Our Neuro Network

Our Neuro Network Content is not medical advice. My dedication to this field is deeply personal. We operate as one 'ohana, united in our pursuit of homeostatic betterment for all.

🧠Our Neuro Network🧠

Honor, hope, and homeostasis for those with acute, chronic, and complex conditions, including neurometabolic, cerebral venous, and cerebrospinal fluid variations. Aloha Ohana Mana Network,

I am a doctorally prepared, board-certified Adult-Gerontology Acute Care Nurse Practitioner (AGACNP-BC), Stroke Certified Registered Nurse (SCRN), and Certified Neuroscience Registered Nurs

e (CNRN) based in Honolulu, HI. My professional passion centers on providing exceptional care to individuals navigating acute, chronic, and complex neurological conditions. My expertise encompasses a wide range of neurological challenges, with a particular emphasis on neurometabolic, cerebral venous, and cerebrospinal fluid (CSF) disorders, as well as related conditions such as hypermobile connective tissue diseases, mast cell activation syndrome, melanocortin-4 receptor deficiency, chronic migraine, headache, and facial pain. These conditions have directly impacted my family, fueling my commitment to patient advocacy and specialized expertise. This personal connection drives my unwavering pursuit to destigmatize these often-misunderstood conditions. I believe in empowering patients through advocacy, fostering supportive networks, providing comprehensive education, advancing research, and delivering compassionate clinical practice. The rapid pace of scientific discovery is illuminating the intricate cellular and metabolic pathways underlying these diseases, offering new insights into their foundations, manifestations, and potential treatment options. By fostering collaborative partnerships with experts and patients who share genetically or neurometabolically related conditions, we can amplify our collective efforts. This collaborative approach accelerates our progress, enabling us to better serve affected individuals, families, and communities. To further this vision, I founded the Ohana Mana Network for Neurometabolic Wellness LLC and host its dedicated podcast. This platform serves as a vital resource and supportive community for our 'ohana of neurometabolic, cerebral venous, and CSF disorders patients, advocates, and experts. Through the power of storytelling, active listening, and mentorship, we honor each individual's journey. Our work is grounded in compassionate, holistic, and evidence-based content, providing hope for a brighter tomorrow. By working together, we can improve the quality of life for those impacted by these challenging neurometabolic conditions. Tiffany Hoke DNP, RN, RNP, APRN-RX, AGACNP-BC, SCRN, CNRN

Ohana Mana Network for Neurometabolic Wellness LLC

Founder & CEO | Medical Director | Neuroscience and Neurovascular Nurse Practitioner

Cancer Survivor Living with Familial Neurometabolic Syndrome, Cerebral Venous, and CSF Disorders

08/31/2026

Do continuous glucose monitors (CGMs) impact hyperinsulinism (HI) care?

✅ Among participants currently using a CGM:
🔹 82% reported that CGM data led to adjustments in their treatment plan (e.g., medication dose/timing, prescribed feeding schedule) and/or daily routine (e.g., snack before activity, avoiding certain activities).

✅ Hypoglycemia prevention actions:
🔹 84% take at least one preventive action every day (e.g. eating food and/or taking medication to prevent a low)
🔹 40% report an average of four or more preventive actions daily

These findings show how CGMs can play a key role in managing HI and preventing dangerous lows.

These insights and more are featured in our 2025 HI Global Registry Annual Report, available at https://congenitalhi.org/higr-annual-reports-and-publications/

What is HIGR? It’s the only patient-powered hyperinsulinism (HI) registry, and your input drives critical research.

Not registered yet? It’s not too late to share your experiences and feel the power of your data! Learn more at higlobalregistry.org at the link in our bio and sign up today.


| Hyperinsulinism | Congenital | HI | Hypoglycemia | Rare Disease

Please follow the CSF Leak Association - The Cerebrospinal Fluid Leak Charity and share their posts to spread awareness ...
08/26/2026

Please follow the CSF Leak Association - The Cerebrospinal Fluid Leak Charity and share their posts to spread awareness of CSF leaks, a TREATABLE cause of brain sag dementia.

Early diagnosis and intervention is life changing and lifesaving.

