Apr

23

I just returned from my daily trip to the hospital, and today, a nurse’s station was setup in the foyer graciously screening blood pressures for passersby.  It dawned upon me that I check blood pressure for patients all day long, but never have my own checked.  So I decided to stop and participate, (incidentally, my pressure was on the low side of normal).  As I sat in the chair it occurred to me how many individuals have high blood pressure that never stop to have it checked, and what an enormous mistake this is.  Disorders of high blood pressure such as stroke, can be averted before they occur with simple management of their blood pressure before it becomes a problem.  The real problem however is that most people don’t perceive that anything is wrong as high blood pressure is insidious with no real signs or symptoms, until something goes catastrophically wrong, such as a stroke, or aneurism.   Well, then it occurred to me that the same thing occurs with balance loss and falls.  Most people don’t know they have a balance problem because they don’t perceive it, (which is a big mistake), and then, suddenly, one day fall and end up in the hospital with a pelvic fracture or even worse.  Not unlike high blood pressure, imbalance is insidious, you do not perceive that your balance is bad, until it gets sufficiently bad that you begin stumbling about.  It is at this point that imbalance becomes notable.  By the time that you realize that you have poor balance, or a balance problem, the cause has already long passed the point of early intervention.  Much like blood pressure, individual’s need to be screened regularly for balance and fall risk to obtain the benefits of early intervention when there is a problem.  Using specialized “computerized posturography” balance testing equipment, in twenty seconds we can determine your stability, your risk of fall, and whether or not you may have a potential neurologic problem that could easily be remedied with early intervention.  My office performs this test free of charge as a community service.  We offer each individual who chooses to take advantage of it four tests annually, all free of charge.  As the test takes little time, it is cheap insurance to stop in once a season and get screened, pass, and get scheduled again for the following season.  Additionally, it should be noted that balance loss is the first sign of a neurologic problem with disorders such as multiple sclerosis, Parkinson’s disease, etc.  Please call our office at (732) 229-5250 to set up a free screening, or to discuss candidacy for treatment of a health concern.

Apr

14

Vertigo, for being one of the top reasons why an individual would go to a doctor, is an extremely misunderstood and frequently inappropriately treated disorder.  Vertigo in and of itself manifests as a symptom, not as a true disease entity.  It is often confused with dizziness, lightheadedness, presyncope, anxiety and cardiac problems.  Frequently, a myriad of diagnostic imaging and other tests are utilized in a futile effort to find an appropriate diagnosis, in lieu of a diligent examination having been performed in the first place.  By and large the most common cause of vertigo is due to a condition called benign paroxysmal positional vertigo.  However, it is important to see a properly trained doctor/therapist when seeking treatment.  Most doctors are not trained at all in treating this disorder, few are trained to correctly diagnose it.  This disorder is not something that will show up on an MRI examination.  This disorder occurs when otoconia, (calcium particles in the inner ear), get into the vestibular labyrinthine canal systems were they do not belong.  When this happens, vertigo occurs whenever there is a change in head position.  Vertigo can be severe but usually subsides as soon as head movements stop.  Treatment for the disorder is dependent on which canal is affected.  There are 3 canals on each side, 6 in total.  Treatment must be specific to the canal system afflicted.  Otherwise, treatment will just continue making you more vertiginous.  Making matters more complex, if the diagnosis is not positional vertigo, the treatment won’t work.  And if the diagnosis is positional vertigo and this specific treatment is not performed, any other treatment will not work.  So as you can see, an accurate diagnosis is of critical importance in obtaining the correct treatment, otherwise success will be low.  There are many causes of vertigo.  As such, there is no one main treatment for it.  Treatment varies pending on what is actually causing the symptom of vertigo.  For individuals who suffer from vertigo, bouts are no fun.  They are frequently associated with nausea and vomiting which can be severe.  Vomiting can lead to electrolyte disturbances and thus other medical problems.  Invariably individuals who suffer from vertigo, also suffer from dizziness and imbalance because of the natural compensation of the perpetual spinning sensation or vertigo.  Without appropriate treatment this can lead to a fall which typically changes the course of ones life.

Apr

3

After having completed specialty postdoctoral neurology course work a few years back in the treatment of children as well as adults with neurobehavioral disorders such as ADD, ADHD, autism, etc, I did not incorporate a plan to attract these types of patients into my office immediately.  Until recently, my office has largely focused in the management of patients with balance and movement disorder syndromes, such as vertigo, dizziness, dystonia, imbalance/fall risk, and patients with other brain injuries such as head traumas associated with accidents.  Recently however, in light of the endemic problems in school systems associated with children with ADD ADHD and other learning disabilities, we decided to incorporate patients with neurobehavioral disorders into our daily practice.  Since the inception of this program, we have taken in several patients with a diagnosis of ADD ADHD, most of whom have been children and most of whom had similar patterns exemplifying the disorder.  Our findings have been congruent with the findings of similar programs in other states in that we have met with a very high level of success.  These children no longer need to be medicated; their teachers have called us to see what we are doing as the children are notably improved, with demonstrable change in behavior and academia, etc.  As a result of our successes here, we are increasing the number of children that we accept into our program.  If you or someone you know is interested in our program, you can start by going to www.dcneuro.net/ADD.htm. From there, you can access a free informational report on the disorder, and also submit an electronic consultation form, which I personally will review.  If we feel you are a candidate for our program, we will let you know, (we will let you know either way).  Because we are currently limiting the number of children we accept into our program, even if we accept you, you may have to be placed on a waiting list, with which we appreciate your understanding.  Our office invests a great deal of time into this program and we spend 30 minutes to an hour with each patient.  As such, we must limit the number of participants.  If you prefer, you may contact my office directly at (723) 229-5250, and ask for Debbie.