The amazing Dr. Baumbach - another life-changing diagnosis?

[mmglobal]

I'm back from Germany and struggling to catch up. Something very interesting happened there. After the week in Berlin for SAS, I spent last week in Straubing with 2 cervical patients. Both are recovering nicely after relatively good experiences... I hope they'll come and post.

When I left Berlin, instead of arriving at Munich Airport and driving east to Straubing, we head west to Munich to see Baumbach. Yes, he came in on Sunday to see 2 clients. We spent from 10am till 10pm with 2 clients.

When going to Germany, if my clients have significant neuro involvement, I always try to get a Baumbach exam because it is more comprehensive than anything I've seen. His insight is remarkable and he frequently adds to the process in a very meaningful way. Even if there is nothing discovered that has an impact on the upcoming surgery and related decisions, having a comprehensive "baseline neuro status" may be very important in the future. (If neuro deficits are discovered after surgery, we often don't know if they existed before.)

(Posting with his permission) One client has a difficult constellation of symptoms, both lumbar and cervical. He's here for cervical surgery because he has significant myelopathy that is affecting his grip strength and dexterity in his hand. This made his c-spine a priority, even though the pain associated with his cervical issues is relatively minor. His chief complaint is severe testicle pain that has been with him since 2000. In 2003, he had a lumbar fusion in an effort to relieve that pain.... no change. In the year that followed, he had 2 more procedures in an effort to relieve that pain... again... no change.

Dr. Baumbach wanted to do more electrophysiologic testing... EMG, NCV, and SSEP. I questioned this because the patient had recent testing that identified a delay in his arm and called it carpal tunnel. Dr. Baumbach explained that the delay may be carpal tunnel, but may also be part of something else and not ruling other issues out would be a mistake. OK... I get it... he's not repeating the testing; he's doing a more comprehensive battery of tests.

Other neuro deficits were discovered in his legs, making a diagnosis of polyneuropathy more appropriate than a diagnosis of carpal tunnel syndrome. Note that Polyneuropathy does describes the symptoms, but not an illness or the cause of the symptoms. Knowing that this exists, it will be necessary to rule-out common causes... lyme disease, diabetes (could be latent diabetes that is not caught by normal screening... glucose tolerance test indicated), B-12 metabolism, thyroid, heavy metal exposure, etc… This is VERY important; however, it is not the amazing diagnosis!

We were at the end of almost 6 hours with Dr. Baumbach for this one patient. We were done and reviewing the results. I asked a question about the testicle pain. The expression on Dr. Baumbach’s face changed and we could see the wheels turning in his head. He asked the patient to get back on the table and proceeded to apply pressure to the lower abdomen/groin area, trying to provoke the pain. Amazingly, Dr. Baumbach was able to provoke the testicle pain by applying pressure. Presumably there is some nerve entrapment / irritation, UNRELATED| to the patient’s spine, which may be involved in this pain syndrome. A few minutes later, the patient remarked that this pressure point that provoked his pain was on a scar for a surgery that he’d had when he was 5 years-old.

Again, this patient was in Germany for cervical surgery, but his most severe pain has gone undiagnosed for the last 7 years and remains severe in spite of a fusion and 2 other procedures. Now he has a chance at getting a proper diagnosis and hopefully, will have a chance at getting it resolved.

As we were wrapping up, I made a comment about his willingness to spend ½ a day with a patient… ending Sunday night at 10pm. He replied, "What's 1/2 a day, when he's been in such pain for so many years?" Dr. Baumbach is incredible. I’m proud and honored to be involved in this process.

More later… all the best….

Mark

[dshobbies]

It's rare indeed for a doctor to give up a Sunday for any patient, let alone spending 1/2 day with each. While in Straubing, you could have blown me over when Dr. B's team made a 'house call' to our hotel.

Not that I want to start something, but our health care system needs to take a look at the current system that's failing most Americans and look at one that is not!

All my best to your patients Mark. I hope they do well.

Dale

[KL Aguilar]

As you know, Mark, I am considering going to Germany for cervical ADR surgery. I remember reading about another patient of yours who saw Dr. Baumbach and was diagnosed with cervical problems even though his problem was leg weakness.

How do I arrange to see Dr. Baumbach prior to going to Dr. Bertagnoli?

[JeffreyD]

Mark,
Thanks for sharing the story about Dr. Baumbach.
I am indebted to Dr. Baumbach for the help he has given me, and also to my wife.
An amazing "prince" of a gentleman, and a diagnostician with no equal.
The hours I spent with him were the key to getting me to where I am today, spinefully and neurologically speaking, and gave Dr. Zeegers the information necessary to perform a successful surgery that dealt with a myriad of symptoms.
I am a man of faith in our Heavenly Father, and I honestly believe that Dr. Baumbach was an answer to prayer for me.

God Bless,
Jeff

[sahuaro]

Just wanted to add another amazing Baumbauch experience: Dr. Baumbach reviewed all of my records and films with care and diligence and then did a 3-way telephone conference with Mark and me--at about midnight his time and prior to leaving on a vacation. He was able to put together a clear description of my problems as evidenced from my records--something my docs here have not been willing to take the time to do. Sure wish I could see him in person.

