His name is Robert*- Rob for short. He seemed as ordinary a new patient as any I had ever encountered in my “lengthy” three year career. The only unusual feature about Rob was the silver dollar-sized bruise perfectly centered in the middle of his forehead.
The patient history form indicated his primary (and only) complaint as migraines, which Rob softly described as “real skullbusters.” “They come and go,” he said. Rob’s very intelligently related history detailed years of suffering. “They have been more frequent in recent years. They have become much more intense. When I have them, they’re debilitating. I have to go into a darkened room and lie motionless for hours, sometimes even for days. I can’t work. My boss told me that if I miss any more work I will lose my job.”
I tried to remain calm and confident while Rob continued to describe endless encounters with health care personnel of every type. “I have had every test there is,” he said. “I have tried every type of drug there is. Nothing has worked. The drugs sometimes reduce pain, but it is still unbearable; and I vomit a lot.” I pointed at the bruise on Rob’s forehead and asked, “Is that what I think it is?” “That depends on what you think it is,” came his immediate reply. “I think your headaches are so bad that you ram your head against a wall to override the headache pain,” I responded.
Rob was not impressed with my recollecting something I had read a handful of years earlier about the behaviors of severe migraine sufferers. “Yes,” Rob responded, rather flatly. “I don’t do it often, but a couple of days ago I had one of the worst skullbusters I’ve had in a while. I couldn’t take it anymore.”
I had come to realize that Rob’s face was the definition of a man in pain. His eyes were those of a tortured man in pain. His every movement was minimized and performed with painstaking care so as not to aggravate his condition.
I found myself wondering if I would be able to help this poor fellow. Actually I was wondering if anything could help him. It seemed he had tried everything. “Everything except chiropractic,” Rob continued. “I’ve tried many different medical doctors including neurologists, psychiatrists, physiatrists, anesthesiologists. I’ve tried acupuncture and massage. In total, I’ve been to fourteen different doctors. I think it only fair to tell you,” Rob continued, “if you can’t help me, I’m going to slip into something heavy and take a long walk off a short pier. I don’t want you to know that if that happens, it’s not your fault.”
No pressure! How could I not feel pressure?! It had become quite obvious to me that Rob was not a man who was even capable of joking anymore. Years of “skullbusters” had been seen to that. He was quite serious. If I couldn’t help him find some relief he was going to kill himself!
“Rob,” I stammered, searching for words that would provide him with a glimmer of hope,”chiropractic is often very effective at relieving many people of their headaches. But, chiropractic doesn’t work the same for everyone. I can’t make any promises, but I can tell you that I am going to work diligently to find if you have a chiropractic problem that can cause a headache, and then I am going to try to fix that problem in hopes that your headaches will subside, or even go away.” Rob weakly nodded that he understood. I felt that I had thoroughly failed at giving him any semblance of hope.
I performed as complete an examination on Rob as I knew how to do. I tried to uncover anything wrong; anything that could be causing his headaches. What I found was not much. Except for a slightly unusual movement pattern in his upper cervical region his physical examination was totally unremarkable. But I couldn’t pin it down. Something, small as it was, was just not right. “There’s only one way to futher find out what is really going on in your upper neck,” I told Rob. “I need to take a few x-rays of the region. Then I can better see what is going on in there.”
I continued with the usual explanation about how many headaches are caused by problems in the neck, and chiropractic treatment of the neck can work towards correcting such problems. Rob seemed to show a slight flicker of hope, or did I just want him to so badly that I imagined it. Anyway, he told me that no one had taken any x-rays of his neck before so we might as well give it a try.
Within fifteen minutes or so, I had a few x-rays of Rob’s neck. I did my usual swift analysis the first time through. I was sure I would quickly find the large alien that I knew must certainly be holding a jackhammer to one of Rob’s cervical vertebrae or the inside of his skull. Nothing. Rob sat quietly in the dimly lit room with me, watching me scan his x-rays mounted on the view box. I began analyzing the x-rays for a second time-this time much more slowly.
Well, that can’t be, I thought to myself. During my second perusal of Rob’s x-rays I noticed that his atlas, the very top bone of the spine, the one upon which the head rests, was rotated out of its normal alignment by an incredible degree. I thought, He should have been crippled or dead with a vertebra that far out of whack!
Rob was no dummy. A computer genius, Rob had brains; even if they were screaming in pain most of the time. He could tell I saw something. “Do you see anything?” He sounded almost hopeful.
“Yes. The top bone of your neck is rotated—a lot.” I continued with a pretty in-depth explanation of cervical anatomy, describing blood vessels and nerves, using “the crimping of a garden hose” example. “But you see,” I continured, “this is rotated much more than I have ever seen or even heard of.” I tried to sound encouraged that we might have found a cause of his pain, while trying not to sound too alarmed at the excessive nature of what I found.
Rob had only one question–”Can you help me?”
“Rob, in chiropractic, we adjust bones that are out of alignment, like this one, and adjust them back into place; kind of like an orthodontist who gently moves teeth into proper alignment.”
Rob only wanted to know one thing, “Will this get rid of my headaches?”
“I don’t know,” I responded, hating myself for being honest. “It should. I would think that it will provide you with some relief. But to be honest, there’s no way to know for sure.”
“When can we start putting this bone back in place? Rob asked. If he wasn’t hurting so so badly from his latest “skullbuster,” I think he would have actually been excited. “We can begin today,” I optimistically responded. And with that, I explained my treatment protocol and began treating Rob.
Now, I would like to brag that Rob was pain-free after his first treatment. I even would have been thrilled to say that Rob responded rapidly after just a few treatments. But to be honest, Rob’s response was slow. He improved incrementally with nearly every treatment. He related that his headaches were diminishing, both in their frequency and intensity. Rob’s face, in fact his very demeanor, changed. At first he began smiling; then joking. He even gained a couple of pounds (he says because he was not just “renting” his food anymore, as he had been before when his migraines made him vomit).
Rob did not miss any more work. In fact while completing his treatment he related to me that he got a promotion at work, which was soon followed by a new car. The Christmas care he sent me several months after his treatment concluded informed me he had even bought his first home. “Life,” he wrote inside the card, “is great. Thanks.”
As a doctor of chiropractic, I see a number of different maladies and disorders, but I never see any immediate life-threatening injuries or ailments, as do emergency room physicians or paramedics. On a few occasions I confess to wondering, What would it be like to save a life? With Rob, I think I know.
The last I heard, Rob was engaged! For Rob, life is great.
Michael Kohler, D.C.