Guest guest Posted April 24, 2010 Report Share Posted April 24, 2010 Hello all, I have a 59 year old female patient suffering from acute onset, Yang-type jaundice due to External Damp-Heat Invasion(Damp prevalent) with significant, underlying, chronic Spleen Qi vacuity. Her AST and ALT levels are high. (I'll have specific details when I see her records on Monday, but she says one of them was over 800 and the other was reported as 'doctor alert' level.) She reports an MD diagnosis of 'chronic autoimmune hepatitis' and was put on prednisone. She says they want her on prednisone for two months, followed by 12-18 months of immunosuppressive drug therapy. She is in otherwise relatively good health and has a pretty clean medical history. I would really like to put her on a bulk, tailored formula, but her MD has told her no herbs (I assume because of a perceived risk of harm to her liver.) I would love ideas, suggestions, and strategies for talking with her MD about integrating biomedical and AOM therapies. Unfortunately, she has no history with this MD (Dr. Frederick Lewis at South Denver Gastroenterology) and, therefore, no preexisting rapport upon which to build. She also has very little rapport established with her regular MD (The patient has only been to the MD three times in recent memory.) I would also like to be prepared with research on specific herbs treating jaundice, hepatitis, and lowering the AST and ALT levels. If any of you could help in locating such research I would greatly appreciate it. In general, I'd love a discussion on the broad topic of talking with MDs about treatments, presenting solid arguments for integration, and locating and presenting research to MDs in a way they are more likely to receive well. Thanks in advance! - John Aguilar P.S. Currently, I am investigating Birch and Hammerschlag's " Acupuncture Efficacy " , Chen's " Chinese Medical Herbology and Pharmacology " , and a book out of Blue Poppy on modern TCM research coming out of China. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2010 Report Share Posted April 24, 2010 It would be helpful to talk with Misha Cohen who is an expert on integrated Hepatitis treatment. http://www.docmisha.com/ She has a certification course in Hepatitis care, which I heard is helpful. K On Sat, Apr 24, 2010 at 12:15 PM, John <Johnwrote: > > > Hello all, > > I have a 59 year old female patient suffering from acute onset, Yang-type > jaundice due to External Damp-Heat Invasion(Damp prevalent) with > significant, underlying, chronic Spleen Qi vacuity. Her AST and ALT levels > are high. (I'll have specific details when I see her records on Monday, but > she says one of them was over 800 and the other was reported as 'doctor > alert' level.) > > She reports an MD diagnosis of 'chronic autoimmune hepatitis' and was put > on prednisone. She says they want her on prednisone for two months, followed > by 12-18 months of immunosuppressive drug therapy. > > She is in otherwise relatively good health and has a pretty clean medical > history. > > I would really like to put her on a bulk, tailored formula, but her MD has > told her no herbs (I assume because of a perceived risk of harm to her > liver.) > > I would love ideas, suggestions, and strategies for talking with her MD > about integrating biomedical and AOM therapies. Unfortunately, she has no > history with this MD (Dr. Frederick Lewis at South Denver Gastroenterology) > and, therefore, no preexisting rapport upon which to build. She also has > very little rapport established with her regular MD (The patient has only > been to the MD three times in recent memory.) > > I would also like to be prepared with research on specific herbs treating > jaundice, hepatitis, and lowering the AST and ALT levels. If any of you > could help in locating such research I would greatly appreciate it. > > In general, I'd love a discussion on the broad topic of talking with MDs > about treatments, presenting solid arguments for integration, and locating > and presenting research to MDs in a way they are more likely to receive > well. > > Thanks in advance! > > - John Aguilar > > P.S. Currently, I am investigating Birch and Hammerschlag's " Acupuncture > Efficacy " , Chen's " Chinese Medical Herbology and Pharmacology " , and a book > out of Blue Poppy on modern TCM research coming out of China. > > > > -- "" www.tcmreview.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2010 Report Share Posted April 25, 2010 Although this is about cancer it is a good book about integrated care from a highly supportive and sympathetic MD. Worth getting for both the patient and for you to present your case. I think it might transfer well to the concerns of your patient and her doctor. Doug Restored Harmony: An Evidence Based Approach for Integrating Traditional Chinese Medicine into Complementary Cancer Care (Paperback) ~ Stephen M. Sagar , " John " <John wrote: > > Hello all, > > I have a 59 year old female patient suffering from acute onset, Yang-type jaundice due to External Damp-Heat Invasion(Damp prevalent) with significant, underlying, chronic Spleen Qi vacuity. Her AST and ALT levels are high. (I'll have specific details when I see her records on Monday, but she says one of them was over 800 and the other was reported as 'doctor alert' level.) > > She reports an MD diagnosis of 'chronic autoimmune hepatitis' and was put on prednisone. She says they want her on prednisone for two months, followed by 12-18 months of immunosuppressive drug therapy. > > She is in otherwise relatively good health and has a pretty clean medical history. > > I would really like to put her on a bulk, tailored formula, but her MD has told her no herbs (I