It's Time To End Psychiatry

[Chriton]

Do you have citations or evidence for these claims? After all, psychiatry is a large field, and much research is done on schizophrenia. You've got to have more than "someone told me" if you want to prove an entire field of experts wrong.

 

Yes! I expected that reply.

 

There is about 4 or 5 peole on this Forum who..If they are losing an argument use the "Can you give me a Citation or evidence"...that is a way to get the better of your opponent.

I know this because I have used it in Politics and Debating.

It wont work with me as I can turn it around and say, "Can you give me a Citation or Evidence to say I am wrong"

 

You can probably refer me to a Site that concurs with your Theory and I could refer you to a Site that agrees with me.

 

I have more insite into the problems of Schitzophrenia as I live with a person who has the Illness.

When I say that someone told me I mean that Psychiatrists who treated my Wife told me, also I phoned Psyciatrists and got other oppinions.

When my Wife was Diagnosed, I tried to read all the Information on the Subject, there was not much information but I did read a book called "Schitzophrenia (A Holistic view)" I cant remember the Author.

 

You are not an Expert on Mental illness so please dont try to put me down as if I know nothing...I live with it.

[Proteus]

Psychiatry is excessively one-sided. That doesn't mean that it's entirely useless. It can be useful if it's combined with psychology. We always need the two sides, analytical and holistic, yin and yang — even in something which is in itself as holistic as the human mind. Medicines might not be very helpful for environmentally determined depressions, but it's excellent for biological depressions.

 

Considering that our brain uses both chemistry as more complex processes, it's bound that both will have deficiencies or disorders now and then. There's diabetes, after all, which is a genetic deficiency of insulin, so why couldn't there be a genetic deficiency of serotonin? It's just wrong to attribute all, or even most, mental illnesses to chemistry. Sure, chemistry almost always plays its part (as does psychology), since that's part of what determines our differences in personality, but even so, medicines aren't always necessary. It's not like a kidney disease.

 

Whether it's chemical or psychological, mental illnesses can be dealt with in both ways — though to what extent depends on to what extent they're chemical or psychological. What's more, mental illnesses can be useful, which is something else which sets it apart from physical illnesses. Very few physical illnesses can come to its use (though they do exist), but almost all mental illnesses can be useful in some way.

 

This is because the mind is so complex that a single gene expression will interact with the mind in innumerably many ways, and these will randomly cause a number of advantages or disadvantages.

[stradi]

Psychiatry is excessively one-sided. That doesn't mean that it's entirely useless. It can be useful if it's combined with psychology. We always need the two sides, analytical and holistic, yin and yang — even in something which is in itself as holistic as the human mind. Medicines might not be very helpful for environmentally determined depressions, but it's excellent for biological depressions.

 

.

 

Meaning no offense, I couldn't agree with you less. Psychiatrists are trained not to look for the biological roots of depression, but to stick a silly DSM label on patients instead. Psychotropic drugs only mask the symptoms. If you average their pharmaceutical trials, they are not clinically significant above placebo (Kirsch).

[bascule]

"A Dose of Sanity" - Sydney Walker

 

"If you knew your history, then you would know where you're coming from"

 

Thank you for citing something. Do you have a web-accessible source?

[stradi]

Thank you for citing something. Do you have a web-accessible source?

 

You can see a partial preview of A Dose of Sanity here:

 

http://books.google.co.uk/books?id=1H_jx9XO4dcC&pg=PP1&dq=a+dose+of+sanity&cd=1#v=onepage&q=&f=false

 

Quite a substantial part of the book is available from this link.

[ecoli]

Yes! I expected that reply.

 

There is about 4 or 5 peole on this Forum who..If they are losing an argument use the "Can you give me a Citation or evidence"...that is a way to get the better of your opponent.

 

Yes... especially if the quack you're debating doesn't have any real evidence, and therefore holds mis-guided opinions.

 

The only people who hate requests peer-reviewed research are the quacks who know they don't have any to back up their claims (AKA, you!)

[Chriton]

Yes... especially if the quack you're debating doesn't have any real evidence, and therefore holds mis-guided opinions.

 

The only people who hate requests peer-reviewed research are the quacks who know they don't have any to back up their claims (AKA, you!)

 

Ha Ha Ha, Personal Eh?..Quack..or Quark..A Quark only means that I am a newcommer to the Forum and not an idiot...We are discussing Psychiatry and there are differing points of view about the subject..So what you are saying is that my Point of view is irrelevant and I must refer you to another point of view from another source?

 

My oppinions are based on living with someone who has the illness and finding out as much as I can about Schitzophrenia..But the information is limited as,

in England, not much research has been done..an earlier post was correct in saying that Drugs only mask the symptoms and dont cure it..there is no known cure.

A person with Schitzophrenia is a human being, so do you think that we should force them to take drugs against their will so as society can then put them away in a closet and forget about them?

Most Psychiatrists dont know what they are doing so prescribe drugs for all illnesses of the brain...that is not a cure, just getting rid of the problem.

Psyciatrists are a waste of time, They know as much as I do about the subject, and that is not much.

 

Since my wife was diagnosed with the problem 10 years ago and had a very bad Psychotic episode she has refused to take Drugs, She left home then and I never knew where she was till about 2 years ago and I brought her home from a very bad lifestyle..since giving her a stable envirnoment and a bit of understanding she seems to be better...she will never be cured but she is adapting realy well without drugs.

 

So instead of attacking me Ecoli Give us the benefit of your knowledge on the subject!!!

