Post count: 13

Thank you. This is very helpful. I’m continually surprised with the notion of – what I don’t know, I don’t know – and how important that what I don’t know, is so critically important to my immediate health and post-surgical success.

Your advice regarding teaching university hospitals; in our community, Johns Hopkins is so highly regarded, I find that no one asks too many questions upon their initial treatment recommendation or, in some cases even they won’t bother with a 2nd opinion. Asking whether or not the fellows will be assisting during such an important and complex surgery seems so obvious, yet one that I’ve not come across to date. Wow!

I agree with you that the benchmark questions are an excellent idea in order to narrow down and find a proper surgeon. Are there any others that come to mind which, you feel may be important and relevant (in addition to dural leaks) regarding a one-two level fusion – and/or even a 3rd Micro-D (yes, still having difficulty giving up this option but, I know I will have a fusion)? The answers from the surgeons are quite critical and may give me the peace of mind (and hand holding) needed to make my appointment.

I have an additional question for you which, recently came to my attention. I’ve been a smoker for the past year – picked it up (after quitting 10 years ago), post my 2nd Micro-D…I think out of sheer boredom and then continued as my situation did not get better over time. I had no idea how (other than the obvious health concerns) I was affecting the healing of my back surgery. The surgeon who performed my initial Micro-D surgery never mentioned the risks – probably because, at that time, I was a non-smoker since college. When I revisited him a month ago regarding the new herniation, he noticed that I indicated that I was a current smoker and said he wouldn’t perform a fusion for 3 months post quit. He never mentioned that this included quit smoking aids, such as, patches, gum, etc. Immediately, I quit smoking cigarettes and started using a patch for help, just in case I opted for a fusion in the near future.

The two JH surgeons said the following:
JH surgeon 1: Director of Neurosurgery program – quit by day of surgery and don’t smoke thereafter. Schedule surgery asap.
JH surgeon 2: Neurosurgeon & Professor Director – quit 3 months prior to fusion, including quit aids like patches, gums, etc. (this is the surgeon I’d planned to do my surgery).

My current condition continues to worsen by the day to the point where current pain is allowing for 4-5 hours of sleep or less; nerve, NSAID and strong pain medications are barely working at all. I notice more limping and some possible urinary dysfunction (less time from needing to and getting to bathroom). I don’t know that I can wait an additional 3 months for a fusion surgery. Do the risks of fusion surgery being a smoker, outweigh the benefits of waiting to have surgery for 2 more months? I’m already afraid of having this surgery. I need to be 100% committed to knowing it will work so it does in fact work but, I don’t want to compromise having a fusion by having smoked/used nicotine quit aids too soon. The research I’ve done online points to waiting but, again…risks/benefits?

One more question…in my reading I keep coming across statements with regard to fusion surgery as “elective surgery.” Does this mean what I think it does? If so, that widens my net of surgeons, since my insurance won’t extend outside of Maryland. Also, means I could take the trip to Colorado.

Thank you again,