Guest guest Posted August 3, 2003 Report Share Posted August 3, 2003 Group, any suggestions, comments, references would be appreciated. Patient 59 male, was in good health. Went through a lot of stress. Has worked around nerve agent( at chemical arms plant), he thinks problem began with food poisioning in March 2003. He got very sick and had antibiotics. Had diarrhea then, seemed to recover, however his BP was slowly rising. He was getting SOB with running, some chest tightness. In May BP went to 180/120 went to hospital, Put on dialysis. Western Dx. Acute Nephritis, IgA nephropathy (autoimmune problem) extensive interstitial nephritis and fibrosis. This was found on left kidney biopsy, MD says *5% of Kd function left, only course of action transplant. Patient getting dialysis 3 times/week. Taking labatrol for HBP, dirutic, was given pregnose which cause swelling, stopped this Review of Systems: Urination normal. no blood in urine, no pain. Swelling has gone down. No back pain, cept with dialysis, male errectile function normal, can have slight discomfort at kidney area, no real pain, heat helps. Patient had loose stools , ok now. He had been getting reflux before problem, not now. No HA's or dizzy(cept after dialysis), no tinitus. Patient shows no sign of infection, no sweats, no feeling of heat. He has had bitter taste in mouth. He has some varicosities on his legs. No other S & s. Tongue: fat, slightly purple, scalloped red sides. Pulse: Drum-like, weaker left cubit, also whole pulse weaker after dialysis. Since dialysis I have been giving him Ac & granule herbs. His BP is between 170/90 and 120/72 (after dialysis). BUN & Creatine came down initially, however creatine has not come down into normal range & high protien meals can make it higher. Dx Sp-Kd Xu with Dampness acummulation(he had ankle edema gone now) Lv depression, blood stagnation. My formulas have slowly changing now Fu Ling 15, Huang Qi 12, Dang Shen 12, Shan Yao 9, Du Zhong 9, Dan Shen 12, Shu Di 9. Sang Ji Shen 9, Zie Xie 9, Zhu Ling 9, Bai shao 6, Chai Hu 6 , formula at 12 g/day. I'm wondering about the autoimmune part, I see no signs of toxins or heat, in fact patient likes heat, however labs state inflamatory calls are scattered widely throughout the interstitium? Overall, his energy is up, BP is down,no chest tightness, he feels better has reduced labatoral to 1/day, still creatine hasn't come down. Ideas? Steve Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2003 Report Share Posted August 3, 2003 Myformulas have slowly changing now Fu Ling 15, Huang Qi12, Dang Shen 12, Shan Yao 9, Du Zhong 9, Dan Shen 12,Shu Di 9. Sang Ji Shen 9, Zie Xie 9, Zhu Ling 9, Baishao 6, Chai Hu 6 , formula at 12 g/day.>>>>>You may conceder much higher dose of huang qi 60g or so, dong cao xia cao, and small dose of jin yin hua Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2003 Report Share Posted August 4, 2003 , Steve Snydes <snydez99> wrote: > Overall, his energy is up, BP is down,no chest > tightness, he feels better has reduced labatoral to > 1/day, still creatine hasn't come down. Ideas? Steve > Steve What is it that you are aiming to treat here? Given that creatinine in itself is not toxic and that he no longer (effectively) has kidneys. Simon > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2003 Report Share Posted August 4, 2003 Simon, my goal however unreasonable it is, is to drop creatine levels to hopefully get the patient off dialysis. What you don't know is that i'm dealing with a unique (amazing) individual here. I have played the devils advocate(in favor of the transplant asp after talking to his MD), however he wants to try to get his Kidneys functioning wihtout that. My goal is also, to make the patient feel better while he has dialysis, which according to him is happeing(placebo?)- it is boosting his energy, taking less med's. ect. I told him last friday that if it were me I'd get on a transplant list & give this a couple of months to see if we can get anywhere (it's been 2 months so far). Ihave one ace up my sleeve, here in Portland one of my teachers Dr Wei Lei, has just published Nephritis Book soming out in October, I may have him go to her as this is her specialty. Steve --- Simon King <dallasking wrote: > , Steve > Snydes > <snydez99> wrote: > > Overall, his energy is up, BP is down,no chest > > tightness, he feels better has reduced labatoral > to > > 1/day, still creatine hasn't come down. Ideas? > Steve > > > Steve > What is it that you are aiming to treat here? Given > that creatinine > in itself is not toxic and that he no longer > (effectively) has > kidneys. > Simon > > > > > SiteBuilder - Free, easy-to-use web site > design software > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2003 Report Share Posted August 5, 2003 Steve, I think that 5% of kidney function,especially if the biopsy confirms how bad things are, is an impossible situation to recover. However my experience is, as you are finding, that herbs can help with dialysis malaise. In this case, I don't think that advocating transplant is to play devil's advocate, one feels a heck of a lot better than on dialysis and it is a safer place to be. Adjusting to the prognosis of organ failure is very hard, especially if it has been a rapid