Edited March 16, 2010 by Chriton

[The Bear's Key]

You can see a partial preview of A Dose of Sanity here:

 

http://books.google.co.uk/books?id=1H_jx9XO4dcC&pg=PP1&dq=a+dose+of+sanity&cd=1#v=onepage&q=&f=false

 

Quite a substantial part of the book is available from this link.

The book seems well referenced and fairly logical. I browsed several chapters, enough to realize if true -- it'll be a slap in the face of *professionals* in most of that industry who so faithfully go by the APA's publication of the DSM.

 

I'd like for more knowledgeable heads to critically examine portions of that book (in the link) and inform us of their own conclusions and why.

[ecoli]

Ha Ha Ha, Personal Eh?..Quack..or Quark..A Quark only means that I am a newcommer to the Forum and not an idiot...We are discussing Psychiatry and there are differing points of view about the subject..So what you are saying is that my Point of view is irrelevant and I must refer you to another point of view from another source?

 

Ah.. the strawman. Another favorite tool of the quack.

 

I was criticizing you for ignoring peer-reviewed research on the subject. Not denying that there are valuable differences in opinion.

 

My oppinions are based on living with someone who has the illness and finding out as much as I can about Schitzophrenia..But the information is limited as,

in England, not much research has been done..an earlier post was correct in saying that Drugs only mask the symptoms and dont cure it..there is no known cure.

A person with Schitzophrenia is a human being, so do you think that we should force them to take drugs against their will so as society can then put them away in a closet and forget about them?

 

And I sympathize with you, but what part of your opinions are not formed by anecdotes. I volunteered for a summer in a pysch hospital and have plenty of experience with geriatric schizophrenic psych patients. Does that make your emotional appeals any less valuable?

 

No... but it doesn't make it good science either.

 

 

Most Psychiatrists dont know what they are doing so prescribe drugs for all illnesses of the brain...that is not a cure, just getting rid of the problem.

Have you been to med school? Done psych fellowships? If not, what qualifications do you have for making these statements.

 

Psyciatrists are a waste of time, They know as much as I do about the subject, and that is not much.

Ok, then describe the intended mechanisms of action for some of these drugs, and maybe you'll be taken seriously.

 

If you don't know (and be honest!) then you can't really claim that you know as much as the psychiatrists, can you?

 

Since my wife was diagnosed with the problem 10 years ago and had a very bad Psychotic episode she has refused to take Drugs, She left home then and I never knew where she was till about 2 years ago and I brought her home from a very bad lifestyle..since giving her a stable envirnoment and a bit of understanding she seems to be better...she will never be cured but she is adapting realy well without drugs.

I've never read any psychiatrist who's said that living in a psych ward is a better environment for a patient than a loving home. But I've also never heard any psychiatrist claim that common prescriptions are "cures."

 

Considering that we have very little idea of the causes of schizophrenia, science isn't offering any cures. We can mediate symptoms, however though trial and error.

 

I wish you and your wife the best of luck.

 

 

So instead of attacking me Ecoli Give us the benefit of your knowledge on the subject!!!

 

Considering you've directly refused to look at research articles with real science in it, why should I bother trying?

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Consecutive posts merged

The book seems well referenced and fairly logical. I browsed several chapters, enough to realize if true -- it'll be a slap in the face of *professionals* in most of that industry who so faithfully go by the APA's publication of the DSM.

 

I'd like for more knowledgeable heads to critically examine portions of that book (in the link) and inform us of their own conclusions and why.

 

I think the overall message about overprescription is true, however it seems to be based off of mostly anecdotal evidence and narratives, as far as I can tell. There must be better, epidemiological data out there.

---

Merged post follows:

Consecutive posts merged

Meaning no offense, I couldn't agree with you less. Psychiatrists are trained not to look for the biological roots of depression, but to stick a silly DSM label on patients instead. Psychotropic drugs only mask the symptoms.

 

This isn't the point of the DSM, which is about standards for diagnosis only. Yes, psychiatrists might be overperscribing and missing biological and environmental causes, but do you think they don't realize this?

[Chriton]

I've never read any psychiatrist who's said that living in a psych ward is a better environment for a patient than a loving home. But I've also never heard any psychiatrist claim that common prescriptions are "cures."

 

Considering that we have very little idea of the causes of schizophrenia, science isn't offering any cures. We can mediate symptoms, however though trial and error.

 

I wish you and your wife the best of luck.

 

Yes you are right, I have little Scientific knowledge of Psychiatry...When my wife of 30 years was in hospital I was very confused and I was looking for answers, I asked Nurses, Physciatric Social workers and Psychiatrists what was going on...except for the Psychiatrists, the rest had no idea about Schitzophrenia, yet they were charged to look after them..I visited every day and saw some people who should have not been there, people who were forced fed drugs against their will and some who were given Electric shock treatment..That was a surprise that it still hapened in this day and age.

One old Lady was there simply because she thought that certain foods would kill her..She kept asking me to get her out of there, it was so sad.

 

The conditions there were more suited to the 18th Century than the modern day, most people in that Hospital were just subdued by Drugs or Electric Shock treatment.

That is my Experience of Psychiatry at work.

 

Schitzophrenia is a Label that is put on a number of Mental illnesses.

for example:

Thinking that Aliens are after you.

Having voices in your head.

Getting angry for no reason.

Collecting silver or shiny metal to avert Devils.

Looking for signs and living your life accordingly.

Thinking that your loved ones want to kill you.

 

Each one of those are a Mental illness in its own right but the Label of Schitzophrenia is put on each one.

 

My wife had all of the above but some people only have one symptom and are Labeled as Shitzophrenic.

