Case studies Osteoarthritis and Polymyalgia rheumatica Chanchal Cabrera MSc MNIMH, RH (AHG)

Transcription

1 Case studies Osteoarthritis and Polymyalgia rheumatica Chanchal Cabrera MSc MNIMH, RH (AHG)

2 Osteoarthritis

3 Woman aged 56 Consulted November 2002, long history of osteoarthritis 7 years after double hip replacement Current exercise: walking, yoga, stationary bike Chronic pain in hips and knees Symptoms in the hips, knees, shoulders, and neck Voltaren (NSAID), physiotherapy, massage, meditation, energy healing Expecting repeat replacement surgery with bone grafts

4 Drank 4 coffees a week, several cups of green tea daily and 8 to 10 glasses of water daily Mostly organic foods, free range meat, chicken, turkey, fish, lots of vegetables and salads, lentils and nuts, whole grains (spelt, kamut, little wheat), not much fruit, no dairy products Normal bowel function General health was good

5 Clinical plan Build sufficient bone density to avoid bone graft Reduce inflammatory joint destruction Promote tissue healing

6 Daily supplements Between meals Turmeric and bromelain 2 g each With meals Salmon oil 2 g Microcrystalline hydroxyapatate 1500 mg (calcium and trace minerals) Glucosamine sulfate 1500 mg MSM 2 g Ipriflavone 200 mg MSM lotion topically

7 Tincture formula Bone, Flesh & Cartilage blend 60 ml Symphytum officinalis (Comfrey), Quercus rubra (Oak bark), Eupatorium purpurea (Gravel root), Althea officinalis (Marshmallow), Verbascum thapsus (Mullein), Juglans niger (Black walnut), Artemisia absinthium (Wormwood), Scutellaria lateriflora (Skullcap), Lobelia inflata (Lobelia). Equisetum arvensis (Horsetail) 10 Curcuma longa (Turmeric) 10 Bryonia dioica (Bryony) 10 Glycyrrhiza glabra (Licorice) 10

8 Willow blend tea Actaea racemosa (Black cohosh) Harpagophytum procumbens (Devil s claw) Filipendula ulmaris (Meadowsweet) Salix alba (White willow bark) Apium graveolens (Celery seed) Zanthoxylum sp. (Prickly ash)

9 Supplemental protocol after re-diagnosis Later added Ginger Salmon oil Devil s claw caps Yucca 4 caps 4 g 4 caps 4 caps

10 Clinical outcome Two months of herbal treatment brought significantly less hip pain, sleeping more soundly (not wakened by pain) More energy, exercised more, started swimming A few weeks later bone density was good, but deterioration of synovial lining membranes caused secondary bone damage in adjacent regions Continued to make notable improvement, much less pain in hips and legs, increased exercise capacity Stopped using analgesics

11 Progression One hip replacement July 2003, no bone graft required Healed extremely well, January 2004 able to walk without a cane and no pain Second hip replacement not required March 2005, patient well, extremely active and pain free

12 Adjusted tincture formula post surgery Glycyrrhiza glabra (Licorice) 15 Centella asiatica (Gotu kola) 15 Equisetum arvensis (Horsetail) 15 Filipendula ulmaris (Meadowsweet) 15 Eupatorium purpureum (Gravel root) 15 Menyanthes trifoliata (Bogbean) 10 Guaiacum officinalis (Lignum vitae) 10 Zingiber officinalis (Ginger) 5

13 Polymyalgia rheumatica

14 64 year old woman Happily married with grown children Worked hard in family business Mostly wild meat (venison, elk, moose), fish twice a week, 4 6 servings of vegetable daily, mostly whole grains, few sweets or desserts, cheese but little other dairy. Ongoing use of Progesterone cream for several years for menopausal mood swings Saline breast implants 20 years previously

15 Fall of widespread aching and pain. Felt stiff and sore and tired. Advil didn t help much but muscle relaxants did help a bit. Diagnosed in the summer of 2003 with PR. with an ESR of 52 (range <20) Immediately started on 10 mg Prednisone - rapid alleviation of symptoms After 3 months the dose was dropped progressively at 1 mg every 2 weeks

16 At time of first presentation she was on 3 mg Prednisone daily Residual neck stiffness and pain, disturbed sleep. Contour neck pillow helped tremendously. Energy still low but active and busy despite this. Working out 3 times weekly for minutes, walking a lot. Bone density scan 2 years prior had been negative but she was taking Fosamax prophylactically because of the steroid use

17 Clinical plan Gluten avoidance Whole grains only 2 x /week Stay on Fosamax while using steroid Continue to reduce steroid slowly Stop drinking coffee Consider avoiding all dairy if symptoms flare up

18 Slowly weaned off Prednisone over 6 months. Symptom flares managed with hypnotherapy Maintained a serious weight training program and walked daily as well as keeping working

19 Tincture Glycyrrhiza glabra (Licorice) 15 Curcuma longa (Turmeric) 10 Dioscorea sp (Wild yam) 10 Viburnum opulus (Cramp bark) 10 Zanthoxylum sp (Prickly ash) 10 Astragalus membranaceous (Milk vetch) 10 Cinnamon zeylanicum (Cinnamon) 10 Zingiber officinalis (Ginger) 5 Piscidia erythrina (Jamaican dogwood) 5 Verbena officinalis (Blue vervain) 5 Piper methysticum (Kava) 5

20 Tea Neurofort tea 50 Actaea racemosa (Black cohosh), Scutellaria lateriflora (Skullcap), Verbena off. (Blue vervain), Hypericum perforatum (St John s wort), Chamomilla recutita (Chamomille), Avena sativa (Oat tops), Valeriana off. (Valerian), Zingiber off. (Ginger), Lobelia inflata (Lobelia) Centella asiatica (Gotu kola) 10 Hyssopus officinalis (Hyssop) 10 Rosmarinus officinalis (Rosemary) 10 Avena sativa (Oat tops) 20

21 Supplements With meals Sterols and sterolins 6 caps daily (3 x 2 caps ) Salmon oil 2 g (2 x 1 cap) High potency B complex 200 mg (2 x 2 caps)

22 Between meals Turmeric and Bromelain Natto kinase Aloe juice 6 caps daily (3 x 2 caps) 2 x 2 caps 2 Tbsp (2 x 1 Tbsp)

23 Emergency use formula Piscidia erythrina (Jamaican dogwood) 15 ml Viburnum opulus (Cramp bark) 15 Chamomilla recutita (Chamomile) 15 Scutellaria lateriflora (Skullcap) 15 Valeriana officinalis (Blue vervain) 10 Leonurus cardiaca (Motherwort) 10 Piper methysticum (Kava) 10 Lobelia inflata (Lobelia) 5 Gelsemium sempervirens (Yellow jasmine) 3

24 August 2008 update Patient remains drug free and using herbs. She now also takes herbal and nutritional treatment for elevated cholesterol.

25