Michigan Head & Spine Institute, Author at Michigan Head & Spine Institute Blog - Page 5 of 8

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On any given day in metro Detroit, a MHSI neurosurgeon can be found treating an ill and critically injured patient in a local emergency department.  It could be a serious injury that caused brain trauma, crushed vertebra in the neck or spine, a brain hemorrhage, a concussion from an injury while playing a sport or bike riding.  Even the weekend warrior can experience a herniated disk.

No one plans to end up in the emergency department, yet should that happen to you or a loved one, there’s no doubt you want the right doctor there to deliver the best and right care possible.

Because MHSI has one of the largest neurosurgical practices in the country, chances are that when someone suffers a brain or spine injury, or is at the brink of death, an MHSI neurosurgeon is on-call in nearly every emergency department in southeast Michigan, to help an injured person through the worst day of their life.

These patients shared their stories of injury and recovery :


Josh was riding his prized motorcycle when a minivan turned in front of him, laying in the street he wasn’t sure just how injured he was, then he met Dr. Tejpaul Pannu in the Emergency Department at Beaumont-Dearborn.


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Neurosurgeons at Michigan Head and Spine Institute have begun using Optune for the treatment of newly diagnosed and recurrent glioblastoma (GBM). Richard Veyna, M.D., is certified to prescribe this wearable and portable medical device, the first FDA-approved therapy in more than a decade for newly diagnosed GBM.

“Our goal at Michigan Head & Spine Institute is to treat cancer patients with the latest, approved therapies available, so we welcome the opportunity to provide Optune as part of a combination treatment for those fighting GBM,” said Richard Veyna, M.D. “We want our patients to have the best possible quality of life. With Optune as a therapy patients are able to go about their daily activities with minimal disruption to their lives.”

For newly diagnosed patients, Optune is used with the chemotherapy temozolomide (TMZ) after surgery and radiation with TMZ. In a clinical trial, adding Optune to TMZ was proven to delay GBM tumor growth and extend survival in newly diagnosed patients compared with TMZ alone. For recurrent patients, it can be used alone when surgery and radiation treatment options have been exhausted. Optune is approved for the treatment of adult patients (22 years of age or older) with GBM. In a clinical trial, adding Optune to TMZ provided an unprecedented five-year survival advantage in patients with newly diagnosed GBM.

About Glioblastoma Multiforme

Glioblastoma, also called glioblastoma multiforme, or GBM, is the most aggressive type of primary brain tumor. While GBM is rare, it is the most common type of primary brain cancer in adults. Approximately 12,500 new cases of GBM or brain tumors that may progress to GBM are diagnosed in the United States each year. (Watch Pamela’s story)

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Optune creates low-intensity electric fields—called Tumor Treating Fields (TTFields)—which potentially slow or stop cell division leading to cancer cell death. Because TTFields do not enter the bloodstream like a drug, they did not significantly increase TMZ-related side effects for newly diagnosed patients. In clinical trials the most common device related adverse events were scalp irritation from device use and headache.

For the treatment of recurrent GBM, Optune is indicated following histologically–or radiologically–confirmed recurrence in the supratentorial region of the brain after receiving chemotherapy. The device is intended to be used as a monotherapy, and is intended as an alternative to standard medical therapy for GBM after surgical and radiation options have been exhausted.

Guidelines for Use of Optune

Optune should not be used if the patient has an active implanted medical device, a skull defect (such as, missing bone with no replacement), or bullet fragments. Use of Optune with implanted electronic devices has not been tested and may theoretically lead to malfunctioning of the implanted device.

Use of Optune together with skull defects or bullet fragments has not been tested and may possibly lead to tissue damage or render Optune ineffective. Do not use Optune if you are known to be sensitive to conductive hydrogels. In this case, skin contact with the gel used with Optune may commonly cause increased redness and itching, and rarely may even lead to severe allergic reactions such as shock and respiratory failure.

