Guest guest Posted February 11, 2011 Report Share Posted February 11, 2011 This is not a direct response to the statement/request but why do we have this huge double standard. 493 deaths per day from medical issues and we get painted as the risky providers? Let's have a little perspective. http://www.wellnessinsideout.com/OUTRAGE_Jan11.pdf (by Louis Sportelli) Seitz, DC Tuality Physicians 730-D SE Oak St Hillsboro, OR 97123 (503)640-3724 From: sharronf@...Date: Fri, 11 Feb 2011 16:06:48 -0800Subject: VBS registry I have had several comments over the last few days from a person who was just in a serious car accident. This person is well aware that they need to see a DC yet they have been told by their local internist and from their co-workers that they should not see a Chiropractor because of the risk of VBS. Yes, I know you have all heard this a zillion times before but really, this is significant. I am wondering if any DC in Oregon, not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form an anonymous registry of all people who are suspected to have been harmed by cervical spine adjustments? Or perhaps, we could ask the OBCE to request that all alleged injuries be reported to them? The reason I ask this is for hard data that we can use to report the actual incidence of VBS here in Oregon. The process would also allow for open communication and teaching of Vascular Interventionists and others. I have brought this up before, numerous times actually, but we need to be on the offense not the defense of this issue. A uniformed informed consent would be helpful once we have Oregon data to use. s. fuchs dc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 11, 2011 Report Share Posted February 11, 2011 I understand, none the less we have a problem. So how to address it is my question? A good offense is the best defense...or so I have heard. s. fuchs dc > > > This is not a direct response to the statement/request but why do we have this huge double standard. 493 deaths per day from medical issues and we get painted as the risky providers? Let's have a little perspective. http://www.wellnessinsideout.com/OUTRAGE_Jan11.pdf (by Louis Sportelli) > > Seitz, DC > Tuality Physicians > 730-D SE Oak St > Hillsboro, OR 97123 > (503)640-3724 > > > > > From: sharronf@... > Date: Fri, 11 Feb 2011 16:06:48 -0800 > Subject: VBS registry > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > I have had several comments over the last few days from a > person who was just in a serious car accident. This person is well aware that > they need to see a DC yet they have been told by their local internist and from > their co-workers that they should not see a Chiropractor because of the risk of > VBS. Yes, I know you have all heard this a zillion times before but really, > this is significant. > > > > I am wondering if any DC in Oregon, > not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form > an anonymous registry of all people who are suspected to have been harmed by > cervical spine adjustments? Or perhaps, we could ask the OBCE to request that > all alleged injuries be reported to them? The reason I ask this is for hard > data that we can use to report the actual incidence of VBS here in Oregon. The process > would also allow for open communication and teaching of Vascular > Interventionists and others. > > > > I have brought this up before, numerous times actually, but > we need to be on the offense not the defense of this issue. A uniformed > informed consent would be helpful once we have Oregon data to use. > > > > s. fuchs dc > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 My first response to Sharon's suggestion is: what would that request for data look like? Calling for that input would put chiropractic under a very uncomfortable microscope for a bit of time.....a time when the fears could be seriously used against us. Could a campaign such as that be successfully counterposed with the '757/day data' from the allopathic side .... or would it just be fodder for the vascular interventionists? It is good intent, Sharon, and the idea certainly has merit, but it could/would really be a gamble for us. Sunny Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com From: dcdocbrian@...Date: Fri, 11 Feb 2011 16:29:09 -0800Subject: RE: VBS registry This is not a direct response to the statement/request but why do we have this huge double standard. 493 deaths per day from medical issues and we get painted as the risky providers? Let's have a little perspective. http://www.wellnessinsideout.com/OUTRAGE_Jan11.pdf (by Louis Sportelli) Seitz, DC Tuality Physicians 730-D SE Oak St Hillsboro, OR 97123 (503)640-3724 From: sharronf@...Date: Fri, 11 Feb 2011 16:06:48 -0800Subject: VBS registry I have had several comments over the last few days from a person who was just in a serious car accident. This person is well aware that they need to see a DC yet they have been told by their local internist and from their co-workers that they should not see a Chiropractor because of the risk of VBS. Yes, I know you have all heard this a zillion times before but really, this is significant. I am wondering if any DC in Oregon, not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form an anonymous registry of all people who are suspected to have been harmed by cervical spine adjustments? Or perhaps, we could ask the OBCE to request that all alleged injuries be reported to them? The reason I ask this is for hard data that we can use to report the actual incidence of VBS here in Oregon. The process would also allow for open communication and teaching of Vascular Interventionists and others. I have brought this up before, numerous times actually, but we need to be on the offense not the defense of this issue. A uniformed informed consent would be helpful once we have Oregon data to use. s. fuchs dc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 Yes, we have a problem. It is the perpetuation of at least a gross exaggeration of risk, and at worst an outright lie. While we cannot argue that there exists "bad Chiropractosr" I don't think they are out there killing people (as opposed to bad surgeons, or drug pushing MD's...) I was going to dig out journal articles to support my claim, but guess what? Chestnut has already done it, and really well! (See attached).I think we as Chiropractors are sensitive to this subject because we were probably all on the receiving end of over-vigorous adjustment while in Chiro College. But that just shows how important practice, skill and training are. That's why we are the experts!So, with regards to this individual and any future similar individuals I would suggest you go on the offensive and tell them their fears are unwarranted (and they better be careful taking those NSAIDS the MD recommended) and refer them to a trusted peer ASAP! Seitz, DC Tuality Physicians 730-D SE Oak St Hillsboro, OR 97123 (503)640-3724 From: sharronf@...Date: Sat, 12 Feb 2011 00:59:51 +0000Subject: Re: VBS registry I understand, none the less we have a problem. So how to address it is my question? A good offense is the best defense...or so I have heard. s. fuchs dc > > > This is not a direct response to the statement/request but why do we have this huge double standard. 