Cervical Injections for Headache in Honduras

[@mannys9130]

Awesome demo because it proves aspiration is critically important!!!!!!! I preach all the time about it...important!

[@lmellick]

Thank you.

[@helicart]

This HA presentation is typically facet joint OA inflammation, with secondary cervical muscle trigger point activity. They are more common in people with thoracic kyphotic deformity, such as this woman. These are resolved long term with 3-4 sessions of facet jt mobilization via a competent physiotherapist. They can come back with enough psychoemotional stress patterning, inadequate fluid intake, sedentary slouched posture, or as reactive arthritis following an infectious disease. Been doing these for 40+ years.

[@lmellick]

Thanks for your input.

[@Tommaso-i7z]

great!

[@JoelWelter]

Thanks for demonstrating the crucial requirement for aspirating before injecting. Complacency breeds bad outcomes. On another subject, how was the weather there during your visit and did you get a chance to just do any touring outside of the mission?

[@lmellick]

Hey Joel, the weather was find. Yes, a lot of work-related touring. We traveled to 3 different villages and provided medical care.

[@JoelWelter]

@@lmellick I like to call that "spreading the love". Good work!

[@ajabisong]

Beautiful!!!

[@lmellick]

Thank you!!

[@DRDS520]

Can you clarify the landmarks you’re using to determine location of the injections? I work in primary care w/ a high % of uninsured patients and have wanted to do occipital blocks for some time, but have been hesitant to attempt due to the location. This seems like it may be a bit more forgiving as far as location and precision is concerned. Thanks

[@lmellick]

I have a number of videos on my channel that may help clarify, but also look up my publications or send me an email address privately and I can send you articles.

[@DRDS520]

@@lmellick thanks- will look into your video library further, but would also love any literature on the procedure you could send my way. Appreciate it. Was trying to figure out how to send a msg privately on KZbin w/ my email and couldn’t find it- would prefer to not put it publicly in comments but let me know if there’s an alternative way to send it to you. Thanks again

[@lmellick]

@@DRDS520 My email address should be associated with my KZbin channel. Use that and email me.

[@digitalastana]

Its procedure need monitoring of BP and ECG?

[@lmellick]

Nope, nothing needs to be monitored.

[@lmellick]

No need to monitor BP or ECG.

[@jeanwillis7774]

Does this work for Status migraine attack? Please ♥️🇨🇦

[@lmellick]

Yes, it can. We found in a retrospective study that 65% had complete relief and 20% had significant improvement but needed some other intervention such ibuprofen before discharge. 75 to 85% response rate is what many clinicians who do it describe.

[@jessecosta9483]

Hey doctor! nurse here... I used to work at a pain management facility where we did trigger points, facet, and esi's... and I have been told I have cervicogenic headaches from severe spinal stenosis, and cord compression at c6-c7. Would this help with these kinds of headaches?

[@lmellick]

Yes, and I would add steroid to the bupivacaine solution.