The 'Stroke' Case - under construction
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Lynn came to me because the UCLA stroke specialist told her, "I don't think you had a stroke.
I don't know what else to do for you. You have 3 choices. You can go to physical therapy to
stretch your neck. You can go to UCLA headache clinic. Or you can go see this lady (that I
heard about from a neurologist colleague of mine - my edit)."
One year ago, Lynn ,61 yrs old, had a sense that something was horribly wrong. She kept
telling her PCP, "you have to do something, something is terribly wrong with me, something
bad is going to happen." Her PCP diagnosed her with anxiety and put her on Zoloft (an
anti-anxiety, anti-depressant). Then in November 2008, she passed out in her driveway and
hit her head on the pavement. She was taken by ambulance to Huntington Memorial Hospital.
In the ER, she met Dr. Ohanian. The ER doctors thought that she had a stroke. Testing was
negative. She followed up with him. In the meanwhile, her blood pressure was erratic and she
was put on Diovan 80mg twice daily. Cardiologists did not think that she had a heart issue,
nevertheless, to be cautious, they insert a loop recorder in her L upper chest.
No one knows what is going on. One day she has a 'panic attack' and drives straight to UCLA.
The cardiologists who thought she was a crazy lady noticed the state that she was in. They
drew blood levels and found that her dopamine levels were "sky high." They now take her
seriously and start a full body scan to look for a dopamine secreting tumor -which is never
found.
Lynn has had migraines for 20yrs. Her body is a physical mess.
On her first visit, I go through my usual spiel about how most patients feel 3-5% relief
immediately. When she sat up, she looks at me sweetly and sheepishly and gives me the bad
news that she feels nothing. What should she do? Is OMT going to work for her?
I told her to make another appointment for next week. By the end of the 2nd visit, I
guaranteed her that she would know whether to continue or not. She asked what about
today? I replied that she would feel a difference later today or at least tomorrow. I did not
know what form it would take, but it will hit her and she would know it.
One week later, just before her appointment, I was up front talking to my receptionist. Lynn
sat in a corner and saw me come up. She switched her seat to one right in my line of view.
Apparently, she was very excited about something and could not wait to tell me.
In the room, I asked her, "When did it hit you and how?" She replied, " The next day. I was so
exhausted, I could not get up out of bed. But you barely touched me. It felt as if you did
nothing. I went home skeptical and was rolling my eyeballs. I told my husband, 'You are not
going to believe this.'" She thought I was kooky. She doubts no more.
I warned her that I managed the physical pain and migraines. As her body healed, if she
continued to stay on the BP meds, then she might bottom out and get into trouble. I told her
that she needed to follow up regularly with her PCP to manage the meds and monitor her BPs.
Her PCP did not know what I was doing and did not want the responsibility. So Lynn was
stuck. I agreed to take that responsibility (me, a pediatrician) if she promised to check her
BPs often on a daily basis and return for treatments weekly.
Three months into our weekly visits, she is so hopeful and full of energy, she books a safari
vacation for the following year. The pressure is on me now to clean her up in 6 months time.
I'm pleased to report that we passed the test. We were able to wean her meds. She went on
vacation and she was in good control. Absolutely no problems.
It is now about one year, 44 visits and she now comes to see me once a month. She knows
when her body needs a treatment. I don't even have to give her instructions for when to come
back. I expect her to need OMT once a month for about another 6 months
I don't know what else to do for you. You have 3 choices. You can go to physical therapy to
stretch your neck. You can go to UCLA headache clinic. Or you can go see this lady (that I
heard about from a neurologist colleague of mine - my edit)."
One year ago, Lynn ,61 yrs old, had a sense that something was horribly wrong. She kept
telling her PCP, "you have to do something, something is terribly wrong with me, something
bad is going to happen." Her PCP diagnosed her with anxiety and put her on Zoloft (an
anti-anxiety, anti-depressant). Then in November 2008, she passed out in her driveway and
hit her head on the pavement. She was taken by ambulance to Huntington Memorial Hospital.
In the ER, she met Dr. Ohanian. The ER doctors thought that she had a stroke. Testing was
negative. She followed up with him. In the meanwhile, her blood pressure was erratic and she
was put on Diovan 80mg twice daily. Cardiologists did not think that she had a heart issue,
nevertheless, to be cautious, they insert a loop recorder in her L upper chest.
No one knows what is going on. One day she has a 'panic attack' and drives straight to UCLA.
The cardiologists who thought she was a crazy lady noticed the state that she was in. They
drew blood levels and found that her dopamine levels were "sky high." They now take her
seriously and start a full body scan to look for a dopamine secreting tumor -which is never
found.
Lynn has had migraines for 20yrs. Her body is a physical mess.
On her first visit, I go through my usual spiel about how most patients feel 3-5% relief
immediately. When she sat up, she looks at me sweetly and sheepishly and gives me the bad
news that she feels nothing. What should she do? Is OMT going to work for her?
I told her to make another appointment for next week. By the end of the 2nd visit, I
guaranteed her that she would know whether to continue or not. She asked what about
today? I replied that she would feel a difference later today or at least tomorrow. I did not
know what form it would take, but it will hit her and she would know it.
One week later, just before her appointment, I was up front talking to my receptionist. Lynn
sat in a corner and saw me come up. She switched her seat to one right in my line of view.
Apparently, she was very excited about something and could not wait to tell me.
In the room, I asked her, "When did it hit you and how?" She replied, " The next day. I was so
exhausted, I could not get up out of bed. But you barely touched me. It felt as if you did
nothing. I went home skeptical and was rolling my eyeballs. I told my husband, 'You are not
going to believe this.'" She thought I was kooky. She doubts no more.
I warned her that I managed the physical pain and migraines. As her body healed, if she
continued to stay on the BP meds, then she might bottom out and get into trouble. I told her
that she needed to follow up regularly with her PCP to manage the meds and monitor her BPs.
Her PCP did not know what I was doing and did not want the responsibility. So Lynn was
stuck. I agreed to take that responsibility (me, a pediatrician) if she promised to check her
BPs often on a daily basis and return for treatments weekly.
Three months into our weekly visits, she is so hopeful and full of energy, she books a safari
vacation for the following year. The pressure is on me now to clean her up in 6 months time.
I'm pleased to report that we passed the test. We were able to wean her meds. She went on
vacation and she was in good control. Absolutely no problems.
It is now about one year, 44 visits and she now comes to see me once a month. She knows
when her body needs a treatment. I don't even have to give her instructions for when to come
back. I expect her to need OMT once a month for about another 6 months