What is a Lifetime Chiropractic Patient?

What Is A Lifetime Chiropractic Patient?

As many of my avid blog readers are already aware, I am a Baltimore Chiropractor that spends the majority of my time treating patients using Chiropractic care. Typically this means that we are treating Baltimore auto accident injury patients with whiplash symptoms: Headaches, neck pain, upper back pain, and lower back pain following Baltimore car accidents. But that also means treating weekend warriors with overuse injuries, and regular folks who wake up with stiff necks and stiff backs. As you might imagine as all people are different and unique, so to are the necessary treatment plans to get these patients out of pain and back into the “real-world.”

I recently saw a new patient to the practice. They were interested in coming in for some treatment for an acute neck injury (they “slept funny” the night before.) However, they had previously gone to another Baltimore Chiropractor who tried to convince them that they would need to be a “lifetime” chiropractic patient in order to receive the most benefit of the proposed treatment.

The patient was startled by this. They were told that they were going to need 65 visits and to spend nearly $3,000 out of pocket up front just to help them with their neck pain. And, having completing this plan, they would need to come in at least once a month “forever” to help maintain the progress that was made on their neck. Having never been to a chiropractor before, this patient asked if this approach to care was normal. They asked if it was necessary to become a lifetime chiropractic patient in order to get out of acute pain.

As you all know, I do not believe that lifetime care for an acute injury is necessary. I am more than happy to get a prospective patient what they want- which is to get out of acute pain and to return them to their normal daily activities as quickly and with as little pain and restriction as possible. When I informed this patient that I would be happy to treat them for 2-3 visits and to get them out of acute pain for the cost of their copay (approximately 20 dollars if my memory serves me) they were elated. I saw the patient for about a week and their pain went away. The patient has since stopped treating for this injury since their pain resolved and their range of motion was completely restored.

Then it occurred to me. This patient HAS become a lifetime patient to me and my practice. I gave them what they wanted and needed and I trust that the next time, should there be a next time, that they need any treatment for neck or back pain, they will likely come back to my practice for additional treatment. He didn’t feel “swindled” “manipulated” or “taken advantage of.” But he has become a lifetime patient. If that means that he never has neck or back pain and I never see him again, then for his entire life, he only ever treated in my office for chiropractic care. This makes him a lifetime patient.

So am I looking for lifetime patients? By my definition- yes. I want people who so trust in the quality of care that we provide that they never look further than my practice for relief of their headaches, neck pain and back pain. But by that same token, am I looking to have someone show up weekly forever and pay my rent and put my kids through college? No – because at some point if chiropractic care doesn’t work for a particular musculoskeletal condition then I don’t want to treat that patient. I want to refer them to another provider who can get them well.

A lifetime patient can come in many forms. Whichever form you choose to be, we are happy to take care of you. If you, or someone you know, requires chiropractic care for auto accident injuries, headaches, neck pain, or back pain, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

Hovding – New Airbag for Bicyclists Hopes to Prevent Whiplash In Bicycle Accidents

As a Baltimore Chiropractor that spends the majority of my time treating patients with auto accident injuries such as headaches, neck pain, and back pain I see more than my fair share of these injuries following Baltimore auto accidents. As the weather got better this summer I saw a shift towards more non-motor vehicle collision injuries. In particular, we started to see more bicycle vs. motor vehicle injuries and plenty of pedestrian versus motor vehicle injuries.

One of the advantages of being situated in a car if it is in a crash is the number of safety features that have been developed to help to minimize the risk of death and injury. In particular, seat belts and front and side curtain airbags really help an occupant to “ride down” a crash quickly to help absorb energy and minimize trauma to the soft and hard tissues of the body.

The problem when we see patients that are involved in bicycle versus motor vehicle collisions and pedestrian versus motor vehicle collision (hit by a car while walking) is that these safety features do not exist outside of a car. Well, that is until now.

Like many of you I spend a fair amount of my work day watching cat videos on youtube, watching the latest lip sync battles on line and following the latest viral video trends. Sometimes this is actually a useful endeavor and I discover things that are new and trending that impact society and my chiropractic practice.

Recently I came across an interesting produce out of Sweden called Hovding. It is essentially an airbag for bicyclists. It has built in sensors that determine if it believes a cyclist is going to suffer an impending crash and it deploys, in an attempt to function as a car airbag and to protect and cradle the head and neck of the cyclist.

It’s got a very simple design. It has an anchor brace that circles the neck. It has a hood that deploys in case it senses an impending crash, and it has an air tank that fills the hood when necessary that rests on the back the cyclist. It has a series of sophisticated sensors that determine when it needs to deploy. It even records the crash details and collects the data for future product enhancements.

