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.

• 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.

  • 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)*

*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.