Archive for January, 2013

An Herbalist’s View. Patient Study-Looking to reduce symptoms in progressive disorders.

Saturday, January 19th, 2013

This patient study looks at how herbs can help improve symptoms when there is little to do to change the primary problem. This is common situation with a number of chronic disorders. A note on confidentiality, I would only ask a patient whom I felt wouldn’t mind having their case discussed on an open forum such as this.  While it is obvious that I wouldn’t say their name, this sort of write-up would be obvious to the patient who is being discussed. Not only do I ask permission, but I want to make sure they would appreciate the idea, as he did here and was glad to share his situation. This case is from the Ithaca Free Clinic so all services and medicines are free. (The clinic also knows that I post on Facebook).

This patient is 57 years old. He had polio when he was three years old, and wonders if some of his current problems are due to post-polio syndrome (this occurs in some polio survivors and can include progressive muscle weakness, fatigue and muscular atrophy).

He developed brain cancer (astrocytoma) at 17 years old. This was in 1972, and the amount of radiation he received (and survived!) is causing many of his major health issues. He has a number of neurological problems from the radiation poisoning which is causing cerebral atrophy (brain shrinking). He sees a neurologist and gets brain scans regularly. I surely don’t understand all the aspects of this situation, but we started working on some of his more problematic symptoms.

The patient eats well (lots of home grown veggies and meat that he hunts) and is in general good health. He has a pretty good attitude about life. Many of his symptoms are progressive and he is appreciative for the reasonably good health he has now. He feels that he might have contracted Lyme a few years ago and took antibiotics for it. The reason I mention this is that it is hard to tell what is causing some of his symptoms, whether they are from post-polio syndrome, Lyme, effects from the radiation, or none or all of the above.

His initial symptoms were; very painful and stiff right arm and shoulder, difficulty sleeping, headaches, and difficulty mentally focusing. He needs about 12 hours a night of sleep to function well.

Our initial treatment strategy was to help him sleep better, increase mental clarity, and reduce some of his muscle pain. We kept the medicines and dosaging simple since it can be hard for him to remember a lot of details at one time. Valeriana officinalis tincture was given for sleep. We first tested it in the office by giving him a few drops to make sure it did not have an antagonizing affect (agitation), which it did not. The Valeriana dosage was 1-2 (1 oz) dropperfuls (about 1.5 to 2.5 ml) before sleep. He was given a 2 oz. tincture for mental clarity with Centella (3 pt), Salix (1 pt) and Acorus (30 drops). Dosage is one 2oz dropperful (approx 2 ml) 3 times daily.

His next visit was a little over a month later. He felt like the herbs were helping and wanted to continue with them. The Valerian was helping with sleep, but sleeping was still difficult. The arm and shoulder pain was about the same as was his difficulty with focusing.
We continued with the Valerian and told him to increase his dosage. We changed the tincture to Centella (2 pt), and 1 pt each of Acorus, Ocimum tenuiflorum and Passiflora. Tincture dosage was 1.5 ml 3 times daily. We also added a powder of Eleuthero (1.75 pt), Crataegus (1 pt) and Passiflora (.75 pt). One teaspoon mixed into water 2 times daily.

The next visit he had lost 7 pounds, mostly muscle. His arm pain was worse, but his headaches were better and he was sleeping better.

The medicines we gave him after this visit were Harpagophytum procumbens capsules for the muscle and joint pain (2 capsules twice daily). We changed the powder to 2 parts Yucca and Glycyrrhiza (his blood pressure is around 112/85) and one part each of Urtica, Eleuthero, Curcuma and Withania (same dosage as previously). We changed the tincture to Centella (1 pt), Gingko (1 pt) and Acorus (.4 pt). (Note, I wanted to use Gingko earlier, but ran out of the tincture, so we had to make some more). Tincture dosage 2 ml twice daily.

A note on a few of the specific herbs we have given him. The Centella, Ginkgo and Acorus are for mental clarity. The Harpagophytum and Yucca are helpful for arthritic-type pain. The Glycyrrhiza, Salix and Curcuma are antiinflammatory. The Urtica, Eleuthero, Glycyrrhiza and Withania are tonics for overall strength. The Passiflora, Ocimum tenuiflorum and Crataegus are nervine tonics.

He came in recently (January 2013), and seems to be in a better state overall. One of the things that also helped was cutting out coffee. The Valerian continues to help him with sleep, and we made up the previous medicines again except for the Harpagophytum capsules.

As you can see, we are not performing any miracles here. The effects of radiation poisoning are progressive, but instead of throwing up our hands to a difficult problem (though not a difficult patient, he readily takes his herbs) our goal is to back down his symptoms. While some of his problems have not gotten better, they have also not worsened, which is a reasonable result with a situation like this. He feels good taking the herbs and coming in for regular consultations. One of his main problems was fatigue due to a lack of sleep, and that has improved, which has the downstream affect of improving overall quality of life, a major goal.