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2/14/2019 in Medical Conditions

The Cerebrum is the largest part of the brain.  Divided into two hemispheres, the outermost layer, the cerebral cortex, has four lobes:

  • Occipital used for processing visual information

  • Temporal, one close to each ear, used for auditory processing, but may also be involved in emotion, learning and pronunciation/ learning a new language.

  • Frontal used for solutions to complex tasks, voluntary movements, forming complete sentences when talking and personality traits

  • Parietal for general sensation and feeling


The Cerebellum is located behind the top part of the brain stem where the spinal cord meets the brain and is made up of two hemispheres.  It receives information from the sensory systems, spinal cord and other parts of the brain and then regulates motor movement.  The cerebellum coordinates voluntary movement such as balance, coordination, posture, and speech, resulting in smooth and balanced muscular activity.

The Brainstem lies underneath and behind the cerebellum.  It controls the flow of messages between the brain and the rest of the body.  The brainstem also controls basic bodily functions such as breathing, swallowing, heart rate, blood pressure, consciousness, and state of sleepiness.

Surveillance can be a good way to move a case to closure.  The success of the investigation depends on both the adjuster and the investigator’s ability to gather accurate and reliable information.  Arm your investigator with as much information as you can provide.  Here are some tips to assure effective surveillance:

  • Select an investigation company that has experienced investigators with a proven success record.   
  • Before the investigation begins, conduct a Social Security trace, ANI trace and social media check.  Make sure these findings are communicated to the investigator.
  • Start off with two full days of surveillance starting at 6:30AM.  Based on the results after two days, decide whether further time is warranted.
  • Always have surveillance conducted on days when the claimant has a medical appointment.

For every 6 million occupants in Low Speed Rear Impact Collisions: 

  • About 3 million will be injured (about the population size of South Carolina).
  • About 1.5 million will have chronic pain (about the population size of Nebraska).
  • About 300,000 of these become disabled usually due to pain (about the population size of Wyoming).
  • Nearly half of all chronic neck pain in America is due to car crashes—mostly Low Speed Rear Impact collisions. 
  • About 9% of all Americans suffer from chronic neck pain due to Low Speed Rear Impact Collisions. 
  • Children are at 2/3 the risk of adults.

Information provided by the Spine Research Institute of San Diego


While we all need to work and have goals set to move us forward in our careers, it is equally important for us to take care of ourselves.  Here are some tips for a health 2019: 

  1. Be thankful – Gratefulness feels good, but we don’t allow ourselves to feel it enough.  We have a lot to be thankful for as individuals and allowing ourselves to truly experience and express our thanks to others is a good feeling that can lower blood pressure, reduce depression.
  2. Commit to being physically fit – This doesn’t mean you have to join a health club and go on a full-blown diet.  Instead, park farther away from work or the mall and walk, take the stairs instead of the elevator, eat a salad for lunch instead of a burger.  Continuing to make better small choices will give you the confidence you need to make bigger changes toward a healthier life.  It doesn’t all have to come at once.
  3. Make quality sleep your priority – Establish a relaxing bedtime routine.  Make sure you get between 7 and 9 hours of sleep each night.  Go to bed and wake at the same time every day, regardless of work day or weekend.  Turn off all electronic devices at least 30 minutes prior to bedtime.  Make sure your sleeping environment is comfortable; lighting, temperature, noise level, etc.
  4. Strengthen social relationships Research shows that social relationships can have a significant impact on mental and physical health.  Quality relationships are more important than quantity.  Friends make life fun and engaging, giving us something to look forward to.
  5. Make someone else happy – The secret to our own happiness is making someone else happy.  
  6. Learn – Continued learning allows us to develop our knowledgebase, improve ourselves, try new experiences, and challenge ourselves.  It also keeps the brain active, engaged, and healthy.

The entire Medical Systems team joins in wishing you a New Year filled with joy and peace. 

Tarsal Tunnel Syndrome is to the foot and ankle as what carpal tunnel syndrome is to the wrist and hand.  Tarsal Tunnel Syndrome occurs when the posterior tibial nerve (running along the ankle and foot) becomes compressed or damaged, causing inflammation of the tarsal tunnel.  This condition results from prolonged walking, running, standing or exercising, traumatic injury, or no apparent reason. 

Often Tarsal Tunnel Syndrome responds well to conservative treatment.  With the goal of treatment being to reduce inflammation and pain, rest, ice, compression and elevation are often recommended along with the use of over-the-counter non-steroidal anti-inflammatory medications (acetaminophen or ibuprofen).  If this is not effective, injection therapy using corticosteroids and local anesthetics can be tried.  Orthopedic devices and corrective shoes may assist in reducing foot pressure.  Exercises learned in physical therapy can help reduce symptoms by stretching and strengthening connective tissues and mobilizing the tibial nerve and opening surrounding joint space reducing compression. 

