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Neurosurgeon report in, I am fuming!
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<blockquote data-quote="Marguerite" data-source="post: 86119" data-attributes="member: 1991"><p>From my experience, neurosurgeons as a class tend to be arrogant and unfeeling towards the patient. The more a doctor specialises, the narrower his field of vision and the less he seems to know about anything else. The British comedian Kenneth Williams said it brilliantly - "Specialists these days are getting better and better at less and less. Soon they will be simply SUPERB - at NOTHING!"</p><p></p><p>The more they specialise, the fewer there are. Think of the number of GPs. Then think of the number of neurologists. Then think of the number of neurologists who then specialise in surgery. Then think of the number of neurosurgeons who specialise further, into the brain, or the peripheral nervous system, or into research, or into the spine. Very few. And by the time someone has done THAT much study and work, their connection back to the patient can be tenuous. They can also get an inflated sense of self-importance. You also have far fewer options to go elsewhere, and they know it. They can get away with being ratbags because if YOU walk out the door, there will be ten more like you, waiting for his expertise.</p><p></p><p>There are exceptions - when easy child was very young and we thought she may have inherited my genetic kidney defect, an IVP was ordered and we were referred to maybe the ultimate in specialists - a paediatric uroradiologist. In other words, he specialised in x-raying the urogenital systems of children. And he was the gentlest, kindest man... it could have been so traumatic for a 3 year old, but instead she sailed through it, largely because of this great doctor.</p><p></p><p>But in my experience, this is unusual.</p><p></p><p>That said, even an utter ratbag of a neurosurgeon should know his stuff. Of course, whether he deigns to say anything to YOU about what he is thinking, is another matter entirely.</p><p></p><p>It's quite likely that he has good medical reasons for refusing the surgery. "According to him, the loss of feeling/control in my fingers is normal."</p><p>He may have meant, "Yes, this is what you would expect with the degree of disc narrowing." You have to recognise that these blokes think of the patient as a specimen of curiosity, rarely as an individual.</p><p></p><p>He led you to believe that he doesn't think treatment of the herniated disc and spurs is not necessary because you're already in pain - it's also likely that the amount of pain you are in (and may have been in for some time) could indicate that trying to fix it surgically would not work because too much damage has occurred, it may be now irreversible. I remember a neurosurgeon seeing me back when easy child 2/difficult child 2 was a baby (she was in hospital with me because I was still breastfeeding her; the neurologist thought this was bizarre, since she was already three months old and surely should have been on formula by then?) My neurosurgeon saw me for about two minutes (he'd already looked at all the test results) and told me that to attempt to fix anything he would have to operate on my cervical spine, it would be risky and there would be no guarantee of improvement; that, coupled with the risk of making things worse, made me choose to not have anything done.</p><p></p><p>The weight - it wouldn't help his attitudes, but it's not just 'fat-ism', it's also the surgical risks. Especially operating in the neck, the amount of fat can really obscure the operating field. Back when I was a working, we had to occasionally operate on cats and often, if we got a large one (not necessarily fat) we had A LOT of trouble trying to locate and isolate the various structures in the neck that were part of the task. Fatty overgrowth, thyroid overgrowth - all made it much harder, and a great deal riskier for the cat. A lot of vets would have refused to do the job. I know that with MY current weight, any surgery on my neck would be much trickier for the surgeon, and riskier for me. </p><p></p><p>This bloke may have been a ratbag (not allowed to use the other, more appropriate Aussie term here) but he may also have been good at his job. Also, he may also have been protecting his statistics - a lot of surgeons do this. If they take on risky surgeries, or surgeries where the outcome may not be that great, it shows up in their stats and that affects their reputation. If he goes to the trouble of operating on you and doesn't get much improvement, or maybe no improvement, then it makes HIM look bad for future patients and future employers.</p><p></p><p>So consider that he may have (in his own charming, ham-fisted way) been right. But I would go get another opinion. </p><p></p><p>You said you had successful surgery a few years ago - first, that doesn't have much to do with THIS proposed surgery. It was a different disc with different problems. But even though your previous surgeon is no longer available, find out who he TAUGHT. Ask your GP to track it down for you. If you could find a former student, you might get similar standard surgery. No guarantees, though. But at least it's a different direction to chase.</p><p></p><p>There is little point going ahead with ANYTHING if you don't trust the doctor. I've seen some good doctors in my time; some of them had appalling bedside manner. difficult child 3 was delivered by a bloke with charming bedside manner and a brilliant reputation. But he did me a grave disservice. My next OBGYN was just as bad - lousy bedside manner and failed to inform me of surgical outcomes. And the one after that - dangerously incompetent. But my current bloke - a darling. And one of the most competent in Sydney. I just wish I'd found him before I had difficult child 3.</p><p></p><p>Whoever you see, they will probably want another EMG. You need to have them done every so often just to chart any changes in your nerve conduction. It's a pain in the everywhere, I do know, because I've had a few over the years myself. I'm trying to count - I've had at least five, I think more. Over 21 years. While I wouldn't rush into one (I'd make sure that any other testing associated, such as VERs, would be done at the same time - minimises trauma) I would accept the requirement, especially if another specialist says you should.</p><p></p><p>So if you want, get another opinion (this sort of surgery shouldn't be contemplated lightly, anyway) but don't expect a good bedside manner. What you NEED is a competent surgeon.