Quality of Life - the Primary Component in Senior Health Care

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Sample Consults

Allgood Harrison, Jr

A text from a patient reads like this:
"My family thinks you are great because of what you have accomplished. My wife has even started talking about getting back together. She can’t understand where all the energy comes from. I do. I am not depressed and have taken only 2 clonazepam this month. That’s down from 8 per day when we first met. I thank God just about every day for you and the approach you take. And thanks for saying you are my friend. That really lifts me up."

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Bestloft, Larry

This patient presented with muscle disorders, severe anemia, and multiple problems throughout his body. The statin drug had begun a prescription cascade which affected him negatively. His multiple coronary catheterizations and stents had not helped him at all. I have yet to understand the need for multiple coronary catheterizations and stents. Removing the drugs through a slow taper process as we slowly titrated in the new alternatives was difficult, but he stuck to the plan and we were successful in reaching our goal. He is now very active again, plays golf several times a week, keeps his own yard and constructed a deck by himself. The physician was very cooperative so our team approach brought this patient back to good health and reduced his drug usage from 22 drugs to down to 6 drugs with a few vitamins. The B12, folic acid and B6 has pulled down his LDL and increased his HDL by 23 points. Stopping the Lipitor reminds me of pulling the plug in the bathtub and all the problems then go down the drain. His progress has been remarkable.

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Biltmore, Gerald

This 99 year old patient was a treat. He was referred to me by his physician to see if we could organize his medications and reduce side effects He is very active and alert so consolidating his cardio/antihypertensive drugs and removing some of the vitamin preparations that were of no benefit would improve his quality of life. He is now 100 and still drives his car daily to visit his sisters, lives alone and conducts all of his own business by himself. I see him in the bank every few days and just think how he is living proof that hard work and clean living pays off. He was a hard working farmer, worked very hard and invested his money well, didn’t drink or smoke, raised 6 children and now at 100 continues to live an independent pain free life.

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Brownlove, Martha

This patient is a very strong willed person. She was taking so many drugs that it was amazing that she could even stand up. It was clear that her anticholinergic drugs exacerbated heart rhythm and when removed there would be no need for all the rhythm drugs. It took 90 days to totally wean her off all the drugs, and sure enough, she didn’t need the rhythm drugs at all. Also, her migraine headaches stopped. There were problems stopping the Fosamax because the doctor falsely believed that it actually makes bone. After several conversations with the doctor I got him to stop the Fosamax which immediately improved her GI problems. I was successful in removing all the drugs and going to my plan which changed her quality of life completely. There was no way to stop her smoking and she would not even discuss it. Today she still does remarkably well, smokes two packs a day and uses oxygen throughout the night but remains very active socially.

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Huntington, Eloise

This patient came to see me at the insistence of her husband and son years after her diagnosis of Parkinson’s disease. She was hostile and cognitively impaired. Her paranoia made it impossible to work with her. I initially believed that her mental problems were drug induced, that she didn’t have Parkinson’s, and that her problems resulted from the multiple use of the dopamine agonists and would clear up if we removed the drugs. She refused to go get the blood chemistry labs I require so the meeting was adjourned. Later she consented to the labs being done. Her family had told the neurologist about my belief, but he sent her to a psychoneurologist who confirmed his diagnosis. After learning this I reiterated the fact that the familial senile tremors had been present in her family dating back four generations. I thought we could resolve her mental condition but I wasn’t sure we could improve the tremors. This could be tried after we had her totally clear of all the dopamine agonists. I started her on Venlafaxine ER 37.5mg at bedtime and titrated up to 150mg at bedtime to control some of the paranoia and help her sleep. The removal of the two dopamine agonists and other drugs were done one at a time slowly with dosing adjustments every 7 to 10 days until all were removed. Two weeks into this tapering the husband called to say he was getting his wife back again since she was so much better and he just wanted to thank me. 90 days later and free from all the other drugs she is back to normal, drives her car, works in the garden, has rejoined her garden club and bridge club, plays with the grandchildren and is a wonderful wife and mother. She now takes only the Venlafaxine ER 150mg along with calcium and vitamins. I plan to start next with some of the old drugs that may improve the tremors in her right hand. Even if this isn’t completely effective, her quality of life will have been improved greatly.

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Marion Upshaw

This patient was in so much pain and was going to a pain that he was going to a pain clinic. They had inserted a stimulator as well as filling him full of massive doses of Oxycontin . His pain was still out of control. He was also on Zocor 80mg daily. This was the root of much of his pain and neuropathy. Additionally he was on a massive 80mg PPI dose. This was causing the leaching of calcium from his bones, also causing unbearable pain. Consistent with his CBC it looked like his bone marrow had stopped making blood and his red and white cell counts were unbelievably low. Tapering him off the opiates therapy was not going to be as hard as tapering off the PPI. This digestive system had be stopped for such a long time that any small dose reduction of the PPI would exacerbate hypersecretions that were very difficult to deal with. With the opiates, PPI, dopamine agonists, potent NSAIDS, and drugs treating the neuropathy unsuccessfully this patient was in a royal mess. The old drug Librax with the Clidinium worked well to reduce nausea and vomiting and calm down the smooth muscles from the spasms which were anticipated during the taper. It took 8 months to get all the drugs completely gone. Since the nausea and vomiting continued to present in cycles throughout the week he was sent to a gastroenterologist who discovered gall bladder disease, so he will remove the gall bladder. This should completely resolve his digestive problems and allow him to progress to the point of having the pain stimulator removed. With some PT he should soon be able to play golf again.

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