Ep. 84 | The Sick Snowbird/A Spoonful of Sugar
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Wondery Plus subscribers can listen to new episodes of Mr. Ballin's Medical Mysteries early and ad-free right now. Join Wondery Plus in the Wondery app or on Apple Podcasts. Appearances can be deceiving. That's especially true in the medical world. One disease can be mistaken for another. And if you make the wrong diagnosis, the consequences can be deadly. In today's episode, we're covering two stories that are not what they seem.

Both concerned women whose alarming symptoms are being caused by something doctors never expected. In our first story, a woman is suffering from nausea that's so extreme she's basically on the brink of death. And in our second story, another woman suddenly starts acting drunk at work, but she hasn't had a drop to drink.

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From Ballin Studios and Wondery, I'm Mr. Ballin, and this is Mr. Ballin's Medical Mysteries, where every week we will explore a new baffling mystery originating from the one place we all can't escape, our own bodies. So if you like today's story, please change the resolution on the Follow Buttons computer by one pixel horizontally and one pixel vertically every single day so that their computer slowly becomes fuzzier and fuzzier over time. And now here's our first story called The Sick Snowbird.

In early March of 2022, 70-year-old Abigail Norris was feeling good as she walked out of the Newark, New Jersey airport. It was chilly outside, but she didn't mind. She'd just spent nine weeks at a friend's house in Southern California. Every day had been filled with sunshine and strolls along the beach. It was the most relaxing winter of her life. Even her chronic back pain felt better in the mild weather.

For decades, Abigail had suffered joint pain from osteoarthritis, and she also had lower back pain that made it hard to even comfortably sit upright, let alone move around. But considering how well she felt right now, she was starting to think that maybe she should just go to California every winter. Three months later, Abigail woke up suddenly in the middle of the night with a sharp pain in her stomach. She fumbled for the lamp on her bedside table, flicking on the light just as another stabbing pain hit her.

She groaned and curled up into the fetal position until the room started spinning. Then a wave of nausea hit her and she hurried to the bathroom just in time to lean over the toilet to vomit. And she would vomit into that toilet bowl over and over again until she was coughing up this yellowish green bile that came from her liver. And every time she felt like she was done throwing up, another wave of nausea would hit and she would throw up again. It was actually Abigail's third vomiting fit in the past few months.

She'd gone to the emergency room the last two times, but the doctors didn't know what was wrong. Both times, the pain went away on its own and she was discharged. She had no idea what was causing these symptoms. At first, she wondered if maybe this was some awful side effect of a migraine, which are very severe, debilitating headaches. She used to suffer from them all the time, but they never affected her gut or made her this violently ill. And this particular vomiting spell was the worst one so far.

More than an hour passed by before Abigail felt certain she was done throwing up. By then, she felt weak and shaky, and the pain in her abdomen was becoming unbearable. Abigail gathered her strength and managed to get herself dressed. She found her purse and staggered out to her car. Even though she feared it would be another waste of time, she knew she had to get to the hospital again. The next morning, Abigail was laying in a hospital bed, vomiting yet again, but this time into a disposable bag.

She had been admitted to the hospital and then an ER doctor had ordered blood and urine tests along with a CT scan of her abdomen. While waiting for the results, he gave her medication for her pain. He also started her on broad-spectrum antibiotics in case she had a bacterial infection. But none of it helped with her stomach cramps and nausea or the vomiting. Abigail could not stop puking even though her stomach was completely empty.

She was exhausted and her stomach hurt so badly that when she wasn't throwing up, all she could do was lie in bed with her eyes closed. Just then, Abigail heard someone come into the room, but she felt too weak to open her eyes. A nurse asked her if she wanted more pain medication. Abigail just shook her head and said no. The pain medication they had given her in the emergency room had not helped, so there was no point in taking any more. Besides, Abigail felt like she'd just throw up anything they put in her system, so she'd rather tough it out and let her stomach rest.

