Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For TBI
Question: Hello and Thank you, Dr. XXXXXXX
Third time a charm, right. I have typed up two other responses that included questions for you and they have disappeared. Not fun when you have a TBI (yes, Traumatic Brain Injury) and have a hard time putting thoughts into written words.
Those others who named and described health issues were not smarter, they wanted to appear as thou they were. LOL
My cardiologist wants to order a QSART test but says he cannot because of crossing over specialist bullcrap boundaries. The Autonomic Clinic he is sending me too, wishes that this test was already done. I know it will be positive because I don't sweet, not even being in a sauna for over a hour. my AC has been on for weeks already and spring just started.
It also took many phone calls to his office and six emails directly to him before he picked up that my HR was going down into the 20's. Ever since Ive gotten out of rehab, I've been trying to get him to order a 72 hour heart monitor and sleep study because of what the one Dr observed before waking me several mornings and all the Dr's mentioning I probably will need a pacemaker. He finally got it, he is going to order the monitor, sleep study and a stress test.
You mentioned the flight or fight response. I realized whilevtalking to the psychologist at the rehab that I was and still am stuck in the flight response. Dr's raised my dose of Venlafaxine to 370mg a day and Klonopin to 2mg twice a day. That hasn't stopped it and I know it's not good on my body. Is there something that can be done to stop it/ move me out of the flight response state?
I asked other questions in the other responses I typed but cannot remember them right now.
I do seriously thank you for how you explained Autonomic Neuropathy. There wasn't anything you said that I didn't know and my cognitive processes were trying to put together that Autonomic Peripheral Neuropathy wasn't something I didn't know about that it wasn't something new to me.
Since the accident caused the TBI, my brain can take days, weeks or months to put things together. I even know when my brain is trying to put info together because I go completely blank and I've been doing that ever since the last email from my cardiologist.
In desperate need of a life again,
XXXX
Third time a charm, right. I have typed up two other responses that included questions for you and they have disappeared. Not fun when you have a TBI (yes, Traumatic Brain Injury) and have a hard time putting thoughts into written words.
Those others who named and described health issues were not smarter, they wanted to appear as thou they were. LOL
My cardiologist wants to order a QSART test but says he cannot because of crossing over specialist bullcrap boundaries. The Autonomic Clinic he is sending me too, wishes that this test was already done. I know it will be positive because I don't sweet, not even being in a sauna for over a hour. my AC has been on for weeks already and spring just started.
It also took many phone calls to his office and six emails directly to him before he picked up that my HR was going down into the 20's. Ever since Ive gotten out of rehab, I've been trying to get him to order a 72 hour heart monitor and sleep study because of what the one Dr observed before waking me several mornings and all the Dr's mentioning I probably will need a pacemaker. He finally got it, he is going to order the monitor, sleep study and a stress test.
You mentioned the flight or fight response. I realized whilevtalking to the psychologist at the rehab that I was and still am stuck in the flight response. Dr's raised my dose of Venlafaxine to 370mg a day and Klonopin to 2mg twice a day. That hasn't stopped it and I know it's not good on my body. Is there something that can be done to stop it/ move me out of the flight response state?
I asked other questions in the other responses I typed but cannot remember them right now.
I do seriously thank you for how you explained Autonomic Neuropathy. There wasn't anything you said that I didn't know and my cognitive processes were trying to put together that Autonomic Peripheral Neuropathy wasn't something I didn't know about that it wasn't something new to me.
Since the accident caused the TBI, my brain can take days, weeks or months to put things together. I even know when my brain is trying to put info together because I go completely blank and I've been doing that ever since the last email from my cardiologist.
In desperate need of a life again,
XXXX
Brief Answer:
Gosh...how to leave the FLIGHT PHASE BEHIND....hmmmm...
Detailed Answer:
I've actually never had that question asked and as a neurologist I don't think I could adequately analyze the situation expertly enough to give you a fair answer compared to a psychiatrist or psychologist.
However, I believe that things of an alternative medicine nature that you could try as I've sent some of my patients to try when they are in similar stages of difficulties such as you describe might be procedures such as:
biofeedback therapy, relaxation techniques, paced breathing exercises, visualization techniques, hypnosis, acupuncture/acupressure, and of course, there could possibly be medicine which raised sufficiently could result in breaking or severing any unwanted or aberrant connections with the ANS so as not to cause burnout.
There is also CBT or cognitive behavioral Therapy, which if done well can be very long lasting and very easy to perform if dedicated to the cause.
Exercising the brain IMMEDIATELY FOLLOWING A TBI is not recommended. Rather, as much of a FULL REST as possible is recommended with gradual return to cognitive tasks which before were rather easy to do and ignore as not significant.
All the best to you and please let me know by writing to me at: bit.ly/drdariushsaghafi how things are going.
Gosh...how to leave the FLIGHT PHASE BEHIND....hmmmm...
Detailed Answer:
I've actually never had that question asked and as a neurologist I don't think I could adequately analyze the situation expertly enough to give you a fair answer compared to a psychiatrist or psychologist.
