What Happens During My First Visit To A Baltimore Chiropractor?

What Happens During My First Visit To A Baltimore Chiropractor?

As a Baltimore Chiropractor, I often meet people in my everyday life who have never been to a chiropractor. Sure, they might understand a little bit about what Chiropractic is or what spinal manipulation is, but they do not know what to expect. Often I hear when a patient shows up “Wow, this was way more medical than I expected!” I suppose I am not sure what it is that they are expecting. So rather than explain the “first visit” to everyone individually, I thought I might write a small blog post about what happens when you arrive for your first visit.

As with any doctors office, the first thing a patient (or perspective patient) does when they get to the office is to sign in with the receptionist. The receptionist will greet them and then hand them some standard paperwork to fill out. This paperwork, just like in your primary care doctors office, records your past medical history, current presenting illness/injury, insurance information, and many standard pieces of medical literature such as informed consent, and HIPAA privacy documents. Most patients can complete the new patient paperwork in about 15 minutes. As such we ask most patients to arrive about 15 minutes prior to their appointment so that they can fill out all of their paperwork and be seen promptly. In addition to filling out paperwork the receptionist will make a copy of your driver’s license and any applicable insurance cards. At this point the receptionist will figure out what the patient’s financial responsibility for the appointment will be. We prefer that patients give us some time to do this on their behalf, because there are TONS of different plans and it is not always quick and easy for us to get information. Most patients who have private health insurance have a copay and/or deductible that applies to chiropractic care. We prefer to have an open an honest discussion with patients about their degree of financial responsibility prior to beginning treatment. That way, there are no surprises when the insurance EOB comes.

Once the paperwork has been filled out to completion the receptionist creates a physical chart for the patient. The charts is placed in the new patient examination room for the Baltimore Chiropractor to review. It is said that medical history makes up 80 % of a diagnosis and I believe that to be true. By the time I have a patient walk down the hall to my new patient examination room I already have a good understanding of what their physical ailments are, why they are here, and whether or not I expect to be able to help them.

I have a patient sit down and explain to me what brings them in: What hurts? How did it start hurting? Have they ever been injured before? How did they improve last time? How did they hear about us? What questions or concerns they might have with chiropractic care. The list of questions that I ask is usually much longer, but for the sake of simplicity, let’s just say that make sure that I understand what their issue is before proceeding.

Now comes the physical examination. I perform a standard neuromusculoskeletal examination on all patients. This helps me to assess the degree of their injury, to determine if x-rays are required, and to confirm my working diagnosis. I also perform a standard physical examination where I record height, weight, and vital signs.

Once I have a good working diagnosis for an injury, we begin some some physical therapy modalities. This is where my clinic is different than most chiropractor’s clinics. Many of the other Baltimore Chiropractors like to have a patient return to the office before beginning treatment to give the impression that they are really thinking hard about what is wrong and whether or not they can help. I don’t like sending patients that are in pain away from the office – I want to give them what they came for – pain relief!

After the patient has received some modalities to help soothe and break up muscle spasms, we usually progress to a chiropractic adjustment room where I render spinal manipulation, or “back cracking” for the layman. I give patients some at-home instructions, provide them with an ice pack to control post-treatment soreness, and we schedule a follow up appointment to monitor their response to treatment. I do not provide long term treatment plans, nor do I require patients to pre-pay for their care. I take each injury and each treatment “a day at a time”.

If you have been considering making an appointment with Mid-Atlantic Spinal Rehab & Chiropractic but have been hesistant to because you did not know what to expect on a first visit, I hope that this blog post shed a little light on the subject for you. Keep in mind, if I do not think that I can help you for your particular condition I will let you know and will help steer you in the right direction. You have nothing to lose and everything to gain by just asking questions.

Dr. Gulitz

Car Accidents with Reindeer?

As a Baltimore Chiropractor that spends the majority of my time treating patients involved in motor vehicle collisions such as car accidents, bus accidents, motorcycle accidents, and pedestrian injuries, I can honestly say that I have never in my life encountered a patient who was injured in a Baltimore auto accident by colliding with a reindeer. That seems to make sense since as far I know there are no reindeer around Baltimore City, except maybe at the zoo for Christmas. Where I grew up in New York we would hear about auto accidents involving “regular” deer all the time. But it Baltimore that does not appear to be a major concern.

