Stay on again, "The most recent evidence suggests that it is not. Although the same evidence suggests that the patient may be entering the chiropractic office for neck pain/headaches or other symptoms that may in fact be a spontaneous dissection of the vertebral artery. If we think this is happening to you, you will be immediately referred to emergency services. In the last dozen years," so we keep careful track ... Pretty busy, "We have seen two people that we think have fallen into this category. Our assessment was that they were walking in our office with the potential of a spontaneous dissection of their vertebral artery." Some of things that I stress on my 12-Course Student Class, just before they graduate, is that the biggest mistake you can make is being afraid to call 9-1-1 when it is in the patients best interests to call 9-1-1. If you think it's in the best interest, call 9-1-1. Your safety is less important than that of the patient. If you do everything right, then it is better off for you, believe it or not. We've had two of these. One of them, it didn't look like it was an immediate emergency, so we had their spouse who drove them to the ER. The second was more scary. We thought that this is one in progression and we didn't even wait for the emergency personnel drive them to an ER. The personnel, the emergency medical personnel in our area, they think that there's no such thing as a smart chiropractor. None of them think, "Oh my gosh, there's some chiropractor that actually understands it and gets it." Now, this is not something that's happening all the time. It is extremely rare. In this particular case, when you send them to the ER like that, is it overkill? It's absolutely overkill unless it's not. If you're on, if you get it, so how'd we do? 50%, so half of them. One was in a spontaneous dissection, the other it was just something else, bt basically, it raised people's opinion of our abilities in the community because we were willing to actually get people to go to the ER as a consequence of the presentation they were having. Again, the last sentence in that paragraph ... It's two paragraphs. The last sentence is, "If we think this is happening to you," meaning a spontaneous dissection, "You will be immediately referred to emergency services." Second paragraph, "Anecdotal stories suggest that chiropractic adjustments may be associated with strokes that arise from the vertebral artery. This is because the vertebral artery is actually found inside the neck vertebrae. The adjustment that is suggested to increase the strain on the vertebral is called the extension rotation thrust atlas adjustment. We do not do this type of adjustment on patients. Other types of neck adjustments may also be potentially related to vertebral artery stroke, but no one is certain. It is estimated that the incidents of this type of stroke is on per every 3,000,000 per neck adjustments." Stop. That references the Paul Carey Study from the '90s that came out of Canada. Okay, go back on, "It is estimated that one per 3,000,000 ... This means that an average chiropractor would have to be in practice for hundreds of years before they would be statistically associated with a single patient stroke." That's my stroke section. Stu, I know you know so much more about this than me, do you have anything you want to add or take away?
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