[treefrog]

Well, I do believe that surgery is what I want (need) to do. There is no other course, except to live with it. I don't believe that is a reasonable choice. And I feel like my back is getting worse, over the two years that I have been dealing with the constant pain, and particularly in the last few months.

Pain management is one thing I am very concerned about. Mostly because I have had an extremely hard time finding drugs that work for me, and don't give me unacceptable side effects (make me sick). If my pain gets much worse, will Opana be able to keep up with it. Where would I be then, without adequate pain medication. I know it might be difficult after surgery as well, but hopefully it would be short term where I would need stronger meds that would make me sick. And I hope the sickness could be controlled with other drugs. My PM doctor did assure me that they would continue to see me, even if I didn't have surgery, and would also handle my pain management after surgery (since she and the surgeon work in the same practice).

I hadn't seen the specific article you mentioned, but I will have to go search for it. I did find a good number of articles here, and I am in the process of reading them. If not having surgery might lead to further deterioration, as apposed to stopping or slowing progression with surgery, then that is a clear reason for me to proceed sooner.

All that said---Yes I do think surgery is my best option.

The question then becomes which surgery to have, when, and who (where). I believe that my surgeon is good, but now I am wondering if making sure I go to the absolute best surgeon is in my best interest. I mean, I'm sure it is, but I have to weigh the difference in care relative to the cost.

I don't necessarily think that two level ADR will benefit me any more than the hybrid, since the fusion is at the L5-S1. The only exception to that, is recovery. I have heard that recovery can be easier and quicker with ADR compared to fusion. If I thought strongly enough that two level ADR is worth it, then the question becomes can I have it here in the US, can I get insurance to pay, or can I afford to go to Germany?

So, I guess I should do more homework. I just don't really know where to begin. It is taking a really long time just trying to get a second opinion, it's been at least three weeks since I first contacted the Duke surgeons office (Dr. Robert Isaacs).

Does anyone know of excellent spine surgeons at Duke University Hospital? Because that is where I am. I am actually extremely surprised that I haven't seen mention of Duke in all the discussions of good surgeons. The other place that I could easily go is Johns Hopkins, as I have family living close by (I used to live there), and could go there after surgery to recover.

The one surgeon that I have already seen (Dr. David B. Musante), was trained at The Texas Back Institute. I think that must count for something.