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Case Summaries of Patients Treated
The information below is a small sampling taken from files of thousands of actual patients who were treated by Dr. Hendler during their stay at the Mensana Clinic, which operated for thirty years in the Baltimore, Maryland area. Identifying information has been redacted due to doctor-patient confidentiality.
Case Summaries:
Case #1 - Patient Name: Mary Lou R - Ms. R. is a 39 year old white female, who had pain in the base of the head, top of the head, traps, and between the shoulder blades, following an auto accident March 2000. She stopped working after the accident, with a loss of income of $300 per week. More...

Prior to being seen in 2002, she was diagnosed with cervical sprain, and had 25 physician visits, X-rays, MRI, but no nerve blocks. Total expenses prior were $ 9,000, or about $4,500/year. She was seen for 2 visits at Pain Clinic, in Jan. 2002. While at our clinic, the doctors found that she did not have a cervical sprain, but that her pain was caused by occipital neuralgia, and a C3-4 disc with instability. She received occipital nerve blocks and she had 100% relief of her pain on a temporary basis. She was referred for an occipital neurectomy, which she had. Ms. R. was discharged from care on Feb. 27, 2002. Total charges for care provided by Pain Clinic were $ 1,166. The patient was sent for vascular flow studies, 3D-CT, flexion-extension X-rays, MRI, and EMG/NCV. Occipital neurectomies cost $ 4,500. The patient has now returned to work, per her referring physician. Had she not been accurately diagnosed and treated, ongoing expenses would have been about $4,500/year for another 20 years, or $90,000.

 

Case #2 - Patient Name: Richard R. - Richard R. a 53 year old real estate agent, was involved in a motor vehicle accident Sept 2003. He had trigger point injections between his shoulder blades, physical therapy, over 45 chiropractic visits, CT of the neck, and repair of two fractured molars from the accident, at a cost of $ 34,843 including follow-up care. He had not been able to work full-time for two years. More...

He came to Pain Clinic May of 2005 His long term disability payments were $ 2,000/month. While at Pain Clinic the patient received a series of facet blocks and root blocks as well as provocative discometry, 3D-CT, flexion-extension X-rays, EMG/NCV, and trigger point injections. He saw a thoracic surgeon, a neurosurgeon, an anesthesiologist, and an oral surgeon. He has received total relieve of his neck pain with a series of facet denervations C2-5, and is now back at work. Total charges for care provided by Pain Clinic were $13,725. Outside consultations and testing cost $ 10,860. Treatment costs were $12,300.

 

Case #3 - Patient Name:  Kari J. -  Kari J., age 23, was injured in a high school cheerleading accident on 1/2/92. After two years of misdiagnoses and inappropriate treatment her condition had deteriorated and she had accumulated $96,955.57 in accident related medical expenses. She was diagnosed with CRPS (RSD) More...
and treated with braces to stop her dystonia. She came to the Pain Clinic 5/17/94, and the treatment plan included a cervical fusion, nerve decompression on both upper extremities, and cervical and lumbar sympathectomies. Costs incurred for physician care and case management when converted to curent dollars were $27,722.16. The total charges for diagnostic testing, consultations and surgeries completed at the clinic's request were $63,788.08. Ms. J. is now married and working full-time. Prior to treatment at Pain Clinic, her annual medical expenses were averaging nearly $50,000.00 and were not providing any improvement. After completing the diagnostic testing and treatment process recommended by the Pain Clinic, Ms. J. no longer requires extensive medical attention.
Case #4 - Patient Name: Janis C. - Janis C., 39, a stock-broker, came to Pain Clinic with a prior diagnosis of Reflex Sympathetic Dystrophy of 18 months duration. She had received numerous sympathetic blocks prior to her admission. She was receiving Long Term Disability payments  More...
of $3,000 per month for a total of $54,000, and had spent over $110,000 of her own money on ineffective medical treatments.  After evaluation and testing at Pain Clinic, she was diagnosed with nerve entrapments of the common, deep and superficial peroneal nerves. She was referred for nerve decompression surgery, which was successful.
Costs for evaluation and treatment at Pain Clinic were $15,430. Additional testing completed outside the clinic was $2,367.  Costs for necessary surgery were $23,897.  After surgery on both legs she is now able to walk and even jog as she did before.  She has re-entered the job market, again as a stock broker. Given total projected cost estimates for ongoing work. comp. payments, long term disability, medical testing, medication, and physical therapy, expected savings until age 65 are shown below.

