LEXINGTON, Ky. (Dec. 3, 2021) — About one year ago, Lowell ‘Tom’ Coots Jr. was experiencing debilitating tremors and episodes of confusion. Because of his health issues, the former accountant was forced to end his career.
“I had to retire. I had to sell my practice,” he said. “I had 420 clients and there was no way my wife, Linda, could pick up all those clients.”
He didn’t know it at the time, but a medication meant to help a sudden medical condition was actually causing him more harm than good.
In June of 2016, Coots suffered a stroke, and just six months later, he experienced another one. Following the second stroke, he began having hemiplegic migraines that caused paralysis on his right side. While being treated at another area hospital, he was placed on a migraine medication known as Depakote.
His headaches subsided, but the tremors and confusion began.
“I’d walk down the hallway and run into the wall, I fell in my garage, I’d stumble all the time, I was shaking in both hands, and I couldn’t write my name,” said Coots. “I also lost the ability to multitask. I couldn’t have more than one tax return in front of me; I used to be able to have five or six.”
Fast forward to May of 2020. Coots found himself rushed to the hospital once again, this time coming to the University of Kentucky Albert B. Chandler Hospital. In addition to suffering a mini stroke, the doctors suspected he had Parkinson’s disease.
“(It was) just out of the clear blue. I had no idea,” Coots said. “I knew I was shaking a little bit, but that was a completely unknown thing to hit us that we now had to deal with along with everything else that was going on from the stroke.”
The then 64-year-old says that news changed his life.
“I’m now thinking, ‘Okay, the books say you have 20 years before your life really gets tough,” he said. “I started taking my social security, because at that point you never know what’s going to happen.”
While coming to terms with this diagnosis, Coots was referred to a headache specialist at UK and began therapies and medication for Parkinson’s. After showing no improvement in his condition, Coots remembers his doctor telling him she wanted him to see a movement specialist, and that they had someone with the right expertise within the neurology department at UK.
“He was on 17 medications when I first saw him in February of 2021,” said Zain Guduru, M.D., neurologist with the Kentucky Neuroscience Institute and assistant professor in the University of Kentucky College of Medicine. “Every medication comes with benefits and side effects; we just have to weigh the risks and benefits.”
Guduru immediately suspected that what Coots was experiencing was drug-induced parkinsonism. Parkinsonism is a condition that closely resembles Parkinson’s disease. But while Parkinson’s disease is caused by nerve cell degeneration in the brain, parkinsonism is caused by other factors, including head traumas and the side effects of certain medications.
In Coots’ case, Guduru thought Coots’ parkinsonism was caused by his migraine medication. Because the medication was helping with his headaches, Coots did not want to stop the drug right away. Guduru then took an alternative route to definitively diagnose whether he had Parkinson’s or not.
Guduru ordered what is called a DaTscan, an advanced technology only available at a couple of places in Kentucky. The results were a relief for Coots.
“It determined that I do not have Parkinson’s disease,” said Coots. “So that was great news.”
Guduru then gradually guided Coots off of the migraine medication as well as several other drugs he had been taking due to the initial Parkinson’s diagnosis.
“Everything just kind of faded back to normal,” said Coots, who is now down to taking only seven medications each day — and two of those are over-the-counter.
“This is an example of taking a holistic approach. We want to treat a person, not just one disease or condition,” said Guduru. “Having multiple specialists available — often within the same department — creates excellent comprehensive care for the patient. Resources like the DaTscan and specialists are available to us. All of this working together led to the final outcome for Mr. Coots.”
Guduru says the initial referral for Parkinson’s disease was a fair analysis, but he was thrilled to be able to remove that term from his medical chart.
“Had he gone somewhere else, he might have ended up staying on the medicine and continuing to experience those debilitating symptoms,” Guduru said.
With his quality of life back, Coots started a new business as a consultant, and he and his wife are once again traveling.
“We were afraid to travel before. I could not go very far from hospitals,” Coots said. “So if we did plan a trip, we would look at where the nearest hospital was.”
The Coots also serve their church, teaching three- and four-year-old children in Sunday school.
“There is no way I could have done that two years ago,” said Coots. “Life was going downhill, and then it started getting better. It has truly been life-changing to not have to take all of those medications.”
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