my take on Boeree and Clavel - decision making for 1 level lumbar M6

[laid up doc]

have been talking w/ these docs and researching logistics all week... thought i'd share my thoughts as a fellow doc (on the other side of the pond, do some nonsurgical spine work but not a spine surgeon)

Boeree is much more direct about certain things, and talks a lot more about details right off the bat. He asked me about my BMI (cuz you can tell on my CT that I'm no supermodel - but not obese), and we talked at length about stopping oral contraceptives well before surgery. He is older than Clavel, did older ADR's before the M6, and has therefore more numbers. he is the consummate professional British gentleman.


He was very reticent to talk much about travel planning and whatnot, deferring to Jo. I think the biggest negative about his practice is that it is in such a remote location - lots of extra logistics involved. From my number crunching - surgery cost is not much more than Clavel, but getting there/around/housing/food are significantly more. You also have to factor in the trip from Heathrow or Gatwick. The housing options are much less plentiful unless you plan to 1. rent a car or 2. take lots of taxis and stay in Southampton or Portsmouth.


Clavel is more than willing and able to talk to you about whatever you want to know - just his general "spiel" is much shorter. He has answered every nit-picky question I asked in a quite satisfactory manner. I sorta "tested" him a bit when it came to my history and imaging - and he knew about all of it. His personality is really quite different than Boeree's - he readily admits that he is quite laid back - and i inferred that he really relies on you being cleared on your end for surgery. most people who are willing and able to fly to Europe and have spine surgery are otherwise reasonably healthy, and you'd be silly not to pass a once-over by your PCP before spending thousands on even the trip planning. imho his ADR numbers are more than enough, and he also does a lot of non-adr lumbar surgery.


Logistics to me are much better in Barcelona - no lengthy airport transfer, plentiful housing options, and all of the convenience of a major city in regards to public transportation, entertainment for travel buddies and hopefully me the last few days, food, shopping, etc. Clavel's assistant Dr Gilete is the logistics man, and has answered all of my emails very promptly i/r/t neighborhoods and whatnot.


In general... I'd rather deal with either of these surgeons than nearly every spine surgeon I know or know of in the US. They're personable, and you can tell that they care about you as a person and not just a number. I have had non-surgeon US physicians provide that level of care, but the only surgeons I know in the US who do that sort of care are cash-only and still aren't quite as good. These guys are cash only too, which does help... but spine surgeons here are NOT suffering (other than the fact that many of their patients never... go... away).


I feel much more comfortable with the whole setup in Barcelona, and connected very well w/ Dr Clavel. I talked to him a lot about surgical approach, what factors go into who does well, when he does or doesn't cut the PLL... etc etc.


For anyone looking to talk to him anytime soon - better hurry, because he's going to be in the US for meetings the last part of October.

[JPJH]

I sent all my spine info to a total of 5 Dr.'s overseas. Narrowed the focus to Dr. Clavel & Dr. Boeree. I liked the both of them very much and have no issue with recommending either one. I ended up going with Dr. Clavel. Dr. Clavel is a bit more calm and collected. The hospital situation in Barcelona I think is far superior to any of the others in England & Europe. The Quiron Hospital is very modern with top notch staff, even if the language can be an issue at times, but you are only there for two nights. My wife and I rented an apartment for the two weeks we were there and had a great time exploring Barcelona. Dr. Clavel has also provided a lot of post surgery support via emails with me.

JPJH
M-6 ADR Oct. 2010 C/4-5 & 5-6, Dr. Clavel.

[laid up doc]

JPJH,

unfortunately, we lumbar spineys are looking at more like 3 days in ths hospital. i have the advantage that i am fluent in spanish including medical spanish, so language is not a concern for me. have talked w/ friends who also speak spanish and they say everything is in castillian and catalan.

looking forward to just getting 'er done... i know it won't be a vacation, but i hope to take in some sights on my walks. i also rented an apartment, in a convenient but not overly tourist area of l'eixample.

Dr Gilete conversed with me on multiple occasions about where various apartments were... he has been a GREAT help on the logistics end. Dr Clavel has answered all of my detailed medical questions to my satisfaction. looking forward to meeting them finally, a week from Tuesday!

[JPJH]

JPJH,

unfortunately, we lumbar spineys are looking at more like 3 days in ths hospital. i have the advantage that i am fluent in spanish including medical spanish, so language is not a concern for me. have talked w/ friends who also speak spanish and they say everything is in castillian and catalan.

looking forward to just getting 'er done... i know it won't be a vacation, but i hope to take in some sights on my walks. i also rented an apartment, in a convenient but not overly tourist area of l'eixample.

Dr Gilete conversed with me on multiple occasions about where various apartments were... he has been a GREAT help on the logistics end. Dr Clavel has answered all of my detailed medical questions to my satisfaction. looking forward to meeting them finally, a week from Tuesday!

Looks like you are set. I wish you all the best. You will be in good hands. I only met Dr. Gilete right before my surgery as he assisted. He is very professional and calming as well. You can tell he and Dr. Clavel are a good fit and work well together. I went at this time a year ago and it was a great time of year to be in Barcelona. We had rain the first night, but after that we did not even need a jacket as the weather was great.

JPJH

[dentalrebel]

Laidup I'm interested to hear how things go. I may be headed toward a ADR. Good luck.

[laid up doc]

dentalrebel -

will be posting updates... don't worry! I leave for BCN on the 16th.

[KanRunMo]

I'm so glad you have found a surgeon and have a date for surgery. Since you are only needing a one level ADR, Dr. Clavel would definitely be experienced in that. I have not seen many people that have had multi-level (2 or more) lumbar ADRs with Dr. Clavel. I need to check with him since that is probably what I would need. I've seen that Mr. Boeree often does multi-level ADRs both Cervical level and lumbar. Of course Stenum Clinic with Dr. Ritter-Lang does many mult-level ADRS. Have you figured out your cost with Dr. Clavel?

[Justin]

Laid up Doc, good luck with Dr. Clavel. You'll have to post updates as things unfold in a few days.

[laid up doc]

KanRunMo - cost of surgery for Boeree and Clavel was very similar (under $30k for 1 level lumbar ADR, all inclusive for surgery/hospital/anesthesia/PT) - but cost of travel/living was a lot cheaper for BCN.

I would have been comfortable w/ either surgeon, but not comfortable being in a small town in England for recovery. I think the motivation to be out and seeing as much of BCN as I can will be good for me (and yes I know not to over-do it!!!) - not to mention that you don't need a car and everything you need is readily available.

Also didn't like the idea of being at a small hospital far from a major hospital were ANYTHING else to happen during surgery or recovery, or to my travel companion. I do think like a dr after all!!! Hope for the best, but always have your worst case scenario plan in mind. I won't rehearse it in my head like I would a work scenario!!

Everyone has their own priorities... from what I'm told, my ADR surgery should be a chip shot since I have no bone spur cleanup, no loss of disc height (ergo probably won't need to cut my PLL or do any distraction). i'm young for a spine pt (under 35), a little chunkier than I should be, but otherwise healthy.

I can't comment much on multi-levels, but there is a guy who posts on another board who had 2 lumbar M6's done by Clavel earlier this year and is doing very well. I do think that Boeree does more multilevel ADR's - hard to say though b/c Clavel operates on a lot of Spaniards as well, who don't come on these boards.

[dentalrebel]

I know your trip is coming up. Just had you on my mind. I'll keep you in my prayers. Good luck.