 

Psyachrists are taught to talk and listen to those people with Mental Illness but they are only learning about the Illness, they do not help the person they are supposed to be Counseling, I believe the answer to the question of the Post is:- "Psychiatry is not fit for purpose"

[stradi]

The book seems well referenced and fairly logical. I browsed several chapters, enough to realize if true -- it'll be a slap in the face of *professionals* in most of that industry who so faithfully go by the APA's publication of the DSM.

 

I'd like for more knowledgeable heads to critically examine portions of that book (in the link) and inform us of their own conclusions and why.

 

 

Me too... I remember thing SWIII must have made enemies by writing it, because he makes the case quite convincingly that DSM psychiatry has not only failed thousands of patients with mental health symptoms, but subverted the practise of law aswell.

 

I would like to have seen him give more interviews on the subject, but he was dead the year after the book came out.

 

This isn't the point of the DSM, which is about standards for diagnosis only. Yes, psychiatrists might be overperscribing and missing biological and environmental causes, but do you think they don't realize this?

 

Could you explain what you mean by "standards for diagnosis"?

[stradi]

Here's the sort of thing psychiatrists may miss if they follow the label, drug and talk therapy model without conducting a deductive differential diagnosis:

 

"It has been estimated that more than one third of people suffering from depression are hypothyroid. Some are in hospital. They receive, over long periods, antidepressants of one sort or another when actually the problem is deficiency of thyroid hormones. It is simply that no one thought of thyroid deficiency as a cause when their illness began; or the simplistic tests failed to reveal it."

 

http://www.tpa-uk.org.uk/depression_explored.php

[Cap'n Refsmmat]

I take back some of what I have said in this thread about schizophrenia.

 

I am looking now at this article in the New England Journal of Medicine, which concludes with:

 

Only a minority of patients in each group took their assigned drug for the duration of phase 1 (rates of discontinuation ranged from 64 to 82 percent). This outcome indicates that antipsychotic drugs, though effective, have substantial limitations in their effectiveness in patients with chronic schizophrenia. Although the rates of discontinuation may have been increased by the fact that patients were participating in a blinded, controlled trial, the rates are generally consistent with those previously observed.

 

The discontinuation was largely due to harmful side effects, lack of efficacy, and the patients simply rejecting the medication. The improvement was among those who managed to stay on the drugs -- not a large group.

 

Another meta-study compared second-generation atypical antipsychotics with first-generation drugs, and found little difference:

 

Four of these drugs were better than first-generation antipsychotic drugs for overall efficacy, with small to medium effect sizes. The other second-generation drugs were not more efficacious than the first-generation drugs, even for negative symptoms. Therefore efficacy on negative symptoms cannot be a core component of atypicality.

 

Stefan Leucht, Caroline Corves, Dieter Arbter, Rolf R Engel, Chunbo Li, John M Davis, Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis, The Lancet, Volume 373, Issue 9657, 3 January 2009-9 January 2009, Pages 31-41, ISSN 0140-6736, DOI: 10.1016/S0140-6736(08)61764-X.

 

So what about those first-generation drugs? Well, in 1977, it was found that schizophrenic "relapse is greater in severity during drug administration than when no drugs are given", and that symptoms got worse with relapse, with other new symptoms coming in. (G Gardos and J. Cole, "Maintenance antipsychotic therapy: is the cure worse than the disease?" American Journal of Psychiatry 133 (1977) 32-36, and G Gardos and J. Cole, "Withdrawal syndromes associated with antipsychotic drugs," AJM 135 (1978) 1321-24)

 

In 1977, the National Institute of Mental Health funded studies to see if schizophrenia could be treated without medications. In the first, those not medicated were discharged sooner, and only 35% relapsed within a year, compared with 45% of the medicated group. Nonmedicated patients stated they found it "gratifying and informative" to go through the psychotic episodes unmedicated, and the researchers concluded that medication stopped the patients from learning to cope with their illness, and prevented them from doing better over the long run. (W. Carpenter, "The treatment of acute schizophrenia without drugs," American Journal of Psychiatry 134 (1977): 14-20)

 

So first-generation antipsychotics didn't do so well, and newer ones don't do much better.

 

This is not to say they don't work at all; in the short term, they do quite well in studies. (Say, over a month or so.) But in long-term treatment, there's all sorts of wonderful side effects and more medication ends up being required, not less.

 

Hmm.

[buddhaneo]

It is true that psychiatry has no future and it is time to end it. There is NO benefit is psychiatry whatsoever.

 

The original poster has only touched on the issues here. I want you to listen very carefully here. Psychiatry is TERRORISM. They are linked with Al Qeada and are trying to take over the world with psychiatry. They will never succeed though because God will stop them. It is a clever and insidious plot and has been quite successful but will never work.

 

They use the money they make to fund terrorism and they all have terrorist training.

 

What isn't clear to some is that the psychiatrists and other mental health workers have the mental illnesses that they diagnose others with. These psychiatrists are seriously ill in a most dangerous way and need to be stopped. In no way should you or anyone else take psychiatric medication. It has serious side effects including making you look mentally ill (which they intend, to further their ends). They are in NO WAY interested in helping anyone. That is not their objective. As I said their objective is taking over the world and they are seriously trying to do it.

 

I do choose My words very carefully here and are speaking the 100% truth.

 

Another side effect of the medications that they give you is pedophillia, an unwholesome obsession with children. We can blame noone but psychiatry for this type of behaviour.

 

Psychiatry needs to be stopped. If any healing method is to work, it needs to look at the whole person and look at life as a complete whole, not look at things in minute details which is a testament to the psychiatrist's small minds. It is clear they lack any real insight into anything of any real meaning and are the real psychopaths.

