Labor Day is the official end of summer and one last chance to hit the road and visit friends, go for a picnic or have fun at the beach. Just remember, you are not alone. Everyone else has the same thing on their minds, so here are a few safety tips for driving during the Labor Day weekend.
It’s 2016, do I have to say “Don’t Drink and Drive?” Yes.
There are still too many people who think drinking and driving is a good idea. A mere 2 beers on a hot day within an hour of driving can impair you, and result in a DUI. Always designate the driver before any drinking takes place.
It’s going to be crowded on the roads and freeways, so leave early.
If you rush around and not account for traffic, you are much more likely to have an accident, get a speeding ticket or just stress yourself and everyone else around you and ruin your day.
Enjoy the drive.
If you’re in California, it’s a beautiful weekend, so take the time to relax and enjoy the drive. Play games with the kids, listen to an audio book, sing… think of drive time as part of the holiday and make it fun!
Be patient and courteous.
Most people will be stressed out, in a hurry or intoxicated because they didn’t read this post :-/ Don’t sink to their unenlightened level. Be the calm and courteous one. Kindness is contagious. If you put your patience and courtesy out there, others will follow suit.
Remember the goal: Arrive Alive
It’s a holiday, have fun and make sure it’s not your last! By taking these tips to heart, you more likely to arrive alive and have fun.
Car Accident Doctor Orange County, California 92868
Car Accident Doctor Orange, CA 92868
Suffering from a car accident is bad enough, but it is only the beginning…
You now have to deal with:
How to fix your car
How to get a rental car to get to work
My neck hurts, what kind of doctor do I see?
Who is going to pay for all this?
Do I need a lawyer?
These are all reasonable questions to ask after a car accident in Orange County, California.
Instead of worrying about ALL these things, concentrate on a couple of the most important points that will let all the other things fall into place without as much stress.
Tips from an Orange County California Car Accident Doctor:
Day 1, Hour 1:
Call the responsible party’s auto insurance and open a claim. Give them only the details of the accident, what happened and emphasize it was the other party’s (their insured’s) fault. Make a note of the time, date and name of person who takes your info. Write down the claim number if they give you one. Tell them you are injured and seeking medical attention and also you need a rental car ASAP because you need to work, go to school, drive kids around, etc.
Call your insurance and report the accident, give them all the details about what happened and the responsible party.
Confirm with your auto insurance company that you have UNINSURED MOTORIST coverage in case the other party ends up not having insurance and conform if you have and the amount of MEDICAL PAYMENTS COVERAGE. The insurance adjuster may say it’s going to be handled by the other insurance and you don’t need to make a claim. This is incorrect and they are just trying to get out of doping their job, which is represent you and make your entire policy available to you to take care of your needs.
Even if you have a mild headache or just stiffness in the neck, tell them you want to open a bodily injury claim and you are going to or already have seen a doctor.
Ask if you have RENTAL CAR INSURANCE, you need to get to work, school, etc
Day 1, Hour 2:
Call a car accident doctor, a doctor who specializes in only car accident injuries. This is a field of specialty more specialized than general medicine or chiropractic, orthopedics or neurology. Make an appointment to be seen ASAP. It should be within 3 days of the accident to prevent any problems later.
Day 1, Hour 3:
Make arrangements for a car to borrow, share or download Uber app on phone to get to important appointments. If you rent a car on your own, you will get reimbursed but a very small amount so get the cheapest car you can and when the other person’s insurance offers make a switch to a rental car place of their choosing to avoid any out of pocket costs.
Day 2 or 3:
Go to the Car Accident Doctor appointment. Take your car insurance info and health insurance info, yes both. Auto insurance is almost alwasy secondary to health insurance. You will be given a thorough examination and asked to complete questionnaires about how you feel and how the accident has affected your daily activities. You may be given a referral for x-rays or other diagnostic work. Follow the doctors advice in treatment, home care, etc. and make sure they are accessible in case you have questions later.