Warnings and Precautions

Optune should only be used after receiving training from qualified personnel, such as your doctor, a nurse, or other medical personnel who have completed a training course given by Novocure™ (the device manufacturer).

Optune should not be used if the patient is pregnant, or thinks she might be pregnant or are trying to get pregnant. It is not known if Optune is safe or effective in these populations.

The most common (≥10%) adverse events involving Optune, in combination with temozolomide, were low blood platelet count, nausea, constipation, vomiting, fatigue, scalp irritation from device use, headache, convulsions, and depression.

The most common (≥10%) adverse events seen when using Optune alone were scalp irritation from device use and headache.

Scalp irritation from device use, headache, malaise, muscle twitching, fall and skin ulcer is considered an adverse reaction related to Optune when using the device alone.

Cautions:

All servicing procedures must be performed by qualified and trained personnel, like Dr. Veyna.

Do not use any parts that do not come with the Optune Treatment Kit, or that were not sent to you by the device manufacturer or given to you by your doctor.

Do not wet the device or transducer arrays.

If you have an underlying serious skin condition on the scalp, discuss with your doctor whether this may prevent or temporarily interfere with Optune treatment.


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Holly Gilmer, M.D. was selected by Women Thrive Conference Program, a program of Michigan Business & Professional Association, as a distinguished leader in her profession and work place! Dr. Gilmer accepted her award on Monday, February 12, 2018, along with six other distinguished women leaders. These distinguished women leaders were chosen by an advisory committee of leading businesswomen and community leaders for excellence in their professions, place of employment and volunteerism.

Dr. Gilmer was asked: What has been your stand out greatest personal achievement that advanced your career? Watch this video clip to see what her answer is.

Holly Gilmer, M.D.


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Every year, Conquer Chiari hosts a walk to raise awareness of Chiari Malformation. All funds raised helped support research, education and awareness of Chiari. If you’re not familiar with Chiari, Chiari is a disease of the brain causing brain tissue to be pushed into the spinal canal. It affects approximately 300,000 people in the United States.  While there is no cure, decompression surgery to improve cerebrospinal fluid flow is the common treatment.

The past few years, Holly Gilmer, M.D. has been a participant in this walk, supporting many of her patients, and also a guest speaker to educate those in attendance of Chiari.

To find out more information on Chiari, please visit our website at: http://www.mhsi.com/brain/chiari-malformation-2/


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Congratulations to MHSI’s doctors named ‘Top Docs’ in the October 2017 issue of HOUR Detroit.  Each year the publishers of HOUR Detroit provide area doctors an opportunity to select the doctors they consider to be ‘Top Docs’. The doctors receiving the greatest number of nominations from their peers are then listed in the magazine as being the best among their colleagues.

For Neurosurgery, Doctors Fernando Diaz, Richard Fessler, Robert Johnson, Fredrick Junn, and Tejpaul Pannu were named, and for Pediatric-Neurosurgery is Holly Gilmer, M.D.

For Pain Management, Doctors Karl Freydl, John Marshall, and Henry Tong were named.

‘Top Docs’ is an honor and shares what their patients already know.


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In our last update about the new EHR (electronic health record) system which launches on Monday, Aug. 28, we shared your help is needed to complete some basic information, like your address, insurance and health history .  Whether you have been a patient for years, or are a new patient you will need to complete online forms one time — before any appointments after August 28th.

Six days prior to your next appointment, an email request will be sent asking you to pre-register for your upcoming appointment.  The email will contain a link to complete the online forms from home. This is the easiest option and will prevent delays at the time of your appointment.

MHSI Pre-Visit Thank You Page

It should take 15-20 minutes to complete and click the submit button.  The information you submit is encrypted for secure transfer to your personal digital medical record. Within in a few seconds, a confirmation will appear on your screen indicating the information was received.

Another option to complete the pre-registration is to arrive 30 minutes early for your appointment and complete the forms on an office iPad, prior to seeing your provider.

