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Dr. XXXXXXX Saghafi You Messaged Me Asking How Things Were
Question: Dr. XXXXXXX Saghafi you messaged me asking how things were coming along I'm trying to reach you regarding this and the email link won't work
Dr. XXXXXXX Saghafi you messaged me asking how things were coming along I'm trying to reach you regarding this and the email link won't work
Brief Answer:
I just checked the email address in the last message and it seems to work
Detailed Answer:
Greetings my good fellow and thank you so much for being so persistent in trying to maintain contact. I'm appreciative. I did check the URL out by copying and pasting the information I provided you in my last message and it pulled up the right page in terms of getting questions to me. Not sure why it didn't want to work for you. Maybe the server was down?
At any rate, did you have any further questions that you wanted to pose or any information that you wanted to share in terms of progress you've made on any front with respect to suggestions I gave for rehab or other interventions? Now, that you've successfully gotten the message to me....I'm all EARS! HA!
Any luck with the AQUATHERAY I told you about? You honestly, don't even need to wait for anyone to put you on any special equipment or tell you anything. You find yourself a public pool...or even a HOT TUB...or even someone's backyard pool with waist or mid-abdomen high water....and you start jogging in place. It doesn't have to be a million miles per hour....nice and easy just to stretch a little....you'll see how quickly you can ramp up depending on how you feel and then, you just start working in little bursts at time to see what you can muster, take a break, maybe walk a lap or 2 in the pool....and then, you have at it again...Do that to begin with for 10-15 minutes and just go through that cycle every day for about a week....then, slowly start ramping up your times and durations little bit at a time.
Cheers!
I just checked the email address in the last message and it seems to work
Detailed Answer:
Greetings my good fellow and thank you so much for being so persistent in trying to maintain contact. I'm appreciative. I did check the URL out by copying and pasting the information I provided you in my last message and it pulled up the right page in terms of getting questions to me. Not sure why it didn't want to work for you. Maybe the server was down?
At any rate, did you have any further questions that you wanted to pose or any information that you wanted to share in terms of progress you've made on any front with respect to suggestions I gave for rehab or other interventions? Now, that you've successfully gotten the message to me....I'm all EARS! HA!
Any luck with the AQUATHERAY I told you about? You honestly, don't even need to wait for anyone to put you on any special equipment or tell you anything. You find yourself a public pool...or even a HOT TUB...or even someone's backyard pool with waist or mid-abdomen high water....and you start jogging in place. It doesn't have to be a million miles per hour....nice and easy just to stretch a little....you'll see how quickly you can ramp up depending on how you feel and then, you just start working in little bursts at time to see what you can muster, take a break, maybe walk a lap or 2 in the pool....and then, you have at it again...Do that to begin with for 10-15 minutes and just go through that cycle every day for about a week....then, slowly start ramping up your times and durations little bit at a time.
Cheers!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
I just checked the email address in the last message and it seems to work
Detailed Answer:
Greetings my good fellow and thank you so much for being so persistent in trying to maintain contact. I'm appreciative. I did check the URL out by copying and pasting the information I provided you in my last message and it pulled up the right page in terms of getting questions to me. Not sure why it didn't want to work for you. Maybe the server was down?
At any rate, did you have any further questions that you wanted to pose or any information that you wanted to share in terms of progress you've made on any front with respect to suggestions I gave for rehab or other interventions? Now, that you've successfully gotten the message to me....I'm all EARS! HA!
Any luck with the AQUATHERAY I told you about? You honestly, don't even need to wait for anyone to put you on any special equipment or tell you anything. You find yourself a public pool...or even a HOT TUB...or even someone's backyard pool with waist or mid-abdomen high water....and you start jogging in place. It doesn't have to be a million miles per hour....nice and easy just to stretch a little....you'll see how quickly you can ramp up depending on how you feel and then, you just start working in little bursts at time to see what you can muster, take a break, maybe walk a lap or 2 in the pool....and then, you have at it again...Do that to begin with for 10-15 minutes and just go through that cycle every day for about a week....then, slowly start ramping up your times and durations little bit at a time.
Cheers!
I just checked the email address in the last message and it seems to work
Detailed Answer:
Greetings my good fellow and thank you so much for being so persistent in trying to maintain contact. I'm appreciative. I did check the URL out by copying and pasting the information I provided you in my last message and it pulled up the right page in terms of getting questions to me. Not sure why it didn't want to work for you. Maybe the server was down?