Later that morning, when Dr. Howard Pinter entered his new patient's room, Abigail's room, he was hit with the stench of fresh vomit. The acid smell lingered in his nose as he approached her. Abigail lay motionless on the bed, her eyes closed. She looked too weak to move. Her face was pale and glistened with sweat. The hair around her face was soaked through and matted to her forehead. It was clear she'd had a long and sleepless night. Dr. Pinter said her name, and he watched as her eyes fluttered weakly, but she didn't say anything.

He realized this was likely the closest thing to a hello that she could muster. He asked her if she could tell him where the pain was coming from. But all Abigail could do was make this low moaning noise, as though talking took too much work. So, Dr. Pinter began an exam, and he pressed gently on her abdomen, asking if that made the pain worse. If he could figure out exactly where the pain was coming from, it would help him diagnose her.

but Abigail didn't even seem to notice his hands on her. So he just continued to press up and down on her belly, trying to pinpoint the origin of her pain, but she didn't react to anything he was doing. Her entire abdomen was apparently throbbing in pain, but him pressing on her abdomen made no difference to her. Because her pain was so widespread, the doctor knew he could probably rule out conditions like appendicitis or kidney stones, which tend to show up in one specific place.

But there was a laundry list of other conditions that could cause abdominal pain like this, and so Dr. Pinter hoped that the true cause would show up either on her CT scan or her lab work. An hour later, Dr. Pinter sat at his desk looking over Abigail's blood test results as well as images of her abdomen from the CT scans. On these scans, he couldn't see anything that would cause pain throughout the entire region, but something seemed to be wrong with the quality of the images. He looked through her medical records and he quickly found an explanation.

Abigail had had a small device called a nerve stimulator implanted in her abdomen years ago to help treat her chronic migraines. It worked by sending electric pulses to her nervous system to alter the way her brain experienced pain. However, since the device was electronic, the interference from it was reducing the picture quality of her CT scans, which made it hard for Dr. Pinter to pinpoint the cause of Abigail's stomach pain. But the scans were not the only thing that troubled the doctor. There was also her lab results to consider.

Her white blood cell count was extremely high, which suggested she was fighting off an infection or inflammation. And the doctor saw yet another problem too. When body tissue does not receive enough oxygen, it begins to die and releases an acid into the bloodstream. Abigail had a rising level of this acid in her system, which meant that some of her tissue could already be dying.

Dr. Pinter worried that she might have a condition called ischemia which occurs when the supply of blood to the organs is cut off. This condition can lead to a heart attack or stroke. Unfortunately, the CT images were not good enough to identify any blockage in the blood supply that could be causing ischemia. However, Dr. Pinter knew he had no time to lose. He grabbed his phone and called down to the cardiology department and scheduled Abigail for emergency surgery later that afternoon.

He needed a vascular surgeon to literally open up her abdomen and look to see if something was blocking her circulation and also to remove any dying tissue. A few hours later, Dr. Pinter received a call from the surgeon who had performed Abigail's procedure. The good news was that Abigail came through the surgery just fine. Her organs looked perfectly healthy and her blood vessels were functioning properly. She did not have ischemia. In fact, it looked like there was nothing wrong with her arteries at all.

Dr. Pinter was glad to hear that Abigail looked healthy, but in reality, she was still very sick with something. And now he had no idea what could be causing these stomach cramps, the high white blood cell count, and the rising level of acid in her body. What he really needed was to get Abigail strong enough so she could speak. That way she could answer questions about her pain and her previous vomiting spells. Without her talking, he feared they'd never get to the bottom of her issue.

Three days later, around lunchtime, Abigail was eating some jello in her hospital bed. Until this point, she'd been getting her nutrients through an IV. This was the first true meal she'd had since she arrived at the hospital. And if it were up to her, it was going to be the last. She just wanted to go home. That morning, the pain in her abdomen had finally subsided. She'd stopped vomiting and could now keep fluids down. For the first time in days, she actually felt hungry. It was like her illness had disappeared.

