CESI, how high
Started by DOctorJay
Pity that lead migrated.
Meet the Doctor | V.K. Puppala | Comprehensive Spine & Pain
Dr. V.K. Puppala, a double-board certified Atlanta pain specialist, is the founder and medical director of Comprehensive Spine & Pain.comprehensivespinepain.com
1 doc has 7 offices
View attachment 352364
Edit: Wow, that's on his front page! Also goes to show that board certification doesn't mean a damn thing.
Further proof patients will agree to just about anything as long as their opioids are refilled…
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Building a bigger case through medical charges. Going for the millions on settlement.
Can't answer your direct Q but I will say there have times where I wanted to do just that but didn't.
Acute HNP with red hot leg pain needs > 1 ESI in most cases. I have had pts follow up 1 week after the first ESI and gotten their second very quickly, but I sort of wish I could just do one on Monday and Friday of the same week.
Agree, but those who were advocating series were doing them despite improvement from one and not having adequate discussion about other methods of management. It is partly that dogmatic practice pattern that has landed all our us in our current predicament of declining reimbursement year over year and having to decipher what Cms actually wants us yo do to get paid..
Long time lurker here, I heard about this Atlanta doc couple years ago while I was in fellowship.
WhoaLong time lurker here, I heard about this Atlanta doc couple years ago while I was in fellowship.
What in the everloving phuckLong time lurker here, I heard about this Atlanta doc couple years ago while I was in fellowship.
Welp, that completes the psychological profile
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If you guys haven’t seen this Pupalla guy’s insta page you really should. I mean he did a 5 level cervical perc disc on a patient! Wtf…you honestly have to be on a Dr. Death level to consider something like that. He apparently does a ton of cervical perc disks. I’m really curious how many complications he’s had
One particular photo of a 3 level kypho he posted looked like only one level was fractured. It’s all very concerning
One particular photo of a 3 level kypho he posted looked like only one level was fractured. It’s all very concerning
i think you are thinking of someone else.
at least not in the 13 + pages of past posts (he passed 2 years ago)
this is right next to a picture of disgraced former HHS secretary tom price.
i know you shouldn't judge a book by its cover, but this guy just looks like a cheesedick
Isn't gorback now Mr M? He's barely on here any more
he'll pop on early few months to tell us all how stupid we are. but yes, thats him
Analgesia108
Full Member
CLO @ 50 degrees with 25G Quincke tip - does this seem epidural?
Looks posterior to me
Posterior. Collimated views would tield better pics and more accuracy.
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agreed, it seems posterior.
it also seems you are scattering radiation to the wind and the open space behind a persons spine. that radiation is bouncing around in that room before it dissipates.
move the c-arm down a little caudally and inferiorly to focus just on the spine at C7, collimate down to a softball size, use low dose, and you will get a better picture and a lot less radiation.
it also seems you are scattering radiation to the wind and the open space behind a persons spine. that radiation is bouncing around in that room before it dissipates.
move the c-arm down a little caudally and inferiorly to focus just on the spine at C7, collimate down to a softball size, use low dose, and you will get a better picture and a lot less radiation.
Posterior. When in doubt grab a lateral. It’s not much use for getting the needle in but once you’ve injected the contrast you can usually see a nice clear posterior epidural stripe even if the CLO is unclear. Agree with comments Re: collimation as well.
D
deleted875186
Posterior, that line going from anterior upper lamina to posterior lower lamina is typical spread when your just posterior and think you get a false loss. Put stylet back in to get good view of needle tip, columinate in, check AP to make sure your still under contra lateral lamina. I don’t typically do a lateral in cervical spine for ESI because the contra lateral is always a superior view. Advance another 1mm and your probably epidural.