At any rate, did you have any further questions that you wanted to pose or any information that you wanted to share in terms of progress you've made on any front with respect to suggestions I gave for rehab or other interventions? Now, that you've successfully gotten the message to me....I'm all EARS! HA!
Any luck with the AQUATHERAY I told you about? You honestly, don't even need to wait for anyone to put you on any special equipment or tell you anything. You find yourself a public pool...or even a HOT TUB...or even someone's backyard pool with waist or mid-abdomen high water....and you start jogging in place. It doesn't have to be a million miles per hour....nice and easy just to stretch a little....you'll see how quickly you can ramp up depending on how you feel and then, you just start working in little bursts at time to see what you can muster, take a break, maybe walk a lap or 2 in the pool....and then, you have at it again...Do that to begin with for 10-15 minutes and just go through that cycle every day for about a week....then, slowly start ramping up your times and durations little bit at a time.
Cheers!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
surgeon is now saying rest as much as possible and said my only to options left were surgery or spinal stimular but he isn't willing to do the surgery I asked about the disketomy and he said it's not a very common surgery anymore and is in reliable and also about the laser sealing he said he'd never heard of such a thing my attorney has been talking with other doctors and said he is upset with the answers my doctor is giving also told me not to diveate from his orders snice its workers comp doctor did finally say surgery would be reasonable but he won't do it
surgeon is now saying rest as much as possible and said my only to options left were surgery or spinal stimular but he isn't willing to do the surgery I asked about the disketomy and he said it's not a very common surgery anymore and is in reliable and also about the laser sealing he said he'd never heard of such a thing my attorney has been talking with other doctors and said he is upset with the answers my doctor is giving also told me not to diveate from his orders snice its workers comp doctor did finally say surgery would be reasonable but he won't do it
surgeon is now saying rest as much as possible and said my only to options left were surgery or spinal stimular but he isn't willing to do the surgery I asked about the disketomy and he said it's not a very common surgery anymore and is in reliable and also about the laser sealing he said he'd never heard of such a thing my attorney has been talking with other doctors and said he is upset with the answers my doctor is giving also told me not to diveate from his orders snice its workers comp doctor did finally say surgery would be reasonable but he won't do it
surgeon is now saying rest as much as possible and said my only to options left were surgery or spinal stimular but he isn't willing to do the surgery I asked about the disketomy and he said it's not a very common surgery anymore and is in reliable and also about the laser sealing he said he'd never heard of such a thing my attorney has been talking with other doctors and said he is upset with the answers my doctor is giving also told me not to diveate from his orders snice its workers comp doctor did finally say surgery would be reasonable but he won't do it
also new MRI shows disc protrusion at L5-s1 along with annular tear now
also new MRI shows disc protrusion at L5-s1 along with annular tear now
Brief Answer:
Surgery is not the best option for you at this point
Detailed Answer:
Good afternoon.
And so I understand that the surgeon who is seeing you is saying that even though he feels is an option that he is not willing to perform the procedure. I do in fact, understand his rationale and if you go back and review carefully the detail of what I wrote to you last time you will see that it is basically echo'ing agreement with his choice to defer surgery.
Doing a surgical procedure for what you are currently demonstrating which is an annular tear along with disc protrusion at L5/S1 in the absence of NEUROLOGICAL WEAKNESS even though there is PAIN is not considered the most prudent approach. This is because (as I stated in my other response) at least 50% of these types of cases where there is a disc defect/tear and even if there were XXXXXXX HERNIATION things will resolve to near baseline levels in 3 years with appropriate conservative therapy which should include PHYSICAL THERAPY.
I understand you say that you've had PT but again, the natural course of this problem is not that it will resolve in several months with therapy, or medication, or acupuncture, etc. Rather, that these modalities should be aggressively continued and kept up and SUSTAINED for a much longer period of time until success is achieved. Alternatively, if you were to develop NEUROLOGICAL WEAKNESS or spasticity, or muscle atrophy directly attributable to a herniated disc then, surgery would be indicated as a last resort. The surgeon is correct in quoting the 50/50 number which is what is commonly mentioned when it comes to these scenarios.
