• Dr. Andrew

    Administrator
    March 8, 2024 at 3:22 pm

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