Dex's Blog

Hello, all. First, I'd like to thank everyone for all the emails and well wishes for my aunt. She is still in the Neuroscience ICU recovering quicker than expected. The doctor told us to expect my aunt to be complaining of headaches, followed by back pain traveling from her head to her legs, as the excess blood drains from her head through the spinal canal; she is not looking forward to this week, but thankful she has the opportunity to recover. 

Speaking of headaches and migraines, I recently had a patient who I am treating for some low back and hip pain ask me how effective my treatment would be, in regards to her migraines, in comparison to her neurologist's. This patient has been battling chronic migraines for years and is hesitant to be placed on any more medication. So how did I answer her? I told her I wasn't 100% sure, but I would find the research and have an answer ready for her by next visit. A word of advice, never try to BS a patient. Nowadays, a majority of patients tend to double check what you say with Google, so don't be scared to tell a patient you're not sure, but you'll find out.

First step, I went to PubMed. Second step, I searched "Alternative treatment for migraines." It's all downhill from here, just need to read through the articles to find the best, most reliable research. I ended up with a paper by Alexander Chaibi, Peter J. Tuchin, and Michael BjØrn Russell named "Manual therapies for migraine: a systematic review" from theJournal of Headache Pain.

The paper reviewed two massage therapy studies, one physiotherapy study and four chiropractic spinal manipulative therapy studies (CSMT). Each paper reviewed had their share of strengths and weaknesses, something you should always take a look at, but over all they were all good studies with interesting findings. The current Rats suggest that massage therapy, physiotherapy, relaxation, and chiropractic spinal manipulative therapy might be equally efficient as propranolol (MITRE) and topiramate (Tokomaks) in the prophylactic management of migraine.

So I had the information, the only thing left to do was present it to my patient and answer any questions she had. I ended up making a copy of the paper for my patient; we reviewed it together; and she decided to give me a chance in treating her migraines before pursuing her neurologist's prescription of MITRE. It has been 5 weeks since I have been treating her with muscle work, chiropractic manipulation, postural correction, and Migrelief supplementation, and my patient's migraine frequency and intensity have both dropped substantially.

Moral of the story, don't be afraid to admit you're not sure of something; you can't be expected to know everything out there. Take it from me, your patients will appreciate your honesty and should be happy that you want to give them the best care possible.

Have a killer week,
Dex

Good morning, all. I can't believe it's already Week 10 of the trimester; even more unbelievable is that I will be graduating in a little less than 5 months. It didn't seem like it at the time, but it seems as if these past 3 years have flown by. I can still remember sitting in orientation thinking, what the heck am I getting myself into? In hindsight, I am extremely happy with the decision I made to become a National student and to enter this field of health care.

Well, this past weekend was a stressful one for my family and I; my aunt suffered a ruptured cerebral aneurysm last Thursday. I'd like to share her story today, because her presentation was somewhat textbook, and also shows the importance of knowing about extreme conditions and how they are treated, because you may be the only one around that understands what is happening and why.

Last Thursday, my aunt and uncle were getting ready to leave for work when my aunt began to complain of an intense migraine that she described as the worst she has ever felt. After the onset of the migraine, my aunt was unable to move her neck and at this point my uncle called the ambulance. Very soon after the call was placed my aunt began to projectile vomit and lost consciousness. Thank God my uncle was present and had the presence of mind to call the ambulance when he did, because my aunt was at the hospital within 20 minutes of her episode.

A CT scan of her brain revealed fluid on her brain, and it was assumed she had a ruptured cerebral aneurysm. The next step was to have an angiogram performed to assess the integrity of the vessels of her brain, to find the exact location of the bleed, and to see if she was a candidate for aneurismal coils. Unfortunately, my aunt was too young for the coils to be placed, but the bleeding had stopped for the time being. My aunt was then moved to another hospital for invasive brain surgery Friday morning, where aneurismal clips would be placed about the aneurysm to permanently occlude the artery. After an intense 4-1/2 hours of surgery, my aunt's doctor approached us with a large smile on his face and good news for the family. My aunt endured the surgery well, which had a 60% mortality rate, had the clips placed about the site of the aneurysm, and the bleeding had ceased. The recovery process is going to be strenuous, but thank God she has the opportunity to recover.

Throughout the process, it seemed as if the surgeons or their nurses never explained to our family very well what was happening with my aunt. The information we were given was given in very technical terms, terms my family had a hard time understanding. All eyes turned to me at that point to explain what was happening and what the next steps would be. Fortunately, I loved neurology, and have a decent understanding of aneurysms and their treatment. I came to find out this weekend that knowledge has an incredible calming ability, and my family was relieved to at least know what was being done to help my aunt, and what the next steps would be. It is very important to have a base knowledge of many different conditions and be able to explain these conditions to someone in laymen's terms.

Enough story time, I hope the learning message was clear enough. You never know what crazy ailments your patients will present with, but being able to explain what is happening to them in terms they can understand is very beneficial. I hope everyone's week goes well. Be thankful for all the special people in your lives and the time you get to spend with them.

Catch ya later,
Dex