Things are progressing. By now, you should have a car accident injury specialist picked and an appointment or have already been to them and are under care. You should also have made contact with the other insurance and possibly have a place to take your car for an estimate. You may have already procured a rental car at the place the estimate is being done at depending on how bad your car is. By now you will know what insurance you personally have to cover your bills. Whether you need to contact an attorney at this early stage or not depends on the severity of your injuries, damage done to the vehicle and cooperation (or lack of) by the responsible insurance company. Everything is falling into place.
The difficult part of being in a car accident is knowing what steps to take.
This article is a just a brief overview of the things you need to do in order to manage your auto accident case properly. For the average person there is a lot to do and know, things most people have no clue about. This is where having someone on your side to guide you through the process comes in handy. A specialist who knows all the ins and outs and who’s focus is on assisting you through the maze. Many people think that’s why you call a lawyer, but you;d be surprised that most personal injury lawyers don’t get all that involved in your case. They help you make a settlement at the end of the case, but they do not do much about gettign your car repaired, find specialists to provide medical services, answer questions, etc. They are too busy and run too many cases to do that.
You Need a Car Accident Concierge.
A concierge is the “go to person” in a hotel who has all the connections, can call you a cab, get you a hard to get table at a restaurant, give you the inside scoop of whats going on in the area. For car accident injuries there is someone who is basically like a concierge for accident victims. He knows all the rules, knows the good lawyers, has contacts with the good doctors in the area who work with accident victims and actually provides car accident treatment services that are second to none. So you get a great car accident doctor AND a personal injury concierge to help you figure out your car stuff, insurance questions, lawyers, imaging and specialist centers, etc. Your expert is accessible via email and often text and voice to help you when you’re out of the office. Many chiropractors treat car accident victims, but few if any provide the expertise and experience and provide these “special” services the way Orange County Car Accident Doctor Barry Marks DC does.
“Orange County Car Accident Concierge”
Dr Barry Marks is a chiropractor with over 30 years experience in personal injury. He has completed hundreds of hours in post-doctorate specialty training programs in orthopedics, brain injury, whiplash, crash reconstruction, forensic examinations, disability evaluations, impairment rating, MRI interpretation, and much more. You can compare Dr Marks’ experience and credentials to any other doctor, medical or chiropractic in Orange County and you won’t find anyone more qualified. All this in a comfortable and welcoming office environment with a kind and empathetic bedside manner.
Car Accident in Orange County California? Call Dr. Marks (714) 938-0575 Now
Dr Barry Marks, DC Car Accident Doctor Orange County, California 92868
1745 W Orangewood Ave #114
Orange, CA 92868
This article discusses BPPV or Benign Paroxysmal Positional Vertigo. This can be a mild dizziness on moving your head to a debilitating problem preventing most activities. Whether the symptoms are mild or severe, the good news is there are fairly simple treatments that can fix the problem.
It Starts in Your Ear…
In your inner ear there is an organ system that senses where you are in space and tells the brain. When you move your head a gelatin-like substance that has tiny crystals embedded on top moves hair cells that detect movement. If the system is working ok, normal head movements can be made without causing dizziness. A common problem can occur though, that causes a malfunction in the system. If your head is shaken very hard, some of the crystals may dislodge and find themselves where they don’t belong. If enough of them are loose they can clump together into a stone. This can cause changes in fluid flow so that when your head moves the fluid continues to flow abnormally and your brain detects motion even though you are no longer moving your head. Your brain becomes confused and you interpret this as dizziness or vertigo. Along with the vertigo you will often also have a rapid twitching or cycling of the eyes from side to side called nystagmus. This results in blurred or double vision.
What’s it Feel Like to Have BPPV?
Dizzy. Nauseous. If you are suffering from BPPV the main symptom is dizziness or feeling like the room is spinning whenever you move your head or change positions from down to up or side to side. You may have double vision, many people become nauseated and some actually vomit because the symptoms of BPPV are so severe. A common complaint is “I get dizzy when I turn in bed and can only lie on one side or I have to sleep with my head propped up.” Others will say, “I get dizzy and feel like I’m going to fall whenever I try to get up out of a chair.”