However, I believe that things of an alternative medicine nature that you could try as I've sent some of my patients to try when they are in similar stages of difficulties such as you describe might be procedures such as:
biofeedback therapy, relaxation techniques, paced breathing exercises, visualization techniques, hypnosis, acupuncture/acupressure, and of course, there could possibly be medicine which raised sufficiently could result in breaking or severing any unwanted or aberrant connections with the ANS so as not to cause burnout.
There is also CBT or cognitive behavioral Therapy, which if done well can be very long lasting and very easy to perform if dedicated to the cause.
Exercising the brain IMMEDIATELY FOLLOWING A TBI is not recommended. Rather, as much of a FULL REST as possible is recommended with gradual return to cognitive tasks which before were rather easy to do and ignore as not significant.
All the best to you and please let me know by writing to me at: bit.ly/drdariushsaghafi how things are going.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
WOW, Dr. XXXXXXX
I asked a question you never been asked. I take that as a compliment.
I started meditating when I was 8 years old. Found guided meditation in my 20's, and the psychologist I use to see used hypnosis with me very often.
Sadly with the TBI I lost the ability to visualize anything. I keep trying but it just doesn't work. That psychologist I mentioned that I talked with while I was in rehab, spent hours with me the last week I was there. He was able to help me reach a hypnotic state by using touch instead of visualization. It was awesome to be able to reach that state again. He made me a CD and I've been using it.
We have been in contact several times and he has a few more ideas of how ge can help me more....even help me control my BP and HR. I see my brain/rehab specialist Friday who wouldn't give us the go ahead to start trying what the psychologist has in mind until he talks/sees me. If he gives the go we start working together Friday after I see my Dr.
XXXX
I asked a question you never been asked. I take that as a compliment.
I started meditating when I was 8 years old. Found guided meditation in my 20's, and the psychologist I use to see used hypnosis with me very often.
Sadly with the TBI I lost the ability to visualize anything. I keep trying but it just doesn't work. That psychologist I mentioned that I talked with while I was in rehab, spent hours with me the last week I was there. He was able to help me reach a hypnotic state by using touch instead of visualization. It was awesome to be able to reach that state again. He made me a CD and I've been using it.
We have been in contact several times and he has a few more ideas of how ge can help me more....even help me control my BP and HR. I see my brain/rehab specialist Friday who wouldn't give us the go ahead to start trying what the psychologist has in mind until he talks/sees me. If he gives the go we start working together Friday after I see my Dr.
XXXX
Brief Answer:
Emotional Dysregulation
Detailed Answer:
Since you've been in brain trauma rehab then, perhaps you've heard the term EMOTIONAL DYSREGULATION. I believe there's a good chance that what you're describing fits into that category of problem. I think it's a very good idea to try different modalities or interventions to get toward more normal thinking and processing of information using hypnosis, visualization if you can regain that capacity....you may simply need to be in a more relaxed state or environment to pull that one off, how about biofeedback, deep breathing exercises.
In fact, I'm sure you CAN visualize again but it has to be relearned if your TBI has caused the ability to be compromised or lost. You can do it....you'll simply rewire the circuit board so to speak. You can use online apps to help with that sort of thing.
I have also been reading and seeing patients in a brain rehab clinic here in XXXXXXX which is offering NAD infusions for addiction problems and withdrawals, however, NAD infusions have also been at least anecdotally found to have utility in some patients with neurodegenerative processes such as Parkinson's and Parkinson's like syndromes, essential tremor, ADHD, and I'm wondering if TBI could benefit from this infusion protocol. I believe the clinic I'm seeing patients in is only one of 2 or 3 clinics in the U.S. approved and licensed to give these infusions and so far I've been seeing a large degree of success. I know the procedure is readily available in Europe but it's not offered in very many places here in the U.S. just yet.
If I've satisfactorily addressed your questions could you do me the kindest of favors by CLOSING THIS QUERY and be sure to include some fine words of feedback on your opinion as to our transaction?
Many thanks for posing your question to our attention on this network and do not forget to recontact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.
This query has utilized a total of 21 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Emotional Dysregulation
Detailed Answer:
Since you've been in brain trauma rehab then, perhaps you've heard the term EMOTIONAL DYSREGULATION. I believe there's a good chance that what you're describing fits into that category of problem. I think it's a very good idea to try different modalities or interventions to get toward more normal thinking and processing of information using hypnosis, visualization if you can regain that capacity....you may simply need to be in a more relaxed state or environment to pull that one off, how about biofeedback, deep breathing exercises.
In fact, I'm sure you CAN visualize again but it has to be relearned if your TBI has caused the ability to be compromised or lost. You can do it....you'll simply rewire the circuit board so to speak. You can use online apps to help with that sort of thing.
I have also been reading and seeing patients in a brain rehab clinic here in XXXXXXX which is offering NAD infusions for addiction problems and withdrawals, however, NAD infusions have also been at least anecdotally found to have utility in some patients with neurodegenerative processes such as Parkinson's and Parkinson's like syndromes, essential tremor, ADHD, and I'm wondering if TBI could benefit from this infusion protocol. I believe the clinic I'm seeing patients in is only one of 2 or 3 clinics in the U.S. approved and licensed to give these infusions and so far I've been seeing a large degree of success. I know the procedure is readily available in Europe but it's not offered in very many places here in the U.S. just yet.
