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9 hours ago · C5-C6 issue affecting my shoulder? in Spine Health

@fdchik22 Yes, absolutely. Dr. Fogelson is one of Mayo's best according to the former CEO who wrote back to me about him after he got my letter. He is excellent. He did his neurosurgrey training at Mayo, and he teaches there too, and everything in his background shows his excellence in academics and that he has been recognized in his field. His surgery was so good that he didn't need to place a drain in my neck, and I woke up with all the pain gone except for what is caused by the surgical path. I also had surgery without hardware for one level and I have only a bone graft and a lot of surgeons probably wouldn't allow that, so he had to trust me to follow directions. The incision was closed in layers with help from doctors in the neuro program and was nice and neat, nothing was glued together there like I see on so many other patient online posts. I stayed in a neck brace until fused. He gave me my life back. I had lost about half my shoulder and arm muscle to atrophy before surgery, and most has come back. I'm trying not to need a spine surgeon again, but if I do, it will only be Dr. Fogelson at Mayo. I've seen 5 spine surgeons at other places and I wouldn't trust most of them. Dr. Fogelson told me he would be my doctor as long as I need him. He is also very personable, and a down to earth nice guy. It doesn't cost anything to ask him to review your imaging, and if he offers you an appointment, you can decide. My experience of everyone at Mayo exceeded my expectations, and I didn't know medicine could be like that where doctors consult each other in an interdisciplinary team approach. I also have thoracic outlet syndrome which muddies the waters a bit causing symptoms that can overlap with spine caused symptoms, and that was evaluated by another doctor and lab there, and that doctor called Dr. Fogelson to discuss it while I was at my neurosurgery consult. I say go for it. If I had to do this over, I would go to Mayo first, and skip the 5 surgeons who didn't want to help me.

12 hours ago · C5-C6 issue affecting my shoulder? in Spine Health

@fdchik22 Hello and welcome to Connect. I am a Mayo spine surgery patient. Mayo is an excellent place for another opinion. I came to Mayo after 5 different spine surgeons wouldn't help me and they didn't understand how my symptoms related to my cervical stenosis and I went 2 years before I could find a surgeon who would help me. I found medical literature with a case like mine, and contacted a surgeon at Mayo with the literature and he reviewed my imaging. I had spine surgery at Mayo Rochester and I can't say enough about the excellence in the quality of my care, and the great results I had from surgery. I was loosing the ability to hold my arms up and control them because of spinal cord compression, and regained my abilities after surgery. It may be a wait to get in, so you will need to call and set up a temporary patient number and arrange to send in imaging and records for review as soon as you can. It sounds like you are ready for surgery and that conservative treatment has not helped much. You can request that your records be reviewed by a particular surgeon, and I did that. I researched a lot about spine surgery before I came to Mayo, and I could tell that I was getting good answers to my questions at my evaluation. I would highly recommend my surgeon, Jeremy Fogelson. Here are some links about him and my patient story. Let me know if you have other questions and if I can help.

https://www.mayoclinic.org/biographies/fogelson-jeremy-l-m-d/bio-20055624

https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

https://sharing.mayoclinic.org/2012/12/23/repaying-a-gift-scholarship-recipient-says-thanks-in-a-special-way/

https://sharing.mayoclinic.org/2017/07/26/spinal-surgery-saves-teen-swimmers-mobility/

http://www.startribune.com/in-second-term-minnesota-gov-markdayton-dealing-with-more-health-problems/361662931/

http://www.startribune.com/gov-mark-dayton-to-undergo-third-back-surgery/497015811/

https://www.mayoclinic.org/medical-professionals/neurology-neurosurgery/news/specialized-expertise-for-spinal-deformity-surgery/mac-20469055