These symptoms are also associated with low blood pressure, iron deficiency anemia and certain medications, especially drugs acting on the heart. It’s important to distinguish between these other causes of dizziness because they can be very serious. If your doctor has already told you, you have vertigo and given you a prescription for anti-vert and not done the treatment suggested in this article, you may want to give this a try to see if your BPPV goes away and you will not need the drugs any longer.
What Causes BPPV?
This vertigo problem can seemingly come out of nowhere with no known precipitating event. Elderly patients are more likely to suffer BPPV with no identified cause. The older we get the easier it is for this to occur. In younger people it is very often the result of your head being shaken or jolted quickly such as after a slip and fall, a sports injury, car accident, having your head tilted back too long at the dentists or hair salon, bumpy mountain bike rides, body surfing, bouncing as in aerobics or Zumba, etc. The sudden movement of the head causes embedded crystals to break off and wander into the canals. If enough of them do this and they coalesce into a sizeable little rock (otolith) they can wreak havoc with the fluid movement in your ear and create dizziness.
How Do You Diagnose Benign Vertigo?
The description you give to the doctor is a strong indicator; sudden onset dizziness on turning your head with recent accident or bumpy activity, no changes in medications recently, etc
Once BPPV is suspected, it is definitively diagnosed with a simple maneuver called the Hallpike Test or Dix-Hallpike Test. This is a provocative test, meaning it is designed to specifically re-create your dizziness in order to determine if it is BPPV and which ear is involved. It can be both ears! Your dizziness and nausea will be aggravated by this test, but it is crucial to properly diagnosing your condition and the good news is, the test is halfway to the treatment and resolution of your vertigo because the treatment will immediately follow the test and only take a short time.
The Hallpike test involves turning your head 45 degrees and lying on your back with your head still in 45 degrees rotation while your head is dangled over the edge of the table or bed. Your head is held in this position for up to 30 seconds to see if your vertigo worsens and most importantly, your doctor is looking for “nystagmus” or a rhythmic jumping of the eyes. If this occurs it indicates that is the problem side. The test is repeated to the opposite side just in case you have it on both sides.
What is the Treatment for BPPV?
Once the side is figured out, your doctor will then perform what is called “Epley’s Maneuver” or “canalith or otolith repositioning maneuver.” This procedure is similar to the Hallpike test in that you are quickly brought back with your head lying over the edge of the exam table with your head turned to the bad side. You are held in this position for up to 2 minutes or when dizziness and nystagmus stops. Your head is then turned to 45 degree angle the opposite angle with head hanging and held another 2 minutes. You may feel dizziness moving. You are then directed to roll onto the side you are turned to with your head facing down towards the table and hold for 2 minutes. Lastly, you are brought upwards to a sitting position holding your head turned. You then straighten out your head and look forward and sit for about 10 minutes. It is important not to tilt your head up or down while waiting for the 10 minutes. Afterward, if your symptoms recur, your doctor will repeat the procedure on subsequent visits until no symptoms return.
Tips for After the Treatment
Avoid tilting head back or forward for the rest of the day.
Avoid sudden head movements for a day or two
Avoid activities that cause a lot of bumping or vibration for a day or two
Avoid sleeping on the affected side for about a week
If the symptoms return, go back to your doctor right away and have the procedure done again. In some cases you may need to have this done 3-5 times. The majority however clear up after only 1 session.
Benign Paroxysmal Positional Vertigo can be a very scary and disabling condition. Luckily it is fairly easy to diagnose and treat without drugs or surgery. If you’ve suffered from vertigo you might want to consider getting checked for BPPV.
How Long Should Chiropractic Treatment Be for Whiplash Injuries?
