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Thursday, October 25, 2012

The Changes to The Florida No-Fault Law: Who will you VOTE for?

The Changes to The Florida No-Fault Law (PIP):  Who will you VOTE for?

Alan Himmel, DC, PA.

I wasn't going to do it.  I told myself that I would not turn this blog into a political tirade or debate.  In fact, if you read through these posts, you will notice that not once have I mentioned my feelings toward a specific political party in the State of Florida.  I mean, I have bashed Governor Scott, because of what he did to the no-fault law.  I think, personally that he is a bad governor.  His stance on education and the school system in Florida is horrible.  He has taken more than a billion dollars of funding from education, to divert to for-profit charter schools.  Oh, now that he has to start thinking of his next term, he is slowly warming up a bit to public education.  It's time to try and look good, and pretend that he cares.

But, I think it's okay that from time to time I talk about politics--a subject that I loath.  Here we go:  I want to point you in the direction of one of my blog posts which lists all the senators that voted for the new no-fault (pip) bill in Florida.

The top group is a list of Senators who fought the changes to the Florida no-fault law, so that your State required benefits remain intact.  The bottom group fought to disrupt and change the law, so that the insurance companies can now deny your claim more easily, and to only give you 25% of the insurance coverage you had before.  It now also eliminates massage and acupuncture from being reimbursable, as well.

Click the link above and open the page.  You will see two groups of politicians.

                                       I encourage you to PRINT THAT PAGE!!

You will need this when you go and vote.  If you are happy with the changes to the no-fault law, then there is a nice list of Senators to vote for.  You can bring the list, and if you see any of these guys who fought for the profits of the Insurance industry on the ballot, just vote for them. You can also find out what district you are in: Here is a site that you can use to figure out what district you are in and who your Florida Senator is: 

If you want to spend a little time looking at the two lists of Senators who voted for or against the No Fault law, you will quickly see that the politicians who voted to move greater profits into the hands of the Billion Dollar Insurance companies were...............  drum roll.............:

Republicans!  There was only one Democrat who voted for the changes out of the 21 Senators who voted for the horrible changes.  That's right.  20 out of 21 Senators are republicans.  If you are a republican, in the health care field, and voted for these guys on this list, you voted to put yourself out of business or at least to reduce your income by 75%.  You also voted to make sure that the big insurance companies like State Farm and Geico, are now guaranteed to make more profit (they always report record profits year after year).  And you also voted to take valuable needed coverage away from Florida drivers.

So, I'm just sayin'...   next time its time to vote, get out there and do what you feel is best, either for yourself, your family, and your patients.  Or, the other option is you can vote to put more profit in the bank accounts of the insurance companies.  If you work for or have a financial interest in,  or have a relationship with an insurance company, I guess the decision is easy.  Good luck. 

Monday, October 22, 2012

Whiplash, Damage to the Ligaments, Normal vs Abnormal Spinal Curves, etc.

More on Whiplash, damage to the ligaments, normal vs abnormal cervical curves, etc.

Alan Himmel, DC.

There is no doubt that chiropractors are best known for their excellence in conservatively treating conditions of the spine, and related back pain.  Whiplash of the neck, whiplash of the low back are certainly the most common.  These injuries happen, of course, when a person's body is thrown by force in one direction or the other, which causes the person's head, for example, to want to stay in its original resting position.  Studies show that head restraints reduce cervical spine whiplash injury.  (1)  When the person's body is thrown forward, and the head stays in its original position, only to catch up with the rest of the body after the impact, a person will likely sustain an injury to the cervical spine.  Likewise, if a person's lower body is quickly and forcefully thrown in one direction while the rest of the body is perfectly comfortable in its original resting spot, a person will likely wind up with an injury to the lumbar spine.

As you can see from the illustration above, the forces involved that affect the spine, in these types of traumas, can be very damaging to the muscles of the neck.

