PANDAS/PANS Clinic At Culver Pediatrics Center

Your healing journey starts here

A  Transformational Healing Journey 

Do you suspect your child has PANDAS/PANS but are not feeling heard by the “traditional” medical system?

Do you already have a great pediatrician that you love for your children’s primary care, but are looking for a doctor to evaluate or treat PANDAS/PANS only?

Do you already have a PANDAS physician for your child, but are looking for an integrative approach to see if it possible to unmedicate?

If you answered yes to any of these questions, Culver Pediatrics Center may be right for your family.

What Families Are Saying

  • "Dr. Adame and Nurse Becca are changing lives."

    PANDAS/PANS Parent

  • "My child went from barely being able to finish one or two hours of school, if that, to being able to go to school full time and thriving."

    PANDAS/PANS Parent

  • "Dr. Adame saved my son's life."

    PANDAS/PANS Parent

  • "My child says their brain is no longer on fire."

    PANDAS/PANS Parent

  • "We have our little girl back!"

    PANDAS/PANS Parent

  • "Dr. Adame and Nurse Becca listened to us when no one else would."

    PANDAS/PANS Parent

Culver Pediatrics Center

Welcome to our community of Butterflies.

We have had the honor and privilege to help many families with children affected by PANDAS/PANS along a transformational, healing journey.

Outcomes Include:

  • Reduction or Elimination of Motor Tics

  • Reduction or Elimination of Vocal Tics

  • Improved School Attendance and Performance

  • Improved Sleep

  • Improved Restrictive Eating

  • Improved Family Relationship

  • Reduced Obsessive Thoughts and Compulsions

  • Reduction or Elimination of Dark/Depressed Mood

  • Improved Separation Anxiety

  • Improved General Anxiety

  • Elimination of Encephalopathic Symptoms

  • Reduced Flare Ups

“I follow the PANDAS Physician Network treatment algorithm, but also integrate a highly personalized, holistic Veggies Over Pills approach tailored to each child’s needs.”

Dr. Noemi Adame

What To Expect When You Join

Our Holistic PANDAS/PANS Program

  • Step ONE

    60-90 Minute Parent/Caregiver Onboarding Appointment

    Before your initial onboarding appointment, you will complete a detailed intake about your child’s symptoms, PANDAS journey, and your family’s lifestyle. Within a week or so after you enroll your child, you will meet with Dr. Adame for a thorough review of your intake responses, your child’s medical history, your PANDAS/PANS journey up to that point, and most important, your goals for treatment. Together, you will set feasible, realistic, measurable short- and long-term treatment goals. This initial appointment can be virtual or in clinic. Your child does not need to be present as this visit is mainly to gather information.

  • Step TWO

    Records Review and Blood Work

    Within 2-3 business days after you enroll, our team will reach out you navigate the onboarding process to obtain your child’s previous medical records and blood work they have had done previously. After your initial onboarding and after Dr. Adame reviews your child’s previous lab results, your child will meet with Nurse Becca for blood work. If you do not live in the northern Indiana region, Dr. Adame will send the lab orders to a lab of your choice near you. Once your child’s lab results are in, Dr. Adame will email you the report along with her detailed recommendations such as nourishment guidelines and supplements to treat micronutrient deficiencies. Dr. Adame and Nurse Becca will review your child’s.medical records and abstract the information into their electronic chart. The more Dr. Adame knows about your child’s history, the better she can formulate a treatment plan. This process can take a 2-3 weeks or longer depending on how quickly we obtain medical records from your child’s previous physicians’ offices.

  • Step Three

    In-Clinic Visit with Dr. Adame at Our Culver Clinic Location

    Within 2-3 weeks after enrolling, Dr. Adame will see your child at our clinic to obtain baseline vital signs, weight, height, and physical exam. This step is essential before she can safely order medications or IVIG or make recommendations besides supplements. This is also a time for your child to meet Dr. Adame and her team and establish trust. This is an unrushed visit. The team blocks out TWO HOURS for your family, though the visit DOES NOT have to last that long. We take cues from the family and child. The reason for the extended time block is to make sure you are the only family in the clinic at the time of your appointment and so that all your questions are answered and most important, that you and your child do not feel rushed. After this visit, Dr. Adame will order indicated medications and IVIG. Please note it can take 2 days to several weeks to process a prior authorization through insurance for IVIG.

