Vital Sign Alterations Associated With Beverage Intake – A Brief Case Series Of Two Patients

Bill Moreau, DC, DACBSP, CSCS Moreau Chiropractic Clinic, Estherville, Iowa

HISTORY: Patient one is an auto repair technician who presented superior thoracic spine pain that was exacerbated by lifting his arms above head level, and neck pain with cervical extension. He recently purchased an automotive repair center and he has been working long hours. He drinks two Monster® beverages per day. Patient one identifies no other drugs or supplementation usage. Patient two is a certified public accountant who is working long hours during the tax season. He presents with left hip pain without radiating lower extremity symptoms. Patient two drinks four Diet-Pepsi soft drinks each day. He identifies no other drugs or supplementation usage.

PHYSICAL EXAMINATION: Patient one demonstrated the following examination findings fixations to motion palpation at C3,C6 and T2. There was notes cervical paravertebral muscle spasm rated at 2/5. Cervical passive range of motion was mildly restricted in left rotation and extension, with vital signs of a brachial blood pressure of 201/104, pulse was 70/minute string and regular. Patient two demonstrated point pain to palpation over the left hip joint, positive left Patrick’s test (Fabere), positive left Laguerre’s sign, and fixation of the left hip with motion palpation, with abnormal vital signs of brachial blood pressure 142/96 and a pulse of 99/minute regular and strong. Patient two drinks four Diet-Pepsi soft drinks each day. He identifies no other drugs or supplementation usage.

DIFFERENTIAL DIAGNOSIS:

Patient One

1. Primary or essential stage two hypertension.
2. Secondary hypertension from renal, vascular, endocrine, neurogenic, or drug/toxin sources.
3. Mechanical Cervical Spine Pain

Patient Two

1. Secondary hypertension from renal, vascular, endocrine, neurogenic, or drug/toxin sources.
2. Elevated pulse rate to a pre-tachycardia level.
3. Mechanical left hip pain.

TEST AND RESULTS: No special testing was performed.

FINAL DIAGNOSIS: Patient one: secondary hypertension from a drug/toxin source with unassociated mechanical cervical spine pain. Patient two: Secondary hypertension from a drug/toxin source with elevated pulse rate and unassociated mechanical hip spine pain.

TREATMENT: Patient one was referred to his family practice physician for co-management for the treatment of stage two hypertension. No cervical spine adjustments were performed do to the abnormal blood pressure reading. Patient one was instructed to discontinue drinking Monster®. After a course of care including temporary anti-hypertensive medications and discontinuing drinking Monster® patient one is normotensive and taking no hypertension medications. Patient two decreased his Diet-Pepsi intake to two drinks per day. In seven days his vital signs had improved to a pre-hypertensive blood pressure of 133/90 and a resting pulse rate of 66/minute that is strong and regular.