News Archives - Michigan Head & Spine Institute Blog

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Spinal fractures can be extremely painful. Often, osteoporosis or osteopenia can be the cause of these compression fractures within the vertebra of the spine. These are sometimes referred to as osteoporotic compression fractures due to loss of bone strength in the mid to lower back.

Women more often than men experience these fractures. This condition can occur without a specific injury or be caused by trauma or cancer of the spine. Chiu Yuen To, M.D., notes older women in the Midwest, who have less exposure to the sun and absorb less Vitamin D, are more likely to experience compression fractures.

Kyphoplasty is a painless procedure performed in the office under local anesthesia. Compression fractures often cause a decrease of height or forward rounding of the spine. Kyphoplasty can quickly relieve the pain caused by this condition.

To learn more about how compression fractures affect the vertebrae, watch this educational video.

Todd Nida, M.D., explains the procedure of Kyphoplasty, “First, a balloon is used to expand the disc and vertebral space and removed. Then a surgical glue or cement is used to ‘unscrunch’ the compressed area of the spine.” Dr. Nida says, “the pain is almost immediately relieved, and most patients return to their regular activities the next day.”

Dr. Nida explains the minimally invasive procedure that treats spine fractures caused by osteoporosis to provide rapid back pain relief and straighten the spine.

 

Christine, a patient of Daniel Fahim, M.D., explains her experience with Kyphoplasty after experiencing seven very painful compression fractures in her mid and lower back brought her life to a halt. After Kyphoplasty, she says, “I’m back” with the goal of walking 20 miles a day in a local breast cancer fundraising walk.

Watch Christine’s story below:

If you have osteoporosis or osteopenia with sudden onset pain in the mid or lower part of the spine it could be a compression fracture. To request a consultation with an MHSI neurosurgeon, call 248-784-3667 or request an appointment at MHSI.us.

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Movement disorders refer to conditions which cause abnormal voluntary or involuntary movements. Symptoms are caused by disorganized electrical signals in specific areas of the brain. Those challenged with essential tremor, Parkinson’s disease, dystonia, and other neurological conditions may benefit from deep brain stimulation (DBS), especially when symptoms progress or medications become less effective.

DBS is performed by neurosurgeons who precisely place one or more wires, called electrodes or leads, inside the brain. The lead is connected to a pacemaker-like device called a neurostimulator that is surgically implanted into the patient’s chest. The neurostimulator then conducts continuous pulses of electric current through the leads to interrupt the disorganized brain signals causing tremor or other movement disorder symptoms.

Insertion of the leads and neurostimulator are typically accomplished in two steps. First, the neurosurgeon places the leads either into one or both sides of the brain, and this is often performed while the patient is awake. In a second procedure the neurostimulator is implanted in the chest while the patient is asleep. Programming of the neurostimulator can be performed by the neurosurgeon, neurologist, or primary care physician, to find the optimum settings that are effective for each patient. There are different devices available that can tailor therapy to each individual patient, and the device representative often has an important role to help the patient become familiar with their programmer and programming settings.

 

For patients with essential tremor, the most common movement disorder, DBS can return a person to normal daily activities like dressing, shaving, eating, and drinking. Symptoms of Parkinson’s disease such as tremor, bradykinesia and rigidity are especially well-treated with DBS, and medication dosages can often be decreased. Dystonia is an uncommon movement disorder, with symptoms of abnormal posturing and twisting movements, which also respond to DBS.

DBS can also be used to treat patients with epilepsy, obsessive-compulsive disorder, or certain pain disorders. These unique disorders are often managed by specialized neurologists and psychiatrists, and a thorough discussion with your specialist is necessary to determine if you are a candidate for this therapy.

At MHSI, a neurosurgeon or functional neurosurgeon will work with a patient’s neurologist or primary care physician prior to and after surgery to ensure that the optimal therapy is achieved.

For more information about DBS, visit our patient education page on the topic, click here. If you or a family member or friend might benefit from DBS, please schedule a consultation by calling 248-784-3667 or visit MHSI.us.

MHSI Neurosurgeons Who Perform DBS 

Dr. Fredrick Junn
Dr. Michael Staudt
Dr. Richard Veyna


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Michigan Head & Spine offers Telehealth appointments through Zoom Cloud Meetings. The following tips will help you prepare for a Telehealth visit.