And her updated lab results seemed to support that idea. Her blood and urine showed no signs of an infection. And so, just like the last two times Abigail had a very serious vomiting and cramping spell, it seemed like everything just sort of went back to normal. The medical staff didn't have an explanation for why she was suddenly better. And so Abigail felt like she was just wasting time and money by staying in the hospital. But a moment later, Dr. Pinter appeared in the doorway. And he told Abigail that he might have an explanation for her pain.

Abigail was surprised but intrigued and asked him to explain. Dr. Pinter said he had two theories. The first was that she might have a rare nerve condition called abdominal migraines.

He explained that when Abigail first arrived at the hospital, he had pressed a hand on her stomach to see where the pain was coming from. That's what made him think that she might be suffering from nerve pain, one of the few types of pain that does not respond to pressure. Plus, Abigail had a history of regular migraines and he explained that abdominal migraines are related to migraine headaches, but they show up as abdominal pain, nausea, and vomiting rather than the more typical headaches.

Dr. Pinter said the other possible theory for what was causing her pain was that she could be suffering from abdominal epilepsy, a very rare type of seizure that causes severe abdominal pain. It's most common in children, but adults can suffer from it as well. And so he asked her if she wouldn't mind staying at the hospital long enough to let the neurology team examine her.

Abigail admitted that Dr. Pinter might be on to something, but she just could not spend any more time in the hospital. So she made a deal with him. If he discharged her, she would book an appointment with the neurologist who had been treating her migraines over the past 20 years to see if maybe he thought either of those theories were what was going on with her. Dr. Pinter said they had a deal. The following day, Abigail was home and she sat down at the desk in her bedroom. She logged on to a Zoom call for a meeting with her neurologist, Dr. Randall Bergen.

Dr. Bergen was not just a neurologist, he was also a psychiatrist, and he had been Abigail's doctor for over two decades, though she hadn't seen him in a long time. When her nerve stimulator was implanted a few years ago, her migraines had cleared up almost completely, so there really hadn't been a need to speak to him.

But now, she told him all about her vomiting spells and Dr. Pinter's theories that maybe she had abdominal migraines or seizures. She also told him about her blood tests, CT scans, and exploratory surgery. None of the doctors could find evidence of anything physically wrong with her. And finally, she told him how her pain just suddenly went away after a few days in the hospital. And she said the same thing had happened twice before since coming back from California.

Dr. Bergen was quiet for a moment, clearly thinking over all the information. Then he asked her a question that nobody had thought to ask her before. Dr. Bergen wanted to know if Abigail smoked marijuana. Abigail was surprised. She assured him that she had never smoked marijuana, but she had eaten it. When she was in California, Abigail's friends kept telling her that weed gummies could help with her chronic back and joint pain, and so she'd given it a try. And sure enough, the gummies had really helped.

Whenever she ate a gummy, it was so much easier to move and walk around or even just do housework. So, ever since she got home from California, she'd been eating six weed gummies a day. When she was in the hospital, she hadn't told Dr. Pinter about the weed gummies because she was embarrassed. Besides, the gummies were supposed to reduce nausea, so she didn't think it was relevant anyways. That's when Dr. Bergen explained that Abigail was suffering from something called cannabinoid hyperemesis syndrome.

It's caused by prolonged use of high-dose cannabis and is characterized by nausea, vomiting, and abdominal pain. Researchers don't know why some people have this reaction to the chemicals in marijuana, but it's thought that the intolerance could be genetic.

The good news was that if Abigail discontinued her use of the weed gummies, her painful vomiting spells would stop. And in fact, that's what was happening each time she was hospitalized. She didn't have access to marijuana gummies, and so after a couple of days, the pain would subside.