Referral Diagnosis:  

Complex Regional Pain Syndrome Type I (CRPS I)                                              (formerly called Reflex Sympathetic Dystrophy (RSD))

Pain Clinic Diagnoses:  

Entrapments of the superficial, deep and common  peroneal nerve

Pre-Clinic Expense:                            $  110,000
Pre-Pain Clinic Disability:                                  54,000
Projected Future Costs, disability
  without Pain Clinic intervention:                   936,000
Projected medical expenses                       230,000 
total expenses without Pain Clinic:            1,330,000
Cost of Pain Clinic:                                  15,430
Costs of outside treatment,
recommended by Pain Clinic:                          26,264
Total Pain Clinic expenses:                              41,694

Total projected savings:                      $ 1,288,306

Case #5 - Patient Name:  Deborah M.  - Deborah M. a 47 year old nurse with a BSN, was injured when a patient fell and pulled her to the ground, in 1986. She had an L5-S1 laminectomy and received only 3 days of relief. Over the years she had over 112 doctor visits,  More...
post-op MRI and CT, facet blocks under fluoroscopic control, 3 epidurals, and physical therapy. Estimated costs of these treatments was $ 47,500.  She has worked full-time despite her pain, but frequently missed days at work due to her pain. She was first seen at Pain Clinic June of 2003.  While at Pain Clinic the patient received a series of facet blocks and root blocks as well as provocative discometry, 3D-CT, bone scan, flexion-extension X-rays, EMG/NCV, and trigger point injections. She saw a thoracic surgeon, and a neurosurgeon. Lumbar facet denervations reduced her pain 75%. She has returned to work. Total charges for care provided by Pain Clinic were $15,384. Outside consultations and testing cost $ 15,450. Treatment costs were $ 4,500.


Referral Diagnosis:        Cervical sprain

Pain Clinic Diagnoses:   

C4-7 facet syndrome, C2-4 disc, with instability, C5-6 disc and radiculopathy, thoracic outlet syndrome, tempro-mandibular joint syndrome

Pre-Pain Clinic Expense:                                            $  47,500
Projected lost wage from missed
time without Pain Clinic intervention:                            28,000
Projected medical costs x 18 yrs.                               54,000
Total expenses without Pain Clinic:                            129,500
Cost of Pain Clinic:                                                15,384
Costs of tests and consults:                                        15,450
Costs of facet denervations,
recommended by Pain Clinic:                                          5,300
Total Pain Clinic expenses:                                            36,134
Total projected savings: $   93,366

Case #6 - Patient Name: Wanda K. -  Wanda K. a 52 year old transcriptionist for a physician, had a slow, progressive onset to her pain over a 15 year period of time. She was tested for Lyme's disease, which was negative, but More...
not tested for gout nor arthritis. She was told she had fibromyalgia, and had 39 chiropractic treatments. Over the years she had over 90 doctor visits, MRI and CT, and physical therapy. Estimated costs of these treatments was $ 48,500.  She has worked full-time despite her pain, but frequently missed days at work due to her pain. She was evaluated at Pain Clinic May of 2004.  While at Pain Clinic the patient received a series of facet blocks and root blocks as well as provocative discometry, 3D-CT, bone scan, flexion-extension X-rays, EMG/NCV, and trigger point injections. She saw a thoracic surgeon, and a neurosurgeon. She was referred for an anterior cervical fusion, lumbar discectomy and fusion and thoracic outlet surgery. She continues to work. Total charges for care provided by Pain Clinic were $ 4,609. Outside consultations and testing cost $ 12,100. Outside surgery costs were $ 84,000.

Referral Diagnosis:                   Fibromyalgia

Pain Clinic Diagnoses      

C4-7 facet syndrome, C5-7 Disc, instability and radiculopathy, L5-S1 discectomy and fusion, bilateral Thoracic outlet syndrome

Case #7 - Patient Name: Margarita C. -  Margarita C. a 44 year old professional had sinus surgery in 2001, and subsequently developed pain in her nose, cheek, forehead and temple. She had subsequent surgical evaluations, and 2 more instrumentations. She finally was "diagnosed" More...
with RSD (CRPS I). She continued to work despite her pain. Estimated medical cost prior to her visits to Pain Clinic were $34,500. She was evaluated by the professor and chairman of plastic surgery at Johns Hopkins Hospital, and referred to Pain Clinic for consultation.  While at Pain Clinic the patient received an evaluation and neurometer testing. She was referred back to the surgeon for surgery, and had 80% relief post-operatively. Total charges for care provided by Pain Clinic were $ 1,200. Surgery costs were $12,000.

Referral Diagnosis:            Complex Regional Pain Syndrome Type I (CRPS I)
(formerly called Reflex Sympathetic Dystrophy (RSD))

Pain Clinic Diagnoses:      

Entrapment of sensory branch of Vii (palatal branch of trigeminal nerve)
Case #8 - Patient Name: Fred W.  -  Mr. W. is 53 years old, with pain following a biopsy of his left first toe on January 14, 1993. Prior to being seen at the Pain Clinic, he was diagnosed with Reflex Sympathetic Dystrophy (RSD), for which he received 3 sympathetic blocks, and More...
ongoing physical therapy. Total expenses prior to Pain Clinic were $14,570, or about $5,000/year. He was first seen at the Pain Clinic on May 13, 1996. While at Pain Clinic, he has peripheral nerve blocks. It was found that he did not have RSD, but that his pain was caused by entrapment of the superficial peroneal nerve, as well as a cyst on the distal metatarsal bone one.

