Thread by @BadgleyLaurence

Twitter thread about these relationships follows:

ANXIETY AND PANIC ATTACKS:
I have my own theories about these disorders in those with #HSD. Panic attacks are common in persons with #Fibromyalgia, the patient population I study.

Often people with #Fibromyalgia come to me by way of federally-funded clinic Psychologists, who are treating them for psychologic disorders. They want me to prescribe major psych meds.

Many of these patients have been diagnosed with major depression & sent for anti-depression meds. Their underlying #Fibromyalgia has not been detected & no one has asked them about their average total nightly sleep time nor number of awakenings.

Patients with #Fibromyalgia sleep like “rotisserie chickens”. They toss and turn & sleep about 3-5 hours total; with several awakenings. Their sleep is interrupted by pain & is non-restorative of brain function. Daytime fatigue & naps are common.

Many of these patients have been diagnosed with major depression & sent for anti-depression meds. Their underlying #Fibromyalgia has not been detected & no one has asked them about their average total nightly sleep time nor number of awakenings.

Many of these patients surface sleep & rarely dream.

Patients with restless sleep are cognitively confused (foggy) & will go into rooms forgetting why. The major consequence of non-restorative sleep is Depression. Neurologists know this, or should. Loss of sleep induces anxiety & worry over inability to reverse downward mood slides

Many persons with #HSD have vertebral spine scoliosis when upright (disks are ligaments). I regard that functional scoliosis might induce impingements of contiguous ANS sympathetic chain, resulting in cardiac rhythm changes & gastric dysfunctions, i.e., Gastroparesis.

Functional scoliosis can be observed by companions of patients. Simply slide 2 fingers down sides of spine. Patient can look in mirror to see one shoulder lower.

Many persons with #HSD have Mitral Valve Prolapse (MVP). Mitral valves of heart are made of cartilage/connective tissue; when floppy can lead to incompetence & loss of forward blood flow when going upright. MVP is not a disease, but a functional disorder.

Another #HSD tissue variation is loss of venous vessel wall cartilage/connective tissue/muscle firmness & contractility. When patients go upright, blood pools in lower extremities depriving brain; causing head rushes & even syncope.

When the brain senses low pressure of blood flow it has options: cause syncope & render body tower horizontal so blood more easily flows to brain. Dystonic flailing are common with syncope & can be misinterpreted as “seizures”; later studied as “pseudoseizures”.

Another option of brain being deprived of oxygenated blood is for autonomic NS (sympathetic) to race heart & lungs, with symptoms experienced as shortness of breath & tachycardia. The person feels like they are about to die. This is called a Panic Attack.

Persons wPanic Attacks & absent laboratory findings (anemia, thyroid, etc.) worry doctors, who then consider psychologic issues; with Psychologist/Psychiatrist referrals to investigate. What these patients really need is cardiac ultrasound to visualize mitral valve in real time.

Those who have frequent syncope need to be referred to a Cardiologist & evaluated for Postural Orthostatic Tachycardia Syndrome (POTS). Psychologic issues are diagnoses of exclusion.

Once branded with psychological problems, many patients have difficulty ever finding a doctor to consider alternative diagnoses; much less to elicit history & stigmata of hypermobility.

A suggestion for patients is to bring wiki-type print outs of problems to doctor. If Dr. dismisses your input & takes not time to describe reasoning for diagnosis, you need to regard excess doctor-ego & find another physician (means “teacher” in Greek).

If the reader has interest in clinical medical references there are none; except for my previous publications. The theories and physiological dynamics offered above are my own novel inventions, and based on countless empirical clinical observations.