16 hours ago · Mysterious shortness of breath in Lung Health

@jwiegers17 @pc72 If you think you may have a physical issue with chest movement contributing to your breathing issues, you may want to look at physical therapy and myofascial release as methods to loosen tissue and muscle restrictions. I have physical issues with my breathing from fascial tightness where one side of my chest restricts proper rib movement, and I don't move my lungs enough. My chest tightness extends from my neck to my pelvis, and that tightness between the rib cage and hip does affect my diaphragm movement a bit. I have also had painful muscle spasms in my chest that restrict breathing. I have thoracic outlet syndrome which is a nerve entrapment of the bundle that passes through the chest between the collar bone and rib cage, and it can frequently cause my first rib which is at the base of the neck to be elevated which makes it difficult for me to breathe. I have been able to improve my breathing and drop my heart rate by doing my stretches and MFR. It has taken me a long time (years) to get this far because of how much was tight. The nerves that service the lungs are passing through the neck and shoulder where it all gets tight, and I might be taking pressure off them and I am mobilizing my first rib. I showed my therapist how I was stretching and she confirmed that. She has been mobilizing my first rib when my breathing is too shallow and my chest is too tight. Here is the link to our discussion which has lots of information. There is a provider finder on the MFR website. https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Thu, Feb 20 1:19pm · Mysterious shortness of breath in Lung Health

@kessme I hope I can offer a suggestion. You might want to have a physical therapy evaluation, and I would recommend a PT who also has the John Barnes myofascial release training. Surgeries leave internal fascial scar tissue that tighten up and can keep the body from moving properly including your chest wall. All the ribs and muscles need to be able to expand properly which creates a vacuum that allows the lungs to expand fully. If anything impairs movement of the rib cage, it can impair breathing. I do have asthma and thoracic outlet syndrome which causes neck and chest tightness under the collar bone where the nerves are passing on their way to the lungs. There are different nerves involved in breathing for the upper and lower parts of the lungs. What happens to me when I can't expand one side of my ribs fully is that I start using neck muscles to breathe which also causes some anxiety and a faster heart rate. When I have allergy and asthma problems it all gets worse, and I can be prone to lung infections if the phlegm gets trapped because my lungs are not moving enough from this physical problem. I do have tightness that extends through my rib cage to my pelvis and does affect my diaphragm movement sometimes. My physical therapist does releases on those muscles, and on the tight muscles near my collar bone and arm pit, and it gets my rib cage moving better, and immediately my breathing is deeper and from the diaphragm. I also do similar stretching at home to keep working on it, and I have lowered my heart rate and slowed my breathing by releasing the muscles between my neck and chest. I am also a cervical spine surgery patient, so I have some scar tissue near this area that will tighten if I don't keep working on it. I know I have a habit of sleeping on my right side, and my body is too tight on the left, so I have been reversing this to try to stretch out my tight left side. I think our habits can contribute to things like this.

Thoracic outlet syndrome is more common than doctors think it is, and most doctors don't understand it because it isn't covered well in medical schools. Sometimes they don't consider a physical problem and how that might cause symptoms. It is worth asking a physical therapist about it, and tests for it will be Doppler imaging to see if the blood supply to the arms is cut off by raising the arm or with a change of head and neck position. Neurologists can diagnose it. Usually physical therapy is recommended for TOS. Doctors who understand it are usually at interdisciplinary medical centers like Mayo and it will be listed as a condition they treat. You might find that physical therapy will help even if you don't go through a lot of diagnosis. MFR works on tight muscle and tissue all over the body and once you learn how it works, you will be able to do a lot on your own at home. The therapist will be able to feel the tight pathways through your body. In my experience, doctors don't usually check for this with their hands, and in medical school, they study stiff cadavers, not living fascial tissue that moves even with restrictions.

