Michigan Head & Spine Institute, Author at Michigan Head & Spine Institute Blog - Page 6 of 8

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

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

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

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

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


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

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

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

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

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

Oh my aching neck…

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

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

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

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

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

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


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

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

Some Possible Causes:

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

Symptoms of Trigeminal Neuralgia

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

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

Treatment for Trigeminal Neuralgia

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

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

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


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The two main blood vessels in the neck that supply blood to the brain are called the carotid arteries. When these arteries narrow, blood flow to the brain is reduced. This is called carotid artery stenosis. The gradual buildup of fatty substances and cholesterol deposits is called plaque.  Plaque occurs as we age, engage in unhealthy lifestyles and don’t manage risk factors, like high cholesterol.

Often, there are often no symptoms until a stroke occurs. So it is important to seek regular physical exams. If your doctor hears an abnormal sound in these arteries a carotid duplex or Doppler ultrasound may be required to examine the blood flow and look for plaque or blood clots.

Medication may be prescribed if less than 50% of the artery is blocked. If more than a 70% blockage is present a carotid endarterectomy or a carotid angioplasty / stenting procedure can improve blood flow to the brain.  Both procedures are usually conducted by a neurosurgeon. In the carotid endarterectomy, an incision is made in the neck and the plaque and diseased portions of the artery are removed to increase blood flow to the brain.

If you find yourself in an emergency situation, like having a stroke that requires a carotid endarterectomy or angioplasty, or your doctor says you need one of these procedures ask for an MHSI neurosurgeon. To schedule an appointment, call 248-784-3667 or online at MHSI.us


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Dr. Holly Gilmer joined her past patients and their families and answered questions about Chiari during the Conquer Chiari Walk Across American on September 17, 2016 at Stoney Creek Metropark. The Conquer Chiari Walk Across America is a series of local awareness and fundraising walks held the same day. The walk is about three miles.

Dr. Gilmer and patients
Dr. Gilmer and patients

Dr. Gilmer was thrilled to be the guest speaker for the Michigan Chiari-Conquer Chiari Walk, and has been for the last few years. Money raised goes to fund Chiari research, education and awareness programs. For more information about future walks and events, check out the Conquer Chiari Walk Across America website

To learn what Chiari Malformation is and how it’s treated, click here.


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Congratulations to MHSI’s doctors named ‘Top Docs’ in the October 2016 issue of HOUR Detroit.  Each year the publishers of HOUR Detroit provide area doctors an opportunity to select the doctors they consider to be ‘Top Docs’. The doctors receiving the greatest number of nominations from their peers are then listed in the magazine as being the best among their colleagues.

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For Neurological surgery, Doctors Fernando Diaz, and Richard Fessler were named, and for Pediatric-Neurosurgery is Holly Gilmer, M.D.

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


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Dr. Veyna
Dr. Veyna

Everyday, the neurosurgeons at Michigan Head & Spine Institute see patients who arrive with head injuries at area hospital Emergency Departments. For Dr. Richard Veyna, it may have all been in a day’s work, but for 13-year-old Drew Pelkowski and his parents it was a life-changing event when Drew was involved in a golf cart accident.

See the entire story on WXYZ-TV as told by Drew’s parents at Beaumont Hospital in Royal Oak.

A GO FUND ME account has been set up to help the Pelkowski’s with medical expenses.


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Updated January 2017:  Please note, that all procedures and visits are at the Meadowbrook Medical Center.

We are pleased to announce that beginning August 1, Michigan Head & Spine Institute is relocating its Novi physician offices only.

If you see your doctor in Novi for a regular office visit, starting on Monday, Aug. 1, you will now be seen at the Meadowbrook Medical Center instead of the Keystone Medical Center. However, if you are scheduled for a procedure in Novi, you should come to the Keystone Medical Center.

Meadowbrook Medical Center – Novi (Regular Office Visit ONLY)
25500 Meadowbrook Road (at W. 11 Mile Rd.)
Suite 250
Novi, MI 48375

Keystone Medical Center – Novi (Procedures ONLY)
46325 W. 12 Mile Road
Suite 150 ~ Please note the NEW suite number
Novi, MI 48377

To make an appointment at the new Meadowbrook office, please call 248-784-3667, these numbers have not changed. You can also request an appointment on our website.


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It’s a pleasure to announce the addition of two highly respected physicians to MHSI’s medical staff. A big welcome to: Fredrick S. Junn, M.D., and Tejpaul S. Pannu, M.D. Their current office will become MHSI’s newest location at: 18181 Oakwood Boulevard, Suite 403, Dearborn, MI 48124. 

Current patients of Dr. Junn and Dr. Pannu will continue to be seen in the same Dearborn office. To schedule an appointment, patients should make note of the new phone number, 313-438-5560.

Fredrick S. Junn, M.D., is a board certified neurosurgeon specializing in movement disorders, general neurosurgery, complex spine disorders, and peripheral nerve injuries.

Tejpaul S. Pannu, M.D., is also a board certified neurosurgeon specializing in complex spinal surgery, brain tumors, Trigeminal Neuralgia, and aneurysm surgery. 

To schedule an appointment with Dr. Junn or Dr. Pannu, please call 313-438-5560.  Or, visit www.MHSI.us to request an appointment online.

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The statistics from the Centers for Disease Control (CDC) are staggering. In the United States, 78 people die every day from an opioid overdose and 1.9 million people have a substance abuse disorder involving prescribed pain relievers, like oxycodone, hydrocodone, and methadone. In fact, since 1999, the number of deaths related to overdose of a prescribed opioid quadrupled.

What was once prescribed strictly for pain related to surgery, an injury, or the physical suffering that accompanies cancer has now become more commonly used for chronic aches and pain.

A doctor's responsibility

A study by the Johns Hopkins Center for Drug Safety and Effectiveness found that half of all pain visits in 2000 were treated with a medication and roughly 11 percent of those prescriptions were for an opioid pain reliever. In 2010, while half were still being treated with medication, the number using opioids rose to 20 percent.

CNN recently produced a special on the topic of opioid abuse, calling it an epidemic and issued a call to action among doctors. They cite the CDC’s recommendation against doctors prescribing opioids for most chronic pain situations, or at least the lowest effective dosage, with the shortest amount of time which is usually a few days.

At the root of the problem are the drugs themselves. Opioids are highly addictive and the body has a tendency to become tolerant, leading the patient to need more and more of the drug in order to manage pain. The patient feels physically dependent and, even if they attempt to cut back on usage, the symptoms of withdrawal can be felt. According to CNN’s Sanjay Gupta, M.D., “80% of new heroin users start by using pain pills, which contain the same type of base ingredients.”

Patients seeing a physician for help managing pain often think that certain kinds of medications are the solution, but for all the reasons stated above, many providers are rightly discouraging the use of opioids for managing things like back pain, arthritis, and other chronic conditions.

What other options are available? Nerve blocks, specialty devices, like TENS units, non-narcotic medications, exercise, dietary changes, behavioral therapy. All should be explored to find relief from chronic pain. In some instances, the use of opioid pain relievers may be warranted but should be managed safely. Patients in search of safe and effective relief have options and, with the assistance of a conscientious physician, will find a non-addictive solution.

Share this article with those who may be using pain medications.