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Did the Chiropractor Actually Break the Baby’s Neck?

mb_wide_baby_20130928195643681759-620x349Over recent months I have watched with a sense of horror the wave of anti-Chiropractic stories and headlines in newspapers and social media.

None more confronting than those that appeared a few weeks ago with the frightening claim of a Chiropractor breaking the neck of a baby.

The Age and the Herald Sun ran with the story:

Doctors are calling for chiropractors to stop treating children after a Melbourne infant’s neck was broken during a chiropractic adjustment that went horribly wrong.

 

It was picked up by the Sydney Morning Herald.

Melbourne paediatrician Chris Pappas said he cared for a four-month-old baby last year after one of her vertebrae was fractured during a chiropractic treatment for torticollis – a wry neck, which is usually harmless in babies. He said the infant, who was rushed to Monash Medical Centre for treatment, was lucky to make a full recovery.

Another few millimetres and there would have been a devastating spinal cord injury and the baby would have either died or had severe neurological impairment with quadriplegia. Everybody was very nervous about this little baby.

 

But while I love a great headline – it would be nice if what the papers reported was correct.

Problem is, the story was not true.

This is a terrible situation for the baby and obviously our hearts go out to the parents. However, I am horrified that this case has been used for nothing more than political spin and grandstanding.

The Chiropractor did not cause the injury – AND this fact was known at the time of the ‘press release’.

The Chiropractor in question was actually assisting the baby for a Neuro-musculoskeletal condition called torticollis – or ‘wry neck’. Something that is quite common in practice and a condition that Chiropractors are well trained and proficiently skilled to handle.

But then never let the facts get in the way of a good story.

And so the ‘saga’ kept rolling…….

It erupted on blogging sites like Essential Baby and social media. Protractors for and against defended their decision to use Chiropractic or call to ban it immediately.

I thought arguments of child abuse where interesting. Some parents saying it is child abuse to take your baby to a Chiropractor, while others were claiming it was child abuse to not take them to a Chiropractor, have the kids live in pain or be drugged unnecessarily.

Either way, why does Chiropractic – a registered, regulated, Government backed and overwhelmingly safe profession get hammered in this manner?

Why does Chiropractic stir up such emotion?

It is like talking about Carlton and Collingwood.

You either barack for the team or you don’t.

If a general practitioner provides pharmacological care (drug therapy) for a neuro-musculoskeletal complaint this is seen as above reproach. Even though drugs are statistically far more likely to cause harm to the infant than any gentle manual therapy.

If a physical therapist provides musculoskeletal care – using the very techniques pioneered by Chiropractors over the last few centuries, but with around half the formal training – this is seen as reasonable and openly endorsed by the medical fraternity.

But if a Chiropractor provides musculoskeletal care for an infant then the ‘war begins’.

I wonder though – is the war more about who is helping the patients – or who is controlling the patients?

You can’t have those peskey chiropractors treating children, it might interfere with the chain of command and cause an unnnesccary reduction of medical visits and drug utilisation.

 

My Two Cents Worth – What’s in a Title? 

Although I started life as a medical scientist with key fields of study in Advanced Neuroscience and Molecular Genetics, I am registered with The Australian Health Practitioner Regulation Agency (AHPRA) in two separate fields of practice. They are Chinese Medicine as well as Chiropractic.

If I was to introduce myself as a Geneticist (which is a large part of our work in my online practice: Emed) most people are quite interested and would like to know more.

I developed Emed to be Australia’s leading eClinic and information resource. Emed provides nutritional solutions based on each individuals genetic and metabolic profiles. Worth a look if you haven’t had a chance.

If I introduce myself as a Chinese Medicine Practitioner who specialises in the treatment of spinal injuries and musculskeletal conditions – again this received with a great deal of interest.

But if I introduce myself as a Chiropractor – there is immediate polarisation in the audience.

I find I almost have to apologise our profession, or face an uneasy resistance that a doctors job is really about assisting the body to heal and educating patients to help them achieve better health. Obviously this is still a ‘radical’ concept.

The irony is that in all my (12) years at varying Universities around Australia, the 6 years of Chiropractic College were by far and away the hardest and most demanding. It is the degree of which I am most proud. It has provided me with the most skills to safely and effectively help others. But more than that, it is the paradigm through which you view life.

If find it puzzling that in the current climate any health practitioner that is cautious about the use of drugs, surgery or vaccines and advocates better health through good nutrition and lifestyle intervention is obviously a heretic.

 

Political Spin, Turf War or Both? 

Each day I see patients that have been either been mis-diagnosed, injured or made worse by their medical interventions.

In fact the only reason I ended up becoming a Chiropractor is due to my sheer frustration with allopathic medicine and propensity for doctors to prescribe a ‘pill for every ill’.

I would venture that most Chiropractors chose this profession as a result of allopathic medicines’ inability to assist them in their formative years.

Most patients that attend Chiropractors are under care because their medical intervention(s) did not work. We don’t see the easy stuff.

We see patients that have been battling for years with health issues. We are their last resort. ‘If you can’t fix me then I don’t know what I will do’ is something I hear each week.