Having said that I was curious if there was any place in the world where there were recorded instances of motor vehicle collisions versus reindeer. As it turns out, there is!

In Norway it is estimated that there are approximately 200,000 wild reindeer that inhabit the land. They blend in with their natural habitat, making it difficult to spot them in the dark. It is estimated that approximately 2,000 of these reindeer are injured or killed each year when they are struck by snowmobiles and motor vehicles in Norway. Who knows how many whiplash injuries human occupants sustain in this reindeer crashes each year.

Interesting, as recently as the year 2010 the people of Norway have begun to spray paint the antlers of the reindeer with reflective coating to help cut down on the instances of reindeer vs. motor vehicle collisions. It is a small test study but so far it appears to be cutting down on the number of car accidents with reindeer.

So while these may not be a big risk in the Baltimore metropolitan area, it does raise a good point: Always make sure to keep your eyes on the road because you never know what may be there. Oh, and for those coding nerds out there…there is an ICD-10 diagnosis code for motor vehicle collision vs. a reindeer. This would fall under the codes V40.5xxA – car driver injured in collision with animal in traffic accident.

So especially this week when extra reindeer are flying around and dropping off presents keep your eyes on the road. Dr. Gulitz and the team at Mid-Atlantic Spinal Rehab & Chiropractic want to wish everyone a Merry Chistmas and a happy and healthy holiday season. We look forward to seeing you all in the new year!

Dr. Gulitz

Inversion Traction for Lower Back Pain Following Baltimore Car Accidents

As a Baltimore Chiropractor that spends the majority of my time treating Baltimore auto accident patients, I often see a lot of patients with lower back pain. Whether it is a rear-end auto accident, side swipe, T-bone, or head-on collision, lower back pain is a very common symptom following Baltimore auto accidents. People tend to think of Chiropractors as “back crackers.” Which, lets face it, we are. In addition to spinal manipulation of the lumbar spine for lower back pain following Baltimore auto accidents, we have a lot of other tools to help loosen up stiff joints and tight spasmodic muscles.

Typically patients with lower back pain following Baltimore auto accidents receive electrical muscle stimulation and some form of traction therapy, in the form of either intersegmental traction and/or mechanical traction. Previous blog posts on these topics can be found on my website.

I recently had a conversation with a patient who was asking me about the appropriateness of inversion traction for lower back pain following his Baltimore car accident. Inversion traction is a device where patients lay on a flat surface and slowly invert (turn upside down) their body. It attempts to reverse the effects of gravity and to decrease the compression on the lumbar spine. For some patients, it is a god send. They lay on the table for about 10-15 minutes at a time 1-2 times per day and they note a dramatic improvement in their lower back discomfort. As with most pieces of medical equipment, some are better than others. The late night infomercial traction tables show people hanging upside down until they are perpendicular to the floor. That is dangerous! Patients should only go about 30 degrees below the horizontal line so as to not have too much blood rush to their head. While I do not currently offer inversion traction in my clinic, I am going to purchase one shortly to help patients make the decision as to whether or not it is something that they want to try at home on their own.

Not everyone is in favor of inversion traction to treat lower back pain following Baltimore auto accidents. Opponents of inversion traction therapy state that it does not offer long term relief of lower back pain. Cardiologists suggest that inversion caused the heart beat to slow, blood to rush to the head and neck, and increased intraocular pressure. For patients with high blood pressure, heart disease, or glaucoma inversion traction could cause health effects such as heart attack, stroke or death.

As with most rehabilitation following a Baltimore auto accident, you should always consult with a professional before doing anything on your own. Provided that you do not have high blood pressure, it is reasonable to try inversion traction to help with mechanical lower back pain following your Baltimore auto accident induced lower back pain. If that does not work for you there are plenty of other treatment modalities that we offer that can help to provide relief.

If you have any questions about lower back pain following a Baltimore auto accident, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help.