A couple of tips:

  • Be sure to complete and save each section as it is completed to avoid re-entering information.
  • Have available your driver’s license, insurance cards, and a list of medications, including vitamins and minerals taken, and the dates
    and types of previous surgeries.
  • If you are not comfortable with a computer, a family member might be a great resource to help complete the forms.

Like most medical records systems, it relies on having an accurate email. We do not sell your emails and will only use them to communicate with you about your care and the practice. This is a one-time request, and we sincerely appreciate your patience.

We believe the benefits to our patients will be many.  Stay tuned for information about using some of the great new tools.

 

 


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Pradeep Setty, D.O. joins MHSI on August 1, 2017.  He specializes in minimally invasive neurosurgery, utilizing endoscopic and percutaneous approaches to treat brain, spine and skull base disorders such as degenerative spine disease, pituitary and brain tumors as well as trigeminal neuralgia.

Dr. Setty trained under several national experts while completing two fellowships in Neuro-Oncology at MD Anderson Cancer Center and Endoscopic Skull Base Surgery at the University of Pittsburgh Medical Center. Prior to that he completed his neurosurgical residency through Michigan State University where he learned minimally invasive approaches to treat complex spine disorders. In addition Dr. Setty spent an extensive time training under the late Dr. Daniel Pieper, MHSI’s own nationally renowned expert in skull base surgery and trigeminal neuralgia.

Dr. Setty will be seeing patients in the Pontiac and Royal Oak locations.  To schedule an appointment with Dr. Setty, call 248-784-3667 or click to schedule an appointment online.


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Whether you call them electronic medical records (EMRs) or electronic health records (EHRs), physicians were required by the U.S. government to implement an EMR system within their practice by 2014.  EHRs were meant to provide a higher level of patient safety and interconnectivity between physicians and hospitals.

Fast forward to 2017, and it is time for many physician practices and some hospitals to update to more robust EHRs, basically because the use of EHRs has out grown the initial capability of the software.

The MHSI team has been working behind the scenes for the last year to prepare a new EMR system that works better for patients, physicians and billing.  “We have targeted Monday, Aug. 28 as our ‘go live’ date,” explains Mary Martin, RN, clinical director at MHSI.  “Our patients will really like what this new EMR system can provide them.”

Coming up: Patients will need to input identification, insurance and health history into the new system. There will be several different ways to enter the information, including online and via an app.  “One important message we want our patients to know at in this stage of implementation is they should not be concerned, all previous medical records remain in-tact and appointments and surgeries will not be interrupted, ” says Ms. Martin.

Stay tuned…Over the summer the MHSI staff are training to use the new EMR. In August, complete instructions for patient’s use of the new system will be provided through newsletters and blogs like this and on the website as the ‘go-live” date gets closer.


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There’s no doubt that technology has changed our lives over the last decade. What was once an internet with minimal and amateur information has become the “internet of things”.   We now use Google for everything we need to know from recipes, to the latest news and even health care education.

To quickly access knowledge, we are constantly connected to our mobile or smart phones, in addition to desktops, laptops and readers.  Some are so connected that addictive behaviors are causing what are often called medical conditions, like Tech Neck, Selfie Elbow, and Pinkie Dent.

Even your doctor increased his or her use of technology with electronic medical records.  This created an unexpected complaint from patients, as doctors more frequently look at a computer screen or iPad during your office visit by answering questions through multiple screens of information, the software requires to get to the next screen.

It is important this information is accurate for your safety. It documents what you share with the doctor and treatment plans that result.  Often, the better your medical records are documented the greater chance the insurance company understands what care you received. This reduces re-billing, and deductibles are more likely to be correct.  This also can reduce payment out of pocket expenses caused by billing errors.

So on the next visit to your doctor, you will better understand the physician is not playing on their phone or computer, but making sure your medical records accurately reflect your medical status and treatment provided.  Asking your physician for eye contact is a request you should feel comfortable making. This simply reminds your provider to take a computer break while attending to your individualized care.