  • Step Four

    Direct Access, Frequent Support, and Holistic Approach

    After your child’s first in-clinic visit, Dr. Adame will schedule weekly appointments, either virtual or in clinic, to discuss your child’s progress and response to any interventions implemented. At Culver Pediatrics Center, we believe in shared decision-making. The family in the most important member of the team. You can also email or text our team for additional questions and support in between appointments. For example, you can text for concerns regarding side effects of IVIG. When your child’s symptoms start to improve and if you are comfortable doing so, Dr. Adame will space out your child’s follow up appointments to bi-weekly or monthly. Dr. Adame will develop a Flare-Up Action Plan for your child and as long as you are a member of the practice, you can text, call, or schedule an appointment.

By working with Nurse Becca and Dr. Adame, we can find a real solution to the pain and harm caused by PANDAS/PANS. The personal approach is what Culver Pediatrics Center is all about! We are humbled by the ways we have been able to change the lives of families affected by PANDAS/PANS.

What is the cost of the PANDAS/PANS Clinic at Culver Pediatrics Center?

Initial Investment: $750 per child (Covers $500 Onboarding fee and first month’s $250 membership fee)

Monthly Membership: $250 per child, starting on the 1st of each subsequent month after the initial investment

The fees include

  • Detailed intake and onboarding

  • All virtual and in-clinic appointments

  • Unlimited text, phone, email communications

  • Review of records

  • Direct access to our team and Dr. Adame for any additional questions or support or guidance

  • Bi-weekly virtual “Pandas and Butterflies” Parent Support Group exclusively for Culver Peds families with children affected by PANDAS/PANS

  • The fee does not include cost of supplements, medications, IVIG, or lab work.

Get to know Dr. Adame before joining the practice, by registering for one of her PANDAS/PANS Parent Informational Group Sessions where she explains her management approach, how to join the practice, and what it means to be part of the Culver Peds family.

Dr. Noemi Adame:

“My approach to PANDAS/PANS treatment highly individualized. What works for one child, may not work for another. We have to be flexible, ready to pivot, and open to exploring different options.”

FAQs

  • To provide each patient with the time and attention necessary to treat them in an integrative, holistic, and personalized manner, we cannot accept insurance, HSA, or FSA for our direct services. Dr. Adame is an out of network physician for all insurance plans. However, you can use your insurance for lab work, medications, and IVIG. We process prior authorizations for IVIG, and we will appeal any denials, but the ultimate decision for approval of coverage depends on the insurance company. This varies by state.

  • We ABSOLUTELY see patients from other states, but they have to be physically at our clinic in Culver to meet with Dr. Adame within a few weeks after enrolling and before she orders medications and IVIG. Most follow up visits can be done virtually. Dr. Adame is licensed in Indiana only (for now!), so she must see your child in person, at our Culver location to establish a legal, doctor-patient relationship. The in person visit is also necessary so Dr. Adame can obtain a baseline physical examination in case your child experiences a reaction to IVIG or other medications. Make it a day or a short overnight trip when you come to your appointments! Culver is our amazing small town by the lake!

  • There is a short wait list. It takes about 2-4 weeks to join our practice, but we promise we are worth the wait!

  • Yes, membership can be cancelled at anytime. We understand circumstances and needs change. We aim to make cancellations and transfer to your new practice as seamless as possible. We will send your children’s medical records to their new doctor upon your request in writing. If you change your mind and decide to re-enroll your children with Culver Pediatrics Center, a re-enrollment fee of $1,000 per child will be charged to your credit card to reactivate their membership.

  • We typically order IVIG to The Memorial Beacon Outpatient Infusion Center, located approximately 50 minutes north of Culver Peds. They are highly-skilled and we have an excellent relationship with the infusion center. Dr. Adame will order IVIG if this high-risk intervention is indicated for your child. IVIG infusion is an outpatient service that takes two full days. If you do not live conveniently located to the South Bend, IN area we can work with you to find an infusion center near you. Please keep in mind that Dr. Adame is only licensed in Indiana (for now!). Depending on the center and insurance, an out-of-state infusion center may decline her order and you will need to travel to Indiana for IVIG. Our team will file a prior authorization (PA) to your insurance company to cover the cost of the IVIG infusion at the outpatient infusion center. The PA process can take from 2 days to over a month depending on the insurance company and the state where the insurance company is headquartered. We make no guarantees regarding your insurance IVIG coverage. We absolutely will appeal all denials and advocate to the insurance on your behalf, but the decision for approval, authorization, and payment lies with your insurance company.