 

Drugs are never the answer and that is all psychiatry offers, that and a quick chat. What can that possibly do? Only harm. Only God and guru can solve your problems and it is a mistake to look anywhere else. Peace.

[stradi]

Finding the Medical Causes of Severe Mental Symptoms: The Extraordinary Walker Exam

 

"As a practicing psychiatrist and neurologist, I've successfully diagnosed and treated hundreds of patients whose emotional and behavioral symptoms were caused by tumors, infections, toxins, medication errors, genetic diseases, and other physical problems. Most of them came to me after being tagged with psychiatric labels - manic depression, anxiety disorder, attention deficit disorder - and being given powerful mind-altering drugs or referral for psychotherapy. By the time they called my office, many were desperate, some were suicidal, and few had been significantly helped."

 

Sidney Walker III, A Dose of Sanity

 

"I'm afraid Mrs. Williams is going to need to be placed in a facility," the doctor said in a call to nurse Barbary Massey of L.A. County's Genesis Program. "Her family can no longer take care of her. She has dementia."

 

"How do you know she has dementia?" asked Nurse Massey.

 

"Her memory is gone," came the reply.

 

"And what else? What medical tests have you run?

 

The phone was silent. The doctor had, in fact, done little testing. Nurse Massey rattled off a series of medical procedures she felt should be done before Mrs. Williams (not her real name) was consigned to the dustbin of "dementia."

 

"I'll make a deal with you," said the physician. "I'll run these tests if you promise to help the family with placing her in a facility." The nurse agreed.

 

Some months went by before Barbara Massey heard that doctor's voice again.. He called to tell her that Mrs. Williams had just left for a vacation in Las Vegas and was having the time of her life. Medical tests had shown she had extremely low thyroid function and a severe urinary tract infection.

 

Once these were treated, the "dementia" vanished.

 

"I'll never make that mistake again," the doctor said.

 

It surprises most people to discover that physical ailments can and do cause severe mental problems. This is probably the most overlooked fact in the practices of psychiatry and psychology. A 1982 study reported in the Journal of the American Medical Association showed that of 215 consecutive patients admitted to a San Francisco hospital with mental problems, 41% had physical disorders that were misdiagnosed as psychiatric. A 1983 article in Schizophrenia Bulletin concluded that 83% of people diagnosed with schizophrenia have physical ailments instead.

 

Many other studies support this. An October 1977 research article by Hall and Popkin in The Female Patient reported that 97 of 100 patients with pronounced visual hallucinations were discovered to have medical problems creating them.

 

And the medical exams done on these patients were not particularly exhaustive in nature nor did they use in-depth biochemical analysis (blood, hair, urine) available today. This leads one to believe that, with more thorough examination, the percentages of misdiagnosis would have been even higher.

 

Probably no American physician understood this phenomena of misdiagnosis better than Dr. Sydney Walker, a board certified neuropsychiatrist from Southern California.

 

When Walker was doing his early medical training in the 1960’s, he went to the school library in search of a text on this subject. He couldn’t find it. Taking the matter to the head of the psychiatric residents, he asked, "Where is the book in the library on the medical causes of psychiatric symptoms?"

 

"There isn’t one," came the reply.

 

"Then I’ll write one," Walker retorted.

 

Incredibly, his 1967 book Psychiatric Signs and Symptoms Due to Medical Problems was the first volume written on this subject in the United States. One other book was written by a European. Even though this phenomena accounts, by some studies, for nearly half the admissions into psychiatric hospitals.

 

Perhaps more amazing is the fact that virtually no other books have been written on this subject since. (Exceptions include Walker’s 1996 A Dose of Sanity and the 1997 book Preventing Misdiagnosis of Women by Elizabeth Klonoff and Hope Landrine.)

 

To fully understand Dr. Walker’s work, I went to watch him work in spring of 1999. I feel very fortunate. Dr. Walker passed away eight months later and it appears he did not turn over his practice to a successor. His great wealth of knowledge has left us.

 

To ensure that his wonderful investigative technique is not lost forever, I am writing down here what I saw him do. Certainly his staff and others who worked with him could give a better description of his technique, but we have been unable to find any of them.

 

Knowledge: The Key to Insanity’s Door

 

Before discussing his exam, we have to consider the man sitting across from the patient. Dr. Walker’s primary tool was knowledge. Just browsing his now-rare Psychiatric Signs and Symptoms Due to Medical Problems gives one a peek at the remarkable collection of data this man had amassed. His life was devoted to the study of any and all physical abnormalities that effect behavior and mental function.

 

Thus where most doctors might limit their search to checking for thyroid problems or brain tumors, Dr. Walker’s seasoned eye looked for liver ailments, kidney problems, metabolic conditions, viral infections, and countless other rare and not-so-rare disorders. Signs and symptoms were his guideposts. He closely studied everything about the patient and listened intently regarding the symptoms the patient presented, large and small.

 

He made a point of keeping up with his studies. His recent books reflected a continuous research of medical literature and books. I remember calling his office to schedule a patient and being told a certain afternoon was "his library time."

 

Along with his knowledge came a dogged attitude. Unlike most physicians in psychiatric hospitals who give a cursory exam, then declare the person schizophrenic or whatever, Dr. Walker KNEW the person was physically ill. He knew it from experience. And he made it his mission to find it.

 

He looked with disdain on doctors who used psychiatric diagnoses – "labels," he called them – as though they were proven physical diseases. "They’re a bunch of frauds," he told me, "and I don’t subscribe to any of it."

