(Snippets from the frontline)
Embarrassed
Gradually over 6 weeks, her symptoms worsened. Being a diabetic two decades, this 70 year old was sensitive to bodily changes.
Now with progressive and ongoing symptoms, she sought a second opinion. Dizziness was prominent, with subtle headache and blurred vision, as well as muscle aches and a new tremor.
We scrutinized her medication, and asked about any new over-the-counter drugs. She had a tremor, but no other gross neurologic abnormalities were found. I referred her to a neurologist. A scan of the brain was normal, and no new diagnosis was made.
In follow-up four week later, her symptoms had resolved. That’s when she fessed up.
Her family did not know she smoked, so in an attempt to stop, a doctor prescribed a medication (“off-label”) two weeks prior to symptoms beginning. In our first visit, asking about medication prompted her to closely review the side-effect profile, yet she still did not reveal this to me nor the neurologist. She stated she was embarrassed. Self-tapering off the drug, her symptoms resolved.
No matter what the main use of a medication, be aware, they all have side-effects.
Eventually she stopped smoking on her own.
Gene Uzawa Dorio, M.D.
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