May Case Study: Female in Pain With No Direct Cause

Welcome to the May 2011 Case Study from the Institute for Nerve Medicine.

In this issue we explore the case of a female suffering from burning and pain that seemed to have no direct cause.

History: This patient presented with a history of left vaginal burning and right lower back/buttock pain for 3-4 years. The patient reports a sudden onset of constant left vaginal burning. There was no injury, accident, trauma prior to the onset of the injury. During a pregnancy she also developed right lower back/buttock pain. She has trialed physical therapy, dry needling, acupuncture with no relief. She has had at least four different Ob/Gyn evaluations with no significant finding. She has also been trialed on Neurontin, Lyrica, Amtriptyline, Zoloft and Elmiron. She notes that over time her symptoms have worsened in severity level. She denies any loss of sensation or strength. The patient denies any changes in bowel or bladder function. She has some relief lying down and taking baths. Her symptoms are aggravated by walking and sitting.

Insurance Talk

The Institute for Nerve Medicine receives many inquiries about our acceptance of insurance.

We work with every patient to help them get the care they need. To that end, we accept insurance for all authorized and pre-certified surgical procedures.

For patients who have financial concerns about undergoing specialty medical services that are out of network, this is important to understand. It allows them to proceed with with their needed surgical procedure(s) as long as they have met their deductible and are willing to work with their insurance company to limit their own out-of-pocket expenses.

This applies to surgery only. If you have any questions, please do not hesitate to contact us at 310-314-6410, or click here to send us an inquiry.

April 2011 Case Study: Neck and Arm Pain

Welcome to the April 2011 Case Study from the Institute for Nerve Medicine.

In this case, we meet a female patient who suffered numerous injuries in a car accident years ago, resulting in painful nerve conditions that persisted until she came to the Institute for Nerve Medicine for treatment.

Case History: This is a female that presented with left occipital pain for the past seven years in addition to left and right forearm pain for the past four weeks.

The patient was involved in a motor vehicle accident in 1996 that resulted in severe whiplash laterally. She notes that following the injury she developed left neck pain with radiating upper extremity pain; however, she was diagnosed with stress and referred for stress reduction.

London Clinic: April 24-26, 2011

The Institute for Nerve Medicine is pleased to confirm the dates for our upcoming London Clinic.

Dr. Aaron G. Filler, MD PhD FRCS, will be seeing patients at the Institute's Harley Street office between April 24-26, 2011.

March 2011 Case Study: 46-year-old male with lower-back and pelvic pain

Welcome to the Institute for Nerve Medicine's March 2011 Case Study. In this example, we learn about a mid-40s male whose lower-back pain turned into more serious pelvic symptoms.

History: This is a 46-year-old male that presented with pain in the left lower back and pelvis. The patient has a long history of focal left lower back discomfort since he was a teenager that did not affect his ability to participate in physical activities.

Approximately five to six years ago he developed rectal prolapse however as it resolved he began to note an onset of pelvic symptoms. He notes that he was experiencing significant pain focal to the left testicle, which made it difficult to properly assess the other involved areas of pain; however, in 2010 following first a varicocele, then an epididymis removal and eventually a left orchiectomy he experienced significant resolution of the testicular pain. However, he had some mild recurrence.

Exclusive: FaceTime with Dr. Filler and his staff

Thinking about surgery but not sure if you will get the support or feedback you need in your post-operative care?

The Institute for Nerve Medicine is proud to announce our FaceTime program for surgical patients. Each INM post-operative patient will receive a new-generation Apple iPod Touch with FaceTime, the innovative video chat software that only requires a wireless (WiFi) internet connection.

January 2011 Case Study: Landmark Tinnitus Treatment by INM

For millions of people, the constant and persistent humming that they hear ringing in their ears is a source of frustration and pain that causes them to become sleep deprived, cranky, and generally miserable.

While hearing loss has its own measurable side effects especially as a person grows older, the word “Tinnitus” which sometimes accompanies the aging process reverberates with the anxiety and tension caused by it symptoms. Because the symptoms of Tinnitus are often subjective, for example the loudness of the ringing is from the patient perspective since there is no external sound to qualify the depth of ringing which means treatment for this condition is often less than precise.