Back surgery can make 50% of people better but it can also make 50% of people worse. Our mentor in training always preached about these sorts of cases. He would say that the best thing to do with patients who demonstrate nothing but pain (no neurological weakness, muscle atrophy, etc) need to be told to go lie in bed and not move until they literally cannot stand either the IMMOBILITY of being in bed or the pain any further then, offer surgery with the understanding that they may actually get worse.
I wouldn't use a vagal stimulator at this point either for the same reasons as the surgery...TOO PREMATURE.....inserting a stimulator surgically is a commitment that you would hate to make if you were to get equal or BETTER relief from just waiting to see auto resolution and doing the AQUATHERAPY and other back exercises, etc. that are generally prescribed.
Another point to keep in mind (and your lawyer should recognize this point as well) is that you can always appeal the decision of the bureau of WC if you disagree but if they go through that process and still settle on no surgical intervention at this time based on what their doctor reports then, the only way you will obtain the surgery is by going to a private physician. I urge you to look for more conservative ways to handle this problem.
Another possibility would be for you to be referred to a NEUROLOGIST for an opinion because as I said if there is demonstration of something such as weakness or loss of muscle mass/atrophy due to significant compression of nerve roots then, surgery is definitely indicated. However, I don't think you really want to be rooting for having such problems because there's still no guarantee that the situation will improve or go back to normal just because you've had surgery and then, you'll end up with definite neurological issues and a surgery that didn't work....that's not a good outcome.
I am hopeful that you will definitely READ again the information I provided in my last response to you as well as this one and see that what is clearly in your interest, I think, is to take the neurosurgeon's advice in terms of resting the back from heavy exertional activities, getting into a pain management program to include aggressive aquatherapy as I've recommended and then, seeing how things go in the next 6-12 months. That is the best MEDICAL APPROACH for you to have the best outcome.
Cheers!
If I've provided useful or helpful information to your question could you do me the favor of CLOSING THE QUERY along with a few positive words of feedback and a 5-star rating if you feel it is deserving?
You can always reach me at the above address for this and other questions. I wish you the best with everything and hope our discussion has aided in your understanding of a few more concepts related to your concerns though at this juncture some of this may not actually be what you were hoping to hear but in fact, it is the best way to handle things medically and surgically.
This query required 60 minutes of professional time to research, assimilate, and file a response.
Surgery is not the best option for you at this point
Detailed Answer:
Good afternoon.
And so I understand that the surgeon who is seeing you is saying that even though he feels is an option that he is not willing to perform the procedure. I do in fact, understand his rationale and if you go back and review carefully the detail of what I wrote to you last time you will see that it is basically echo'ing agreement with his choice to defer surgery.
Doing a surgical procedure for what you are currently demonstrating which is an annular tear along with disc protrusion at L5/S1 in the absence of NEUROLOGICAL WEAKNESS even though there is PAIN is not considered the most prudent approach. This is because (as I stated in my other response) at least 50% of these types of cases where there is a disc defect/tear and even if there were XXXXXXX HERNIATION things will resolve to near baseline levels in 3 years with appropriate conservative therapy which should include PHYSICAL THERAPY.
I understand you say that you've had PT but again, the natural course of this problem is not that it will resolve in several months with therapy, or medication, or acupuncture, etc. Rather, that these modalities should be aggressively continued and kept up and SUSTAINED for a much longer period of time until success is achieved. Alternatively, if you were to develop NEUROLOGICAL WEAKNESS or spasticity, or muscle atrophy directly attributable to a herniated disc then, surgery would be indicated as a last resort. The surgeon is correct in quoting the 50/50 number which is what is commonly mentioned when it comes to these scenarios.
Back surgery can make 50% of people better but it can also make 50% of people worse. Our mentor in training always preached about these sorts of cases. He would say that the best thing to do with patients who demonstrate nothing but pain (no neurological weakness, muscle atrophy, etc) need to be told to go lie in bed and not move until they literally cannot stand either the IMMOBILITY of being in bed or the pain any further then, offer surgery with the understanding that they may actually get worse.
I wouldn't use a vagal stimulator at this point either for the same reasons as the surgery...TOO PREMATURE.....inserting a stimulator surgically is a commitment that you would hate to make if you were to get equal or BETTER relief from just waiting to see auto resolution and doing the AQUATHERAPY and other back exercises, etc. that are generally prescribed.
Another point to keep in mind (and your lawyer should recognize this point as well) is that you can always appeal the decision of the bureau of WC if you disagree but if they go through that process and still settle on no surgical intervention at this time based on what their doctor reports then, the only way you will obtain the surgery is by going to a private physician. I urge you to look for more conservative ways to handle this problem.
