Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Blood test normal, Chest discomfort, Chest pain, Chorea
Clinical narrative: On May 21, 2021, patient received the 2nd dose of Covid-19 Pfizer vaccine.   On May 31, 2021, 10 days later, we had a family celebration at 1pm for his 91st birthday.  His family noticed the right side of his face a little droopy.  His wife noticed his left arm and leg had slight strange movements. On June 2, 2021, late pm, his family noticed left arm and leg flailing uncontrollably and slurred speech with right side facial paralysis.  Some mental confusion.   Other symptoms that appeared over the next 2 days, all occurring at the same time and severe for the next 2 weeks: -severe fatigue and had no energy. -chest tightness -severe dry mouth -inside of mouth covered in cold sores (he gets one cold sore every few years normal, this was all over inside mouth and not normal) -lips bleeding with bottom lip appearing swollen -alternating hot/cold episodes but no fever -low blood pressure episodes, drops randomly, (normally has high blood pressure) -skin sensitivity, pain to touch on both arms and legs -bottoms of feet tingling, pins and needles sensation -large amounts of foam-like/sticky phlegm down throat, had to clear throat constantly -lost almost complete sense of smell and taste -eyes: he was being treated for dry/burning/matted eyes.  After the vaccine, all of this was much worse plus he had horrible light sensitivity. All light hurt his eyes and his vision declined. *all of these symptoms lasted approximately 4 weeks and then subsided except for the following 3 which he still has: 1 fatigue/no energy.  2 cannot fully smell or taste. 3 eye problems. On June 4th, 2021, symptoms were extreme and chest pain was severe.  Patient went to medical facility.  They ran many tests.  We listed them in #19 as best as we could remember.  Nothing out of the ordinary.  Doctor or the hospital will have access to these records. Diagnosed acute chorea and sent him home. On June 5, 2021, patient went to doctor for an office visit.  Later that evening his vision blurred so patient again went to the same Emergency Room.  They ran more tests.  They diagnosed Tremor and sent him home.  Patient says ?he feels like his whole body system changed after the second dose.?  Patient continued to follow up with doctor, who is a wonderful dr.  Doctor prescribed 2 short-term medications on separate occasions (Levetiracetam & Carbamazepine).  They did not relieve symptoms.  Dctor referred patient to specialist. On June 23, 2021, specialist ordered an MRI and prescribed Risperidone 0.5mg.  This appears to have worked for the arm and leg movement problem. Throughout this time period of May 21 - Aug 14, different eye drops were also issued at different times. Alphagan, Latanoprost; OD, Dorzolamide. He continues to seek help for his eyes.  They are not better. As of August 14, 2021, all symptoms appear to be gone except for fatigue, no energy, the eye problems (eye pain, poor vision, light sensitivity), and partial loss of smell and taste.   Patient is not fully recovered.  His fatigue and lack of energy is severely affecting his health and lifestyle.   Pre-adverse event, Patient had good energy and was full of life.  Daily, he would spend hours tending to his large outdoor garden, building projects in his woodshop, driving to visit friends, running errands in town, and on occasion he would take a job through his construction company.  Since the 2nd dose of vaccine, he is now 85-90% homebound, only having about 15 minutes worth of energy to move around before he has to rest.  He is also unable to drive. To the best of our ability, this is how we remember the events above occurring.