process, and prehaps treating is a useful part of that adjustment. I think that there is a strong case to be made for longterm treatment to damp down the IgA process which might effect any future kidney and, if and when he has another kidney and is over the first very heavy anti-rejection regimmine, to think about chronic rejection which is thought to be a consequence of poor blood supply and sclerosing. This said, if he does recover some function I would be very interested to hear. Simon , Steve Snydes <snydez99> wrote: > Simon, my goal however unreasonable it is, is to drop > creatine levels to hopefully get the patient off > dialysis. What you don't know is that i'm dealing with > a unique (amazing) individual here. I have played the > devils advocate(in favor of the transplant asp after > talking to his MD), however he wants to try to get his > Kidneys functioning wihtout that. My goal is also, to > make the patient feel better while he has dialysis, > which according to him is happeing(placebo?)- it is > boosting his energy, taking less med's. ect. I told > him last friday that if it were me I'd get on a > transplant list & give this a couple of months to see > if we can get anywhere (it's been 2 months so far). > Ihave one ace up my sleeve, here in Portland one of my > teachers Dr Wei Lei, has just published Nephritis Book > > soming out in October, I may have him go to her as > this is her specialty. Steve > > Simon > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2003 Report Share Posted August 5, 2003 My understanding is that doctors are generally resistant to giving transplants to patients with kidney failure due to autoimmune causes because the transplanted kidney will be subject to the same autoimmune attack. They would prefer to give a kidney to someone who could use it longer, with less likelihood of rejection. Is this somehow not the case with this patient? Pat " Steve Snydes " <snydez99 To: om> cc: Re: Re: Nephritis, Renal Office: Hypertension 08/04/2003 07:19 PM Please respond to chineseherbacadem y Simon, my goal however unreasonable it is, is to drop creatine levels to hopefully get the patient off dialysis. What you don't know is that i'm dealing with a unique (amazing) individual here. I have played the devils advocate(in favor of the transplant asp after talking to his MD), however he wants to try to get his Kidneys functioning wihtout that. My goal is also, to make the patient feel better while he has dialysis, which according to him is happeing(placebo?)- it is boosting his energy, taking less med's. ect. I told him last friday that if it were me I'd get on a transplant list & give this a couple of months to see if we can get anywhere (it's been 2 months so far). Ihave one ace up my sleeve, here in Portland one of my teachers Dr Wei Lei, has just published Nephritis Book soming out in October, I may have him go to her as this is her specialty. Steve --- Simon King <dallasking wrote: > , Steve > Snydes > <snydez99> wrote: > > Overall, his energy is up, BP is down,no chest > > tightness, he feels better has reduced labatoral > to > > 1/day, still creatine hasn't come down. Ideas? > Steve > > > Steve > What is it that you are aiming to treat here? Given > that creatinine > in itself is not toxic and that he no longer > (effectively) has > kidneys. > Simon > > > > > SiteBuilder - Free, easy-to-use web site > design software > > > > Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2003 Report Share Posted August 5, 2003 , " Pat Ethridge " <pat.ethridge@c...> wrote: > My understanding is that doctors are generally resistant to giving > transplants to patients with kidney failure due to autoimmune causes > because the transplanted kidney will be subject to the same autoimmune > attack. They would prefer to give a kidney to someone who could use it > longer, with less likelihood of rejection. > This is absolutely not the case in the UK, any autoimmune process is by no means certain to start up again in the new kidney and if it does it may be very mild and the least of the problems for the longterm health of the kidney. My kidneys failed after 30 years of IgA disease, so I had a long time to look into it.Chronic rejection is the main problem for kidney lifespan and this is not related to the original disease as far as I am aware. Simon > > > > > > > > > ====================================================================== ======== > NOTE: The information in this email is confidential and may be legally > privileged. If you are not the intended recipient, you must not read, use or > disseminate the information. Although this email and any attachments are > believed to be free of any virus or other defect that might affect any > computer system into which it is received and opened, it is the responsibility > of the recipient to ensure that it is virus free and no responsibility is > accepted by Cadwalader, Wickersham & Taft LLP for any loss or damage arising > in any way from its use. > > ====================================================================== ======== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2003 Report Share Posted August 5, 2003 Pat I want to thank you & Simon for bringing up this point, frankly I have no idea what his MD's have in mind. I