493 deaths per day from medical issues and we get painted as the risky providers? Let's have a little perspective. http://www.wellnessinsideout.com/OUTRAGE_Jan11.pdf (by Louis Sportelli) > > Seitz, DC > Tuality Physicians > 730-D SE Oak St > Hillsboro, OR 97123 > (503)640-3724 > > > > > From: sharronf@... > Date: Fri, 11 Feb 2011 16:06:48 -0800 > Subject: VBS registry > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > I have had several comments over the last few days from a > person who was just in a serious car accident. This person is well aware that > they need to see a DC yet they have been told by their local internist and from > their co-workers that they should not see a Chiropractor because of the risk of > VBS. Yes, I know you have all heard this a zillion times before but really, > this is significant. > > > > I am wondering if any DC in Oregon, > not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form > an anonymous registry of all people who are suspected to have been harmed by > cervical spine adjustments? Or perhaps, we could ask the OBCE to request that > all alleged injuries be reported to them? The reason I ask this is for hard > data that we can use to report the actual incidence of VBS here in Oregon. The process > would also allow for open communication and teaching of Vascular > Interventionists and others. > > > > I have brought this up before, numerous times actually, but > we need to be on the offense not the defense of this issue. A uniformed > informed consent would be helpful once we have Oregon data to use. > > > > s. fuchs dc > 1 of 1 File(s) Chestnut stroke rebuttal.pdf Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 I believe Sunny raises a very good point. The cure could be worse by far than the disease-pun fully intended. There is abundant evidence showing the safety of HVM. Schneider DCPDX On Sat, Feb 12, 2011 at 9:01 AM, Sunny Kierstyn <skrndc1@...> wrote:  My first response to Sharon's suggestion is: what would that request for data look like?  Calling for that input would put chiropractic under a very uncomfortable microscope for a bit of time.....a time when the fears could be seriously used against us. Could a campaign such as that be successfully counterposed with the '757/day data' from the allopathic side .... or would it just be fodder for the vascular interventionists?    It is good intent, Sharon, and the idea certainly has merit, but it could/would really be a gamble for us.  Sunny Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com  From: dcdocbrian@...Date: Fri, 11 Feb 2011 16:29:09 -0800 Subject: RE: VBS registry  This is not a direct response to the statement/request but why do we have this huge double standard.  493 deaths per day from medical issues and we get painted as the risky providers? Let's have a little perspective. http://www.wellnessinsideout.com/OUTRAGE_Jan11.pdf (by Louis Sportelli) Seitz, DC Tuality Physicians 730-D SE Oak St Hillsboro, OR 97123 (503)640-3724 From: sharronf@...Date: Fri, 11 Feb 2011 16:06:48 -0800 Subject: VBS registry I have had several comments over the last few days from a person who was just in a serious car accident. This person is well aware that they need to see a DC yet they have been told by their local internist and from their co-workers that they should not see a Chiropractor because of the risk of VBS. Yes, I know you have all heard this a zillion times before but really, this is significant.  I am wondering if any DC in Oregon, not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form an anonymous registry of all people who are suspected to have been harmed by cervical spine adjustments?  Or perhaps, we could ask the OBCE to request that all alleged injuries be reported to them? The reason I ask this is for hard data that we can use to report the actual incidence of VBS here in Oregon. The process would also allow for open communication and teaching of Vascular Interventionists and others.  I have brought this up before, numerous times actually, but we need to be on the offense not the defense of this issue. A uniformed informed consent would be helpful once we have Oregon data to use.  s. fuchs dc   -- Schneider DC PDX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 A simple response to critics of manual manipulation and the risk of VBS is simply to offer Activator or similar treatment where adjustments are done in the prone neutral position. To my knowledge there has never been a successful claim of VBS caused by an Activator adjustmentIf I'm wrong please provide a citation in the literature. R Johansen D.C. PC,DABCOChiropractic Life Center12762 SE Stark StreetPortland Oregon 97233Voice 5032557746,Fax 5032550818----- VBS registry I have had several comments over the last few days from a person who was just in a serious car accident. This person is well aware that they need to see a DC yet they have been told by their local internist and from their co-workers that they should not see a Chiropractor because of the risk of VBS. Yes, I know you have all heard this a zillion times before but really, this is significant. I am wondering if any DC in Oregon, not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form an anonymous registry of all people who are suspected to have been harmed by cervical spine adjustments? Or perhaps, we could ask the OBCE to request that all alleged injuries be reported to them? The reason I ask this is for hard data that we can use to report the actual incidence of VBS here in Oregon. The process would also allow for open communication and teaching of Vascular Interventionists and others. I have brought this up before, numerous times actually, but we need to be on the offense not the defense of this issue. A uniformed informed consent would be helpful once we have Oregon data to use. s. fuchs dc ____________________________________________________________$65/Hr Job - 25 OpeningsPart-Time job ($20-$65/hr). Requirements: Home Internet AccessChannel11NewsReport.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 FROM: Spine 2008 (Feb 15); 33 (4 Suppl): S176–183 Cassidy JD, Boyle E, Côté P, He Y, Hogg- S, Silver FL, Bondy SJ Centre of Research Expertise for Improved Disability Outcomes, University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, ON, Canada. dcassidy@... STUDY DESIGN: Population-based, case-control and case-crossover study. OBJECTIVE: To investigate associations between chiropractic visits and vertebrobasilar artery (VBA) stroke and to contrast this with primary care physician (PCP) visits and VBA stroke. SUMMARY OF BACKGROUND DATA: Chiropractic care is popular for neck pain and headache, but may increase the risk for VBA dissection and stroke. Neck pain and headache are common symptoms of VBA dissection, which commonly precedes VBA stroke. METHODS: Cases included eligible incident VBA strokes admitted to Ontario hospitals from April 1, 1993 to March 31, 2002. Four controls were age and gender matched to each case. Case and control exposures to chiropractors and PCPs were determined from health billing records in the year before the stroke date. In the case-crossover analysis, cases acted as their own controls. RESULTS: There were 818 VBA strokes hospitalized in a population of more than 100 million person-years. In those aged <45 years, cases were about three times more likely to see a chiropractor or a PCP before their stroke than controls. Results were similar in the case control and case crossover analyses. There was no increased association between chiropractic visits and VBA stroke in those older than 45 years. Positive associations were found between PCP visits and VBA stroke in all age groups. Practitioner visits billed for headache and neck complaints were highly associated with subsequent VBA stroke. CONCLUSION: VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care.From: Sharron Fuchs <sharronf@...> Sent: Fri, February 11, 2011 4:06:48 PMSubject: VBS registry I have had several comments over the last few days from a person who was just in a serious car accident. This person is well aware that they need to see a DC yet they have been told by their local internist and from their co-workers that they should not see a Chiropractor because of the risk of VBS. Yes, I know you have all heard this a zillion times before but really, this is significant. I am wondering if any DC in Oregon , not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form an anonymous registry of all people who are suspected to have been harmed by cervical spine adjustments? Or perhaps, we could ask the OBCE to request that all alleged injuries be reported to them? The reason I ask this is for hard data that we can use to report the actual incidence of VBS here in Oregon . The process would also allow for open communication and teaching of Vascular Interventionists and others. I have brought this up before, numerous times actually, but we need to be on the offense not the defense of this issue. A uniformed informed consent would be helpful once we have Oregon data to use. s. fuchs dc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 Sorry, forgot to sign that last email.best,Jay Lindekugel, DCConcordia Chiropractic Center5425 NE 33rd Ave.Portland Or. 97211From: Sharron Fuchs <sharronf@...