If I've satisfactorily addressed your questions could you do me the kindest of favors by CLOSING THIS QUERY and be sure to include some fine words of feedback on your opinion as to our transaction?
Many thanks for posing your question to our attention on this network and do not forget to recontact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.
This query has utilized a total of 21 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr. XXXXXXX
The rehab I was in covered everything. I had more PT and OT than any other therapies because my Dr's and my goal was to improve what I could/can do physically to improve the quality of my life. It was going great until the tachycardia hit.
I also know about Emotionally Dyeregulation because when the accident occurred I was two classes away from my masters degree as a psychologist.... Ironically, I was planning on being a neuro-psyche researcher who focused on the mind/body connection. Can you think of any pathology that is more mind/body connection than Autonomic Neuropathy?
The psychologist at the rehab isn't planning on using anything to help ED, he is planning on using techniques that are mind/body connection since I already have knowledge and interest in it.
As for NAD infusions, how I wished many months ago when I read about it that it was available when I was going through serious withdrawal from the new release fentanyl patch they came out with years ago. I was on the highest does at the time and they didn't have as many different doses back then, so going from one dose down to another was hell. I finally told my Dr forget this, give me methadone and just get me completely off this crap. Of course after we had me completely off of it, I won my appeal to receive the name brand. No I didn't go back on it, was happy to be off of it.
I came across it while researching different types of infusions used to treat POTS. When none of the normal medications seemed to be helping me, I was trying to find something that would. Totally believed saline infusions would help me and was able to prove that they help me extremely while at the rehab.
Like most woman with POTS, my symptoms get way worse during my menstrual. I normally end up at the ER/ED because I start vomiting, cannot stop and end up dehydrated. Of course I started a menstrual while at rehab, none of my Dr's wanted anything to do with giving me a saline treatment. They changed my anti-nauseous meditation but it didn't help much. When my brain/rehab Dr came in and seen how bad I looked, I asked him if I sent you research articles from XXXXXXX Mayo, NIH and Vanderbilt would you at least consider it. He said yes. Originally told they would do it once but I improved sooo much that they were done every night until I left. First thing out of that Dr's mouth the day I was being discharged was we gotta find and convince a cardiologist to put in a port.
Last night I wrote you two more questions. Once you answer them, if you can then I will close out everything with this topic. Reason I say if you can, is because your not a mind reader. Best you might be able to do is give a medical quess
XXXX
Hi, Dr. XXXXXXX
Forgot to put this in my last response. You wrote
"you CAN visualize again but it has to be relearned if your TBI has caused the ability to be compromised or lost. You can do it....you'll simply rewire the circuit board so to speak."
Any ideas would be appreciated. Right after the accident, I was using a book by XXXXXXX Crawford: she put many different theories together on how to reconnect right and left sides of the brain for those that suffer TBI's or strokes. I've worked with many different cognitive therapist and two neuro-psychiatrist, I've read books on how to relearn things that you could do, how to learn things period after learning styles have been damaged, I've tried things online, thus far nothing has helped.
The city I live in offers art classes to those 5th graders up that show potential in art. I had scholarships for five years. One of the things I learned was actually everyone can draw because they are able to make circles, triangles and squares. How well they can shade depends if their picture turns out looking like a child or artist drew it.
Knowing everything is made up of those three shapes has of course trained my brain to see them, at least until the accident. I've been working on just visualizing a circle for over a year and haven't been able to do it. Even after drawing one, starring at it for a while. The real exercise was to visualize a colored in circle, then add more, even having them lay over each other, while visualizing the colors that each part should be.
I'm not real good with numbers either. It takes me 20+ times hearing a number before I have it written down properly. Math and logic were my second learning style.
The rehab I was in covered everything. I had more PT and OT than any other therapies because my Dr's and my goal was to improve what I could/can do physically to improve the quality of my life. It was going great until the tachycardia hit.
I also know about Emotionally Dyeregulation because when the accident occurred I was two classes away from my masters degree as a psychologist.... Ironically, I was planning on being a neuro-psyche researcher who focused on the mind/body connection. Can you think of any pathology that is more mind/body connection than Autonomic Neuropathy?
The psychologist at the rehab isn't planning on using anything to help ED, he is planning on using techniques that are mind/body connection since I already have knowledge and interest in it.
As for NAD infusions, how I wished many months ago when I read about it that it was available when I was going through serious withdrawal from the new release fentanyl patch they came out with years ago. I was on the highest does at the time and they didn't have as many different doses back then, so going from one dose down to another was hell. I finally told my Dr forget this, give me methadone and just get me completely off this crap. Of course after we had me completely off of it, I won my appeal to receive the name brand. No I didn't go back on it, was happy to be off of it.
