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  • Confused again!


    Okay, I have now seen 3 different ortho surgeons, and I'm confused all over again. I saw Dr. Shelokov back in 2000-2003, and he said either then or later, I was going to require surgery due to the progression and pain. The I saw Hanson 1/07, and he said that he agrees with Dr. Shelokov and I need surgery, but it isn't an emergency and I have time. Now I saw Dr. Marco yesterday and HE said that, while surgery is an option, he would wait. Of course, he didn't have all of my films from past years as Dr. S's office didn't send the films yet. So he can't judge the progression. However, he said that (and this is what really confuses me) (i) pain is usually a contraindication for surgery and (ii) if it were him, he would pass on surgery for now. He suggested exercise (like I have time) as a treatment for the pain and said that my pain is probably mostly related to a secondary condition like fibromyalgia (sp?) and not my back.

    Well, first of all, I've seen on this site that pain is probably the #1 indication for surgery and not a contraindication. I mean, I do appreciate a conservative approach, but I've been doing that for 30+ years. The only things that have worked were injections and pills. The problem is that I don't have TIME for me. I work 45 hours a week, spend 15 hours a week commuting (1 1/2 hours each way), and have twins to take care of when I get home - I also am not sleeping well due to pain. So, (i) I don't have time for that (wether it's work or my kids doctor and therapy schedules), (ii) I don't have time for exercise, and (iii) I don't have time for surgery. Of those three, I can make time for a surgery as it is for a defined period of time. If there are complications, well..., everyone will just have to take a deep breath and let me TAKE time.

    The one thing Dr. Marco really didn't have an answer for was "what can I do if I don't have surgery to help me with this pain?" His answer was exercise to get my endorphins going. Please, do not misunderstand me. I believe Dr. Marco is a really nice doctor and he took a lot of time with me. I just don't know that he has a realistic idea of my situation and, from what he said, I doubt he has experience with long term non-surgical scoliosis treatment.

    Please, let me know your thoughts as I am right back to the beginning - doubting my decision. Thanks.

    Ann
    Last edited by Houston Curves; 03-03-2007, 09:05 AM.
    44 year old female
    Surgery on Nov. 1, 2010
    Dr. Darrell Hanson, Methodist Hospital
    Posterior Only, 9 hours
    Presurgical: T 61 Degrees, L 58 degrees, with 15 degrees of thoracolumbar rotation
    Postsurgical: T 26, L 25

  • #2
    Hi Ann...

    I agree that the top indication for scoliosis surgery in adults is pain, so I'm not sure to what Dr. Marco was referring. I notice that he's not a member of the Scoliosis Research Society, which makes me wonder if he does very little scoliosis surgery.

    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


    • #3
      Ann,

      Is Dr. Marco an adult scoliosis specialist? I know he's a renowned ortho, but...I would tend to trust someone whose specialty and ongoing emphasis is adult spine deformities.

      I'm sure you DO have time, as you're only 40.... but it sounds as though you have already made up your mind that you want to have the surgery. After all, this surgery IS elective....a fact that really blows my mind. I really don't understand his comment about pain being a contraindication. On the other hand, exercise DOES help a lot with the pain, I have found.

      When I first went to see Dr. Boachie, he first recommended physical therapy and painkillers, and asked me to "consider" surgery. He asked to see me again in six months, at which time he looked at my x-rays again and said, "At some point, you will have to do something about this." I said, "Meaning..surgery?" and he said Yes. But he never said, "Oh my gosh, you'd better have surgery right away!!" It would have been easier to make the decision if he HAD said that, but....I have learned that it's standard practice for these guys to treat surgery as a last resort in all but the very most severe cases. There are just no guarantees with this surgery, unfortunately.

      I'm rambling a bit, both those are my thoughts.

      Chris
      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

      Comment


      • #4
        Hi Ann,
        I had progressive scoli as an adult...at 46 my last reading was 53 degress. When u go for opinions.thats exactly what you'll get..every doctor will think something elses.Dr. Boachie in NY thought I shouldn't have surgery. Other doctors felt that it would progress and my quailty of life would be deminished if i didnt have surgery..So I thought about it and decided to have the surgery.Its comes down to you making the choice. Good Luck
        CONNIE


        Surgery June 28th 2004
        fused T4 -L3
        Hip graft
        Grown 1 1/2 inches
        25/o upper T 15/o
        53/o T 15/o
        37/o L 6/o
        Dr. Micheal Nuewirth
        New York City

        August 6, 2004
        Pulmonary Embolism
        complication from surgery

        January 2007 currently
        increasing pain at the T4/5
        point irratation heardwear

        Comment


        • #5
          Thanks

          Singer, your doctor sounds a lot like Doctor Shelokov when I saw him 5-6 years ago. He said that eventually I will have to do something about this. While I do agree that I have made up my mind about having surgery, I haven't made up my mind about when to have surgery. I would like to put it off forever, but I know I can't do that. And, when I look at my pain, which just seems to be steadily increasing, and my quality of life issues, it just depresses me so much. I would love to belive Dr. Marco when he says everything will be okay if I wait, but I don't know how to manage the pain if I wait - and I don't see exercise as an immediate option given my lifestyle (or lack thereof). I am also very, very confused by the "contrindication" comment too. I think everyone who replied is right, and he probably isn't a "spine" doctor, but just a very good ortho. He's a really nice person too.

          Thanks everyone for your help on this. I think I will give more credence to doctors who specialize in scoliosis, and take everything with a grain of salt. Again, I really appreciate all of your support.

          Ann
          44 year old female
          Surgery on Nov. 1, 2010
          Dr. Darrell Hanson, Methodist Hospital
          Posterior Only, 9 hours
          Presurgical: T 61 Degrees, L 58 degrees, with 15 degrees of thoracolumbar rotation
          Postsurgical: T 26, L 25

          Comment


          • #6
            Ann, you have received some good advice and the only thing I want to add is how important it is to find a doc who specializes in the treatment of adult spinal deformities. Although it's been said before, it really can't be stressed enough.

            Best of luck,
            Brandi
            Brandi
            Congenital Scoliosis, 58* lumbar curve
            Combined Anterior/Posterior Spinal Fusion w/Laminectomy May 22, 2006
            L1-S1
            Dr. William Lauerman
            Georgetown University Hospital, Washington, DC
            Pedicle Subtraction Osteotomy @ L3, Posterior Spinal Fusion L2-L4, rod removal with re-instrumentation T10-S1 and Laminectomy February 5, 2009 to correct flatback
            http://brandi816.wordpress.com/

            Comment


            • #7
              I just have to chime in here because Dr. Marco is a favorite doctor of mine. He has done a fellowship in spinal deformity surgery at Rush Presbyterian in Chicago with Hammemberg and Dewald, so he has the qualifications. Having said that, I believe the emphasis of his practice is on musculoskeletal oncology. The way he put it to me was that my daughter is a candidate for surgery when her curves were at 50, but was never pushy about the idea. He just made sure I knew the consequences of whichever decision I chose.

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