Schedule an appointment
Your appointment can be scheduled through the office where you see your MHSI provider. You will receive a Zoom link and passcode just before the appointment through text or phone. If you need to reschedule your appointment, please contact us within 24 hours of the appointment via the patient portal or by calling 248-784-3667.

Find the right location
Find a quiet place to communicate with your physician. Make sure this is a location where you won’t be disturbed by others coming into the room or background noises like the television, radio, pets, or noisy appliances. Be sure to have plenty of space around you – you may be asked to move around during your appointment so your physician can see your movements. DO NOT hold your Telehealth visit while you are driving or sitting in a vehicle – MHSI will reschedule your appointment as a result. Make sure there is plenty of light in the space where you hold the meeting so your provider can see you clearly.

Prepare your personal details
Come prepared to discuss your medical history or any pre-existing conditions you have. Be sure to mention any symptoms you may be experiencing since your last appointment. Check your prescriptions so you can discuss refills if they are needed. And, be sure to write down any questions or concerns you may have so you don’t forget to ask during the appointment. 

Set up technology
Telehealth appointments require an internet-connected device and use of a video source from a smartphone, computer with camera, or tablet. Make sure that your equipment is fully charged or plugged in and reliably connected to the internet before your appointment. Headphones or earbuds provide the best sound quality and can help reduce feedback or background noise.

Our virtual appointments are available through the Zoom Cloud Meeting application. Be sure that you have downloaded the most current program from the App store for your phone, tablet or computer. The application is free to download.

Test your software in advance of your scheduled appointment by visiting the Zoom website at https//zoom.us/test. 

Get connected
Be sure to be connected to the internet and locate the meeting link in your appointment email. Follow these steps to connect:

  • Click the Zoom link in the email or text to launch the Zoom application. 
  • Enter the Meeting ID and Passcode from the email appointment to join the meeting. 
  • You will see a preview window and a button that states “Join with Video,” click the button to begin. 
  • You may be asked by Zoom to allow permissions or enable video and audio.
  • Join the audio by selecting “Call via device audio” or “Call via internet”
  • Please be patient with your provider if they do not arrive precisely at the appointment time.

For more assistance a short video on How to Join a Zoom Meeting can be viewed here.

We will try to assist you in getting connected the best we can – but we cannot provide IT support. Please have assistance available with you at your appointment time if you have difficulties connecting. If you are unable to get connected, your appointment may be rescheduled.

Click here to download our connection tips sheet and keep it for future reference during your scheduled appointment.


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Richard D. Fessler, M.D.
Richard D. Fessler, M.D.

Michigan Head & Spine Institute extends congratulations to our own Richard D. Fessler, M.D., who has been named The Detroit Medical Center’s (DMC) Specialist-In-Chief of Neurosurgery. In addition to continuing to treat patients at MHSI, Dr. Fessler will provide medical direction and leadership for the DMC’s Department of Neurosurgery assisting in the growth of the program as well as serving as Chief of Neurosurgery at DMC Detroit Receiving Hospital. The DMC’s CEO has stated that Dr. Fessler will be integral in the efforts to build upon the program’s rich history and tradition of providing the community with advanced, high quality and compassionate care.

Dr. Fessler is one of the founding partners of MHSI where he treats complex vascular abnormalities of the brain, neck and spinal cord for the treatment of aneurysms, carotid artery disease and stroke. He has been named an HOUR Detroit Top Doc for more than 12 consecutive years.

Dr. Fessler has been affiliated with the DMC over the years. He formerly served as Chairman of the Department of Surgery at Ascension St. John Hospital in Detroit and as the Medical Director of the health system’s Stroke Network and Telemedicine Program. He is responsible for creating several statewide programs offering state-of-the-art care to stroke and aneurysm patients. Prior to joining Ascension, he served as Vice-Chairman of the Department of Neurosurgery at William Beaumont Hospital in Royal Oak.

For more details about Dr. Fessler, read his profile page on the MHSI website by clicking here.

 

 


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A subspecialty of neurosurgery and neurology, a neuroendovascular specialist surgically treats complex brain and spinal cord vascular lesions from inside the blood vessels using minimally invasive techniques.

The goal of an endovascular procedure is to keep blood flowing through the blood vessels or to prevent a blood vessel from bursting. Catheters (small hollow tubes) and very small devices, some no thicker than a strand of hair, are used to fill the space in the vessel and seal it. This helps prevent blood flow and the potential for the blood vessel to burst. In some situations, to keep the blood flowing and relieve pressure on the vessel a stent or flow diverter is inserted.

