Patient was an elderly Hispanic woman who came in for a neurological visit. (Its amazing what internists cover...) She came in with very severe muscle weakness in her legs and on the right side of her ribs. She did have diabetes but was taking medications for it. She had visited another doctor, a Neurologist, and another physician. Those two doctors stated that the patient may have Parkinson's disease which worried Doc.
Doc wondered how advanced the disease must be since a neurologist had already diagnosed it.
However, during the examination, Doc determined that she had hypoglycemia. She reviewed her medications and noticed that patient took both amaryl and glimepiride. Those drugs are notoriously known for causing hypoglycemia. Doc decided that she should try stop taking glimepiride and see what happens. Over time, she gradually got much better and had more and more energy. Eventually, Doc decided that all of her diabetes medications were to be stopped since her diabetes was under control.
Doc stated that some physicians often try to look for the next test and even sometimes are looking for the next pricey work up. But in our over-medicated society, drug side effects can easily be missed or even overlooked. Sometimes the simplest things are just under your nose and no amount of tests or workups can substitute for just logical, rationale thinking.
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