> Sent: Fri, February 11, 2011 4:06:48 PMSubject: [From OregonDCs] VBS registry I have had several comments over the last few days from a person who was just in a serious car accident. This person is well aware that they need to see a DC yet they have been told by their local internist and from their co-workers that they should not see a Chiropractor because of the risk of VBS. Yes, I know you have all heard this a zillion times before but really, this is significant. I am wondering if any DC in Oregon , not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form an anonymous registry of all people who are suspected to have been harmed by cervical spine adjustments? Or perhaps, we could ask the OBCE to request that all alleged injuries be reported to them? The reason I ask this is for hard data that we can use to report the actual incidence of VBS here in Oregon . The process would also allow for open communication and teaching of Vascular Interventionists and others. I have brought this up before, numerous times actually, but we need to be on the offense not the defense of this issue. A uniformed informed consent would be helpful once we have Oregon data to use. s. fuchs dc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 With all due respect, and without maligning your proficiency and success with Activator I do not agree! This is capitulation! This places Activator technique on a pedestal of safety while perpetuating the myth of danger associated with HVLA. Did your read the Chestnut rebuttal? I am not arguing against Activator or any other instrument adjusting, but I am arguing for the safety and efficacy of HVLA adjusting! If we deny ourselves the right to provide this care we are denying our patients a very powerful and effective tx for numerous complaints and "wellness!" We have to stop being apologists and nurturing fear in ourselves and therefore others. I do not subscribe to the notion that HVLA is antiquated and the future is in instrument adjusting. Instruments are great, but like our hands are just tools; the real power is between our ears! Seitz, DC Tuality Physicians 730-D SE Oak St Hillsboro, OR 97123 (503)640-3724skrndc1@...CC: dcdocbrian@...; From: drjohansen@...Date: Sat, 12 Feb 2011 18:58:30 +0000Subject: RE: VBS registry A simple response to critics of manual manipulation and the risk of VBS is simply to offer Activator or similar treatment where adjustments are done in the prone neutral position. To my knowledge there has never been a successful claim of VBS caused by an Activator adjustmentIf I'm wrong please provide a citation in the literature. R Johansen D.C. PC,DABCOChiropractic Life Center12762 SE Stark StreetPortland Oregon 97233Voice 5032557746,Fax 5032550818----- VBS registry I have had several comments over the last few days from a person who was just in a serious car accident. This person is well aware that they need to see a DC yet they have been told by their local internist and from their co-workers that they should not see a Chiropractor because of the risk of VBS. Yes, I know you have all heard this a zillion times before but really, this is significant. I am wondering if any DC in Oregon, not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form an anonymous registry of all people who are suspected to have been harmed by cervical spine adjustments? Or perhaps, we could ask the OBCE to request that all alleged injuries be reported to them? The reason I ask this is for hard data that we can use to report the actual incidence of VBS here in Oregon. The process would also allow for open communication and teaching of Vascular Interventionists and others. I have brought this up before, numerous times actually, but we need to be on the offense not the defense of this issue. A uniformed informed consent would be helpful once we have Oregon data to use. s. fuchs dc ____________________________________________________________$65/Hr Job - 25 OpeningsPart-Time job ($20-$65/hr). Requirements: Home Internet AccessChannel11NewsReport.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 ....and if you want the whole study: http://www.ccachiro.org/ecms.ashx/Doc/EntireStrokeStudy.pdf Seitz, DC Tuality Physicians 730-D SE Oak St Hillsboro, OR 97123 (503)640-3724sharronf@...; From: pdxchiroguy@...Date: Sat, 12 Feb 2011 11:17:02 -0800Subject: Re: VBS registry FROM: Spine 2008 (Feb 15); 33 (4 Suppl): S176–183 Cassidy JD, Boyle E, Côté P, He Y, Hogg- S, Silver FL, Bondy SJ Centre of Research Expertise for Improved Disability Outcomes, University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, ON, Canada. dcassidy@... STUDY DESIGN: Population-based, case-control and case-crossover study. OBJECTIVE: To investigate associations between chiropractic visits and vertebrobasilar artery (VBA) stroke and to contrast this with primary care physician (PCP) visits and VBA stroke. SUMMARY OF BACKGROUND DATA: Chiropractic care is popular for neck pain and headache, but may increase the risk for VBA dissection and stroke. Neck pain and headache are common symptoms of VBA dissection, which commonly precedes VBA stroke. METHODS: Cases included eligible incident VBA strokes admitted to Ontario hospitals from April 1, 1993 to March 31, 2002. Four controls were age and gender matched to each case. Case and control exposures to chiropractors and PCPs were determined from health billing records in the year before the stroke date. In the case-crossover analysis, cases acted as their own controls. RESULTS: There were 818 VBA strokes hospitalized in a population of more than 100 million person-years. In those aged <45 years, cases were about three times more likely to see a chiropractor or a PCP before their stroke than controls. Results were similar in the case control and case crossover analyses. There was no increased association between chiropractic visits and VBA stroke in those older than 45 years. Positive associations were found between PCP visits and VBA stroke in all age groups. Practitioner visits billed for headache and neck complaints were highly associated with subsequent VBA stroke. CONCLUSION: VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care.From: Sharron Fuchs <sharronf@...> Sent: Fri, February 11, 2011 4:06:48 PMSubject: VBS registry I have had several comments over the last few days from a person who was just in a serious car accident. This person is well aware that they need to see a DC yet they have been told by their local internist and from their co-workers that they should not see a Chiropractor because of the risk of VBS. Yes, I know you have all heard this a zillion times before but really, this is significant. I am wondering if any DC in Oregon , not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form an anonymous registry of all people who are suspected to have been harmed by cervical spine adjustments? Or perhaps, we could ask the OBCE to request that all alleged injuries be reported to them? The reason I ask this is for hard data that we can use to report the actual incidence of VBS here in Oregon . The process would also allow for open communication and teaching of Vascular Interventionists and others. I have brought this up before, numerous times actually, but we need to be on the offense not the defense of this issue. A uniformed informed consent would be helpful once we have Oregon data to use. s. fuchs dc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 Amen! Lyndon McGill, D.C. Salem, Oregon www.SalemSpineClinic.com www.EvolvingDaily.com > With all due respect, and without maligning your > proficiency and success with Activator I do not agree! > This is capitulation! This places Activator technique on a > pedestal of safety while perpetuating the myth of danger > associated with HVLA. Did your read the Chestnut > rebuttal? I am not arguing against Activator or any other > instrument