Chiarians Unite

Paying it forward ... One family at a time!

PATIENT REGISTRY *NEW*

ARE YOU SICK AND TIRED OF BEING SICK AND TIRED?  We, as a GLOBAL CHIARIAN COMMUNITY, need to ASK for change otherwise we will get what we've always got ... Little understanding in and out of the medical community ... Which translates, at times, to out-dated care, or at the very worst, wrong care or no care at all!

Currently there are no real numbers of how many people are currently afflicted with Chiari, Syringomyelia, etc.  Each group (medical, government, etc) we spoke with wanted to know the current count for which we had no concrete answers. Numbers of afflicted help them to determine NEED.

Chiarians Unite is creating a database of Chiarians, Syringomyelians, etc. to prove the need for change.  With this information, we intend on involving the National Institutes of Health (NIH), National Organization for Rare Disorders (NORD), and other officials who can aid us in our desire to create change and understanding regarding Chiari, Syringomyelia, Hereditary Disorders of the Connective Tissue, Pseudotumor Cerebri, etc. 

We need to request further understanding in the area of Chiari and Related Disorders.   Neurologists, neurosurgeons, radiologists, radiologist's tech support, nurses, PCPs, pediatricians, optometrists, ophthalmologists, the list goes on and on, need to seek out new information regarding:  new understanding about Chiari; the length and width of Chiari redefined; the importance of correct diagnosis; myriad of other related conditions; new surgical techniques; etc.

Chiarians Unite is also preparing a proposal to seek cooperation, and then sponsorship, for a Chiari and Related Conditions Medical Conference here in Ohio.  Only Ohio residents will count towards our goal for a Chiari and Related Disorders Medical Conference here in Ohio ... BUT ... We hope to collect enough information within EACH STATE and COUNTRY to help facilitate a Chiari and Related Disorders Medical Conference in your area!  Please share this form with others you know are afflicted.

By filling out this form, I give Chiarians Unite permission to use the information herein to: help secure a Chiari and Related Disorders Medical Conference within the State of Ohio; gather a count of afflicted to be used in awareness regarding the disorders contained within Chiarians Unite site; and secure a relationship with others* who can aid in research and education.

PLEASE fill out this form for each family member afflicted.  All areas are required - Thank you for your assistance!

Again, thank you so much for your help and support!

Chiarians Unite Staff

*NOTE:  Information may be shared with NIH (National Institutes of Health), NORD (National Organization for Rare Disorders), government entities, medical providers within the United States and foreign countries, etc. in order to show relevance/need in this area.

*Relationship to patient:
Self
Parent
Sibling
Grandparent
Aunt/Uncle
Legal Guardian
Doctor
Medical Professional
*What conditions do you have? Check all that apply.
Chiari Malformation
Syringomyelia
Tethered Spinal Cord
Pseudotumor Cerebri
Pseudotumor-like Cerebri
Intracranial Hypertension
Hereditary Disorder of the Connective Tissue
Ehlers Danlos
Marfans
Sticklers
Slipped Disc in Cervical Area
Slipped Disc in Thoracic Area
Slipped Disc in Lumbar Area
Spina Bifida
Spina Bifida Occulta
Functional Cranial Settling
Craniocervical Instability
Retro Odontoid Pannus
POTS - Postural Orthostatic Tachycardia Syndrome
Scoliosis
Basilar Invagination
Basilar Impression
Other disorder not specified here
*Other family members affected?
Yes
No
Not sure
Suspect but not confirmed
*Have you had surgery?
Yes
No
Some surgeries but not all needed
*What would you like changed (check all that apply)?
Awareness
Research
Community Education
Medical Personnel Education
Corroboration within the Neurosurgery field to search for answers, determine basic protocol, etc.


*Would you be interested in attending a Chiari and related medical conference in Ohio?
Yes
No
I would seriously consider attending.

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