In May 2000, a woman walked into my practice who was about to change my life.
Lesley—a cheerful, friendly woman in her late forties—had obvious difficulty walking, and struggled simply to get out of a chair. Her main complaint was back pain, although she also had pins and needles, shortness of breath, and a heavy leadlike feeling, especially in her hands. Her back pain was so severe that she had undergone exploratory spinal surgery four years earlier. The surgeons had found nothing, sewed her up, and sent her home.
As part of my examination, I asked her to lift her right leg off the table. With much shaking, grunting, and groaning, she eventually edged her leg to vertical, and then limply dropped it again. Her other leg fared no better. The short distance from horizontal to vertical took ten seconds.
While this was extraordinary, her other muscles were just as bad. She was so weak, she could not step down from a chair without falling to the floor. She told me that one of her favourite hobbies was horse riding, but she could no longer ride since it was impossible for her to get off the horse without collapsing on the ground—a very painful experience unless she happened to land on a pile of straw.
In all my training and fourteen years in practice, I had never encountered this before. Such extreme weakness is usually only seen with serious neurological diseases. In addition to running all the normal orthopaedic and neurological tests, I did what I could to rule out hysteria, multiple sclerosis, motor neuron disease and a few other conditions. Lesley’s condition did not seem to fit any classical diagnosis, a fact which relieved me since all the neurological diseases have extremely poor outcomes and very few useful treatments. Besides, what I needed was an explanation, not a diagnosis.
At that stage, I had no idea what was wrong with her, but I welcomed the opportunity to test my new theory, a theory built upon finding the causes of muscle weakness.
If my theory was right, I had to be able to cure Lesley, not just treat her. And cured she was, just after she had her gold crowns removed.