A Progress Note dated 04/11/2017, by Neha Shah, M.D. (Immunology), stated that the patient presented with an Ehlers-Danlos syndrome. She had been feeling better. Her energy has been improved a little. She was able to walk and sit down. The patient complained of intermittent bone pain (long bones). Her review of systems was positive for joint issues, nocturnal urination, trouble falling back to sleep, fatigue, weight gain (30-40 pounds over the last 2 years), constipation, dyspepsia, fever, night sweats, and chills. Eye floaters, sore throat, sinus congestion, difficulty breathing, occasional chest pain and palpitations, joint swelling in the knees, anemia, muscle weakness, and paresthesias were also noted. Her physical examination was unremarkable.
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(Immunology), stated that the patient presented with a severe headache described as sharp and worsened with Valsalva and when lying down. The headache lasted for 15-20 minutes. She reported no benefit from the prior use of Aleve. It was noted that baking soda and a black strap molasses (in water) decreased the pain. She felt that her feet have grown in size. She also felt that the bottom of her feet and her forearm skin were thickened. The patient also felt a puffy hands. According to the nurse, the condition may be some kind of eosinophilic fasciitis type of process likely a reaction to gadolinium. Her review of systems was positive for a right tonsillar pustule with surrounding erythema, and cervical lymphadenopathy on the right. According to the provider, the patient had a possible gadolinium toxicity as evidenced by increased bone pain diffusely and visual changes since infusion on 01/03/2017, cognitive dysfunction, headaches, paresthesia, and fatigue. The treatment plan included Methylenetetrahydrofolate reductase, a CT scan to detect any structural abnormalities, and a referral to Neurology. Curcumin, N-Acetyl-L-Cysteine 600, Milk Thistle, and Simylarin were …show more content…
The patient complained of an intermittent mild headache (specific points in the head), fatigue, burning and severe pain in the hands, feet, and calves, severe pain in the bones, and a brain frog. The patient also had a purplish discoloration of her toes. She was unable to wear compression stockings ( for her POTs) secondary to the pain in her feet. Her blood pressure was 117/88 mmHg. Her physical examination revealed a ruptured right tonsillar pustule. On 02/16/2017, her ANA test revealed a result of 1:160. On 05/10/2017, it was noted that the patient had a gadolinium count of 16 mg/g (high). A skin biopsy was suggested. According to the provider, the patient's pre-chelation laboratory results revealed upper normal limits. However, with post-chelation, she had extremely high levels of urinary gadolinium excretion, confirming high body load of stored gadolinium. The patient had severe ice-pick like head pain which lasted for several weeks right after the first round of chelation with DTPA (2 days) in early May 2017, which has subsided in the subsequent weeks. However, the patient still presented with peripheral pain, bone pain, fatigue, and brain frog. Continued D-Ribose and anti-inflammatory diet were
(Immunology), stated that the patient presented with a severe headache described as sharp and worsened with Valsalva and when lying down. The headache lasted for 15-20 minutes. She reported no benefit from the prior use of Aleve. It was noted that baking soda and a black strap molasses (in water) decreased the pain. She felt that her feet have grown in size. She also felt that the bottom of her feet and her forearm skin were thickened. The patient also felt a puffy hands. According to the nurse, the condition may be some kind of eosinophilic fasciitis type of process likely a reaction to gadolinium. Her review of systems was positive for a right tonsillar pustule with surrounding erythema, and cervical lymphadenopathy on the right. According to the provider, the patient had a possible gadolinium toxicity as evidenced by increased bone pain diffusely and visual changes since infusion on 01/03/2017, cognitive dysfunction, headaches, paresthesia, and fatigue. The treatment plan included Methylenetetrahydrofolate reductase, a CT scan to detect any structural abnormalities, and a referral to Neurology. Curcumin, N-Acetyl-L-Cysteine 600, Milk Thistle, and Simylarin were …show more content…
The patient complained of an intermittent mild headache (specific points in the head), fatigue, burning and severe pain in the hands, feet, and calves, severe pain in the bones, and a brain frog. The patient also had a purplish discoloration of her toes. She was unable to wear compression stockings ( for her POTs) secondary to the pain in her feet. Her blood pressure was 117/88 mmHg. Her physical examination revealed a ruptured right tonsillar pustule. On 02/16/2017, her ANA test revealed a result of 1:160. On 05/10/2017, it was noted that the patient had a gadolinium count of 16 mg/g (high). A skin biopsy was suggested. According to the provider, the patient's pre-chelation laboratory results revealed upper normal limits. However, with post-chelation, she had extremely high levels of urinary gadolinium excretion, confirming high body load of stored gadolinium. The patient had severe ice-pick like head pain which lasted for several weeks right after the first round of chelation with DTPA (2 days) in early May 2017, which has subsided in the subsequent weeks. However, the patient still presented with peripheral pain, bone pain, fatigue, and brain frog. Continued D-Ribose and anti-inflammatory diet were