Stenum Hospital and Dr. Ritter-Lang

[WPKat]

I just had surgery at Stenum 7 days ago. I think overall it was a positive experience. I was surprised to learn that I wouldn't have an opportunity to meet w/ Ritter-Lang before the surgery (my evaluation letter said I'd meet with him and Dr. Zechel prior to the proceedure). I only found out he was the "phantom" surgeon about 24 hours before I was due in the OR so I didn't turn back. Malte Petersen had told me on two separate occasions that he'd bring Ritter-Lang to see me following the procedure, but I never did see the guy. Kinda makes me wonder... I know he is very shy and introverted and he does have the experience I was looking for, so this was the compromise I had to make (unwillingly though).

The care is pretty good - the nurses are excellent and the staff seems very supportive. However, communication seems not to be their forte. For example, one patient had such a complicated case that they implanted a different disc model than discussed prior to surgery (one other than the models I was told in my consult that they were exclusively using) . Obviously, there was a technical rationale behind the decision, and of course, you sign waivers so that the surgeon can do what he needs to do once he goes in and has a look around... but the problem was, nobody told him what was done until WE (the patients) noticed on his X-rays that our devices were different - this was 3 days following surgery (they do follow up X-rays on the Monday). Of course, when the issue was raised, the doctors addressed it, but it wasn't until we started asking questions. I wonder if they would have ever communicated these details if we hadn't raised the issue.... it's just a little weird. Culture differences, maybe...

We had a few conversations with their staff about expectations coming from the US (and I should note that I've been to Germany about a dozen times previously and know the culture pretty well) apparently they have slightly different thinking on what kind of treatment we actually get in the states. I never had a surgeon that didn't want to evaluate me personally well before the procedure, or who didn't come out and talk to the patients immediate family just following the conclusion of the operation, or come to check-up and debrief the patient once he/she was conscious and awake from anesthesia. Apparently, some of the Stenum international department thought all US doctors act like Ritter-Lang, so it should have been no surprise. And keep in mind, for domestic patients it's probably less of a a big deal since they aren't paying >30kUSD out of pocket..

Anyway, I don't want to bash - they did an excellent job - I just want to enlighten because somehow I missed the "phantom" surgeon aspect of Ritter-Lang prior to heading to Germany. Once I got there and saw it personally, it all made some more sense to me... but this is just how it is. If I had to do over again, I'd probably end up right back at Stenum because I have a better chance of insurance reimbursement there, because my company has offices and HR staff ready to assist me in Germany, and because Stenum has tons and tons and tons of experience doing this. I didn't have a complicated procedure (single level), so I probably could have gone to say, Barcelona, for example, and saved some dough, but not sure I'd do that if I did it again.

It's difficult traveling so far to get a procedure done - I miss home and want to be in my zero gravity chair right now sitting w/ my dog who's stuck in a kennel... but hey, when you know ADR is the right thing for you, and you want the best opportunity for success, Stenum is a very good potential choice for you. Let me know if you want to discuss my experience further offline.

badbatzmaru,

So to be clear, you never met with Dr. Ritter-Lang - before or afterwards? No one came out to talk to you or your immediate family after your surgery was done? What about the rest of the folks in your group? Did they have the same experience?

I am really very surprised that you were not given the opportunity to meet with the surgeon beforehand and the non-communication between patient and surgeon is disconcerting as well.

In Stenum's 2005 documentary (which they just sent me), they show Dr. Zechel and the anesthesiologist meeting separately with the patient and her family to answer questions beforehand. They also met with Dr. Zechel before they were discharged. It shows the anesthesiologist talking to them in the ICU after she woke up. As you mentioned, your letter from them said pretty much the same would happen for you. Given all that, I believe they are well aware of American expectations.

It is more likely a reflection of the surgeon himself or the lack of time they might have had beforehand. It doesn't mean he's not an excellent surgeon, but I would be uncomfortable with not being able to meet with him first myself.

I'm not all that surprised that a change of device was made mid-stream. I once went in for what was suppose to be a simple diagnostic procedure under sedation only to wake up in mega pain, disoriented, confused and very sick. The nurses made a big deal about not letting me get up. They kept saying I would faint. What? I have been sedated several times before, what's the big deal? They would not tell me why either. Neither my husband or I had any idea whatsoever what happened until the surgeon finally showed up well over two hours later to explain. It turns out that after he diagnosed my condition, he decided on the spot to put me under with a general and do another procedure entirely to treat it. I must watch way too much TV, because I really thought he would of had to ask my husband's permission before changing the game plan. It was not a life threatening situation, simply a matter of convenience, so he had plenty of time to talk to him. Even here, once you sign that peice of paper they can do pretty much whatever they deem necessary.