Another possibility would be for you to be referred to a NEUROLOGIST for an opinion because as I said if there is demonstration of something such as weakness or loss of muscle mass/atrophy due to significant compression of nerve roots then, surgery is definitely indicated. However, I don't think you really want to be rooting for having such problems because there's still no guarantee that the situation will improve or go back to normal just because you've had surgery and then, you'll end up with definite neurological issues and a surgery that didn't work....that's not a good outcome.
I am hopeful that you will definitely READ again the information I provided in my last response to you as well as this one and see that what is clearly in your interest, I think, is to take the neurosurgeon's advice in terms of resting the back from heavy exertional activities, getting into a pain management program to include aggressive aquatherapy as I've recommended and then, seeing how things go in the next 6-12 months. That is the best MEDICAL APPROACH for you to have the best outcome.
Cheers!
If I've provided useful or helpful information to your question could you do me the favor of CLOSING THE QUERY along with a few positive words of feedback and a 5-star rating if you feel it is deserving?
You can always reach me at the above address for this and other questions. I wish you the best with everything and hope our discussion has aided in your understanding of a few more concepts related to your concerns though at this juncture some of this may not actually be what you were hoping to hear but in fact, it is the best way to handle things medically and surgically.
This query required 60 minutes of professional time to research, assimilate, and file a response.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Surgery is not the best option for you at this point
Detailed Answer:
Good afternoon.
And so I understand that the surgeon who is seeing you is saying that even though he feels is an option that he is not willing to perform the procedure. I do in fact, understand his rationale and if you go back and review carefully the detail of what I wrote to you last time you will see that it is basically echo'ing agreement with his choice to defer surgery.
Doing a surgical procedure for what you are currently demonstrating which is an annular tear along with disc protrusion at L5/S1 in the absence of NEUROLOGICAL WEAKNESS even though there is PAIN is not considered the most prudent approach. This is because (as I stated in my other response) at least 50% of these types of cases where there is a disc defect/tear and even if there were XXXXXXX HERNIATION things will resolve to near baseline levels in 3 years with appropriate conservative therapy which should include PHYSICAL THERAPY.
I understand you say that you've had PT but again, the natural course of this problem is not that it will resolve in several months with therapy, or medication, or acupuncture, etc. Rather, that these modalities should be aggressively continued and kept up and SUSTAINED for a much longer period of time until success is achieved. Alternatively, if you were to develop NEUROLOGICAL WEAKNESS or spasticity, or muscle atrophy directly attributable to a herniated disc then, surgery would be indicated as a last resort. The surgeon is correct in quoting the 50/50 number which is what is commonly mentioned when it comes to these scenarios.
Back surgery can make 50% of people better but it can also make 50% of people worse. Our mentor in training always preached about these sorts of cases. He would say that the best thing to do with patients who demonstrate nothing but pain (no neurological weakness, muscle atrophy, etc) need to be told to go lie in bed and not move until they literally cannot stand either the IMMOBILITY of being in bed or the pain any further then, offer surgery with the understanding that they may actually get worse.
I wouldn't use a vagal stimulator at this point either for the same reasons as the surgery...TOO PREMATURE.....inserting a stimulator surgically is a commitment that you would hate to make if you were to get equal or BETTER relief from just waiting to see auto resolution and doing the AQUATHERAPY and other back exercises, etc. that are generally prescribed.
Another point to keep in mind (and your lawyer should recognize this point as well) is that you can always appeal the decision of the bureau of WC if you disagree but if they go through that process and still settle on no surgical intervention at this time based on what their doctor reports then, the only way you will obtain the surgery is by going to a private physician. I urge you to look for more conservative ways to handle this problem.
Another possibility would be for you to be referred to a NEUROLOGIST for an opinion because as I said if there is demonstration of something such as weakness or loss of muscle mass/atrophy due to significant compression of nerve roots then, surgery is definitely indicated. However, I don't think you really want to be rooting for having such problems because there's still no guarantee that the situation will improve or go back to normal just because you've had surgery and then, you'll end up with definite neurological issues and a surgery that didn't work....that's not a good outcome.
