Hello, So I have surgery with Dr. Hackman on October 2nd, but I think im going to cancel (again). Have you had surgery with Hackman or Cognetti can you pleaee share your experience. Main reason I may cancel is because I have a interview with a hiring Manager on the 23rd and if I get the Job it will not be wise to have such a serious surgery a week after being hired. Another reason is because ive read many testomonials of both Drs. And it seems like Hackman has a fair amount of Post-op complications / mishaps due to surgery and it seems like Cognetti has far fewer maybe 2 or 3 i saw compared to Hackmans 10-20 ive read having complications Post-op (these were mostly from the ES facebook group), but it seems like overall Cognetti has better results. Thank you all who can give me insight on this situtation.
Dr. Cognetti has more years of ES surgical experience than Dr. Hackman so a longer surgical history. I think initially Dr. Hackman was cutting the styloids very close to the skull base so more of his patients were having trouble w/ facial nerve irritation which caused temporary post op lip droop & eyelid paralysis. As far as I know those problems resolved for most of our members who saw Dr. Hackman for surgery early on. More recently, it seems those problems are less prevalent after his surgeries so I’m guessing he’s refined his technique a bit.
I also recall reading (maybe on our forum) that Dr. Cognetti trained Dr. Hackman in doing ES surgery. Doctors Cognetti and Hackman
Thank you @Isaiah_40_31 yeah it really seems Cognetti has overall better outcomes/results. Would you happen to know any resources they may help me pay for my surgery in case I cancel with Hackman, most likely I think I am. Im terrified with so much anxiety and fear about doing this surgery and with the stories people here and the facebook group have told overall I have more peace of mind going forward with Cognetti. I wish ive done this sooner and now im on a time crunch but i really dont want to ruin my life post-op by going forward with someone where i may have a higher chance of a medical mishap. Anyway yeah are there any resouces to help me pay for my surgery cause if i cant get the surgery this year i wont have Blue cros Blue sheild ppo anymore and idk how good this potential job i have lined up insurence is. Also worst case scenrio i dont get the job. Ill need financial assistance for the surgery and i have no clue how to navigate that. Do you have any recomendations?
I’d call Dr. Cognett’s ofc Monday morning to schedule an initial consult. I don’t know how far out he’s booking, but if you can get the consult this year & let him know your insurance issue, he may be able to fit you into his schedule before 2025. I maintain that doctors are ultimately the masters of their surgical schedules in spite of what their schedulers may tell you.
There is also the chance of getting a cancellation both for the consult & surgery to move whatever dates you get to sooner. You can ask to be put on a cancellation list if they keep one, otherwise you can call the ofc several times a week to ask if there has been a cancellation.
Dr. Cognetti will do an initial consult via telehealth but will need you to send a disc of your scans once you have an appt scheduled.
I believe Dr. Cognetti’s surgery rates are negotiable for cash paying patients (ie those w/o medical insurance) & are about 1/3 the cost charged when a patient has insurance. This is pretty typical of the way things are done in most doctors’ offices & hospitals.
If you do end up needing financial aid, the best I can offer is the program on our home page - WITT.
https://forum.livingwitheagle.org/search?q=WITT
Dr cognetti did not train Hackman. They were in school together. Cognetti was one year ahead and Hackman was chief resident . I spoke to Hackman about this. I don’t believe Hackman has had more problems as a matter of fact I know of two people that Hackman did a revision on Cognetti patients. Also he does still cute to the skull base. Obviously with all the doctors there are patient complaints. Cognetti years ago did more surgeries for ED than Hackman but o believe Hackman is probably doing a little more than him the last few years. They did go to the same residency program . Again they were in the same training program and they were trained by the same doctor as they were both residents in Philadelphia.
Thanks for that info @adriene61 ! I certainly agree with @Isaiah_40_31 that while some members have had facial nerve numbness post surgery, it resolves with time. And Dr Hackman doing bilateral surgery is a big bonus for many members…
Thx for your update @adriene61 & for straightening out my misconception re: Dr. Hackman’s ES training.
For @Cdbruce, Dr. Cognetti may still be the best choice because of the substantially lower cash price charged for patience w/o medical insurance. Dr. Hackman’s charges are inflexible & are the same for insured & uninsured patients. I know his fees are pre-set by UNC Hospital Admin, but it makes seeing him w/o medical insurance only possible for those who have deep pockets financially. This is first hand information not speculation on my part.
It is unfair to compare one experienced surgeon to another as I agree that no doctor has a 100% success rate surgically. Patient outcome often has to do w/ a particular patient’s body’s ability to heal, comorbidities that may also be present & sometimes due to Dr. error as medicine is & always will be “a practice”.
I totally agree with you about outcomes. I think commodities have a lot to do with outcome. Patients are very quick to blame every symptom on eagles. I had heard of people getting discounts for cash pay, I went to UNC website and looked copied and pasted this. I know legally they can not change the price with insurance involved.
