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  • Interesting Office Visit & Present for Sharon

    As someone with scoliosis (surgically untreated), pain management has become an issue as I age. Last year the pain was so sever (from the moment I would get out of bed in the morning) that I consulted with an SRS surgeon about possible surgery. I was told that my spine could be straightened and that it would take two, possibly three operations to do this. And that if I elected surgery, that I should prepare for the possibility of going on disability. I struggled with that information and decided to give Spinecor a try first, in April of this year. I'm very glad I did, I no longer wake up in pain. I've been able to cut my pain medication in half - and often don't need it at all - as long as I can pretty much move throughout the day at my own pace. At the same time - while I can do more physically, in the course of doing more, I will still sometimes experience pain - albeit the pain is localized in just one area as opposed to my entire back .. hence I still see another surgeon in the same practice as my SRS surgeon, for pain management.

    I adore the specialist that I see for this. He's from Egypt - fantastic looking :-) patient with all the questions I have and very informative. I've been feeling some fatigue. A urinalysis was ordered to make sure I'm metabolizing the medication ok - seems fatigue can be a sign of not doing so because the liver is compromised.

    Anyway, in the course of today's visit, I was told I had a really really really bad back. Love it when I'm talked to in lay terms I can understand :-) He said my back is so bad that if I did have surgery that I would probably end up in a wheelchair (he said shrugging his shoulders). Ironically I was told 40 years ago, that if I didn't have surgery I would end up in a wheelchair by age 50. He also said that even though I can do more before feeling pain - that I shouldn't because I could cause damage to my spine. No more washing my own car he said - and that I should find a way to have others do anything possible, like laundry and grocery shopping. He said this is how he would advise his own sister (was happy he didn't say grandmother).

    My cobb angles are not all that bad - started with the largest of two at 52 degrees left (46 out of brace last Spinecor xray). And fortunately my heart and lungs are not compromised. A LOT of thoracolumbar rotation though. And of course all the things that come with being well seasoned - degenerative disc disease, some arthritis and a few other things I don't know how to spell. I find it curiously odd that even with the vastly improved instrumentation of today, that surgery is not my best option, given my condition.

    I find myself pondering tonight. What if I had surgery 40 years ago, with near antiquated instrumentation by now - I would still have had the degenerative disc disease and all the rest of the fun aging stuff by now. Where would I be? Back to square one with pain management? I don't know.

    Brace adjustment tomorrow - returning to my specialist in three months for the yearly xray check.

    Here's my present for you Sharon - I remember you saying that you would pay to see two independent people measure the same xray and come up with the same cobb angles. I asked my specialist to pull out the xrays from a few days before being fitted with my brace. As you know my spinecor provider took before brace xrays ... both measurements, that of the surgeon and my spinecor provider are: the same! The office visit today was not all that uplifting until that point - Is this close enough to put the check in the mail?

    Last edited by mamamax; 12-07-2009, 09:01 PM.

  • #2
    Hi mamamax
    i read your post with interest...am wondering why the medical people describe your back in such extreme terms...i, too, have scoliosis, with rotation, spinal stenosis, degenerative disc disease, & severe arthritis in my spine...yet i was told by 3 of the top scoli surgeons in nyc (including dr boachie)that i could be operated on successfully with one operation (possibly divided into 2 days for anterior/posterior approach...so maybe that is 2 operations, i dont know)...i have never heard or had a doctor quoted as saying that a wheelchair would be the result after surgery, especially with today's improved instrumentation & techniques...?! all the doctors did say that i would need fusion to the sacrum due to degeneration of discs, but none suggested in any way that i would end up in some way completely dysfunctional..to the contrary...they all seemed to feel that i could have a fully functional life, should i decide on the surgery....

    i just wonder why or how your situation is/got to be so extreme...?

    i wish you the best...& continued success with the results you have been getting with bracing!

    best regards
    jess
    Last edited by jrnyc; 12-07-2009, 09:19 PM.

    Comment


    • #3
      Hi jrnyc - to answer your question, I don't know ... but I think this is just another illustration of how one diagnosis can vary from specialist to specialist. I think we have seen that a lot in forum here.

