Q&A 03.08.24

[Dr. Andrew]

10/11/2023

CC – onset end of January 2023, sick, nauseous, vomitting, fever, and went to Urgent Care; tested for Strep due to red throat (due to vomiting), test came back positive for Strep G. which is very rare; blood

PROGRESSION – ended up gonig to several clinics, MDs, urgent cares, Rheumatologists for the same symptoms of nausea, body aches, vomiting

GASTRO MD – ordered more blood work and upper Endoscopy all WNL

RHEUMATOID MD – referred to after GASTRO MD workup…diagnosed with DYSAUTONOMIA / POTS

CARDIOLOGIST MD – worked

DIGESTIVE:

DIET –

Breakfast – would skip breakfast about 70% of the time;

First meal – school lunch: pizza, chicken fingers, fries, tater tots

Snack after school – crackers/cheese, jerky, string cheese, deli meat,

Dinner – 5:30pm right before hard practices – meat, veggies and starch;

UPPER GI – NAF;

CHRONIC VOMITING – an early symptom and a chronic symptom, initially would vomit before bed at night, tried GERD medicine, no impact, nochange; dry heaving and complex vomiting for 6 weeks which settled down and pattern changed; after 6 weeks he started vomiting throughout the day but no longer dry heaved; after starting Mirtazapine (alpha 2 adrenergic receptor blocker) his vomiting went away for 6 weeks but now after starting school and getting a mild cold his vomiting came back, dizziness, nausea,

ANTIBIOTIC EXPOSURE – 5-6 rounds total in his lifetime; a couple of these rounds happened this year trying to treat the Strep G. infections;

SLEEP: Lights out 9:30, typically takes 20-25min to fall asleep and stays asleep until the morning;

Wake up 6:45am leave for school 7:15am; picked up at 3:40pm, then home from 4-5:30pm; practice 6-8pm (3x per week plus game);

HORMONES:

Atheletic programing –

VITS/SUPPS:
CURRENT SUPPLEMENTS:
* None on file

MEDS/LABS:

BLOOD LABS – when onset of illness, had low WBC and high inflammatory markers ESR; some iron deficiency symptoms; low Hgb12+, low HCT;

CURRENT MEDICATIONS:

* FLUDROCORTISONE ACETATE …………. (0.1MG QD)
* MIRTAZAPINE ………………………….. (30MG QD) given this around May, late spring and subsequently improved throughout the summer, increasing salt and water intake;

HAPLOTYPE:

PHENOTYPE: chronic severe hypoglycemia and meal skippping driving dysautonomia and catecholamine-related dysfunction; upper GI shut down as a side effect of chronic glucagon exposure and high adrenalin exposure;

TODAY’S PLAN: Hypoglycemia eating pattern; Shake, adrenal support;

FUTURE PLAN:

11/06/2023

NEUROLOGICAL Dx – pediatric dysautonomia;

12/13/2023 2:16 pm – Overall not much progress; minimal output energy wise and athletics;

BLOOD TESTS – high ESR +36; low Vitamin D3 +27; hsCRP 5.0;

REVIEWED MYCOTOXIN – High Ochratoxin A mild high; High Citrinin moderate high;

REVIEWED OAT – very low biomie markers, severe depressed microbiome; depressed AMINO ACIDS and MITOCHONDRIA METABOLITES;

GI MAP – High Strepp and Staphylococcus;

01/15/2024 2:11 pm – By the week of Christmas, he hasn’t complained at all about feeling worse; keeping his heartrate under 150bpm; doing 30 minutes of cardio at a 150bpm ceiling and then lifting;

OVERALL PROGRESS – 90% off his lows;

03/05/2024 1:58 pm – Was doing great until yesterday when he woke up feeling gross, dizzy and blacking out; been playing baseball, winter training indoors 3-5x per week;

Dr. Andrew Rostenberg

• This reply was modified 4 months, 2 weeks ago by  Dr. Andrew.
• This reply was modified 4 months, 2 weeks ago by  Dr. Andrew.

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[Marsha]

29-year-old female, who is infertile and showed up as mold toxicity on her OAT. She has begun the toxicity protocol and is having 7/10 pain in her low back, radiating into her shoulders and neck. The pain starts every afternoon about 2 PM and last until the evening, but she wakes up with no pain. is this detox or gallbladder? Possible kidney stone?

[Dr. Andrew]

Pain that gets worse as they day goes on but is better in the morning suggests muscles are involved – they rest at night and work during the day. I would look at improving drainage – GB flush, coffee enemas, rebounding, epsom salt bathing, etc. – to move the toxic lymphatic waste out of her system more efficiently.

[Marsha]

Thank you!