Visit with Dr. Coufal

[Jim M2]

Maria,
I'm glad you mentioned the Marcaine in the disc spaces post procedure. The last time I had a discogram I was very agitated afterwards. If I am successful making my case for a discogram I'll negotiate the Marcaine up front. I have an appointment with my PM doctor one week from today (5/20/14).

[Jim M2]

For a number of different reasons I've decided to cancel the ADR explant for now. I want to study my situation longer and possibly have some more diagnostics. I'll start another thread to get everyone's input on my evolving symptoms.

[Maria]

Sounds very reasonable to me especially with a degree of concern or doubt regarding pain generators (or any part of the proposed surgery). Good luck Jim.

[mmglobal]

Jim, I'm glad that you will wait until you are more certain about your path. In the absence of issues that make this urgent or emergent, you can decide later to move forward with the 'maximum' surgery... but you can't undo it. Better to be sure.

All the best,

Mark

[Tim]

Hi Jim

In an earlier post from this thread you mentioned that "Dr. Yeuug (of DISC - Desert Institute for Spine Care, The Leaders in Minimally Invasive Endoscopic Laser Spine Surgery fame) said he could always find the pain generator".
I was wondering if you ever took this any further?
I ask because I'm in a similar'ish position to you in that I suspect my L5/S1 Charite level may be the cause of (or at least a large contributing factor towards) my continuing problems (low back pain and bilateral leg pain with pain worse in the lateral calves). In my situation the doctors don't seem to want to consider this because they can't see past my degenerate L4/5 which is pretty uniquely sandwiched between my 2 ADR's at 5/S1 and 3/4..
In the UK there's a guy called Martin Knight who specialises in Minimally invasive Endoscopic Laser surgery pretty much like Dr Yeung. His techniques don't seem to carry much credence with the rest of the 'spine surgical community'. I managed to have a brief telephone conversation with him and he said he could use a procedure called spinal probing to detect the level of my pain generators. The procedure is apparently carried out in an aware state under light sedation and I believe is commonly used as an intraoperative diagnostic tool during some MISS procedures..
Details of the procedure can be found at the following links;
Spinal Probing
Diagnosis
Spinal Probing & Discography - Spinal Foundation

I wonder if Dr Yeung might suggest a similar diagnostic procedure in your case.
I have not moved forward with this yet (partly due to the fact that the main stream surgical community seem sceptical of this particular surgeon and are seemingly unaware of this technique, + it's pretty expensive) but would be interested to know what Dr Yeung might suggest for you…
I don't know if Dr Yeung is the type who'd have a brief conversation on the phone or via email or if you'd actually have to visit to get any idea of how he'd propose to find your pain generator - after all he does claim to be able to "always find the pain generator"
Just throwing it out there….

Wishing you well
Tim

[Jim M2]

Hi Tim,

No, I haven't taken up diagnostics with Dr. Yeung. Initially I'll be dealing with my pain management doctor on 6/24 to see what he might be able to do. This is mainly due to convenience. I don't know if or when I would contact Dr. Yeung. It is interesting but unfortunate to see you dealing with similar symtoms.