074- Back Surgery, Chiropractic, and Coach Steve Kerr

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Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmead. This week we are back and talking a little bit about a story which you have probably been familiar with over the last couple weeks and that is Golden State warriors head coach Steve Kerr. He's had ongoing struggles after multiple back surgeries and we're gonna talk a little bit about the tail in that one where the research meets that story and how it impacts your patients. Before we get started I will say a few words as I do each and every week about Rock Tape Rock Tape, makers of the world's best kinesiology tape are proud to introduce completely redesigned Rocksauce and Roxauce Chill powerful topical muscle and joint pain relief now available in 3 ounce roll ons and 32 ounce clinical pump tops. Give long lasting pain relief to your patients. 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That gets massive amounts of more exposure and the Evidence Based Chiropractor podcast can continue to climb up the charts. So I would appreciate it if you took a few moments and did that as soon as you finish this week's episode. Also a little bit more housekeeping. Smart Chiropractor is live. If you didn't get an opportunity to hop in on the initial launch, the cart still is open. It is never going to close, but the initial launch price is gone. You can check that out. Smartchiropractor.com Modern chiropractic patient education and it is full, full spectrum online and off and it is a robust platform. Can't wait to get started. Also this coming weekend, this next weekend, I will be in Vegas for Cairo Sushi. If anybody out there I know there's a few hundred people out there that are attending, please shoot me a message. Come up, say hi, let's take a picture together. I would love to connect. Without further ado, we will dive into this week's hot button topic. I've looked at articles on cnn, on Yahoo, on espn, on Forbes and everything in between that is talking about the struggles that Golden State warriors head coach Steve Kerr has continued to have after multiple spine surgeries. And I think it's a really important tale. You know, these things are brought to light often when a celebrity is involved. But I know as chiropractors, each and every week, each and every day we see Pat struggled. There's a time and a place for surgical intervention, do not get me wrong. But we do see patients that have continued to struggle after surgery and they're not getting the headlines that Steve Kerr is. So that double edged sword of being a celebrity is that of course people want to know what's going on with him, but it also brings to light some of the challenges. And if you did not follow what Steve said, I'll give you a little quote because I think it's really important. You know, the other day he missed. If you're not a basketball fan, Golden State warriors are a professional basketball team, NBA team and they are one of absolute favorites to win the championship this year. But like every team, the head coach is an extremely important part of that. He started missing games during their playoff run and he's had ongoing challenges with his back. But he had to answer some questions because of it and the reporters wanted to know and he was gracious enough to answer. And here's a quote from, from, from Coach Kerr. He said, I quote, I can tell you if you're listening out there, stay away from back surgery. I can say that from the bottom of my heart. Rehab, rehab, rehab. Don't let anyone get in there. And here's the context of where Coach Kerr comes from. That he had a ruptured disc just a couple years back and with that he had a surgical intervention and the first surgical intervention that he had unfortunately ended up in a CSF leak. This is what we know, this is well documented. So he had a cerebrospinal fluid leak and the cerebrospinal fluid, as we know, but I'll kind of touch on it briefly as well. The cerebrospinal fluid is really, it's part of the lubrication, the pressurizing system that is intradural. So it surrounds the brain, surrounds the spinal cord. And one of the most common, one of the absolute most common complications with any sort of spine surgery is that the dura, the spinal cord is nicked, it's touched, and there is a dural leak. Often that's a cerebrospinal, that's a CSF leak. Now typically what happens is that there might just be, it could heal on its own. Potentially one or two stitches is placed or sometimes even something as upgraded as a bludge patch has to take place to sort of stop the leak. Now, for most patients, that leak results in simply. I say simply, but it's not fun for the patient. It simply results in a pretty severe migraine for a few hours or maybe even a day after the procedure. But for some patients, and it seems as though Coach Kerr is in this situation, it results in some pretty significant long term impairment. It can result in ongoing migraines. It can become an ongoing problem if the leak does not seal. And there can be potentially continued leakage. It can also result in a variety of almost what I'd call neurological symptoms where patients can sometimes have a great sensitivity to light. They might have nausea, they might have significant headache, they might have positional issues where going from sit to stand, going from lying down to seated creates a lot, a lot of challenge. Everything from nausea to vertigo to migraine headaches and everything in between. And it's really a big deal because this can be greatly impacting in his case. I mean, you look at somebody like Coach Kerr, he was a professional athlete. If anybody out there remembers, he played with Michael Jordan on the Chicago Bulls for a number of years. And this is a high level athlete that also is highly incentivized