You Learn Something New Every Day


For the medical-type people out there:

Had a patient tonight complaining of esophageal spasms. Her only history was Parkinson’s disease and hypertension, along with all the usual meds. She’s not the first I’ve cared for with that complaint, but I’d be lying if I said I was experienced with that particular malady. This lady didn’t act like the others, however. The patients I’ve dealt with in the past tended to retch and gag with their esophageal spasms, but this lady just repetitively cleared her throat.

And I mean repetitively, as in without letup. You could tell it was bothering her, and somewhere from the dark recesses of my memory, I vaguely recalled something about Nitro relieving the symptoms.

Since our protocols require us to contact medical control when we think the hoof beats herald the arrival of a zebra, I called it in. The ER doc concurred with my course of treatment, and told me to go ahead with the sublingual nitroglycerin. I wound up giving her three before we got to the hospital.

They didn’t work.

Checked with the ER doc a few hours later, and he told me that the culprit was Mirapex, her new anti-Parkinsonian med. Mirapex is a dopamine agonist, and apparently has been known to cause dystonic reactions. The ER doc hadn’t known that either, until the neurologist he consulted had pointed it out.

And like most dystonic reactions, the symptoms miraculously disappeared with 50 mg of Benadryl.

Something to file away in the old memory banks…

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