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A dentist’s severe pain signaled a nearly invisible disorder

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For over a year Tara Zier waited in vain for the vise-like tightness in her chest and the pain in her neck to subside.

The Northern Virginia dentist’s life imploded in October 2014 when her ex-husband, the father of their children, who were then 11 and 13 years old, killed himself.

At first Zier thought that her pain could be the product of intense stress combined with grief. But nothing she did seemed to help, and her neck pain, an occupational hazard for dentists, was getting worse.

In January 2015, Zier was driving back from Vermont with her kids after a snowboarding trip when she stopped at the Garden State Parkway. Zier had been struggling with severe bronchitis for several days; becoming increasingly short of breath and dizzy, feeling too sick to drive the rest of the way home. She spent the next four days in a New Jersey hospital, where she was treated for pneumonia.

As the year progressed, Zier continued to feel unusually exhausted. Her chest felt tight and her neck hurt.

But the tests of her lungs and heart were normal, and multiple MRI scans of her spine and neck found nothing that would explain her symptoms.

»READ MORE: Medical Mystery: A surprising solution after years of shortness of breath and heart problems

In January 2016, Zier saw her internist, who diagnosed severe psychological distress and advised her to take the anti-anxiety medication he had prescribed after the death of her ex-husband.

Zier thought physiotherapy might help; instead, she felt worse. Multiple sessions of cognitive behavioral therapy with a mental health advisor were not helpful. Nor was she given a series of steroid injections into her throat by an anesthetist. A cardiologist, a neurosurgeon, and an ENT specialist found nothing to complain about.

Most important to her is the realization that her children, devastated by her father’s suicide, had only one parent.

“Nothing can happen to me,” she remembers that she often thought.

In early 2017, Zier was treated in the emergency room of a Maryland hospital for excruciating neck pain that was diagnosed as muscle cramps.

The emergency room doctor prescribed diazepam, the widely used (and abused) sedative commonly known as Valium, along with brief corticosteroid treatment.

For the first time in many months, Zier recalled, “I actually felt better.” But the pain quickly returned when she stopped taking the medication.

»READ MORE: Medical Mystery: A non-healing bruise signaled a serious problem

Shortly afterwards she went to see a second cardiologist and a psychiatrist; both told her that she had chronic anxiety. The psychiatrist suggested to Zier to spend time “not being a patient”.

It was advice she found offensive and frustrating.

“I don’t rule out a mental health problem at all,” said Zier, now 50, “but there was something wrong with my body.”

In October 2017, her internist sent her to a neurologist in Washington after she reported sudden numbness on the side of her face and worsening dizziness.

“I thought he would blow my mind,” recalls Zier, “but he listened to me.”

The neurologist ordered an MRI of her brain along with a series of blood tests.

Among them was a test to measure the level of antibodies against glutamic acid decarboxylase (GAD), a protein that is involved in the production of an important neurotransmitter in the brain. The neurotransmitter known as gamma-aminobutyric acid (GABA) helps control muscle movement and regulate anxiety.

The GAD antibody test is used in diagnosing diabetes and epilepsy and to detect a rare, progressive neurological condition called stiff person syndrome (SPS), which affects the brain and spinal cord, causing alternating stiffness and painful muscle spasms, as well as increased sensitivity to stress, noise or other stimuli. Most people with SPS have elevated anti-GAD antibody levels. Some studies have found that they also have lower levels of GABA, which may explain their persistent anxiety.

“All of your tests were normal, except for one,” recalls Zier when the neurologist told her. Your GAD65 antibody level measured 25,000 units per milliliter (U / ml); normal is less than 5 U / ml.

The neurologist told Zier he believed she had SPS, even though he had only seen one other case in his nearly 40-year career.

»READ MORE: Medical Mystery: The young athlete had groin pain for months but no previous injury

SPS was first identified by doctors at the Mayo Clinic in 1956 and is believed to affect about one in a million people, most of them women with an autoimmune disease such as type 1 diabetes. (Zier suffers from Graves’ disease, which causes an overactive thyroid.) The disease may be due to a defective immune response; it is often misdiagnosed as Parkinson’s disease, multiple sclerosis, severe anxiety, or, less commonly, agoraphobia.