Given the trends towards urbanization and decreased dependence on fossil fuels I see more and more riders taking to their bicycles in the future. An invention such as Hovding could go a long towards decreasing or eliminating concussions, headaches, and neck pain in those that choose to ride bicycles. I think it is a great invention whose time has come. Detractors point to its price point of $300 euros (approximately $335 US as of the time of this blog post) and say that it is too expensive. I personally think that its a small price to pay to help protect the only brain, spinal cord, and neck we will ever have.

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

Dr. Gulitz

Autonomous Ubers – An Idea Whose Time Has Come Or Disaster Waiting to Happen?

As a Baltimore Chiropractor that spends the majority of my time treating patients with auto accident injuries such as headaches, neck pain, and back pain, I have begun to see more and more Baltimore auto accident injury victims who have been injured at the hand of an uber cab. We’ve all seen them and we’ve probably all used them as they are everywhere these days. Just about anyone with a driver’s license and a car and take you wherever you are going for a small fee. These “industry disrupting” uber cabs have been great for citizens looking to make a few extra dollars on the weekend but they are not without their risk and concerns over safety and liability.

In another instance of life immitating art, Uber is attempting to roll out the first every autonomous taxi cab vehicles. I remember first seeing a similar idea watching “Total Recall” with Arnold Schwarzenegger where he was a passenger in a “Johnny cab.” These vehicles are set to hit the road in Pittsburgh this week. They are being met with a mix of optimism and skepticism as you might imagine.

I think the IDEA of a self driving taxi cab is fantastic. Companies such as uber won’t have to worry about the issues regarding whether their drivers are employees or independent contractors. It seems like it would be easy to get where you are going just by typing in an address in a phone and using a predetermined credit card to pay for the fair.

But what of safety? Opponents say that the technology is largely untested. It views the Pittsburgh citizens as “sitting ducks” and “guinea pigs” in an experiment. Some early reports on these vehicles is that they have trouble with bridges, puddles, rain and snow. Since that is the case Pittsburgh seems like an odd choice as it has tons of all of the above! Not to mention the subtleties of driving from hand gestures to lights blinking- how will the computers on board respond to these “unspoken” communications?

Uber has made it a point to say that each of these autonomous driving taxi cabs will have a “driver” who is able to take over at a moments notice in case of an emergency. So that’s a bit relieving. However many people do not feel that there is enough regulation around this new technology and they are fearful of what may happen. And of the data collected in these interactions, who has access to it? Is it just the private companies such as Uber or do they have to turn the data over to the government for evaluation?

One thing is for certain. These self driving ubers, even with all of the sensors and gadgets will inevitably cause crashes. It is likely, therefore, that they will cause injury. Will they permanently disfigure someone? Kill someone? And will their rates of crash and injury be better or worse than we as humans have been responsible for? I suppose it all remains to be seen.

Would you let a self driving Uber take you to the movies? Or would you stick with a normal taxi or uber? Share your thoughts below.

If you, or someone you know, has been injured in a Baltimore auto accident within an uber (autonomous or driven) please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500.

Dr. Gulitz

SCIWORA – A Scary Finding in Minors Involved in Baltimore Auto Accidents

As a Baltimore chiropractor whose clinic spends the majority of its time treating individuals involved in Baltimore auto accidents, we come across many types of injuries as a result of these Baltimore car accidents. We traditionally see patients with headaches, neck pain, and back pain. Occasionally we see cuts, scrapes, bruises, and concussion as well. As specialists in treating this Baltimore auto accident injuries we get really good at picking up on subtle injuries that often go unnoticed by other providers.

One since type of injury that can be difficult to diagnose is called a SCIWORA injury. The acronym stands for Spinal Cord Injury WithOut Radiographic Abnormality. This is a special term for injuries that occur to minors below age eight that involves transient injury to the spinal cord without any radiographic (x-ray) proof of its occurrence.

It may not be a surprise to many that there are thousands of children injured in motor vehicle collisions (in Baltimore and elsewhere) every year and that motor vehicle collisions are the number one cause of infant mortality for children between 5-19 in the United States.

Following a Baltimore auto accident injury it is normal for a parent to take their child to a local Baltimore emergency room or a Baltimore urgent care location for evaluation. At these evaluations which are largely overbooked and under-staffed it is not unusual for these patients to have a physical exam but to not have any x-rays taken. As these rooms get more and more crowded we are starting to see a shift of parents taking their children directly to Chiropractors and Physical Therapists for initial evaluation and treatment. Typically these evaluations will include x-ray (radiographic) analysis to rule out fracture, dislocation, or more importantly ligamentous instability that could indicate trouble for their child.