Chiropractic Treatment Duration for Whiplash Injuries
After a car accident, one of the most common questions that arise is how long treatment should go on. As a patient you may be concerned because treatment takes up a lot of your time. Your attorney will want to know because it affects the outcome of your case. Insurance companies want to know and often cite too much treatment was an argument to minimize your case.
Professional Practice Guidelines
You first need to understand that a doctor specializing in car accident treatment does not just treat you “willy-nilly.” Whiplash specialist doctors use “guidelines” to tell them an expected range of treatments that are appropriate based on your individual injury. Professional practice guidelines are a set of parameters derived through studying the medical and scientific literature. Guidelines are then submitted to other researchers, institutes or licensing boards for comments and approval. If the guidelines are considered useful and well documented, they may be officially adopted by the profession.
When it comes to chiropractic treatment of whiplash and other injuries from car accidents, there are a few guides to consider. The most well received, best documented and universally accepted guidelines are the “Croft Guidelines.”
In 1993, Arthur Croft, D.C., M.S., M.P.H., F.A.C.O., F.A.C.F.E., published a set of management guidelines in the ACA Journal. These guidelines have also been published in Whiplash Injuries: the Cervical Acceleration/Deceleration Syndrome, second edition, in 1995 and in a recent Canadian practitioner’s guide to whiplash injuries, sanctioned by the Canadian Chiropractic Association.
The Croft Guidelines have been a part of our literature now for over 2 decades. No competing guidelines relative to whiplash treatment have been published during that time. Several American state chiropractic organizations and associations, as well as in at least one Canadian province, have adopted the Croft Guidelines.
The vast majority of true car accident injury experts rely on the Croft Guidelines to determine the severity of their patient’s injuries and an estimate on how long treatment may take.
Using the Croft Guides for Duration of Treatment
The first step is to determine the “severity” or “how bad” an injury is. In a previous post, I outlined how the Croft Guides gives specific factors to use to determine severity of injury. See “How Bad is My Car Accident Injury?” for details.
Once your doctor has established the severity as either a Grade I, II, II, IV or V, the doctor consults the guidelines to see the predicted range of treatment numbers and duration. For example looking at the table below, a Grade II injury may require daily treatment (7 times in 1 week) for 1 week, then may require treatment at 3 times each week for 4 weeks or less, then 2 times each week for 4 weeks or less, then 1 treatment per week for 4 weeks or less and finally 1 time per month for 4 months or less. The total duration (TD) of treatment may be upwards of 29 weeks and the total number (TN) of visits may be up to 33 visits.
You will note that I have said “may” and “up to” many times; that is because these are practice guidelines and not rigid rules. Patients may need slightly more or less treatments depending on their individual injuries. The point is, there are professionally recognized practice guidelines that have been published by medical researchers and experts that assist the doctor, the patient, attorneys and insurance adjusters in understanding the anticipated duration of treatment.
When an automobile insurance adjuster claims that chiropractic treatment has gone on too long, the question is, “based on what?” What guidelines have they used to substantiate their assertion? Most insurers will not cite any guides. Others may try to cite disability guides or other references, but these guides are for work injuries or general non-traumatic neck or back complaints. They are not generally accepted guides specifically for chiropractic treatment of a whiplash injury. Car accident injuries have been shown in the literature to be unlike any other type of injury or cause of neck and back pain.
As the victim of a car crash injury, understanding these guides will help set you at ease knowing that your treatment is being provided in the most scientific and professional manner possible.
You might be surprised how the “severity” of or “how bad” your injury is determined. Most people believe it has to do with:
How much vehicle damage there is
How fast the vehicles were traveling
How much pain you are in
Whether or not you take an ambulance ride to a hospital
Whether or not you miss any work
Many other incorrect reasons
How to Determine Car Accident Injury Severity:
Rather than subjective information like the above or from a doctor merely giving an educated guess, true car accident injury specialists such as myself use “professional practice guidelines” or “guides.” Guides are a set of rules for doctors that have been established through scientific research to tell them how to practice. Guides tell a doctor objectively, what the items are that lead to a specific diagnosis. Guides can also give doctors direction on what types of treatment are most beneficial for certain conditions.
