Advanced Neurology Supports The Brain-Body Connection
When his doctor controlled his fluctuating blood pressure, Carleton was no longer afraid of fainting and falling. Interventional neurology care, close to home, changed his life for the better.
When Carleton Weber, 79, fainted and fell onto the floor of his garage, he needed surgery to stop internal bleeding in his brain. After his third fall, he ended up in AHN Jefferson Hospital.
But this time turned out differently, because general neurologist Dr. Mihaela Nowak stopped by his room and listened to his story.
Fluctuating blood pressure
Carleton’s fluctuating blood pressure was hard to predict. If it dropped suddenly, without warning, he could lose consciousness. As a result, he stayed at home, unhappy and frustrated.
He also had transient ischemic attacks (mini strokes) that caused blackouts. Falls were especially dangerous for him as he was also on blood thinners for atrial fibrillation, an erratic or rapid heart rate. Because of the medication, any injuries could cause uncontrollable bleeding.
Dr. Nowak told me, ‘This needs to be addressed,’ and took the bull by the horns,” said Carleton. “My health today is the result of her intervention.”
Understanding the ups and downs of blood pressure
Hypertension, also known as high blood pressure, is a common problem. About 45% of adults in the U.S. have high blood pressure. Unfortunately, only 1 in 4 adults with high blood pressure have it under control.
Chronic high blood pressure can lead to strokes, heart attack, and heart disease. It may be related to family history, age, ethnic background, or lifestyle factors, like weight and alcohol use. There aren’t always symptoms, which is why you should have your blood pressure checked regularly.
If you have high blood pressure, AHN doctors can help you treat it with medication, diet, exercise, and by quitting smoking. At the AHN Comprehensive Hypertension Center, specialists can help patients who have high blood pressure that hasn’t responded to treatment.
Very low blood pressure, hypotension, is dangerous too. It can cause dizziness, fainting, dehydration, fatigue, depression, and other symptoms. If this happens to you often, keep track of when it occurs and what you were doing at the time, and discuss it with your health care provider.
Orthostatic hypotension is low blood pressure that is triggered when you shift from sitting or lying down to standing up. It can be due to an underlying disease but is also caused by dehydration, standing up too quickly, medication side effects, or aging.
Patients with fluctuating blood pressure, that spikes high and low, should also seek medical advice.
Finding a balance
Dr. Nowak determined that Carleton’s fainting spells were due to orthostatic blood pressure that was dangerously low when he stood up and shot up high when he sat or laid down. She began a coordinated effort to control his blood pressure and other medical conditions.
Carleton now takes two medications to keep his blood pressure on an even keel — two of the 16 pills he takes a day to address his heart issues and his Parkinson’s disease.
Dr. Nowak is also a Parkinson’s specialist and works with Carleton to control that condition.
“Dr. Nowak is very respectful. She gives you a lot of attention and answers questions well,” said Carleton. “She is one of the bright spots in everything I’ve been through. I’m healthier today because she got involved.”
“My treatment at Jefferson was pretty decent. They know my name there now. I’m not sure if that is a good thing,” he joked.
Focused, coordinated care brings results
Dr. Nowak explained that Carleton’s falls were a symptom of blood pressure variance and could affect his other issues in life. “He was on seizure medication and his Parkinson’s is under control, but his orthostatic blood pressure put him at risk.”
Dr. Nowak took the lead on managing his blood pressure with advanced neurology care. She also prescribed a new blood thinner medication for his heart. “Little by little, in a stepwise manner, he’s progressed without any bad events,” she said. “I’ve seen Carelton numerous times, and he is doing very well. His wife Cindy is very supportive and realistic, as well. She is a good, objective caregiver.”
This treatment has changed Carleton’s life. He is happy to be able to get back to his activities, driving short distances, visiting friends, going on errands. He uses a walker when he feels he needs to, but often manages without it. He knows this is progress, but he’d like to go more than 10 miles from home.
“Cindy and I love to travel. We would have had two or three trips planned at this point,” he said. “I’m doing everything I can to get to the point where we can take a cruise.”
Dr. Nowak offers options for complex care
Dr. Mihaela Nowak did her neurology residency with AHN, so she was happy to return here in 2019 as a certified neuro specialist to provide comprehensive neurology care in the South Hills.
“As doctors, we have to be knowledgeable, but the other essentials are communication and trust,” she said. She is passionate about her specialties — epilepsy and sleep disorders.
Once a week, she sees epilepsy patients at AHN Allegheny General Hospital (AGH).
She is also a generalist, ready to help patients — and their primary care providers — with a range of neurological conditions.
“During the first patient visit, I listen as best I can, stay open to their needs and fears, and find out anything that didn’t go well in the past,” she said.
Dr. Nowak offers plenty of resources, but also corrects misconceptions about Parkinson’s disease and other illnesses. “We live in a day and age with a lot of options for treatment, new drugs, and transplants. And we can do it right here at AHN.”
Dr. Nowak earned her medical degree from Carol Davila University School of Medicine in Bucharest, Romania, and discovered her s