Living with an autoimmune disease can be complianced and very limiting. There are around 80 different types of autoimmune disorders ranging in severity to mild to disabling, depending on which body system is under attack and to what degree. This case study is a good example of how integrated medicine can be used to manage severe disorders.
Client Intake Scenario
Five years ago, this client presented with an acute fever and severe pain leading to hospitalization and severe intervention of high dose steroids. After almost 3 weeks in the hospital and investigation of various diseases she was diagnosed with a non-specific autoimmune condition. She remained on high dose steroids for almost two years, each time she lowered her dose the inflammation increased, and she was hospitalized. After almost three years, she became pregnant at which time she ceased the steroids and had no recurrence of the autoimmune disease while pregnant and 6 months later. When she met with me, she recently had experienced a full recurrence with hospitalization and life-threatening inflammation and fever.
The client reports she sleeps poorly, 4-5 hours per night and then can’t sleep anymore. Bloodwork reveals elevated liver enzymes. She is also concerned about her cold hands and feet even when in warm places. She has two young children, but reports she is sick and tired and frustrated with her current health state. Despite getting the best care she can find because of her location and connections within the medical community, she has never gotten better. Life “looks grim” and she can’t imagine how long she can “live this way”. Notable diet characteristics include that she drinks 48-64 oz. of soda every day and her diet is high in frozen and processed foods and low in fruits and vegetables. She does not engage in physical activity beyond caring for her children (ages 3 and 6 years). She takes Methotrexate (immunosuppressant), prednisone (40 mg/day), and a beta blocker.
This was an interesting case, very complicated with actually some very simple strategies involved. It is very difficult to present in the case study how ill this person was. She was homebound and had two little kids to care for and went to the grocery store maybe once a week. She took her duties caring for the household very seriously, especially because was not working anymore. This client was in and out of the hospital and almost died prior to seeking herbal treatment.
The first thing I noticed when I met with her was the sense of desperation to get better. She had a prior history working in a medical clinic and had pursued so many traditional strategies with limited success. Some of the treatment she was getting was helping, however it was definitely not resolving things. Honestly, during the initial assessment I was saying to myself, “hmm what are we going to do here?”. I had to really take my own advice and step back and try to support the nervous system and digestion first. Its easy to come up with a hundred ideas for this person to support their lifestyle, but I could tell the client just didn’t have energy for that and it would stress her out even more. So, I wanted to create a treatment plan that did not take a lot of energy or money. I also wanted to link it to her current medical protocol because her health was so fragile.
The first thing I did was look at how much caffeine she was drinking. When I asked her to cut back, she was able stop drinking soda fairly quickly, which was impressive. So many of us know how hard that is! There was an immediate change from that because she was able to sleep better with a higher quality of sleep, which made a huge difference in how she was feeling and healing. The second dietary change we made was increasing the quality of the frozen food she was using. I didn’t think eliminating frozen food would be manageable due to her difficulty moving around and the intensity that cooking for a family can bring. She also started with a little exercise, like walking to the mailbox type of exercise. She was nervous about this, but I accompanied her a few times and it ended up being a good catalyst for other movements and reduced some of her fear of the pain associated with movement.
To use a true integrated approach, I also met with her primary care physician and specialist and discussed the amount of prednisone she was given, its long-term use, the immunosuppressants she was on and my concerns with the approach and the side effects she was experiencing (elevated liver enzymes, etc.). They agreed and also expressed concern about the long term use as she had been on them over five years with little change and the conversation turned to how we could reduce the use of pharmaceuticals and work collaboratively to help the client using a more cohesive approach. We ended up adding in licorice root, which potentiates prednisone making it more effective and mediates some of the side effects. Working with the physician we created a protocol of licorice tea and a gradual reduction in prednisone. The dose eventually moved from about 40mg./day to 5 mg/day. This took around 4 months; she ended up hospitalized once. We played with the dosage a lot over the course of time and monitored her status extensively. I also used herbal bitters to help her digestion and some adaptogenic herbs. The long and the short of it, is that over the course of that time she got much of her life back and she was able to come off of the higher dose of steroids and had more energy. The thing that I really appreciate about this case was that the positive impacts of the herbal approach gave her a new sense of hope. We are continuing to work together and over time she is making additional progress. We continue to fine tune her diet and lifestyle strategies. It is important to note, we tried a LOT of different herbs, and I am sharing with you only the things that worked. Our bodies are dynamic and always changing. Sometimes, healing takes time, and it always requires ongoing adjustments.