have a friend who had a liver transplant & got one even though he had Hep-C. The only thing I can say is that they want him to have a transplant. I'm still in the dark as to dealing with an autoimmune disorder with so little s & s. Steve --- Pat Ethridge <pat.ethridge wrote: > My understanding is that doctors are generally > resistant to giving > transplants to patients with kidney failure due to > autoimmune causes > because the transplanted kidney will be subject to > the same autoimmune > attack. They would prefer to give a kidney to > someone who could use it > longer, with less likelihood of rejection. Is this > somehow not the case > with this patient? > > Pat > > > " Steve Snydes " > <snydez99 To: > > om> cc: > > Re: > Re: Nephritis, Renal > Office: > Hypertension > 08/04/2003 07:19 > PM > Please respond to > chineseherbacadem > y > > > > > Simon, my goal however unreasonable it is, is to > drop > creatine levels to hopefully get the patient off > dialysis. What you don't know is that i'm dealing > with > a unique (amazing) individual here. I have played > the > devils advocate(in favor of the transplant asp after > talking to his MD), however he wants to try to get > his > Kidneys functioning wihtout that. My goal is also, > to > make the patient feel better while he has dialysis, > which according to him is happeing(placebo?)- it is > boosting his energy, taking less med's. ect. I told > him last friday that if it were me I'd get on a > transplant list & give this a couple of months to > see > if we can get anywhere (it's been 2 months so far). > Ihave one ace up my sleeve, here in Portland one of > my > teachers Dr Wei Lei, has just published Nephritis > Book > > soming out in October, I may have him go to her as > this is her specialty. Steve > --- Simon King <dallasking wrote: > > , Steve > > Snydes > > <snydez99> wrote: > > > Overall, his energy is up, BP is down,no > chest > > > tightness, he feels better has reduced > labatoral > > to > > > 1/day, still creatine hasn't come down. Ideas? > > Steve > > > > > Steve > > What is it that you are aiming to treat here? > Given > > that creatinine > > in itself is not toxic and that he no longer > > (effectively) has > > kidneys. > > Simon > > > > > > > > SiteBuilder - Free, easy-to-use web site > > design software > > > > > > > > > > > > SiteBuilder - Free, easy-to-use web site > design software > > > > Chinese Herbal Medicine, a voluntary organization > of licensed healthcare > practitioners, matriculated students and > postgraduate academics > specializing in Chinese Herbal Medicine, provides a > variety of professional > services, including board approved online continuing > education. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2003 Report Share Posted August 6, 2003 Perhaps this question should be rephrased in a more general way. Is there any special way to deal with patients with autoimmune diseases which may not show severe or clear CM patterns, depending on the stage, as " autoimmune disease " is strictly a WM concept. I have wondered if stimulating certain points or using certain herbs (especially those described by Western texts as " strengthening immunity " ) might accelerate the autoimmune reaction progress, or maybe dampen it. In some cases, the CM patterns seem very mild, so it is hard to see how treatment can affect the disease progress itself, since it seems more to strengthen the patient generally. Perhaps CM cannot be used specifically in this instance? Is there current work in China which addresses autoimmunity in a more direct sense? I have a lot of confusion around this issue and would appreciate any insight from others. Pat " Steve Snydes " <snydez99 To: om> cc: Re: Re: Nephritis, Renal Office: Hypertension 08/05/2003 06:31 PM Please respond to chineseherbacadem y Pat I want to thank you & Simon for bringing up this point, frankly I have no idea what his MD's have in mind. I have a friend who had a liver transplant & got one even though he had Hep-C. The only thing I can say is that they want him to have a transplant. I'm still in the dark as to dealing with an autoimmune disorder with so little s & s. Steve --- Pat Ethridge <pat.ethridge wrote: > My understanding is that doctors are generally > resistant to giving > transplants to patients with kidney failure due to > autoimmune causes > because the transplanted kidney will be subject to > the same autoimmune > attack. They would prefer to give a kidney to > someone who could use it > longer, with less likelihood of rejection. Is this > somehow not the case > with this patient? > > Pat > > > " Steve Snydes " > <snydez99 To: > > om> cc: > > Re: > Re: Nephritis, Renal > Office: > Hypertension > 08/04/2003 07:19 > PM > Please respond to > chineseherbacadem > y > > > > > Simon, my goal however unreasonable it is, is to > drop > creatine levels to hopefully get the patient off > dialysis. What you don't know is that i'm dealing > with > a unique (amazing) individual here. I have played > the > devils advocate(in favor of the transplant asp after > talking to his MD), however he wants to try to get > his > Kidneys functioning wihtout that. My goal is also, > to > make the patient feel better while he has dialysis, > which according to him is happeing(placebo?)