A stooped posture is characteristic of SPS and some people can become too difficult to walk. Others fear leaving their homes because the sound of a car horn can cause violent, unpredictable muscle spasms that can lead to a fall.

The neurologist prescribed Valium and baclofen, a muscle relaxant, both of which are the main treatments for SPS.

“I was relieved that I had a diagnosis,” said Zier, who had to quit dentistry, “but was afraid of what it meant.”

Zier’s internist helped her get a consultation at the Mayo Clinic. She spent a week in Minnesota undergoing additional tests that confirmed the SPS diagnosis and participated in Mayo’s pain management program.

Zier eventually opted for treatment near his home at Johns Hopkins’ Stiff Person Syndrome Center, considered the only one of its kind in the world.

For the past few years she’s seen Scott Newsome, the neuroimmunologist who runs the center.

Although Zier was diagnosed much more quickly than most people with SPS – the average delay after the onset of symptoms is about seven years – their experience is fairly typical.

“People are laid off early and are believed to have a mental health problem or are exaggerating,” observes Newsome, an associate professor of neurology who estimates he has seen about 200 people with SPS. Prolonged anxiety, he said, seems intrinsic to SPS and has been present in every patient he has seen.

»READ MORE: Medical Mystery: Persistent knee pain with no relief from steroid injections

Zier doesn’t have the dislocating symptoms caused by muscle spasms that can occur in severe cases. But, Newsome added, “most people” [with SPS] are disabled and their lives are turned upside down. “

Treatment is aimed at relieving symptoms, improving mobility, and slowing the progression of the disease, which has a variable and unpredictable course. In addition to medications ranging from muscle relaxants to immunotherapies, water therapy, stretching, and cognitive behavioral therapy are recommended.

Zier’s condition appears to have improved in recent years, although pain is a constant. “Every day is a struggle,” she said. “I am glad that I am breathing and that my dog ​​is lying on the couch with me.”

Zier recently founded the non-profit group Stiff Person Syndrome Research Foundation, which, along with research funding, aims to raise awareness of SPS.

She remains concerned about the skepticism she initially encountered, an experience that seems to be common among those who share her diagnosis.

“The stress that comes with a diagnostic odyssey is unreal,” she said. “I’m not an easily offended person, but getting fired again and again was very tough.”

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With first Louisiana location now open, Eleanor Health brings compassionate, whole-person care for addiction and mental health to Baton Rouge | Sponsored: Eleanor Health

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Editor’s note

This article is brought to you by Eleanor Health.

A nationally recognized team that specializes in the treatment of addictions and mental illnesses has landed in Baton Rouge. The new clinic will offer on-site services and reach the entire state of Louisiana with a virtual care platform.

“I believe that when prospective members join us, they are ready to make a life change,” said Julie Insyxiengmay, lead clinician at the Baton Rouge site. “Eleanor Health offers a number of services that set us apart from other substance use treatment programs. Every member who comes to our treatment because of their substance disorder has the opportunity to get involved with our care team at different levels of care: medication assistance provider, registered nurse, therapist, community recovery partner and member experience administrative specialist. At Eleanor Health, we believe in the harm reduction model that fully supports the autonomy of parishioners in their treatment. ”Holistic care is a key pillar that enables the interdisciplinary care team to develop personalized care that is tailored to the parishioner’s recovery goals . This approach promotes the best results specifically for the members.

Eleanor Health officially opened its Baton Rouge facility in February. This is the first Eleanor Health location in Louisiana. Additional locations are in Massachusetts, New Jersey, North Carolina, Ohio and Washington.

Eleanor Health’s services include drug therapy, counseling, mental health care, and more. They are intended for all people aged 16 and over who are struggling with or are affected by an addiction disease. Anyone who signs up for services is known as an Eleanor Health Community member because when you join their community you are a lifelong member.



Julie Insyxiengmay – Senior Clinician | Louisiana



What sets Eleanor Health apart from other companies is the individualized approach to stigma that begins as soon as someone calls. Anyone can contact the staff on behalf of themselves or a loved one to begin the journey. This step usually starts with the Access Team.

“Our access team is made up of Eleanor Health employees, not third parties or an automated system,” said Tylynn Mayo, Growth Marketing Associate at Eleanor Health. “When someone contacts us, they can sit down and have a real conversation with someone on our team.”