I am hopeful that you will definitely READ again the information I provided in my last response to you as well as this one and see that what is clearly in your interest, I think, is to take the neurosurgeon's advice in terms of resting the back from heavy exertional activities, getting into a pain management program to include aggressive aquatherapy as I've recommended and then, seeing how things go in the next 6-12 months. That is the best MEDICAL APPROACH for you to have the best outcome.
Cheers!
If I've provided useful or helpful information to your question could you do me the favor of CLOSING THE QUERY along with a few positive words of feedback and a 5-star rating if you feel it is deserving?
You can always reach me at the above address for this and other questions. I wish you the best with everything and hope our discussion has aided in your understanding of a few more concepts related to your concerns though at this juncture some of this may not actually be what you were hoping to hear but in fact, it is the best way to handle things medically and surgically.
This query required 60 minutes of professional time to research, assimilate, and file a response.
Surgery is not the best option for you at this point
Detailed Answer:
Good afternoon.
And so I understand that the surgeon who is seeing you is saying that even though he feels is an option that he is not willing to perform the procedure. I do in fact, understand his rationale and if you go back and review carefully the detail of what I wrote to you last time you will see that it is basically echo'ing agreement with his choice to defer surgery.
Doing a surgical procedure for what you are currently demonstrating which is an annular tear along with disc protrusion at L5/S1 in the absence of NEUROLOGICAL WEAKNESS even though there is PAIN is not considered the most prudent approach. This is because (as I stated in my other response) at least 50% of these types of cases where there is a disc defect/tear and even if there were XXXXXXX HERNIATION things will resolve to near baseline levels in 3 years with appropriate conservative therapy which should include PHYSICAL THERAPY.
I understand you say that you've had PT but again, the natural course of this problem is not that it will resolve in several months with therapy, or medication, or acupuncture, etc. Rather, that these modalities should be aggressively continued and kept up and SUSTAINED for a much longer period of time until success is achieved. Alternatively, if you were to develop NEUROLOGICAL WEAKNESS or spasticity, or muscle atrophy directly attributable to a herniated disc then, surgery would be indicated as a last resort. The surgeon is correct in quoting the 50/50 number which is what is commonly mentioned when it comes to these scenarios.
Back surgery can make 50% of people better but it can also make 50% of people worse. Our mentor in training always preached about these sorts of cases. He would say that the best thing to do with patients who demonstrate nothing but pain (no neurological weakness, muscle atrophy, etc) need to be told to go lie in bed and not move until they literally cannot stand either the IMMOBILITY of being in bed or the pain any further then, offer surgery with the understanding that they may actually get worse.
I wouldn't use a vagal stimulator at this point either for the same reasons as the surgery...TOO PREMATURE.....inserting a stimulator surgically is a commitment that you would hate to make if you were to get equal or BETTER relief from just waiting to see auto resolution and doing the AQUATHERAPY and other back exercises, etc. that are generally prescribed.
Another point to keep in mind (and your lawyer should recognize this point as well) is that you can always appeal the decision of the bureau of WC if you disagree but if they go through that process and still settle on no surgical intervention at this time based on what their doctor reports then, the only way you will obtain the surgery is by going to a private physician. I urge you to look for more conservative ways to handle this problem.
Another possibility would be for you to be referred to a NEUROLOGIST for an opinion because as I said if there is demonstration of something such as weakness or loss of muscle mass/atrophy due to significant compression of nerve roots then, surgery is definitely indicated. However, I don't think you really want to be rooting for having such problems because there's still no guarantee that the situation will improve or go back to normal just because you've had surgery and then, you'll end up with definite neurological issues and a surgery that didn't work....that's not a good outcome.
I am hopeful that you will definitely READ again the information I provided in my last response to you as well as this one and see that what is clearly in your interest, I think, is to take the neurosurgeon's advice in terms of resting the back from heavy exertional activities, getting into a pain management program to include aggressive aquatherapy as I've recommended and then, seeing how things go in the next 6-12 months. That is the best MEDICAL APPROACH for you to have the best outcome.
Cheers!
If I've provided useful or helpful information to your question could you do me the favor of CLOSING THE QUERY along with a few positive words of feedback and a 5-star rating if you feel it is deserving?
You can always reach me at the above address for this and other questions. I wish you the best with everything and hope our discussion has aided in your understanding of a few more concepts related to your concerns though at this juncture some of this may not actually be what you were hoping to hear but in fact, it is the best way to handle things medically and surgically.
This query required 60 minutes of professional time to research, assimilate, and file a response.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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