Dr Shevel’s response to PC Guy:
PC Guy came from Australia to me for treatment of headache that resulted from a cosmetic laser procedure to the left temple. From the extensive correspondence between us it appeared that his pain was most probably from two sources – arterial and muscular.
I will quote the relevant parts of our correspondence to illustrate what really happened, but the full emails are available if you would like to read them.
On 20th May 2011 he wrote “The diagnosis of injury to the vessel was made based on the following, I have a visible, and pulsatile vessel in my left forehead, (picture attached) that was not in this state prior to the treatment and that lies directly in one of the spots the laser was used”. In the same email he wrote even “if the vessel is responsible there seems to be lot of other stuff going on like muscle pain and stiffness”. Below is the picture he sent me of the damaged artery.
On 5th June 2012 he wrote that he had decided to come to South Africa for treatment. My reply “I have cc ed this e-mail to my practice manager, Nicole Smith, who will assist you with the necessary arrangements. We ask patients to stay for at least two weeks”.
He arrived a year later on 20th August 2013, and was scheduled to have the surgery on 21st August 2013. He delayed the surgery until 23rd August, so we lost two days of his trip. On 23rd August he underwent the procedure, which included cauterization of both arteries and muscles. The treatment was discussed in detail with him, and he signed the necessary consent for both muscles and arteries.
Despite our request that patients stay for two weeks after their procedures, he left two days after the surgery but promised that he would return should further procedures be necessary. On 2nd September 2013 he wrote “I will let you know how I am going in a few weeks and see if I need to come back for some more work”.
On 18th October he wrote “are you able to administer the Botox as if so returning to Joburg may be my only option. Please let me know and I am sorry I am so negative”.
I replied the same day saying “Yes, I most certainly am able to give you the Botox – I just hope that it gives you relief from your constant pain.”
“Did I ever send you the following link for a biofeedback headband that some people find helpful for muscle tension? http://www.stopgrinding.com/order.htm the one to get is the standard sleepguard system”.
This was intended as an interim measure that may have given him some relief until he returned – clearly any discussion of Botox was aimed at treating muscle tension, so biofeedback for muscle tension could possibly have helped.
Unfortunately he appeared to take umbrage at this, and unleashed a torrent of abuse on various internet sites. Please note that PC Guy is not a cluster headache sufferer, yet he has seen fit to post as if he is on Cluster Busters which is a site devoted to cluster headaches.
His criticisms included:
The difference in the cost of diagnosis between South African patients and foreign patients. With regard to the difference in fees for foreign patients, there are very good reasons:
- Foreign patients have unlimited access to me and my time for the duration of their stay, as well as with all the other members of my team. There is no other medical facility that I know of that provides the care and service that we do, especially for people who are far from home.
- Every foreign patient is given a mobile phone with my direct number, so that they are able to contact me at any time of the day or night. They are encouraged to contact me for the slightest problem, and people who have been here for treatment will confirm that I have no hesitation in making house calls to them at all hours if necessary.
- Because foreign patients are here for a limited period of time, and because they often need follow-up treatment after the first intervention, there is no further charge no matter how much extra treatment has to be administered.
- The cost also includes a very costly embolization procedure if necessary to close difficult to access arteries. This is also paid to the specialist that does the procedure by the South African patients’ insurance. For foreign patients the total cost includes this.
- The very expensive CT angiogram scan that we have to take before the surgery is paid for in South Africa by the patient’s medical insurance. Foreign patients have to pay themselves. This is paid to the radiologists who do the scan, and is not part of our fee.
He also wrote on one site that the diagnosis cost 3,500 Australian Dollars and that the surgery cost 8,500 Australian Dollars, totaling 12,000 Australian Dollars. The website is http://www.mdjunction.com/forums/ndph-support-forums/general-support/11040564-surgery-at-the-headache-clinic-johannesburg
On another site though, he claimed that he was charged 20,000 Australian Dollars. https://clusterbusters.org/forums/topic/2898-dr-elliot-shevel/?hl=shevel
He wrote “I have received no support from Dr Shevel or the Clinic in any way. No after care, not even an email other than brief replies to emails I sent following my surgery”. http://www.mdjunction.com/forums/ndph-support-forums/general-support/3650329-claim-for-successful-treatment-for-ndph .
This is also patently not true – we had e-mail contact on a number of occasions – on 29th August 2013, I emailed him (unsolicited) as follows:
I hope your flight back was pleasant and uneventful.
The tenderness and soreness of the left temple are most certainly related to the extensive muscle cauterization – this usually subsides in approximately four weeks. The feeling of a tight band should subside as well.
I have not encountered skin numbness before following muscle cautery, but as you have very little subcutaneous fat, some of the small nerves in the skin may have been cauterized when I did the muscle – these will, I have no doubt, recover with time.
If you can find an ointment containing methylsulphonylmethane (also called MSM) and apply it to the tender areas, you may get substantial relief and quicker healing.
How are the spots in the neck that I cauterized?
I emailed him again on 29th August, 16th September, and 18th September.
It is indeed unfortunate that I was unable to help him – in medical practice it is a fact of life that even with the best will in the world, there will be treatment failures. In this instance though, PC Guy himself played an important part, as he did not stay for the two weeks that was necessary to complete his treatment, and he did not return, as he had promised, for the treatment to be completed. Had he done so, the chances are that he would have had a very positive result.
He claimed that I said there would be no numbness. This is not true, as post-operative numbness of parts of the scalp following arterial surgery is a common occurrence, and all patients are warned beforehand of the possibility.
Below are the sites that we are aware of that PC Guy has posted on:
Below is a link to some extensive email correspondence concerning NDPH which may be of interest