adjusting, but I am arguing for the safety and > efficacy of HVLA adjusting! If we deny ourselves the > right to provide this care we are denying our patients a > very powerful and effective tx for numerous complaints and > " wellness! " We have to stop being apologists and > nurturing fear in ourselves and therefore others. I do not > subscribe to the notion that HVLA is antiquated and the > future is in instrument adjusting. Instruments are great, > but like our hands are just tools; the real power is > between our ears! > > Seitz, DC > Tuality Physicians > 730-D SE Oak St > Hillsboro, OR 97123 > (503)640-3724 > > > > skrndc1@... > CC: dcdocbrian@...; > From: drjohansen@... > Date: Sat, 12 Feb 2011 18:58:30 +0000 > Subject: RE: VBS registry > > > > > > > > > > > > > > > > > > > > > > > > > > > > > A simple response to critics of manual manipulation > and the risk of VBS is simply to offer Activator or > similar treatment where adjustments are done in the prone > neutral position. To my knowledge there has never been a > successful claim of VBS caused by an Activator adjustment > If I'm wrong please provide a citation in the literature. > > R Johansen D.C. PC,DABCO > Chiropractic Life Center > 12762 SE Stark Street > Portland Oregon 97233 > Voice 5032557746,Fax 5032550818 > > ----- VBS registry > > > > > > > > I have had several comments over the last few days from a > person who was just in a serious car accident. This person > is well aware that they need to see a DC yet they have > been told by their local internist and from their > co-workers that they should not see a Chiropractor because > of the risk of VBS. Yes, I know you have all heard this a > zillion times before but really, this is significant. > > > I am wondering if any DC in Oregon, not me, would be > willing to contact the Vascular Interventionists in Oregon > and seek to form an anonymous registry of all people who > are suspected to have been harmed by cervical spine > adjustments? Or perhaps, we could ask the OBCE to request > that all alleged injuries be reported to them? The reason > I ask this is for hard data that we can use to report the > actual incidence of VBS here in Oregon. The process would > also allow for open communication and teaching of Vascular > Interventionists and others. > > I have brought this up before, numerous times actually, > but we need to be on the offense not the defense of this > issue. A uniformed informed consent would be helpful once > we have Oregon data to use. > > s. fuchs dc > > > > > > > > > > > __________________________________________________________ > __ $65/Hr Job - 25 Openings > Part-Time job ($20-$65/hr). Requirements: Home Internet > Access Channel11NewsReport.com > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 13, 2011 Report Share Posted February 13, 2011 Well, what we have now is no PR on this issue , no uniform informed consent no Oregon data and a bad rap. The vascular interventionists in the state see the vessel dissections and the thromboembolisms and with a history of seeing a DC guess who gets blamed? With a registry we would have real Oregon data and hopefully a speaking relationship with the doctors who see these issues first hand. If it is so safe what is there to be afraid of?SharronSent from my iPhoneOn Feb 13, 2011, at 10:09 AM, "Bluepearl2001" <bluepearl2001@...> wrote:I think we need to be VERY careful about what we ask for.Be mindful also of the recent move by Kaiser to eliminate cervical manipulation.These are strange times. Cost cutting, lots of fear.I for one am happy to be left alone to do my careful and helpful work and pay my minimal malpractice premiums. Ann VBS registry I have had several comments over the last few days from a person who was just in a serious car accident. This person is well aware that they need to see a DC yet they have been told by their local internist and from their co-workers that they should not see a Chiropractor because of the risk of VBS. Yes, I know you have all heard this a zillion times before but really, this is significant. I am wondering if any DC in Oregon , not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form an anonymous registry of all people who are suspected to have been harmed by cervical spine adjustments? Or perhaps, we could ask the OBCE to request that all alleged injuries be reported to them? The reason I ask this is for hard data that we can use to report the actual incidence of VBS here in Oregon . The process would also allow for open communication and teaching of Vascular Interventionists and others. I have brought this up before, numerous times actually, but we need to be on the offense not the defense of this issue. A uniformed informed consent would be helpful once we have Oregon data to use. s. fuchs dc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 13, 2011 Report Share Posted February 13, 2011 Sharron,You are correct, we need PR on this issue, unfortunately we don't have the money that our medical cousins do. I think your vision is through a legal lens rather than a Chiropractic perspective however. These vascular interventionists you speak of probably see oxidized cholesterol in the intima of the vessels and blame the vascular disease on cholesterol, after all the "evidence based studies" prove it, right? Wrong, (the studies are epidemiological and don't show causation, and the drug studies just show that cholesterol is lowered but not that cholesterol causes heart disease). Another myth prevails and the drug makers profit at our expense! We don't need a bucket for our assumed guilt. We need to be on the offensive, like you have said, not offense through falling back to our collective foxholes! Review the 7 points Chestnut makes in his concluding summary of facts on page 4 of his article (pg 371). Review the article that shows no difference in stroke rates between DC's and PCP's for patients presenting with neck pain or headache. We don't need informed consent because the risk, if present, is so minimal as to be a non-issue. Sure, the perception is there, obviously within our profession as well as with the public, but where is the REAL evidence? Seitz, DC Tuality Physicians 730-D SE Oak St Hillsboro, OR 97123 (503)640-3724bluepearl2001@...CC: From: sharronf@...Date: Sun, 13 Feb 2011 10:45:31 -0800Subject: Re: VBS registry Well, what we have now is no PR on this issue , no uniform informed consent no Oregon data and a bad rap. The vascular interventionists in the state see the vessel dissections and the thromboembolisms and with a history of seeing a DC guess who gets blamed? With a registry we would have real Oregon data and hopefully a speaking relationship with the doctors who see these issues first hand. If it is so safe what is there to be afraid of?SharronSent from my iPhoneOn Feb 13, 2011, at 10:09 AM, "Bluepearl2001" <bluepearl2001@...> wrote: I think we need to be VERY careful about what we ask for. Be mindful also of the recent move by Kaiser to eliminate cervical manipulation. These are strange times. Cost cutting, lots of fear. I for one am happy to be left alone to do my careful and helpful work and pay my minimal malpractice premiums. Ann VBS registry I have had several comments over the last few days from a person who was just in a serious car accident. This person is well aware that they need to see a DC yet they have been told by their local internist and from their co-workers that they should not see a Chiropractor because of the risk of VBS. Yes, I know you have all heard this a zillion times before but really, this is significant. I am wondering if any DC in Oregon , not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form an anonymous registry of all people who are suspected to have been harmed by cervical spine adjustments? Or perhaps, we could ask the OBCE to request that all alleged injuries be reported to them? The reason I ask this is for hard data that we can use to report the actual incidence of VBS here in Oregon . The process would also allow for open communication and teaching of Vascular Interventionists and others. I have brought this up before, numerous times actually, but we need to be on the offense not the defense of this issue. A uniformed informed consent would be helpful once we have Oregon data to use. s. fuchs dc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2011 Report Share Posted February 15, 2011 Sharron, OR DCs,  Interesting thread on VBI and cervical manipulation. I tend to agree with Sharron that the best defense is a good offense. While I agree that VBI caused by cervical CMT is indeed so rare that it needn't even be covered in the usual informed consent discussion, none-the-less it is a hot topic outside our profession. Just check out the court cases that implicate DCs in strokes. (And ask a DC who's been sued what it's like... )  IMHO the responsible thing to do is take this problem seriously. A " disease registry " makes a lot of sense. Maybe the OBCE in its " public protection " role could take this on. It speaks directly and powerfully to (what should be) our sense of the need to protect the public. VBI happens in all sorts of minor neck trauma (visiting the hair dresser, installing a flourescent tube, sex) and also, inarguably, with cervical manipulation.  