to be coaching these games monetarily and pride wise. And for him to have to take a step back and really not be able to get out there and do what he loves to do, that's a huge, huge, huge quality of life issue. So I think the key important part about with the story here with Coach Kerr is, as he said, rehab, rehab, rehab. And as we well know, the research continues to come out. As we touched on just a few weeks back, and this is where this comes full circle. We touched on this just a few weeks back when the American College of Physicians came out and said, I mean, we're not even going as far as surgery. We're going to the first line defense. They said before NSAIDs are prescribed. I mean, that's the typical PCP way of taking care of any musculoskeletal and back pain issue. That's the tried and true way that they typically go about it. And the American College of Physicians came out and said, hold on a second. Before you even prescribe an nsaid, the patient, the person should attempt chiropractic care and or other conservative care measures. So I think with Coach Kerr, this is. I mean, we see the opioid. I mean, I could go on and on about this, but we see the opioid epidemic and the challenges that that's having on the future generations. So we're really at this interesting dichotomy because you take the amount of spine surgery that's being performed is rather robust and that's gone uphill. And again, I'll be very frank, in my day to day, I do a lot of MRI overreads for potentially pre surgical patients. And one of the things I take a lot of pride in is that we want to make sure, specifically at the group that I'm with, we absolutely make sure all conservative care is exhausted before anybody starts entertaining the idea of a surgical, surgical intervention. Consequently, everything we do is minimally invasive as well. So it's really a different ballgame. But conservative care, certainly before surgery, as Coach Kerr says, rehab, rehab, rehab. And we have some patients that get a little bit of what I'd call ants in their pants sometimes. I think we all do, where patients might not be responding after treatment, maybe they might not responding after two treatments, maybe they went to physical therapy and they're begrudgingly coming into a chiropractor one time to see if a miracle is performed. And the truth of the matter is they shouldn't be jumping into a surgical intervention. It is absolutely imperative that all patients exhaust conservative care. And that doesn't mean just one form. They should really be going and looking at the variety of conservative care spectrum before entertaining the idea of a surgical intervention. There's a time and a place. There's a time and a place. There's a. You know, as BJ As Palmer once said, you know, there's a limitation of matter. There's a certain uphill battle where at a certain point a disc extrusion, a sequestration, a fragment might not be going back or fall into a position where the patient, the person can live with a high quality of life, but a vast majority of the time with extensive rehab, with time and with the right approach to care, which if you're listening out there, that's us chiropractic care, it can do absolute wonders and borderline, might I even say practical miracles as far as patients improvement in quality of life, improvement in function and decrease in pain. So a cautionary tale with Coach Kerr is that not only he had a quote unquote successful procedure as far as taking the pressure off the nerve, here's the other thing to keep in mind. He had a successful procedure in terms of disc pressing on the nerve causing radiculopathy. Disc taken care of, no more pressure on the nerve. But it's the consequences and the complications from that procedure that's actually left him in much rougher of a spot than I would imagine he was in before he had that procedure. So conservative. The research shows it. We should be proud. We should be loud. Chiropractic care is absolutely the most safe and effective conservative care option ever, I would venture and say ever founded. And with that being said, patients that are exploring the opportunity for surgical intervention absolutely need to start talking about chiropractic care at a higher level before they entertain a surgical intervention. If they fail all conservative care measures, well, then that's a decision that they have to make between them and their families. But before that, forget about opioids, forget about surgery, forget about injections. Even before they take an nsaid, they need to absolutely be thinking about chiropractic care as the first choice, the first line of defense to get well. We do a lot more than back pain, we do a lot more than neck pain, we do a lot more than headaches. But absolutely, for every patient that's suffering from that, chiropractic should be their first stop. And then for other things, I believe we should be their first stop as well. So that's what I wanted to touch on this week. I think Coach Kerr is a great example to share amongst your family and friends. I think it's a great example to share amongst Facebook. I posted a little link on this on Facebook. I think it reached 10,000, 15,000 people. It shot through the roof. So it's a hot button topic. People have a lot of interest in it. It is certainly worth talking about. I hope you have a fantastic week in practice. I will be out in Vegas next weekend. If you have not checked out the evidence based chiropractor, our program, our monthly program, how to build relationships with other providers in your community, that is exactly what we talked about today. Visit us at the evidence basedchiropractor.com Nobody does it better. Or check me out at thesmartchiropractor.com have a great week in practice and I will talk to you soon.

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