[withmore]

I have an appointment with Dr. Brantigan for July 16th. Finally going to get to the bottom of this long drawn out situation.

Diana

[Sea Pines 50]

good for you, diana!!!

dr. charles brantigan is one of the BEST in the west, as they say. i know he can help you unravel this in the mile-high city. it certainly wouldn't hurt to make an appointment with steve annest or david sanders, too, since you're going to be there anyway and most health insurance plans will cover second opinions, especially when it comes to something such as this, which quite possibly could involve vascular surgery (i am in no way saying you are a candidate for vascular surgery, mind you...that is up to the big guns, totally!)

you want to make a measured decision re which surgeon you choose, and while you cannot go wrong with any of the 3 guys practicing there in denver, each does have his own approach, personality, diagnostic testing protocol and aftercare program (or lack thereof)... so if i were you, i would maximize those travel dollars and really check it out!

johannacat's recent thread on "how i chose my surgeon" (see "doctors and PT" sticky or use search function to find it) could be very helpful to you here; whether it puts you to sleep or keeps you up at night could also be a diagnostic clue as to whether or not you really, truly HAVE TOS and how badly you have it, diana

but seriously... TOS surgery is NOTHING to be entered into lightly as i'm sure you've gathered from reading this board. it's no picnic to recover from, there is no guarantee whatsoever that it will either lessen the amount of nerve compression or pain levels in your poor body, - especially if you've not had a timely dx, unfortunately - and in some cases, there can be not only little to no improvement but even a worsening of sx post-op. you don't hear about disaster stories, though, in connection with the denver docs, and i wouldn't worry about that. dr. brantigan has an excellent reputation.

most surgeons wouldn't agree with me on this, as they like to pump their pretty stats up way high (like their chests ). i am telling you this as a TOS patient, and one who has had the surgery at that. surgeons tend to minimize the recovery time, and they maximize the results of the surgery, in general. that is my opinion, and only my opinion.

OK, brantigan fans, you get to weigh in now...

(kidding! i'm only kidding and i'm not looking to start a battle of any sort here; i think we can all agree that there are 3 shining stars in denver. correct?)

how long are you planning to be out in denver? maybe i'll meet ya there; i'm overdue for a visit. i just love that place!

alison

[bettertoser]

I'm very happy for you! Doc B IS one of the best in the west as the poster mentioned.

He is NOT one of those docs that "pump their pretty stats up way high" as he doesn't have to make his living doing TOS surgeries. Besides, the only stats he cares about is that his patients do well, and they do, VERY well post op.

He saves lives doing trauma vascular surgery that's the hard type of surgery, anything after that is easy for him. Maybe that's why TOS patients do so well after his surgery. His thinking is less is best. Maybe that's why often patients that go see him thinking they have TOS are turned away because he doesnt think they have it or it isn't bad enough yet to do surgery even though patients want it or have been convinced by others on this forum they need it or need it a certain way.

I know he & the other Denver docs don't think much about this forum and have their nurses or office girls scan it now and then. Many patients go to them saying they read about this type of surgery or this was done or this is best, whatever. Best thing is to go there and let him decide what is good for you.

At least you will get a top guy in the field of vascular surgery and a well known TOS doc giving you an answer!

I wish you all the best! You will be in very good hands with Doc B.

[johannakat]

Certainly, he is selective about his operative patients. If he does think you are a good surgical candidate, you probably are, whthere or not you choose to have surgery with him.

I would second Alison's suggestion that while you are there, visit with at least one of the other docs. It is a very good thing to have multiple opinions, and surprising what things they agree adn disagree on.



ALso, having been to see Brantigan and Sanders as well as several LA docs I'd be happy to share advice or anser questions by PM if you have any. (Of course, many here have seen him so I don't mean to say my opinions are better or worse, and certainly I found my own experiences with all the docs to be somewhat different than I expected based on others' comments')

best of luck to you

Johanna

[johannakat]

withmore- , how did your appt with Dr Lowe go?

just curious,
johanna

[bettertoser]

Hi,

You need to do what you feel is best and not what anyone here suggests, it's up to you and no one else.

This is a general explanation/opinion meant FOR "withmore" from someone who works in medicine, nothing more.

The trouble with seeing other doctors is that they will most likely have different opinions, but that can also hurt a patient. It would be different if the doc you were going to see wasn't known for his surgery or didn't have great outcomes for patients, then one should be seeing a few.

When you get other people that have seen the docs but not have surgery with that certain doctor no matter who it is, you have to remember that what one patient has another will not. That makes a huge difference as to why some patients see doctor after doctor, they read so much about an illness & what happens, what types of surgery and they all become and "expert" in it that when they present themselves to the docs the patients want a certain type of surgery or want it done their way. Most docs say no thanks. If a patient doesn't seem like they'll be compliant from the get go any doctor has the right to not treat.

