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Do you need spine surgery?

Sunny G – 57 – July, 2011…

I am writing four weeks after discharge from Mt. Sinai Hospital where Dr. Antonacci and his team, consisting of Laura Cuddihy, M.D. and Joel Gorenstein, P.A., performed extensive scoliosis surgery on me. I am a 57 year old woman, born with a congenital scoliosis, first diagnosed at the age of 4 and monitored throughout childhood by orthopedic professionals at teaching hospitals. During my adolescent growth spurt, when the danger of my curvature escalating greatly was maximal, my parents elected to avoid “Milwaukee” bracing and/or surgery and sent me instead to a chiropractor 3 times per week for two years. This appeared to stabilize the situation. Although my curvature was somewhat visible I did not experience much pain from it during my twenties and thirties.

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My forties and fifties, however, were an entirely different story. My curvature worsened, I developed an extremely visible “hump” on my back, and a limp that caused people to ask daily, “Are you okay”. My legs were uneven in length; one hip was flat and the other extremely curvaceous. The left side of my rib cage was sitting on my hip. My internist noted that I had lost over two inches in height. I began to feel that I looked like a freak more and more each day. My two adopted children, ages 10 and 15, though too tactful to say so, were becoming embarrassed about being seen with me in public, or so it felt. More importantly, I was in chronic, often very severe pain. Simple necessary responsibilities such as cooking were becoming almost impossible to execute. In fact, making dinner required that I go to bed for the night….just too painful to stay erect.

My internist referred me to Dr. Antonacci’s practice in Princeton, New Jersey and I went to the appointment never expecting that surgery was a possibility at my age. I assumed he would refer me for physical therapy. Instead, he recommended surgery. I was floored, but there was something reassuring and modest as well as substantive about his manner. I left “considering” it and phoned a friend whose uncle, Dr. Xethalis, is a well-known orthopedist specializing in “knees” in New York City. I asked my friend to call his uncle to give me a name for a second opinion and “while you’re at it, please ask if he’s ever heard of an orthopedist named M. Darryl Antonacci who practices in Princeton”.

Within ten minutes, my friend called me back and said, “My uncle says if you’re seeing Antonacci, you don’t need a second opinion, it doesn’t get better than that. He says Antonacci’s a big guy in Manhattan and his practice is mostly in the City. My uncle says if Antonacci says you need surgery, you need surgery. But he’ll give you a name of a spine guy for a second opinion if you really want one”.

I took the name and went to see the second orthopedist recommended by my friend’s uncle. He too suggested that surgery was my only true alternative. Unlike Dr. Antonacci, however, this man’s bedside manner was not tactful (he must have referred to me and my spine at least ten times during the consult as “deformed” and “deformity”) and his approach to my surgery was not thoughtful or conservative, in the way that Dr. Antonacci’s was. In contrast, I would come away from my consultations with Dr. Antonacci aware of my strengths rather than my “deformities”. “Look how even your shoulders are in spite of everything, you have compensated very well”. He was not patient in the way that Dr. Antonacci was in explaining, and re-explaining the medical basis of what surgery would involve. For a novice like me, terrified at what was entailed, I needed multiple explanations, and Dr. Antonacci took as much time and repetition as I required.

I first consulted Dr. Antonacci in mid-winter and soon thereafter made the decision to get the surgery; however, I set the date for mid-June. During that time Dr. Antonacci recommended that I participate in physical therapy to strengthen my core and extremities so as to better tolerate the surgery, as well as to have stronger legs and arms with which to compensate for not being able to bend my back during my convalescence.

This is where the “personal concierge service” of Dr. Antonacci’s office took over. A woman named Chris handled every aspect of pre-certification required in my case, from pre-authorizing my physical therapy to any of the pre-operative examinations (CT scans, myelograms etc.) that Dr. Antonacci needed, as well as the hospitalization and surgery itself. I never spoke one single time with my insurance company. All was handled for me. Any time I had a question, Dr. Antonacci’s office took my calls immediately or returned them within the day. The very first day that I met Joel Gorenstein, he gave me his cell phone number so that I could reach him any time.

Once in the hospital, Joel greeted me in “scrubs” to say hello and reassure me, and soon I was brought to the anesthesiologist, whose team was extremely respectful, reassuring and competent and 7 and a half hours later I awoke in Recovery. Friends and other lay people had told me how uncomfortable everything would be especially the first little while in Recovery, but frankly, I was on sufficient medication that I remember being very calm and surrounded by flanks of capable doctors and nurses. I was not in very much pain and I did not feel in the least frightened. I was told that the surgery has been successful, had ended at 7:30 p.m., and that Dr. Antonacci and his team had gone home for the night and would see me the next day.

The next morning at 7 a.m. Dr. Cuddihy was there checking up on me. Every day, either she, Joel, or Dr. Antonacci came to check on me, always looking fresh, energetic and professional. With my surgery on Monday, I was discharged on Saturday. During this time, Dr. Antonacci and his surgical team handled my family’s questions, including some delicate family matters, with great tact, wisdom and care. They gave just the right amount of information needed — neither too much nor too little — for my relatives to absorb.

Four weeks later, at home now, I still hold up a hand-mirror to my large bathroom mirror so that I can see my back. The results are simply unbelievable. I have a straight back!! No more hump at all! My left rib cage no longer sits on my left hip; it’s at the same height as the right side of my rib cage. My hips are even and they are equally curvaceous, instead of one being flat and the other overly curvy. I have my “old” height back; I’m 5′ 5″ again, just like I used to be. I am not ashamed and humiliated about myself anymore!! My ten year old daughter proclaimed, “Mom, your back looks fantastic!!” I really could cry of happiness.

As to the recovery, I really can’t tell you too much about that since I’m only four weeks into it, but with pain-management medications that have been prescribed by Dr. Antonacci’s team, it’s definitely quite tolerable. I have to wear a brace during the day probably for several months (we’ll know more after Dr. Antonacci takes X-rays in another few weeks), I can’t drive or do much around the house in terms of chores because I have to wait for the bones in their newly arranged positions to fuse on to the rods, bolts and pins which Dr. Antonacci has inserted. But what a small price to pay for what will be a pain-free life within 3 to 6 months, and a normal-looking, dare I say, even a pretty body?

To Dr. Antonacci and your Team and Office Staff, there are not existing words in the English language to express my gratitude. A long and difficult surgery completed smoothly and successfully, the cosmetic results exceeding even what Dr. Antonacci had told me to expect.

Thank you with my whole heart,

P S.: I am happy to talk with any person considering this type of surgery.

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