Bellagio Resort & Casino 2008

Bellagio Resort & Casino 2008

Sabin’s tests/results

I am out of the hospital, but still suffer from strong headaches and dizziness. The doctors do not know what caused the stroke and why I still feel awful. These are some of the tests that I took that came up neg. CT Scan, EKG, EEg, Tee, Carotid artery, Liver ultrasound -looks like I do have a baby though. Ha, Spinal tap. Those are all clear which is good!!! MRI- shows lesion on my brain in my thalamus and cerebellum.
I can do daily life, but it is hard. I have to concentrate to just walk straight! My appetite has slimmed, speaking of, which I can’t have anything. No alcohol, no caffeine, low sugar, no Meat, low cholesterol, and so on.
I have to take aspirin for the rest of my life- Blood thinner. No contact sports. Basically, I can play golf! No exercise, have to keep my heart rate down.
That’s pretty much it for now….. Oh, No driving which all of these equals no work. I don’t know how I am gonna survive, that all scares me pretty bad.
It may take me a while to get back to you if you respond, but I do take a look at everyones’ response and it truly lifts my spirits and helps greatly. Please ask any questions! The more everyone knows, the more it may help someone else!

TESTS & RESULTS

-US Carotid Duplex Scan Bilat- (Carotid Ultrasound)- 6/24/09- Dr. Chamian

FINDINGS- No Significant plaque formation. The peak Systolic velocities within the ICA as well as the ICA/CCA ratios were within normal limits bilaterally. Vertebral artery flow is antegrade bilatererally.

IMPRESSION- No Significant carotid stenosis.

XR Chest 1 View AP or PA- 6/24/09- Dr. Yang

Findings- The lungs show no focal infiltrates and there are no pleural effusions. The cardiomediastinal silhoutte is with normal limits.

Impression- No Acute radiographic abnormality.

CT Brain W/O Contrast (Brain Scan) 6/24/09- Dr. Yang

Findings- The ventricles are mid-line and symmetric. There is no mass effect, shift, or hydrocephalus.  Cerebral Sulci are also symmetric and appear normal for age. No evidence of intracranial bleeding or cortical infaract. (whatever that says huh. Who can read and understand that?)

Impression- Unremarkable noncontrast CT of the brain.

MR Angio Head W/O Contrast (important one!)- 6/24/09- Dr. Chamian

Findings- There is artesia or hypoplasia of the right P1 segment. The P2 segment is mainly supplied through the posterior communicating artery. The visualized major arterial segments around the circle of Willis are otherwise of normal and uniform caliber and without findings to suggest stenosis, occlusion, or vasculitis. No evidence of any significant berry aneurysms.

Impression- Essentially unremarkable MR Angiogram of the head. Atretic of Hypoplastic right P1 segment.

MRI Brain W & W/O Contrast (evidence of a stroke)- 6/24/09- Dr. Chamian

Findings- There are multiple small irregular shaped lesions noted in the cerebellar hemisphere bilaterally as well as small lesions in the cerebellar vermis and a 1.9cm size lesion in the left thalamus. The signal changes characterized by increased signal intensity on the diffusion-weighted images and decreased signal intensity on the ADC maps. These lesions are also mild to moderately hyperintense on the T2-weighted sequences and slightly hypointense on T1-weighted imaging. They show evidence of enhancement. Based on the above characteristics, these lesions most likely represent areas of acute ischemic (stroke) injury. The distribution of these images favors some kind of embolic phenomenon. There is no acute mass effect, midline shift or intracranial hemorrhage. Basilar cisterns are patent. No cerebrovascular flow avoids are present.

Impression- There are multiple lesions noted in the cerebellar hemispheres and cerebellar vermis as well as within the left thalamus. Signal characteristics of these lesions indicate that these lesions are acute infractions, most likely due to an embolic phenomenon.

Pertinent Labs- 6/24/09- Glucose 139, BUN 22, the rest of CBC and CMP normal. CT of head is Neg. Chest X-ray is Neg. EKG sinus tachycardia.

Urinalysis toxicology screen positive for Benzodiazepines (xanax… I have never taken it!) Urinalysis is significant for trace ketones and trace protein.

Lumbar puncture was performed. 6/24/09

A 22 gauge spinal needle was advanced in. On the second pass, slightly blood-tinged spinal fluid was obtained. A total of 8 ml of spinal fluid was obtained in 4 vials.