It's one thing to talk to others that have had successful surgery with a doctor for whatever illness, but another thing to talk to others that have NOT had surgery but seen the doctor. After all, it's not the personality one "shops" for is it? It shouldn't matter what others say if they DID NOT have surgery, it's the folks that have had great results post op that matter in ones illness.

Take time to relax and not worry, it's up to you to do what you want.

You will do fine. Positive thinking!!

[Jomar]

Diana,
Best of luck with your appt.
The suggestions for a second opinion from another of the Denver docs is a good one I think- if you can manage it.

[johannakat]

BetterTOSer, you seem to think Doc Brantigan is the only qualified TOS doctor in the world.

It isn't the case. Withmore, If you see multiple qualfied doctors and they have different opinions, then you should consider those opinions and how they apply to you. Exploring and learning about TOS as well as the various diagnostic techniques will make you a better educated patient.

Each doctor does their own thing, and has their own approach to TOS. Dr Brantigan has the Spiral CT, it is good for bony abnormalities. It will see certain orientations of vertabrea to other bony sturctures that Dr Brantigan has learned in his experience are usually associated with TOS. It will NOT not see fibrous bands, muscle abnormalities, scar tissue, or any other soft tissue problem that may be present. Dr Sanders has the MAC nerve conduction study and concentrates more on soft tissues. Depending on why type to TOS you have, one technique may "see" abnormalities and the other may not.

THe MAC test that Dr Sanders requests is highly unpleasant, but came back very abnormal for me. the Spiral CT that Dr brantigan does was ony mildly unpleasant and came back compeltely normal for me. If Dr Brantigan was the only Doc I had seen, i might think the TOS was all in my head. It may be completely opposite for you, depending on what causes your TOS.

But is precisely BECAUSE they have different approaches that I would suggest seeing both. They probably WILL give you different ideas and perspectives about what is going on, but if you are truly a good surgical candidate they will PROBABLY both suggest surgery. They are both extremely qualified and loved by their various patients.

It is a GOOD thing to be an educated patient, familiar with what is in your medical records. It does not mean you tell the doctors what to do, it just helps to ensure they get all the pertinent information from your previous treatments.

Since TOS is so difficult to diagnose, do not despair if it does not show up on any one particular test. Have as many as you can afford...or as many as it takes to get an answer you are comfortable with.

As for BetterTOSer's comment, I respectfully disagree...there is RARELY only one way to skin a cat.

Absolutely the best of luck to you

Johanna

[johannakat]

PS, dr sanders sees people in his office on tuesdays....so you should be able to make an appt the folllowing day.


PPS, I did not see nor do I know dr Annests approach to surgery, and cannnot comment other than to say he is also well known and well respected in the field. He would certainly also be a fine choice for a second opinion.

[Sea Pines 50]

and don't forget about dr. steve annest.

he is not chopped chicken liver, folks.

dr. reeves, who is a pain psychologist at cedars sinai and also a fellow at ucla i believe, writes in his book about preparing for surgery: the mind/body approach (can't put my hands on the exact title at the moment, but i will get it for you if you do indeed become a candidate for TOS surgery as a result of this trip to denver and your consult[s] there; gave my copy to steve annest, as a matter of fact, for his ever-crowded waiting room...), that some people are "information gatherers" by nature, and when facing major surgery do better behind finding out all they can about the nature of their injury or illness, the best surgeon to perform the operation to correct the damage, what the recovery time is, what rehab entails, etc. etc. etc.

others do better by placing their faith and trust in the medical professionals and hoping for the best. they simply do not want to know from all those pesky details and scientific facts. doctor knows best, and all like that there. (i guess you'd better hope this personality type has a good "doctor picker...").

if i had to go out on a limb, my guess would be that most TOS'ers belong in the former personality group... sort of a no-brainer, right? OK, terrible pun, sorry.

i do think talking to former patients who've had surgery with a doctor is always a good idea. i just wish there was a way to talk to the not-so-successful stories in addition to the success stories, to get a truer picture, but i suppose you can't fault any of these guys for directing you to their proudest moments, now can you? as long as the patient is willing to talk to you, it doesn't violate anything under the HIPPA laws for the surgeon's office to give you the contact info, so be sure to ask for it. it really helps.

and do bring with you any recent medical records. annest was only interested in one prior year's worth. saved me from having to rent a U-haul to go to denver

also, he had a dedicated coordinator to work with the out-of-state TOS'ers. i assume drs. brantigan and sanders work much the same way, as all 3 have patients seeking much-needed specialized care from all over the country. make that from all over the world.

TOS does not discriminate.

good luck. i'm excited for you. feels good to take action, doesn't it?

everybody has their favorites. it's none of it personal.

alison