 

He called his work "neuronal reductivism." (I may be simplifying it but that was the main phrase he used.) After years of research, he concluded that an intact nervous system should function normally unless something is impacting it. His great asset was his grasp of all the ways in which neurons could be affected.

 

The Exam

 

The Interview: The exam began with a 1 to 2-hour interview. The patient he saw when I was there was a 26-year-old woman with a history of "manic depression."

 

"There’s no magic in any of this," he told her, referring to the vague, unmeasurable "mental illness" ascribed to the young woman. "There are reasons why you feel the way you do, and we’re going to find them."

 

He proceeded to ask her what her mental symptoms were. When did these start? Describe them in detail. Then he asked about her physical symptoms and went into depth on them. For example, if she said headache, he asked how severe, where, what time of day, did it happen after meals, etc.

 

The combined collection of physical and mental phenomena gave him a general concept of what potential ailments she might have. (A limited number of disorders led to that particular combination of symptoms.) To narrow it further he had her go through a typical day, describing how she felt when she woke up, drank coffee, had breakfast, etc.

 

A good sample of this extensive 24-hour day questionnaire is given in Dr. Walker’s book A Dose of Sanity, Chapter Seven (pp. 170-171 of the paperback).

 

He asked further questions about her medical history, her track record of cold, flu, strep infections, and others.

 

Now he had a lot of information to work with. He began to formulate hunches, though he kept them to himself. He began asking questions to verify or disprove his hunches. For example, her answers indicated a blood sugar problem (a critical problem since the brain runs on glucose). Dr. Walker asked if her wounds healed slowly. "Yes, my mother was commenting on that," came the reply.

 

From her answers he began to suspect post-streptococcal sensitivity, a condition of unusual mental phenomena occurring after strep infection. He told her this. He said, "Now one particular symptom is almost a sure indicator of this. Did you have a lot of nosebleeds as a child?"

 

"Yes," came the answer.

 

The interview continued in this light, with Dr. Walker going down various avenues of questioning to support or disprove various hunches the symptoms led him to.

 

The Physical Examination: The physical exam lasted 15-20 minutes. It became clear that Dr. Walker was a purist, doing everything by the book, taking no shortcuts. He tested sense of smell, poked here and there, brushed a feather on her skin, tested arms, eyes, feet, gait. He had blood pressure checked on both arms, which I had never seen in my three years of working in a hospital in my college days.

 

In short it was a full exam of bodily systems, taking little for granted.

 

As he inspected her fingernails, he offhandedly remarked to his assistant, "Chews fingernails. Lead candidate." I asked what this meant, and she said people who chew their fingernail commonly have lead in the blood (which can adversely affect behavior). They pick it up from their fingers. Sure enough, the woman was found to have a lead level in her blood.

 

The EEG: The woman was hooked up with a portable EEG. Electrodes were glued to her head and she was instructed to keep notes of her activities, mood changes, etc. for the next 20 hours or so. She was then tested with the EEG under various stimuli such as strobe lights, etc.

 

The Lab Tests: The morning after the exam she went to a lab for testing. Eight vials of blood were drawn and she did a 5-hour glucose tolerance test. Other blood was drawn in the afternoon. Urine was taken as well.

 

Please Note: Some parts of the remainder of this report contain considerable "medicalese." Professionals will find it of interest as it shows the exact technical steps taken. Non-professionals can still decipher much of it and can learn from the level of in-depth effort that was taken.

 

Dr. Walker’s findings on the patient appear after this lab test section.

 

The following tests were done:

 

Glucose, fasting

Glucose

Sodium

Potassium

Chloride

BUN

Creatinine

BUN/Creatinine

Uric acid

Calcium

Phosphorous

Magnesium, Serum

Total Protein

Albumin

Globulin

A/G Ratio

Bilirubin, Total

Alk. Phos., Total

GGTP

AST (SGOT)

ALT (SGPT)

LDH

Iron

Cholesterol

Triglycerides

HDL Cholesterol

LDL Cholesterol

Chol./HDL Risk Ratio

T-4, Thyroxine

T-3 Uptake

T7 (Calculation)

T-7 (Calc.)

TSH, Serum TSH

5-hour Glucose Tolerance

CBC w/ Diff.

ESR – Westergren

Mono Screen

Febrile Agglutins

Typhoid H

Typhoid O

Paratyphoid A

Paratyphoid B

Brucella Antibody

Proteus OX-19

Streptococcal AB. QT

Cortisol, A.M.

Cortisol, P.M.

Thyroglobulin AB

Thyroid Peroxidase

Lead, Blood

Carboxyhemoglobin

Urinalysis w/Microscopic

After the lab work was completed, the patient returned to Dr. Walker’s office where the EEG apparatus was removed. She was told to return to his office a week later.

 

Conclusions

 

The woman met with Dr. Walker with an air of great anticipation. His main findings were as follows:

 

She had hyperinsulism, that is, an abnormal drop in blood sugar, which can manifest itself in many ways, including anxiety, sleeping problems, and fatigue – all symptoms the woman was experiencing.

A low morning cortisol level. Cortisol is an adrenal hormone, classified as a steroid. One effect of a low level is nausea, which was a frequent complaint of the woman. A later visit to an endocrinologist showed the cortisol drop was created by the hyperinsulinism in #1 above.

Lead in the blood (as Dr. Walker predicted). Though in a "normal" blood range, Dr. Walker said lead shouldn’t be showing up at all. The woman’s father worked in an electroplating plant and may have brought home dust. The woman was instructed to not chew her nails and to wash her hands regularly.

Carbon monoxide levels. Again, though in a "normal" blood range, Dr. Walker said the level likely dropped during the interval of her flying to California and could have been in a high range at home. He said she should have zero. He recommended having her furnace checked.

