Anybody have experience with Dr. Filler?

[fortitudine]

Our son has had a very serious injury to his brachial plexus and or possible avulsion of c5 nerve root. We are in Canada but are looking for a second opinion, particularly in case we can't get timely treatment at home.

I've read about Dr. Filler and made an appt. to see him in 2 weeks but I'd love to hear from anyone who has or knows someone who has sen Dr. Filler.
Obviously our problem is not really spine related other than in the surgical skill area, but any info on his staff, his manner, etc. would be helpful.

[mmglobal]

I have been to see Dr. Filler with a client and have several clients who have seen him. His MRN technology is very interesting. So far, for the spine patients, I have not seen it pay off, but I still believe in the technology. I think that there is a subset of the spine patient population that has specific pathology that will be better diagnosed with MRN and better treated with the unique surgeries and therapies that Dr. Filler has pioneered. Whether this is 40% of us, 25%.... 10%... I don't know. I am anxious to watch our experience level with Dr. Filler and his treatments grow. I'll keep you posted as I learn relevant info.

His office is very well run and I've had incredible access to knowledgeable staff that can answer all my questions straight away. In addition to the spine patient, I had a serendipitous series of chance meetings that put a man in touch with me, exactly at the time I was getting to know Dr. Filler. His son is a world-class athlete who was sidelined with an issue that looked like it was going to end any possibility of a career in professional sports. He'd been through the mill with some top orthopedic and neurosurgeons and was told that he had zero options.... it was over.

I was able to connect him with Dr. Filler and expedite the process. That was important because he needed to return to school and save his spot on the team. It turned out that he was a good candidate for a nerve release surgery. While his professional sports status is unclear and he still stands a limited chance of returning to sports at that level; his surgery went well and resolved the immediate problem. The chance may be limited, but it is still a chance. I'm thankful that Dr. Filler's office is so well run that this could be pulled of very quickly and effectively.

While it remains to be seen about MRN for spineys, I look forward to watching this unfold. I believe that Dr. Filler is the real deal with a unique method of diagnosis and treatment that, while it may not be what many of us, or even most of us need.... for some of us, it's magic that is not available elsewhere.

Mark.

PS... Dr. Filler's book (autographed!) is available from the lending library, but there is already a waiting list. I hope they'll send me another copy or two. The lending library system is not quite operational yet... I've got some programmers working on it. Info on Filler's book is here.

[Stephen]

I went to see Dr. Filler in July due to pain in my coccyx and sacrum area, so my problem is different from yours. He sent me for MRN (neurography) from which he ascertained there was pathology at my pudendal nerve, near the coccyx. Then I went in twice (in August and September) for nerve blocks using his MRI-guided method; but he was unable to achieve the blocks on both occasions. The reason for that is still unclear.

I have always found him to be a pleasant man who has attended carefully to my questions. My only complaint would be that on two occasions, following the nerve block procedures, he failed to keep scheduled telephone appointments with me. I understand a neurosurgeon gets very busy and unavoidable circumstances arise; but I thought it would have been appropriate for him to notify his office staff of telephone appointments he had missed so someone could at least call me to explain and reschedule. As it is, I called and rescheduled and he finally got to me the third time.

Overall, my experience with him has been favorable. I hope he can find a solution to your problem.

[nopain]

Interesting that I logged on today to see if there were any posts on Neurgraphy.

To differientiate between sciatica and piriformis it seems a God send.

It bothers me immensly that the patent prevents distribution. You would think the alogrithums could be used across the nation and across the world. Why not distribute them at a reasonable cost. Limiting a potential treatment to 3 scanning centers seems selfish. I hope someone can set me straight on why these are not available at other centers.

Sure I know all about the need for Doctors to be trained to read and interpret these scans, but they are trained and read other types of scans... so it is certainly not out of the question.

I hope this doesn't come down to just money.

I called the center and the woman on the telephone was less than friendly to me. Perhaps I got her on a bad day. I was quoted $1,800 per scan plus the visit with the Doc at $500 to $700. So it's not an inexpensive proposition.

I have paid anywhere from $450 to $1,100 for traditional Cervical Spine Scans.

It only makes sense that pathology suspected in the nerves and not visible on regular MRI scans would be steered towards a technique which could show the nerves more clearly.

Very frustrating to know about a technology and not have it reasonably available. It's like the battle with the FDA to get ADR's approved in the USA, while we already know they work in Germany. Sure you need to be a candidate, but why limit ones options... especially an individual who is suffering.

Reminds me of the Old "Cheeseburger Pepsi" skit with Dan Aykroid from Saturday Night Live. No matter what you ordered you got a Cheeseburger and a Pepsi.

I have no doubts in the competency or genuine desire to see patients improve that I have read in whatever I could find about Dr. Filler. I'm sure as a Doctor he is excellent. I was impressed that he does procedures while using MRI as the imaging tool - avoiding the use of radiation (I suppose there is not magnetic material in the instruments?).

If I were you I would definiately keep the appointment. And please post your experiences. Getting in to see world class physicians can be tough. If you know in fact you do need surgery... I can also recommend you take the time to send your Films to Dr. Stanton Schiffer in Freemont California. He is a very genuine and caring person. Mark has first hand experience with him as well.

Again please post your results and experiences. I am trying to save the money to get the 2 scans I need. And after 4 traditional MRI's I am certainly ready for someone to take a closer look at the nerves themselves.

[mmglobal]

I asked at Neurography Institute about the patent limiting access to such important technology. This is not a direct quote... I'm paraphrasing some of the reply...

The MRN is patented to protect the quality of the scans delivered. There are many radiological facilities claiming to produce nerve imaging. The problem is there are no nerves appreciated on them past the nerve roots (that have been seen so far). The quality of some studies would be very low, and of no use, if we “opened the gates” and let everyone use the MRN protocols. Some sites have been shut down because the technologists failed time after time to run correct MRN protocols. We simply must maintain the quality.

Based on what I've seen, $1800 for this scan does not seem unreasonable. While cash pay patients can get traditional MRI's for under $1000, I've heard of several patients who were expected to pay 'billed amounts' in excess of $2000 when their insurance companies denied coverage. (This happened to me personally, but I never had to pay, because the insurance company finally came through.

Mark

[fortitudine]

I cancelled our MRN appointment with Dr. Filler after I received some wise words from someone who is way further along the brachial plexus thing than we are. At the time I asked the question that started this thread, we were unable to get an MRI here and the MRN looked like a good bet. But we ended up getting the MRI here, and I had meanwhile learned that MRI's are not the answer, nor are MRN's - things can be missed on both. (Not to mention out of pocket costs of $4000+) And as someone else said, (was it you, Mark M.?) if you are looking for anomalies on nerves, you'll always find them. That said, my contact has seen Dr. Filler for BP issues and is reasonably impressed with him.

As to why the technology is so limited in its availability, it is not so much an issue of copyright or even competence, as it is one of proof of efficacy. There are some published articles on MRN, but insufficient conclusive data yet to satisfy others that the extra training and software is worth the cost. For example, my contact was pleased that the MRN showed nerve avulsions that the MRI had not, but when the surgeon opened him up, he found another avulsion that read as normal on the MRN.

[tisury]

I called the MRN center also, and as No Pain said, the woman was definetely less than friendly. I can't help but think that maybe this test could help with my "disgnosing dilemna". Maybe not though. I was told $3000 for the lower spine. She said it was a flat fee .......regardless. The cost is a little overwhelming since I am still making payments on other procedures that I had to pay out out of pocket for, and deciding whether to go to Germany. It is considered experimental by my insurance.