But patients have been trying to get better.  They have been going to their GP’s for years for spinal related conditions and not getting a decent outcome. They are not getting neuro-musculoskeletal care. They just get drugged. They are getting pharmacological care.

I see so many patients that are merely being placated with pain killers while their orthopaedic conditions get worse and they accept an increasing level of disability.

‘Your bones are rotten and nothing can be done – you will just have to live with it’ seems to be code for ‘it is time you went to a Chiropractor’.

 

If our current ‘take’ on medicine had all the answers then Chiropractic would not exist.

On the other hand…

GP’s see our ‘mistakes’.

I am quite sure that allopathic practitioners see our patients that are either mis-diagnosed or aggravated by their physical treatments.

We tend to see the ‘failures’ of the other side. And they ours.

It is the nature of the game.

It is like trying to get a builder and an architect to work together. One wants curves and the other wants straight lines.

One health profession considers that you are born with disposable bits, the other wants to leave them intact.

 

Can We End the Turf War?

So, in the next few weeks, when I see yet another patient with a spinal fracture or disc injury that has been missed by the hospital or their general practitioner do I go to the Board? Do I call The Age or A Current Affair?

Is it appropriate to grandstand on the situation to extract political points from the other side?

Or perhaps would it be appropriate to call the practitioner, discuss the case and work together for the common good of the patient?

Did the Paediatrician involved in the case contact the Chiropractor to discuss management? Or did he let his inherent bias get in the way of looking after the patient?

Dr Pappas said … ”I don’t think chiropractors should be treating infants full stop. In my opinion it’s inappropriate ….”

 

Was this evidence based – or opinion based care?

In Canada women receive Chiropractic care as part of government funded natal care.

Just as you would see an obstetrician to consider the health of mum and the bubs. So too would the Chiropractor assess the spine and lumbopelvic structures of the mother so she can have a safe and potentially drug free delivery.

After the baby is born, naturally the mother has her spine managed by resident Chiropractors. The child is also assessed and treated as required by the Chiropractor – who after all,  is the most well trained to provided such spinal related care.

There is no political uproar. There is no ‘us and them’.

There is only practitioners from different specialities working together for the good of the patients.

As is should be.

And as we do in this practice.

All children after delivery should be assessed by a Chiropractor. Just as they are assessed by a Paediatrician or general practitioner with a paediatric background.

We may have differing views – and that is ok. We may have differing philosophical opinions, but this should never get in the way of what really matters – providing the best possible and safest care for patients.

 

 

UPDATE:

The Australian has uncovered the expert report commissioned by the Australian Health Practitioner Regulation Agency (AHPRA) and the report shows the baby did not have a broken neck in the first place.

The baby had a condition known as congenital spondylolysis, a malformation of the spine and it can run in families.

The father of the baby had a similar congenital condition.

The congenital condition is rare but it can be confused with “hangman’s fracture.”

The AHPRA commissioned independent expert found in any event, the Chiropractor did not apply sufficient force to cause a fracture.

National President of the CAA, Dr Laurie Tassell said, “The Chiropractor could not and did not cause an injury to the child.”

“The CAA is outraged that the AMA and its camp followers have launched a campaign to stop Chiropractors treating children based on an alleged injury that never happened,” Dr Laurie Tassel said.

“It is shameful that the entire Chiropractic profession has been smeared and attacked, over something that did not occur.”

“AMA President Dr Steve Hambleton should apologise for his public comments on this matter.”

“Queensland MP Dr Alex Douglas should admit that his attack on the Chiropractic profession was also based on ignorance of the facts” said Dr Tassell.

 The CAA will now seek to have the reporting of this matter corrected in every media platform that ran the original wrong story.

 

UPDATE:

AHPRA documents clearing a Chiropractor of an alleged neck ‘break’ were tabled in Queensland Parliament last night.

Please see the following extract from Hansard:

Mrs Jo-Anne Miller, Shadow Minister for Health, (page 3386) Queensland Parliament

“AHPRA did indeed properly investigate this matter, and I table the independent expert report received by AHPRA, along with the consulting radiologist’s report and a CD containing copies of the MRI, CT Scans and x-rays taken of the child.

I now quote from the radiologist diagnosis –

“CONCLUSION: No evidence of fracture. The appearance of pedicles at C2 is consistent with bilateral spondylosis.”

In plain terms the child suffered from a congenital condition which prevents the spine hardening in the normal way.

The symptoms of this condition can be confused with what is known as hangman’s fracture, but the radiologist report right from the beginning of this matter made it clear there was no fracture. The child’s father had a similar condition.

 

The Chiropractor did not and could not have broken the child’s neck because there never was a broken neck to begin with.

There are clear lessons here about the need for effective communications between health practitioners from different health professions treating the same patient.

 

UPDATE:

I am sure the Chiropractor involved or the Chiropractic Association will proceed with defamation charges against the Paediatrician. As they would be within their rights.

This was quite a shoddy piece of sensationalist and alarmist journalism.

However once the lawyers are involved no one wins – only the lawyers.

It will do little forward cohesive interaction between the professions.