Monday, October 14, 2013

Does Your Kaiser Doctor Know Best?

Case Study - Migraine headaches caused by cervical spine kyphosis.

A 48 year old female patient presents to Chiro-Health, Inc with complaints of daily migraine headaches, jaw pain, neck pain and severe muscle spasms.  She has had all these symptoms in the past but the last 2 months the frequency and intensity of the symptoms increased to unusual level.  The patient was  seen in our office before for occasional chiropractic adjustments for the same symptoms and chiropractic care always provided a relief.  During my meeting with the patient I suggested x-rays, since the condition was returning and it was getting worse.  The patient has Kaiser insurance, and is concerned about cost.  I suggest that she speaks to her Kaiser provider and request the x-rays to be done at Kaiser, this way they will be covered by insurance.  Next day, the patient calls me to ask me what views will she need, she got the Kaiser doctor to prescribe the x-rays, but the doctor did not know what x-rays to order. So naturally I e-mail the views needed and the Kaiser doctor orders the study.  The patient takes the x-ray in the Kaiser facility  the next day, and I receive an e-mail from the patient that her Kaiser doctor told her there was nothing wrong with the x-ray.  Look at the image.  The one on the left is the patient x-ray in a lateral view, taken from the side.  The one to the right is a lateral cervical (neck) spine that is very close to normal.  I showed these images to my twelve year old daughter and asked her which spine looked healthier, and she instantly picked the right image. These are my concerns:
1) Kaiser doctor does not see the need for x-rays, based on patient history, when they are indicated
2) Kaiser doctor does not know what are the views needed to evaluate cervical spine
3) Kaiser doctor misinforms the patient that the x-rays look great, no need for concern

I requested the x-rays and scheduled the patient for a follow up.  This is what's wrong with the left x-ray, which belonged to the patient:
There is a loss of cervical curvature
There is fusion between cervical vertebrae 5 and 6, most likely congenital (patient was born with it.)
There is phase 2 Degenerative Joint and Disc disease, meaning decreased motion, bone spurs, neurological deficiency

I started extension traction with the patient in our office, meaning that she laid over a pump that provided pressure to her cervical spine, over time it is expected that the curve will correct or at least improve.  The patient has been doing the traction at home for the last month, she has not had any migraine headaches, the pain and the spasm in the neck muscles have decreased by 80%.

I am upset with the fact that the Kaiser doctor, but I am sure that what she did is not because she did not care for the patient, but because she did not have the tools to care better.  All she could offer was  medication for the migraine and muscle relaxers.

The purpose of sharing this case study is to make these points: always get a second opinion, please ask to see your x-rays and the radiology report, know that chiropractic car could provide a natural solution to many conditions.  Consult with chiropractor to see if safe, natural chiropractic care could be appropriate for your condition.

For more information on this article or the cervical posture pump you can reach Dr. Mazgaloff at (415) 546-1461 or on the web at and watch the posture pump animation video.

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