assume because of a perceived risk of harm to her liver.) > > I would love ideas, suggestions, and strategies for talking with her MD about integrating biomedical and AOM therapies. Unfortunately, she has no history with this MD (Dr. Frederick Lewis at South Denver Gastroenterology) and, therefore, no preexisting rapport upon which to build. She also has very little rapport established with her regular MD (The patient has only been to the MD three times in recent memory.) > > I would also like to be prepared with research on specific herbs treating jaundice, hepatitis, and lowering the AST and ALT levels. If any of you could help in locating such research I would greatly appreciate it. > > In general, I'd love a discussion on the broad topic of talking with MDs about treatments, presenting solid arguments for integration, and locating and presenting research to MDs in a way they are more likely to receive well. > > Thanks in advance! > > - John Aguilar > > > P.S. Currently, I am investigating Birch and Hammerschlag's " Acupuncture Efficacy " , Chen's " Chinese Medical Herbology and Pharmacology " , and a book out of Blue Poppy on modern TCM research coming out of China. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2010 Report Share Posted April 28, 2010 Thanks for the leads. I had a good talk with Dr. Greg Sperber (Clinic Directer at PCOM). He said that I need to speak in the MDs terms and address his concerns directly (i.e. the potential for herb-drug interactions and the effect of the herbs on the liver). Specifically, he said to learn and be able to speak to the ADME scheme (Absorption, Distribution, Metabolism, and Elimination) and the cytochrome P450 system (CYP). I spent several hours with Lange's 'Basic and Clinical Pharmacology' and the book Dr. Sperber co-authored with Bob Flaws, 'Integrated Pharmacology'. The latter was a great help, with a whole section dedicated this exact dilemma I'm in. They give a lot of good ideas for the process of interacting with MDs, as well as suggesting a basic protocol for the management of a patient currently taking pharmaceuticals. As far as this situation I'm in, my patient asked me to wait to contact her MD until this Friday, when she speaks with him and shares her desires and concerns, including bringing herbal formulas into treatment. For now, we're doing acupuncture every other day, which is greatly helping her digestive system handle the prednisone and looks to be improving her severely low energy levels. We're also successfully altering her diet to be more Spleen friendly. Her ALT and AST levels are down from the 900's to the 200's, though her bilirubin levels are still quite high. Her jaundice is slightly improved. We'll see how it goes. I welcome any other thoughts or ideas people out there may have. - John On Sun, Apr 25, 2010 at 1:14 AM, wrote: > > > Although this is about cancer it is a good book about integrated care from > a highly supportive and sympathetic MD. Worth getting for both the patient > and for you to present your case. I think it might transfer well to the > concerns of your patient and her doctor. > Doug > > Restored Harmony: An Evidence Based Approach for Integrating Traditional > into Complementary Cancer Care (Paperback) > ~ Stephen M. Sagar > > --- In <%40>, > " John " <John wrote: > > > > Hello all, > > > > I have a 59 year old female patient suffering from acute onset, Yang-type > jaundice due to External Damp-Heat Invasion(Damp prevalent) with > significant, underlying, chronic Spleen Qi vacuity. Her AST and ALT levels > are high. (I'll have specific details when I see her records on Monday, but > she says one of them was over 800 and the other was reported as 'doctor > alert' level.) > > > > She reports an MD diagnosis of 'chronic autoimmune hepatitis' and was put > on prednisone. She says they want her on prednisone for two months, followed > by 12-18 months of immunosuppressive drug therapy. > > > > She is in otherwise relatively good health and has a pretty clean medical > history. > > > > I would really like to put her on a bulk, tailored formula, but her MD > has told her no herbs (I assume because of a perceived risk of harm to her > liver.) > > > > I would love ideas, suggestions, and strategies for talking with her MD > about integrating biomedical and AOM therapies. Unfortunately, she has no > history with this MD (Dr. Frederick Lewis at South Denver Gastroenterology) > and, therefore, no preexisting rapport upon which to build. She also has > very little rapport established with her regular MD (The patient has only > been to the MD three times in recent memory.) > > > > I would also like to be prepared with research on specific herbs treating > jaundice, hepatitis, and lowering the AST and ALT levels. If any of you > could help in locating such research I would greatly appreciate it. > > > > In general, I'd love a discussion on the broad topic of talking with MDs > about treatments, presenting solid arguments for integration, and locating > and presenting research to MDs in a way they are more likely to receive > well. > > > > Thanks in advance! > > > > - John Aguilar > > > > > > P.S. Currently, I am investigating Birch and Hammerschlag's " Acupuncture > Efficacy " , Chen's " Chinese Medical Herbology and Pharmacology " , and a book > out of Blue Poppy on modern TCM research coming out of China. > > > > > -- Check it out! www.DenverChineseMedicine.com Foundations of Health www.DenverChineseMedicine.com/FoundationsofHealth.aspx About Acupuncture and Oriental Medicine www.DenverChineseMedicine.com/AboutCM.aspx Quote Link to comment Share on other sites More sharing options...
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