Thursday, August 28, 2008

Case Study: Swollen Glands

OBSERVATION:

A mother brought her son (3 yrs. 8 mos.) to my office because his glands were swollen. Six weeks prior to the visit, he had a cold that developed into an ear infection and she gave him oral antibiotics. The ear ache went away but his glands stayed swollen.

She said he tires easily and has temper tantrums when he’s tired. In my office he was responsive, curious, and very articulate, with good fine and gross motor skills.

DIAGNOSIS:

The glands are still swollen because not all virus or bacteria left the body, a condition known as Lingering Pathogenic Factor. It was caused in this case by the use of antibiotics thereby (in terms of Chinese medicine) weakening Qi and/or creating phlegm. Phlegm isn’t just the accumulated solidified mucus or sputum found in the respiratory system (lungs & sinus) as described in Western medicine. In TCM, “the concept of Phlegm is very wide-ranging and important…[and] extremely frequent in clinical practice. [It] is at the same time a pathological condition and an aetiological factor.”[1]

One way to understand how Phlegm manifests in the body is to think of the different states of water (gas, liquid, solid). Some common manifestations of phlegm are in the head (foggy feeling, clouded thinking), in the digestive tract (“damp”, bloating) and the lungs (expectorant). In this case, the manifestation of the Phlegm is his swollen glands.

Part of the problem with using antibiotics to treat infections is that bacteria become drug resistant very quickly, and infections tend to easily reoccur.[2] Besides creating drug resistant bacteria, some antibiotics directly injure the immune system by blocking protein synthesis within mitochondria reducing production of White Blood Cells (WBC).[3] When antibiotics inhibit WBC production, the body is slow to return to normalcy (i.e. the glands remain swollen, he’s still tired) and there are lingering symptoms.

TREATMENT:

I used massage to stimulate points along his arms, hands, neck and upper back and chest in order to enhance the Lung function of expelling pathogenic factors and reduce phlegm. The points I focused on were LI4, GB20 to Clear pathogenic wind, Lu5 to clear phlegm from the Lungs, Lu9 to Tonifies the lungs and St36/Ren12 to Tonifies the spleen. His tiredness was the result of Spleen Qi Deficiency caused by the antibiotics.

I taught him how to stimulate his chest points by tapping with his fists like Tarzan. I taught his mother how to massage the other points. I also prescribed Chinese herbs to take at home. Empowering the patient and caregiver increases healing. Illness is no longer something that happens to them but is a process they can manage.

OUTCOME:

I talked with the mother the week after his visit. She said he took the formula (as drops in his drinks) for 3 days and the swelling in his glands went down. His normal color returned and he is easier to handle (because he is not as tired as before). This was I expected.

GOING FORWARD:

To prevent this from becoming a chronic condition, I highly recommend using Chinese herbs instead of antibiotics. Antibiotics are designed to kill bacteria. Chinese herbs are available in antibacterial AND antiviral formulas. Chinese herbs are prescribed to enhance normal function of the body and improve your health.

Though antibiotics can occasionally improve some symptoms, especially those caused by inflammation, they possess no direct action to do anything other than kill the bacteria. If the cause is viral, you’re taking a drug you don’t need.

q Antibiotics can’t relieve distress or pain.

q Antibiotics can’t promote drainage.

q Antibiotics can’t repair damage.

q Antibiotics can’t prevent recurrence or any of the other issues commonly encountered in a case of Acute Otitis Media (AOM) – ear infection.

Children who take antibiotics have repeat infections, often causing a prolonged merry-go-round cycle. All common epithelial infections of the nose, throat, ear, lungs, skin, urethra and bladder can successfully be treated with Chinese formulas. In terms of ear infection, antibiotics are not only unnecessary; they are harmful. [4]



[1] Maciocia, Giovanni. The Foundations of Chinese Medicine. Edinburgh: Churchill Livingston, 1989 (ISBN 0-443-03980-1)

[2] “The authors believe the frequent use of antibiotics for common ear infections raises risks that children will harbor drug resistant bacteria during subsequent illness. They point out that children whose previous ear infections were treated with antibiotics have a rate of Apicillin (amoxocillan)-resistant bacteria that is three times higher during subsequent otitis media.” JAMA November 26, 1997; 278(20):1643-1645

[3] “A number of antibiotics (e.g., streptomycin) that act by blocking protein synthesis in bacteria also block protein synthesis within mitochondria and chlorplasts.” http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/E/Endosymbiosis.html

[4] “Pediatric Ear Infections” Fratkin, Jake Paul, OMD L.Ac., NEWS FROM GOLDEN FLOWER, Fall 2004

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