United Brachial Plexus Network, Inc.

I don't really hear any argument going on, but perhaps I am missing something. I think it is great to have these discussions and I personally appreciate learning and hearing other peoples perspectives.

Training, education and particular orientations obviously impact a doctors practice one way or the other. It would be impossible to escape that. They are taught to view things a certain way and to intervene a certain way. Some may ask why does it matter, but I think it might matter a lot to some parents who want explore different options/orientations for their child. I would suspect a lot of similarities among bpi doctors but I have heard a lot that makes me realize there are some differences as well. We also need to recognize that some procedures, such as arthroscopic cannot be done by doctors who were not trained in orthopedics. It is a speciality of that field, and probably vice versa for other specialities.

I think all that matters is that we explore options and realize that training/orientation can make an impact, just as individual approaches do. I guess the trick is just trying to decide who, when and where to benefit from the different approaches and perspectives.

I'm curious as to why there seems to be this undertone about "arthroscopic" surgery. There is currently only one procedure that a couple of doctors feel comfortable doing it arthroscopically. So please educate us, what's the big deal? It's not like other doctors aren't doing the same procedure, they just do it with a normal sized incision.

Have you ever had arthrscopic surgery? I did. It's not like you don't have pain. Just because they make a smaller incision on the outside doesn't mean that they haven't cut you totally up on the inside.

And lastly, just because you have a smaller incision doesn't mean that it will heal any better. I've seen plenty of kids at picnics that had arthroscopic surgery whose smaller incisions had huge keloids.

Orthos can do nerve grafting, they don't need to use a neurosurgeon.

Yes, several of the ortho bpi doctors do primary nerve surgery and are trained to do so, like a previous guest mentioned. Dr. Waters is a highly respected doctor, who I would fully trust to do primary surgery and there are others too.

Simply put, when I said "what does it it matter" I meant as far as one doctor being better than another. And it that case, it has no bearing whether they are an ortho or a plastic surgeon.

And I never said that othros don't do the nerve grafting itself. However, I don't know of any who do it without the direction of a neurosurgeon. For example, at TCH, Dr. Laurent would do the exploratory work than Dr. Nath ot Shenaq would do the grafting.

I cannot speak for Drs. Kozin or Waters, but I believe Kozin uses a neurosurgeon (Dr. Piatt, I think).
If I am wrong, then please post.

In my previous post, I meant to say Kozin may do the graft but a neurosurgeon does the exploratory work to see what needs to be repaired, etc.

Just to add, it hard to follow who is saying what when people post as "guest". It lends to a question of accountability. How do I know you've seen any of the doctors? I think sometimes people post as guests just to stir the pot.
My name is right there. You can check my previous posts and see whom I chose to see. It is hard to have a civil debate with someone and you don;t know which guest is which.

There are different guest posting and people do for various reasons, which most people respect. You mention "it is hard to have a civil debate". I don't see a debate; I just see dialogue and hope we can keep it respectful. There has been no problems or pot stirring so to speak, on these boards for quite a while. I have no reason to doubt any poster and as for me, I have no idea about primary surgery with Kozin. It is my understanding that Waters, Grossman, Hentz and several others do it by themselves, but I could be mistaken.

We have not had the Triangle Tilt surgery so I can't offer much of an opinion on it. I would love to see before and after pictures though. In our Neck of the woods this surgery is not offerd....here is hoping that one day it is as it sounds like a logical surgery.

I also wanted to add that each Doctor is differen't and their abilities are differen't also ......so it's difficult to judge one by what others are capable of...therefore you have to ask the Doctor if you want to know .



Peace and blessings,

Lenni

I did some research on my own. I looked up all of the more popular hospitals (TCH, Boston, Shriners in Philly, Miami, and Nath) with the members of this board. All of the BPI clinics, with the exception of Shriners, list(or listed as with TCH) neurosurgeons as part of their team. Kozin at Shriners mentioned his affiliation with a neurosurgeon when I was at the Shriner's symposium. Like I said, regardless of what type of surgeon they are the approach is multi-discplinary.

I am not intending to argue with anyone, simply stating the facts. I don't see why it is so important to separate the doctors who are in the BPI field. They are all striving for the same goal of helping our kids, they just go about it different ways.