The introduction is also posted on Spotify as a podcast by “Gerry at The Health Equation”
You can search Spotify for “Gerry at The Health Equation”
Or use the link below
https://podcasters.spotify.com/pod/show/gerrygaj
Below is the specific link
Gerry Gajadharsingh writes:
I had a patient yesterday with a very challenging set of symptoms. Without going into full details one of his main symptoms was a feeling that his whole body is numb and he has lost 99% of sensation. He is feeling weak and understandably very distressed regarding his symptoms which have been going on for over two years, it is having a significant impact on living his life.
He has seen countless neurologists, had numerous brain scans and other investigations all paid for privately with them all concluding he is depressed. And they can’t find an obvious medical/pathological reason to account for his symptoms. Interestingly, he also saw a professor of cardiology who in my opinion correctly concluded he had an autonomic nervous system dysfunction, but with no treatment offered.
Like many patients with so-called medically unexplained symptoms they are labelled depressive, unfortunately many patients find this difficult to accept and simply do not believe the label. And what patients believe and what they do not believe has a big impact on whether they will get better or not.
Depending on the part of the body that is expressing the symptoms they are called different things, in this case it would be called a functional neurological disorder or FND, I have recently blogged about functional abdominal symptoms.
It is important to understand that whatever symptoms the patient has they are actually real. The sad takeaway from most patients who are labelled with anxiety/neurosis/depression is that their symptoms are not real and they do not feel believed. I believe this is one of the reasons why these patients rarely get better if they get stuck in the normal conventional medical paradigm.
The majority of patients who develop symptoms have functional problems. They do not have obvious pathology/disease processes to account for their symptoms. This leads to endless frustration with the conventional medical system as generally when the test results are normal conventional medical doctors are unsure what to actually do to help the patient and this is enormously frustrating for both the clinicians and the patients.
In this particular case, and sometimes it’s not so obvious, when I examined him via capnometry and heart rate variability monitoring or HRV (which assesses the balance within his autonomic nervous system), he was hyperventilating. With a very fast breathing rate and as a consequence low levels of end tidal CO2, which compromises oxygen delivery on a cellular level and also adversely affect pH and balance within the autonomic nervous system.
Whilst this sounds complicated, it really isn’t. It’s just really the words that are not commonly used if you’re not in the clinical world.
Almost all chronic symptoms have an element of what we called central nervous system sensitisation. Essentially some sort of initial trigger/trauma/event triggers off a set of symptoms. For some people, this can set off a cascade of reactions some of the mediated psychologically some of them physiologically (as in this case with breathing pattern disorder) and often both, which causes the brain to be hardwired maintaining a vicious circle.
Education and understanding of the driver of symptoms is critically important. I personally think this is not adequately taught to clinicians both in conventional and complementary medical practices.
Many complimentary medical practitioners don’t know enough about medicine and many conventional medical practitioners don’t know enough about functional medicine.
My experience over the years in seeing new patients with complex problems, I follow up with a comprehensive written report. The time it takes me to do the report far exceeds the time I spent during the consultation. However usually both I and the patient are appreciative in the sense that it gives a much deeper understanding to the patient of what has happened. They tend to be much more motivated and understand why they have to look at the multiple factors which are driving their symptoms.
https://www.thehealthequation.co.uk/diagnostic-consultations/
There is an excellent book called “It’s all in the brain” by Dr Suzanne O’Sullivan. What she means is it is not all in the mind. She is a Consultant Neurologist and specialist in clinical neurophysiology. She decided to write a book on the many patients presenting with neurological symptoms sometimes very serious such as being confined to a wheelchair, where no obvious medical/pathological reason was found. It helped to highlight that although there may not be an obvious medical or pathological reason for the patient’s symptoms there is usually a functional reason. However, she again expresses frustration as to the reluctance of patients to accept a functional diagnosis. It was fascinating to look at her Google reviews which were equally split between five stars and one star (you either loved the book or hated it) with the one star reviews from people saying essentially they did not believe anything she had to say.
To give you some reference, Functional neurological symptoms (FNS), also known as functional neurological disorder (FND) or conversion disorder, refer to a group of neurological symptoms that are real but are not caused by structural damage or disease in the nervous system. Instead, these symptoms arise from abnormal functioning of the nervous system. FNS can mimic symptoms of neurological conditions like stroke, epilepsy, or multiple sclerosis, but without a clear organic cause.
Here are some common functional neurological symptoms:
- Motor Symptoms:
- Weakness or Paralysis: Sudden loss of strength in a limb or an inability to move parts of the body.
- Tremors or Jerks: Involuntary shaking, jerking, or spasms that can resemble seizures.
- Abnormal Gait: Difficulty walking, including staggering or dragging a foot.
- Dystonia: Abnormal muscle tone, leading to twisting movements or abnormal postures.
- Sensory Symptoms:
- Numbness or Tingling: Sensations of numbness, tingling, or a “pins and needles” feeling, often in a limb or face.
- Visual Disturbances: Blurred vision, double vision, or even temporary blindness.
- Hearing Loss: Sudden loss of hearing without an identifiable cause.
- Seizure-like Episodes (Non-Epileptic Seizures):
- Psychogenic Non-Epileptic Seizures (PNES): Seizures that resemble epileptic seizures but do not have the same electrical activity in the brain.
- Cognitive Symptoms:
- Memory Problems: Difficulty recalling recent events, feeling “foggy headed,” or experiencing periods of confusion.
- Concentration Issues: Trouble focusing or sustaining attention.
- Speech and Communication Issues:
- Dysphonia or Aphonia: Weak or hoarse voice, or complete loss of voice.
- Stuttering or Difficulty Speaking: Sudden onset of speech difficulties.
The exact cause of FNS is not fully understood, but it is thought to involve a combination of psychological, social, and biological factors. Stress, trauma, or psychological conflicts can often play a role, but not everyone with FNS has a history of these issues. The symptoms are not intentionally produced and can be very disabling.
Diagnosis of FNS typically involves ruling out other neurological conditions through tests like MRI, EEG, and blood work, along with careful assessment by a neurologist or psychiatrist. Treatment often includes a combination of psychotherapy, physical therapy, and sometimes medication to manage symptoms and underlying psychological factors.