Retainer Service – Case Report

The daughter of an 85 year old female, found my name on a holistic medicine website. The patient was taking a huge amount of supplements and was interested in a non-pharmacological approach for managing atrial fibrillation (irregular heart beat that increases the risk of strokes).

After an initial home visit, the patient signed up for the retainer service, so she could call me at any time of the day. Despite being told the risks, she elected to go off the blood thinner (Coumadin) in favor of a natural blood thinner. She called me within a month of going off Coumadin to report 30 seconds of slurred speech. I convinced her to re-start Coumadin and discontinue the natural blood thinner. There were no further symptoms of embolic phenomenon (stroke activity).

Within one month later, the patient called to say she was having palpatations (heart beating fast) and chest pain because she had discontinued the medication that keeps the heart from beating fast (it caused her insomnia). I re-started that medication and increased the dose as needed until the symptoms were managed. Subsequently, the medication was switched to one that did not cause her insomnia.

Both the mini-stroke (TIA or transient ischemic attack) and the episode of rapid atrial fibrillation with chest pain, could have resulted in a trip to the emergency room with subsequent hospitalization. The patient was successfully managed in the comfort of her home through the retainer service and has the peace of mind of knowing that expert medical advice is only a phone call away.