Medical Alert Info

Melissa Ellen Milton. DOB: 3/23/1960.

Primary care physician: Dr. Joeseph O’Connell

MANA Clinic, Fayetteville, Arkansas

His office: 479-443-3536

MANA has the medical records for the past 25 years on this patient.

Emergency Contacts: Michael Milton (husband) 479-459-8997. Daughters Liz Krauft 479-200-1913 and Helen Smith 479-595-3413.

  • Ehlers Danlos Syndrome

    • Body manufactures faulty collagen.

    • Fragile blood vessels and other tissue (vascular EDS).

    • Hypermobile cartilege and ligaments (hypermobility EDS).

    • Diagnosed by genetic testing (vascular) and clinical exam by rheumatologist.

    • Has caused repeated tearing in eye retina tissue. Six repair surgeries.

    • Has caused sensorineural hearing loss. 45% loss in right ear. 35% loss in left ear. Face patient and be close up when speaking.

    • Has caused a hiatal hernia (from vomiting).

    • Causes mystery bruising and mystery sprains.

  • Dysautonomia (Autonomic Nervous System malfunction)

    • Tachycardia and bradycardia.

    • Hypertension and Hypotension. (Highs over 200/180. Lows as low as 6/30), Cycles up and down. NO BLOOD PRESSURE MEDS!)

      • Patient on oxygen 24/7 to prevent passing out daily (for 30-90 minutes) from hypoxia during random blood pressure crashes.

      • Hypotension easily resolved with oral caffeine (coffee works fine). Being upright raises bp too.

      • Hypertension easily resolved by lying patient down and warming skin with warming blankets, heating pads, warm bath, etc.

      • Body position and room temperature are triggers.

        • Upright = hypertension. Lying down = hypotension.

        • Cold = hypertension. Hot = hypotension.

    • Probably caused by the EDS.

    • Diagnosed by two Tilt Table Tests (patient fainted from bp crash each time).

  • Ankylosing Spondylitis

    • Patient is immunocompromised, per Dr. O’Connell.

    • Prone to runaway infections from minor injuries, minor insect bites, minor burns, etc.

      • Doxycycline is primary care physician’s go to oral antibiotic.

    • Diagnosed by genetic testing and having two siblings also with AS.

  • DRUG INTERACTIONS

    • No blood pressure meds (up or down)!

    • No NSAIDS (caused fluid in lungs)

    • No Fluroquinolone antibiotics (No Cipro. No Levaquin. etc.)

      • Due to Ehlers Danlos Syndrom puts at risk for aortic dissection

    • No nitrous oxide (genetic testing indicates dangersous interactions)

    • Local anesthesia does NOT work on this patient. Due to Ehlers Danlos Syndrome (local anesthesia dissipates too quickly through the tissue).

  • CURRENT PRESCRIPTIONS:

    • Oral: Furosemide, 40 mg, 1 or 2 twice daily for edema.

    • Oxygen 24/7. Two Liters. For Dysautonomia. Buoys blood oxygen levels so the patient won’t pass out during blood pressure drops. Without oxygen patient passes out daily from hypoxia for 30-90 minutes.

    • Inhaler: Albuterol (as needed)*

    • Eye Drops: Flurometholone steriod eye drops (as needed)*

    • Occasional Doxycycline or amoxicillin as “go to” antibiotics for minor injuries (minor bug bites, minor burns, minor chest congestion, etc.) that otherwise turn into runaway infections.

*For pain control & breathing during bi-monthly autoimmune flares (from Ankylosing Spondylitis). Use Inhaler 4 times daily for breathing with lung inflammation. Use Eye drops times daily for eye inflammation pain. Also Ibuprofin + Tylenol 4 times daily for joint inflammation pain. No use of these during the 4-6 weeks between autoimmune flares.

‍ ‍ FAMILY HISTORY

    • Both Parents, 3 siblings, deceased.

    • 1 living sibling.

    • Two siblings also inherited the Ankylosing Spondylitis autoimmune issues.

    • Married, husband. Two adult children. Two grandchildren, one with suspected Ehlers Danlos Syndrome.

    • 1 Niece deceased at age 29 from Vascular Ehlers Danlos Syndrome and Dysautonomia, non-repairable aortic dissection.

    • A grandmother and brother died of kidney failure. Two other grandparents and mother died of cancer. A brother died of liver failure. A grandparent died of stroke. Mother had severe stroke leaving her brain damaged for final ten years of life.

PRIOR SURGERIES:

  • Gall bladder removed

  • Thyroid surgery to remove lump (was benign)

  • Breast surgery to remove lump (was benign).

  • Breast reduction surgery and implants.

  • Many oral surgeries (jaws too small for teeth, a common EDS trait).