rpsgt, reegt, rst 50 year old female with insomnia ...2017/1… · 50 / female. background. 50 year...
TRANSCRIPT
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50 Year Old Female with Insomnia, Migraines, Fatigue, Anxiety
D A L L A S , T E X A S
B R I A N R AT Z E RR P S G T, R E E G T, R S T
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5 0 / F E M A L E
Background
50 year old, right-handed postmenopausal female with a “declining QOL” and a goal
to “get off all her medications”. She has right sided shoulder and neck pain that will
sometimes trigger migraine headaches. As a child, she sustained a right-frontal head
injury in an automobile accident. Family history of sleeping problems, manic-
depression, anxiety, obesity & addiction.
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Presenting Symptoms
• Migraine headaches (daily and disabling) logged daily
• Insomnia
• General Fatigue
• Decreased Mental Clarity
• Poor Memory
• Hypertension
• Anxiety
• Depression
• Declining QOL “I’m not feeling like myself anymore”.
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Medications
• Benicar
• Bupropion
• Cambia
• Compazine
• Cymbalta
• Gabapentin
• Hydrocodone
• Tizanidine
• Topiramate
• Tramadol
• Zolpidem
• Botox injections for migraines
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Baseline Testing
SYMPTOM TRACKER: (19 – ALL 10’S= 190)
• Migraine Headaches
• Bruxism
• Difficulty Falling and Maintaining Sleep, Difficulty Waking
• Difficulty Thinking Clearly, Following Directions, Making Decisions, Completing Tasks, Remembering Names
QIK CPT
• Performance Index = 98
• Accuracy Index = 82
• Poor Concentration, Sustained Attention, STM, Word Finding and Verbal Expression
• Slow Thinking
• Lack of Social Interest
• Unmotivated
• Anxiety
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What I Did
• Client kept a log of migraine headaches (initially)
• Aggressive approach, 30’ b2b sessions 2x/wk thru S14
• Mode of NF = Advanced Media Player
• T3-T4 titrated down to 0.01mHz in 3 sessions
• ↑ Dreaming, ↑ focus & Attention, “feeling pretty good”
• S6> +T4-P4 -feeling “wound up for a few days and forehead “tension & tightness”
• Following 10 day break (Travel)
• ↑ H/A both frequency & magnitude
• Began taking Natural Progesterone per NP at this time
60 Sessions (ILF=54, AT=6, SYNC=1)
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What I Did
• T3-T4 b2b, returned w/o h/a, sleeping better and ↓ Ambien, (taken off the progesterone)
• S13> Client reports small h/a “I felt like it should be worse but for the most part, my brain was ableto resist the headache”
• ↑ Resilience
• ↓ Gabapentin 900mg – 600mg.
• S15 ↓ Topamax by half, no h/a in weeks, Single sessions
• S20> No h/a in weeks, ↓ Ambien (2.5mg), ↓ Gabapentin (300mg)
• RE-EVALUATION - 1
• ST>↓43% (190↓108),
• QIK CPT> Slight ↑ in both PI (98-99) & AI (82-85)
60 Sessions (ILF=54, AT=6, SYNC=1)
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What I Did
• S22> Fainted/LOC @ work due to an Anxiety attack. +T4-Fp2 (b2b)
• S24> Went to 45’ sessions (insurance will only pay for one per day) w/ 15’ each placement.
• S26> No h/a, Sleeping well, feeling better, “More in control”, ↑ Focus & Mental Clarity, ↑ Sense of wellbeing and ↑ Social involvement “had a lot of fun socializing at a party and am reaching out to people I have not in a while”.
• S30> Now off all meds except her BP, Ambien (1.25mg) & Tizanidine.
• Feeling more productive and far more in control
• Her husband commented on how well she is doing
• Sessions in 5 day intervals now
60 Sessions (ILF=54, AT=6, SYNC=1)
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What I Did
• S33> Daughter went back to school,
• ↑ Emotional reactivity (crying), regret, fragile, withdrawn, small h/a and shoulder pain (Hydrocodone)
• S36> Client feeling like she is regressing, “not doing as well as before”.
