Five Doctors, Stumped
Explanation for Woman's Fast-Growing Tremor Turns Out to Be Elementary
Tuesday, May 6, 2008; Page HE01
A. Bruce Munro wonders how things might have turned out if he hadn't lost it and dialed 911.
The retired obstetrician had watched with mounting alarm as his wife, Bettie, seemed to get sicker by the day. For decades her health had been stable, regulated by medicines she took to control her cholesterol, blood pressure, Type 2 diabetes, a thyroid condition and a mood disorder.
But in March 2006, Bettie Munro had developed a tremor that became very bad very fast. Doctors assumed she was suffering from a rapidly progressive case of Parkinson's disease, but the neurologist treating her was baffled about why the increasingly potent drugs he prescribed didn't seem to help.
On Dec. 22, 2006, while Munro was getting his wife dressed for the day, he snapped. She had fallen three times and could no longer feed herself. "I thought, 'This is it, I can't handle this at home,' " Munro recalled. He picked up the phone and called for help. An ambulance whisked Bettie Munro from their house in a Loudoun County retirement community to Inova Loudoun Hospital.
Less than an hour later, a doctor stepped into the waiting room with stunning news. Bettie Munro didn't have Parkinson's disease -- or any other neurological ailment. The cause, so basic a resident should have suspected it, had managed to elude the four experienced doctors caring for his wife -- and Munro himself.
"The one smart person in all this was the ER doctor," said Bruce Munro, who recently celebrated his 80th birthday. "Five doctors learned a lesson that won't be forgotten."
Now 77, Bettie Munro, who spent three weeks in the hospital and a rehab center, has recovered completely. She says she remembers little of her nine-month ordeal. (Memory loss is a symptom of the problem.) Mostly she recalls feeling perplexed about her repeated falls.
The first occurred in March, around the time she was recovering from a stomach virus. She was taking her son and daughter-in-law to lunch when she fell in the restaurant parking lot for no apparent reason. She didn't lose consciousness or hurt herself and insisted she was fine. Soon afterward she developed a tremor in her hands and consulted a neurologist.
The neurologist said he thought the problem might be Parkinson's and suggested she take a drug to control the tremor. Munro decided against it: Her symptoms were mild, and she was already taking more than half a dozen medicines.
But three months later, she returned to the neurologist. Her tremor had gotten worse, and she agreed to start taking a drug used to treat Parkinson's.
Over the summer, her gastrointestinal problems persisted. Concerned, a gastroenterologist ordered several tests and then performed a colonoscopy. He found nothing unusual.
In August, she saw her psychiatrist for a routine appointment. About the same time, the neurologist discontinued the first drug, which was costing the couple $500 a month, and prescribed two less-expensive medications in an attempt to control the worsening tremor.