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12 yom diagnosed with “Dysautonomia” and seeing no progress, no results for approximately 7-8 months.
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 fileMEDS/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:
Dr. Andrew Rostenberg
:: ADJUSTMENTS::
– Lumbar Back (QL testing)—————————————-
NEUROLYMPHATIC REFLEXES
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Gallbladder: 4
Stomach: 6
Pancreas: 6
Adrenal cortex, right: 5
Ileocecal valve, right: 4HR – 93
BP – 110/60 supine L vs. standing L 125/70 L-
This reply was modified 6 months, 1 week ago by Dr. Andrew.
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This reply was modified 6 months, 1 week ago by