I came across it while researching different types of infusions used to treat POTS. When none of the normal medications seemed to be helping me, I was trying to find something that would. Totally believed saline infusions would help me and was able to prove that they help me extremely while at the rehab.
Like most woman with POTS, my symptoms get way worse during my menstrual. I normally end up at the ER/ED because I start vomiting, cannot stop and end up dehydrated. Of course I started a menstrual while at rehab, none of my Dr's wanted anything to do with giving me a saline treatment. They changed my anti-nauseous meditation but it didn't help much. When my brain/rehab Dr came in and seen how bad I looked, I asked him if I sent you research articles from XXXXXXX Mayo, NIH and Vanderbilt would you at least consider it. He said yes. Originally told they would do it once but I improved sooo much that they were done every night until I left. First thing out of that Dr's mouth the day I was being discharged was we gotta find and convince a cardiologist to put in a port.
Last night I wrote you two more questions. Once you answer them, if you can then I will close out everything with this topic. Reason I say if you can, is because your not a mind reader. Best you might be able to do is give a medical quess
XXXX
Hi, Dr. XXXXXXX
Forgot to put this in my last response. You wrote
"you CAN visualize again but it has to be relearned if your TBI has caused the ability to be compromised or lost. You can do it....you'll simply rewire the circuit board so to speak."
Any ideas would be appreciated. Right after the accident, I was using a book by XXXXXXX Crawford: she put many different theories together on how to reconnect right and left sides of the brain for those that suffer TBI's or strokes. I've worked with many different cognitive therapist and two neuro-psychiatrist, I've read books on how to relearn things that you could do, how to learn things period after learning styles have been damaged, I've tried things online, thus far nothing has helped.
The city I live in offers art classes to those 5th graders up that show potential in art. I had scholarships for five years. One of the things I learned was actually everyone can draw because they are able to make circles, triangles and squares. How well they can shade depends if their picture turns out looking like a child or artist drew it.
Knowing everything is made up of those three shapes has of course trained my brain to see them, at least until the accident. I've been working on just visualizing a circle for over a year and haven't been able to do it. Even after drawing one, starring at it for a while. The real exercise was to visualize a colored in circle, then add more, even having them lay over each other, while visualizing the colors that each part should be.
I'm not real good with numbers either. It takes me 20+ times hearing a number before I have it written down properly. Math and logic were my second learning style.
Brief Answer:
Many Thanks for your complimentary feedback
Detailed Answer:
I know that I know very little of the details of your injury...or very much about you in general except for what you've shared in a few messages, however, I don't think I 'm going too far out on a limb when I tell you that in my opinion if you have not yet obtained the Master's degree in Psych...that I believe that is still very possible. Maybe you're already in the process....but I wanted to mention that after reading the intro lines on this last message. I say that for a couple of reasons. One, in analyzing your writing style, grammar, orthography, and linearity of thought processes (while answering your questions) my impression is that you clearly have the fund of knowledge substrate and command of language to go through a Master's Program degree despite your TBI. I see TBI patients daily in large numbers since I work in the VA Hospital in XXXXXXX in addition to my private practice where I also see patients referred for NAD infusions. The infusions are not done by my practice but rather I consult in the infusion center where they are done. I believe I've developed a bit of a 6th sense by watching TBI victims in the way the present and handle themselves to predict which ones will be able to do what after going through either the NAD infusions or conventional cognitive rehab....which is not so "conventional" since you have look hard and wide to find anybody who labels themselves as a COGNITIVE REHAB SPECIALIST....insurance doesn't pay for it yet....the VA certainly doesn't do it....they lump that job together with Speech Therapy which is Ok....better than nothing....but not the same.
Anyways, long story short..I believe you have sufficient substrate and ability to perform complex cognitive tasks that require attention, precision, and concentration so that learning pathways can be blazed and concretized in the limbic system as well as appropriate frontal and temporal areas so as to be able to successfully such a program.
As far as ideas are concerned....if I had as many ideas as XXXXXXX Crawford on how to go about "rewiring the circuitboard"....I'd be publishing my own books I suppose....nah...probably not....I'd rather be BLOGGING! LOL.....My schtick is this....coming up with a hard and fast rule to apply to everybody...even if in general terms (in my very humble opinion as a simple neurologist) is a very tough proposition. I get that idea from being a headache specialist. I've learned over the past 20 years of treating such patients that the minute you fall into a routine....no matter what Big Pharma says or not.....then, the patient is doomed to at least...mediocre results.....know what I mean? Every patient has to have a treatment protocol tailored to their headaches but also to their lifestyles, culture, socioeconomic levels, intelligence levels, motivational levels, other comorbidities, yada yada yada.....
The same holds when it comes to working with TBI patients.....regimented outlines or protocols are seldom worthwhile even writing out for anybody...UNLESS YOU KNOW THEM rather well....what the mechanism of their injury was, how much they've recovered, what actually they have recovered, what still needs work, neuropsych results, etc. etc. etc. Get the picture?
