Date:01/01/06 Happy new year. And what a year it promises to be.
For work comp and other cases I was thinking Friday how easy ultrasound spine scan makes diagnosis and detection of malingering. Most people are of good will and their pain pretty much correlates to sites of inflammation on ultrasound spine scan. Physiologic exceptions are when anti-inflammatories are employed, when a spine disc totally collapses, or in cases of exhausted immune systems such as cancer, and cancer with some types of chemo therapy (Anti-inflammatory drug really do lower inflammation levels! Seems like it actually is such a stress relief that early general inflammation belies the severity when the disc totally herniates! Cancer is pre-staged by inability to launch strong inflammation. Some types of chemo-therapy are simply murder for the immune system and kill inflammation on a temporary basis.)
Even those who amplify their pain are 90% of the time in my practice people of good-will who have simply lost their way a bit, become over-whelmed by job stresses. Let me give you an example of this handled with ultrasound very cost effectively:
A young man (25 yr. old) comes in with severe low back pain after sweeping at work. He is a skilled machinist, but the boss ordered him to sweep up, and in this unfamiliar motion action activity, the machinist's back began to ache severely, and now a week later he can't work due to the pain. ULTRASOUND SPINE SCAN REVEALED NEAR ZERO INFLAMMATION SIGNS IN THE LOW BACK (L1 - S3). The patient upon re-history claimed he was taking no drugs of any type, prescription or OTC. While administering accelerated healing therapy (another anti-malingerer test - if no change then there is nothing to heal) NO CHANGE WAS NOTED during 12 minutes of application (maximum length, average patients respond in one to three minutes with textural micro-lymph changes - - even collapsed discs show this attempt at healing sign during ultrasound monitored ACCEL). So as the minutes of ACCEL went past 5 minutes I began to remind this young fellow that he was a father, a lover, a husband, and an excellent bowler, as well as an upstanding member of his church group, and that after all was said and done the job was not the world, just a job. Also reminded him he could not be sure why the boss asked him to clean up. He seemed to feel insulted, and I reminded him he was not a mind reader, and maybe the boss asked him to clean up because he (the young fellow) was the MOST reliable and the best worker who the boss knew could clean the place well with no back talk or nonsense. Perhaps he was #1 in his boss's eyes!
Not totally amazingly I received a call from this chap early the next morning. He cancelled any follow-up visits, he was back at work, and all pain had disappeared over night. He said he thought the ACCEL and I were great. See? Sometimes the ACCEL and ultrasound spine scan can indicate where the damage is by default (in the ego) too! People, good people, well meaning people lose their true vision and a little restoration of "the overview" (God loves you, I love you, your wife loves you, your kids love you, and your boss maybe loves you too, and if your boss does not, there are other jobs out there with nicer bosses, BECAUSE YOU ARE A LOVABLE GUY.) sometimes works wonders.
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