Physical Therapist – Sydney Severance

A statement by Susan Chalaela- Physical Therapist, Charleston, SC:

The upright dynamic weight bearing MRI has been used in medicine for about 15 years. There are pathologies that cannot be seen in traditional spine MRIs but can be detected by the upright MRI. The upright dynamic MRI is the most crucial assessment for diagnosing spinal instability. Many times patients are misdiagnosed due to traditional supine MRI. Many patients often are misdiagnosed and mistreated at a number of other facilities prior to coming to Charleston to be seen by specialists with knowledge in this field. Presently the nearest MRI is several hours away from MUSC which has caused a great deal of hardship for the patients as well as our team. Even then, the upright MRI is not performed to the physician’s specifications, resulting in misdiagnosis and or the need for it to be repeated where the patient may have to pay out of pocket. Many patients, due to extreme hardship in their disabling neurological symptoms and or extreme financial hardship, are unable to follow up and continue to suffer without correct treatment. Another issue worth mentioning is delayed scheduling resulting in again extreme hardship financially and progression of symptoms increasing the risk of complications and poorer outcomes.

I am a physical therapist here in Charleston, SC who specializes in hypermobility disorders including Ehlers Danlos Syndrome and Cranial Cervical Instability and Cervical Instability. I started my practice in 2017 because of the invaluable need for my niche specialty and clinic. There is a lack of knowledge with physical therapists and the medical community, in understanding this disorder. Many of us will tell you that we either had not heard of this in physical therapy school or medical school or had learned about it by a couple of sentences mentioned in a textbook. I have been working hard over the past 4+ years to better understand these disorders to improve treatment for these patients, as well as develop a formal education program for practitioners to understand how to work with people with hypermobility and instabilities within their joints.

My practice has grown to treat patients from all over the country and more recently the world is searching for answers to their unexplained symptoms which are extremely debilitating at times and many are left bedbound. I refer many patients to MUSC to see specialists in this field. Once seen by them, many if not all require dynamic imaging including an upright cervical flexion/extension MRI, of which these patients must travel several more hours to obtain this imaging for answers. Many of these patients are very sick with debilitating neurological symptoms and find it difficult to travel, occasionally needing Angel Flights or medical flights in extenuating circumstances. Some travel by RV from across the country, due to being bed-bound and the inability to be upright. All of this makes it difficult if not near impossible to travel, especially if they do not have the financial means to do so.

It would be of extreme value for MUSC to have this very valuable imaging available to these patients to arrive at quicker diagnosis allowing for a sooner treatment plan with less financial, emotional/psychological, and physical hardship on these patients. It will allow the process to run smoother with less time and money spent on diagnosing these patients and making a medical plan. If we had this imaging, many of these patients would have hope with less feeling of hopelessness due to the extensive process of time, money, and travel to get answers making it more possible for many to come here for answers. We are understanding more about hypermobility as a whole and as medical practitioners learn about it, we will have more patients diagnosed and due to the power of social media will be heading here to Charleston to get help and answers to their misunderstood neurological symptoms. We are seeing more and more patients with a hypermobility disorder who are finding us here in Charleston, and meanwhile, there are only a few medical practitioners who understand this disorder. The cell phone and computer industry is growing significantly and the younger generation is developing with spine abnormalities secondary to the evolution of the human race. Therefore, biomechanically our requirements and undue stresses on our joint alignment are causing damage to our nervous system, needing an improved understanding of how to protect those at a younger age.

A statement by Susan Chalaela- Physical Therapist, Charleston, SC:

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