• ↓ RF to .005mHz in 1 session, “more tired than normal”
• Lingering anxiety, “attacked by my dreams”.
• S38> Initially Great then Lethargic, groggy, withdrawn, anxious.
• ↑ RF to 0.008mHz
• ↑ Alertness
• S39> Feeling Great again, productive, social, no anxiety upon waking, resiliency- talking herself back up when necessary.
60 Sessions (ILF=54, AT=6, SYNC=1)
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What I Did
• REEVALUATION - 2
• ST>↓32% (190↓60)
• QIK CPT>
• ↑PI to 122 from 99
• ↑AI to 109 from 85
60 Sessions (ILF=54, AT=6, SYNC=1)
• S40>↑Anxiety, ↑Emotional reactivity
• S41>AT (P3-P4 for 6 of next 10 sessions, last one Afz-Pz)
• Initially AT (Positive)
• Alert & no anxiety
• Waking without Anxiety
• ↑Productivity
• ↓Emotional Reactivity
• ↑Energy
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What I Did
• S42>AT (P3-P4)
• “Waves of happiness”
• “Sound of water feels like negative energy leaking out”
• S43> Daughter noted how well client was managing
• No anxiety upon waking for 3 days
• Work projects making more sense & easily solved
60 Sessions (ILF=54, AT=6, SYNC=1)
• S45> AT (P3-P4) Began feeling ill & congested
↑Anxiety
↑Emotional Reactivity
• S47> AT (P3-P4)
• ↑Depression
• Taken off her BP medication temporarily for low BP
• Prescribed Clonazepam prn for anxiety
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What I Did
• S49>AT (AFz-Pz)
• S50>ILF T4-Fp2 & T4-P4
• ↑ Anxiety
• ↑ Depression
• Right side NF
• ↑ RF 0.01mHz
60 Sessions (ILF=54, AT=6, SYNC=1)
• S51>ILF
• Migraine Headache
• Added T3-T4 to T4-Fp2 & T4-P4
• S58>
• “I can feel my brain trying to fix itself”
• BP medication & single Tizanidine
• Anxiety continues to improve (may be due to her daughters departure).
• S60> SYNCHRONY (10’ - Less tired and more clear)
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What I Did
• REEVALUATION - 3
• ST ↓28% (190 ↓ 55)
• QIK CPT
• PI↑ 128 (122) / (98)
• AI↑ 123 (109) / (82)
60 Sessions (ILF=54, AT=6, SYNC=1)
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Outcome
ILF: 54 Sessions (OPTIMAL RF = 0.01mHz)
• OLD FREQUENCIES: 47 sessions
• NEW FREQUENCIES: 7 sessions
A/T: 6 Sessions
• OLD: (P3-P4) 5 sessions
• NEW: (Pz-AFz) 1 session
SYNCHRONY: 1 Session (Pz-AFz)
Current Status
MEDICATIONS Off all medications except
1. Blood Pressure
2. Tizanidine at bedtime (1mg)
3. Clonazepam wafers as needed for sleep.
SYPMTOM TRACKING: (190 ↓ 55 = 28%)
QIK RETEST:
1. PI ↑ 128 from 98
2. AI ↑ 123 from 82
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Lessons Learned
1. The latest software is powerful and should be implemented carefully and purposefully.
2. Be aware the impact of hormone therapy
3. Client sensitivity to front-back AT vs P3-P4
4. Some Insurance limit NF to one session per day
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All Symptoms
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To Share
• “I’m not feeling like myself anymore”
• “I feel like my headache should have been worse, but for the most part, my brain was able to fight it off”
• “I feel more in control”
• “I feel like I am regressing, not doing as well as before”
• “Attacked by my dreams”
• “I can feel my brain trying to fix itself”
• “Feeling great again”
• AT= “Waves of Happiness”
• AT= “The sound of the water is like negative energy leaking out”
• SYNC= “Less tired and more clear”