While the cause is unknown many believe that Tinnitus is caused by a variety of issues such as withdrawal from some pain medications, ear infections, nose allergies and more recently popular in-ear headphones such as used with MP3 music players.

January Internet Talk

The internet is a wonderful advance in technology that provides a plethora of information and learning that can be very beneficial to many patients.

We would also like to highlight the inherent dangers of the internet and the lack of factual integrity that can sometimes be accompanied with this resource.

For example, the majority of comments made online about physicians are about the patient’s lack of insurance benefits. Because the patient has chosen a plan that restricts specialty care and out of network benefits the reimbursements are sometimes low. Rather than filing online complaints against the insurance plan or taking up these issues with their human resources advocates, patients tend to blame the doctors for their lack of insurance coverage.

Dr. Filler Book Signing Feb. 16 in Santa Monica

Every month, we receive numerous inquiries from local doctors and medical practices who would like to meet with Dr. Aaron Filler and learn more about our services and possibly refer patients.

This February, there is the unique opportunity to come to our offices and meet with clinical staff, including Dr. Filler.

Come join us for a book signing of “Do You Really Need Back Surgery,” the bestselling book written by Dr. Filler. The book signing will be part of a Santa Monica Chamber of Commerce event, to be sponsored by The Green Room Santa Monica, this coming February 16, 2011, from 530PM-730PM.

The Chamber event and book signing is a great way for local hospital administrators, physicians and the general public to meet Dr. Filler in person.

To RSVP, click here or call The Green Room Santa Monica at 310-452-5314. Space is limited, so don't delay.

December 2010 Case Study: 46-year-old female with Piriformis Syndrome

Welcome to the December 2010 case study from the Institute for Nerve Medicine.

This example involves a 46-year-old female presenting with left buttock pain with numbness radiating down the lower extremity into the foot for the past three and a half years. The initial onset was following a combination twisting-and-pulling motion with heavy luggage. Since the onset she has had numerous treatments, including acupuncture, rhizotomies, physical therapy, epidurals and piriformis injections with no relief.

How much will this cost?

Each week we get several hundred inquiries asking us how much our services cost.

If we have not already seen you as a patient, then it is very difficult to tell you exactly what your care will cost. In fact, most providers will not be able to tell you because there is no way of knowing what the confirmed diagnosis or resulting service action may be.

November 2010 Case Study: Male Pudendal Nerve Syndrome

Welcome to the Institute for Nerve Medicine's November 2010 Case Study.

In this example, we meet a 30-year-old, right-handed male with reports of bilateral testicular pain with pressure, achiness, tightness and burning also with intermittent shooting pain down the right lower extremity.

Audio transcripts of your INM consultation now available

Many patients come into the doctor’s office with so many questions and concerns but when they are face to face with the provider they sometimes forget main issues during the course of discussion.

We advise patients to research the medical standard of care and to read medical peer review papers and objective outcome data when seeking treatment. It is also a good idea to try and focus the discussion by writing down the top five or six questions that are of concern and leaving space below each one so that when you ask the question you are able to write down the physician response. This way when you are away from the office or speaking to loved ones at home, you can exactly recall what the answer is to your concern and eliminate any confusion.

Welcome to the New Nervemed Waiting Room

It's a common problem for many medical appointments…the long wait in the waiting room.

Unfortunately, clinical care — especially with neurosurgical consultation — sometimes incurs delays due to image reviews or reports from other physicians. And in many instances, the patient case is very complicated and protracted. Good consultations simply take time.

Coverage Recession?

There has been a new development in the wake of the new health care reform legislation. In essence, the reform states that all medically necessary services must be authorized for coverage.

As a result, many insurance carriers are now classifying specialty medical services as not medically necessary, accomplishing the reclassification by using paid physician consultants and external reviewers who are not in the same specialty of medicine and consequently do not have a clinical knowledge and expertise to sufficiently make the determination.