A special x-ray called angiography is performed in a special procedure room at the hospital.  This helps the neuroendovascular specialist determine where the blood flow is restricted in the vessel, where the vessel is bulging or tangled and preventing proper blood flow. Angiography is also used to guide the catheters through the vessels from the groin to the treatment area where the repair is made during a minimally invasive procedure.

Rarely does a patient have the option to choose a neuroendovascular specialist.  The treatment for conditions like an ischemic or hemorrhagic stroke or an impending rupture that can occur with a brain aneurysm or an arteriovenous malformation or AVM in the brain or spine begin in the emergency department.

It is comforting to know that MHSI’s Richard Fessler, M.D., is the area’s leading neuroendovascular specialist. In fact, he was one of the first neurosurgeons to bring this specialty to metro Detroit.  He also trains other neurosurgeons this subspecialty, including Interventional Neurologists Ahmad Thabet, M.D., and John Whapham, M.D., and Neurosurgeon John Steele, M.D.

MHSI neurosurgeons and interventional neurologists are on staff at all the southeastern Michigan health systems, and are on-call in all the major emergency departments to treat conditions requiring neuroendovascular procedures and neurosurgical cases.

Watch Heather’s, Duane’s and LaMonte’s stories in their own words:

 


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Downriver Communities Now Have Neurosurgery Expertise

When looking for a neurosurgeon, you want someone you can trust with head, neck and spine conditions. Someone who has expertise with a good reputation. Someone close to home.

MHSI opened a new office, conveniently located on the campus of Beaumont Hospital, Trenton. Staffed by neurosurgeons Ratnesh Mehra, D.O., Pradeep Setty, D.O.  and Jeffrey Jacob, M.D., we offer the caliber of care and treatment you expect, only closer to home.

Neurosurgery is delicate, and you want the best, most experienced surgeons. The team at MHSI – Trenton has a complex set of skills including minimally invasive and robotic surgery, superior knowledge of brain tumors, and leading-edge experience with skull base and spine surgery.

Patients have long traveled to MHSI to be seen by specialists who provide the full spectrum of care for head, neck and spine conditions, because we provide a range of treatment and diagnosis options that are unparalleled in Southeast Michigan. And with the new Trenton office so close to home, receiving our care just got easier.

This is our tenth location and our first Downriver. Opening another office cements our mission to you: Provide the best, most experienced care. Spine, neck and head conditions are complex, and you want the best surgeon. With the team at MHSI working for you, helping you make the best decisions for your health, you know you have the professionals you want on your side.

The new location on Fort Street, on the campus of Beaumont Hospital, Trenton, opens up conveniences for patients as well. Imaging, testing, therapies and more are within arm’s length at the hospital, while the doctors you trust are right there with you.

We are accepting new patients, seeing post-op patients and continuing to provide care for those in the follow-up stage of care. You can call 248-784-3667 for an appointment, or request one online.

Expertise makes a difference, and the difference is MHSI.


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Several months ago we shared how the Michigan Legislature had passed sweeping changes to the Michigan No-Fault Insurance Law and the Michigan Insurance Code – known as SB1. A “trailer bill,” HB4397 was passed on by the Michigan House and Senate that included some modifications, which was signed into law on June 11, 2019.

These changes take effect on July 1, 2020. It requires you to consider the level of personal Injury Protection (PIP) coverage should you be in an auto accident. The default amount caps at $250,000.  It also removes lifetime medical benefits, should they be needed.

While on the surface a reduced auto insurance payment sounds great to all of us, but what is the level of risk you are willing to take? Here’s a guide of cost savings to help you make an educated decision:

  • $0 personal injury protection (a 100% savings on the PIP coverage but risks having no medical care as a result of an auto accident).
  • $50,000 of personal injury protection, plus $200,000 for immediate trauma care (a 45% savings for those who opt out of PIP).
  • $250,000 of personal injury protection (a 20% savings for those who opt out of PIP).
  • $500,000 of personal injury protection (a 10% savings for those who opt out of PIP).
  • Unlimited personal injury protection (Insurers are mandated to offer it).

