Dr. Granet speaks

Apparently, Otis DID e-mail Dr. Granet. I was cc'd on Dr. Granet's
reply TO Otis.

Otis? Maybe it's time you left s.m.v. You are dishonorable AND
thoroughly discredited.

----Dave Granet's reply----

Otis-

I sadly googled myself after your message and was horrified to find my
name bandied about with such venom. I will respond to your question
but I would appreciate a more civil discussion if it involves me in
any way.

As to the adjustable sutures - here is the short history. I have
asked Neil Brooks if I may share his medical history and he has given
me permission in order to answer this query.

Neil came to me years ago having seen many pediatric ophthalmologists
around the country. He was frustrated by his long history of
strabismus and accommodative problems. We spent much time discussing
his options and I was impressed by his intelligence. I "assigned" him
much homework hoping to ease his frustration by educating him. (As an
aside, when Neil comes in I have our junior residents block out an
extended time period to examine him, review his history and chat - for
THEIR education.)

On one appointment while again discussing possible surgery Neil
broached the idea of delaying the adjustment as long as possible to
allow his brain to adapt before we finalized the location of the
muscle. I had done some related research previously and had
considered the idea but never done it. I was aware of the work done
by Christine Burns from Florida along these lines.

Neil and I discussed the options and I pieced together some parts from
the medical literature (like Rick Saunders - "Do we need to tie the
knot?" and my own work with hyaluronic acid). With much courage Neil
proceeded knowing I had never done this surgery before. From his
success we have done many hundreds of these procedures, presented at
national meetings and combined our data with some other centers (some
we triggered to use this procedure, others had worked along similar
lines) to create a manuscript just submitted for publication. I have
since taught many fellows, american and international this approach so
it has affected more patients than I could ever help myself.

Whenever Neil comes in I point out the pivotal role he played in the
development of delayed adjustable sutures. I may have eventually
reached the same place or not, but the fact remains it was his issues,
his persistence in wanting a delayed adjustment and his courage to
allow me to try that was the "tipping point" for us in San Diego.
I'd like to think that the team effort of an educated patient with a
caring educated medical partner is the future of health care. It is
what we strive for. I wish that always lead to perfect outcomes.

Neil Brooks has had a complicated and tortuous ocular past; he has
partnered in his care - reading in a careful and intelligent manner
the ophthalmic literature on every issue as it pertains to him. I
have hopefully aided his education and care. However, I will add, he
is not a doctor and should not provide medical care. To my knowledge
his comments to other patients I've seen have been cogent and
appropriate.

I hope this answers your question. So that there is no
misunderstanding feel free to forward this entire message to the
usegroup. I will also send to Neil. I have no wish to "enter into
the fray" nor do I want to receive a barrage of email that takes me
away from patients or family. I would hope that sci.med.vision would
be a safe cordial place for folks to come and chat, learn, discuss and
maybe even disagree on topics relating to vision.

Sincerely,
David Granet
October 7, 2007

.

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