3D Tour: see inside our neurological testing
This interactive 3D tour walks through a tilt table test. First a healthy person, then someone with dysautonomia on a standard tilt test, then the same test at the Keiser Clinic with a transcranial Doppler ultrasound watching blood flow to the brain, a capnograph reading end-tidal CO2, and a hands-on bedside neurological exam. Turn on JavaScript to take the tour.
It follows 6 real patients who came in with labels like POTS, ME/CFS, post-concussion syndrome and long COVID. Each had something different going wrong, and each got a different plan.
Hannah, college student: came in with POTS, PVCs
Hannah is a college student. She gets lightheaded and badly short of breath, and her heart skips beats, which doctors call PVCs. She'd already worked on her diet and her body chemistry, and nothing touched it.
Her neck is cutting into her brain's blood supply
Standing drops blood flow to one side of her brain, and her neck is part of the reason. Head turns cut her blood flow and set off her skipped beats.
At 10 days, Hannah was on the right track, and her treatment came home with her. We built her a home program so she could keep making progress on her own. Getting better takes time, and she spent her summer out enjoying herself.
Claire, 21: came in with POTS for 2 years
Claire got sick at 19, away at college. 2 years later she's living back in her childhood bedroom with headaches, lightheadedness, severe brain fog, and fatigue that gets worse with any activity. She can't drive, go to school, or go out with friends.
Her racing heart is covering for her brain
Upright, the left side of her brain loses about a third of its blood flow. Her eye tracking and her sense of touch fail along with it, and they recover when she lies down.
Within a week, the blood flow in her brain was already changing, and she had more energy. After about a month she was driving, working out without crashing, going out to dinner with friends, and planning her return to school.
Noah, 15: came in with POTS, after a head injury
Noah is 15. A cold virus made him pass out, and he hit his head when he fell. Since then he's had severe migraines, heavy pressure in his head, dizziness, air hunger, and exhaustion. He missed 4 months of school, and now he makes it a couple of hours a day.
His brain can't read his body clearly enough to run it
Both sides of his brain lose blood flow upright, the right side much more, and thinking makes it worse. His eyes, his sense of touch, and his coordination show a brain that can't read his body clearly.
By the retest, his migraines, the heaviness in his head, and his lightheadedness were easing. He took simple exercises home and kept improving. He's back at school, running and swimming, without setting off flares.
Ben, 21, college athlete: came in with POTS
Ben is 21, a college athlete. It started with nearly passing out while driving. Within a year he had chest pain, palpitations, shortness of breath, twitching muscles, and cold purple hands and feet, and he'd lost 20 pounds. He had to stop school and sports, and he couldn't walk into a grocery store.
The small nerves that steer his blood have gone quiet
A small-fiber neuropathy. The nerves that steer blood through his vessels have gone quiet, so blood pools in his legs and hands when he stands, and in his head when he lies down.
2 months later, he wrote to us. He still had some eye floaters, a pulsing in his back at night, and weight to put back on, and we're working through those together. He'd kept up his exercises, and he was riding an upright bike, lifting light weights, getting ready to start fall semester in person, and coaching a team at his old baseball facility.
Rachel, working mom: came in with ME/CFS, long COVID
Rachel caught COVID, and her life went off the rails. Heavy brain fog, dizziness, and malaise so deep she spent her days in bed in a dark room, unable to work.
Her brain's blood vessels lost their reflexes
COVID left the blood vessels in her brain unable to regulate themselves. Upright, she loses about half her brain's blood flow. Her balance system still works, and that gives us a way in.
She stopped crashing after activity, slept better, and felt a little better each day. She kept building until she went back to work and back to taking care of her kids.
Laura, healthcare professional: came in with ME/CFS after whiplash
Laura worked in healthcare at a high level and was very active, until a whiplash injury. Now she faints, gets excruciating headaches, and lives with chronic pain. She had to stop working, and she spends most days in bed. She arrives in sunglasses with her hood up, just trying to get through the visit.
Moving her neck pinches an artery
When her neck moves, a carotid artery gets squeezed from the outside, and the blood flow to her brain drops. That's what makes her faint.
A few days in, she rode to the clinic without throwing up. The sunglasses came off, and she started talking with people. Within a couple of weeks, she was running at the clinic.
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