Findings- 101 red blood cells in the 1st tube. with 1 red blood cell in the 4th. There is 2 white blood cells in the spianl fluid. CSF Glucose level was 81, protein level of 34. Central spinal fluid bacterial antigen panel is negative.

EEG 6/25/09- Dr. Chopra

Findings- recorded in the awake and drowsy state. The basic background activity is composed of 11 cycle per second medium voltag, well formed alpha activity, best found in the posterior head regions. There was a moderate amount of low voltage fast activity seen most prominently in the anterior derivations. During drowsiness, buildup of background activity occurs within normal range. Hyperventilation elicits no change. Photic stimulation elicits no change.

Impression- This EEG is within normal limits but a normal EEG does not rule out a seizure disorder. Please correlate clinically.

Transesophageal Echocardiography (TEE) 6/27/09- Dr. Dawood

Findings- 1. Structurally normal aortic and mitral valves. 2- chamber sizes were found to be within normal limits. 3- Left ventricular systolic function appeared to be within normal limits. 4- The contrast study did not show any right to left shunt. 5-Normal left ventricular systolic function was noted. 6-No thrombus or vegetation was seen. 7- Aortic and mitral valves were visualized adequately. 8- Tricuspid and pulmonic valves were visualized partially, and no vegetations were seen.

US Liver 6/27/09 -Dr. Chamian

Findings-The liver appears unremarkable and is normal size and echogenicity. Gallbladder is unremarkable. No gallstones. The common bile duct measures 3 mm. Right kidney appears normal. Pancreas appears normal.

Impression- Unremarkable liver ultrasound

Discharged on 6/28/09- Patient can not drive. Dilaudid and Meclizne prescribed. Dilaudid for head pain and Meclizine for dizziness. Aspirin 81 q-day.

Electronystagmogram (ENG) 7/2/09- Nuerologist Dr. Boulware

it evaluates how well your eyes, inner ears, and brain maintains your balance. STILL AWAITING RESULTS.

BAER scheduled for 7/15/09- Nuerologist Dr. Boulware

Met with Ms Dr. Chamian 7/1/09 General practioner

She asked what my area of study was in….. What I majored in? I am photographer! “Your really smart and educated about all these topics. Its impressive,” she says. “I know, I am young and would like to know where I stand and what I am going through.” I cracked back.

She wants me to see a hemotologist because part of my Cuagulation Test showed my Antithrombin 3 to be low. It can lead to a super rare disease that only 30 people have ever been diagnosed with. The body has a nature to produce its own blood clots.

NO physical therapy is scheduled or needed. They did prescribe it, but I didn’t feel it was needed.

Apt. with Ms Dr. Chamian 8/6/09

July 15th follow up with Dr. Boulware for BAER & ENG, blood work Results

Findings- All unremarkable for all tests.

He is suggesting another CT SCAN and MRI to make sure there are no blood vessels in my head or neck that can be the cause.

July 16th &July 20th Dr Chamian apt from Aug 6th moved up

I was told by Dr. Boulware that he can not do anything more at this point! I have neg results on all tests and he is at a lose. He did call me later in the day wanting me to have more CT Scans and another MRI. If Neg, his statement still stands. He wants to double check that there are no Ruptured or culprit blood vessels in my neck.

In between the phone call I met with Dr. Chamian on the 16th and the 20th (I am unhappy and needed to talk) On the 16th, we discussed the option of leaving Nevada to seek care. In meantime she recommended a Cardiologist because my heart rate is always high but energy levels fluctuate. That also constitutes a possible Thyroid problem which would need a Endocrinologist. She has referred me to both.

On the 20th, I went back because I am dissatisfied with the direction I am being treated. I don’t feel any Dr. is paying attention to the constants I have explained. They do know of them as I have explained to them all, but I feel not enough attention has been given to them. They are 1) A heavy massage from chiro where my head pain is resulted in loss of vision, loss of balance, extreme mood shifts, and overall altered state. It came on within 30 mins of treatment and lasted apx. 2-4 hours and went away. 2) After that, I could make myself dizzy with the head to the left over the shoulder and tilted slightly up. I could do this ant any time always with the same result. 3) Apx 7-10 days from that chiro visit. I woke up with a 90% certainty that I slept with head over my left shoulder and completely out of it which lead to the hospital visit and current status.

She believes that I have a legitamit grief and that I am such a rare case that it is important test anything that can be a possible cause. I believe that it is a blood flow issue with the possibility of my anatomy altered from others where I pinch my own blood flow resulting in it not reaching my brain. Understands I am not happy and expresses that my case is so rare and all are stumped.

