Meet Otto: The First Self Driving Truck

Meet Otto: The First Self Driving Truck

As many of my avid blog readers are already aware, I am a Baltimore chiropractor that spends the majority of my time treating patients in Baltimore with headaches, neck pain, and back pain. Sometimes these patients present following Baltimore auto accident injuries and Baltimore truck accident injuries, and sometimes they are “desk jockeys” or “weekend warriors.” The thread that unites them is the presence of spinal pain and discomfort that prevents them from actively participating in their activities of daily living. They always want to get out of pain and back into their normal routines.

One of the things that I like to spend my time blogging about on this website is technology. Several posts ago I discussed that new autonomous Uber cabs were on the road in Pittsburgh. As we discussed in that blog post, only time will tell how able Uber will be to get these cars on the roads in all major cities.

Uber is not stopping its quest for global transportation domination only with passenger vehicles. Uber recently aquired a company called Otto for $680 million just a few months ago and it has already managed to make its first semi-autnomous delivery of cargo in Colorado just this past week. What was the precious cargo that traveled from Fort Collins to Colorado Springs? 50,000 beers!

Unlike traditional cross-state and cross-country trucking outfits that require a large labor force of drivers to operate these big rigs, Otto sets out to help the bottom line of big businesses by decreasing their dependence on human control (which is the number one cause of accidents, injuries, and deaths on highways) all while decreasing fuel costs.

I’ll admit. As I was reading some articles about Otto on the web, I got nervous thinking about what it would feel like to see an 18 wheeler driving without a truck driver. But Otto doesn’t like to think of itself that way. It likes to think of the human truck driver on board as a “co-pilot” that can engage control of the truck with the push of a button.

Highways seem like a natural fit for semi-autonomous trucking operations. The roads are generally straighter. There are few if no pedestrians. There are no stop signs. And the already stretched thin work force of drivers can focus on the “tricky” driving that still requires human interaction. The driving that takes the truck the first few miles to the highway and the last few miles to its delivery zone. That is, it does not appear to be looking to eliminate human employees as drivers.

The first autonomous co-pilot on Otto was Walt Martin. He joked that he would be busy taking naps and practicing his yoga in the back of the truck while it drove over 120 miles to its destination.

Otto trucks only require about $30,000 worth of equipment to retrofit a traditional big rig into a high tech automated vehicle. It requires 3 LIDAR laer detection units, radar on the bumpers, and a high precision camera sitting above the windshield – thats basically it.

The makers of Otto foresee a future where trucks are “just trains on software rails”. They foresee their driving copilots as “harbor pilots” who just do the tricky navigation required before and after the highway driving on any given trip.

As with regular Uber cabs, it is still to be seen if semi autonomous of autonomous driving trucks will actually make the roads safer (as is being claimed) or if it will lead to more injuries and death due to some combination of computer and human error.

I am curious to see how long the next autonomous Otto ride will be and which additional obstacles (wind, rain, bumpy roads, etc) it will need to overcome. I, for one, welcome our new computer overlords.

If you, or someone you know, has been injured as a result of a truck or auto accident in Baltimore and require treatment, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

Chiropractic and Stroke – Neck Spinal Manipulation is Safe

As a Baltimore Chiropractor that spends the majority of my time treating patients with headaches, neck pain and back pain, I often get asked questions about neck spinal manipulation. Patients, even those with neck pain, are sometimes afraid of undergoing any neck spinal manipulation fearing for their health and safety. I understand their concerns and to those who would be candidates for cervical spine (neck) manipulation I usually discuss a few points. In light of the recent report of the death of Katie May, model and snapchat star who died last February after having visited a Chiropractor following a fall while on a photo shoot, I thought it may be appropriate to discuss the safety of neck spinal manipulation. There are a few things to consider here.

First, Chiropractic is safe. While it is true that there can be negative outcomes from spinal manipulation including with neck spinal manipulation (typically joint sprain and soreness), there is no evidence that chiropractic adjustments (neck spinal manipulation) can cause stroke. As it turns out, the largest and best quality study performed to date looked at the medical records of all 11 million peope in the Canadian Province of Ontario over a 9 year period, and found that patients who went to a chiropractor for neck problems were no more likely to have stroke following their neck treatment than patients who went to their primary care physicians. As far as my practice is concerned, I have been a licensed Chiropractor for almost 8 years. In that time I have performed well over 10,000 neck adjustments without a single serious complication that I am aware of. I also perform neck adjustments on my friends, family and loved ones without any undue concern for risk. In fact, when my neck is stiff and sore I usually have a colleague evaluate and adjust my neck.