Poor blood flow to the arms (thoracic outlet syndrome). Remedied by swimming.

Note: Dr. Walker’s suspicion about strep sensitivity was off by a hair. The patient barely tested in the normal range for strep. And for those who may be interested, the price of the service, including lab and EEG, totaled about $1900.00.

 

The following is the full medical report by Dr. Walker, giving all procedures done and areas examined. For futher information on details of the "Extraordinary Walker Exam," see his book A Dose of Sanity

 

IDENTIFYING INFORMATION AND REASON FOR THE STUDY

 

This is a 26-year-old white right-handed female referred for an evaluation regarding her ongoing behavioral problems.

 

PRESENT ILLNESS

 

The patient states that she had no problems until approximately age 12. At that time she found herself unable to think straight, was indecisive, and felt like she was "on cloud nine." She also had episodic anxiety, dizziness, abdominal stress, and headaches. Over the course of the next 14 years the patient has been evaluated and treated with a variety of psychotropic drugs to include: Lithium, Depakote, and Paxil. She has had three psychiatric hospitalizations. The latest was in February of 1999, where she was maintained for approximately 3 weeks and discharged on Depakote and Paxil.

 

At the present time, the patient's typical 24-hour day is described as going to bed between 10 PM and 11 PM. It takes her about 1 hour to fall asleep. She is a light, restless sleeper. There is no bruxism or sleep walking. There is occasional snoring and she is up 1 time at night for nocturia. She sleeps on a regular bed. Her bedroom is above the gas furnace in the basement. She is up at 7 AM or 8 AM and does not feel refreshed. She does not eat a breakfast but does have a cup of coffee with cream. This improves her sense of well being. Her morning hours are spent doing housework and generally being bored. She has an hour nap and awakens feeling fatigued. She does watch television occasionally. She eats lunch at noon which consists of a tuna sandwich or a salad with juice. She does not eat desert. She feels somewhat improved after this lunch. Afternoons are spent with approximately 1 hour of exercise walking the dog. She does not snack or nap. She continues to do some additional domestic chores prior to her mother coming home at 4:30 PM. Supper is at 5 PM or 6 PM of spaghetti, salad, a hamburger, bread and water. She feels fatigued after this supper. The evenings are spent socializing on Tuesdays, Thursdays and Saturdays at church. Other nights she socializes with her family.

 

The patient denies any recent weight loss or gain. There is no history of postprandial sweating. She is aware of generalized itching, burning urination and slow wound healing. She has had urinary tract and vaginal infections in the past. A grandmother and great aunt had adult onset diabetes. A grandfather and great uncle had alcohol sensitivity. The patient is aware of a low tolerance to alcohol.

 

She denies any episodes of loss of consciousness or head trauma. There is no micropsia or macropsia. She has had episodes of generalized body tremors that lasted 20 to 3O seconds. She related these to her anxiety, panic attacks. She has had no previous EEGs or contrast studies.

 

The headaches have been around for a number of years but she is unsure of when they started. Her last headache was yesterday in the afternoon which was a dull discomfort over the right frontal region usually associated with some dizziness and occasionally nausea. Her headaches are worse with the use of aspirin. They can be precipitated with not eating and questionably improved with eating. These headaches occur approximately 2 times a week. The patient is also aware of a consistent headache during her premenstrual period which is relieved following the onset of menses. She is presently premenstrual.

 

The dizziness is described as recent with changing positions from lying to sitting and lasts about 10 to 15 seconds but is not associated with vomiting or nausea.

 

Developmental History

 

The patient was a product of a normal 9-month gestation during which time mother gained 25 to 30 pounds. She was under a doctor's care and had no preclampsia, high blood pressure, protein in her urine, no tobacco, alcohol or medications during her pregnancy. The labor was spontaneous and lasted 7 to 8 hours. Her birth weight was 8 pounds 5 ounces. The patient presented head first, moved all extremities and cried spontaneously. The patient was bottle fed and had colic. She sat at 6 months, stood at 10 months, walked at 12 months, unsure of when she declared her right-handedness, toilet trained at 18 months. She did not practice pica. She did not have a pre-school experience and kindergarten was poor. She had some difficulty in grade school with the label of slow. She graduated from high school and took 1 year of nurse assistant training. She has worked in that field since that time. She is presently unemployed because of her illness.

 

Inoculation History

 

DPT X 3, Polio X 3, measles and mumps inoculations. No high temperatures or frank febrile convulsions. Negative tine test.

 

Past Medical History

 

The patient had chicken pox, no rheumatic fever or scarlet fever. She did have repeated strep infections, however. She did have one recent hospitalization for pneumonia and psychiatric problems. The pneumonia was considered viral. She was told she has a cardiac arrhythmia. There is no kidney disease, liver disease, tuberculosis, gout, arthritis, or venereal disease. She is unsure about sugar in her urine. There is no high blood pressure and she is allergic to milk.

 

 

Family History

 

Details about the father is unknown. Mother is 42 years old, right-handed and has been in a psychiatric hospital since the delivery of the patient followed by a postpartum depression. There is no history of heart disease, liver disease, kidney disease, bone or joint disease. A great- grandfather had tuberculosis. A grandfather was hospitalized for mental illness since 1959. A grandmother has carcinoma of the cervix and breast cancer.

 

 

Social History

 

The patient lives in a house with her step-mother and father. There is a gas heater down in the basement. She has a dog in good health. She does not use tobacco or alcohol now. She discontinued the use of tobacco 2 years ago. Her habit was ½ to 1 pack of cigarettes a day which she did for 2 years. Her hobbies are reading.