Even if the risk from cervical CMT is 1:1million, I think we have an obligation to figure out as much as we can about it so we can prevent it, recognize it when it is happening and know what to do about it if and when it does...not to mention keeping a good malpractice policy in place.  A. Simpson, DC DABCOMedical Director, Vice PresidentThe CHP Group6600 SW 105th Ave, Suite 115Beaverton, OR 97008503-619-2041 O503-367-0872 C503-644-0442 F Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2011 Report Share Posted February 15, 2011 There is so much going wrong under the medical model of care currently with research and treatment. Maybe if a drug company came out and said that chiropractic is very safe, we might change some minds(kidding) I don't know. The good news is:1. The facts are on our side. 2. Many more MD's, PA's and NP's are referring to chiropractic for all sorts of issues. 3. Patients "get it" when you explain the current state of research.You are correct to suggest that MD's need to be alerted to the safety of chiropractic. However, here is how I see the registry idea going down:Group of chiro's/MD's form a committee to set up said registry. One "high-ranking" MD decides to steer it to his own limited view as to the dangers of chiropractic. The registry gets set up. Somebody dies after seeing a chiropractor. Now it is "established" that chiropractic is deadly despite the fact that temporal proximity does not prove causality. We get to be all over the evening/national news in a way none of us would like. This is very much like the conclusion which was drawn from a document (i think you posted) several months back showing 70'sh deaths due to manipulation since it's inception. This document was then taken to show that chiropractic is dangerous. Since the author could find NO PROVEN BENEFIT to neck manipulation in the literature, the risk/benefit ratio was considered 0. Then you get Kaiser yanking neck manipulation as a knee-jerk reaction to bad scientific conclusions.The study below gets right to the heart of things. We could send this study to all the MD's in Oregon, but I am not sure that line of effort yields much.There is nothing more impressive to a physician than results. When a patient is sitting in front of them and they let their MD know that chiropractic has been the largest factor in the positive change of a condition, we have the greatest power to change that MD's mind. It is slow, but I think that we continue to do good research, and help the individual in front of us. These are our two greatest PR tools.Best, JayFrom: Sharron Fuchs <sharronf@...> Lindekugel <pdxchiroguy@...>Cc: Sent: Sat, February 12, 2011 12:56:59 PMSubject: Re: VBS registry This is good but it isn't getting out enough. What do you think of an Oregon registry?Sharron FuchsSent from my iPhoneOn Feb 12, 2011, at 11:17 AM, " Lindekugel" <pdxchiroguy@...> wrote:FROM: Spine 2008 (Feb 15); 33 (4 Suppl): S176–183 Cassidy JD, Boyle E, Côté P, He Y, Hogg- S, Silver FL, Bondy SJ Centre of Research Expertise for Improved Disability Outcomes, University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, ON, Canada. dcassidy@... STUDY DESIGN: Population-based, case-control and case-crossover study. OBJECTIVE: To investigate associations between chiropractic visits and vertebrobasilar artery (VBA) stroke and to contrast this with primary care physician (PCP) visits and VBA stroke. SUMMARY OF BACKGROUND DATA: Chiropractic care is popular for neck pain and headache, but may increase the risk for VBA dissection and stroke. Neck pain and headache are common symptoms of VBA dissection, which commonly precedes VBA stroke. METHODS: Cases included eligible incident VBA strokes admitted to Ontario hospitals from April 1, 1993 to March 31, 2002. Four controls were age and gender matched to each case. Case and control exposures to chiropractors and PCPs were determined from health billing records in the year before the stroke date. In the case-crossover analysis, cases acted as their own controls. RESULTS: There were 818 VBA strokes hospitalized in a population of more than 100 million person-years. In those aged <45 years, cases were about three times more likely to see a chiropractor or a PCP before their stroke than controls. Results were similar in the case control and case crossover analyses. There was no increased association between chiropractic visits and VBA stroke in those older than 45 years. Positive associations were found between PCP visits and VBA stroke in all age groups. Practitioner visits billed for headache and neck complaints were highly associated with subsequent VBA stroke. CONCLUSION: VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care.From: Sharron Fuchs <sharronf@...> Sent: Fri, February 11, 2011 4:06:48 PMSubject: VBS registry I have had several comments over the last few days from a person who was just in a serious car accident. This person is well aware that they need to see a DC yet they have been told by their local internist and from their co-workers that they should not see a Chiropractor because of the risk of VBS. Yes, I know you have all heard this a zillion times before but really, this is significant. I am wondering if any DC in Oregon , not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form an anonymous registry of all people who are suspected to have been harmed by cervical spine adjustments? Or perhaps, we could ask the OBCE to request that all alleged injuries be reported to them? The reason I ask this is for hard data that we can use to report the actual incidence of VBS here in Oregon . The process would also allow for open communication and teaching of Vascular Interventionists and others. I have brought this up before, numerous times actually, but we need to be on the offense not the defense of this issue. A uniformed informed consent would be helpful once we have Oregon data to use. s. fuchs dc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2011 Report Share Posted February 15, 2011 Thank you Dr. Simpson. Of course, I am going to agree with myself also...but I have to tell you that when I say these things I don't take them lightly. I talk to and meet with experts in many fields often. I have had numerous calls over the years - more than I think I should- regarding vessel injury diagnosed post manipulation. I know where these people go for care. I know there is rumor and concern about this from the medical profession. I am trying to give the power and control to us. To develop a registry and search for the cause of the injury and develop data, data, data gives us the power and control. s. fuchs dc > > Sharron, OR DCs, > > Interesting thread on VBI and cervical manipulation. I tend to agree with > Sharron that the best defense is a good offense. While I agree that VBI > caused by cervical CMT is indeed so rare that it needn't even be covered in > the usual informed consent discussion, none-the-less it is a hot topic > outside our profession. Just check out