Tales From The Table…
This blog entry is about stories from my table from this past week. I had two interesting cases that will demonstrate why a trip to the chiropractor may have been the most logical step for these individuals, but each ended up not being my patient. Keep reading to see where this story makes sense. I’m always happy to see patients, but I’m never one to pass up proper doctoring just to attempt a quick fix for a patient in need.
The first patient found my clinic through an internet search. She came in with headache and neck pain, which is very common at my office. She had dealt with this issue for months. Her previous doctors had attempted to manage her pain through spinal injections. After my initial exam, I determined she should have an MRI to assess her upper spine for potential problems. She told me she had had an MRI 2 months ago, so I had my staff acquire the report. The morning before her afternoon appointment, I was reviewing her MRI and noticed some alarming findings. I decided that I needed to call her radiologist for clarification and verify some of these findings. This patient had 3 levels of herniated discs that were pushing in to the space of the spinal cord. One was even noted as severe and the doctor could not see any space! I immediately called the patient and told her that my concern was that she was not in the right clinic for treatment. We routed her to a neurosurgeon for evaluation. I will let the neurosurgeon make the call as to whether she is a surgical candidate or not, but I will not touch this patient without clearance from him.
The second patient was a referral; she was the daughter of a long time patient’s friend—simple right? Sometimes these patients tell the friends how we can get them in and fix them right up! Occasionally these patients are expecting some quick-lube type of service but this is another case of proper doctoring prevailing. This patient presented with neck pain and weakness and other neurological signs and symptoms, and as per protocol I send out for an MRI of the upper spine. Before she got to the upper spine MRI, she called the clinic complaining of lower back pain. She had hurt her back and the pain was worse than her neck! We instructed her that she should come in and be evaluated so we could get her on the right path. Her mother called and asked if we could just add in a lower spine MRI since we were already doing the upper. We explained that we needed to document the reason for approval from insurance company. The patient came in and we were talking about her low back pain and I was going through her tests to see if she in fact needs a lumbar MRI. She informed me that she had been to the ER twice and they sent her home with 4 different meds–which are not helping. Then she told me that the night or so before, her legs went numb, she fell and she lost bladder control! I asked her if she drove to my clinic and she said yes. She said her mom could come get her and I said that was probably a good idea considering she recently lost control of her legs and driving a car could be perilous not only for just her but those around her! She went to the ER that night with my referral and with this new information they admitted her, performed an MRI. and brought in a neuro specialist! They found a condition that causes fluid filled sacs to form in the spinal cord which can alter or shut off function of the nerves that control different parts of her body.
On the surface, both patients were Chiropractic candidates, but after further examining and evaluating they were not. Both had common spinal complaints and asked for my help, and I wanted very much to help both of them, but without listening and understanding their symptoms and conditions and sticking to my protocols for treatments, things could have turned out very differently. These sorts of cases should demonstrate to potential patients of any doctor that, even though the questions and examination seem long and drawn out, it really is the right thing to do for both the health of the patient and from a risk perspective for the doctor. At Health By Logic in Beavercreek, Ohio, we are committed to getting the best care possible for our patients even if it’s not in our clinic. If I am one link of the chain that helps solve a health problem for a patient I feel I have been a good doctor.