However, the weed gummies made Abigail's life so much better that at first she actually really didn't want to stop using them despite the downside. So she tried lessening the dosage and the frequency, but still she would get violently ill and have stomach pains and so eventually she did stop taking them altogether. And while her lower back pain and osteoarthritis did come back, she at least stayed out of the hospital and has not experienced pain or nausea since.

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Go to chime.com slash disclosures for details. On Fear Thy Neighbor from i-D, hear true stories from the victims of deadly neighborhood disputes. Most violent crimes that capture the public's imagination are

are about serial killers or crimes of passion. But what happens when the person you fear the most is living right next door? Each episode focuses on a different town where neighbors fall out over what should be minor and resolvable issues. Like when a neighbor borrows a lawnmower but returns it damaged, which sets off a violent course of events. Or how a man in Vancouver moves into a new building and finds himself helping out an elderly neighbor, then they have several disagreements and a falling out that leads to his death.

Hear these true stories told by the victims, their families, and their neighbors, featuring real 911 calls and surveillance archives. Listen to Fear Thy Neighbor wherever you get your podcasts. And now here's our second story called A Spoonful of Sugar. On a warm spring afternoon in 2011, a woman named Brooke Scott arrived at her lively real estate office in Massachusetts with a box of warm chocolate chip cookies for her staff.

Brooke walked from cubicle to cubicle, handing out cookies and patting people on the back to celebrate a huge sale for that month. But when Brooke arrived at the cubicle belonging to an agent named Kelly Romano, she stopped short. Normally, 52-year-old Kelly had the energy of a woman half her age, constantly chatting with clients and combing through the latest listings. Today though, Kelly was hunched over in her chair. Her face was pale and slick with sweat, and she stared at the box of cookies in Brooke's arms with glassy eyes.

Kelly reached for one of the cookies, but when she stood up, she swayed back and forth before her knees buckled and she sank back into her chair. Brooke just shook her head. She couldn't smell any alcohol in Kelly's breath, but it was clear. Kelly was drunk in the office. Again. Brooke whispered to Kelly that they had talked about these day drinking episodes several times over the past year. But Kelly insisted she was sober, and Brooke was making a big deal out of nothing. But Brooke had had enough. She told Kelly to take some time off.

and then picked up the phone to call her a ride home. The following day, Kelly went out to run errands with her husband Peter. She still didn't feel quite right, but she was sure the time off would help. As they drove through town, her cell phone rang. It was one of her clients, asking her to set up an appointment to go see a house he wanted to buy. Kelly promised she would set it up. However, the moment they hung up, she completely forgot what property they'd been talking about.

Kelly felt rattled by this. She never forgot details like that. So she promised herself she would call that client back once she was feeling less fuzzy. An hour later, Kelly and her husband Peter had finished their grocery shopping and were loading their bags back into the car. Peter needed to make some calls, so Kelly hopped in the driver's seat and pulled out of the parking lot. And after a few minutes, Peter put his phone on mute and looked over at her and with a confused look on his face asked Kelly where she was going.

Kelly looked around and realized she didn't know where she was. Now, she still knew how to drive, she could tell a red light from a green light, but when she tried to remember the way home, she couldn't. She felt like a lost child. At this point, Kelly knew something was definitely wrong. This was not just brain fuzziness.

So she pulled the car over and she and her husband switched spots. And as she slumped into the passenger seat, Peter looked over at her with concern. He asked her if she knew what year it was or who was the President of the United States. Kelly knew this was a standard way to check someone's cognitive abilities and she felt a pang of terror as she realized she didn't know the answers to either of Peter's questions. All of a sudden, Kelly could barely focus at all. She felt like her brain was being flicked on and off like a light switch.

And then her mind went completely blank. Suddenly, Kelly opened her eyes back up. She realized she was lying down in her kitchen. She had no idea how she'd gotten there. She looked over and saw Peter crouch next to her. And then she also realized she was surrounded by paramedics. Peter told her she'd been acting strange the entire way home. And when they went to put their groceries away about 15 minutes ago, Kelly had just collapsed. And so Peter had called 911.