Of course, we absolutely want the surgeon to do what is in our best interests, but we have every right to know if they change gears and why. We shouldn't have to ask; I believe it is the surgeon's duty and responsibility to let us know what they did. But like you, I am an American and feel I have an absolute right to know. Perhaps your insight into their culture is correct and they have a completely different outlook on it. Regardless of the reason for the non-communication, I am disappointed to hear it.

I am really glad to hear though that the nurses and medical staff are living up to their excellent reputation and are being so supportive - their contributions make a huge difference.

If you have any else you prefer to share offline, please send me a private message.

I'm sorry to hear that you had to leave your dog behind in a kennel. Being a caring dog owner myself, I consider her part of my family. I'm sure you are looking forward to being reunited.

I really appreciate your sharing your experience with me, and please, keep me updated on how you are doing.

Thanks ... K

[mike86]

I just had surgery at Stenum 7 days ago. I think overall it was a positive experience.

Here is a question I really want answered: did they give you options on the ADR device? Do they carry other devices?

Thanks and sorry for all the quesitons!

[badbatzmaru]

I never met or saw (consciously) Ritter-Lang. I suppose he was the one who did the surgery, but of course I woke up doubting that he even existed.... my wife inquired about my surgery w/ the international department (Ilka, Melanie, Malte) and they said I was still in - I asked for her after being conscious for about 15-30 minutes in ICU, and the nurse called down for her to be escorted in. So, no, nobody came and told my immediate family that I was out of surgery and no status updates. And it was the same for the other 4 people in my group. Only 1 of the 5 actually got a visit from Ritter-Lang in the ICU.

Just like the video, I met w/ the Anesthesiologist beforehand, I met w/ Zechel beforehand (and met w/ another English speaking doctor simultaneously and prior to this b/c he doesn't speak English). And in the ICU, the anesthesiologist came by and asked how I was doing within probably 1 hour (I couldn't tell you what time it was really) and Zechel came in and showed me the fluoroscope images with the thumbs-up sign.

And yes, I had choices with ADR devices. I don't know what they actually carry in stock - but I hadn't finalized my decision until the day before surgery. I was thinking about a Prestige LP and nearly decided on it, but at the last minute I concluded the M6 was best for me, and nobody at Stenum tried to sway my decision either way. I'm not sure what other devices they stock but you can certainly ask.

[WPKat]

I never met or saw (consciously) Ritter-Lang. I suppose he was the one who did the surgery, but of course I woke up doubting that he even existed.... my wife inquired about my surgery w/ the international department (Ilka, Melanie, Malte) and they said I was still in - I asked for her after being conscious for about 15-30 minutes in ICU, and the nurse called down for her to be escorted in. So, no, nobody came and told my immediate family that I was out of surgery and no status updates. And it was the same for the other 4 people in my group. Only 1 of the 5 actually got a visit from Ritter-Lang in the ICU.

Just like the video, I met w/ the Anesthesiologist beforehand, I met w/ Zechel beforehand (and met w/ another English speaking doctor simultaneously and prior to this b/c he doesn't speak English). And in the ICU, the anesthesiologist came by and asked how I was doing within probably 1 hour (I couldn't tell you what time it was really) and Zechel came in and showed me the fluoroscope images with the thumbs-up sign.

And yes, I had choices with ADR devices. I don't know what they actually carry in stock - but I hadn't finalized my decision until the day before surgery. I was thinking about a Prestige LP and nearly decided on it, but at the last minute I concluded the M6 was best for me, and nobody at Stenum tried to sway my decision either way. I'm not sure what other devices they stock but you can certainly ask.

badbatzmaru,

It does seem rather odd that he hasn't talked with you at all. Perhaps Dr. Zechel and Dr. Ritter-Lang work as a team, with Dr. Zechel taking the lead when meeting with patients? Maybe one of their former patients on this Forum knows the answer and can shed some light on it.

I am sure your wife and the other family members were all quite anxious waiting for the update that never came. Although here the surgeon does come out to give an update, family members are not allowed to see you until you are transferred to your room, which can be a long wait. Out of respect for the family members, however, someone still should have come out to let them know you are OK.

Both of the issues you brought up I personally would have taken granted as standard practice and would not have thought to ask about. Thanks for giving me a head's up!

