Doctor Would’ve Killed Him if He Didn’t Call Us

When a doctor comes up with a diagnosis, people usually automatically assume that he is not to be questioned, as if it were a matter of certainty that because he's a doctor, it automatically means that he number one, gathered all the possible data to be gathered. Number two, analyzed it through every different way in order to not miss any single possibility. And number three, double checked his answer before really submitting it.

And from what I've seen in my experience in the medical world, this is especially applicable and true if the doctor at question is a neurologist purely due to the intricacy and complexity of that field itself. But in today's video, I'm gonna tell you a story of how a boxer was not only dangerously and life-threateningly misdiagnosed by a renowned neurologist, but also how during a really routine consultation, I was able to find the root cause of all of his complaints and help him lead a normal life. So a couple of months ago, I was booked for a consultation by a man named Gregory.

And Gregory really had a routine request of me. His primary request was for me to design a cognitive enhancement stack for his brother, Brian, who had been in a really steady state of deterioration. Basically, he wanted me to design a stack of whatever I saw fit from stimulants to nootropics to peptides, whatever, in order to help his brother who had been declining steadily after his neurologist had given him a really incurable disease for a diagnosis.

Basically, in his early 40s, Brian had started to develop neurocognitive and behavioral symptoms that were really quite bothersome to him, including frequent forgetfulness, difficulty concentrating, and misplacing items quite frequently was a big one for him, he said, as well as mood disorders. So that went from mood swings to total depression to a complete absence of an emotional response, and so on. So naturally, being alarmed by such symptoms, he was rushing to find a good neurologist in his area in order to go and attack the issue as soon as possible with the best of the best, he thought.

And to his surprise and luck, and lack thereof, maybe, he was able to book a consultation that was quite soon with a neurologist that's very renowned in his area, that's very well known for being good and having good results with patients, and so on. And yeah, the consultation was booked for the following week. So yeah, the time comes for his consultation with the neurologist, Brian goes in, he presents his complaints, the neurologist asks him questions to gather data, and he does a physical exam on him, and so on.

But little did Brian know, as soon as the taking history portion was over, the diagnosis was already made. See, here's Brian's history. Brian was passionate about boxing and really fascinated with it since a very young age.

And in his late teens, he joined a boxing gym, a local boxing gym, and he was very good at it. And he was training hard almost daily. And in his early 20s, he started being good enough to compete in local fighting events.

In his mid 20s, he did not even suffer financially. He was working a well-paying job and still training boxing, even sporadically, but still training boxing, still doing what he loves. And yeah, in his late 30s, he made enough money to open up his own little boxing gym where he can be the main coach and train members and train with his friends, and so on.

That was all the information his neurologist needed to give him a death sentence, sugar-coated diagnosis, or a sugar-coated death sentence of a diagnosis called CTE, or chronic traumatic encephalopathy. You see, here's the problem. It does fit.

It does make sense because he did have repeated blows to the head. When you train boxing, you'd get sparred a lot, and you spar a lot, and you get hit in the head a lot, even though they're more cushioned gloves. You do get hit in the head a lot.

But it's a condition that you really can truly only diagnose post-mortem. And if someone comes in with these symptoms, we've all seen Muhammad Ali and Spencer Fisher get brain injuries from being consistent fighters and so on. So he gave him that diagnosis.

He told him, there's really nothing you can do. There's no cure for it. All we can do is manage your mood issues.

And he gave him antidepressants and told him to do frequent checkups, as well as stay away from head contact during training. Now, when I did ask Gregory, the boxer's brother, of how the checkups went, he said that Brian was deteriorating rapidly over the last year and a half, and checkups really just showed two more odd symptoms, one which he called oddly walking or trouble walking, I forget now what the brother called it, but the other one being urinary incontinence. And when I asked him if any brain scans were done, any MRI or a CT at the very least, he said no.

The doctor said it's undiagnosable properly unless post-mortem or in the later stages, you can see nonspecific brain atrophy, which is true. So why bother? You know, the diagnosis is already set. It's already there.

We know what's happening apparently, and there's nothing more we can do apart from symptomatically managing him and trying to slow down progression with physical therapy and speech therapy and all that. Well, I did write him the cognitive enhancement stack that he wanted of me, but I also really insisted that he showed me how his brother's odd walking or difficulties walking looked. But when I did see his walking difficulties, it was really what we call a wide-based gait.

Now, a wide-based gait is what we see in things like cerebellar ataxia or sensory ataxia or vestibular dysfunction or specific neurodegenerative diseases that can affect the basal ganglia and so on. So it really is not that specific of a sign, right? That's why we do scans. But anyway, being that he has a combination of neurocognitive behaviors and forgetfulness, mood disorders, etc, a wide-based gait and urinary incontinence, that made me think of a condition that often goes undiagnosed or misdiagnosed called normal pressure hydrocephalus, okay? This man did not have any brain scans, and here's how normal pressure hydrocephalus works.

It is a type of communicating hydrocephalus where excess cerebrospinal fluid builds up in the ventricles of the brain, thus resulting in a either normal or slightly elevated pressure of the cerebrospinal fluid. Now, why is that important? Because it's not gonna give you direct and really bright intracranial pressure increase symptoms like Cushing's triad of irregular respirations, bradycardia and hypertension, or nausea and vomiting, et cetera. It's not acute.

It happens just slowly with time, and the patient gradually gets worse, and it's easily missed. Unless you do an MRI and you can see the ventricular dilation, then you can suspect it. But this man did not have any scans.

He was just given the death sentence from the get-go, and that was it because of his medical history, all right? So yeah, I insisted he gets his brother a brain MRI. I told him to make sure to go tell the radiologist or technician or whoever it was that was doing that MRI to note the ventricular dilation that they're gonna see because you don't know how they're gonna swing it away. Oh, it's not normal pressure hydrocephalus.

You can blah, blah, blah, ventricular dilation, whatever. But anyway, thankfully, Brian qualified for ventricular peritoneal shunt. He did need some physical therapy, but now he's leading a normal life.

Sure, with some limitations on his training, but it's for his own good. He went from almost becoming a vegetable to living a normal life, you know? That's the real dangers of a misdiagnosis.

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