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Message |
    
Dr. A I Kabbara
Username: Abdallah
Registered: 06-2007
| | Posted on Thursday, October 11, 2007 - 03:34: | |
Dear Forum, a friend is consulting me about his daughter condition , i will cut and paste the description of her case.It seems to me that she has been completely kidney depleted after a major illness , but i would like the input of the forum on this :
Late one night last May -- before falling asleep -- my daughter
Elianna
had the sudden onset of SOB (no wheezing on exam and normal pulse ox
sat),
tachycardia, severe upper abdominal & chest pain, and c/o of her throat
feeling tight (no airway compromise), with fever of >101 degrees for
2-3
days, followed a few days later by the onset of myalgias and
arthralgias
and extreme fatigue. Elianna also had diarrhea for about 2 weeks,
starting
with the day of illness onset. (My older daughter also had some GI
upset,
N/V about 2-3 days later.) Elianna also had periodic fever spikes the
first few weeks, though each peak seemed to be a little lower than the
previous one; she has had persistent temps in the 99's (including last
time
we measured, a few weeks ago).
Elianna's joint and muscle pains have lessened to some extent over the
last
few months, but still bother her. She also still has the extreme
fatigue
and some postural sx (e.g. feeling faint while taking a shower),
abdominal
complaints, and occasional complaints of shortness of breath (still
without
wheezing, and which in the past have not responded significantly to
albuterol inhalers). She also complains occasionally of some
paresthesias,
such as tingling in extremities, pain followed by weakness in legs
(especially her calves), "strange" feeling under skin in arms and legs
which she describes as being "as if her muscles were feeling anxious",
and
muscle twitching/tics in various muscle groups.
Her only previous significant medical history (besides grass/animal
allergies) was migraines, for which she had been on topiramate;
however,
she had been on steady dosing for several months before this event, and
the
topiramate was stopped shortly afterward. She was also taking OCP's to
control her acne, and had been on a steady regimen of those for several
months before the event. She has been started on very low dose
cyproheptadine for her migraines (and possible abdominal
migraines). Elianna also c/o severe non-migraine headaches from time
to
time (? tension H/As).
Elianna has had the mega work-up (mono, lyme, inflammatory and
autoimmune
dz, upper endoscopy, CT abdomen, several CXR, U/S gallbladder,
Cardiology,
Rheumatology, GI and Allergy consults, etc., etc.) , and almost
everything
has turned up negative. There was a question of H. Pylori based on the
CT
scan, but the peds GI person ruled that out, and porphyria has also
been
ruled out by urine testing.
Essentially the only positive findings have been an IgE level >800, and
some moderate heart rate abnormalities on the tilt-table test. Elianna
recently had her allergy appointment, and had markedly positive skin
tests
to grass seed (which was in the kitchen trash can on the day her
symptoms
first started), as well as milk and egg protein -- so she's trying to
avoid
those for at least a month per the allergist's recommendation -- but no
substantial changes yet. She also had ketonuria on several urinalyses,
but
our pediatrician pooh-poohed that, saying it was due to stress.
What we're left with so far is a diagnosis of post-viral
dysautonomia. Elianna is now at least able to go to school for a few
hours
a day, and can take enough classes to graduate. But she still fatigues
extremely easily, and has had to give up on her extra-curricular
activities. She's also not at all sure that she will be able to
audition
for voice programs in college -- let alone travel for visits -- which
is a
problem, since she was planning on a dual-degree program (Music &
Psychology).
Currently, her therapeutic regimen includes: nadolol, flourinef,
doxepin,
buproprion, Zyrtec, Prilosec, cyproheptadine,
OCP's, NSAID's prn, and a higher-salt, higher fluid intake diet. One
of
her physicians thought Singulair might be helpful, but the allergist
didn't
want us to start her on that as yet -- has her on nasal steroids
instead.
|
Shmuel Halevi
| | Posted on Friday, October 12, 2007 - 09:40: | |
Dr. Kabbara, I think that your friend's daughter has been taking too much medications which probably depleted her Wei qi. She has probably had an attack of rheumatic fever based on L/K deficiencies. Probably some kind of damp-cold-wind lodging on the L system and muscles related to Tai Yang segment. A strict Chinese diagnosis is needed with herbal treatment instead of chemistry. |
Dr. A I Kabbara
Username: Abdallah
Registered: 06-2007
| | Posted on Saturday, October 13, 2007 - 00:26: | |
i think all these medication that she is currently on are meds after the problem started , these meds were a trail of solving the problem , but obviously it has not been working , ..do you think there is any role for acupuncture, and what is your point selection ,. |
Shmuel Halevi
| | Posted on Saturday, October 13, 2007 - 20:45: | |
Of course you can use acupuncture as well, or solely. What I wrote on my previous post, was a mere suggestion based on no diagnosis. In order to conduct an effective treatment, there is no escape from diagnosing her condition according to the eight principles of Ch. diagnosis, and only then selecting the appropriate formulas and technique. Point selection by itself, will not solve any of her problems. |
Shmuel Halevi
| | Posted on Saturday, October 13, 2007 - 20:47: | |
An addition to that;
If you do reach a diagnosis, and you wish to discuss specific approaches, points or techniques that might suit this diagnosis, I'll be glad to assist. |
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Postviral syndrome