Foreman's Case Study

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A famous wheelchair-using trumpet player named John Henry Giles loses his breath and collapses from a lack of oxygen while playing. At the hospital, House is intrigued that John Henry has been paralyzed for two years without sufficient explanation. Cuddy tells House that they are only treating John Henry for pneumonia, since his paralysis is treated by his doctor in California, Marty Hamilton. Foreman, who did a residency with Hamilton, is requested to lead the case. Hamilton had already diagnosed the paralysis as an effect of ALS, which would explain the pneumonia. House does not agree with this suggestion and seeks other explanations for the paralysis. As Foreman does the blood work, John Henry requests a "Do Not Resuscitate" order. Foreman has John Henry administer an IVIG, which ends up limiting the blood in his lungs, causing him to crash. Chase wants to intubate, but Foreman mentions the DNR. House intubates anyway. House reasons that it was the IVIG that caused the reaction, not the disease. House is hit with a…show more content…
Looking over John Henry's MRI, Cameron notices signs of a stroke, which would explain the paralyzed arm. Foreman explains the options to John Henry. They can give him heparin to thin his blood and remove the clot, but it could hurt his lungs. Another option is brain surgery to remove the clot. The surgery will either result in his death, or a clearing of the blood clot. Not wanting to risk his lungs, John Henry opts for the surgery. The surgery is a success. John Henry can move his arm following the embolectomy and is able to feel House touching his leg. The doctors are baffled. Hamilton thinks his ALS treatments are the answer. House thinks they need to take John Henry off the dozen drugs they are giving him in order to restart the dosage one by one to see which is having the effect. If not, the toxicity of the useless drugs could kill

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