Oh my aching neck…

Does your neck and back ache after hours on your laptop or smart phone?  Lots of media stories share how new conditions are being attributed to overuse of technology, like:

Tech Neck – slumping over and looking down strains the neck muscles may result in damage to cervical disks.   And, it creates a more wrinkled throat and neck.

Selfie Elbow – sounds ridiculous but it is caused by taking too many selfies and over-using the muscles surrounding the elbow and wrist.

Pinkie Dent – that’s right, many hold their devices bending their pinky for long periods of time. Sometimes the finger is hard to straighten as the tendons in the finger become less flexible.

MHSI Physiatrist Karl Freydl, DO, explains that it’s important to take a break and recognize that any repetitive movement can cause muscle strain.  “While it’s good to take a break, seeking the advice of a physiatrist to can improve and restore muscle memory.  Sometimes therapy is the answer, but in more severe cases a cervical disk or joint could be damaged.”

No one is immune to the effects of technology on the neck, hands, elbows and eyes.  Limit your use with an app that times your use or set the timer to remind you it’s time to take a break. Stretching your neck backwards, rolling your shoulders and giving your hands and eyes a break may be just what’s needed.

To schedule an appointment with an MHSI Physiatrist (Physical Medicine & Rehabilitation physician), call 248-784-3667 or click here


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Patients arrive at Michigan Head & Spine Institute with many different conditions and injuries.  We hear from our patients that learning about conditions other than what you might be experiencing often helps family members or friends. So this month the MHSI Health Education Series will discuss trigeminal neuralgia.

Robert Johnson, M.D., MHSI neurosurgeon explains, “Pressure or damage to the trigeminal nerve can cause malfunction of the nerve which leads to the pain in the face known as trigeminal neuralgia.” Trigeminal neuralgia usually affects more women than men, and those over 50 years of age. Doctors may use medications, and sometimes surgery to relieve the pain and release the pressure on the nerve.

Some Possible Causes:

  • Contact between a normal blood vessel and an artery/vein
  • Aging
  • Multiple Sclerosis or other movement disorders
  • Brain lesion
  • Stroke or facial trauma
  • Abnormal position of blood vessel related to the nerve

Symptoms of Trigeminal Neuralgia

There are many symptoms of trigeminal neuralgia which could include one of these patterns:

  • Extremely painful, sharp electric-like spasms that may last a few seconds to a few minutes.
  • Spontaneous attacks of pain while doing regular daily activities such as talking, brushing your teeth, or chewing.
  • Pain that is triggered by sounds, wind or touch.
  • Pain that affects one side of the face, rarely does it affect both sides of the face.
  • Constant aching or burning pain.
  • Pain is usually in the areas that are supplied by the trigeminal nerve: cheek, jaw, teeth, gums, or lips. Pain in the eyes and forehead are less common.
  • Attacks become more frequent and increase in intensity.
  • Pain, for an unknown reason, isn’t usually felt while sleeping. Knowing this may help physicians pinpoint if it could be a migraine or toothache rather than trigeminal neuralgia.
  • In atypical trigeminal neuralgia, a severe migraine in addition to the sharp electric like spasms may be present.

Treatment for Trigeminal Neuralgia

Medication, which may include muscle relaxers, anti-seizure drugs, and antidepressants to target the inflamed nerve, may be prescribed to those diagnosed with trigeminal neuralgia. In some cases, surgery may be needed to relieve the pressure that is causing the nerve disruption. These surgical options may include:

  • Microvascular decompression – relocating or removing a blood vessel that is in contact with the trigeminal nerve. This is done with a small incision behind the ear on the side of your pain
  • Tumor Removal
  • Gamma Knife Radiosurgery
  • Glycerol injection – the sterile glycerol damages the trigeminal nerve and blocks pain signals
  • Balloon compression

Robert Johnson, M.D., Jeffrey Jacob, M.D., and Daniel Michael, M.D., are all MHSI neurosurgeons who specialize in treating trigeminal neuralgia.  If you identified these symptoms as those you may be experiencing, please call MHSI for an appointment, 248-784-3667.