[annapurna]

First, to head off potential arguments I want to say that there are excellent US docs and lousy European docs. One continent doesn't have a monopoly on either good or bad medicine. The first real ADR was the Charite, since taken off the market. It was developed over 20 years ago in Germany. The Charite was approved in the US about seven years ago. That's the first real benefit that Europe has over the US. The devices have been available there longer. The FDA is slower to approve medical devices and our insurance system places a huge impediment in the way of any kind of medical progress. I'll just state that baldly as the discussion of why would take a whole separate forum, much less thread.

If you can find a US doc willing to treat your whole condition and you can verify his/her skill and experience to your satisfaction, more power to you. If you can get your insurance company to cover the surgery, please post how you managed to get that major miracle to occur. Most of the forum will recommend you for sainthood if your method ended up working for others.

That said, a whole lot of the US patients going overseas are now doing so because they can't get what they need in the US or can't afford to pay US hospital costs after their insurance company refuses to cover any part of the operation(s). Laura was different as we went overseas back before the ADRs were approved in the US. European surgeons often do have an edge on US surgeons on tricky work, multiple levels, or combinations of ADRs, fusions, and non-surgical options. You can find a US surgeon that could do any one of them but not too many that have the experience in combining them.

MOST IMPORTANT ADVICE I CAN OFFER: It's your back and your health; don't let the doctor or surgeon refuse to answer your questions or buffalo you into something you're not comfortable with. You need to get into the driver's seat on this and accept the doctor or surgeon as if they were the skilled navigator. They tell you what can be done and where you'll need to go but you ultimately need to make the decisions. I don't doubt that you're doing that but I wanted to make sure it gets said so you know that you're doing the right thing.

Because Laura's spine adventures started so long ago, it's not fair to post details of all of the idiots she tried to get help her; they might have improved with time. I will say that we saw at least a dozen docs of different types before settling on a small number of docs who'd work with us. My rule of thumb was to see what the doc thought of us being knowledgeable patients. If the doc wanted dumb patients, we didn't want to work with them. I wasn't trying to impress anyone with our knowledge but if I asked a reasonable question based on what I'd learned and the doc didn't like that I knew enough to ask the question, I counted that visit as over.

Your doctor is probably right in suggesting that a plan of action should be formulated and followed somewhat quickly. If you are degenerating, you could reach the point where nerve damage becomes permanent and surgery would not do much for your pain. On the other hand, this is the time to measure twice before cutting once. The wrong surgery will land you in more problems than simply waiting. I'd suggest aggressively searching on this board and others to see if there are any good spine surgeons in your area. At the same time, try to gather all of your imaging studies and medical records so that you have the option of sending them overseas and/or hand carrying them to a surgeon in your area. I'd also take a hard look at how well you travel. If a hour in the car is agony, a ten hour flight to Europe is probably not going to happen. If you can handle a car trip, even on meds, you might expand the area you consider local to see if there's somebody around you that will work with you. You'll need that for follow-up, even if you do decide to go overseas. Lastly, you could consider the US spine centers like Texas Back. As the joke goes, some people swear by them, some people swear at them. They'd likely be a plane flight for you but it might make you feel more at home if the idea of a European medical vacation is daunting.