Wes Gonzales, director of operations at Eleanor Health, said these interpersonal connections are an integral part of the philosophy of offering personalized care that addresses all aspects of a person’s health.

“We really believe in a holistic approach,” he said. “We see ourselves as a psychiatric home for our members. This includes coordination with general practitioners and specialists to ensure that the needs of the members are met across the board. “

Insyxiengmay went on to say that Eleanor’s co-founders spent hours and hours researching to adopt this new model. Previous studies have shown that treating a person’s mental and emotional health is just as important as treating a physical addiction to a substance. The groundbreaking data we are now collating shows that the success of harm reduction with behavior therapy is key to long-term recovery. Harm Reduction is a practical strategy to reduce the negative effects of drug use on the member and their support system. With the growing opioid crisis, it is imperative that the industry analyze where programs to use substances have failed and adapt to more innovative practices.



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Westmoreland (Wes) Gonzales – Operations Director | Louisiana



“At Eleanor Health, we understand that mental health is closely related to drug addiction. Therefore, we offer evidence-based practices to ensure they understand their addiction process, engage in a harm reduction process, and learn to use coping strategies and strategies to confidently support their recovery. Therefore, at Eleanor Health, our mission is to help people affected by addiction live amazing lives.

The Baton Rouge Clinic already serves community members who use opioids and other substances. The members come from all backgrounds and from all walks of life. To help them stay on track, Gonzales said all Eleanor Health services are offered on an outpatient basis, with flexible scheduling and virtual treatment. We accept some major insurance plans like Medicare, Medicaid, and United Healthcare and offer affordable payment plans. We want to give as many members as possible the opportunity to imagine a different life.

“The flexibility we offer enables our members to get on with their lives and responsibilities, but also receive the care they need to manage their addiction,” he said. “You can receive drug treatment and services from in-house therapists, a community recovery partner for peer support, and a nurse care manager for general health. It’s about creating more positive interactions and reducing the stigma surrounding substance use disorder. We want people to feel comfortable and accepted with us. “

The Eleanor Health Baton Rouge Clinic is located at 3975 O’Neal Lane, Suite B. For more information, visit www.eleanorhealth.com, call 225-269-9646, or email gethelp@eleanorhealth.com .

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Michigan confirms 1st human case of hantavirus, a disease spread by rodents

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Earlier this week, Michigan health officials reported the state’s first confirmed case of Sin Nombre hantavirus, a disease spread by rodents but not between individuals.

The Michigan Department of Health and Human Services (MDHHS) announced that an adult woman in the Washtenaw district was recently hospitalized with severe lung disease from the Sin Nombre hantavirus. The person was likely exposed while cleaning an unoccupied apartment that showed signs of active rodent infestation, MDHHS said.

Related: Tick risk is now rife in Michigan – what you should know

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The hantavirus was first discovered in 1993 in the southwestern United States as responsible for hantavirus lung syndrome (HPS) in sick patients. Since then, HPS has infected people in the United States and America. Hantavirus infections are associated with domestic, work, or leisure activities that involve people coming into contact with infected rodents. Most of the cases have been identified in adults and usually appear in spring and summer.

As of last year: CDC warns of “unusual or aggressive” rodents foraging in the midst of COVID-19

“HPS is caused by some strains of hantavirus and is a rare but serious and sometimes fatal respiratory disease that can occur one to five weeks after a person has been exposed to fresh urine, feces or saliva from infected rodents,” said Dr. Joneigh Khaldun. Chief Medical Executive and Chief Deputy for Health at MDHHS. “Anyone exposed to hantavirus-infected rodents is at risk for HPS, and healthcare providers with a suspected hantavirus case should contact their local health department to report the case and discuss options for confirmatory testing.”

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Humans become infected when freshly dried material that is contaminated with rodent excretions is disturbed and inhaled, gets into cracks in the skin or mucous membrane or when contaminated food or water is swallowed. Rodent bites can also transmit hantaviruses. The highest risk of exposure is when entering or cleaning structures that have been infected by rodents. There are no documented cases of human-to-human hantavirus transmission in the United States

Related: Metro Detroit is among the worst areas for rats in the US

Symptoms of HPS may initially be non-specific and include fever, chills, body aches, headache, and gastrointestinal symptoms such as nausea, vomiting, diarrhea, and abdominal pain. The disease can progress to coughing and shortness of breath. HPS has a 40% death rate.

