Phone consultation with Dr. Nick Boeree

I had my telephone consultation with Dr. Nick Boeree from England today.  My phone rang at exactly the time that his PA had arranged with me via email yesterday.  He assured me that he was ok, and had just had a bump on the head and apologized for having to reschedule.  I didn't ask specifically what happened as we moved right into other matters.  We first reviewed my history and it was quite obvious that he had reviewed the information I had sent and looked carefully at my MRIs.  He said that it looked like the L5-S1 disc was degenerating and had lost some height towards the back and was bulging out after the re-herniation.  He also mentioned that my L4-L5 disc looked like it had a very very slight darkening that was nothing to worry about now and would be more of a concern if I were going to get a fusion or a non shock absorbing disc (like those available in the US).  He didn't think it warranted any action now, but was more just something to keep in mind.  We also talked about my symptoms, where I had pain etc.  He advised that he didn't think getting another L5-S1 discectomy would be a good option since I didn't heal well from the first one and it would cause the loss of more disc height.  This was right inline with what I was thinking, but it was good to get confirmation from a pro.

He then explained the disc replacement procedure which was pretty similar to the information he has on his website, which is very detailed and clear.  We also talked about some of the risks of the surgery, but he said that they would be very minimal for someone of my age who doesn't have any other major medical issues.  He said that he really would have no reservations at all about doing the surgery and while there were always risks and he could not absolutely guarantee no problems, he felt that I was an excellent candidate for a disc replacement.

We then talked about his experience with disc replacement surgery.  He has been doing them for about 10 years, using the Charite and ProDisc before switching to the Spinal Kinetics M6 which he felt was a far superior disc.  He has done multiple 100s of disc replacement operations and usually does 1-2 per week on average, with the rest of his time spent doing other spine related surgeries.  He went over some of the testing they do for the M6 which simulated a lifetime's worth (or even more) of usage with no problems.  I said my only concern was how the polymer based materials would stand up over 20 or more years of usage in the body with regards to the polymers oxidizing and becoming brittle over a long period of time and he said that the materials used in the disc had been used in other medical applications such as knee and hip replacements and had shown no/very little signs of that type of degradation.  He was also careful to say that as the disc is still relatively new, it has not had time to amass years of a proven track record so there could be unknown factors that could arise in the distant future.

He stressed that he had no monetary interest in the M6, owned no shares of the company and used it solely because he thought it would give the best outcomes to his patients compared to any other discs on the market.  He also stressed that he was very committed to providing 1 on 1 treatment for a specific patients needs and was not running a "surgical factory" where he was just trying to get as many patients through as possible.  He said his highest goal was not to make loads and loads of money, but to make sure his patients got the best care he could provide.

I asked him about activities that I would absolutely want to avoid after having recovered from a disc replacement (it takes around 3 months for the bone to grow into the disc to secure it in place) and he said that I would have very few restrictions but did warn that things like bungee jumping, trampolining, and sky diving would probably not be advisable (but pullups would be ok, since I like to do these as part of my workouts).  He said that even though the disc itself is much stronger than a natural disc, the place that a failure would most likely occur would be that the artificial disc could possibly become separated from the bone in the event of an extreme hard landing while the spine was in extension (ie bending backwards).  He said it was hard to give absolutes and guarantees about what would be unsafe, but he said to use common sense and err on the side of caution.  In general, it would take a pretty traumatic event to cause a problem, but that doesn't mean one could do the extreme activities without some risk.

He talked for the entire 30 minutes before having to move onto another patient consultation.  He said I should think it over and if I wanted to proceed, that I should email him or his PA.  The lead time for getting the surgery is usually 3-4 weeks at a minimum but he did mention that he was vacationing for a week in July so it would probably be in the August time frame at the earliest. 

My general impressions were that Dr. Boeree was a very kind, thoughtful, honest, articulate, humble, and intelligent person.  I got no sense at all of any sort of arrogance from him. I felt very comfortable talking to him and at no time did I get the impression that he was trying to pressure or persuade me to get the surgery.  He simply laid out the facts and the risks and his opinions.  This is in line with all of the other numerous reviews that I have read from other patients of his.

I emailed back to get a price quote just to make sure, even though I had a good idea of what it will run as well as information about lodging, transportation, etc. and barring any unforeseen surprises, I'm pretty much set on getting the surgery from him.  Now will just be a matter of nailing down the date, and working out the logistics which will be no small task.