis because 1) the additional surface of the anterior part of the spine ensures a better fusion (less non-fusions) and 2) it's hard to get much correction from posterior only because of the stiffness of the spine in older individuals. If you feel really strongly that you want only posterior surgery, you may want to discuss these issues with the surgeons you interview.

              Regards,
              Linda
              Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
              ---------------------------------------------------------------------------------------------------------------------------------------------------
              Surgery 2/10/93 A/P fusion T4-L3
              Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

              Comment


              • #8
                Chris, as I said in another reply, I HAVE to go out of state. The one spinal surgeon in Hawaii, I was not thrilled with and didn't feel he had enough experience in older adult scoliosis surgery, and being 57, I'm not going to risk it. Since I'm with Kaiser, I'm ending up in Oakland, and really feel great with Dr. Gorek. I've been in touch with one of his "older" patients who says she is really happy with her surgery by him. As Linda says, he recommends both anterior and posterior for the best correction and results. And he does the 2 surgeries together. It could take up to 12 hours they say! I'd rather get it all done at once and have the best possible correction. I'll be out anyway! So we'll see!
                Berta in Hawaii

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                • #9
                  Chris,

                  I know what you mean about finding a great surgeon vs a good one, it seems that sometimes we can get confused and wonder what the difference is, since it is often brought up on the forum. Before having my revision last year, I actually started to second guess myself so much and even my parents told me that if I wanted to, to go to NYC to see Dr.Boachie. That was a bit nuts on our part b/c my ortho is a very good and experienced one, and I'm Canadian therefore would have had to pay for surgery

                  I can think of at least 4-5 people from this forum who had the fastest and smoothest recoveries and are pain free for the most part who didn't get surgery from Boachie, so that should mean something.

                  Maybe you could go see him just to see how much he would fuse and what his opinion is, to compare with others.

                  It's a tough decision, take your time and good luck.
                  35 y/old female from Montreal, Canada
                  Diagnosed with scoliosis(double major) at age 12, wore Boston brace 4 years at least 23 hours a day-curve progressed
                  Surgery age 26 for 60 degree curve in Oct. 1997 by Dr.Max Aebi-fused T5 to L2
                  Surgery age 28 for a hook removal in Feb. 1999 by Dr.Max Aebi-pain free for 5 years
                  Surgery age 34 in Dec.2005 for broken rod replacement, bigger screws and crosslinks added and pseudarthrosis(non union) by Dr. Jean Ouellet

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                  • #10
                    arizona surgeon

                    i was living in arizona and was sent to the sonoran spine center and saw dr. dennis crandall. he diagnosed my having klippel-feil syndrome after 38 years of not knowing. i had neck fusion that didnt go well and im stuck here in michigan. my home is in arizona and i will go back to dr crandall for my spine surgery. he is a good guy, very serious but he knows more than most docs do. i read online where a lady came from alaska for him to do her surgery. he did not do my neck fusion.
                    laura

                    Comment


                    • #11
                      TO: abhbarry

                      Hi. Have you scheduled your surgery with Dr. Tribus. What can you tell me about him? I have a brother and sister who live in Madison and they've asked me if there's any way I can have surgery there as it would be so much more convenient for them to assist me. In fact, my brother and sister-in-law have suggested staying at their house while recovering. I did a Mapquest and it looks like Dr. Tribus' office is only a mile from my brother's house.

                      Thanks,

                      Chris

                      Comment


                      • #12
                        Surgeon Choices

                        Chris, i can really identify with your comments. I saw a total of 6 surgeons before making my final choice. They all were considered top surgeons but in the end, I made my decision on INSTINCT.
                        I had even contacted the Mayo Clinic and some European institutions. I used every connection that I have!! To make a simple point, Dr. Boachie actually worked at Rancho Los Amigos, an LA county facility prior to HSS in NYC. There are many talented and brilliant doctors that are not necessarily the most famous. When I contacted one famous surgeon's office, he actually recommended that I see a specialist in my city who had done a fellowship with him....In the end, it didn't make sense for me personally to travel to NYC (or elsewhere) when equally competent and talented doctors could treat me locally. I also had a very good rapport with one local surgeon and TRUST is a key component in this process.

                        Comment


                        • #13
                          Hi Chris,

                          If you have found a doctor that you trust and you are also blessed with family close by that are willing to help you that are close by, that has to be a wonderful feeling!!!

                          Hope all goes well for you!!!

                          Shari

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