Tolle Causam
Shannyn Fowl, ND
So many pulmonary pathologies are difficult to treat and sometimes even difficult to diagnose. Pneumonia, on the other hand, is usually a clear diagnosis after an X-ray, and naturopathic tools are pure gold when it comes to treatment.
In this article I will share a few cases of pneumonia. Please notice that 3 of these cases were failed by standard-care treatment options and that it took a natural approach to finally achieve healing. Please be assured that, as naturopathic doctors, you not only have an incredible array of tools to use, but when you “take in the essence of a patient,” you can also use those tools with extraordinary accuracy. Please also note that because of their healing experience, most of the patients described here are now natural health advocates and patients for life.
Case Study 1: After 3 Months of Antibiotics
A 73-year-old male presented to my clinic with pneumonia of 12 weeks’ duration. He reported that his symptoms began several months prior, initially starting as unilateral facial nerve irritation and swelling. This facial nerve issue was treated with antibiotics.
He was very busy with family visits, then became so fatigued that he was unable to do anything. No one else in the family had been sick. Over the next 3 months he was treated 4 times with IV and oral antibiotics, had 3 inconclusive lung biopsies, and his lungs were aspirated twice. He would feel temporarily better after antibiotics. His most recent doctor’s visit was to the emergency room, 4 days before consulting me, where he was given a chest X-ray and a new prescription of antibiotics.
The patient has continued to experience shortness of breath and night sweats, and has lacked energy to the point where he struggles to get dressed for the day and spends the day on the couch. He reported no other underlying health conditions, other than an enlarged prostate.
Physical exam revealed a very tired man without a cough.
Lungs had light expiratory wheezes on the left, but 2-3-second expiratory wheezes on the right. No anterior wheezes were found. Slight crackles were noted inconsistently.
No other physical abnormalities were found.
Impressions
Although this patient was supportive of naturopathic medicine in general, he had not sought care with a naturopathic doctor or used natural medicine before this condition. Both patient and wife seemed like they would follow through, if not, in fact, desperate to find something that worked so that he could get back to “living.” This case seemed clearly to have some viral influence.
Treatment Plan
- Get copies of lab tests, pathology reports, and X-ray reports to me
- Mustard packs 1-2 times daily on the back or chest for 3 days or until we discuss stopping them. Patient given a handout and briefly instructed on the procedure in the office.
- Warming socks at night. Handout provided.
- Vitamin A for anti-viral effects and repair of mucosal tissue. Told to take with food.
- Start with 50 drops (500 000 IU) per day for 3 days
- Reduce to 25 drops (250 000 IU) per day for 3 days
- Day 7: Reduce to 12 drops (120 000 IU) per day for 3 days
- Day 10: Reduce to 6 drops (60 000 IU) per day for 2 weeks after symptoms abate
- Aromatherapy: Patient given an essential oil combination containing Pinus silvestris, Eucalyptus globulus, Melaleuca viridiflora, Terebenthina, and Thymus vulgaris. Told to take 5 drops up to 5 times per day.
- Bland diet of soups, veggies, and meats
- Patient was directed to call with any questions and to follow up by phone in 3 days. He was told that he should see results within 3 days, and was instructed to call if signs or symptoms worsened.
Follow-up
He did call in 3 days, but to report that he was doing 95% better than he had in 4 months. He felt very grateful. He was told to continue the treatment plan and to follow up in the office in 3-4 days in order to review labs and auscultate his lungs. It took him a month to follow up.
At this 1-month follow-up, he reported that he was 80-95% back to normal. He had started some exercise and was getting back into life again, in general. He still needed an afternoon nap. His appetite was also improving, though he was still having night sweats and some wheezing. He’d had no facial swelling reoccurrences. He’d stopped the warming socks because he was developing some fungus on his feet.
Physical exam revealed clear lungs with good air movement.
His labs from our first visit showed high WBC, iron-deficiency anemia, negative TB test, and low vitamin D. A differential was not run on the CBC, which would have been helpful.