After that visit with Dr. Chamian on the 20th, I got a certified mail letter from her DROPPING me! She gave no reason for why as well!

July 21st Dr Nguyen Hematologist Apt.

Ordered a Milk jug worth of blood for an enormous amount of tests ran. He claimed the Hospital only a 5th of what he would have done. One thing he is testing is to see if I have really thick blood that would make my body more prone  to clotting

Results are due back Aug. 18th Apt that day as well

July 22nd CT Scan Scheduled- CANCELED

July 25th MRI Angio Test Scheduled- CANCELED

I AM CHANGING NEURO DOCS.

I am now in limbo waiting… I really would rather see dr.s and get answer or at least they are working on it. Since I am changing Nuero Dr.s I have to wait a little bit.

Apt. at RUSH Medical in Chicago on Sept. 21st

Rush has a stroke division dedicated to individuals for the ages under 50

I am basically starting over with all new Dr.s at this point!!!

Aug. 6th apt. with  Dr. Nahkle an Endocrinologist

Dr. Nahkle has scheduled some more blood work and a test for AUG 7th to test for an Autonomic dysfunction. He believes it may be a nerve related issue. If not, he has no clue. Learn more here- http://tinyurl.com/4am78c

Aug. 7th apt. with  Dr. Nahkle for Autonomic Dysfunction

Ansar Test

Findings- Moderately high heart rate. Blood pressure increases when I am standing as it should Decrease while standing.

Results- Body is releasing too much adrenaline- called Neuropathy. Also a risk for Orthostatic Hypertension. Learn more here. http://tinyurl.com/no887n

Treatment- There are many possibilities that hopefully Mayo will explore and treat.

Aug. 13th apt. with Dr. Santos a Neurologist- CANCELED

Mayo Clinic in Scottsdale, AZ with the Neurology department on Aug 11th

(See the Mayo Clinic page for all details besides the MRI Results below)

Aug 14th Mayo Report of MRI

Technique: Sagittal T1, Axial T2, and gradient-echo T2 series. Axial and coronal FLAIR and diffusion of the brain. 2-D and 3-D MRA neck. 3-D MRA head. bolus MRA of the neck. 15 ml of multiHance administered intranvenously.

Comparison: Outside MRI brain 6/25/09

Findings:
Multiple chronic infracts in the cerebellar hemispheres as well as the left Thalamus demonstrate expected evolution. No evidence of acute infract. Otherwise the brain is unremarkable.

Intracranial MRA demonstrates a fetal origin of the right PCA. Otherwise intracranial circulation is with in normal limits.

Cervical MRA reveals antegrade flow in both vertebral arteries. Bilateral carotid bifurcations are normal. The origin of both vertebral appears normal. No evidence of luminal narrowing to suggest dissection at the this point in either vertebral artery.

Aug 26th apt with Dr. Mock, a cardiologist.

He wants another type of test scheduled to look or a PFO. Wants a treadmill test to look into my heart rate issues as well.

Sept. 3rd Treadmill Test with Dr. Mock

The test basically showed that I am a healthy young man. The high resting heart rate is still in question though

Oct. 5th at Barnes with Dr. Carpenter, a Neurologist

Well… That appointment was a complete waste!!! I was so frustrated. I mean, the first question Dr. Carpenter asked me was, “What can I do for you? What’s the problem?” Are you serious??? I had 3 phone conversations with his office stating that I was a cash patient, traveling to see him, and did not want to see him unless he had something new to bring to the table! He had nothing. Nothing!!!! Why did he even see me? Knowing that I was a cash patient? Hell, maybe he didn’t know. Poor communication in their office. I’ve had way too many doctor visits getting the same responses. He even started speculating with causes but saying it in a way that I should believe him. If that was my first doctor visit, I probably would have taken everything he had to say to be true. He could have been helping someone else instead of taking advantage of me and doing more unnecessary billing! He said that it wasn’t a waste of time… I asked him how it was a good use of time then and he only repeated things that were in my case or that I already new. He didn’t go over the case prior to my apt. as I was told and it was evident. Plus, he looked at digital MRI’s of mine for the first time while I was there. I am just going to become a neurologist and have a practice called No B.S. Neurology~! Seriously, why not.

Transesophageal Echocardiography (TEE) 10/16/09- Dr. Mock (A repeat test)- Cancled

Dec. 1st Neurologists apt. with Dr. Cohen at Sunrise Hospital in Las Vegas


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