Mr. W. was discharged from care on June 19, 1996. Total charges for care provided by Pain Clinic were $9,535. Surgery cost $6,500. The patient has now returned to school and is pursuing an undergraduate degree. Had he not been accurately diagnosed and treated, ongoing expenses would have been about $5,000/year for another 20 years, or $100,000. 

Referral Diagnosis:   Complex Regional Pain Syndrome Type I (CRPS I)

                                                    (formerly called Reflex Sympathetic Dystrophy (RSD))

Pain Clinic Diagnoses       Entrapment of the superficial peroneal nerve

                                                     Cyst on distal metatarsal.

Case #9 - Patient Name: Marty O.  -  Marty O., age 45, a computer consultant, was involved in two motor vehicle accidents and a slip and fall. The first accident occurred in 1993. She had both a cervical and lumbar fusion for a total cost of $126,521 including follow-up care. More...
She had not been able to work full-time for two years when she first came to Pain Clinic on February 25, 1997. Her long term disability payments were $3,000/month, or $720,000 'til age 65.

While at the Pain Clinic, she had provocative discogram, facet blocks, root blocks, bone scan, gallium scan, Indium 111 scan, 3D-CT, arthrograms, vascular flow studies, and nerve blocks.

Total charges for care provided by Pain Clinic were $13,701. Although she has had previous failed surgeries, after lumbar and cervical fusions recommended by Pain Clinic at a cost of $89,560. she was able to return to work on a full-time basis in September of 1998, earning in excess of $120,000/year.

 

Referral Diagnosis:   Failed Back syndrome, "whiplash" – cervical sprain

Pain Clinic Diagnoses:      

1.    Wedge compression fracture T12
2.    LI wedge compression fracture
3.    C6-7 disc bulge and spondylosis
4.    LS-SI fibrosis
5.    L4-5 disc herniation
6.    Thoracic outlet syndrome bilaterally
7.    Disrupted disc L3-51
8.    Disrupted disc L4-5
9.    Disrupted disc C4-5
10.  Disrupted disc C6-7
11.  Disrupted disc C3-4
12.  C4-7 facet syndrome
13.  Left lateral meniscus tear
14,  Avascular necrosis of the hips bilaterally
15.  Left sided tempro-mandibular joint syndrome
16.  Severe reactive depression

Case #10 - Patient Name: Linda K.  -  Linda K., age 52,  was injured in a motor vehicle accident in October of 1996.  Three days after the accident she returned to work, but was only able to tolerate working for five additional days, before leaving work, as a supervisor in the post office. More...
She received conservative care, P.T., medication, and some minimal testing at a cost of $15,980.She began receiving private disability payments of $1600 per month, or $249,600, over a 13 year course. Projected medical expenses over 13 years would have been $6,000/year for medication, doctors visits, and P.T., or $78,000

While at the Pain Clinic she had flexion extension X-rays with obliques, 3D-CT, provocative discograms, vascular flow studies, and peripheral nerve blocks. Her total charges were $11,074.  She had one surgery to release the right radial and ulnar nerves and a second surgery to release nerves in the left arm, for total costs of surgery and follow-up care of $14,590.  After receiving disability payments for 15 months, she returned to work on March 1, 1998, at her same position in an office.

Referral Diagnosis:  Lumbar strain, Cervical sprain

Pain Clinic Diagnoses: 

1.         C5-6 spondylosis with associated cord compression
2.        Retrolysthesis C5 on C6
3.        Instability C5-6
4.        Disc space narrowing at L5-51
5.        Thoracic outlet syndrome bilaterally
6.        Bilateral ulnar nerve entrapment
7.        Right radial nerve entrapment
8.        Right carpal tunnel syndrome



Case # 11- Patient Name: Minerva R. -  Minerva R., age 35, was injured In a motor vehicle accident on 8/14/93.  She continued to work for some time following the accident.  She had two TMJ surgeries and facet rhizotomies in the cervical and lumbar spine. More...
In August of 1997 she stopped working because she could no longer tolerate her pain.  She received $125 per week from the auto carrier and $250 per week from her employer. Medical expenses from the date of her injury to the time she was seen at the Pain Clinic, were in excess of $27,000.

While at the Pain Clinic, Minerva R. received provocative discograms, flexion-extension X-rays, a trial with a body jacket, and facet denervations. Total charges for care provided at Pain Clinic were $20,548.00. Ms. R. underwent an anterior cervical fusion as recommended by the clinic on June 1, 1998, at a total cost of $47,879  Exactly four months later the Ms. R. returned to her job.

 
 
AND THERE ARE MORE ...