Health Direct - Summer 2018 - 10

Salina neurologist helps patients begin
recovery from rare, disabling diseases
By John Berggren


hankfully, complex neurological diseases that strike
younger people and leave
them paralyzed are relatively
uncommon in the general population.
That's part of why getting a definitive diagnosis can be tricky. Finding a
treatment that brings results can be
equally challenging.
That was the case for two local
women in their 40s. They'd seen specialists throughout the region looking for answers to why they could no
longer walk. Doctors were on the right
track, but unable to offer a definitive
diagnosis or adequate treatment. The
care they needed ended up being found
in their own backyard through Salina
neurologist Lien Diep, M.D., and their
recovery began at Salina Regional
Health Center's inpatient rehabilitation unit.

Two Angelas,
Two Rare Diseases
Angela Duvall is a fighter in every
sense. For nearly 10 years she had been
crippled with painful muscle spasms
and stiffness that eventually left her
confined to a wheelchair. She saw doctors all over the Midwest looking for
answers. Eventually neurologists diagnosed her with a rare disease called Stiff
Person Syndrome. They tried a variety


of medications
and treatments
with little success. Some treatments even made
Duvall's muscle
worse. Every couple of weeks, her
Lien Diep, M.D.
pain and misery
would become so
bad she'd go to the emergency department to try and find relief. That's where
she met Diep, who took an interest in
helping her find a solution.
Angela Fitzwater had been suffering from declining health for nearly two
years. At first, she dealt with severe
neuropathy, causing the sensation of
pain and numbness in her extremities,
mainly her legs. Her health worsened
to the point where she was falling down
all the time for unexplained reasons;
eventually she couldn't walk at all.
Neurologists around the region ordered
batteries of tests, but they couldn't come
up with definitive answers. Fitzwater was
eventually hospitalized for other health
issues, including possible seizures and
blood clots, when Diep became involved
in her care. As Diep studied volumes of
medical history on Fitzwater, she began
to piece together answers and diagnosed her with Chronic Inflammatory

Demyelinating Polyneuropathy (CIDP),
a rare disease that causes muscles to
become floppy and weak.

Nerves Misfiring
Both Stiff Person Syndrome and CIDP
are autoimmune diseases that attack
the body's nervous system. In Stiff
Person Syndrome, nerve impulses
fire constantly, causing muscles to
tightly contract and spasm, resulting in
extreme pain and disability. With CIDP,
nerve impulses become disrupted,
causing numbness, pain and weakness
in the extremities.
While the diseases differ, the treatment is strikingly similar. Diep recommended a plasma exchange for both
patients based on her familiarity with
the treatment during her training at
Johns Hopkins University in Baltimore.
(She also trained at Howard University
and George Washington University in
Washington, D.C.) Plasma exchange
is a treatment in which the body's

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