I honestly do wish you could be in the XXXXXXX area...but for a bit of an extended period of time so that I can work with you as I work in a customized way with all of my TBI patients when we are visiting for purposes of cognitive assessments, progress reviews, and protocol analysis so as to keep their regimens of exercises, medications, fully updated. In other words, take the training wheels off the bike as soon as they are ready to ride the BIG BOYS's bike instead of keeping them on until you get around to thinking about taking them off....make sense? But doing it long distance would be a trick....I don't know that I'm quite that talented.....and unfortunately, even though I do make housecalls to my patients....according to your profile... XXXXXXX is just a ways off my GPS map to be able to handle and still get home for supper by 6p! HAHA!
I have seen some pretty amazing things happening with NAD infusions....but unfortunately, I also believe that since the data I have is purely anecdotal (we're working on collecting the information in a more publishable way) it is not possible to make solid recommendations for the treatments to anybody but drug addict/withdrawal victims based on what I've witnessed and the patients I've examined.
If you can see any way of visiting one of the most up and coming U.S. metropolises in the last 10 years then, I'd be happy to meet you, learn the nitty gritty details about you that would be much more likely in being able to advise concrete plans of action and ideas than what could possibly be accomplished long distance. Also, I forgot to mention that in large part the other part of the equation that doesn't work very well long distance is the team of other specialists I rely on to help do the neuropsych testing, the implementation and supervision of activities, etc.etc. I can't pack them up in the trunk and do a house call! LOL!
Again, your confidence and kind comments on the last thread was very much appreicated and I hope I've provided just a bit more to think about although I know it wasn't exactly what you were likely hoping for...though an invite to XXXXXXX as we spruce up the city for the summer convention in July isn't a half bad date only because the whole town is going through a renaissance and that's electric to anybody who lives or visits....especially since LeBron XXXXXXX and his court live here too! LOL!!
All the best to you. Keep me apprised of how things go and if I can still be of help down the road(s).
This query has utilized a total of 54 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Many Thanks for your complimentary feedback
Detailed Answer:
I know that I know very little of the details of your injury...or very much about you in general except for what you've shared in a few messages, however, I don't think I 'm going too far out on a limb when I tell you that in my opinion if you have not yet obtained the Master's degree in Psych...that I believe that is still very possible. Maybe you're already in the process....but I wanted to mention that after reading the intro lines on this last message. I say that for a couple of reasons. One, in analyzing your writing style, grammar, orthography, and linearity of thought processes (while answering your questions) my impression is that you clearly have the fund of knowledge substrate and command of language to go through a Master's Program degree despite your TBI. I see TBI patients daily in large numbers since I work in the VA Hospital in XXXXXXX in addition to my private practice where I also see patients referred for NAD infusions. The infusions are not done by my practice but rather I consult in the infusion center where they are done. I believe I've developed a bit of a 6th sense by watching TBI victims in the way the present and handle themselves to predict which ones will be able to do what after going through either the NAD infusions or conventional cognitive rehab....which is not so "conventional" since you have look hard and wide to find anybody who labels themselves as a COGNITIVE REHAB SPECIALIST....insurance doesn't pay for it yet....the VA certainly doesn't do it....they lump that job together with Speech Therapy which is Ok....better than nothing....but not the same.
Anyways, long story short..I believe you have sufficient substrate and ability to perform complex cognitive tasks that require attention, precision, and concentration so that learning pathways can be blazed and concretized in the limbic system as well as appropriate frontal and temporal areas so as to be able to successfully such a program.
As far as ideas are concerned....if I had as many ideas as XXXXXXX Crawford on how to go about "rewiring the circuitboard"....I'd be publishing my own books I suppose....nah...probably not....I'd rather be BLOGGING! LOL.....My schtick is this....coming up with a hard and fast rule to apply to everybody...even if in general terms (in my very humble opinion as a simple neurologist) is a very tough proposition. I get that idea from being a headache specialist. I've learned over the past 20 years of treating such patients that the minute you fall into a routine....no matter what Big Pharma says or not.....then, the patient is doomed to at least...mediocre results.....know what I mean? Every patient has to have a treatment protocol tailored to their headaches but also to their lifestyles, culture, socioeconomic levels, intelligence levels, motivational levels, other comorbidities, yada yada yada.....
The same holds when it comes to working with TBI patients.....regimented outlines or protocols are seldom worthwhile even writing out for anybody...UNLESS YOU KNOW THEM rather well....what the mechanism of their injury was, how much they've recovered, what actually they have recovered, what still needs work, neuropsych results, etc. etc. etc. Get the picture?
I honestly do wish you could be in the XXXXXXX area...but for a bit of an extended period of time so that I can work with you as I work in a customized way with all of my TBI patients when we are visiting for purposes of cognitive assessments, progress reviews, and protocol analysis so as to keep their regimens of exercises, medications, fully updated. In other words, take the training wheels off the bike as soon as they are ready to ride the BIG BOYS's bike instead of keeping them on until you get around to thinking about taking them off....make sense? But doing it long distance would be a trick....I don't know that I'm quite that talented.....and unfortunately, even though I do make housecalls to my patients....according to your profile... XXXXXXX is just a ways off my GPS map to be able to handle and still get home for supper by 6p! HAHA!