- it is > boosting his energy, taking less med's. ect. I told > him last friday that if it were me I'd get on a > transplant list & give this a couple of months to > see > if we can get anywhere (it's been 2 months so far). > Ihave one ace up my sleeve, here in Portland one of > my > teachers Dr Wei Lei, has just published Nephritis > Book > > soming out in October, I may have him go to her as > this is her specialty. Steve > --- Simon King <dallasking wrote: > > , Steve > > Snydes > > <snydez99> wrote: > > > Overall, his energy is up, BP is down,no > chest > > > tightness, he feels better has reduced > labatoral > > to > > > 1/day, still creatine hasn't come down. Ideas? > > Steve > > > > > Steve > > What is it that you are aiming to treat here? > Given > > that creatinine > > in itself is not toxic and that he no longer > > (effectively) has > > kidneys. > > Simon > > > > > > > > SiteBuilder - Free, easy-to-use web site > > design software > > > > > > > > > > > > SiteBuilder - Free, easy-to-use web site > design software > > > > Chinese Herbal Medicine, a voluntary organization > of licensed healthcare > practitioners, matriculated students and > postgraduate academics > specializing in Chinese Herbal Medicine, provides a > variety of professional > services, including board approved online continuing > education. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2003 Report Share Posted August 7, 2003 , " Pat Ethridge " <pat.ethridge@c...> wrote: > Perhaps this question should be rephrased in a more general way. Is there > any special way to deal with patients with autoimmune diseases which may > not show severe or clear CM patterns, depending on the stage, as > " autoimmune disease " is strictly a WM concept. I have not come across herbs being explicitly stated as for autoimmune diseases, but in the kidney context, for instance, this might be seen as implicit in the frequent use of huang qi despite the pattern. So much so that an article I am translating at the moment thinks it necessary to discuss why not to use huang qi in damp heat kidney disease. More commonly though, in the kidney formulae for kidney disease whether they are autoimmune or not the pattern approach is predominant. I have wondered if > stimulating certain points or using certain herbs (especially those > described by Western texts as " strengthening immunity " ) might accelerate > the autoimmune reaction progress, or maybe dampen it. Prehaps it is more useful to see autoimmunity as a chaotic process and herbs like huang qi as regulating that process. In some cases, the > CM patterns seem very mild, so it is hard to see how treatment can affect > the disease progress itself, since it seems more to strengthen the patient > generally. Overall this seems to be a problem of merging fuzzy WM and CM concepts. For autoimmunity is not an overstrong immune system in a simple sense and to " strengthen the patient " in a CM sense might of course involve removing pathogenic qi but even if one is talking about boosting the qi, then this most certainly has application to autoimmune diseases many of which are precipitated by an external pathogen invading a weakened defensive qi. Eg wind cold damp in rheumatoid arthritis or wind cold or heat in IgA disease. Hence the frequent use of huang qi. I too would be very intersted if there are CM articles about autoimmunity as a specific entity. Simon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2003 Report Share Posted August 7, 2003 Simon and others, WIth IgA problems in particular, there often seem to be certain predisposing or triggering factors: premature birth (which in theory leaves maternal cells circulating in the bloodstream, possibly triggering later autoimmunity), family history of autoimmune disease (in particular, pernicious anemia) -- both of which would seem to relate to Jing or pre-natal essence. Subsequent viral attack (like mononucleosis, Epstein-Barr, etc.), or invading EPF, can trigger an autoimmune reponse. Also, there is typically poor or inappropriate diet, leading to fungal overgrowth or poor digestion (weak Spleen), as well as frequent antibiotic overuse (suppressing EPF). No one of these factors is usually sufficient to trigger the autoimmune response, but all together will. So treating all these issues (weak Jing, weak Spleen, etc.) will strengthen the patient, without necessarily stopping the autoimmune process. Long-term, the gradual breakdown of systems leads to Yin fire syndrome. Does this sound right? Pat ============================================================================== NOTE: The information in this email is confidential and may be legally privileged. If you are not the intended recipient, you must not read, use or disseminate the information. Although this email and any attachments are believed to be free of any virus or other defect that might affect any computer system into which it is received and opened, it is the responsibility of the recipient to ensure that it is virus free and no responsibility is accepted by Cadwalader, Wickersham & Taft LLP for any loss or damage arising in any way from its use. ============================================================================== Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.