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Hit from behind and neck injury

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On April 2 2012 I was a passenger during work hours in a Pajero 4WD vehicle. The Vehicle whilst stationary waiting to turn, was hit from behind by another 4WD with enough force to move the car I was a passenger in about a metre over to the opposite side of the road. The car was subsequently written off.
As a passenger in the vehicle at point of impact my head was turned toward the driver as he talked, I was removed by around 4 ambulance officers from the vehicle and was taken to John Hunter Hospital with suspected broken neck. The only Xray taken of the neck was during this time, a CT scan I think.
For the remainder of 2012 I had allot of physiotherapy and massage as dual therapy Anti inflammatory and pain relief prescription drugs, Attended Anytime Fitness regularly - but rather than project myself into a negative attitude and I could have quite easily played on workers compensation, I returned to work without losing much time at all attending some sessions in my own time. I really enjoy the job I do.
I again was hit from behind in another accident whilst stationary during work hours at traffic lights this time as driving, but appeared not to have had anymore injury, just prior to going on holiday to the USA. Before my departure I saw WorkCover Doctor who prescribed me anti-inflammatory and pain medication for the trip, in case I needed it and suggested I maybe get a massage whilst on holiday if required.
I attended a one off massage session at the Waikiki international market place and saw multi-skilled therapist who thought she may be able to fix my neck area up. This she did after one massage therapy session. I returned home feeling allot better.
I had been in contact with Insurance company in regard to getting a MRI scan done on the neck area, which was approved by them for me if the Doctor required it. I then saw Workcover Doctor on 15 November 2012, told her of my experience and how much I was feeling better, but that i still had a dull ache on the right side of the back of my skull, which the Workcover Doctor gave me no answer for.
I also suggested that I get an MRI done just to put a mark on wear my recovery was up to, but was told that it wouldn’t show up soft tissue damage, and that under workers compensation I was covered virtually for ever and a day as a liability to the company should it flare up.
During the whole year I made it clear I was not looking for a claim just to get back to normal self , and thinking that I was going to be looked after at my work environment if aspects associated with the injury did flair up.
2013 Throughout the year I was on/ off over the counter 15mg Codeine maybe One to Two days a week this self managed therapy was enough for me to keep going and push through the year. I didn’t see WorkCover Doctor till December(Paid for out of my own pocket) after the removal of coincidentally My Left Thyroid. (The passenger side)
UNDER OUR WORKCOVER POLICIES ANY INJURY OR CHANGE TO THE AREA MUST BE REPORTED.
It was during this visit I was told that changes under the workers compensation were made by government and because I haven’t played the workers compensation game and attended the doctors surgery I was virtually not covered.
I had seen my own Doctor over the Thyroid swelling as I thought it was separate issue. I believe the accident played a contributing factor to the thyroid problem.
I was operated on as the swelling was pushing against my trachea.
I had a goiter, people live with goiters un-operated on, and the Thyroid had swollen quite rapidly. After the removal of the Thyroid, the dull ache on the right side of the back of the head had gone. how much of a coincidence was that? The Specialist on her first visit to me was concerned and said she wasn't sure if it required to be removed?
I asked if the thyroid may have stirred up as a result of the car accident and the seatbelt. My doctor says no but they cannot explain questions in regards to old bleeding, new bleeding, or the swelling or why it was swollen.
I have received defensive treatment from both the specialist and My own doctor. I do believe it has helped and am not sure why they are so defensive. I do believe they have helped.
The Thyroid was sent away for a biopsy:- attached report:
As far as I am concerned the Thyroid did cause me discomfort, I am not on on going medication BUT the aches on my left hand side back of neck /shoulder to neck extending from mid shoulder blade to the back of the head have returned to a point of pain.

I went and saw my doctor again over the pains in the neck, told him that in march/april 2013 and again in december 2013 I had two attacks of electric shock, so this is once before the thyroid removal and once afterward. it was from the neck down both sides/can't remember if tingling was more on one than the other side, but it happened neck to fingers down arms and feet and toes… both lasting less than several minutes.. They were the only two atticks like that.
He does not want to give me an MRI or continue and examination. I want to find the cause once and for all.
He said if I went to another doctor and told him i had electric shock he would tread me for anxiety. Yep I probably am getting stressed but more ticked off putting up with pain./symptoms.
------------
My symptoms are usually always the same leading back to the neck area, but this morning I have like a tightness down the whole area mid shoulder to sore central neck and occasional hard to describe like a missed step all left hand side..this had happened a few times but i haven't said anything to anyone about it because i didn't think it much.. noting everything now i know I'm on my own looking after my injury.
SO IT BRINGS ME TO THESE QUESTIONS!!!
I am planning to go to another Doctor - I don't know why my doctor has gone strange. I need to have this pain fixed or find out once and for all what the problem is.
I have had enough, its time to find a cause and treat the cause not the symptoms.
Q. Is it possible the thyroid was caused or reacted because of the motor vehicle accident?
Q. Should I have been given an MRI? at ACCIDENT or when I asked for it? If yes I will take this information back to my Workers comp doctor.
TO MY NEW DOCTOR I PLAN TO SEE what do I ask him.
Q. Regardless of previous question- I want to get to cause Do I need an MRI? if so what radiation level?
Q. what do you think may be causing my pain?, from my research I had come up similar to the the "brachial nerve".
it seems my head/neck was hit was similar to that in Wikipedea brachial nerve motor bike, although I was in a car.
What are / would new doctor be really looking for, i am only guessing.
As I said i am paying for this myself so I need to find a cause, not a symptom.

Category: Internal Medicine Specialist

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Hello,

Thank you for choosing DoctorSpring.

I have gone through your medical history.
Let me answer your specific queries.

1. No, it cannot be said that the thyroid swelling was due to the accident (from the biopsy report). But the biopsy do show evidence of old haemorrhage. (bleeding). So one of the injury had caused a minor bleed in the thyroid. BUT that bleed cannot be ascertained as the cause for the swelling.

2. You should have given a CT Scan of the neck at the time of injuries and when you asked for it. (not MRI). This is because MRI is an inferior investigation for the neck region for assessing a bony injury. Bony injury is the major concern here (especially since you have a electrical shock like sensation). MRI would not have diagnosed this and what ever MRI could have picked up (like soft tissue changes , swelling) would not influence the treatment.

3. It is better if your new Doctor requests for a CT neck and Ultrasound of the neck. It could be followed up by an MRI to visualise the soft tissue, and to rule out any disc bulge. If it was just a case of neck pain an MRI could have been a good option. But since there is a history of trauma a bony injury has to be ruled out first by a CT>

4. The cause of the pain could be a pinched nerve in the neck (from an injury to the neck. This can be tested clinically by a neurological examination and confirmed by testing. If the suspicion is high

Hope this helps
Feel free to ask followups
Thank you


Patient replied :

Thankyou - I attended the new doctor and without hesitation gave me a MRI which was never done.
still awaiting results from a few days ago, but it seems to show, and he said he is not an expert reader, that the MRI shows a bulge disc in the area of concern, the cord appeared from his limited knowledge good, but more discs had deteriorated. He said he would leave his next attack on what to do after an expert sends him a report. This was two days ago, and still waiting for that report.
Its a pity I couldn't get another specialist to read the scans for an in-depth report.

I know i have paid for the service but a really big thankyou.


Hello,

Glad that the MRI report has not shown something very serious. A disc bulge is very much manageable. If you have the report or few slides you can share it here. I can get you an expert opinion on that.

Thank you


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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