The NurflugelBlog is a place where I can vent my spleen about pretty much anything that crosses my mind. Politics, religion, those annoying little indignities we all have to put up with - I have plenty to say about them.

Location: United States

Tuesday, August 28, 2007

First Opinion, Revisited

OK, back to the first neurosurgeon with the list of questions that I asked the second one...

Strangely enough, the first guy was actually easier to deal with than the second guy. He explained that the differences in diagnoses was probably due to conservatism. That, and my unspoken observation that the second guy didn't test for Babinski's reflex, which my right foot is positive (take a fingernail and move it stiffly along the bottom of your foot arch, from the heel, along the curve, to the ball. If your big toes don't twitch, or curl down, that's normal. If they twitch up, that's bad, and an indication of spinal cord damage. My right big toe twitches up). Hence the first guy saying I've got myleopathy (bad), while the second guy says not.

Myleopathy=surgery needed soon, no myelopathy=no surgery needed.

But, the first guy said that he's OK with monitoring the situation until something changes, as long as I'm aware of the risks - I'm more prone to spinal cord injury in car accidents or falls, and if I wait too long, the bony growths on my vertebrae will be difficult to remove, as there's not a lot of room in the spinal canal to start with (hence my problems).

He did acknowledge that the laminaplasty would have placed me in an unusual position for later ADR, as not a lot of ADRs have been done with previous laminaplasties - probably a red flag for insurance. Plus, he's only done 3-4 previous laminaplasties (it's a pretty new procedure), not a huge track record.

The interesting thing is that in talking about Dr. Bertagnoli (whom he hadn't heard), he was much cooler about the possibility of going abroad for surgery. I told him I'd send him some links for Dr. Bertagnoli. When I asked about getting X-ray and bone density tests, he said he'd authorize that. He even said that he'd be interesting in following my progress after getting surgery abroad if I chose to do so - the second guy wanted nothing to do with it if I didn't have it done here. He repeated the concern the second guy did about if problems arose, it'd be difficult to find help here for devices not currently being used or approved by the FDA. That's reasonable...

He also pointed out that at this point, other than some isometric exercises, there's not a lot that physical therapy can do. The disks are shot, and that's that. The isometrics will be good for strengthening the neck muscles, but moving the neck around a lot is bad.

So, it looks like I'll probably be going to Germany in the next year or so, unless some of the devices undergoing trial get approved. It'd sure be nice to have a guy who's done a ton of these do it, rather than someone who just started...


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