DocTalk

Joakim.

 

Thanks. I remind myself that a good editor is worth their weight in gold.

 

It's been awhile...and there is an explanation for my laziness. Suffice it to say, that between seeing patients in the ER, writing for WebMD, and speaking tours, the website has been neglected. That said, a graphic update is in the works and today marks the return of weekly columns (I hope).

This week we're talking about tib fib fractures, with french gymnast Samir Ait Said reprising the role of Joe Theismann
agony of defeat...tib fib fractures - MD direct

 

Carson Wentz breaks a rib and is out indefinitely? Probably 4-6 weeks like most people who have similar injuries. But why does he need a CT of his chest. Spoiler alert... he doesn't. This week's column:

imaging rib injuries: CT...really?...not - MD direct

 

Injuries this NFL preseason are a reminder that it is a violent sport and pain is an expectation. In the real world, pain is something to be avoided and treated. The rules are changing though and narcotic prescription may be harder to come by.

narcotics role is changing - MD direct

 

About Teddy Bridgewater's knee dislocation
knee dislocation disaster - MD direct

 

Doc, do you have any experience with Cauda Equina Syndrome?

 

This was good information. Thanks.
Appreciated this insight:
This is not an injury that always gets better, even with the best of care. The prognosis for a “normal” knee, one which is stable and without pain happens about 60-70% of the time, 20% will have reasonable function and the last 20% will have a chronically painful, unstable knee.

 

Not a common complication of back injury or disease but common enough to always warrant investigation.

Most common symptoms is urinary retention. The question always becomes whether the inability to urinate is because of spinal cord issues or because there is too much pain to relax the sphincter to allow the bladder to empty.

MRI is test of choice and index of caudal equine has to be high. Failure to fix the underlying problem may lead to permanent paraplegia.

 

That's exactly what a friend of mine is going through right now. He had emergency surgery two Fridays ago. I hope he gets some functions back - currently catheterized and walking with a walker with numbness in one leg.

He has a very high tolerance for pain, and had back issues for a long time. None of us (his family, our rec league team) had ever heard of CES. Absolutely shocking to have his world get turned upside down and now start facing a "new normal".

For me, it was a reminder that pain signals should be looked at in this day of modern medicine. I no longer think of back pain as just simple back pain and getting old.

Absolutely scary. My friend says he's basically survived a car accident, without being in a car accident. Devastating.

Thanks for the reply, DocTalk!

 

A normal neurologic exam does not guarantee a normal brain. Lessons to be learned from Matt Shoemaker.
normal exam..abnormal head ct - MD direct

 

This week it's about missing a diagnosis and the tricks the body can play...courtesy of Zach Ertz.
thoracic outlet syndrome...when a diagnosis hides - MD direct