Secondly, Chiropractic care is effective. A chiropractic approach to neck pain and other spinal pain is at least as effective as any other treatment. For patients with many types of neck pain and headache there is at least as much scientific evidence showing that chiropractic treatment is effective as there is for any other medical or surgical treatment, including the use of NSAIDs and opiod drugs. In face, in several head-to-head studies, common chiropractic treatments for neck pain  (such as manipulation, mobilization, and exercises) have been shown to be as effective or more effective than pharmaceutical treatments. Further, no large study has ever found manual treatment for neck pain to be less effective or more risky than pharmaceutical treatment.

Finally, Chiropractors are well trained professionals. We are well educated and well trained to identify risk factors to determine who may not be a good candidate for neck manipulation treatment. The safety of our patients is, of course, our paramount concern when determining if cervical spine manipulation is appropriate.

While it is truly sad and unfortunate that Katie Mae lost her life, it is important to understand what a rare circumstance her outcome truly is. Despite this terrible circumstance, millions of people across the country continue to rely on Chiropractors such as myself and my team to provide them with neck pain relief every year.

If you, or someone you know has questions about cervical spine manipulation and are curious if chiropractic care is appropriate for you, please contact Mid-Atlantic Spinal Rehab & Chiropractic for a consultation. We would be happy to answer any questions that you may have.

Dr. Gulitz

(the previous was reproduced with permission of Dr. William Lauretti D.C.)

Increased Access to Chiropractic Care Linked with Lower Healthcare Costs and Better Outcomes

As many avid blog followers already know, I am a Baltimore Chiropractor who spends the majority of my time utilizing chiropractic care to treat headaches, neck pain, and back pain in Baltimore, MD. Whether it be the weekend warrior type, the blue-collar worker, of a Baltimore auto accident injury patient, I have been a licensed chiropractor for almost 8 years and have been helping patients with these conditions since graduation from Chiropractic College in December of 2008.

A recent study highlighted by U.S. News sheds light on what I have long believed and understood, that access to Chiropractic care can not only lower healthcare costs (a burden we all share) but can lead to better outcomes for those patients receiving the care.

A while back I shared the story of how I initially became a chiropractic patient. The short version of it is that I injured my lower back when I was about 18 or 19. I tried the typical regimen of care – stretching at home, over the counter drugs, physical therapy, and consultations with orthopedic surgeons. I was a “failed” back pain patient who was told at 19 that I would need surgery or that I would need to learn to live with the back pain for the rest of my life. At my mother’s recommendation I decided to see her chiropractor. I thought that it probably wouldn’t help but that if there was a chance it could help, it was a chance I had to take. I had nothing to lose. As the story goes, I was about 80 percent improved in about four treatments. I couldn’t believe it. Why did no one tell me that Chiropractic care was an option? Why did “main stream medicine” convince me it was surgery or learn to live with it?

The article in U.S. news points out that I was not alone in my journey to heal my back pain. According to the article Americans as a whole spend nearly $300 billion a year on treatment for pain including musculoskeletal disorders. As you might imagine a lot of this financial burden is spent trying to help people with neck and back pain. That’s where Chiropractors come in.

The article notes a study by the Mercatus Center at George Mason University that examined how medical occupational licensing laws are affecting the health care market. They found that the broader the scope of practice for chiropractors became and the more their incomes rose, the better the outcomes for patient care and satisfaction became and the less costs there were as a whole. Now why is this?

Generally speaking, family physicians and internists only can practice what they know and what they were trained on. They know medicine and intervention such as surgery. So, when a patient comes to them with these complaints, it is natural for them to recommend medications and then eventually surgery. This leads to increased costs and decreased patient satisfaction. Tied in the with the fact that medical care and interventions are so expensive compared to chiropractic care, its no wonder that healthcare costs are skyrocketing.

Another thing to consider is that typically if paid through health insurance, many primary care physicians need to control care and make referrals. While it is likely that they want what’s best for their patients, they are more likely to keep a patient in their system and buying healthcare services from their colleagues than it is that they will refer them to “non main stream” chiropractic providers. That view is largely changing and we are seeing a shift where primary care physicians are referring clients for chiropractic care. Furthermore, in states such as Maryland it is very easy for prospective chiropractic patients to bypass their medical providers directly and have “direct access” to chiropractic evaluation and treatment. It appears as if the monopoly that medicine has had on controlling how patients access care has had a significant impact on healthcare costs and therefore outcomes.