Kelly nodded, confused, and then just tried not to move while the paramedics checked her vitals. Also, one of them pricked her finger to test her blood sugar levels, and after checking, he told her that her blood sugar was very low, a condition called hypoglycemia that can cause confusion and dizziness. Kelly asked if they were going to take her to the hospital now, but one of the paramedics just shook his head. He said that she should be fine as soon as she got her blood sugar elevated again. So he helped her sit up and then handed her a little package of jelly beans to eat.

After a few minutes of eating them, Kelly was feeling better. Before the paramedics left, they told her to always keep some fast-acting carbohydrates like juice or candy on hand for whenever she felt lightheaded or woozy. Even though Kelly was still totally shocked by what had just happened to her, she was grateful to know what was actually wrong with her. This was hypoglycemia. However, she had to figure out why she became hypoglycemic.

A few days later, Kelly sat across from her doctor, hoping for a plan or some sort of medicine to keep these episodes from happening to her again. Aside from these episodes being terrifying, she also just couldn't afford for people to think she was drunk all the time. The doctor explained that most likely, her body was making too much insulin, the hormone that regulates the amount of sugar flowing to the cells, especially the brain.

Insulin is very important, but too much of it can pull too much sugar out of our bloodstream, robbing cells of their fuel. And so her brain didn't have the energy it needed to help her remember things or talk, and she didn't have the strength to stand up. That's why she was passing out in the middle of the day like she was drunk.

But when the doctor looked over her most recent blood test, he was surprised. He told her that her insulin levels were slightly elevated, as if she had just eaten, even though she hadn't. But he told her to just keep an eye on it and keep an emergency stash of jelly beans on hand just in case her blood sugar plummeted again.

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More than a year later, Kelly's husband, Peter, paced around his office with his phone to his ear. He was trying to reach Kelly at work, but she wasn't answering her office line. He had left her four messages in the past hour, and he was getting worried because she hadn't called him back. He sighed in frustration as his call went to voicemail again, and he left message number five. Over the past 12 months, Peter had helped Kelly manage her low blood sugar.

He stocked the fridge with juice boxes and made sure there were always packs of her favorite candy in her purse. He knew his wife was not happy with the 25 extra pounds she had gained from all the extra sugar, so he made sure they always went for a walk together before work. Peter knew Kelly was doing her best to keep her struggles from her colleagues, and for a while it had worked. She didn't have any more of those low blood sugar moments when her colleagues thought she was drunk.

But lately, Peter had noticed her low blood sugar moments were getting more frequent, and Kelly had to eat more and more sweets to snap out of them. And so that's why he had gotten into the habit of calling her at work every afternoon to check in on her. After still not hearing back from his wife, Peter decided to call the front desk at Kelly's office and ask the receptionist to check on Kelly. The receptionist said she could actually see Kelly right now sitting at her desk. And from the looks of it, it seemed like Kelly was sort of talking to herself.

Peter's stomach immediately sank because this sounded like the start of an episode. But the receptionist told him there was a bottle of apple juice on Kelly's desk. And at that, Peter brightened. It sounded like his wife had the situation in hand. As long as she drank the juice, she would be fine. He thanked the receptionist and hung up, feeling a bit relieved, but still wanting to talk to Kelly that night to make sure she really was okay.

But when Peter got home that night, he found Kelly stumbling around their kitchen slurring her words. And so immediately Peter jumped into action. He held a glass of orange juice to her lips, and after a moment, she kind of came back to herself. And once she had recovered, he insisted this had gone on long enough. They both agreed Kelly needed to see a specialist. A week later, Dr. Frank Miller listened as Kelly described her embarrassing episodes and the constant suspicion that she was drunk at work.

