Dr. Ashley Alker

Anything that can kill you does eventually bring you to the emergency department.

But then there's the sneaky things, the things where people, you know, some of the least effective

helpful.

And unfortunately, a lot of doctors, their least favorite complaints are weakness and dizziness because it can be anything.

It can be anything from you're just tired today to a stroke or to something like botulism.

I had a patient who came in who was having just generalized a little bit of weakness.

And I noticed his or her eyelids were a little bit droopy.

And in

you know that moment after talking to the patient it kind of had set off something in my mind where I thought you know we should probably check for these things and it was a very lucky find because this is something that you know often gets missed at least the first time if not the second time so you know hidden amongst hundreds of complaints that aren't

necessarily, you know, life-threatening, but are emergencies to the people who come to the department because they can't possibly get healthcare other places.

They don't have a primary care.

They don't have insurance, whatever the reason is, but hidden amongst, you know, the failings of our healthcare system that bring, you know, hundreds of thousands of people to the emergency department

every year are people who are dying.

And so picking those people out through, you know, good triage and through good histories and talking to the patients and, you know, really understanding the patient's story, that's how you find those people.

So the droopy eyelid story, that is one of the – it's called ptosis, and it's one of the signs of botulism.

And botulism is kind of a sneaky bacteria because the bacteria itself isn't really the issue.

The issue is that once botulism is contracted, it creates a toxin, and that toxin –

makes you have certain types of weakness.

And that weakness eventually will affect your respiratory muscles and cause you to stop breathing.

So you have to catch it at a certain point in time.