The U.S. News article goes on to state that while allowing a broader scope of practice to Chiropractic care has lead to a measurable effect on the market (as seen in terms of decreased costs and increased health outcomes) the same can not be said for a broader scope of practice for physical therapy.

As a Baltimore Chiropractor I am an advocate for patients getting whatever treatment they need to help with their neck and back pain. In most instances, a short course of conservative chiropractic therapy is appropriate and will bring about resolution of their conditions. In some instances, as I have pointed out in previous blog posts, patients do not improve as expected and are referred quickly and appropriately to other specialists for evaluation and treatment. I believe that it is imperative that my chiropractic colleagues and I spend more time educating the medical professionals in our community of the value that we provide to our patients. If there’s evidence that we can help decrease patient suffering while lowering healthcare costs then it is something that we need to do for the good of humanity and the financial solvency of this nation.

If you, or someone you know, has neck or back pain and would like to speak to a Baltimore Chiropractor, please call (443) 842-5500. We would be happy to help!

Dr. Gulitz

The Most Dangerous Street Intersections in Baltimore City

As a Baltimore Chiropractor that spends the majority of my time treating injured clients involved in Baltimore auto accidents and who have suffered Baltimore auto accident injuries including headaches, neck pain, and back pain, I have long wondered where the majority of the Baltimore City auto accident injuries were taking place. That is, this is a large city with many small windy roads and a large diverse population. I was curious where the majority of the crashes were taking place.

Well fortunately for me, I do not need to look any further. By following a law office’s blog post the information was brought right to the forefront for me. It shows down to the intersection exactly how many injury-reported crashes were made in 2015 for each intersection in Baltimore City. There were more than 9,000 reported injuries in Baltimore auto accidents in 2015. So here are the top 6 more dangerous intersections as of 2015 as measured by number of injury-reported crashes.

1) Gwyns Falls Parkway and Reisterstown Road – 46 accidents

2) Northern Parkway at Jones Falls Expressway (JFX) – 38 accidents

3) Orleans Street at Gay & Enstor Streets – 36 accidents

4) West Cold Spring Lane at Jones Falls Expressway (JFX) – 34 accidents

5) South Monroe Street at Washington Boulevard – 27 accidents

6) West Northern Parkway at Falls Road – 26 accidents

Obviously not all Baltimore auto accident injuries occur on road intersections. There are plenty of parking lot crashes and street crashes. It stands to reason that the streets surrounding these above intersections are also very popular auto accident injury streets. In particular Gwynns Falls Parkway reported over 240 crashes in 2015 and Washington Boulevard reported 130 for the year. I suspect that this has more to do with the fact that these are busy streets than that there is anything really wrong with the design or lay out of these streets.

The Baltimore City Police Districts reported the following number of auto accident injury related crashes in 2015: Northeast District (1,442), Northern District (1,320), Northwest District (1,092), and finally Central District (1,070).

As my company prepares for its expansion into Northwest Baltimore (6810 Park Heights Avenue, Suite C4, Baltimore, MD 21215), this blog post makes it clear that our expansion into the northwest is necessary, as a high percentage of the total auto accident injuries in Baltimore City seem to take place up there. I look forward to providing care to those unfortunate Baltimore City and Baltimore County residents that are injured in auto accidents.

If you, or someone you know, has been injured as a result of a Baltimore auto accident injury and require treatment, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help.

Dr. Gulitz

Some Patients Fail To Improve With Chiropractic Care

By now I am sure that my avid blog followers are aware that I am a Baltimore Chiropractor that treats patients in Baltimore, MD with headaches, neck pain, mid back pain, and lower back pain. These aches and pains can be from overuse injuries, chronic pain from a lifetime of hard work, or they can be acute injuries suffering from Baltimore auto accidents, Baltimore slip and fall injuries, and Baltimore worker’s compensation injuries. Like all business owners I like to highlight my “wins” and showcase the patients who have had favorable outcomes and resolutions with treatment in this office. I had a patient recently who came to the office and asked me about my “losses” – that is, the patients that fail to improve with chiropractic therapy. This patient wanted to know what happens to them? Do they live with their pain? Do they need surgery? I thought that this was an interesting blog topic so I decided to showcase two recent losses, that ended up with positive outcomes.