Here are some links that may be of interest. I have also included our discussion on Myofascial Release that has a lot of information on where to find information and MFR therapists.

https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988

https://www.painscience.com/articles/respiration-connection.php

https://trainingandrehabilitation.com/how-truly-treat-thoracic-outlet-syndrome/

Wed, Feb 19 9:00am · Anyone had an Anterior Cervical Corpectomy and Discectomy with Fusion? in Spine Health

@jesfactsmon Yes, I know that commercial about the "re-instated surgeon". We all should keep that in the back of our minds and expect the best from our doctors. I did search the state medical boards that license physicians to make sure that any doctor that I wanted to see was licenced and has not had disciplinary action against them and I recommend that patients do that. Doctors need to earn your trust with their expertise. Having blind faith as a patient doesn't help you, so ask questions. There are also online success & complication rates for medicare patients for specific procedures for surgeons and the institutions where they practice, so you can compare them. That doesn't really tell you how it relates to your case, and Medicare patients might have a lot of other health issues that can add to the complication rates. Insurance companies also keep track of success rates, and you can ask them for the information. I have physical issues that cause nerve compression with tight tissue and work on that in physical therapy. I have thoracic outlet syndrome which is nerve and vessel compression in my neck and shoulder. I also have been a caregiver to my elderly parents and have learned a lot advocating for them and the moderators like to call on me for input about a lot of topics. Sometimes, I find medical literature and post that. In my PT, I do a lot of myofascial release and I started the discussion on that. It can help neuropathy if there is a physical cause, and it helps break up surgical scar tissue. I'm sure this has helped me in my recovery from spine surgery. You might like to look up TED talks about fear. I hope that I will be a presenter there one day and tell my story about how I overcame the biggest fear in my life. Thanks for your comments.

Wed, Feb 19 12:08am · Watching a Meningioma Brain Tumor in Brain Tumor

@alex3l I can say from experience that sometimes the best surgeons at respected facilities can still miss important clues and discredit patients who give them this information when they don't understand it. I came to Mayo Rochester after being turned down by 5 spine surgeons. I clearly had cervical stenosis with spinal cord compression and it caused all kinds of crazy pain all over my body that was reproducible and changed with the direction I turned my head. During that time, I was doing everything I could to learn about my condition. I watched spine surgeons making presentations about their cases at conferences that I found online. I always researched everything I could about a surgeon I wanted to consult and read their papers and research looking to see if their area of interest was a match for me and looked for online videos of the surgeon. That is how I found the conference videos. I looked at where the surgeon trained and got their degrees and if they had been recognized with academic awards or recognized in their field. It was doing that that led me to medical literature about cases like mine and I found what all the surgeons were missing that explained why my case was different, and I sent this literature in with a request to see a particular Mayo surgeon. I knew he would understand this because I found the literature after looking up a term in his paper, "funicular pain" and it gave me the hits on the case literature. I also had the help of a good physical therapist and had a 3 dimensional understanding of how the body works mechanically, and I have a biology degree, so I can understand a lot of what I read. I had worked in university neuroscience research right out of college, and after that, I went to art school and learned to visualize everything and had studied anatomy with the biology and at art school which helped me understand why pain changed in relation to body position. I am pretty intuitive at reading people which helped me gauge the response I was getting at a consultation and I knew enough to know if I was getting good answers and if the surgeon was interested in having me as a patient, and if he had confidence in his ability to help me. I had a list of detailed questions I would ask about surgery and a doctor's specific success record if I got far enough at a consultation, and I would ask how that might apply to me with any other health issues that I may have. I also wanted to know that any surgeon I considered was happy in their life and career. I had read a book called, "Back in Control" written by a spine surgeon that I saw in the online conference videos who also himself became a spine surgery patient and that opened my eyes to how much stress a surgeon can have and that like the rest of the population, stress can lead a person to end their life. I wanted to know that my surgeon loved his job, and I asked others doctors about that who knew him. I chose a surgeon who trained at Mayo in neurosurgery, and also had orthopedic spine training, and who taught both at Mayo's neurosurgery program and at conferences and who also was a deformity expert, who understood using both artificial discs and fusion. He had done brain surgery and there were some media articles about that. With my face to face interview, I knew that he was an expert in his profession and had done thousands of surgeries like mine, answered my questions intelligently and with confidence and he offered to help me. I knew I could trust him. I had great results and just filing out a survey wasn't enough, so I wrote a letter to Mayo's CEO and sent that in with the survey. I got a personal letter back form the CEO telling me how respected my surgeon is at Mayo and that he is one of their best, so my intuition and self referral served me well.

Here are some videos where you can learn a lot from surgeons. For anyone who doesn't want to see actual surgery videos or photos, don't go to the links.

Here are some NREF videos, and if you scroll this page down to the bottom, there are 5 videos about skull base surgeries.

https://www.youtube.com/user/NREFvideos/videos

This is another at Seattle Science Foundation that discusses Meningiomas

I don't know if you would be a candidate, but Mayo also has the Proton beam for treating cancers. They showed this in the Ken Burns documentary on Mayo with the recovery of a toddler with brain cancer. https://www.mayoclinic.org/departments-centers/proton-beam-therapy-program/sections/overview/ovc-20185491

I know you are asking about age and experience, and I used to think that way too. A lot of spine surgeons I saw were probably in their 40's. From what I have heard from one of my doctors, surgeons tend to develop back problems from bracing and leaning over the operating tables and they may retire from performing surgery early for this. A younger surgeon will also have more recent training in new techniques. Certainly you want a surgeon with a specialized interest in what you need who does more of these procedures, and there are skull base interests listed in neurosurgeon's profiles. I think Mayo does update doctor profile photos. My surgeon's photo was updated once since I started with him 3 years ago. The profiles have graduation dates for their degrees, etc. I do have a connection with my surgeon, and if you want, I can ask him for his recommendation. You'll want to look at my Mayo patient story.

https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

https://sharing.mayoclinic.org/2012/12/23/repaying-a-gift-scholarship-recipient-says-thanks-in-a-special-way/

https://sharing.mayoclinic.org/2017/07/26/spinal-surgery-saves-teen-swimmers-mobility/

http://www.startribune.com/in-second-term-minnesota-gov-markdayton-dealing-with-more-health-problems/361662931/

http://www.startribune.com/gov-mark-dayton-to-undergo-third-back-surgery/497015811/

https://www.mayoclinic.org/medical-professionals/neurology-neurosurgery/news/specialized-expertise-for-spinal-deformity-surgery/mac-20469055

Tue, Feb 18 10:24pm · Anyone had an Anterior Cervical Corpectomy and Discectomy with Fusion? in Spine Health

@jesfactsmon Hi Hank. I am a Mayo cervical spine surgery patient with a single level ACDF at C5/C6. I had spinal cord compression and a great outcome from my Mayo surgery. That being said, I am also a member of the facebook ACDF group, but I prefer to participate here instead because I can provide more information here and personally it means a lot to me to share what I have learned through my experience to help someone else on that difficult journey. On the facebook group, they will delete posts that have any identifying information for the surgeon or the facility. That makes it hard to share medical literature that could be beneficial, and to be honest about my surgical outcome or even to share Mayo's or other general medical information because it can be construed as promoting Mayo or other facilities. The facebook group tends to be more about patients venting or expressing their fears and frustrations rather than detailed information and patients who have success tend to leave the group. I like to share detailed information that explains things because it helps reduce fears of procedures, and I can't share freely when the group moderators are overly concerned. Here on Connect I can share my Mayo story and also pass along information about spine surgery that are not related to Mayo. Not everyone can come to Mayo, and it helps that we can encourage others to seek the best treatment they can find. When someone is considering a major surgery, the skill of the surgeon, their team, and the facility are very important. Finding the best surgeons in the field and doing everything you can as a patient to increase your success will go a long way toward a great recovery. I came to Mayo after 2 years of consulting several surgeons and none would offer surgery and they missed understanding and connecting my symptoms to my spine injury. I was just getting worse, loosing muscle mass and coordination and loosing the ability to control my arms. During that time, I was also watching online presentations at spine surgery conferences for surgeons by surgeons, and reading medical research literature. When I got to Mayo, I knew that I was getting the right answers, and I had already found medical literature that explained why my case was different. If a surgeon isn't confident, you don't want them operating. I knew I was getting a confident surgeon with the right answers by the way he answered my questions, and I already understood my MRI images before I met him.

It sounds like your friend is getting consistent opinions. I believe a corpectomy removes the vetebral body (bone). A discectomy removes the disc (cartilage), and then the fusion is when the bones grow and heal together because a bone spacer is placed between them. When discs collapse, it can cause the jelly like inner nucleus to be squished out, and that causes inflammation. The body tries to stabilize it by remodeling the bone and growing bone spurs. For me, the disc and bone spurs went right into my spinal cord and compressed it which caused random pains all over my body. The uneven pressure on the end plates of the vertebrae also causes the bone remodeling, and given enough time, the spine can start to fuse itself with bone overgrowth, and that causes problems that affect spine alignment and compression on nerves that exit the spine between the vertebrae. It might be possible that excessive bone growth could make the problem inoperable if it goes on long enough. I have read posts by patients who are wheelchair bound and paralyzed by spine injuries who refused surgery. I know the fear of surgery is real and can be very disabling itself, but you have to weight that against the prognosis of what happens if there is no surgical intervention. Always ask the surgeons questions about what they think about when would permanent and irreversible nerve damage begin to happen, and when is the best time to think about surgery. There may be several different procedures that could address the problem, or different approaches, so always ask why they recommend as they do.

Yes, there are great outcomes out there and I am one of them. Here are some links with my story and some other patient stories about my surgeon, Jeremy Fogelson. I am 3 years post op and doing great. If I need spine surgery in the future, I will return to my surgeon at Mayo. Let me know if I can be of further assistance or answer any questions. For anxiety, counseling can help a lot. One of my greatest lessons in life was to overcome my surgical fears and deprogram them, so fear doesn't control me any more. I worked out my own ways to cope with the fear and learn from it. I've been tested by some other medical issues and fear can still creep in, but I will recocgnize it sooner and be able to get it under control. Those disabling fears usually come from a past experience that creates an automatic reaction because the original fear was not processed and understood. I was still thinking like a 6 year old, and I found a new way to think about my medical dilemma that wasn't so threatening. It is possible to overcome the fear, and in doing that to choose your best choice for your future instead of letting your fears make that choice for you.

https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

Here are a few other links about Dr. Fogelson.

https://www.mayoclinic.org/biographies/fogelson-jeremy-l-m-d/bio-20055624

https://sharing.mayoclinic.org/2012/12/23/repaying-a-gift-scholarship-recipient-says-thanks-in-a-special-way/

https://sharing.mayoclinic.org/2017/07/26/spinal-surgery-saves-teen-swimmers-mobility/

http://www.startribune.com/in-second-term-minnesota-gov-markdayton-dealing-with-more-health-problems/361662931/

http://www.startribune.com/gov-mark-dayton-to-undergo-third-back-surgery/497015811/

https://www.mayoclinic.org/medical-professionals/neurology-neurosurgery/news/specialized-expertise-for-spinal-deformity-surgery/mac-20469055

Mon, Feb 17 5:16pm · Pain Pill Addiction and Neuropathy - Looking for Guidance in Neuropathy

@oldkarl I'm glad the turmeric helps you, but it won't make blood cells pass through the vessel walls. The blood cells are floating in the plasma and sometimes the cells can get clumped together. Keeping hydrated will add to blood volume by adding to the fluids so the cells can pass more easily. The arteries carry the oxygenated blood which passes through smaller vessels until it get to the smallest of all, the capillaries where sometimes, just a few cells can pass at a time, from there it empties into veins that get larger as it goes back toward the heart and lungs to be re-oxygenated. The blood cells never leave the circulatory system unless there is a tear in a vessel and that is what happens in a bruise where blood cells escape. The body fluids can pass through the vessel walls and that is how the exchange of gasses happens with the cells in your body. Turmeric does help decrease inflammation. I don't know how turmeric and warfarin interact, but that would be a good discussion to have with your doctor. It's always good to discuss any supplements you are taking when you discuss medications.