received 10/19/00

Univera Health Care
899 Main St.
Buffalo, NY 14203

Dear Dr. R.:

This lady found significant improvement through acupuncture treatments. Her neck feels better than when I saw her on 8/2/00. She does stand with her head jutted forward about 1cm from the trunk. She can forward flex the chin to the chest and extend 16cm. Rotation is allowed 70 degrees bilaterally. She can abduct bilaterally 180 degrees with troubles. There is tenderness over both lateral epicondytes of the elbows, in addiction to ongoing pain in her heel.

It has now been ten full months since this lady was involved in a motor vehicle crash. This lady has not worked full-time since the accident, however, was working on a part time basis throughout the spring, however, couldn’t perform her duties as a hairdresser.

She continues to have troubles. At this point I would not recommend surgical intervention. She is going to need ongoing non-operative care with the acupuncturist. My major concern is that the job as a hairdresser is that of a profession in which the hairdresser needs to stand for long periods of time, in addition to keeping their arms abducted and being able to support themselves with their trunk, thorax and neck musculature. I don’t believe that this lady is going to be able to return to this kind of work, particularly if she unable to tolerate her present symptoms at ten months after injury

Orthopedic& Spine Surgery