K

[New-disc]

Badbat,

Please keep us all updated on your recovery.

Took me about 6 months to feel the surgery was worth it.

With training.. I was able to do a 10 mile Mountian hike 1 year after surgery.

Take it slow..

Todd

[rhatzy]

I just had surgery at Stenum 7 days ago. I think overall it was a positive experience. I was surprised to learn that I wouldn't have an opportunity to meet w/ Ritter-Lang before the surgery (my evaluation letter said I'd meet with him and Dr. Zechel prior to the proceedure). I only found out he was the "phantom" surgeon about 24 hours before I was due in the OR so I didn't turn back. Malte Petersen had told me on two separate occasions that he'd bring Ritter-Lang to see me following the procedure, but I never did see the guy. Kinda makes me wonder... I know he is very shy and introverted and he does have the experience I was looking for, so this was the compromise I had to make (unwillingly though).

The care is pretty good - the nurses are excellent and the staff seems very supportive. However, communication seems not to be their forte. For example, one patient had such a complicated case that they implanted a different disc model than discussed prior to surgery (one other than the models I was told in my consult that they were exclusively using) . Obviously, there was a technical rationale behind the decision, and of course, you sign waivers so that the surgeon can do what he needs to do once he goes in and has a look around... but the problem was, nobody told him what was done until WE (the patients) noticed on his X-rays that our devices were different - this was 3 days following surgery (they do follow up X-rays on the Monday). Of course, when the issue was raised, the doctors addressed it, but it wasn't until we started asking questions. I wonder if they would have ever communicated these details if we hadn't raised the issue.... it's just a little weird. Culture differences, maybe...

We had a few conversations with their staff about expectations coming from the US (and I should note that I've been to Germany about a dozen times previously and know the culture pretty well) apparently they have slightly different thinking on what kind of treatment we actually get in the states. I never had a surgeon that didn't want to evaluate me personally well before the procedure, or who didn't come out and talk to the patients immediate family just following the conclusion of the operation, or come to check-up and debrief the patient once he/she was conscious and awake from anesthesia. Apparently, some of the Stenum international department thought all US doctors act like Ritter-Lang, so it should have been no surprise. And keep in mind, for domestic patients it's probably less of a a big deal since they aren't paying >30kUSD out of pocket.

Anyway, I don't want to bash - they did an excellent job - I just want to enlighten because somehow I missed the "phantom" surgeon aspect of Ritter-Lang prior to heading to Germany. Once I got there and saw it personally, it all made some more sense to me... but this is just how it is. If I had to do over again, I'd probably end up right back at Stenum because I have a better chance of insurance reimbursement there, because my company has offices and HR staff ready to assist me in Germany, and because Stenum has tons and tons and tons of experience doing this. I didn't have a complicated procedure (single level), so I probably could have gone to say, Barcelona, for example, and saved some dough, but not sure I'd do that if I did it again.

It's difficult traveling so far to get a procedure done - I miss home and want to be in my zero gravity chair right now sitting w/ my dog who's stuck in a kennel... but hey, when you know ADR is the right thing for you, and you want the best opportunity for success, Stenum is a very good potential choice for you. Let me know if you want to discuss my experience further offline.

I talked with Zechel for about an hour and the anesthesiologist for about an hour. They were great. When I woke up from the surgery, my wife was standing there. There were about 3 of us in the recovery room and the spouses were there too. Maybe it was just something else going on. Ritter-Lang came to my room the next day to basically say hi and in so many english words asked how I was doing. Overall, they were great.

Mark

[Terry Newton]

I am one of the recipients of the last multi-level disc replacement surgeries due to the extremeness of this surgery. Now they tend to do multi-level in multiple trips. I had two surgical teams listed on my report and did not meet with two of them including Dr Ritter-Lang and another surgeon that I never heard of at the clinic. Needless to say I was in so much pain and despair when i arrived that I surrendered completely to their care and assistance. I have never regretted my decision. For a year prior to my surgery I walked with a cane and looked like a bent over, little old man. I went back to work at exactly two months to the date of my four level ADR replacement surgery. I've never looked back. I started exercising as soon as I arrived home with snowshoeing and spinning. I was back on my bicycle in five months and rode 2,234 miles that first season. Naturally it took a long time to feel top-shelf. Over two years to be precise. I never let it stop me from any activity, my height increased from four disc installation, I suffered distraction pain and took Lyrica for about one and a half years after the surgery. I had spinal injections every three months to help with the pain and, at one year, went a whole year before my next injections. I am very satisfied with the results I achieved and would not hesitate to recommend them for surgery and would go back there in a heart beat if necessary.