I have seen some pretty amazing things happening with NAD infusions....but unfortunately, I also believe that since the data I have is purely anecdotal (we're working on collecting the information in a more publishable way) it is not possible to make solid recommendations for the treatments to anybody but drug addict/withdrawal victims based on what I've witnessed and the patients I've examined.
If you can see any way of visiting one of the most up and coming U.S. metropolises in the last 10 years then, I'd be happy to meet you, learn the nitty gritty details about you that would be much more likely in being able to advise concrete plans of action and ideas than what could possibly be accomplished long distance. Also, I forgot to mention that in large part the other part of the equation that doesn't work very well long distance is the team of other specialists I rely on to help do the neuropsych testing, the implementation and supervision of activities, etc.etc. I can't pack them up in the trunk and do a house call! LOL!
Again, your confidence and kind comments on the last thread was very much appreicated and I hope I've provided just a bit more to think about although I know it wasn't exactly what you were likely hoping for...though an invite to XXXXXXX as we spruce up the city for the summer convention in July isn't a half bad date only because the whole town is going through a renaissance and that's electric to anybody who lives or visits....especially since LeBron XXXXXXX and his court live here too! LOL!!
All the best to you. Keep me apprised of how things go and if I can still be of help down the road(s).
This query has utilized a total of 54 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I'll respond more later gotta let all that fully sink in but wanted to say actually you could leave in the morning, see me and make it home for dinner. I keep changing my profile, particularly where I live but it's doing whatever it wants. I live in the Burgh - XXXXXXX and wish for many reasons that I had a way to get to XXXXXXX and money to stay for at least a few weeks for care of medical issues that I have that no one is/has done anything about
Well at least I'm no longer in Afghanistan any longer.
I use to charge quite a bit for house calls also. Sadly that little stupid state line would also keep me from working on you, your family, friends and anyone else to pay you....I'm a Myo-facial Trigger Point Release Therapist
Yes, use to go to XXXXXXX a lot when I was younger been to over 20 Browns games, at least 80 Indians games, 6 Cavaliers games and played against several of Clevelands professional and tournament softball teams
Dr. XXXXXXX
The compliments I gave you do not even come close to the ones you gave me. THANK YOU!
I have gotten a lot of my writing skill back but its far from what it use to be. It takes me a long time to put into written words my thoughts. When it comes to reading something and answering question about what I just read, I don't even get 20% correct and that is on 4th grade level. I don't complain that much about this because it is coming back slowly. Originally, right after the accident I couldn't write down one word to try and help me remember something.
I did complete the course that I was in when the accident occurred. I went from 100% to a C- in Pathology a course I use to teach at to training schools and a community college of nursing. Tried and failed the last course that I need twice. I thought it was such a good idea to put off Algebra 2 for my last course, figured it would give me incentive to finish up strong with a course I knew would be tougher than any of the other ones.... Giant Mistake. As I stated in one of my questions as backup information, I cannot write numbers that people speak to me, let alone do whatever needs done to solve a problem.
The accident occurred 12/1/10. I have been a shut in since mid Dec 2012. I couldn't even get out to see a Dr. for two in half years. Since mid Dec 2012 I haven't been out of the house 25 times, all but twice were to see Dr's or have test done.
The accident occurred while I was parked on the side of the road with my flashers on because there was four seperate accidents happening infront me that involved 20+ cars. Some other people did the same thing as I did. One of them was leaning in my passenger door talking with me. I have no clue, if someone warned him or he seen it coming but he took off. I was turned sideways talking with him, when he took off, I instinctively started to turn forward but I didn't get very far. The back of my head hit the hardest part of the car/where the seatbelt is attached at least. Six times.
It was a 19 year old driving they figure 60 mph in a 25mph zone on a road that wasn't safe due to ice to be driven on. Both our cars were totalled. His car, they had to break out the back window to get him and his friend out. My car, he blew out my passenger front tire and cracked the frame on passengers side, oh forgot he hit me on driver back side.
The ED doctor wrote me a note knowing I wouldn't remember her telling me. " To never forget how lucky you are to be ALIVE!!!" Most of the time, I don't feel very lucky. I have lost everything except one thing, which I will lose in Dec. that being my CMTPT license.
You wrote "Every patient has to have a treatment protocol tailored to their headaches but also to their lifestyles, culture, socioeconomic levels, intelligence levels, motivational levels, other comorbidities, yada yada yada.....LMAO but sooooo true and you wouldn't be able to guess how many Dr's over the years have refused to take me on because with my health issues I'm an extremely difficult case to treat and instead of them thinking, hhhhmmmm I get to practice medicine if I take her on, they think, she doesn't fit in the protocol box I like to work with.
It is kinda sad that Mainline a cognitive rehab therapy company hasn't branched into Ohio yet. A friend of mine has been very happy with his job for months, more than he use to be. He was put in charge of a cognitive rehab program set up by the Government to work with Veterans. Hopefully it will work out wonderfully and expand to more states.
