Friday, September 23, 2022

Restoring Quality of Life with Ultrasound Studies and NeuroProsthetics


ANALYZING PAIN: GETTING TO THE BOTTOM OF THE 
"CRIME SCENE"  - 
From an interview with Dr. Robert L. Bard

Russ saw me with a severe scoliotic curve to the spine including lordotic upper spine changes and an abnormal MRI scan report. However, in spite of the markedly abnormal mid and upper disc disease, his pin point pain was in the right hip posterior region which he delineated with his forefinger. Ultrasound imaging is a dynamic and patient inclusive examination. After I did my preliminary scan Russ took the probe and placed the probe over the painful area. The normal gluteus muscle is light gray but the right buttock muscular tissue was dark gray where he held the transducer. As he rotated the hip the bone appeared intact in real time motion without evidence spur or arthritis but the sacroiliac joint at that level was irregular. 

Ultrasound uses Doppler blood flow sonography that measures vascular activity that is elevated in inflammatory states. The image showed four times the normal vessels supplying a non inflamed joint and the 3D/4D quantitative image of the hemodynamic activity confirmed moderate neovascularity in the region. This type of inflammation is also called “inflammatory spondylitis” originally described in the radiology journals and rheumatology literature in 2010. This is a critical distinction categorized under the heading of “arteritis” which is a diffuse disorder also affecting the blood vessels including the brain arteries and eye vasculature resembling Rheumatoid Arthritis in progressive clinical course. The 2021 International Inflammatory Skin Conference at the New York Academy of Medicine made the connection of inflammatory disease to heart disease and stroke and also to increased cancer risk. For example, the common skin disease psoriasis of the nail often develops into painful joint swelling and tendinitis. Rosacea of the nose is associated with inflammation of the eye. Gout with a painful toe may foreshadow the beginning of kidney disease or due to the body’s reaction to a high blood pressure medicine. 

In Russ’s case, since spondylitis is associated with iritis (inflammatory involvement of the iris), we were able to check his cornea, lens, iris and retina. Russ’s story opens up a global look at medicine because an ophthalmologist will not likely consider back pain as a related issue to eye pathology. A dermatologist may miss the connection of the typicial “butterfly” rash of the collagen disease “lupus” to an increased likelihood of stroke or cancer. A pulmonologist could study the acute shortness of breath in a patient just landing from a long flight whereas the cardiologist will check for pulmonary emboli in a heartbeat.

Ultrasound is non invasive, portable in some cases, real time and shows functional changes as far as abnormal structure (bone fracture vs sprain) and altered hemodynamic such as cancer vessels supplying an aggressive melanoma or breast cancer.  Dynamic sonography of the joints is available without an MRI scanner and microcalcium (gout crystals) are visible in seconds that are invisible to most xrays and MRI scans (calcium stones appear black on MRI while showing bright white on sonograms. Point of care ultrasound (POCUS) is now used by the military to bring the diagnostics to the injured patient and at home use of this technology monitors COVID-19 patients avoiding hospitalization. 

Russ Allen (R) "reclaiming the best of life"
with family in active travels and sports

The compact size of new devices means that sterilization is fast and battery power assist allows greater portability as has been used in recent building collapses in Florida. Many statewide emergency services have adopted wireless transmission of ultrasound studies to the Trauma Center before the victim enters the hospital. In many cases, such as high school sports, an ankle sprain may be distinguished from a fracture by an experienced coach guided by a remote overreader to verify that the bone is intact and that the pain is due to a bruise type soft tissue injury. We often let the pediatric patients place the examining sonogram probe where they hurt most and copious amounts of ultrasound gel affords virtual non pressure contact on an injured eye that is swollen shut to check for retinal detachment.



A RETROSPECTIVE ON SMART-SENSE RESEARCH
By: Russ Allen (transcript from private interviews)

Thanks to the power of the almighty Google and rusted referrals, I was directed to Dr. Robert Bard  in NYC thanks to his countless articles, video seminars and blogs.   I was looking for a specialist who is passionate for doing what is least invasive and optimal for the patient. With Dr. Bard, I found a man who devoted his life to expanding his understanding of the latest invasive in medical technologies, always looking for at least invasive modality and is continually sharping as saw as a medical expert.  

The imaging that I've used to diagnose my conditions included ultrasound, MRI, and an x-ray, all of which give different insight into what's going on in my body. The benefits of the ultrasound are I'm able to see inflammation within the nerves and muscles of my body.  These would not be apparent in the MRI or an x-ray in the same way. The x-ray was able to dramatically show the curvature of my body. And the MRI is able to see the degradation of the ver vertebra in my back. The ultrasound is used on the most sensitive tissues in the most sensitive areas (including little babies inside their mothers).

I've gone over my ultrasounds with Dr. Bard-- specifically looking for solutions and medical treatment options. I found the whole field of ultrasound continues to evolve. We're at a stage now that there are things you can do with ultrasound that historically was not possible, and that will eclipse some more invasive methods to diagnose different conditions.  What I love about that unit is any nurse practitioner trained to use. I can take it to the emergency room, a community clinic, a senior center... and get a tremendous amount of usable clinical data right there in the moment that can change that person's life.


FROM THE MEDTECH SIDE
Leadership in the medical community is comprised of an array of difference makers.  Many have committed to the noble profession of providing direct patient care while others dedicate their lives to research and exploration.  And then there is that special breed of visionary whose best work is in pioneering new ground as technical innovators - reinventing the very future of protocols and  clinical strategies.  It is this type of healer that holds the unique ability to see beyond the current trends with the creative courage to risk, explore and pave new ventures.

Recent decades have abundantly shown the synergy between technology and medicine, together blazing new trails of problem solving for the human need to heal, recover and restore quality of life- all in the name of life extension. "In the case of Russ Allen, quality of life with chronic pain is greatly affected and it limits the ability to perform normal activities of daily living.  

With his new treatment protocol, he is able to improve his wellness, improve his health, and start living his optimal life. And being able to do that with wearable neuro stim allows him to improve in his exercise routine. It also motivated him to improve his nutrition. Wellness technologies like the AxioBionics BioBelt (tm) also allows him to sleep, which we have seen through numerous studies, is essential to recovery. If you're not sleeping, you're not going to recover or reduce pain from your injury", states Josh Schueller, PT. 





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