Dr. Miller was an endocrinologist, which is a doctor who specializes in hormone disorders. Dr. Miller swiveled his chair to the computer screen to take a look at her blood work, and he saw that her blood contained an amount of insulin that was normal for someone who had just eaten. However, Kelly had taken the test on an empty stomach. Dr. Miller double-checked with Kelly, and she insisted that really, she hadn't eaten anything and only had sips of water for the 12 hours before she took this blood test.

Dr. Miller looked at the results again. Kelly's pancreas, the organ that makes insulin, was busily doing its job even though there was no sugar in her body to process. Dr. Miller thought he might know what was wrong with Kelly. He explained that he wanted to run one more test to confirm his suspicions. But this test would involve more than just another vial of blood. The test was called an endoscopic ultrasound.

He explained that he would guide a long flexible tube fitted with a special instrument down her mouth and into her digestive system. He would wind it through her body until it landed near her pancreas. Then he would take a good look and tell her what he found. By the look on Kelly's face, Dr. Miller knew the thought of him snaking a tube through her insides made her uncomfortable. But he assured her she would get through the procedure just fine. And she would.

When she awoke from the procedure, Dr. Miller was happy to report that he'd located the reason for her last few years of misery. The endoscopic ultrasound showed a blob the size of a pencil eraser on Kelly's pancreas. This blob was a benign tumor called an insulinoma, which was made of cells that produce insulin.

Normally, the body tightly controls how much insulin the pancreas makes. But the cells in this tumor pumped out insulin constantly whether the body needed it or not. And so all that extra insulin kept her blood sugar low no matter how much sugar she consumed. In 2013, the tumor was successfully removed. Kelly's life went back to normal. She stopped needing to eat so many sweets. She was able to lose the extra weight she had put on. And the rumors of her day drinking were finally put to rest.

Follow Mr. Ballin's Medical Mysteries on the Wondery app, Amazon Music, or wherever you get your podcasts. You can listen to new episodes of Mr. Ballin's Medical Mysteries early and ad-free right now by joining Wondery Plus in the Wondery app, Apple Podcasts, or Spotify, or by listening on Amazon Music with your Prime membership. Before you go, tell us about yourself by completing a short survey at wondery.com slash survey.

From Ballin Studios and Wondery, this is Mr. Ballin's Medical Mysteries, hosted by me, Mr. Ballin.

A quick note about our stories. They're all inspired by true events, but we sometimes use pseudonyms to protect the people involved, and some details are fictionalized for dramatic purposes. And a reminder, the content in this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment. This episode was written by Aaron Lan and Allison Taylor. Our editor is Heather Dundas. Sound design is by Andre Pluss.

Our senior managing producer is Callum Plews, and our coordinating producer is Sarah Mathis. Our senior producer is Alex Benidon. Our associate producers and researchers are Sarah Vytak and Tasia Palaconda. Fact-checking was done by Sheila Patterson. For Ballin Studios, our head of production is Zach Levitt. Script editing by Scott Allen and Evan Allen. Our coordinating producer is Samantha Collins. Production support by Avery Siegel. Executive producers are myself, Mr. Ballin, and Nick Witters.

For Wondery, our head of sound is Marcelino Villapando. Senior producers are Laura Donna Palavoda and Dave Schilling. Senior managing producer is Ryan Lohr. And our executive producers are Aaron O'Flaherty and Marshall Louis. For Wondery. For Wondery.

Hey, I'm Mike Corey, the host of Wondery's podcast, Against the Odds. In each episode, we take you to the edge of some of the most incredible adventure and survival stories in history. In our next season, it's 1980, and in the Pacific Northwest, the long, dormant volcano Mount St. Helens is showing signs of life. Scientists warn that a big eruption is coming, but a restricted zone around the mountain is limited by politics.

On May 18th, hikers, loggers, reporters, and researchers are caught in the blast zone as the volcano erupts. They find themselves pummeled by a deadly combination of scorching heat, smothering ash, and massive mudslides. The survivors have to find their way to safety before they succumb to their injuries.

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