</p><p></p><p>Good luck. I hope you can get the information you need.</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 86119, member: 1991"] From my experience, neurosurgeons as a class tend to be arrogant and unfeeling towards the patient. The more a doctor specialises, the narrower his field of vision and the less he seems to know about anything else. The British comedian Kenneth Williams said it brilliantly - "Specialists these days are getting better and better at less and less. Soon they will be simply SUPERB - at NOTHING!" The more they specialise, the fewer there are. Think of the number of GPs. Then think of the number of neurologists. Then think of the number of neurologists who then specialise in surgery. Then think of the number of neurosurgeons who specialise further, into the brain, or the peripheral nervous system, or into research, or into the spine. Very few. And by the time someone has done THAT much study and work, their connection back to the patient can be tenuous. They can also get an inflated sense of self-importance. You also have far fewer options to go elsewhere, and they know it. They can get away with being ratbags because if YOU walk out the door, there will be ten more like you, waiting for his expertise. There are exceptions - when easy child was very young and we thought she may have inherited my genetic kidney defect, an IVP was ordered and we were referred to maybe the ultimate in specialists - a paediatric uroradiologist. In other words, he specialised in x-raying the urogenital systems of children. And he was the gentlest, kindest man... it could have been so traumatic for a 3 year old, but instead she sailed through it, largely because of this great doctor. But in my experience, this is unusual. That said, even an utter ratbag of a neurosurgeon should know his stuff. Of course, whether he deigns to say anything to YOU about what he is thinking, is another matter entirely. It's quite likely that he has good medical reasons for refusing the surgery. "According to him, the loss of feeling/control in my fingers is normal." He may have meant, "Yes, this is what you would expect with the degree of disc narrowing." You have to recognise that these blokes think of the patient as a specimen of curiosity, rarely as an individual. He led you to believe that he doesn't think treatment of the herniated disc and spurs is not necessary because you're already in pain - it's also likely that the amount of pain you are in (and may have been in for some time) could indicate that trying to fix it surgically would not work because too much damage has occurred, it may be now irreversible. I remember a neurosurgeon seeing me back when easy child 2/difficult child 2 was a baby (she was in hospital with me because I was still breastfeeding her; the neurologist thought this was bizarre, since she was already three months old and surely should have been on formula by then?) My neurosurgeon saw me for about two minutes (he'd already looked at all the test results) and told me that to attempt to fix anything he would have to operate on my cervical spine, it would be risky and there would be no guarantee of improvement; that, coupled with the risk of making things worse, made me choose to not have anything done. The weight - it wouldn't help his attitudes, but it's not just 'fat-ism', it's also the surgical risks. Especially operating in the neck, the amount of fat can really obscure the operating field. Back when I was a working, we had to occasionally operate on cats and often, if we got a large one (not necessarily fat) we had A LOT of trouble trying to locate and isolate the various structures in the neck that were part of the task. Fatty overgrowth, thyroid overgrowth - all made it much harder, and a great deal riskier for the cat. A lot of vets would have refused to do the job. I know that with MY current weight, any surgery on my neck would be much trickier for the surgeon, and riskier for me. This bloke may have been a ratbag (not allowed to use the other, more appropriate Aussie term here) but he may also have been good at his job. Also, he may also have been protecting his statistics - a lot of surgeons do this. If they take on risky surgeries, or surgeries where the outcome may not be that great, it shows up in their stats and that affects their reputation. If he goes to the trouble of operating on you and doesn't get much improvement, or maybe no improvement, then it makes HIM look bad for future patients and future employers. So consider that he may have (in his own charming, ham-fisted way) been right. But I would go get another opinion. You said you had successful surgery a few years ago - first, that doesn't have much to do with THIS proposed surgery. It was a different disc with different problems. But even though your previous surgeon is no longer available, find out who he TAUGHT. Ask your GP to track it down for you. If you could find a former student, you might get similar standard surgery. No guarantees, though. But at least it's a different direction to chase. There is little point going ahead with ANYTHING if you don't trust the doctor. I've seen some good doctors in my time; some of them had appalling bedside manner. difficult child 3 was delivered by a bloke with charming bedside manner and a brilliant reputation. But he did me a grave disservice. My next OBGYN was just as bad - lousy bedside manner and failed to inform me of surgical outcomes. And the one after that - dangerously incompetent. But my current bloke - a darling. And one of the most competent in Sydney. I just wish I'd found him before I had difficult child 3. Whoever you see, they will probably want another EMG. You need to have them done every so often just to chart any changes in your nerve conduction. It's a pain in the everywhere, I do know, because I've had a few over the years myself. I'm trying to count - I've had at least five, I think more. Over 21 years. While I wouldn't rush into one (I'd make sure that any other testing associated, such as VERs, would be done at the same time - minimises trauma) I would accept the requirement, especially if another specialist says you should. So if you want, get another opinion (this sort of surgery shouldn't be contemplated lightly, anyway) but don't expect a good bedside manner. What you NEED is a competent surgeon. Good luck. I hope you can get the information you need. Marg [/QUOTE]
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