[Maria]

I can believe there is someone out there that is such a great diagnostician and would spend that amount of time with patients. This is why I wanted to be working in the medical field in the first place, to work along side someone that actually cared~

To think that I became a neuro/ortho patient myself (working in Neurosurgery) and the road trip I've been through with doctors/surgeons in the U.S. I don't think I can come up with one experience that would match what Mark has brought forth re Dr.Baumbaugh and this particular patient in the whole 26 years I've been a spinal patient ~

Once upon a time when I first entered into the nursing field, it seemed that healthcare was actually about just that vs. strictly business..

What's a half a day when he's been in pain for so many years~ thank you Dr. for thinking that way~ we spinal patients are indebted to that type of compassion (I believe any type of patient with any healthcare concern/prob would be)~

[wilsonrob]

What a refreshing thought that a doctor who is bound by the Hippocratic Oath would be motivated by care and compassion for the patient instead of greed and money. Individuals can make a difference. We need more Dr. Bambauch's. There is hope.

[Poncho]

It's amazing when comparing the differences in industry cultures when comparing the medical profession abroad to our own. - Not just reading about it but experiencing it too - even though it was less than stellar reasons that landed us over there.

[rosedee]

I plan on writing in detail about my experiences at the Alphaklink a fortnight ago, but for now just want to add here my experience with Dr Baumbach. He spent from 6pm to 10pm giving me the most thorough neurological examination I have ever had. Without sight of my scans and x-rays (Dr Zeegers was very insistent I not show them to him!), he identified all the areas of my spine at which the scans had shown any pathology.

One of the important aspects of the assessment for me was Dr Baumbach's demonstration of the impact of my cervical spine pathology on my lumbar problems. This means, finally, an understanding and explanation of why for 30 years whenever I've had an acute episode, my walking has always been a "very strange" and defining feature (the speed of a toddler and as stiff as an automaton when I try to go faster and very painful), which has always either puzzled clinicians or been met with marked scepticism. Not only is Dr Baumbach an impressive diagnostician, he is very patient, kind and courteous.

As a result of my trip to Germany (planned in 4 hours flat!!), I will no longer be having 4 major, separate surgeries at the same time. And for this I owe Mark a huge debt. He was pivotal in facilitating my German consultations and in stopping me making the 2nd biggest mistake of my life (1st being my first lumbar surgery in 1982). The depth of his knowledge and understated empathy, together with the strikingly unusual respect he has earned from the top surgeons and doctors, make him a unique resource for patients.

[Maria]

Mark,
I think I'm going to try to get over to Germany this fall to see Dr.B before I do anything. I'm having symptoms that I've not had before and would like a workup that is as thorough as one can get ~

Working on details to be able to get over there...

[JeffreyD]

Maria,
I absolutely want to encourage you to see Dr. Baumbach.
Some of you on this forum know a little about my adventures over the many years I have dealt with severe spine problems. Dr. Baumbach is worth the trip and worth every penny (I mean euro).
God Bless,
Jeff

[Lyndsay]

I think that is incredible, fantastic even that there is a Dr out there who is so dedicated to his patients! I only wish I could go out & see him myself! I'm only in the UK so not too far from Germany but some how I don't think BUPA will cover the cost, sadly!

Rosedee, I'm interested in how you managed to get out there so quick & look forward to reading your account of your trip

Lyndsay x

[Jim M2]

Extremely rare to hear of such people as Dr. Baumbaugh. They're not making dollars by dedicating so much time to individual patients. Dr. W (Whitworth) is another one. And let's not forget Mark Mintzer. I dare say most of Mark's patients are off-track or out of options after experiencing our dysfunctional health care system with it's time-driven, careless doctors. They end up under Mark's guidance where a way is found. Much could be written about this.

[paindoc]

This is actually a very common problem seen particularly in patients with inguinal hernia repairs, and sometimes after spine surgery in the upper lumbar/ lower thorasic spine (the following nerves originate there). The ilioinguinal nerve and genitofemoral nerves can be entrapped by scar tissue after the surgery.I'll bet that scar from when the patient was 5yrs old was most likely a hernia repair. As a former surgery resident, I was able to perform hernia repairs often and now as an interventional pain doc it is easy to see why the problem is so widespread. During the surgery, the ilioinguinal nerve has to be reflected out of the surgical field. This is often done using hemostat clamps, which sometimes find themselves clamping the nerve and not the tissue surronding it! Also, because the problem is so common, there was one attending who used to cut the nevre to "deinnervate" it, so that entrapment pain could not occur. As an ill-informed surgeon, this made sense...cut the nerve and the patient can't have any pain right? WRONG!!!! The proximal end of the neve grows neural "buds" that will constantly fire looking for the distal end which is no longer there. This "firing" causes even worse pain in many of these patients.I'll bet I don't got 2-3 weeks without seeing a nerve entrapment like this, and the answeris to cryo the nerve. This seems to work the best without damaging the nerve itself. Sometimes a revised surgery is in order for an enterapment, but the thing that seems to work the best is placing a spinal cord stimulator lead underneath the skin along the path of the nerve.