Took all my meds, put my medical alert wrist thingy on, heading to bed. I know if I'm dehydrating, particularly if still vomiting and cannot get water into me. to head to the ED. No one has given me any symptoms, BP, HR or oxygen numbers inwhich I should go. I'm feeling horrible, chest pressure, really weird head wise, terrible pain even in my arms from blood pooling, norm only have blood poooling in legs, BP and oxygen are way lower than my norms, and HR is way high in all positions and.hasn't dropped in hours. About.the time I started feeling yucky.
I wake up often to roll over because of pain. If there is any types of vital numbers or symptoms that someone should head to the ED, respond, I'll eventually will read it
Well at least I'm no longer in Afghanistan any longer.
I use to charge quite a bit for house calls also. Sadly that little stupid state line would also keep me from working on you, your family, friends and anyone else to pay you....I'm a Myo-facial Trigger Point Release Therapist
Yes, use to go to XXXXXXX a lot when I was younger been to over 20 Browns games, at least 80 Indians games, 6 Cavaliers games and played against several of Clevelands professional and tournament softball teams
Dr. XXXXXXX
The compliments I gave you do not even come close to the ones you gave me. THANK YOU!
I have gotten a lot of my writing skill back but its far from what it use to be. It takes me a long time to put into written words my thoughts. When it comes to reading something and answering question about what I just read, I don't even get 20% correct and that is on 4th grade level. I don't complain that much about this because it is coming back slowly. Originally, right after the accident I couldn't write down one word to try and help me remember something.
I did complete the course that I was in when the accident occurred. I went from 100% to a C- in Pathology a course I use to teach at to training schools and a community college of nursing. Tried and failed the last course that I need twice. I thought it was such a good idea to put off Algebra 2 for my last course, figured it would give me incentive to finish up strong with a course I knew would be tougher than any of the other ones.... Giant Mistake. As I stated in one of my questions as backup information, I cannot write numbers that people speak to me, let alone do whatever needs done to solve a problem.
The accident occurred 12/1/10. I have been a shut in since mid Dec 2012. I couldn't even get out to see a Dr. for two in half years. Since mid Dec 2012 I haven't been out of the house 25 times, all but twice were to see Dr's or have test done.
The accident occurred while I was parked on the side of the road with my flashers on because there was four seperate accidents happening infront me that involved 20+ cars. Some other people did the same thing as I did. One of them was leaning in my passenger door talking with me. I have no clue, if someone warned him or he seen it coming but he took off. I was turned sideways talking with him, when he took off, I instinctively started to turn forward but I didn't get very far. The back of my head hit the hardest part of the car/where the seatbelt is attached at least. Six times.
It was a 19 year old driving they figure 60 mph in a 25mph zone on a road that wasn't safe due to ice to be driven on. Both our cars were totalled. His car, they had to break out the back window to get him and his friend out. My car, he blew out my passenger front tire and cracked the frame on passengers side, oh forgot he hit me on driver back side.
The ED doctor wrote me a note knowing I wouldn't remember her telling me. " To never forget how lucky you are to be ALIVE!!!" Most of the time, I don't feel very lucky. I have lost everything except one thing, which I will lose in Dec. that being my CMTPT license.
You wrote "Every patient has to have a treatment protocol tailored to their headaches but also to their lifestyles, culture, socioeconomic levels, intelligence levels, motivational levels, other comorbidities, yada yada yada.....LMAO but sooooo true and you wouldn't be able to guess how many Dr's over the years have refused to take me on because with my health issues I'm an extremely difficult case to treat and instead of them thinking, hhhhmmmm I get to practice medicine if I take her on, they think, she doesn't fit in the protocol box I like to work with.
It is kinda sad that Mainline a cognitive rehab therapy company hasn't branched into Ohio yet. A friend of mine has been very happy with his job for months, more than he use to be. He was put in charge of a cognitive rehab program set up by the Government to work with Veterans. Hopefully it will work out wonderfully and expand to more states.
Took all my meds, put my medical alert wrist thingy on, heading to bed. I know if I'm dehydrating, particularly if still vomiting and cannot get water into me. to head to the ED. No one has given me any symptoms, BP, HR or oxygen numbers inwhich I should go. I'm feeling horrible, chest pressure, really weird head wise, terrible pain even in my arms from blood pooling, norm only have blood poooling in legs, BP and oxygen are way lower than my norms, and HR is way high in all positions and.hasn't dropped in hours. About.the time I started feeling yucky.
I wake up often to roll over because of pain. If there is any types of vital numbers or symptoms that someone should head to the ED, respond, I'll eventually will read it
Brief Answer:
Now that's interesting....
Detailed Answer:
Your location profile suggests that you are in the Dallas/Ft. Worth area of the world....i.e. XXXXXXX
You're right....could be out to the Burgh and back by dinner.....BUT....I don't think you'd want to see my travel rates for doing HOUSE CALLS in another state....aside from the fact, I don't have a license to practice medicine in PA. HA!
