Chiropractic coalface stroke

Chiropractic coalface stroke suggests what to do in an emergency.

A colleague reports from his Chiropractic Coalface:

A 40 year old male consulted me for sub-occipital pain. He denied any history of previous serious illnesses or injuries and the physical exam was unremarkable other than for upper cervical restrictions and muscle tension.

I gave him about 3 treatments over a period of about 7-10 days and he was responding well.

The two vertebral arteries join to form the Basilar Vertebro artery.

Vertebro basilar accident

A clot or spasm may cause a vertebro basilar accident, or in other terms a chiropractic coalface stroke.

On about the fourth treatment I did an occipital lift after the usual soft tissue treatment (I don’t believe I had done it previously). I then told him to get dressed as I went to fetch the appointment book in the receptionist's office (he was my last patient on a Friday and the receptionist had already gone home). When I got back, he had his shirt on but was just sitting in a chair. I asked what was wrong - he said he felt light-headed. I said he had probably got up from the table too quickly and told him to lie down again, which he did.

He gradually became more dizzy and said he felt nauseous. I got a bowl and he vomited.

He became more drowsy and began sweating. I phoned for an ambulance, which came quickly. By the time it arrived, he was comatose. I also phoned his wife at home and told her that he wasn't well and that I was taking him to hospital and that she should meet me there. I went with him in the ambulance and told the admitting GP what had happened.

His wife wasn't there, but his brother had come. He told me that the patient had had a similar incident some years before and that his symptoms had started after the two of them had been pulling a boat onto land at the Vaal Dam, the patient having tripped over a stone and fell backwards, hitting his head on the ground - none of this the patient revealed in the history-taking!

Fortunately, he recovered and there was no case. It's an unpleasant experience for any doctor, potentially devastating for the patient and his/her family, but rare compared to the incidents that beset medicine.

So, my advice to my colleagues should they experience a similar incident? Just be sensible, don’t panic, apply CPR if necessary and don’t delay in calling for help.

Chiropractic coalface stroke

Chiropractic coalface stroke is a very rare event; if it wasn't our insurance premiums would be on a par with gynaecologists.

I personally have given probably several hundred thousand cervical manipulations without any serious incidents, but always aware that one is working where angels fear to tread.

Aside: It's also essential that a patient who may have had a stroke or vertebro basilar accident immediately be administered a drug like Warfarin that prevents clot formation; that can only be done by a medical doctor. When in doubt, it's better to assume the worst, as this wise man did, and get immediate medical help. All's well that ends well, but this CHIROPRACTIC COALFACE STROKE casefile could have had a different ending had he not been so astute. Stroke chiropractic is VERY rare but it can and does happen.

Modern diagnostic imaging can determine whether the patient has had a stroke or not; an immediate response to this emergency can mean the difference between death or permanent disability, and full restoration.

Dr B

Omega 3

The omega 3 oil found in fatty fish, fish oil, walnuts, flax seed and, to a lesser extent, pecan nuts has remarkable anti-clot factors. Eat them as regularly as you can, at least one preferably every day; whether you're anxious about chiropractic coalface stroke or not.

I add flax seed to the sesame seed I use when making our own hummus. How to make tahini - a sesame paste is a vital part of making hummus, a "super food" in the battle against raised cholesterol, a major factor in stroke. So we make flax-and-sesame tahini. 

Flax seed nutrition information

Flax adorns the fields of Europe, and I suppose the rest of the world, blue or white flowers, yielding a seed that is the richest vegetable source of omega-3 fatty acids.

Omega-3 is a very powerful anti-oxidant, meaning that it is itself very readily oxidised - goes rancid. That's why fish (and house guests!) go off after three days. Flax seed oil too. Don't buy it in bottles, either in softgel capsules that keep the oxygen out, or better still grind it yourself: Freshly ground flax seed nutrition information ...

It's so easy to grind your own flax seeds using a simple, inexpensive coffee grinder. Add a tablespoon of the ground flax seed to your muesli every morning; if you bake bread include it in the ingredients, usually added later otherwise the bread doesn't rise properly.


› Chiropractic coalface stroke

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti-inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He is doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost pain-free. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily stroll has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift; he has a short leg.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. X-rays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65-year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88-year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done. 

10. Mr X is a 71-year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a few months ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he could not sleep on that shoulder.

13. Mr D, a 71-year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors should not be treating the elderly most medical sites state but that is so much bunkum.

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Interesting questions from visitors

CLS writes:

Greetings, Dr B.

You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

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Knowing that up to 70 percent of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there is a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong. Give plenty of detail if you want a sensible reply.

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