Good-luck with your decision making process and I am available for further discussion.

[Maverick]

Feb. 21, 2010
Hello Everyone:
I had my operation in Stenum April 24, 2009. 10 months in 3 more days. I had two Maverick discs at the L3 and L5-S1 level and a 360 degree fusion at the L4-L5 level. Dr. Ritter Lang performed the surgery. Dr. Zechel for post care. The surgery was amazing. I went into anaphalptic shock due to an unknown allergy to Cephalexin (penicillin) seconds before the surgery and they went ahead with the surgery anyway and all was well. I had no nausea, no drowsiness, no after effects from the anesthetic after the surgery and that was a huge plus. I was on pain meds for quite awhile, in the hopsital for 7 days. I had a very hard time lifting myself up on the bed for many days. However, I was up and dressing myself and showering within days. I recommend you stay the time the Dr.'s recommend as many leave too early and then wonder why they have some problems. I was very lucky to go to Bad Zwischenahn (the Rhododendrum Capital of Germany - very beautiful in April) and the Reha-Zentrum which is the Rehabilitation Hospital for 10 days. A very wise choise. A lot of patients go to a hotel in Bremen for three days after surgery, have a couple of massages, then fly home. It is very, very expensive and my Health Insurance provider did not accept my application when I came home. My General Dr. and my Neurosurgeon in Canada would not accept this surgery so I did not have their blessings. In fact the Neurosurgeon informed me and my General Dr. that if I went to Germany he would not take me back as a patient unless I contacted a bacterial infection and was dying. The Neurosurgeon only wanted to fuse the L4 and L5. When I asked him what he proposed we do with the two herniated disc above and below...he said "oh you will be looking at more surgery down the road"...that was when I chose to go to Stenum as I knew in my heart that it was the right move for me. I felt I was to old to have several back surgeries when Stenum would fix it all in one. Money was a concern but my health was more important.

I am now off all pain medications. Yahoo!!! I have been able to bend, move, and recently walk a kilometer a day. I do have some achiness in the lower back when I sit too long or bend too much so this is a sign telling me to still be careful. I still have a bit of a problem putting socks on and tying up shoes! I still have some nerve pain along the lower left leg and some numbness in the foot but I think it is being caused by a severe degenerating hip that Stenum found on the X-rays. I am standing up straight and walking straight. I was hunched over and walking with a cane and should have had a wallker but refused to go that route. Stairs are difficult due to hip and degenerating knee. I was falling down without any notice before surgery and was so lucky I didn't injure myself more. I was on the gound and wondering what the heck was going on. Very frightening to say the least. Do I recommend Stenun....Heck Yes in a heartbeat...

If your planning to go to Stenum please feel free to contact me at any time. I don't get on this forum regularly and do hope that I have posted this in the correct manner. Regards, Maverick

[badbatzmaru]

badbatzmaru,

It does seem rather odd that he hasn't talked with you at all.

UPDATE: Thanks to Jim or whomever is lurking these forums and reporting back to Stenum. I was able to meet Dr. Ritter-lang before I departed Bremen. Stenum phoned my hotel room and offered to have me come in on the Friday following my surgery to meet w/ the doctor after he was done w/ that week's surgery. I guess it was obvious that I was unhappy not having met my surgeon, so kudos to Stenum for trying to make it right and have me leave on a good note. I completed my final check-up and paperwork at the same time b/c I didn't want to make the trip back to Stenum twice (just to avoid 2x more 30 min cab rides). Malte was very accommodating and got my paperwork together on a few hours notice, and after waiting about 2 hours for surgery to finish, I had a ~10 minute discussion of my post-op X-rays w/ Ritter-Lang. He is a very nice man, and was able to answer my technical questions with great detail - a post-op discussion with him completely put my mind at ease. The funny thing was how Malte (and Ritter-Lang) both emphasized that it was nice for me to be able to meet him "again" - although I didn't count the first meeting since I don't recall being conscious. Anyway, whatever... it's done and I'm content. The point is that R-L is an excellent surgeon and really is very pleasant to speak with. I'm glad I finally got the opportunity.

[rob wilson]

I have the all steel Maverick. It seemed like such a simple design. 2 piece all steel. I certainly would prefer a design that mimics a natural disc like the M6 L. However, can the ploymer withstand the long term force and stress in the lumbar. This would be a non issue in the cervical where there is so much less stress.