The first “loss” was a friend of mine who came to see me with neck pain and radiating right arm pain. He is an avid weight lifter and had been having neck pain and radiating right arm pain for about six months off and on. I treated him like I would any other patient – I performed a history and physical examination. Based upon my findings we took an x-ray of his neck to rule out instability and to look for neuroforaminal narrowing. Everything looked good so we began treatment. I saw him twice the first week for therapy. He felt a bit better after the first visit and then worse after the second visit. I told him to come back the next week. His condition had progressively gotten worse over the weekend, so we decided to discontinue further treatment until he got an MRI. At this point he had some grip strength weakness and increased arm pain – all of which we had discussed could possibly happen. After we got his MRI about a week later the bad news was revealed. The patient had a large extruded disc herniation in his neck. Although chiropractic care has a good history of helping patients with disc herniations, this particular herniation due to its size and the fact that it was encroaching his spinal cord was likely a surgical candidate. This was heartbreaking for both me and my friend. I referred him to a local orthopedist for a consultation. About a week later, with understandable concern for his health and well being, he underwent a successful anterior surgical decompression surgery with fusion. This means that the herniated disc was removed and the two bones that it was separating were fused with a metal cage to prevent them from slipping. I followed up with my friend about a week later and he was so relieved. All of his arm symptoms had resolved and his neck pain had decreased by about 80 percent. So did Chiropractic care fail him? No – while it is true that he did not respond favorably to my treatment, part of Chiropractic care is to continually re-assess a patient’s condition and to make changes to the treatment plan based on a patient’s response to therapy. In this man’s case he required an MRI and ultimately surgery to fix his condition. He could not have been more thankful for the treatment and referrals we gave him and made on his behalf, because left to his own devices, he likely would have done nothing for six or more months, and he could have potentially re-injured himself worse at the gym moving forward.

The second “loss” was a few months prior to the above example. A young woman who was about 40 presented for care with lower back pain and left and foot numbness. She was a fairly active woman who liked to do yoga and go to the gym, but had stopped recently due to back and leg issues. I told her that we would try two weeks of treatment and re-assess her condition. She was doing well for about 3-4 visits and then her condition worsened. She felt increased back pain and increased leg numbness. These “red flags” made it clear to me that a lower back MRI would be in order. So, we ordered her an MRI. Similar to the example above, the patient had a sizable disc extrusion with lower back nerve root compression. We discussed that it was likely that the disc herniation was compression the nerves going to her left leg and foot. She had a family friend who was a spinal orthopedist so I encouraged her to take her MRI findings to him for an evaluation. As expected based on her response to treatment and her MRI findings, he recommended surgery. Given her age and response to treatment before chiropractic care and after chiropractic care, she elected for surgical intervention. She had a lumbar laminectomy with discectomy. That means that they shaved a hole in her lower back vertebrae and shaved down the offending disc. Less than a week later she came in to “catch me up” on her progress. She was about 75 percent relieved in terms of back pain and 100 percent of her leg numbness had resolved. She admits that it was the best she had felt in almost a year. She was very appreciative of the fact that we had tried to help her with conservative chiropractic therapy and that we referred her to another provider when her clinical condition worsened.

Both of these examples demonstrate how, despite what most chiropractors would like you to believe, we are not magicians or mystical healers. We are neuromusculoskeletal practitioners that are limited in scope, but experts in what we do. In both instances the above patients were referred for MRI imaging and ultimately had to undergo decompressive spinal surgeries. Although surgery and anesthesia are not without risk, both patients ultimately did well with their procedures and their symptoms have improved considerably. When I asked both patients what they thought about the therapy they received, rather than being upset with the fact that chiropractic care could not “fix” them, they were very appreciative that they were referred “downstream” to providers who could ultimately tackle the underlying problems. In fact, both patients who failed with conservative chiropractic therapy have since continued to refer their family and friends to the practice, since they so appreciated the care that we provided to them in their times of need.

I tell all of my new patients that we will begin with a few conservative treatments to see how they will respond to care. Ideally if patients respond favorably as expected, we reduce their treatment moving forward. If they worsen, as in the examples above, we make timely referrals for imaging or to other specialists. To me, chiropractic care is limited in scope. But rather than this being a negative, I look at this is a positive. It means that we can focus on what we do well and we can refer patients to where they need to be quickly so that they can ultimately improve their condition quickly.

If you, or someone you know, has headaches, neck pain, or back pain and are interested to learn if Chiropractic care could benefit you, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz