Question
Dr. Leatherman,

Thankyou very much for the information.  I hope you don't mind me following up some more.  I thought I'd post a little more information yet, to get some more of your thoughts and insight into my problem.

The medical doctors I seen following this episode never mentioned that whiplash may have occured.  And to tell you the truth, I may have thought that a lot of the symptoms such as dry mouth, etc. were from drinking too much, but re-hydrating did not necessarily help.  I believe they mis-diagnosed a lot of the symptoms as being from acid reflux, even though no meds ever helped.  

Regarding getting an MRI done, I guess some of these may be indications, and some may not?

- the headaches (as you mentioned).
- I actually have been getting puffiness and tingling in my fingers lately.
- tightness or numbish feeling in the area of the face around the mouth.
- I do get neck aching and sometimes a burning feeling in the back near the base of my skull (often in morning upon awaking).
- I can turn my neck to one side much farther than to the other.  I also have a bit of "wryneck" from what I understand and one shoulder is a bit lower.
- other symptoms present daily such as nausea (usually from within head), dry mucousy mouth, bad teeth grinding, tinnitus, difficulty concentrating, dry-heaving, dyspahgia (throat swelling), shortness of breath, and a weird habit of air swallowing/movement along with the bruxism.
- one side of my face even seems a bit puffier than the other according to others.
- having an odd-feeling area in the back of my neck (extrasensitive lump to the right of center). This lump seems to pop around a bit or move slightly when pressure applied with finger.
- basically it feels like someone hit me on the back of the head with a stick a lot of the time! and it almost feels like a lot of the symptoms originate in the area at the base of my skull or at the top of my neck.  I often get a knotted feeling here along with the dry sick feeling I get in my throat.

I guess before I go forth with a type of treatment, I would like some "proof" of what the problem is, otherwise it is difficult to really know what requires fixing.  

So, some more questions I have are:

But I suppose that having the problem area show up on a test will vary by what is wrong and what type of testing is being done?

Based on the indications is there any other types of testing that may be useful to me?

Can a whiplash type injury result in dry mouth and lips over a long period of time?

Thanks again very much...

Kevin



Followup To

Question -
Dr. Leatherman,

Thanks,
Some additional info..

Bloodwork, endoscopy/ colonoscopy, barium swallow - upper GI , ultrasound, sinus CT scan (all normal). Had fundop. surgery on my esophagal valve  as they thought the problem was reflux -  no change.

Neck x-ray was normal to MD.  It had good curvature (chiro) however there may have been a slight discrepancy between the right and left  on the frontal shot past the mouth (I don't know exactly what or how relevant - something to do with openings or gaps). I plan on going for an MRI (C-spine?) in the near future.

He used a type of temperature gage to check my neck and it showed heat at the very top of my neck.


Followup To

Question -
About three years ago, I was in an altercation while at a bar - basically I was physically assaulted and I was intoxicated at the time (which may or may not have anything to do with this story).  Anyway, I got sick (vomitted) that night and I ended up with a sore neck for about two or three weeks after.  After this incident I ended up feeling very poorly (nauseated and general unwell feeling) and upon recent reading, I realize that I had many of the symptoms of whiplash - nausea, buzzing in head, dry mouth, stiff neck etc.  

Well three years later, I still have these symptoms and am dealing with chronic unexplained illness and weight loss.  In addition, now I get headaches, bad bruxism, face numbness, dry-heaving, and some tingling and puffiness in my fingers.  I still have the tinnitus, nausea, and dry mouth and esophagus as well.  None of this can be explained through extensive medical testing. I don't have a lot of neck pain, but have noticed an odd feeling bump on the right side of my spine right at the base of my skull - it doesn't feel well when pressed and seems out of place, if it is part of my spine.  It almost feels numb in this area as well - like my scalp is shrinking when pressure is applied.  Does this sound like something here may be causing my problems/sickness, possibly a result of the original incident 3 years ago?  Thanks for your input.

Kevin

Answer -
Dear Kevin,  

Answer
Kevin,

If you want proof of injury, whiplash injury is very difficult to document after this long a period of time.  The best way to document would have been with cervical spine x-rays specifically a lateral, flexion, and extension x-rays soon after the injury.  The key that you would be looking for is an alteration to the normal cervical curve, and ligament instability visualized on the flexion/extension views.  That being said, new x-rays will still show any progression of degeneration, as well as the spinal structure you have today which may very well be worse than a few years ago.  In addition, the dry mouth etc... can be a sympton of whiplash, but this is not a common symptom.  The upper neck tightness, neck pain and well as headaches are the most common symptoms we see after whiplash trauma.  Numbess and tingling into the hands and fingers is also common.

Concerning the MRI, again the headaches, and the tingling and numbness are an indication, but the facial symptomatology you have described is more likely from a cranial nerve injury which will not be documented on a cervical MRI. It may show up on an MRI of the brain, but often these injuries are too small to show on conventional diagnostic tests.  Whiplash documentation is mostly from case history, mechanism of injury, clinical findings, and some diagnostic findings.  

Unfortunately, most medical professionals don't know anything about whiplash injury, and it is overlooked a majority of the time!  Not to mention the fact that insurance companies always downplay certain whiplash documented injuries.  Whiplash associated disorders are frequently written off as false claims which makes it even harder for proper care to be administered.  This is why I want you to look over the Spine Research Institute of San Diego's website thoroughly and find a Chiropractic Physician locally to help you.  I truely believe that upper cervical adjustments and myofascial work will improve your symptoms.  I wish you were local so I could give you a proper examination and review your previous radiographs.

In addition the wryneck that you speak of and the lower shoulder contribute to the ongoing problems.  Whenever you have a biomechanical change in the body such as abnormal movement patterns, there is going to be additional pain, muscle spasm, and degeneration.  It is the same as having your automobile tires unaligned, they will degenerate and wear out quickly!  These issues need to be addressed with active stretching and range of motion exercises as well as possible structural rehab if needed, (www.idealspine.com).

Now I am a very medially oriented Chiropractor, and I refer to the medical physicians in my community on a weekly basis, but in your case all the medical diagnostic work-ups have fallen short at identifying a problem.  You say the doctors have written you off and now three years later you still have ongoing symptoms.  I think it is time you tried a different route, don't give up!!  In addition, I would seriously think about the nutritional considerations we talked about and discuss them more thoroughly with a local professional who has post-graduate training in biochemistry and nutrition.

Keep me posted.
Dr. J. Shawn Leatherman