  • Dr. Adame is a Western-trained, evidence-based physician. She follows the PANDAS Physician Network treatment algorithm that includes Ibuprofen, Steroids, Antibiotics, and IVIG. Dr. Adame will also explore additional interventions such as Low Dose Naltrexone (LDN) and brain-protective supplements if indicated in your child’s case. She also integrates a holistic approach to reduce inflammation with high-protein, high-fiber, plant-forward nourishment and other non-pharmaceutical interventions. Once remission is achieved, and with shared family decision-making, we encourage a move to UNMEDICATE with close follow up and support.

  • Dr. Adame is a general pediatrician with expertise in complex cases since her residency. During her career as an academic hospitalist, she diagnosed and treated children with medical complexity and even published a paper on the topic. Families travel to see her for challenging cases besides PANDAS because of her expertise and holistic, integrative approach. If Dr. Adame’s evaluation yields a diagnosis other than PANDAS, she can offer the same level of compassionate and thorough medical care for your child as she does for all her families.

  • If you have a long drive to see us, or if you wish to be close to Dr. Adame’s office when your child gets IVIG, staying in Culver overnight is a reasonable option. We recommend The Fox’s Den if available. They are located within the Culver Township limits and about a 7 minute drive from Culver Peds. If their space is not available, we recommend reaching out to Jenny Lutrell through her website or email or Mariah Sroufe. If you feel comfortable doing so, you identify yourself as a Culver Pediatrics Center/Dr. Adame patient, Jenny can help you find a one night rental which are challenging to find in Culver.

  • Some families may want to stay in or near Culver while their child gets IVIG and for a day or two after in case they experience adverse effects. For dining options, we love Culver Coffee Company and Frida’s Mexican Restaurant. There is a CVS pharmacy and small grocery store in Culver. Plymouth (about 20-25 minutes North of Culver), has Walmart, ALDI, and Kroger, as well as CVS and Walgreens. Be sure to shop at Culver’s Main Street stores while you are here. The Culver Visitor Center Website is a great resource to plan your stay.

What Do We Do?

  • Recognize each person is on their own unique PANDAS/PANS healing journey

  • To Put Out the Fire: Follow The PANDAS Physicians Network Diagnostic and Treatment Algorithm

  • Screen for nutritional deficiencies such as Vitamin D, B12, Folate, Ferritin, and Iron and treat if indicated

  • Screen for other conditions such as lead toxicity, metabolic, rheumatological, tick-borne illness, and potential infectious triggers for PANS/PANDAS

  • Tailor laboratory work, diagnostic evaluation, and treatment for the unique needs, history, response, and progress of each child

  • Recognize that inflammation is the key feature of PANDAS/PANS, therefore any intervention that reduces inflammation will reduce symptoms and Protect The Brain long term

  • Guide feasible mind, body, spirit holistic interventions that reduce inflammation including high-protein, high-fiber, anti-inflammatory nourishment, physical activity, restorative sleep, mindfulness-based stress reduction, avoiding toxins, earthing and engaging with nature, natural sunlight, and social connections

  • Recommend a supplement cocktail for optimal cognitive health that includes magnesium, vegan omega3, and Vitamin D

  • Encourage any degree of progression towards high-protein, high-fiber, anti-inflammatory nourishment to reduce inflammation, protect the brain long term, and improve gut-brain health connection. We offer tools to guide families with this intervention.

  • When indicated and with shared decision-making with the family, prescribe other brain-protective, anti-inflammatory, immune-modulating interventions such as Low Dose Naltrexone

  • Recommend therapy and counseling with a PANS/PANDAS-informed therapist

  • When indicated, prescribe pharmaceuticals to reduce symptoms until the anti-inflammatory effects of the PANDAS Physician Network Algorithm and the holistic interventions take effect

  • Work with families to develop an individualized Flare-Up Action Plan

  • Once remission is achieved, and with shared family decision-making, we encourage a move to UNMEDICATE with close follow up and support