As with all patients, a proper history and physical examination is required in order to make an appropriate diagnosis. This can be especially challenging in children since many times their verbal skills may not be up to par with that of their parents. As you can imagine, it is also hard for parents to describe pain and symptoms that children are feeling. Additionally, it is not unusual for children to avoid telling to the truth to a “stranger” during an exam and to generally go into “avoidance mode” and withhold key answers during an evaluation. To further complicate matters, typically SCIWORA injuries do not manifest until about 3-4 days following a Baltimore auto accident injury.

So then how do we determine if a SCIWORA is present? The key is to make the patient (child) feel comfortable enough to open up to you so that they can describe the pain they are feeling. It is understandable that this may take several visits before they feel comfortable with a provider to tell them everything.

Providers need to evaluate for a TFNE (transient focal neurological episode) that may have taken place during or shortly after the crash. These symptoms may include, but are not limited to, ataxia, unilateral anosmia, tinnitus, memory problems, nystagmus, impairment of tactile sensation, positive cranial nerve examination, hypoesthesia, and muscle weakness. It can be challenging for a minor or their parents to describe these symptoms to a provider. Even still, these symptoms may last minutes or hours depending on the severity.

If these symptoms are present on history, then motion x-rays of the affected region (typically neck or lower back) are indicated. This involves taking x-rays of the patient in extremes of motion both in flexion (bringing the chin to the chest, or bending forward) and extension (bringing the neck all the way back or hyperextending the lower back and looking to the ceiling). This can be used to look for any bony slippage, which could indicate ligamentous instability. If there is suspected ligamentous instability, then referral for MRI or CT scan is appropriate. Provided the presence of a SCIWORA is indicated on advanced imaging, then referral to a neurologist or pediatric neurologist is indicated to help monitor and evaluate the condition.

Many patients and children are able to walk away from Baltimore auto accident injuries without injury while others are not so lucky. Even when things seem ok, it is always worthwhile to get a medical evaluation to determine if there are any latent underlying pathologies that may have otherwise gone unnoticed. We see many children in this office following Baltimore auto accident injuries. Fortunately, I have only ever seen one with a SCIWORA injury in my approximately 8 years of licensed practice.

If you, or someone you know, has been injured in a motor vehicle collision and require an evaluation and treatment, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

Meet Graham – The Only “Human” Who is Designed to Survive a Car Crash

As many of my blog readers and followers know I am a Baltimore Chiropractor that spends the majority of my time treating Baltimore auto accident injury patients. My staff and I routinely diagnose and treat whiplash in Baltimore, along with Baltimore headaches, Baltimore neck pain, and Baltimore back pain. While not all of our patients are Baltimore auto accident patients, probably about half of them are. That is why I spend so much time blogging about Baltimore auto accident injuries.

I came across an interesting news story that felt very appropriate given the type of patients that we routinely treat. The Australian state of Victoria under the “Transport Accident Commission” worked alongside a trauma surgeon, a crash investigation expert, and an artist to design a “human” that would be capable of surviving an auto accident. The project is meant to highlight how fragile the human body is, and how susceptible we all are to the traumatic forces involved in even slow impact motor vehicle collisions.

So what would it take to survive all types of auto accident injuries? “Graham” was designed with the following:

• a flattened face to absorb more energy
• larger skull with more cerebrospinal fluid to cut down on the incidence of concussions
• hoof-like legs with added joints to help him avoid impending crashes in the first place
• ultra-thick rib cage lined with “natural airbag” sacs
• Ribs that extend to the base of his skull, that is, an absence of a neck.

You can see some pictures of Graham here. While I do not think that his physical appearance is enough to make you “swipe right” on Tinder, the visual presentation of Graham is nonetheless quite striking. I have been treating Baltimore auto accident injuries for over four years and have been treating auto accident injuries for approximately eight years and I have not met anyone that resembles Graham in design. We all have different “human metrics” (height, weight, thickness, male/female, age, etc) that make us more or less susceptible to injuries in Baltimore auto accidents. The cars we ride in along with the vehicle crash dynamics also play into the likelihood of suffering injury. But the point is no design (not even the human body) exists perfectly to avoid injury.

We have to remember that cars, though ubiquitous, are nonetheless capable of severely injuring, or even killing those around us. We have to be mindful of the skill and attention that it takes to operate these machines and we need to be more cautious while doing so.

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

Dr. Gulitz