      I've heard the wheelchair word more than once .. the first time 40 years ago. It didn't happen, although the pain levels were unreal by age 59. And my surgeon today was being very candid in his opinion - and I noted used the word "probably" not "certainly" ... he was voicing his opinion based on his experience, and advising me as he would his sister.

      If I were mega wealthy I'm sure I could fly around the world and get opinions more to my liking.

      Thank you for your well wishes - never thought I'd be like a poster child for adult bracing :-)
      Last edited by mamamax; 12-07-2009, 09:47 PM.

      Comment


      • #4
        Originally posted by mamamax View Post
        As someone with scoliosis (surgically untreated), pain management has become an issue as I age. Last year the pain was so sever (from the moment I would get out of bed in the morning) that I consulted with an SRS surgeon about possible surgery. I was told that my spine could be straightened and that it would take two, possibly three operations to do this. And that if I elected surgery, that I should prepare for the possibility of going on disability. I struggled with that information and decided to give Spinecor a try first, in April of this year. I'm very glad I did, I no longer wake up in pain. I've been able to cut my pain medication in half - and often don't need it at all - as long as I can pretty much move throughout the day at my own pace. At the same time - while I can do more physically, in the course of doing more, I will still sometimes experience pain - albeit the pain is localized in just one area as opposed to my entire back .. hence I still see another surgeon in the same practice as my SRS surgeon, for pain management.

        I adore the specialist that I see for this. He's from Egypt - fantastic looking :-) patient with all the questions I have and very informative. I've been feeling some fatigue. A urinalysis was ordered to make sure I'm metabolizing the medication ok - seems fatigue can be a sign of not doing so because the liver is compromised.

        Anyway, in the course of today's visit, I was told I had a really really really bad back. Love it when I'm talked to in lay terms I can understand :-) He said my back is so bad that if I did have surgery that I would probably end up in a wheelchair (he said shrugging his shoulders). Ironically I was told 40 years ago, that if I didn't have surgery I would end up in a wheelchair by age 50. He also said that even though I can do more before feeling pain - that I shouldn't because I could cause damage to my spine. No more washing my own car he said - and that I should find a way to have others do anything possible, like laundry and grocery shopping. He said this is how he would advise his own sister (was happy he didn't say grandmother).

        My cobb angles are not all that bad - started with the largest of two at 52 degrees left (46 out of brace last Spinecor xray). And fortunately my heart and lungs are not compromised. A LOT of thoracolumbar rotation though. And of course all the things that come with being well seasoned - degenerative disc disease, some arthritis and a few other things I don't know how to spell. I find it curiously odd that even with the vastly improved instrumentation of today, that surgery is not my best option, given my condition.

        I find myself pondering tonight. What if I had surgery 40 years ago, with near antiquated instrumentation by now - I would still have had the degenerative disc disease and all the rest of the fun aging stuff by now. Where would I be? Back to square one with pain management? I don't know.

        Brace adjustment tomorrow - returning to my specialist in three months for the yearly xray check.

        Here's my present for you Sharon - I remember you saying that you would pay to see two independent people measure the same xray and come up with the same cobb angles. I asked my specialist to pull out the xrays from a few days before being fitted with my brace. As you know my spinecor provider took before brace xrays ... both measurements, that of the surgeon and my spinecor provider are: the same! The office visit today was not all that uplifting until that point - Is this close enough to put the check in the mail?

        Well, you've now given us plenty of clues (area of Florida, ethnicity, and good looking) as to who your surgeon might be, and I still can't figure it out. I have photos of all the active SRS members. I'm guessing that he's not as popular a surgeon as you've lead us to believe.

        I've talked to hundreds, maybe thousands, of adult scoliosis patients. I can't remember anyone ever telling me that their specialist told them that surgery would result in the patient being wheelchair bound. I would question this surgeon's skill therefore.

        What makes you think that you'd have DDD for certain? While the probability is high (with or without surgery), there's no guarantee.
        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


        • #5
          Mamamax, it is great that you're having such good pain relief from the Spinecor. Sometimes I wish I could get hold of one myself (as a post fusion patient with residual curves of 45/35), it looks very comfy and supportive

          The wheelchair thing has always struck me as something that can be used to influence patients by either scaring them into having surgery, or scaring them from having surgery. It's so emotive. Back in the 1970s kids were routinely told that they WOULD end up in a wheelchair if they didn't have the surgery, and these days I've seen surgeons appear to dissuade people with minimal curves who are keen on having surgery for cosmetic reasons by emphasising the risks.

          Most people assume that "ending up in a wheelchair" means that they would probably end up with some degree of paralysis. In reality, I know several people with extremely severe uncorrected JIS and AIS of over 150 degrees, and none of them are wheelchair users for this reason. They do have very poor respiratory function and some rely on oxygen, which severely curtails their movements; I think that it is probably this, and pain, rather than paralysis that would force people with unfused scoliosis into a wheelchair.

          It's a horrible thought Thankfully some of the people I know with curves of this magnitude have had successful surgery in recent years, which has kept them from needing oxygen and has definitely preserved their quality of life.

          Comment


          • #6
            Originally posted by LindaRacine View Post
            Well, you've now given us plenty of clues (area of Florida, ethnicity, and good looking) as to who your surgeon might be, and I still can't figure it out. I have photos of all the active SRS members. I'm guessing that he's not as popular a surgeon as you've lead us to believe.

            I've talked to hundreds, maybe thousands, of adult scoliosis patients. I can't remember anyone ever telling me that their specialist told them that surgery would result in the patient being wheelchair bound. I would question this surgeon's skill therefore.

            What makes you think that you'd have DDD for certain? While the probability is high (with or without surgery), there's no guarantee.


            Hi Linda - nice to see you :-) and happy belated birthday!

            The pain management surgeon (from Egypt) is not the SRS surgeon. The SRS surgeon said I should prepare for the possibility of going on disability - the pain management surgeon (from Egypt) was offering a candid opinion based on his experience which no doubt is not on the same level as the SRS surgeon.

            I don't know how popular my SRS surgeon is but no one has ever said anything bad about him here. The not-SRS surgeon said I had DDD - we're talking degenerative disc disease right? Anyway I would hope he's qualified to diagnose that.

            I have had to hear the wheelchair word more than to my liking. 40 years ago in Virginia - a little over 10 years ago in Columbia Missouri (SRSs) ... both of those times as a prognosis if I didn't have surgery - then today if I did. Freaked me out.

            Comment


            • #7
              I guess I just have a few observations:

              - What did you really hope to achieve by basically titling your post "So take THAT, Sharon"?

              - "Really, really, really bad back ... " ... "so bad that ... "?

              I'm having a tough time imagining a competent doctor - PM or ortho - using those terms - and admittedly, it negates his competence in my mind. I'm doubtful (with those vocabulary limitations) he's qualified to reliably comment on your Cobb. I'd say proceed at your own risk.

              Bottom line? He may share office space with the proclaimed SRS surgeon, but he is ... not one.

              We're back to apples to apples (vs. oranges) again.

              - For someone who repeatedly regurgitates research refs, I'm surprised you might not know how to spell a few things about your own body. Mimic isn't a talent of all that much use; real knowledge IS.

              - You're the first one to play innocent, calling for camaraderie (like in Dingo's "Torso Rotation" thread) when you dig yourself in a hole. You're also the first to persist in the smarmy, (not even) thinly veiled hostility in your posts. Look back at you questioning Sharon how she behaves in her professional life (which, I have no doubt, is as factual as here), and you're doing that grandmotherly thing with the "Certainly you know that ..." and "Glad you understand that ..." when no one agreed with you at all.

              That's passive-aggressive behavior to a tee. You're all good until someone tilts your applecart ... and it has a wonky wheel *anyway*, sister.

              Has it occurred to you, in all your "well-seasonedness" that *maybe* if you didn't behave a certain way, people might respond to you differently?

              I'm surprised you only now mentioned today's appt. with all the other posting you did.

              Regards,
              Pam
              Last edited by txmarinemom; 12-07-2009, 10:19 PM.
              Fusion is NOT the end of the world.
              AIDS Walk Houston 2008 5K @ 33 days post op!


              41, dx'd JIS & Boston braced @ 10
              Pre-op ±53°, Post-op < 20°
              Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


              VIEW MY X-RAYS
              EMAIL ME

              Comment


              • #8

                Pam

                My comment to Sharon was in jest - trying to find some humor in this day. It was nice to see the same readings. I don't think Sharon would have taken offense -

                Sharon - if you did, I'm sorry, meant no harm.

                As for the rest - I was sharing my experience - like everyone else here.

                Your post is horrible and probably the worst on record. I can think of only one word for it - poisonous.
                Last edited by mamamax; 12-07-2009, 10:34 PM.

                Comment


                • #9
                  Originally posted by tonibunny View Post
                  Mamamax, it is great that you're having such good pain relief from the Spinecor. Sometimes I wish I could get hold of one myself (as a post fusion patient with residual curves of 45/35), it looks very comfy and supportive

                  The wheelchair thing has always struck me as something that can be used to influence patients by either scaring them into having surgery, or scaring them from having surgery. It's so emotive. Back in the 1970s kids were routinely told that they WOULD end up in a wheelchair if they didn't have the surgery, and these days I've seen surgeons appear to dissuade people with minimal curves who are keen on having surgery for cosmetic reasons by emphasising the risks.

                  Most people assume that "ending up in a wheelchair" means that they would probably end up with some degree of paralysis. In reality, I know several people with extremely severe uncorrected JIS and AIS of over 150 degrees, and none of them are wheelchair users for this reason. They do have very poor respiratory function and some rely on oxygen, which severely curtails their movements; I think that it is probably this, and pain, rather than paralysis that would force people with unfused scoliosis into a wheelchair.

                  It's a horrible thought Thankfully some of the people I know with curves of this magnitude have had successful surgery in recent years, which has kept them from needing oxygen and has definitely preserved their quality of life.
                  Thank you Toni - because of your perspective I'll sleep a lot better tonight! And that's the truth. For the moment I have no heart and lung compromise .. oh Lord, hope to keep it that way. Thank you so much!

                  Comment


                  • #10
                    Originally posted by mamamax View Post

                    Pam

                    My comment to Sharon was in jest - trying to find some humor in this day. It was nice to see the same readings. I don't think Sharon would have taken offense -

                    Sharon - if you did, I'm sorry, meant no harm.

                    As for the rest - I was sharing my experience - like everyone else here.

                    Your post is horrible and probably the worst on record. I can think of only one word for it - poisonous.
                    Passive-aggressive humor is NOT in jest. Although Sharon can certainly speak for herself, I'll give you a tip: Piety is not becoming, and if you have to toss in an apology after the fact, it wasn't funny in the first place.

                    It's unfortunate you only perceive poison as things that come your way.
                    Fusion is NOT the end of the world.
                    AIDS Walk Houston 2008 5K @ 33 days post op!


                    41, dx'd JIS & Boston braced @ 10
                    Pre-op ±53°, Post-op < 20°
                    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


                    VIEW MY X-RAYS
                    EMAIL ME

                    Comment


                    • #11
                      Mamamax...

                      The Pain Management visit begs the question... Why?

                      Originally posted by mamamax View Post


                      So far, for me as an adult, bracing with Spincor is performing beyond all my expectations.

                      As an adult, my protocol is different than that of an adolescent - I only wear the brace during the day - approximately 10-13 hours a day. This is what has been recommended for my specific condition - and as you will see up thread, this involved a progressive break in schedule. There has been an occasional time or two recently, when I have gone 24 hours without the brace (I know bad me), when I do pain levels remain dramatically reduced and comparatively non existent - the postural improvement also holds during this brief time period.
                      http://www.scoliosis.org/forum/showt...5741#post85741
                      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


                      • #12
                        Um, yeah ... what Linda asked ...

                        Aside from wondering why no mention of a PM visit alllllll day, I'm puzzled by the account of said visit that seems to come from a person who's never seen a PM. Something akin to me describing when the doctor checked my prostate.
                        Fusion is NOT the end of the world.
                        AIDS Walk Houston 2008 5K @ 33 days post op!


                        41, dx'd JIS & Boston braced @ 10
                        Pre-op ±53°, Post-op < 20°
                        Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


                        VIEW MY X-RAYS
                        EMAIL ME

                        Comment


                        • #13
                          Metadiscussion on moderation styles

                          <begin metadiscussion>

                          I understand that this board is run in a different way, and for a different purpose, from the Scoliosis Support board. For this reason, I've disagreed with Dingo's complaints about the moderation style on this board.

                          The scoliosis support forum is well-staffed and has a supportive style, which lets them step into and calm down all disputes. This board has only one moderator and a more scholarly style, so it's understandable that the moderator would only respond behind the scenes to complaints about particular posts.

                          However, neither form of moderation supports "calling out" members or seeming to have a dog in the fight. Maybe I have an over-sensitive ear for these things, but I found this sentence:

                          "I'm guessing that he's not as popular a surgeon as you've lead us to believe."

                          jarring from a moderator, as well as the tone of this question:

                          "The Pain Management visit begs the question... Why?"

                          If a moderator has a question about the veracity of a post, there are ways of going about checking the information without seeming to be pitted against the poster. For an example, check out how the moderators at the Scoliosis Support forum handled Dingo's abstract. They were direct, honest, and caring. They wanted to get to the truth rather then to prove a point.

                          When moderators cannot remain impartial (or, at least *appear* to be impartial), it tends to poison the air in a forum. Those on the "in" side become brave and hyper aggressive (witness txmarinemom's post in this thread - this post would only be written by someone who is fairly sure the moderator agrees with her). Those on the "out" side take more vieled swipes, because they're likely to be muzzled (witness the locked threads and people pussy-footing around forbidden topics).

                          It's OK to have a "sassy and opinionated" moderator a political forum, where people's opinions have no immediate affect on the lives around them. But, a moderator dealing with people's health and well-being really has to hold themselves to a higher standard of impartiality and compassion. Everyone else can take sides, but the moderator, by definition, cannot. Or, they can, but they can never *appear* to take sides.

                          <end metadiscussion>

                          Comment


                          • #14
                            Originally posted by hdugger View Post
                            ... Those on the "in" side become brave and hyper aggressive (witness txmarinemom's post in this thread - this post would only be written by someone who is fairly sure the moderator agrees with her). Those on the "out" side take more vieled swipes, because they're likely to be muzzled (witness the locked threads and people pussy-footing around forbidden topics)
                            Hdugger,

                            As much as I ~really~ want to be part of the "cool crowd", you apparently haven't been here long enough to realize Linda doesn't always agree with me.

                            My comments aren't hers, nor can you (or I) even guess her personal opinion of them.

                            You refer to me as hyper-agressive, but at least I say what I mean. I'll take that any day over namedropping (ad nauseum), and transparency on the scale of used Neutrogena.
                            Fusion is NOT the end of the world.
                            AIDS Walk Houston 2008 5K @ 33 days post op!


                            41, dx'd JIS & Boston braced @ 10
                            Pre-op ±53°, Post-op < 20°
                            Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


                            VIEW MY X-RAYS
                            EMAIL ME

                            Comment


                            • #15
                              txmarinemom,

                              We seek out these forums in the most fragile periods of our lives, concerned for our children or ourselves, full of pain and fear. It's not really the time for flamboyant self-expression.

                              Each little "gotcha" post turns away someone who wants to ask a question. And the preponderance of "gotcha" posts in certain topics makes it almost impossible to freely explore ideas - it's as if there were little mine fields everywhere. At a time when we most need the freedom to explore ideas, the minimal job of a moderator is to clear the minefield and make discussion possible.

                              I don't expect everyone to behave - it's a trying time, people are in pain, and frankly feeling bitchy and at wits end. But I would press upon you the image of walking into a waiting room and seeing people waiting for reports for their child/love one/self, and then decide what tone is appropriate.

                              Comment

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