Surgery can be performed for severe or chronic cases that do not respond to any other forms of treatment.  The procedure releases (or decompresses) the tarsal tunnel with a recovery period of 6 weeks up to several months.  Surgery is successful in about 50%-90% of cases.

Fortunately, tarsal tunnel syndrome is a rare disorder.



Medical Systems prides our reputation for accurate, reliable work product and works hard each and every day to make sure we’re earning it.  Providing you with honest, truthful, and accurate IMEs is our priority. 

This holiday season we are looking back with appreciation for your loyalty.  We value our relationship with you and look forward to working with you in the year to come.

The entire team at Medical Systems joins in wishing you a very Merry Christmas and a new year filled with peace, joy and success.


Christmas can be a very stressful time of year with cooking, shopping, baking, decorating, traveling and entertaining.  And what about the social interactions with relatives we would rather not see? 

Here are some tips to make your Christmas as stress-free as possible:

Plan Ahead

In early to mid-November, start making a list of the things you need to do for Christmas.  Prioritize your list and delegate tasks when possible.  Hint:  Keep your list in a place where you can reference it and build on it from year to year.

Shop Online

Shop from the comfort of your own home to save time.  Packages get delivered right to your door and you can even order many things gift wrapped for a nominal fee.

Complete Tasks Early

Start anything you can do parts of early and finish up closer to Christmas.  For example, mix cookie dough and freeze it until you’re ready to bake.  Start writing Christmas cards early – a few every day – until they are all done and then mail them all at once.  Doing partial tasks early cuts time off when you really need it.

Know When to Stop

Give yourself a deadline.  Decide when you will stop preparing and start enjoying.  Work hard to stick to this goal.

There are several areas of research that may prove successful; stem cell injections, a Collagen Meniscal Implant (CMI), and 3-D research.

In a clinical trial of stem cell injections for meniscal tears, only 15% of participants experienced an increase in meniscal tissue at one year following treatment.  This could be because without healthy cartilage to pad the bones that meet in the knee joint, the bones become battered and misshapen and a new meniscus can’t fix that damage.  So, it would make sense to try stem cell medicine on people with new injuries who do not have the damage to their bones.

The Collagen Meniscal Implant, a biological completely absorbable implant made from highly purified collagen with a porous structure showed some promise.  This device is attached arthroscopically to fill the void resulting for damaged or lost meniscal tissue and makes use of the body’s own ability to re-populate the structure with its own cells over time to regenerate the normal structure of the meniscus.  There is data showing benefit in chronic meniscal injuries for the right patient.

In a study successfully conducted on sheep, a meniscus was regenerated with a 3-D printer, infused with human growth factors that prompt the body to regenerate the lining on its own. It begins with MRI scans of the intact meniscus in the undamaged knee.  The scans are converted into a 3-D image which is used to drive a 3-D printer.  A scaffold in the exact shape of the meniscus down to a resolution of 10 microns (less than the width of a human hair) is produced within 30 minutes.  This research is preliminary but it demonstrates potential for meniscus regeneration.

However, the reality is at present there’s little that orthopedists can do to regenerate a torn knee meniscus.  Small tears can be sewn back in place, but larger tears have to be surgically removed which helps with pain and swelling, but leaves the knee without its natural shock absorber.  There are three viable options on the horizon, but they are still in the research stages and it could be years before they are offered to the general population.


At this time of Thanksgiving we at Medical Systems pause to count our many blessings: 

The freedoms we enjoy in this great country in which we live. 

Its opportunities for achievement. 

The friendship, confidence and loyalty you have shown in us. 

Our families, friends and co-workers.

For all of these things we are deeply thankful.  This Thanksgiving, please accept our sincere appreciation for the opportunity you have given us to work with you.  We are deeply thankful and extend to you our best wishes for a happy and healthy Thanksgiving,

Your friends at Medical Systems

The best way to obtain a good recorded statement is to have a predetermined process for planning and preparation of the interview.  Here are some tips to conduct a thorough interview:

  • Be a Good Listener – Thoroughly listen to what is being said, do not think about your next question or what you’re going to say next.  Clear your head and simply listen to what is being said.  You may pick up on new information that would otherwise not be communicated.
  • Standard Questions – These should be predetermined by insurance company protocol and based on the type of insurance coverage and injury.
  • Focus Questions – In advance of the interview, review all information available and prepare a list of questions that focus on the specific injury and how it occurred.
  • Flexibility – Be ready to take the interview in a different direction depending upon the answers to standard and focus questions. 

The success of the investigation depends on the adjuster’s ability to gather accurate and reliable information.

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