Also To Consider:

Does the cost of purchasing added PIP coverage outweigh the cost of an ambulance ride which can cost between $500 into the thousands depending on the care rendered? An emergency room visit or surgery could be thousands of dollars depending on the nature of the injury and care provided. If rehabilitation or physical therapy is needed, depending on the type and length of time could be a lifetime financial burden on a family.

With the new cap levels, if you hit someone who has the lowest amount of mandatory liability insurance of $50,000 in Michigan, and you have selected a lower PIP cap amount, medical bills can mount up with no insurance available to pay for it. That leaves Michigan drivers dangerously medically and financially exposed.

If you think your medical insurance will cover the cost of care from an auto accident, you might be wrong! Be sure to talk with your health insurance company or employer representative about how to coordinate medical benefits with your auto insurance PIP coverage.

As of July 1, Michigan becomes a Tort state. What that means is that without additional liability coverage on your auto insurance policy, if you are found to be 51% at fault the other individual in the auto accident has the right to sue you personally for their financial losses related to the accident. What Michiganders have come to think of as a ‘No Fault State’ has changed and put the burden of liability on the auto owner.

Why Are We Sharing This Information?

The changes to the Michigan No-Fault law are many and very complex. This is new territory for insurance companies, and we believe the impact of this change is not clearly understood by legislators, yet it’s now law.

We treat many patients who were injured in an auto accident. We know the physical damage an auto accident can cause. We know how it changes our patient’s lives. Adding a financial burden on top of physical injuries may severely impact those involved in an auto accident.

Under this new legislation, you may be sued and held financially liable for medical expenses, if you are held responsible for the accident and the person (s) involved in the accident should they reach the cap of their medical coverage. It is important to protect your family and financial assets should you or a child be in an auto accident, regardless of who is at fault.

We are physicians, not lawyers or insurance agents. We want our patients to be informed about the potential of health and financial consequences as a result of changes to the Michigan No-Fault Auto Insurance.  We can’t advise what is right option for you, we suggest to at least have a conversation with your auto insurance provider to learn your options.


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5:30 a.m. David Wegener made his first cup of coffee. Then strange things started happening. He dropped his cup on his desk. He tried to send a text, but couldn’t quite hit the letters. He told his wife he might need to go to the doctor, but it never occurred to him he might be having a stroke.

He went on to his tile shop to get his crew ready for the day. With a little numbness and weakness in his right hand, he decided to go to the Ascension Providence Rochester ER.

His initial neurological exam didn’t indicate a stroke. But a CT scan did in fact show a blocked artery to his brain. The ER immediately sent the scan to neurosurgeon Richard Fessler, M.D., FAANS, FACS. Using specialized software, Dr. Fessler could determine the right treatment for the stroke within two minutes.

Life-saving treatment. David was transferred immediately to Ascension St. John Hospital, a Comprehensive Stroke Center and a Level 1 Trauma Center, where Dr. Fessler had a team waiting. David went straight into a minimally invasive stroke procedure that saved his life.

David Wegener now makes healthy living a priority after receiving lifesaving stroke treatment at Ascension Providence Rochester ER. Courtesy photo

Ascension Michigan specializes in acute stroke care, with the busiest stroke care system in Michigan and the only system in the state using the advanced imaging software.

“Timing is critical in treating stroke and I could see Mr. Wegener didn’t yet have permanent damage,” said Dr. Fessler. “We were able to dissolve a potentially disabling blood clot by injecting medication into his artery. He got better while he was still on the table.”

Care with compassion. “The entire team that cared for me was wonderful,” said David, “from the people who transferred me to the nurses who answered all my questions. They really listened to me.”

David went home in a few days with none of the typical aftereffects of stroke. The week after, reality sank in.

“I realized I could’ve died,” he said. “I dodged a bullet.”

With his own business and three daughters in college, David acknowledges he has a lot to live for. And he’s committed to putting his health first. His new priorities: losing weight, increasing physical activity and reducing stress.

“The changes I’ve needed to make in my life, I used to put them in pencil,” he said. “Now they’re in ink.”

Check in for any Ascension emergency room at GetAscensionMichiganCare.com.

Remember: If you’re having a serious emergency, get to the nearest emergency room or call 9-1-1.

To learn more about stroke and stroke symptoms, click here to visit our information page. To schedule an appointment with a MHSI expert, visit our website at www.mhsi.us.

