Announcement from Andrew J. Holman, MD
After 21 years, I retired and closed my Renton, WA, office in June, 2013. However, patients continue to contact me for assistance. I am working out details to be available for a new kind of medical visit: a research-oriented patient encounter.
In addition to a providing a typical history/ physical exam and written recommendations, I encourage patients to bring complex questions and even publications to address. Not all patients wish to discuss the nuances of current research affecting their condition, but this encounter is designed to review physiology as well as cause and effect (as best we understand it).
This is a cash practice (cash, credit card, checks accepted at time of service) with a deposit required for consultations. The rate is $300/hour for consultations lasting an hour. Follow-up visits are $100 for up to 30 minutes. I will have a sliding scale for low income patients and offer free visits for indigent patients as able. All proceeds go to funding further research, but are regrettably not tax deductable.
My areas of interest and expertise include benign hypermobility syndrome, unexplained widespread pain, fibromylagia and how the autonomic nervous system influences autoimmune disease expression and treatment outcomes. Recommendations will be sent to referring clinicians to implement ongoing care plans.
If you have a pain puzzle and have seen 'everyone' unsuccessfully, I look forward to meeting you. No one can guarantee results, but I will apply a research-oriented approach to your situation in an attempt to sort out what's actually wrong and determine how to address it.
More information can be found at www.PositionalCordCompression.com and by searching 'Holman AJ' for my publications at http://www.ncbi.nlm.nih.gov/pubmed
Finally, some patients may find that my invoice, fully or in part, may be reimbursed by their insurance, but they should check with their carrier in advance.
This website is designed for patients and families interested in rheumatology research. Essentially, rheumatologists are immunologists trying to reverse autoimmune diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), etc. Some rheumatologists also study and treat fibromyalgia (FM) The most common types of arthritis are degenerative osteoarthritis and mechanical back pain usually addressed by other specialists such as orthopedists, physiatrists, chiropractors, osteopaths and neurosurgeons.
Rheumatoid Arthritis (RA) affects 2-3 million Americans and is the most common form of connective tissue disease. It causes inflammation of synovial tissue lining the joints. This inflammation can be so severe that it damages the cartilage, bone and connective tissue. Occasionally RA can affect the skin, muscles and internal organs. Thankfully, new advances in treatment have occurred over the last five years, and exciting research continues.
Fibromyalgia is not an autoimmune disease. Nevertheless, it can be just as disabling. It is associated with widespread or generalized muscle pain and profound fatigue for 6-10 million Americans. Diagnosis is by a history of pain located in all four quadrants of the body for at least 3 months and the presence of at least 11 of 18 "tender points". Fibromyalgia is strongly associated with stage 4 sleep deprivation caused by an overactive sympathetic nervous system. Fibromyalgia can co-exist with any disorder painful enough to disturb sleep quality, including positional cervical myelopathy. Other illnesses such as thyroid disorders, cancer and neurological diseases can mimic fibromyalgia. A thorough evaluation to determine the cause of pain is essential before your caregiver can begin to treat it effectively.
PC3 or positional cervical cord compression has been found in 56-71% of patients with FM and in 85% of patients with chronic widespread pain (CWP). Ongoing research here continues to investigate its possible association with other conditions, such as migraine and whiplash. Identification of this entity significantly influences treatment options and outcome. Fortunately, 85% of the >3000 patients identified at Pacific Rheumatology Associates dating back to 2003 have been managed without requiring surgery. An innovative PT program has been developed locally and the flexion-extension C-spine MRI can be done anywhere. More information can be found at:
Please have a look. Thank you.