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“We can prevent and reduce the risk of hantavirus infection by taking precautions and being aware of the possibility of it,” says Dr. Juan Luis Marquez, medical director for the Washtenaw County Health Department. “Use rubber, latex, vinyl, or nitrile gloves when cleaning rodent-infested areas, ventilate the areas for at least 30 minutes before working, and make sure to thoroughly disinfect or disinfect the areas before cleaning.” Wet the chlorine solution. “

Hantavirus cycle. (NSF)

Hantaviruses are a family of viruses that are mainly distributed by wild rodents and are found around the world. Several hantaviruses have been identified in the United States that can infect humans, and each hantavirus has a primary rodent host. The main hantavirus in the United States that causes HPS is Sin Nombre virus, which is spread by the deer mouse and white-footed mouse.

The greatest risk of hantavirus infection is opening up or cleaning up closed rodent-infested buildings without adequate protection. Healthcare providers with a suspected hantavirus should contact their local health department to report the case and discuss options for confirmatory testing.

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Hantaviruses are viruses and are susceptible to most disinfectants (dilute chlorine solutions, detergents, general household disinfectants including those based on phenols, quaternary ammonium compounds, and hypochlorite). Depending on environmental conditions, these viruses are likely to survive for less than a week indoors and much shorter periods of time (hours) when exposed to sunlight outdoors. Special precautions should be taken when cleaning up after rodents. If the rodent infestation is severe, it is recommended to consult a pest controller.

COVID-19 vs. Hantavirus Lung Syndrome (CDC)

Copyright 2021 by WDIV ClickOnDetroit – All rights reserved.

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Delta Variant Producing More Severe Illness, Doctors in China Say

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As the delta variant of the coronavirus spreads in southeast China, doctors are finding that the symptoms are different and more dangerous than those they saw when the first version of the virus spread to downtown Wuhan in late 2019.

Patients are getting sicker and worsening much faster, doctors told state television Thursday and Friday. Four fifths of symptomatic cases developed a fever, they said, although it was not clear how this compared to previous cases. The virus levels that are detected in their bodies rise to higher levels than previously seen and then drop only slowly, the doctors said.

Up to 12 percent of patients become seriously or seriously ill within three to four days of the onset of symptoms, said Guan Xiangdong, director of intensive care medicine at Sun Yat-sen University in Guangzhou City, where the outbreak has concentrated. In the past, the proportion was 2 or 3 percent, but occasionally up to 10 percent, he said.

Doctors in the UK and Brazil have reported similar trends in the variants circulating in these countries, but the severity of these variants has not yet been confirmed.

The testimony from China is the latest indication of the dangers posed by Delta, which the World Health Organization described as a “worrying variant” last month. First identified this spring in India, where it has been blamed for widespread suffering and death, Delta has since become the predominant variant in the UK, where doctors suspect it is more contagious and may infect some people who only take one of two doses from a. have received Covid19 vaccination.

However, China has uniquely detailed data as it has essentially universal testing near outbreaks that allow officials to gather detailed information on the magnitude of the cases.

The proliferation of Delta in southeast China is drawing more attention to the effectiveness of China’s homemade vaccines. The Chinese authorities have not stated how many of the new infections have occurred in people who have been vaccinated. In some other countries where Chinese-made vaccines are widely available, including Seychelles and Mongolia, infections are increasing among those vaccinated, although few patients are reported to have developed serious illnesses.

Last week near Shenzhen there were a handful of cases of the alpha variant, which first appeared in the UK.

With some other parts of the world still struggling to source and run large numbers of coronavirus tests, southeast China has used its local production of scarce chemicals to run tests on a remarkable scale. Authorities said they carried out 32 million tests in Guangzhou, which has a population of 18 million, and 10 million in the neighboring city of Foshan, which has 7 million people.

Guangzhou has also isolated and quarantined tens of thousands of residents who were near the infected. The testing and quarantine appear to have slowed but not stopped the outbreak. China’s National Health Commission announced on Friday that nine new cases had been found in Guangzhou the day before.

“The epidemic is not over yet and there is still a risk of virus transmission,” said Chen Bin, deputy director of Guangzhou City Health Commission.

Albee Zhang contributed to the research.

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