The doctor’s office, decorated in a rich hue of pastel blue, had a calming and serene atmosphere. Sierra and Chantal signed in with a woman at the front desk who gave them a pager that would vibrate when the doctor was ready to see them. In the meantime, Chantal completed patient information forms and questionnaires about her medical history.
While waiting, Sierra read the patient testimonials posted on the bulletin board in the waiting room filled with patients. The pager beeped several minutes later, they stood up, and an older woman with gray hair came through an open door into the waiting room to greet them.
“Chantal Rhys?” she asked.
“Yes,” said Chantal.
“Hello, my name is Lena. I’m the nurse. You may follow me.”
“Is it OK if my sister, Sierra, comes with me?”
“Yes,” said Lena. They followed her to an exam room.
“Please step on the scale so I can get your height and weight.”
“You’re 66 inches tall and you weigh 134 pounds. You may step down and sit on the examination table. Next, I need to put this device on one of your fingers.”
“OK,” said Chantal sticking out a finger on her left hand.
“Now, I need to check your temperature and blood pressure.” She placed a thermometer in Chantal’s mouth and a blood pressure cuff around her right arm.
“Thank you,” said Lena. She removed the blood pressure cuff from Chantal’s arm and wrote down the numbers for the vital signs she checked. “The doctor will be right in.”
A few minutes later, there was a knock on the exam room door. A tall attractive African-American man, about forty, entered the room.
“Hello, I’m Dr. Cory.”
“Hi, I’m Chantal and this is my sister Sierra.”
“Hello,” said Sierra.
“It’s nice to meet you both.” He looked at the notes in the chart that he held and said, “I see that Chantal has been having nightmares, and she is currently taking Plavix for atrial fibrillation.”
“Yes, Chantal was born with patent foramen ovale. She takes the medication to prevent complications from the hole in her heart. Her heart condition is managed by our family cardiologist in our hometown, Thousand Oaks.”
“Is there a strong history of heart disease in your family?” asked Dr. Cory.
“Our parents were fairly healthy, but our paternal and maternal grandfathers both have high blood pressure,” said Sierra,
“How can I help you?” he asked.
“I would like to find a way to cope with the nightmares that I’m having.” said Chantal.
“How often do you have the nightmares?”
“I’ve had two in the last few days.”
“Do you feel stressed? Is there a history of anxiety, or other mental health issues?”
“No,” said Chantal. “I recently broke up with my boyfriend, but the nightmares started before the breakup, when we were happy, or so I thought.”
“My concern is that the nightmares are disrupting Chantal’s sleep. She’s waking up screaming, full of sadness, and crying, which wakes me up out of my sleep when I hear her. Several years ago, she received psychiatric treatment for nightmares and post traumatic stress disorder after our parents died together in a plane crash,” said Sierra.
“Chantal, there are triggers in your environment, that can activate memories of your parent’s accident,” said Dr. Cory. It could be something as simple as heat billowing from the tarmac on the highway as you’re driving on a hot summer day. It is possible that your nightmares and the PTSD are related. Although, clinically the PTSD may be resolved.”
“For some reason, I just don’t think the nightmares are about my parents accident. I don’t believe they are related.”
“Are the nightmares violent?” he asked.
“Yes, I guess so. In each of the dreams, an accidental death occurred in a large mansion, during a violent storm. A man fell to his death when a stairway collapsed in the first nightmare. In another dream, a young woman died after she was impaled to a wall by a steel pole through her chest, which blew into the mansion with strong winds caused by the storm. In the last dream, another woman died from a severe head injury.”
“Would you say you are able to recall your nightmares without any confusion?”
“Yes, I’ve been able to recall everything,” she said. “I’ve also experimented with lucid dreaming to learn more about the characters in the dreams.”
“After a nightmare occurs, are you able to return to sleep again?”
“Yes, usually after Sierra comes into the room to comfort me and rock me back to sleep.”
“I’d like to check your pulse and listen to your heart and lungs.” said Dr. Cory.
“OK”, said Chantal.
He took her wrist and checked her pulse. Then, he placed his stethoscope on her chest and told her to breathe normally. Next, he told her to take deep breaths in and out. He followed the same procedure again when he placed the stethoscope on her back.
“Well, I urge you to keep up your current regimen with the Plavix for the atrial fibrillation. Because of your medical history, a non- invasive behavioral therapy for the nightmares will be best. I would not recommend any medications at this time. Lucid dreaming is a good start. It allows you to manipulate the storyline of a dream or nightmare when you’ve recognized you are in a dream.”
“Last night, I had a lucid dream” said Chantal.
“She spoke to a man in her dream, which resulted in her literally talking in her sleep. She was so loud, I awakened from my sleep. Is there any danger with lucid dreaming?” asked Sierra.
“No, not at all.” Looking at Chantal, Dr. Cory said, “Take it slow and stay calm when you experiment with your actions during a lucid dream. Over time, you will have more control and self-awareness.
He took two brochures from a brochure holder and gave one to each of them.
“Imagery Rehearsal Therapy is another behavioral therapy you may want to consider. It involves recalling your dream, and rewriting any part of the dream for a favorable outcome. When you have the nightmare again, the script you created will replace the original undesirable storyline.”
“Great, thank you Dr. Cory,” said Chantal.
“Do you have any more questions?”
“No. Thank you,” said Sierra.
“Thank you again,” said Chantal.
“The pleasure was mine.” he said.