A seventy-four year old female whom we will refer to as “Eva” (not real name) presented to the clinic in January 2020 (pre-covid) with a diagnosis of Lyme disease. She had difficulty walking as her gait could best be described as a slow waddle with a noticeable stiff, swollen and sore left knee. Navigating the stairs was extremely challenging and performing deep knee bends was next to impossible. She had been using a wheelchair to get around and relied on this method of transportation for warehouse shopping or navigating airports. Eva was diagnosed with uncontrolled hypertension in 2009 and was prescribed over the next 10-20 years various prescription medications including : Atenolol 25 mg BID and thyroid medication which changed to a compounded prescription several years ago that consisted of 88 mcg of T4 and 14mcg of T3.
2019 Lab results: WBC 3.5, elevated Ferritin 446, Cholesterol 284, LDL 196, serum glucose of 101, Fibrinogen 423, and CRPhs of 3.7. HDL 57 and GFR 80 were both lower than the reference ranges.
PMH: In her 30’s, Eva recalled experiencing unusual symptoms of dizziness and migrating joint pain, yet it took another 10 years BEFORE Lyme disease was the confirmed diagnosis based on her symptomatology, Western Blot, and CD57 results. We also cannot exclude demographics of residences in Connecticut and Maryland as a child before moving to Hawaii 14 years ago.
She received the standard treatment at that time of 8 months of Doxycycline, along with a host of other antimicrobials prescribed sequentially over a two year period such as Cefuroxime, Metrondiazole, Augmentin, Cyclobenzabrine. She then explored and received Chinese herbs, Acupuncture, massage, and QiGong. She had some momentary relief of symptoms.
In 2019, she sought out naturopathic treatment options for a recent 30 lb wt gain, continued joint pain stiffness and weakness, especially of left knee, a creepy crawly feeling in her lower legs also known to travel to her head/scalp, as well as another unusual symptom she described as a full body vibration, strong enough to shake the bed. Recently she received a diagnosis of melanoma, Stage 2, which caused significant anxiety and fear over its return. Other skin issues on her list included painful boil formation on her back Thoracic 5-7 area, constantly recurring and erupting and episodes of shingles which re-appeared even after she received the shingles vaccine.
BP: 140/80 P: 78 PO%: 97 T: 98.6 WT: 190.3 HT: 5’4’ BMI: 32.6 (obese)
IMPRESSION:
Eva is clearly a person still struggling with a higher than normal microbial load despite all the treatment received thus far. The sequelae to infectious disease is compromised immunity, inflammation, and cardiovascular disease usually caused by hyper viscosity of the blood, and pain leading to decreased mobility which cannot be ignored if eradication of disease is the goal.
In the modern world these cases are common complex diseases. For many physicians, it is difficult to know where to start. In natural medicine, we have two major cornerstones which we use as the foundation of treatment 1) nutrition and 2) circulation. Fortunately, #1 can assist #2. Eva was placed on a plant based, non processed food diet. Anti-inflammatory and hypo-lipidemic foods and herbs were emphasized.To further address her circulation, I prescribed Lumbrokinase and a treatment commonly used before the advent of prescription drugs called Constitutional Hydrotherapy to improve circulation while optimizing immunity and liver function. This treatment also had the benefit of drawing out the skin infections which the patient referred to as boils. These ‘boils’ presented as large infected sebaceous cysts the largest measuring 2×3”. After a series of 3 treatments, she was finally ready for hyperbaric oxygen chamber treatment (HBOT). Her lower extremity swelling had decreased enough to allow for greater ROM and she now had enough mobility to crawl in and out of the chamber.
The hyperbaric treatments achieve anti-inflammatory benefits by increasing the oxygen levels in all tissues of the body. In Eva’s case, it did not disappoint. Eva’s hsCRPdropped to 1.11 from 3.7 and her Fibrinogen with the help of the fibrinolytic enzyme decreased from an initial reading of 423 to a respectable 282. Many research papers are available confirming the effectiveness of eradicating aerobic/anaerobic bacteria, arthritis, and other inflammatory diseases with a low pressure chamber (1.4 ATM). It’s an effective treatment for debilitated patients as they are not required to exert any energy while receiving treatment. In fact, many patients fall asleep in the supine position during this process. HBOT is also a wonderful alternative for people with poor venous access. Eva received daily (5x/week) 90 minute sessions for 4 weeks, which were reduced to every other day, and then to one time a week during the first peak of COVID for a total of 44 treatments from February to August 2020.
The results in just two months were phenomenal. Eva lost 13 pounds and was able to cut her blood pressure medication in half. As a result, her knee/ankle swelling and limited range of motion were much improved. She was able to walk and climb stairs with a normal gait. The only assistance she felt she needed was utilizing her hand and arm strength to assist with stair climbing. Eva was also able to get in and out of the chamber with deeper flexion of the hip muscles and resume her 2 acre yard walks. In addition to these improvements, the unusual symptoms of creepy crawly skin sensations cleared after 35 treatments. Sleep normalized and her energy was back! Skin infections were also minimized. She was referred to a dermatologist for further prevention of melanoma recurrence.
One year follow up:
With the continuation of COVID, she opted to purchase her own chamber which she utilizes 3-4 times a week in her own home. She described her pain level as minimal. Her activity level has remained high. Her only complaint was shoulder pain for which she received physical therapy and myofascial release treatment in the past. On physical exam, ROM is limited only in the last 5 degrees of anterior and lateral extension but significantly limited to 45 degrees of posterior extension. Her sebaceous cysts have cleared and not returned. Her weight is down a total of 17 lbs. Blood pressure has remained low on 25mg Atenolol daily.
Vitals: BP: 122/75 P: 70 PO: 97% WT: 173lbs BMI: 30 (obese)
LABS: hsCRPand Fibrinogen have creeped up slightly to 1.4 and 358 respectively. Serum fasting glucose is now down to 88. Her WBC’s and neutrophils are within the reference range but considered too low from a naturopathic perspective. Her Ferritin levels remained high in the 400’s despite normal Iron, Transferrin, and Iron Binding Capacity. She refused liver imaging to rule out Hemochromotosis but agreed to IV Vitamin C to further aid in reducing infection, inflammation, improve collagen, and possibly lower ferritin levels. We have recommended she resume Lumbrokinase to help reduce Fibrinogen levels. She has agreed to these recommendations. I shall attempt to provide an update on this casein the near future.