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For the last few weeks, MHSI physicians have been treating many of our current patients using TeleHealth virtual visits. We are pleased to announce that we are expanding virtual visits to new patients beginning immediately. For those who need to be treated in the office, as always, we follow CDC guidelines for safety and cleanliness.

To schedule a TeleHealth virtual visit or in person visit, call (248) 784-3667 or request an appointment online.

Frequently Asked Questions: TeleHealth

Q. How do I schedule a TeleHealth virtual visit with my doctor?
A. Call the office at 248-784-3667 to schedule an appointment. You may also request an appointment through your patient portal.  Or if you are a new patient, you can request an appointment using the online form.

Q. Does my insurance cover the TeleHealth virtual visit?
A. Most insurance companies have relaxed their regulations and now cover this service.

Q. Will my TeleHealth virtual visit be with my doctor?
A. Your scheduled appointment will be with your doctor, nurse practitioner or physician assistant. If you are a new patient, you will visit with the practitioner you are scheduled to see.

Q. Will my TeleHealth virtual visit be private?
A. Yes, we are using Zoom software which is HIPAA compliant, all audio, video and screen sharing data is encrypted to protect your identity. Being in a quiet and private area of your home is suggested. We appreciate patients being dressed appropriately which includes shirts and pants. Please do not attend your visit while driving a car.

Q. What if I am not very computer savvy?
A. We are very patient and will guide you through each step.

Q. What type of technology or equipment do I need for a TeleHealth virtual visit?
A. When your appointment is scheduled, you will receive instructions for how to download onto your computer, iPad or smartphone, the meeting software called Zoom. A few minutes before your appointment, open your preferred browser (we recommend Google Chrome) and type in Zoom.com. At the time of your appointment, you will receive a phone call to provide a secure meeting ID number and password to join the meeting. Staff will be able to assist you with this process.

Q. How long will I be with my doctor?
A. Most visits require 10-20 minutes of your time.

Q. What if I really need to be seen by my doctor in the office?
A. In addition to virtual visits, MHSI doctors are still treating patients in the office, if it is necessary. For example if stitches, staples, or shunt removal is needed or if it is determined an office visit is necessary during your TeleHealth virtual visit. You should be aware that we continue to follow CDC guidelines for safety and cleanliness, along with following the State of Michigan’s physical distancing requirements.

To schedule a TeleHealth virtual visit or in person visit, call (248) 784-3667 or request an appointment online.


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Postponing non-emergent surgeries due to the COVID-19 Pandemic reduced Michigan Head & Spine Institute (MHSI) neurosurgery procedures by 95%.  The impact on patients, employees and the neurosurgeons were many, and meeting the challenge to continue to treat patients was achieved with these swift actions:

  1. Neurosurgeon partners and administrators took a 45% pay cut. This ensured that employees will continue to be paid at various levels and those working with patients in clinics will receive a 25% premium.
  2. Telehealth was immediately implemented and within 7 days more than 80% of patient consultations were conducted virtually.
  3. Neurosurgeons continue to support their local hospitals through on-call in the Emergency Departments for trauma and urgent cases.

“We are extremely proud of our employees.  They are committed, creative and flexible every day in meeting the challenges caused by this pandemic,” said Robert Johnson, MD, president of MHSI.  “As a designated critical infrastructure service, MHSI employees are committed to patient care.  Every member of MHSI is screened daily when they arrive to work.  The financial decision to support our employees was the right thing to do for the]m and our patients.”

Dr. Johnson explains, “We didn’t want our patients to be concerned about their medical treatment or feel abandoned by their doctors. At the same time, reducing exposure to the COVID-19 virus among our patients, employees and our physicians was a critical factor in moving to Telehealth. We believe the actions taken will better protect everyone as MHSI continues to take every precaution possible through this crisis.”

Richard Fessler, MD, MHSI neurosurgeon and practice partner says, “We had planned for years to gradually enable telemedicine and the current pandemic coincided with our initial roll-out.  MHSI is the largest multi-disciplinary neurosurgical practice in the United States to employ virtual visits on a platform of this scale. Telehealth allows us to provide new patients and our existing patients with access to care during the Covid-19 pandemic and in the future.”

Dr. Fessler explains, “We are grateful to our patients and staff for their support during this unprecedented time.”

MHSI uses Zoom.us which offered a HIPAA compliant product.

If you are patient with a brain, neck, back or spine problem, find out if it can be addressed by a virtual visit: https://www2.mhsi.us/about/contact-mhsi/.