These spinal type whiplash injuries vary.  Sometimes the injury is simply to the muscles that support the neck or the low back.  These injuries are usually the least dangerous.  Other times the injury could be to the muscles and tendons, which is more of a troublesome type sprain of the soft tissues.  And, in the more severe cases, the injury could be to the muscles, tendons, nerves, and ligaments.  Any one of the above injuries are very painful and debilitating.  However, the whiplash type injuries to the ligaments are by far the most difficult for patients, and usually require more frequent therapies for a longer period of time.

Above you can see the ligaments that hold the vertebrae together.  As you can see, these ligaments are crucial for the integrity and maintaining the normal anatomy of the spine.  Any disruption of the above ligaments can cause weakness, hyper-mobility, or movements of the bones.

The issue with injuries to ligaments, is that these are supporting structures that connect two or more bones to each other.  These ligaments include the longitudinal ligaments of the spine, and from time to time, depending on who you talk to, I have heard the inter-vertebral discs being referred to as ligaments, because they connect between two bones.  Think of the longitudinal ligaments like the bark on a tree.  They go lengthwise up and down the spine, and in the case of the spine, offer support, so that each of the bones of the spine are lined up on top of the next in a certain fashion, which don't allow the bones to shift and move easily forward or backward. They are very important for support. (2) Very often, one of the most common things I see on x-ray or MRI, to a person's spine after a car collision, is what the radiologist calls "straightening of the spine", or in the more severe cases,  retro (backward) listhesis where a bone moves backward compared to another bone, or antero (forward) listhesis, where a bone moves forward compared to another bone. Take a look below:


The image on the left is a good example of straightening.  The image on the right is the way the cervical curve is supposed to look.

In my opinion, both straightening of the spine or either antero or retro listhesis confirms an injury to the longitudinal ligaments.  This is because these ligaments are designed to keep the vertebra in the correct anatomical position.  Bones that are out of position have lost their supporting structure, which is the function of the ligaments.

Note that the bones have moved in relation to the bone above or below.  This can happen with a disruption of the posterior or anterior longitudinal ligaments.

A colleague of mine likes to tell his patients that these injuries are "very tricky" because often times the patient begins to feel better within a couple of weeks, only to have a relapse in pain, as if the injury just happened.  Worse than that, if left untreated, these types of injuries become more debilitating, and eventually can result in chronic, lifelong physical issues.  Typically, these patients, when left untreated, begin to develop arthritic conditions  because now the mechanics of the joints are not correct, and are stressed.

1.  2009 Nov;24(9):699-707. Epub 2009 Aug 8. Whiplash injury prevention with active head restraint. Ivancic PCSha DPanjabi MMBiomechanics Research Laboratory, Department of Orthopaedics and Rehabilitation, Yale University, School of Medicine, New Haven, CT 06520-8071, USA.

2.   2012 Oct 11;45(15):2668-72. doi: 10.1016/j.jbiomech.2012.08.012. Epub 2012 Aug 30.  The effects of ligamentous injury in the human lower cervical spine.
Devin Leahy PPuttlitz CM.  Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA.

Wednesday, October 10, 2012

Spamming Blogs


Dear potential Blog Spammers,

Congratulations!  You found my Blog.  This is basically where I post my thoughts regarding the Florida No-Fault Law, and the changes that are coming in 2013.   This is also a place to discuss injuries, treatments,  therapies that work, therapies that don't work, and some interesting facts.  The original intent of this blog was to pool some thoughts together with other doctors, lawyers, injured people, and frustrated Florida residents.

However, over the last few months, and the couple thousand visitors who have cruised through the articles, all I seem to get here is people spamming.  They are trying to post their url on this blog, with a useless comment.  At least if you are going to take the time to find this blog, and post your url, can you at least make an intelligible comment?  I will allow you to post your url here, but if you are not going to contribute in a useful way, I am going to delete your post.  In other words, please don't bother because I am the moderator and you will be removed.  Understand?   I have been nice so far and have let some people on, but I am not being nice anymore.

Oh, and there are sponsors on this blog.  If you like what you read, please visit the sponsors on this page.

Professionally yours,
Alan Himmel, DC.