avi (04/28/83)
<FLAME FUELED>
I am objecting to an article by mit-eddie!enid that starts with:
Under no circumstances should you get back surgery ( I assume you
meant spinal fusion or fusion of the offending discs) Don't do it, you
have your whole life ahead of you! ......
She was responding to a letter by Bob Platt. The questions asked included:
I have had back (disc) problems for the past two years.
My doctor is recommending a surgical procedure called
a laminectomy, which I understand is the traditional
method of dealing with such problems. I understand
that there are now alternatives to standard back
surgery. One involves an enzyme called chymopapain,
and another is a technique called 'micro-surgery'.
........
I object to the tone of her answer. Net.med is not the place to give
medical advice in such a peremptory tone. I have medical training, and
would not dream of giving medical advice without doing an examination (and
probably not even then). I am not very pro-surgery myself, but I get
quite angry with people who summarily reject all forms of surgery without
even considering it.
I have assisted in performing many forms of spinal surgery including
laminectomies and spinal fusions. Surgical techniques have greatly
improved. When I had my spinal fusion done at the age of 14 (for scoliosis)
I had to stay in bed for nine months - in a cast. Many similar patients
are up and around in two weeks today. I personally was happy with the
results of my surgery and am able to bend adequately using my hips and the
rest of my spine.
There are over two hundred known causes for "back pain" - many of them
related to stress and psychosomatic causes. I would strongly urge that
many of these other factors should be ruled out before surgical
intervention is attempted. Chymopapain is an "enzyme" that is able to
"digest" away the collagen protein that is a major component of the
cartilaginous tissue between the bones that make up the spine. Injecting
this into the appropriate places between the disks, may help relieve
the pressure on a nerve as it comes out of the spine. It is not 100%
effective and does have some risks. It can only cure a limited number
of back problems.
I agree that exercise - and many other "natural" forms of therapy should
be used - when appropriate. I do not believe, however, that a chiropractor
or podiatrist (or someone manipulating tarot cards) is going to cure a
lung cancer or even Herpes Simplex. I would recommend that Bob should
get a second opinion, as he is now doing. An awful amount of questionable
(and sometimes just plain criminal) surgery is being done.
<FLAME LOWERED>
I would like to clarify that I did not bother to complete my degree. I
went back to school and got another degree in CS, so I could be happy.
I am not offering any advice, but do want to clarify the question and some
of the issues involved. I do have both a bias against some medical practices,
and quite a bit of knowledge about medicine. I do want people to contribute
to the net, but do we have to start another "abortion" type of debate again?
Why can't we discuss issues - instead of supplying knee-jerk responses.
Avi Grossjwb (04/30/83)
Amen to Avi Gross. I was going to let this one pass (as I have done most
of them lately) because ANY comment is likely to be misunderstood by at
least a few people. As for the issue at hand, back pain in general,
including disk problems, is a VERY controversial issue. Before getting
any treatment, I would want to be evaluated by one or more competant
Orthopedic Surgeons (The truly good ones do a relatively small amount of
back surgery--they just inherit taking care of back problems). How do
you know who is competant? My bias would be to talk to either one who
has fairly recently completed training, or, preferably, to a faculty
member or attending physician at an institution engaged in significant
medical teaching (medical school, large teaching hospital). This is not
to say physicians in private practice 30 years are worse. The groups
I listed are usually more exposed to the pros and cons of controversial
issues and more willing to try newer techniques--and the enzyme injec-
tions are both new (at least FDA approval is) and controversial. Also
there is big money in back surgery and physicians in teaching situations
usually are compensated in a more indirect method. (Note I do NOT mean
to imply this makes difference in action which is deliberate--it's a
subtle influence.
Jack Buchanan (MD--note this is a caveat so people won't mistake me for
a true healer)billw@sri-unix.UUCP (07/08/83)
#R:mit-eddi:-13700:sri-unix:15400004:000:171 sri-unix!billw Apr 28 23:07:00 1983 If you break your neck, by all means let them fuse your vertebrae together. NOt being able to bend your neck beats not being able to move! Semi Seriously Bill Westfield