the court cases that implicate DCs > in strokes. (And ask a DC who's been sued what it's like... [?]) > > IMHO the responsible thing to do is take this problem seriously. A " disease > registry " makes a lot of sense. Maybe the OBCE in its " public protection " > role could take this on. It speaks directly and powerfully to (what should > be) our sense of the need to protect the public. VBI happens in all sorts > of minor neck trauma (visiting the hair dresser, installing a flourescent > tube, sex) and also, inarguably, with cervical manipulation. > > Even if the risk from cervical CMT is 1:1million, I think we have an > obligation to figure out as much as we can about it so we can prevent it, > recognize it when it is happening and know what to do about it if and when > it does...not to mention keeping a good malpractice policy in place. > > > A. Simpson, DC DABCO > Medical Director, Vice President > The CHP Group > 6600 SW 105th Ave, Suite 115 > Beaverton, OR 97008 > 503-619-2041 O > 503-367-0872 C > 503-644-0442 F > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2011 Report Share Posted February 16, 2011 Sharron and ,With all due respect to both of you, there are much better ways to protect the public than a registry.Let's assume that we went ahead with a registry and 5 years shows 20 vascular events that occurred after manipulation. What have we proven?I argue that it would be scientifically meaningless, and a PR nightmare. We would then need to find a large population, over a long period of time to do a study and see if VBI occurs on doctor visits without manipulation as often as it occurs on doctor visits with manipulation. We already have that study and it showed no causation. It showed VBI to occur at the same rate after PCP visits for neck pain as it does following a chiropractic visit for neck pain.BECAUSE VBI happens in all sorts of minor neck trauma shows that it happens all the time, not that minor neck trauma is the cause. If you are about to have a VBI, it is going to happen if you sneeze, look behind you, go see a chiropractor or see your PCP. The authors of the study I posted earlier have come to this conclusion. This is why the 10 year task force on neck pain stated that neck manipulation is very safe.I am all for continued research in the area of VBI as long as the design is of high quality and yields meaningful information. This is for the safety of our patients first and the longevity of the profession second. Remember, our patients are on to much more dangerous interventions if we do not help them.Best to you both, Lindekugel, DCConcordia Chiropractic Center5425 NE 33rd Ave.Portland Or. 97211From: sharron <sharronf@...> Sent: Tue, February 15, 2011 4:34:43 PMSubject: Re: VBS registry Thank you Dr. Simpson. Of course, I am going to agree with myself also...but I have to tell you that when I say these things I don't take them lightly. I talk to and meet with experts in many fields often. I have had numerous calls over the years - more than I think I should- regarding vessel injury diagnosed post manipulation. I know where these people go for care. I know there is rumor and concern about this from the medical profession. I am trying to give the power and control to us. To develop a registry and search for the cause of the injury and develop data, data, data gives us the power and control. s. fuchs dc > > Sharron, OR DCs, > > Interesting thread on VBI and cervical manipulation. I tend to agree with > Sharron that the best defense is a good offense. While I agree that VBI > caused by cervical CMT is indeed so rare that it needn't even be covered in > the usual informed consent discussion, none-the-less it is a hot topic > outside our profession. Just check out the court cases that implicate DCs > in strokes. (And ask a DC who's been sued what it's like... [?]) > > IMHO the responsible thing to do is take this problem seriously. A "disease > registry" makes a lot of sense. Maybe the OBCE in its "public protection" > role could take this on. It speaks directly and powerfully to (what should > be) our sense of the need to protect the public. VBI happens in all sorts > of minor neck trauma (visiting the hair dresser, installing a flourescent > tube, sex) and also, inarguably, with cervical manipulation. > > Even if the risk from cervical CMT is 1:1million, I think we have an > obligation to figure out as much as we can about it so we can prevent it, > recognize it when it is happening and know what to do about it if and when > it does...not to mention keeping a good malpractice policy in place. > > > A. Simpson, DC DABCO > Medical Director, Vice President > The CHP Group > 6600 SW 105th Ave, Suite 115 > Beaverton, OR 97008 > 503-619-2041 O > 503-367-0872 C > 503-644-0442 F > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2011 Report Share Posted February 16, 2011 I would most heartily agree with and his reasoning on the registry idea. The studies are out there for those who have an open mind. If we are trying to convince the folks who are out to get us or who do not have an open mind are job is hopeless. We will only end up shooting ourselves in the proverbial foot-if not the head.  We as a profession have better things to do with our energy to promote the safety and quality of our care-things such as the comparative study on the cost effectiveness of chiropractic care within the WC arena here in Oregon.. Schneider DCPDXOn Wed, Feb 16, 2011 at 9:13 AM, Lindekugel <pdxchiroguy@...> wrote:  Sharron and ,With all due respect to both of you, there are much better ways to protect the public than a registry. Let's assume that we went ahead with a registry and 5 years shows 20 vascular events that occurred after manipulation. What have we proven?I argue that it would be scientifically meaningless, and a PR nightmare. We would then need to find a large population, over a long period of time to do a study and see if VBI occurs on doctor visits without manipulation as often as it occurs on doctor visits with manipulation. We already have that study and it showed no causation. It showed VBI to occur at the same rate after PCP visits for neck pain as it does following a chiropractic visit for neck pain. BECAUSE VBI happens in all sorts of minor neck trauma shows that it happens all the time, not that minor neck trauma is the cause. If you are about to have a VBI, it is going to happen if you sneeze, look behind you, go see a chiropractor or see your PCP. The authors of the study I posted earlier have come to this conclusion. This is why the 10 year task force on neck pain stated that neck manipulation is very safe. I am all for continued research in the area of VBI as long as the design is of high quality and yields meaningful information. This is for the safety of our patients first and the longevity of the profession second. Remember, our patients are on to much more dangerous interventions if we do not help them. Best to you both, Lindekugel, DCConcordia Chiropractic Center5425 NE 33rd Ave.Portland Or. 97211 From: sharron <sharronf@...