 

REVIEW OF SYSTEMS

 

Head: There is a history of headaches. There is no history of loss of consciousness, head trauma or seizures.

 

Eyes: The patient has worn glasses for 14 years. It has been 6 months since last refraction. There is no double or blurred vision, or field cuts. Patient does see rings around lights. The patient's color vision appears normal. There is history of eye infections and photophobia, but no history of eye trauma.

 

Ears: There is no history of infections. There is evidence of deafness and hypersensitivity to sounds. There is no ringing or diplacusis, but she does have episodes of dizziness. Patient does experience motion sickness and gets car sick.

 

Nose: The patient has no difficulty breathing or smelling. There is no history of infections, discharge, or trauma. There is history of nose bleeds.

 

Mouth: The patient has her own teeth. There is no chewing difficulty, mouth soreness, tongue biting, jaw clicking or trauma. There are silver/mercury tooth fillings.

 

Neck: There is no limitation of movement, pain or swallowing difficulties. No hoarseness or fullness.

 

Chest: There is no history of chronic cough, hemoptysis, dyspnea, pneumonia, or asthma. There is possible hyperventilation.

 

Heart: There is no history of cyanosis, ankle swelling,' exertional dyspnea or fainting. Patient does experience chest pain and does have evidence of tachycardia. When sleeping, the patient uses 3 pillows.

 

Abdomen: There is no diarrhea or vomiting. There is some nausea and constipation. No black or bloody stools, excessive belching or flatus. Patient does have recurrent abdominal pain.

 

GU: There is history of urinary tract infections and vaginal infections. No hematuria, pyuria, or dysuria. There is nocturia and frequency. Menarche was reached at age 13. Menstrual cycles of 28 days. Gravida 0, para 0, AB O. Last menstrual cycle was March 15, 1999.

 

Extremities: There is no limitation of movement or cramping. There is no weakness, discoloration, or swelling. There is evidence of uncontrolled movements with panic attacks.

 

Skin: The patient is not able to tan; she burns. There is itching and slow wound healing. There is no evidence of abnormal hair growth.

 

Endocrine-Metabolic: There is no heat or cold intolerance, no salt or sugar craving. There has been no recent weight loss or gain. The patient does not experience postprandial sweating but does have excessive thirst. There is a specific food preference for spaghetti.

 

Toxic: Patient experiences metallic taste but no exposure to insecticides and has no adverse reaction to drugs.

 

 

GENERAL PHYSICAL EXAMINATION

 

The patient appeared as a well-hydrated, well-nourished white female in no acute distress. Her height was 164 cm. Her weight was 197 lbs.

 

Vital Signs: Blood pressure on the right was 132/76; blood pressure on the left was 114/70. Pulse was 63, and temperature was 98.4 degrees.

 

Head: Normocephalic. No evidence of exostosis, tenderness or bruits.

 

Eyes: Sclerae, conjunctivae and cornea were clear. There was no inflammation or discharge. Eyelids were of normal texture and station and eyebrows were of normal distribution. There is a mild proptosis of the eyes bilaterally.

 

Ears: External configuration was normal; external canals with cerumen bilaterally. Tympanic membranes were glistening bilaterally. No adenopothy or discharge.

 

Nose: Both nostrils were patent. There was no sepal deviation, polyps, or discharge.

 

Mouth: Teeth were in good repair, no gingival ulceration, or inflammation. Tongue was of scalloped texture and posterior pharynx was clear. There are multiple silver/mercury amalgams in the upper and lower jaw.

 

Neck: Supple. Trachea was in the midline. Carotids were palpable bilaterally at 1+, greater on the left than on the right. No thrills or bruits were noted and no masses were felt.

 

Chest: Symmetrical. There was normal female breast tissue without dimpling masses or discharge, and no axillary adenopothy. Patient has not had a mammogram.

 

Lungs: Clear to auscultation and percussion. No rales or rhochi were noted.

 

Heart: PMI was diffuse. No heaves or thrills were noted and no murmurs were heard.

 

Abdomen: Slightly obese, non-tender and non-rigid. No rebound or masses were felt.

 

Rectal: Deferred.

 

GU: There was no CVA tenderness. Pelvic was deferred, patient had a PAP smear within the last 6 months.

 

Extremities: There was no limitation of movement, straight leg raising to 90 degrees. Addson maneuver was positive bilaterally. Point tenderness from the posterior neck at C2 and T5 was sensitive without radiation.

 

Skin: Warm, clear, and moist. Evidence of nail-biting bilaterally, spoon nails bilaterally, transverse ridging in the nails bilaterally, and an acne form eruption over the face and back. There was no excoriation, slow wound healing, or abnormal hair growth.

 

 

NEUROLOGICAL EXAMINATION

 

MENTAL STATUS -

 

General Appearance and Behavior

The patient arrived on time for her appointment; she was neatly dressed and carefully groomed. She participated actively and earnestly in the review of information. She was oriented to the time, place, and person.

 

Memory

She denies any memory difficulty. Memory was intact to remote, intermediate and recent material.

 

Speech

The patient spoke in well-modulated tones with some difficulty pronouncing her S's. She performed the lingual and labial sounds adequately.

 

Mood

The patient is prone to being sad and feeling hopeless and weeps uncontrollably. The patient does have sleeping difficulty. She has considered suicide, however, there is no history of gestures.

 

Thought Content

 

The patient is preoccupied with herself and her symptoms. There are no hallucinations: visual, auditory or olfactory.

