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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 32756
Experience:  Over 20 yrs of Family Practice
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Needs help getting referrals to x,y. or z specialists for

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George needs help getting referrals to x,y. or z specialists for assessment. Top of the list of undiagnosed injuries are a concern for possible brain injury. What field is best suited for identification and treatment if applicable?
George was hit while walking across an intersection. He went right through the windshield up to his waist. He does not remember losing consciousness but the paramedics notes he did not recall being hit, and another motorist saw him lying across the hood which he now denies. He had 2 more accidents one falling down the stairs and one tripping onto the sidewalk with his bike.
Since then his health has gradually deteriorated- his present symptoms include depression anxiety and He claims the following problems and using your pain scale
1-right ankle wants to curl under.
2-right knee constant irritation from steel rod,when active.
3-right leg causing balance problems.
4-right shoulder pain where staple is 2-3,pressure on right shoulder
irritates right side of neck.
5-right side of neck,pain with rotation.
6-pressure to right back of head increases with activity,2-3 morning
4-5 end of day.
7-ringing in head,5-6 morning,8-9 end of day.
8-left ankle,numb on bottom,stiff in morning 1-2 pain scale.
9-left knee cracks and grinds 1-3.
George did a self assessment online and found he answered 90%+ questions positive for brain injury for what that is worth.
What specialists has he seen and what studies have been done so far?
Customer: replied 5 years ago.
He had a CAT scan in the hospital a few days after the accident. At one point there was a comment re suspected brain contusion, then the CAT scan came back negative. There is a period of perhaps a week when George was confused but a note generally to the effect oit was due to alcohol withdrawal. Several years later he was seen by a rehabilitation specialist who noted how poorly George was able to recall his history of medical treatment, made a number of comments on George's alcoholism but nowhere is there any indication he was referred for a brain injury assessment. It is now 5 years from the accident. Right now I do not have access to all his medical reports.
is he still drinking? And for now he hasn't had a formal psychological evaluation of his cognitive abilities?
Customer: replied 5 years ago.
p.s. 5 days after the accident because his confusion persisted he had a second CAT scan, which noted a mild generalized loss of volume and a focus of low attenuation with the left corpus striatum that is likely to represent a dilated perivascular space there are no focal parenchymal lesions. No evidence of contusion or extra-axial hemorrhage.
Impression: No acute abnormality shown.
OK--but as to my last question above?
Customer: replied 5 years ago.
Sorry I missed your last question. George stopped drinking completely after his last accident 2- 3 years ago. I have had problems getting competant evaluations from local neuro-psychologists although I have huge respect for one in Denver Colorado who is tied in with a lightning strike survivor's clinic. Because of my prior difficulties on another case I would prefer to postpone a new? formal psychological evaluation of his cognitive abilities? The rehab consultant suggested perhaps a psychiatric evaluation which George does not favor, but he does accept most of my advice. His current partner told me one day he called out to her while working on an email "how do your spell "is" which shocked her.
Customer: replied 5 years ago.
I must go out of town for 24 hours but may be able to check if you have any suggestions in the meantime-- many thanks for your work so far.
When you can respond back to me, can you be a bit more explicit as to exactly what you're looking for in the way of information?
Customer: replied 5 years ago.
Dear Dr. Chip
George is facing a great deal of pressure- a functional capacity assessment suggested George is capable of returning to full time employment with a graduated program yet he has no job to go back to and the assessment had to be postponed a number of times because his blood pressure went off the charts. He has a more sympathetic occupational therapist also funded by the insurance company and I have suggested the functional capacity assessment opinion is a blatant error.
My question: what referral(s) for assessment of George makes the most sense in these circumstances?
What type of doctor did the functional capacity assessment?
Customer: replied 5 years ago.
not a doctor, a rehab consultant traditionally hired by the insurance company as far as I know- George's previous attorney hired a rehab doctor who commented on Georges stupidity but made no apparently investigation of brain damage.
you're saying that he has been evaluated by a neuropsychologist?
Customer: replied 5 years ago.
sorry my experience with neuro-psychologist here has been with another client altogether, but I am hesitant to go down that road again and Denver is a long way from George.
Just for clarification--in what way is George your client and what do you mean by being hesitant to go down the same road?
Customer: replied 5 years ago.
I am representing George in my capacity as a personal injury attorney. The same road is hiring a local neuro-psychologist and expecting a professional opinion.
you don't think you'll get a competent, unbiased opinion from the neuropsychologist you have at your disposal?
Customer: replied 5 years ago.
indeed that sadly is my expectation. As a group I have no respect for them.. George is barely able to function between his permanent physical disabilities and his headaches, ringing in his head. He is a former faller and used to working in punishing conditions but he has been taken down in recent years.
I am on my way, it has been a pleasure exchanging thoughts & information. Regardless you have helped me solidify my thoughts as I must contact his GP this coming week.
Well, I tried to help, but obviously he needs a competent, unbiased neuropsychological evaluation with a battery of cognitive testing and interviews. If he's as incapacitated as you say, it should be no problem getting him certified as disabled and unable to work in a gainful manner.
Dr. Chip and 2 other Health Specialists are ready to help you
Customer: replied 5 years ago.
Hey Dr. Chip. His family doctor has referred George to the Anxiety and Mood disorder clinic in the local hospital, I have sent a note for help from a great neuro-psychologist in Denver and I am meeting with the rehab team on Monday. I appreciate your help.
Sounds great--I wish the both of you good luck.
Dr. Chip and 2 other Health Specialists are ready to help you