I will call and ask soon to verify as I don’t want to spread false information. I personally think it is dangerous to tell any patient who they would be better off with, I get your point about insurance if he didn’t have insurance. Personally if I were going to do the surgery I would want it paid by insurance and get the healing over in an old job and not start a new job ill with a chance of surgery looming and the length of healing time for some, but thats me.I always tell them anything I know to educate them and then to get as much information as they can and then choose who they are comfortable with. I truly appreciate your knowledge and sharing information. You are a blessing to many and helped need in my journey to recovery. I couldn’t do it. Please don’t take this email the wrong way. I think they are both in the top five for ES personally. Have a great day.
@adriene61 - No offense taken. I try to be careful here not to make hard recommendations to a particular doctor, but there are times when a member’s situation seems to dictate a more specific recommendation. If a member becomes uncomfortable w/ the idea of having surgery w/ one surgeon, my goal is to refer them to someone who has equal skill & experience.
I appreciate the info you’re researching re: lower prices at UNC for cash paying patients. I worked w/ one of our international members as a liaison w/ UNC as he has to pay out of pocket to see Dr. Hackman. The negotiated price only dropped from $45 K to $36 K for him which is well out of reach for most people & is a financial drain for him. As you know ES makes us desperate for relief from symptoms so a number of our members have emptied their savings trying to recover. I argued on his behalf for a lower price since he would have huge travel expenses in addition to the surgical cost, but the billing department had no flexibility & was constrained to charge the pre-established rates set for them. Dr. Cognetti/Thomas Jefferson Hospital charges a little over $8 K for patients paying out of pocket for ES surgery.
I appreciate this thought & didn’t intend for what I said to infer, @Cdbruce would be better off w/ Dr. Cognetti, only that he would be another good option (which he’d already mentioned himeself) if he felt uncomfortable w/ Dr. Hackman. I had previously suggested he contact Dr. Hackman to have a conversation w/ him pre-op which might help him feel more comfortable about his upcoming surgery.
To finish, I made this statement based on the fact that Dr. Cognetti was on the Doctors List for this forum when I joined in 2014. Dr. Hackman didn’t appear until you mentioned him (a BIG Thank You, BTW!) in 2020. My assumption that the two doctors’ levels of ES surgical experience were very different was potentially not accurate as I expect there are a number of doctors in this country who do ES surgeries & maybe even vascular ES surgeries, whom I have never heard of. I will be more careful about what I say in that regard in the future & appreciate your constructive criticism.
I’m very glad to know you benefitted from the support I offered you during your recovery & I appreciate that you pop back in from time to time to offer support to those who are still struggling with ES. 
That’s quite a difference. I don’t know with todays prices how they go that low but that’s great.
Cdbruce speaking from my own experience, Dr. Hackman’s work on me was nothing short of magnificent. I had two styloids removed June 5th that were enlarged horizontally versus elongated laterally. I cannot speak for Cognetti.
Yes it was a rough experience at UNC, and yes it was expensive. However I lived with ES for 3 long years, and suffered in silence. My two cents? Dr. Hackman is world class. The hospital itself? older place BUT it gets the job done 
Thank you @HappyBear how are you feeling now? I know you had other issues outside of ES, but i was wondering if youve noticed a difference in your pain with ES. Like are you in any Post-op pain still? Or ES pain Still? And if not how long post-op did it take for your ES and Surgical pain to go away?
The difference in pain has been night and day. Yes, I have other problems caused by blunt force impacts, including the whipflash that caused ES to begin with; and by black mold exposure that I’ve only recently learned about (A licensed plumber screwed me over by not installing a toilette correctly in 2020, and then in 2021, failing to securely tighten a new 1" water line that leaked for 3 years…causing mold in my front yard…I got a double whammy! The enemy has been at work). About post-op pain…Before the surgery, I did a LOT of spiritual work…visited the Relic of St. Jude 4 times (touched its glass case) in 4 different churches, started attending Catholic Mass and doing the sacraments, had 2 “healing sacrament” oil healings by 2 different priests, and most importantly, began doing confession. All of which I was not raised with. The day of the surgery, I did experience a miracle. The Queen of Heaven (AKA, Holy Virgin Mary) entered the surgery room. I became aware about 15 seconds before entering anesthesia. No complications at all following surgery other than the normal healing. Was hiking the next day…although SLOWLY. The only rough patch was one nurse at UNC from Africa…The woman had a lot of darkness around her that I picked up on, and did not treat me with the courtesy of respect. Had her for maybe 6 hours then she rotated out. About surgical pain…I’d say…well dang…I have a HIGH pain tolerance so I’m going to say 2 weeks. The flight back alone was rough because of the incompetence of american airlines. Indeed, instead of getting “wheeled in” to the boarding area, I had to walk myself in because their was a line of people waiting for the wheelchair porters. I would have missed my flight! So I hobbled to the plane VERY slowly