 

Intelligence

The patient is a high school graduate who has had one year of nursing assistant school. She was concrete on all 4 proverbs tested.

 

Judgment

 

The patient answered a hypothetical question appropriately and appears to be exercising normal adult judgment.

 

 

 

CRANIAL NERVES -

 

I. Olfactory

Patient was intact to smell of cloves.

 

II. Optic

Visual acuity: O.D. 20/200. O.S. 20/200. No extinction to bimanual visual stimuli. No field cuts to confrontation. Funduscopic examination revealed optic pallor greater on O.D. than O.S., sharp margins and generous cupping bilaterally. The arteriovenous ratio was 1-6. Maculae were normal. No evidence of exudates or hemorrhages.

 

III. Oculomotor, IV. Trochlear and V. Abducens

Pupils: O.D. 6 mm. O.S. 6 mm. They reacted poorly to light directly and consensual. Reaction to near vision was good. Medius rectus and mild proptosis. No nystagmus. Extraocular muscles were full.

 

VI. Trigeminal

Corneals were suppressed bilaterally (she has worn contact lenses). Perception to sharp stick was intact in all three divisions bilaterally. Jaw Jerk was fine. Masseters and pterygoids showed good strength bilaterally.

 

VII. Facial Nerves

No weakness, atrophy, fasciculation or asymmetry. Chevostick was negative.

 

VIII. Acoustic

The patient heard a watch ticking at 5 cm. on the right and 5 cm. on the left. Weber was to the midline. Rene showed air conduction greater than bone conduction bilaterally.

 

IX. Accessory Nerve

Sternocleidomastoid and trapezius showed good strength right and left.

 

X. Hypoglossal Nerve

Tongue protruded and was scalloped. There was no evidence of weakness, tremor fasciculation.

 

REFLEXES -

Pectoralis, biceps, triceps, brachioradialis and finger flexion were 0-1+ and symmetrical. Abductors, patella, suprapatellar and Achilles were 0-1+ and symmetrical.

 

Upper Motor Neuron

There was evidence of Oppenheim, Gordon, Chaddock, and Babinski and no Hoffman.

 

 

Cortical Reflexes

There was no snout, grasp, suck or palmomental. There was no extinction to bimanual tactile stimuli, no perseveration.

 

Superficial Reflexes

Abdominals were absent bilaterally.

 

Sensory

Sharp to pin prick, sensitive to light touch. Intact to position and vibration. No stereognosis. Evidence of graphesthesia on the left.

 

Cerebellar

Finger to nose, heel to shin, rapid alternating movements, check reflex, tandem gait and augmented tandem gait were performed well. Augmented Romberg was negative. Lingual and labial sounds were performed well.

 

ExtraDvramidal

No gabellar and cogwheeling. The patient showed normal pendular movements with reflex stimulation of lower extremities and normal accessory movements with walking.

 

Motor

There was no atrophy, fasciculation or weakness, proximally or distally, right or left. There was no drifting of outstretched arms.

 

Gait

The patient's gait was normal.

 

 

ASSOCIATED NEUROPHYSIOLOGIC DATA

 

The EEG was non-focal; dysrhythmic, with alteration of the wave forms during the three-minute hyperventilation and five-hour glucose tolerance test.

 

ASSOCIATED BIOCHEMICAL DATA

Reveals five-hour glucose tolerance test with a 2½- hour low of 57 and a 3 hour low of 61. Serum lead level of 1.0, level of carbon monoxide 0.7, and AM cortisol of 5.0; the normal is 6.2 to 29. The PM cortisol is 3.4; the normal is 3.0 to 17.3. Borderline antistreptolycin titer of 197; it should be less than 200 to be significant. A proteus OX19 with a titer of 20, it should be 1 to 20; this is borderline.

 

 

SUMMARY AND CONCLUSIONS:

 

This now 26-year-old female has a 14-year history of behavioral difficulties, treated with a variety of psychotropic drugs and anticonvulsant medications. The patient has had an ongoing sleep problem, bites her nails, is aware of hyperventilation, and has a poor eating habit.

 

General Physical Examination

 

Reveals a positive Addson maneuver, neoform rash, and transverse ridging of the nail beds with nail biting.

 

Neurological Examination

 

Reveals a concrete response on all proverbs tested. Fractory there bilaterally at 20/200. Absent corneal reflexes, absent abdominal reflexes, graphesthesia on the left.

 

Associated Biochemical Data

 

Reveals a 2 ½ - 3-hour low in the five-hour glucose tolerance test. A borderline antistreptolycin titer. Equivocal prodious OXA titer. Evidence of lead and carbon monoxide. The EEG was non-focal, but abnormal consistent with a toxic metabolic post-infectious basis.

 

IMPRESSION

 

1. Cortical lability, moderate.

2. Hyperinsulinism, probably influencing #1.

3. Hyperventilation syndrome episodic, probably influencing #1.

4. Lead acute and chronic exposure, probably influencing #1.

5. Carbon monoxide exposure acute and chronic, probably influencing #1.

6. Possible adrenaline insufficiency, probably influencing #1 and #2.

7. Thoracic outlet syndrome.

 

 

RECOMMENDATION

 

1. Identify and eliminate sources of lead and carbon monoxide.

 

2. Stabilize metabolic parameters by avoidance of refined carbohydrates.

 

3. Consultation with a endocrinologist for the characterization of steroid metabolism.

 

4. Physical therapy for the thoracic outlet syndrome.

 

5. Re-breathe into a brown paper bag for episodes of hyperventilation.

 

6. Evaluation of abnormal parameters in 3 to 6 months.

 

 

SYDNEY WALKER, III, M.D.