Dr. Gulitz

Thanksgiving- The Most Dangerous Driving Holiday

If you are like most Americans you are probably already mentally preparing yourself for an all day festival of catching up with friends and family, eating too much, and watching 10 hours of football on Thursday. Thanksgiving truly is an American holiday that helps us to remember what is important in life beyond the 9-to-5 daily grind. Chances are you will likely be driving to a destination to spend time with your loved ones. Like most major U.S. holidays, time away from work and an increased in the “holiday spirit” usually leads to an increased congestion on the roadways. Coupled with lower gas prices, it is safe to assume that this year will see an inordinate amount of extra cars on the road before Thanksgiving. Unfortunately for everyone on the road, this means more accidents, more injuries, and in many cases, more deaths. While many people believe that New Year’s Eve is the most dangerous driving holiday, it is not. The number of fatalities associated with Thanksgiving driving is actually the highest out of all major U.S. holidays. (For those of you interested, the top 5 holidays associated with fatalities due to impaired driving are #5 Christmas, #4 Memorial Day, #3 Independence Day, #2 Labor Day, and #1 Thanksgiving!)

The reason behind the increased number of auto accidents due to Thanksgiving is more than just a “volume game.” Yes, there will be more vehicles on the road. But there will also be a lot of impaired driving, late night driving, and navigating unfamilar roads. After all, how many of us are working Wednesday and then driving that evening to get to our destination? Chances are its about all of us. If it can be avoided, I would recommend leaving Tuesday night and skipping work Wednesday (provided you don’t get fired!), or leaving in the wee hours on Thursday morning. After all, you will get to spend another night in your own comfortable bed. As someone that spends a lot of time traveling on the day of Thanksgiving, the roads are usually wide open.

The Red Cross recently put together a list of recommendations to help ease Thanksgiving travel and to hopefully reduce the likelihood of there being car emergencies. Here is their list:

1. Inspect your vehicle before you leave – make sure it is in good working order.

2. Refill all fluids- fuel, windshield washer fluid, engine oil if low.

3. Designate a safe driver – Not even one drink should be allowed. After all, police will be cracking down.

4. Get extra rest – Take an extra hour nap to be extra alert. Leaving the morning of should eliminate this problem.

5. Obey the rules of the road – Slow down in work zones, designate a texter, and observe posted speed limits.

6. Give yourself time – Allow for delays due to congestion. Take frequent breaks and don’t let road rage get the best of you. We are all in this together!

7. Use headlights – It makes it easier for you to see and for others to see you.

So while you sit at your desk reading this blog post and wishing you were hundreds of miles away eating turkey and wearing pants with an expandable waist line, just remember, we are all in this together. Please, slow down, give yourself time, and make good decisions.

For the less fortunate who are injured as a result of a Baltimore auto accident on Thanksgiving and require our services for headaches, neck pain, and back pain, Mid-Atlantic Spinal Rehab & Chiropractic will be happy to help rehab you from your auto accident injuries following Thanksgiving. Please call (443) 842-5500 to schedule an appointment. Happy Holidays!

Dr. Gulitz

Automobile Insurance Explained By a Baltimore Chiropractor

As a Baltimore Chiropractor that continues to spend the majority of my time treating Baltimore auto accident patients with headaches, neck pain and back pain, I often get asked to explain various aspects of an automobile insurance policy to an injured patient when they walk in the door to my office. While it is true that I am not an auto insurance salesman, nor am I an attorney giving legal advice, it is important for consumers to understand what they are and are not buying when they purchase automobile insurance in Maryland. If you have questions about any of the coverages after reading this blog post please contact your auto insurance representative. If you do not have one and would like me to refer you to some knowledgeable professionals, please let me know. In no particular order here are the coverages that you are typically offered for a Maryland automobile insurance policy:

1) Bodily Injury. This is the amount of liability that the insurance company provides you in cases of an at fault accident. State minimum level in Maryland is $30k/$60k. That means that if someone injures you while you are in another vehicle or are a passenger in this vehicle, the driver of the at fault vehicle will be insured by their insurance company for UP TO $30k/person injured not to exceed $60k per accident. If there were 2 injured clients they could each attempt to recover up to $30k apiece. For drivers that have significant assets: businesses, homes, cars, etc, it usually makes sense to purchase more than the legal minimal amount of insurance. Most people carry amounts of $100k/$300k, and still some carry more. Generally speaking, it is not that much more money to carry significantly more liability insurance. When calculating how much you need, don’t just look at the price of the premium. Look at how many assets you would like to protect in the unfortunate circumstance that someone gets injured by you in your motor vehicle.

2) Property Damage. This is how much money an insurance company will pay on your behalf to fix whatever you broke. Typically it is another vehicles car or bumper, but in some instances, it can be homes, barns, light posts, etc. I believe the state minimum for property damage (PD) is $10k, but most insurance sales people recommend more than that “just in case.”