We used to live in Boardman....went to XXXXXXX frequently....the kids loved the play area of the IKEA store on Route 30! And the Carnegie Museum of Art....never been to either a Steelers or Pirates game....of course, not.....I'm from Cleveland--- LOL.....well, if you could find a way to XXXXXXX and had some contacts up here that would let you hang out for a few weeks...then, that would be optimal.
Have you ever been to Cleveland?
Brief Answer:
Are you connected with the VA
Detailed Answer:
Hello again you Terrible Towel Person,
Glad you're not in Afghanistan anymore. Does this imply that you are a veteran...can't imagine anyone being there just for vacation purposes! If that's true are you connected to the VA and if so, have you seen neurology in XXXXXXX for the TBI incident? They have a full neurology service in Pitt and obviously, VA neurologists are likely more sensitized to this problem than non-VA docs. I run several clinics at the XXXXXXX VA so that's why I'm asking. Sometimes we TRY sending our overflow patients to them....they don't like it...but we try!
Now that's interesting....
Detailed Answer:
Your location profile suggests that you are in the Dallas/Ft. Worth area of the world....i.e. XXXXXXX
You're right....could be out to the Burgh and back by dinner.....BUT....I don't think you'd want to see my travel rates for doing HOUSE CALLS in another state....aside from the fact, I don't have a license to practice medicine in PA. HA!
We used to live in Boardman....went to XXXXXXX frequently....the kids loved the play area of the IKEA store on Route 30! And the Carnegie Museum of Art....never been to either a Steelers or Pirates game....of course, not.....I'm from Cleveland--- LOL.....well, if you could find a way to XXXXXXX and had some contacts up here that would let you hang out for a few weeks...then, that would be optimal.
Have you ever been to Cleveland?
Brief Answer:
Are you connected with the VA
Detailed Answer:
Hello again you Terrible Towel Person,
Glad you're not in Afghanistan anymore. Does this imply that you are a veteran...can't imagine anyone being there just for vacation purposes! If that's true are you connected to the VA and if so, have you seen neurology in XXXXXXX for the TBI incident? They have a full neurology service in Pitt and obviously, VA neurologists are likely more sensitized to this problem than non-VA docs. I run several clinics at the XXXXXXX VA so that's why I'm asking. Sometimes we TRY sending our overflow patients to them....they don't like it...but we try!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have typed up 9 responses to you and lost them all one way or another. Doesn't appear as I'm suppose to ask or respond much to you today.
Not connected to VA. Never been to Afghanistan it's where my profile use to say I was from.
I'm still feeling horrible today, not seeing well is one of my symptoms, head if extremely fuzzy, have head ache, still pooling paidiastolic and systolic blood pressure n, nauseous, very dizzy, hard time breathing at times, chest pressure and more.
Resting/laying and sitting my vitals are on my low norm side but standing they are weird. Never been like this before, examples: 94/80 pulse 127, 94/76 pulse 115, 86/73 pulse 132, 97/83 pulse 109, 96/83 pulse 120
Should I be concerned? Should I post this as a completely new question?
It's when I stand for more than two minutes that my HR drops into the 20's
Third paragraph, I accidentally pasted paidiastolic and systolic blood pressure it was part of another question I was going to ask that I cut out.
Should say, still have pooling blood, nauseous......
Not connected to VA. Never been to Afghanistan it's where my profile use to say I was from.
I'm still feeling horrible today, not seeing well is one of my symptoms, head if extremely fuzzy, have head ache, still pooling paidiastolic and systolic blood pressure n, nauseous, very dizzy, hard time breathing at times, chest pressure and more.
Resting/laying and sitting my vitals are on my low norm side but standing they are weird. Never been like this before, examples: 94/80 pulse 127, 94/76 pulse 115, 86/73 pulse 132, 97/83 pulse 109, 96/83 pulse 120
Should I be concerned? Should I post this as a completely new question?
It's when I stand for more than two minutes that my HR drops into the 20's
Third paragraph, I accidentally pasted paidiastolic and systolic blood pressure it was part of another question I was going to ask that I cut out.
Should say, still have pooling blood, nauseous......
Brief Answer:
TBI and orthostatic pressures
Detailed Answer:
From what you've written your pulse rates are exceedingly high for being at rest or even in a seated or standing position. And the blood pressures are certainly on the lower than expected side for that sort of heart rate or TACHYCARDIA. Certainly, TBI can be associated with changes of this type if autonomic dysfunction occurs but you would need to be examined by an autonomic specialist. The numbers you present could be consistent with POTS but I don't know because you've not said anything about your posture or changes in your posture when taking these pressures.
TBI and orthostatic pressures
Detailed Answer:
From what you've written your pulse rates are exceedingly high for being at rest or even in a seated or standing position. And the blood pressures are certainly on the lower than expected side for that sort of heart rate or TACHYCARDIA. Certainly, TBI can be associated with changes of this type if autonomic dysfunction occurs but you would need to be examined by an autonomic specialist. The numbers you present could be consistent with POTS but I don't know because you've not said anything about your posture or changes in your posture when taking these pressures.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
