Knowing When to Ask for Help

Hello all. Well, my weekend was capped off right, with Spain winning the EuroCup for the second consecutive time. Sunday morning my pals and I met for breakfast, all in our Spain jerseys and began getting ready for the final match that started later in the day. By 5 p.m., my buddies and I, along with anyone else in a red jersey, were on cloud nine watching La Furia Roja raise the EuroCup once again. This was the first time in history a national team has won 3 major titles in a row (EuroCup2010, World Cup 2010, EuroCup 2012).

I suppose that's enough gloating for now. Today I'd like to share a little tale about a patient I began to see last week. This patient had been seen before in our clinic about a year and a half ago for the same complaint of dizziness. The patient had been previously diagnosed and treated for cervicogenic vertigo. The treatment given a year ago did help her condition, the patient reported, but never really got rid of her dizzy spells. I say dizzy spells, because what the patient described didn't sound like vertigo. The patient was experiencing a sensation of falling through the ground, almost as if she was riding a down-going elevator. The spells could come at anytime during the day and were reported to not have any correlation with head movement or any other triggers. After working the patient up, my differential diagnosis was leaning towards a cerebellar issue, possibly cerebellar fatigue.

2012-07-03_humphreys
Dr. Humphreys

Neurological issues are somewhat difficult to nail down with a definitive diagnosis and treatment. Realizing I may be a tad over my head, I called in the big guns, Dr. Robert Humphreys, neuro-extraordinaire. It just so happened that Dr. Humphreys was here in Florida at the time, and took an hour out of his busy day to help me and my patient, and perform a neuro evaluation. I can now say from experience, that sitting through a lecture is one thing, but actually watching Dr. H perform his exam and reason through subtle cortical findings to reach a diagnosis, is something completely different and extremely educational. Dr. H used functional neurology to determine that the patient was experiencing this symptom of falling due to a decreased ability of her left cerebrum to communicate with her right cerebellum. Activating, or jump-starting, the left side of her brain with propioceptive input and known left-sided brain activities eliminated the patient's secondary symptoms and previous positive cortical findings. It is our hope, that with the treatment plan Dr. H and I came up with, the patient's dizzy spells will also be eliminated.

I learned a lot from this patient. Aside of this being a cool case, and getting to work with Dr. Humphreys, I think the real lesson here was knowing when to ask for help. Yes, I could have treated the patient how she was treated previously, she had reported that the previous treatment had even helped, but would that have been what was best for her? The patient's best interest should always be at the forefront of treatment, not the doctor's pride, or ease of a treatment regime. My patient appreciated me telling her that I didn't know exactly what was wrong with her, but I would find someone who could find out.

I hope everyone enjoyed the story today, and enjoys a nice break in the middle of the week for Independence Day. I plan on spending the day on the beach Wednesday doing what I do best.

Catch everyone on the flip side,
Dex