To determine the severity of specifically a car accident injury, the most well known and scientifically proven set of guidelines are the “Croft Guidelines.”
The guidelines were published by Arthur Croft, D.C., M.S., M.P.H., F.A.C.O., F.A.C.F.E an internationally known doctor and researcher in the spinal trauma field in 1993. These guides were published in his book, “Whiplash Injuries: The Cervical Acceleration/Deceleration Syndrome,” second edition and have been adopted by many state boards of Chiropractic in the US and Canada. There are other guides used in the profession, but most of them borrow heavily form Croft, therefore the original source is best to use.
Within the Croft Guidelines injury severities are determined by objective findings at the time of the initial examination. It is crucial your treating doctor understand how to do a proper and thorough examination of a car accident whiplash injury since failure to recognize some features of an injury could result in the improper severity, which you will see later, leads to incorrect frequency and duration of treatment and overall prognosis. This is just one among many reasons why auto accident victims need to be evaluated by a true car accident injury specialist and not just any doctor.
Looking at the Croft Guidelines we can see there are five injury grades (severities): Grade I through V. The examination findings are clearly stated on what constitutes a given grade or severity. The most common Grades are II and III. Many Grade I’s do not feel enough pain to see a doctor. This is why using guidelines rather than subjective pain is a better method. Grade V’s are rarely seen in private practices in the initial onset, because they are usually triaged at a hospital and undergo surgery. Chiropractors and other therapists may work with them post-surgically. Grade IV’s are not uncommon in a chiropractor’s or other private practitioner’s office, but not as commonly as II and III. It is imperative the treating doctor can recognize a Grade IV and team treat with orthopedists and/or neurosurgeons since these patients usually suffer from disc herniations, nerve injury or ligament instability that may require surgery.
Common Mistakes in Applying the Croft Guides for Injury Severity
Because most doctors treating car accident injuries are not actual specialists in the field, they do not know how to tell which grade to apply because they do not know how to document things like ligament injury and/or ligament instability so they may not be able to decide between a Grade II and Grade III. When your doctor takes a look at your x-rays (ALL accident cases require x-rays of the spine, period) and you see your neck curve is decreased, flat or reversed, that is a sign of ligament injury. The ligaments running up and down the inside of your spine keeps the proper tension that makes your neck curve properly. This is just one example of how a specialist can do a proper exam and apply the findings to the guides for a well documented severity of injury.
Injury Severity Grading is Important in Car Accident Whiplash Cases
Everything in a personal injury whiplash case flows from the severity grading. Once your doctor knows the severity, he or she will know what treatment types are best, what imaging studies to refer you for, what other specialists need to be consulted, etc. The Croft Guides also tells the doctor what frequency and duration of treatment is typical. Your long-term outlook for recovery (prognosis) is also determined by the grade of your injury.
Remember, these are guides and some patient’s heal faster or slower than others and there are complicating factors that can extend care, but in general, the guides give you, your doctor, your lawyer and the insurance company some notice of what to expect treatment wise.
Of course that is only IF your doctor is aware of these guidelines and knows how to use them. My guess is about 25-30% of chiropractors are aware of the Croft Guides and about 10% actually use them regularly. I would estimate that less than 10% of any medical specialists know of or use these guides. And sadly, maybe 20% of lawyers know of them and less than 10% of the doctors they work with use them. The numbers of doctors who are actually true whiplash specialists are very few. Many doctors treat car collision injuries, but very, very few have actual post-graduate specialty training in this field.
Objective Evidence of Injuries to Prove Your Case and Improve Your Treatment
Rather than just guessing or putting all patients through the same old cookie cutter process, specialists in car accident injuries use professional guidelines to make key decisions about your injuries and treatment. Injury severity is an important first step in the process of documenting your injury that leads to decisions on what type of treatments are needed and the frequency and duration of care.