I started Our Neuro Network because it happened to my family. It can happen to anyone. If it happens to you or yours, we are here for you as a community.

08/25/2026

Ask five people with Usher syndrome how they found out, and you’ll hear five different stories.

That’s because Usher syndrome doesn’t follow one script.
With type 1, babies are typically born with severe to profound hearing loss. They may also have balance differences that can delay sitting or walking. Vision changes often begin during childhood or the teen years. These changes are caused by retinitis pigmentosa (RP), an eye condition that leads to progressive vision loss.

In type 2, hearing loss is also present at birth, but balance is usually unaffected. Vision changes from RP tend to begin later, often during the teen years or early adulthood.

Type 3 can look different again. Hearing and vision loss usually begin later and get worse over time. Some people may also develop balance problems.
Usher syndrome can look different from person to person, even among people with the same type. That’s why hearing, vision, and genetics specialists may all play a role in connecting the dots.

However your diagnosis unfolded, it’s real. It’s valid. And it’s only the beginning of your story.

This kicks off a five-week series on the science behind USH. Next Friday: What does it take to turn a suspected diagnosis into a confirmed one?

ID: Graphic with white background, bold navy text, DNA helix images upper right and lower left. USH Awareness Day logo bottom right.

08/25/2026
08/24/2026

"Representation helps patients feel seen, understood & confident in the healthcare system. When patients encounter physicians from a range of backgrounds, it reinforces that excellence in medicine is inclusive." -Kendrick Johnson

I am deeply grateful for my colleagues at the Society of NeuroInterventional Surgery for their mentorship, inclusion, su...
08/24/2026

I am deeply grateful for my colleagues at the Society of NeuroInterventional Surgery for their mentorship, inclusion, support, advocacy, and compassionate, knowledgeable care of those of us living with cerebral venous and CSF disorders. I am honored to be part of a community that co-creates a sustainable future filled with hope and evidence-based progress.

Aloha, SNIS! Meet Tiffany Hoke, DNP,AGACNP-BC, SCRN, CNRN joining us from Hawaii! She says that living with a rare, inherited neurometabolic disorder and complex cerebral venous and CSF disorders has profoundly influenced her approach to patient care. Her years as a healthcare provider and a patient have reinforced that listening, validating patients' experiences, and partnering with them in decision-making are just as important as technical expertise.

08/23/2026

On the cover this week, a new Lancet Editorial examines the deteriorating state of LGBTQ+ rights globally and its implications on health.

Read this & more in our latest issue: http://spkl.io/61877OX6N

07/25/2026
05/18/2026

Ketogenic diets can be transformative for some neurological and metabolic conditions, but they are not metabolically neutral for everyone.

My own experience showed a dramatic rise in LDL-C and non-HDL cholesterol after starting a ketogenic diet, despite favorable triglycerides and HDL levels. Rather than abandoning the approach immediately, I adapted. I shifted toward olive oil, avocados, nuts, seeds, and fatty fish while reducing saturated fat and dietary cholesterol intake. I cut out half-and-half, whipping cream, and many cheeses. When I do have cheese, I enjoy high protein Parmesan as a flavorful treat with a zing. I stopped using MCT oil daily to maintain ketosis, and use it as a support for hypoglycemic periods on instead (rapidly converted to glycogen in liver). Over time, my lipid profile improved substantially, and will continue to normalize.

This phenomenon is real. Some individuals experience marked increases in LDL-C on ketogenic diets, potentially related to altered lipid trafficking and intestinal sterol hyperabsorption. Monitoring matters. Personalization matters. Physiology matters.

The goal is not ideology and a one size fits all approach. The goal is individual neurometabolic optimization and homeostasis.

Keto may help one system while stressing another. Understanding that balance, measuring biomarkers, and making individualized decisions with your healthcare team is how we move toward precision medicine instead of one-size-fits-all nutrition advice.

I am grateful my lipids improved with adaptation and prioritization of healthy fats, as my brain’s fuel system is much more stable on a ketogenic diet when compared to a standard American diet, which caused hypothalamic obesity and worsening hypoglycemic unawareness in the setting of my autosomal dominant MC4R deficiency.

Knowledge. Awareness. Action.

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