3) Uninsured/Underinsured Motorist Coverage. Mayland state law dictates that all drivers must purchase this coverage. It exists to help an injured driver get access to money in the instances where a) the at-fault driver is uninsured and does not carry any insurance or b) has liability insurance, but not in an amount that is enough for you to fully recover from your injuries and pain and suffering. While uninsured and underinsured motorist coverages are separate entities, they tend to be grouped into the same field on your auto insurance policy. Maryland requires that drivers purchase at least the state minimum $30/$60k UM/UIM Policy. However, what most people do not know is that you can purchase an amount up to and matching what you purchased for liability coverage. Let’s look at an example:

I carry 100/300k liability coverage to protect me from a loss if I injure someone when I am driving. I have to by law carry 30/60k UM/UIM coverage in addition in case I get injured and the person that injures me doesn’t have insurance or if they do but it isn’t enough to help me recover. Maryland mandates that you carry AT LEAST the minimum policy, but you can extend it to an amount that equals, but does not exceed, your liability coverage. In this instance, I should elect to pay for UM/UIM coverage in an amount of 100/300. So the underlying advantage of buying higher limits of liability is that it affords you the option to buy more UM/UIM.

4) Personal Injury Protection (PIP): I have spoken about this in a few past blog posts. This is money used to pay for all reasonable, customary, and usual expenses arising from injury in a Maryland automobile accident, regardless of fault. So whether you were driving a car that caused a crash or were a victim of the crash, or were a pedestrian or bicyclist, you could recover from the PIP coverage component of an automobile insurance policy. PIP is written in amounts that vary from $2,500 to $10,000 and is mandatory to be offered to anyone purchasing automobile insurance in Maryland. It can be waived at the time of the underwriting of the insurance policy. PIP can also be used by an injured client to recover for lost wages while they are incapacitated after a motor vehicle collision. It is really an invaluable source of money for the injured client. The other nice thing is it is really cheap. Most people purchase about 2,500 of PIP and spend about 50-70/year for the option to use it. I purchases 10,000 PIP for my automobile policy and it only cost me $101 for the year. The coverage costs pennies but is well worth it.

4b) MedPay. This is in addition to PIP and is only available on a few auto insurance policies in Maryland. Similar to PIP MedPay will pay medical providers, chiropractors, physical therapists, and hospitals for care rendered as a result of your collision. There is no wage loss component however. Some policies will allow you to purchase both PIP and MedPay. Many people decline this coverage if they have health insurance. But keep in mind, health insurance can decline to cover you for injuries sustained in a motor vehicle collision and if they do not, you are responsible for a copay on each visit. MedPay does not require a copay and does not need to be repaid at the termination of your treatment.

5) Comprehensive. This is the amount of money your car is insured for (up to the value of the vehicle) for instances OUTSIDE OF COLLISIONS where the vehicle was damaged. This includes, but is not limited to, acts of god, striking animals while driving, theft, arson, and being stolen. Every auto policy has comprehensive on it and it can be expensive since most cars get damaged a lot when any of the above events occur. As a pro tip, you can reduce your expense for the comprehensive component of the automobile policy if you raise your deductible (deductible is how much money you have to pay out of pocket before the insurance will pick up the tab).

6) Collision. This is to pay for damage to your vehicle in instances where your car actually collides (hence the name) with another surface – be it another car, or a wall, or a tree. As with comprehensive, it comes with a deductible that you would have to pay before the insurance company would pick up the tab.

7) There are a slew of other optional coverages that you can purchase for your automobile. These usually include reimbursement for towing a vehicle, rental car reimbursement, trip interruption, and emergency transportation. These are not mandatory but may well be worth the cost.

As I said above, this was by no means meant to be an exhaustive compendium of all auto insurance coverages in Maryland, but rather an overview just to get the conversation started. I understand that auto insurance is not a “sexy” topic, but one that drivers need to better understand so that they can better protect themselves in cases of an accident.

I would recommend that you contact your auto insurance salesperson if you have specific questions about what your current policy covers or does not cover, as I am not legally allowed to give you advice on what to purchase or what you are or are not currently covered for.

If you have been injured as a result of a motor vehicle collision in Baltimore and require treatment, please consider Mid-Atlantic Spinal Rehab & Chiropractic for all of your auto accident injury treatment needs. You can call us at (443) 842-5500 to schedule an appointment.

Dr. Gulitz