From: Richard Merkin <████████████████>
Sent: Thursday, October 16, 2014 2:06 PM
To: 'jeffrey E.'

Hi,</=>>

Sorry for the delay. I spoke to both UCLA and Keck s=hool of medicine. Both, of course would love to see you, but I am sure tha= is not necessaryll could set up neurosurgical consults in Boston or Johns=Hopkins just as well]. There is no extrusion and with bulging discs there =nbsp;certainly is the opportunity with therapy to control the symptoms. Fo= disc issues with, if you can manage the pain, the results six months late= do not show any advantage of surgery. For the stenosis that is a differen= issue. Unfortunately many surgeons[most] operate by the MRI and not by th= signs and symptoms of the patient. Have you seen a neurologist? Have you =otten an EMG and a nerve conduction study? These tests will help decide if=you would or should have surgery today or can delay as long as possible[ma=be forever]. If you do decide to go to the next step and want me to, I wil= come and accompany you to your physician. Hope you're feeling better!

=