> Sent: Tue, February 15, 2011 4:34:43 PM Subject: Re: VBS registry  Thank you Dr. Simpson. Of course, I am going to agree with myself also...but I have to tell you that when I say these things I don't take them lightly. I talk to and meet with experts in many fields often. I have had numerous calls over the years - more than I think I should- regarding vessel injury diagnosed post manipulation. I know where these people go for care. I know there is rumor and concern about this from the medical profession. I am trying to give the power and control to us. To develop a registry and search for the cause of the injury and develop data, data, data gives us the power and control. s. fuchs dc > > Sharron, OR DCs, > > Interesting thread on VBI and cervical manipulation. I tend to agree with > Sharron that the best defense is a good offense. While I agree that VBI > caused by cervical CMT is indeed so rare that it needn't even be covered in > the usual informed consent discussion, none-the-less it is a hot topic > outside our profession. Just check out the court cases that implicate DCs > in strokes. (And ask a DC who's been sued what it's like... [?]) > > IMHO the responsible thing to do is take this problem seriously. A " disease > registry " makes a lot of sense. Maybe the OBCE in its " public protection " > role could take this on. It speaks directly and powerfully to (what should > be) our sense of the need to protect the public. VBI happens in all sorts > of minor neck trauma (visiting the hair dresser, installing a flourescent > tube, sex) and also, inarguably, with cervical manipulation. > > Even if the risk from cervical CMT is 1:1million, I think we have an > obligation to figure out as much as we can about it so we can prevent it, > recognize it when it is happening and know what to do about it if and when > it does...not to mention keeping a good malpractice policy in place. > > > A. Simpson, DC DABCO > Medical Director, Vice President > The CHP Group > 6600 SW 105th Ave, Suite 115 > Beaverton, OR 97008 > 503-619-2041 O > 503-367-0872 C > 503-644-0442 F > -- Schneider DC PDX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2011 Report Share Posted February 16, 2011 Excellent response ! Seitz, DC Tuality Physicians 730-D SE Oak St Hillsboro, OR 97123 (503)640-3724 From: pdxchiroguy@...Date: Wed, 16 Feb 2011 09:13:13 -0800Subject: Re: Re: VBS registry Sharron and ,With all due respect to both of you, there are much better ways to protect the public than a registry.Let's assume that we went ahead with a registry and 5 years shows 20 vascular events that occurred after manipulation. What have we proven?I argue that it would be scientifically meaningless, and a PR nightmare. We would then need to find a large population, over a long period of time to do a study and see if VBI occurs on doctor visits without manipulation as often as it occurs on doctor visits with manipulation. We already have that study and it showed no causation. It showed VBI to occur at the same rate after PCP visits for neck pain as it does following a chiropractic visit for neck pain.BECAUSE VBI happens in all sorts of minor neck trauma shows that it happens all the time, not that minor neck trauma is the cause. If you are about to have a VBI, it is going to happen if you sneeze, look behind you, go see a chiropractor or see your PCP. The authors of the study I posted earlier have come to this conclusion. This is why the 10 year task force on neck pain stated that neck manipulation is very safe.I am all for continued research in the area of VBI as long as the design is of high quality and yields meaningful information. This is for the safety of our patients first and the longevity of the profession second. Remember, our patients are on to much more dangerous interventions if we do not help them.Best to you both, Lindekugel, DCConcordia Chiropractic Center5425 NE 33rd Ave.Portland Or. 97211From: sharron <sharronf@...> Sent: Tue, February 15, 2011 4:34:43 PMSubject: Re: VBS registry Thank you Dr. Simpson. Of course, I am going to agree with myself also...but I have to tell you that when I say these things I don't take them lightly. I talk to and meet with experts in many fields often. I have had numerous calls over the years - more than I think I should- regarding vessel injury diagnosed post manipulation. I know where these people go for care. I know there is rumor and concern about this from the medical profession. I am trying to give the power and control to us. To develop a registry and search for the cause of the injury and develop data, data, data gives us the power and control. s. fuchs dc > > Sharron, OR DCs, > > Interesting thread on VBI and cervical manipulation. I tend to agree with > Sharron that the best defense is a good offense. While I agree that VBI > caused by cervical CMT is indeed so rare that it needn't even be covered in > the usual informed consent discussion, none-the-less it is a hot topic > outside our profession. Just check out the court cases that implicate DCs > in strokes. (And ask a DC who's been sued what it's like... [?]) > > IMHO the responsible thing to do is take this problem seriously. A "disease > registry" makes a lot of sense. Maybe the OBCE in its "public protection" > role could take this on. It speaks directly and powerfully to (what should > be) our sense of the need to protect the public. VBI happens in all sorts > of minor neck trauma (visiting the hair dresser, installing a flourescent > tube, sex) and also, inarguably, with cervical manipulation. > > Even if the risk from cervical CMT is 1:1million, I think we have an > obligation to figure out as much as we can about it so we can prevent it, > recognize it when it is happening and know what to do about it if and when > it does...not to mention keeping a good malpractice policy in place. > > > A. Simpson, DC DABCO > Medical Director, Vice President > The CHP Group > 6600 SW 105th Ave, Suite 115 > Beaverton, OR 97008 > 503-619-2041 O > 503-367-0872 C > 503-644-0442 F > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2011 Report Share Posted February 16, 2011 If Dr. M. Freeman still trolls this list serve I would like to hear his opinion of this study. Especially this : ‘ Chiropractic care is popular for neck pain and headache, but may increase the risk for VBA dissection and stroke.’ s. fuchs dc From: Lindekugel [mailto:pdxchiroguy@...] Sent: Saturday, February 12, 2011 11:17 AM Sharron Fuchs; Subject: Re: VBS registry FROM: Spine 2008 (Feb 15); 33 (4 Suppl): S176–183 Cassidy JD, Boyle E, Côté P, He Y, Hogg- S, Silver FL, Bondy SJ Centre of Research Expertise for Improved Disability Outcomes, University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, ON, Canada. dcassidy@... STUDY DESIGN: Population-based, case-control and case-crossover study. OBJECTIVE: To investigate associations between chiropractic visits and vertebrobasilar artery (VBA) stroke and to contrast this with primary care physician (PCP) visits and VBA stroke. SUMMARY OF BACKGROUND DATA: Chiropractic care is popular for neck pain and headache, but may increase the risk for VBA dissection and stroke. Neck pain and headache are common symptoms of VBA dissection, which commonly precedes VBA stroke. METHODS: Cases included eligible incident VBA strokes admitted to Ontario hospitals from April 1, 1993 to March 31, 2002. Four controls were age and gender matched to each case. Case and control exposures to chiropractors and PCPs were determined from health billing records in the year before the stroke date. In the case-crossover analysis, cases acted as their own controls. RESULTS: There were 818 VBA strokes hospitalized in a population of more than 100 million person-years. In those aged <45 years, cases were about three times more likely to see a chiropractor or a PCP before their stroke than controls. Results were similar in the case control and case crossover analyses. There was no increased association between chiropractic visits and VBA stroke in those older than 45 years. Positive associations were found between PCP visits and VBA stroke in all age groups. Practitioner visits billed for headache and neck complaints were highly associated with subsequent VBA stroke. CONCLUSION: VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care. From: Sharron Fuchs <sharronf@...> Sent: Fri, February 11, 2011 4:06:48 PM Subject: VBS registry I have had several comments over the last few days from a person who was just in a serious car accident. This person is well aware that they need to see a DC yet they have been told by their local internist and from their co-workers that they should not see a Chiropractor because of the risk of VBS. Yes, I know you have all heard this a zillion times before but really, this is significant. I am wondering if any DC in Oregon , not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form an anonymous registry of all people who are suspected to have been harmed by cervical spine adjustments? Or perhaps, we could ask the OBCE to request that all alleged injuries be reported to them? The reason I ask this is for hard data that we can use to report the actual incidence of VBS here in Oregon . The process would also allow for open communication and teaching of Vascular Interventionists and others. I have brought this up before, numerous times actually, but we need to be on the offense not the defense of this issue. A uniformed informed consent would be helpful once we have Oregon data to use. s. fuchs dc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2011 Report Share Posted February 16, 2011 If Dr. M. Freeman still trolls this list serve I would like to hear his opinion of this study. Especially this : ‘ Chiropractic care is popular for neck pain and headache, but may increase the risk for VBA dissection and stroke.’ s. fuchs dc From: Lindekugel [mailto:pdxchiroguy@...] Sent: Saturday, February 12, 2011 11:17 AM Sharron Fuchs; Subject: Re: VBS registry FROM: Spine 2008 (Feb 15); 33 (4 Suppl): S176–183 Cassidy JD, Boyle E, Côté P, He Y, Hogg- S, Silver FL, Bondy SJ Centre of Research Expertise for Improved Disability Outcomes, University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, ON, Canada. dcassidy@... STUDY DESIGN: Population-based, case-control and case-crossover study. OBJECTIVE: To investigate associations between chiropractic visits and vertebrobasilar artery (VBA) stroke and to contrast this with primary care physician (PCP) visits and VBA stroke. SUMMARY OF BACKGROUND DATA: Chiropractic care is popular for neck pain and headache, but may increase the risk for VBA dissection and stroke. Neck pain and headache are common symptoms of VBA dissection, which commonly precedes VBA stroke. METHODS: Cases included eligible incident VBA strokes admitted to Ontario hospitals from April 1, 1993 to March 31, 2002. Four controls were age and gender matched to each case. Case and control exposures to chiropractors and PCPs were determined from health billing records in the year before the stroke date. In the case-crossover analysis, cases acted as their own controls. RESULTS: There were 818 VBA strokes hospitalized in a population of more than 100 million person-years. In those aged <45 years, cases were about three times more likely to see a chiropractor or a PCP before their stroke than controls. Results were similar in the case control and case crossover analyses. There was no increased association between chiropractic visits and VBA stroke in those older than 45 years. Positive associations were found between PCP visits and VBA stroke in all age groups. Practitioner visits billed for headache and neck complaints were highly associated with subsequent VBA stroke. CONCLUSION: VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care. From: Sharron Fuchs <sharronf@...> Sent: Fri, February 11, 2011 4:06:48 PM Subject: VBS registry I have had several comments over the last few days from a person who was just in a serious car accident. This person is well aware that they need to see a DC yet they have been told by their local internist and from their co-workers that they should not see a Chiropractor because of the risk of VBS. Yes, I know you have all heard this a zillion times before but really, this is significant. I am wondering if any DC in Oregon , not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form an anonymous registry of all people who are suspected to have been harmed by cervical spine adjustments? Or perhaps, we could ask the OBCE to request that all alleged injuries be reported to them? The reason I ask this is for hard data that we can use to report the actual incidence of VBS here in Oregon . The process would also allow for open communication and teaching of Vascular Interventionists and others. I have brought this up before, numerous times actually, but we need to be on the offense not the defense of this issue. A uniformed informed consent would be helpful once we have Oregon data to use. s. fuchs dc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2011 Report Share Posted February 16, 2011 Notice this subtle difference in this objective statement for the same article:Summary of Background Data. Chiropractic care ispopular for neck pain and headache, but may increase therisk for VBA dissection and stroke. Neck pain and headache are common symptoms of VBA dissection, whichcommonly precedes VBA stroke.Hint, the word is may. Journal editors at work? Always a good idea to read the full study: http://www.ccachiro.org/ecms.ashx/Doc/EntireStrokeStudy.pdf(yes, I sent this link earlier) Note that the entire abstract is longer and less inflammatory. Seitz, DC Tuality Physicians 730-D SE Oak St Hillsboro, OR 97123 (503)640-3724 From: sharronf@...Date: Wed, 16 Feb 2011 16:39:26 -0800Subject: RE: VBS registry If Dr. M. Freeman still trolls this list serve I would like to hear his opinion of this study. Especially this : ‘ Chiropractic care is popular for neck pain and headache, but may increase the risk for VBA dissection and stroke.’ s. fuchs dc From: Lindekugel [mailto:pdxchiroguy@...] Sent: Saturday, February 12, 2011 11:17 AM Sharron Fuchs; Subject: Re: VBS registry FROM: Spine 2008 (Feb 15); 33 (4 Suppl): S176–183 Cassidy JD, Boyle E, Côté P, He Y, Hogg- S, Silver FL, Bondy SJ Centre of Research Expertise for Improved Disability Outcomes, University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, ON, Canada. dcassidy@... STUDY DESIGN: Population-based, case-control and case-crossover study. OBJECTIVE: To investigate associations between chiropractic visits and vertebrobasilar artery (VBA) stroke and to contrast this with primary care physician (PCP) visits and VBA stroke. SUMMARY OF BACKGROUND DATA: Chiropractic care is popular for neck pain and headache, but may increase the risk for VBA dissection and stroke. Neck pain and headache are common symptoms of VBA dissection, which commonly precedes VBA stroke. METHODS: Cases included eligible incident VBA strokes admitted to Ontario hospitals from April 1, 1993 to March 31, 2002. Four controls were age and gender matched to each case. Case and control exposures to chiropractors and PCPs were determined from health billing records in the year before the stroke date. In the case-crossover analysis, cases acted as their own controls. RESULTS: There were 818 VBA strokes hospitalized in a population of more than 100 million person-years. In those aged <45 years, cases were about three times more likely to see a chiropractor or a PCP before their stroke than controls. Results were similar in the case control and case crossover analyses. There was no increased association between chiropractic visits and VBA stroke in those older than 45 years. Positive associations were found between PCP visits and VBA stroke in all age groups. Practitioner visits billed for headache and neck complaints were highly associated with subsequent VBA stroke. CONCLUSION: VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care. From: Sharron Fuchs <sharronf@...> Sent: Fri, February 11, 2011 4:06:48 PM Subject: VBS registry I have had several comments over the last few days from a person who was just in a serious car accident. This person is well aware that they need to see a DC yet they have been told by their local internist and from their co-workers that they should not see a Chiropractor because of the risk of VBS. Yes, I know you have all heard this a zillion times before but really, this is significant. I am wondering if any DC in Oregon , not me, would be willing to contact the Vascular Interventionists in Oregon and seek to form an anonymous registry of all people who are suspected to have been harmed by cervical spine adjustments? Or perhaps, we could ask the OBCE to request that all alleged injuries be reported to them? The reason I ask this is for hard data that we can use to report the actual incidence of VBS here in Oregon . The process would also allow for open communication and teaching of Vascular Interventionists and others. I have brought this up before, numerous times actually, but we need to be on the offense not the defense of this issue. A uniformed informed consent would be helpful once we have Oregon data to use. s. fuchs dc Quote Link to comment Share on other sites More sharing options...
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