MVD done by second year resident?

My neurologist recently referred me to a neurosurgeon. When I got to my appointment, I found out that I was not to see a neurosurgeon, but a second year resident. I have no insurance, so that didn't surprise me. After getting my history and looking at my MRI, I was told that I look like a good candidate for an MVD, but that it would be done by the resident and supervised by the neurosurgeon.

Commonsense says that all specialist have to start somewhere, but it also says an experienced hand is better at some things. The resident said she has performed the surgery before and the only side effect she personally had seen for all MVDs at that hospital, not just her cases, was a cf leak.

I am a mom of six and I want to kiss my little guys without fear of pain. I want to promise a family day out and not have to take it back because I can't move without crying. I want them to know me, not the vegetable-like version of me with a bad attitude. I hate always feeling like a burden to my husband and children.

Since an attending is there, would I be safe? Am I just so desperate to find the old me that I am not thinking clearly? Am I taking an unnecessary risk? I dont know if there is any other way to have the MVD since I don't have any insurance, don't qualify for marketplace insurance and my state didn't expand Medicaid.

I am torn...should I trust a resident to perform an MVD? Any thoughts? What would you guys do?

Well believe it or not surgeries performed by residents have better outcomes than surgeries performed by senior attendings performing surgeries alone. The difference is slight but still important. The most important consideration is really what is the medical center itself's outcome and complications. The resident will follow their protocol to the T. If their protocol is successful, then what you can expect is a slightly better chance of avoiding their "stuff happens" complications, which is as you state is most commonly a CS leak. (Which incidentally is not uncommon in terms of a general complication and something easily taken care of)

There are a number of scholarly article and studies out there but this news article is encouraging:

http://www.reuters.com/article/us-health-surgery-residents-outages-idUSKCN0T226N20151113

If you want more let me know and I can point you to the "numbers" articles.


Thank you! I would love to read all the information you can share with me!

I have dreamed of having the MVD for years, but it was always one of those things that seemed like it wasn't going to happen. Suddenly I may have the chance and the reality is more intimidating than I thought it would be. I don't want to make things worse. I know that I can "survive" the pain I deal with daily, but complications from surgery are terrifying. The more information I have, hopefully, the more comfortable I will be with surgery in general.

On a silly note...today the song Human Again from Beauty and the Beast is playing in my head...perks of having six kids, even serious decisions lead to animated characters☺
ModSupport said:

Well believe it or not surgeries performed by residents have better outcomes than surgeries performed by senior attendings performing surgeries alone. The difference is slight but still important. The most important consideration is really what is the medical center itself's outcome and complications. The resident will follow their protocol to the T. If their protocol is successful, then what you can expect is a slightly better chance of avoiding their "stuff happens" complications, which is as you state is most commonly a CS leak. (Which incidentally is not uncommon in terms of a general complication and something easily taken care of)

There are a number of scholarly article and studies out there but this news article is encouraging:

http://www.reuters.com/article/us-health-surgery-residents-outages-...

If you want more let me know and I can point you to the "numbers" articles.

Please tell me how you would handle this! I want to know how others feel!

Right now I feel very vulnerable for sharing so much about myself and not hearing but one response. Does anyone have any thoughts?

Sorry you have had few responses famof8,

I'm going to reply via a repost which was originally meant for you, but when I tried to upload a couple of days ago either my connection was bad or the site was problematic.

What I would suggest is you try everything and anything before destructive procedures- including MVD, sometimes there is no going back.

Someone has just restarted the thread on chiropractic.

Hi,
Whilst I understand your concerns,


Whilst meaning no disrespect to the pioneering DRs of MVD, one of which has recently passed away, who have helped many, MVD.....;


There is no evidence vascular compression causes TN, only that the PROCEDURE may help and has various elements,
Proposed vascular compression of the TN peripheral nerve follow few rules of any other peripheral nerve compression,


Folks are shown to have vascular compression and no TN symptoms,


Why isn't vascular compression of extra-cranial nerves not seen as a problem,


The right side is more affected, when the left has a larger nerve root,


MVD doesn't help a lot of folks,


The trigeminal nerve root has its own internal blood supply including an arteriole, yet an artery outside of it is said to be the accepted cause???


Remission is put down to remylination of the nerve fibres, yet circa 30% of the nerve fibres in the root are unmylinated,


Medical intervention at the neck- nerve blocks have helped folk, which doesn't address vascular compression,


Dental intervention/ procedures are stated by patients circa 30% accordind to RED's survey on this site, as the route cause of certain cases, they don't cause vascular compression at the nerve route,


A lot of folk circa 30%+ state postural issues affect their TN, but less reported are things that would have a more direct affect on blood pressure, and hence vascular compressions at the TN nerve root,


Many people have additional syndromes e.g. Migraine for which MVD is not a procedure, but share a common mediator at the spinal trigeminal caudalis situated in the neck, recent research shows a connection between the two.


A number of folk are diagnosed with TN, with additional symptoms which overlap with other head/ facial pain complaints; occipital neuralgia, migraine, tearing, swelling, inner ear pain etc. the common denominator- not vascular compression at the TN root


Individuals do exhibit other cranial neuralgias which show a common neuronal connection in the nucleus mentioned above. Have they also got vascular compression on these nerves that occur no where outside of the cranium? yet they have a connection, these cranial nerves, in the spinal trigeminal nucleus,


Some people, and research, as with the above, has shown a connection, have one of many autoimmune diseases, many of which have musculo-skeletal implications acting on the spine and joints, where the spinal trigeminal nucleus sits.
"PERSONNEL opinion, vascular compression (AVM's, chiari etc., excluded ) as told doesn't cause cranial nerve neuralgias.


As time goes on, even the weekly research as stated on pubmed, the likely hood of vascular compression causing TN would seem less and less likely, or at least it adds a great big question mark."


In summation, all avenues should be investigated before destructive procedures.


Present day, if not sorted G.P. >>Meds>>Neuro>>>Meds>>>neurosurgeon>>>needle/ knife/ nasty drill, far from the ideal situation.
Some would argue for evidence based medicine, how much evidence- none before the first MVD's were carried out, My belief is that the spinal trigeminal nucleus was not even identified before Dandy proposed the theory of vascular compression at the TN nerve root, and to this day is ignored despite evidence, by G.P.'s neuros, surgeons etc.

P.S. these days if I reply to a thread it often spells the death knoll for it, for whatever reason, so apologies in advance, but you may want to start a new one in the near future. Folk I assume think I'll try that, or alternatively opt to stay clear of the nut job

Just concerned that a lot of folk seem to accept drugs and destructive procedures before the tame.

A link that may be of interest:

http://www.livingwithtn.org/page/cervogenic-model

Wishing you well.

You also mention a positional aggravating relieving factor when yo sleep which can indicate a mechanical problem

I totally agree with you aiculsamoth. I am seeing a cranial jaw alignment dentist and have seen promising results. I kept coming out of my AO chiro adjustment but felt the relief. I knew there was a connection there. I am now in the UK undergoing Dr Amir’s treatment. Please read his website it explains a lot of what was missing within the jigsaw I had researched. http://dramir.com/index.php

Good luck to you famof8. I do hope you find the right path in you decision.