During this visit, the patient was advised to take vitamin D, probiotics, iron, zinc, and a garlic/cinnamon combination (to be taken 3 times daily with food), to prevent a reoccurrence. An X-ray was ordered for 2-4 weeks. He was advised to take good care of himself, since weakened lungs could increase his risk for a repeat pneumonia.
The patient did not follow up for an entire year, only presenting at that point for a rising PSA. In this visit, he reported complete resolution of the pneumonia and symptoms after following the recommended treatment plan. After months of a geriatric patient battling pneumonia, and 4-6 scripts of antibiotics, 3 cultures, and inadequate labs, through naturopathic care he was able to feel 95% better within 3 days and experience complete resolution of his pneumonia within 4-6 weeks of seeking care. This is not an isolated case; naturopathic medicine is gold for pneumonia.
Case Study 2: Dragged in by a Spouse
A 45-year-old male presented with strained breathing. He would lean forward in his chair and off to one side. He had congestion, green-colored sputum, fatigue, wheezing, fever, and chills. His symptoms started with a head cold 2 weeks prior; then his ear became clogged. Muscle aches in his thighs made it difficult to sleep and caused him to moan. Although he felt too tired to even check his emails, he’d been jogging daily. His wife did the warming socks procedure for him and started him on vitamin C, vitamin A, and zinc. She also told him to take an herbal immune-boosting formula (Echinacea, Spilanthes, Baptisia spp, and Commiphora myrrha), which he was still taking when he came to my office.
On physical exam, his lungs sounded suspicious for pneumonia, with lots of crackles. He was sent for a stat X-ray and given 2 local options where they could cash-pay. We also drew some blood for lab tests.
Impressions
This case involves a spouse of a current patient. He didn’t necessarily buy into our office’s philosophy of medicine until he had a need himself. With the nature of his discharge and discomfort, bacteria seemed involved, but I wanted to protect him from a complicated viral infection as well. We also discussed how to protect the rest of the family by limiting their exposure to his saliva including droplets of saliva from respiration, sneezing, and coughing. We also discussed how pushing ourselves with stress can impair ciliary function in the lungs; when defense resistance is lowered, an infection is more likely to go deeper into the chest.
I did not encourage this patient to call with questions, since we were already getting a massive amount of calls from this family. However, I repeatedly covered what was safe and not safe, in an attempt to address any questions pertinent to the treatment plan. I encouraged his wife to write down any questions that arose so we could cover them in person in a few days. Imaging and labs can be financial obstacles for patients, so being aware of cash-pay options, where patients can get in quickly with minimal frustration, will help you provide quality care.
Treatment Plan
In the meantime, the patient was instructed to take the following:
- Vitamin C: 3 grams or to bowel tolerance
- Magnesium for muscle pain: 2 capsules at bedtime (too much can cause diarrhea)
- Vitamin A: Start with 7 drops (70 000 IU) for 5 days. Then reduce as follows:
- 6 drops for 3 days
- 5 drops for 3 days
- 4 drops for 3 days
- 3 drops for 3 days
- 2 drops for 3 days
- Antimicrobial product containing vitamin A and 7-8 botanicals: 1 tablet 3 times daily with food. If side effects (eg, headaches, nausea, belly pain, dryness), take only 2 tablets daily. If no problems, increase to 4/day, then 6/day (2 tablets 3 times daily) for 7 days.
- Drink plenty of water
- Ginger tea, to increase body temperature and warm the lungs
- Inhale eucalyptus-scented steam (place eucalyptus oil in steamer or use in the shower)
- The patient was told that he should be getting better by the third day of treatment; if not, we would do something different. He was instructed to follow up for lab and imaging results.
Follow-up
I spoke with the patient and his wife by phone the next day to discuss lab results, which included electrolyte imbalances, elevated liver enzymes, WBC elevation (neutrophils primarily involved), and bronchopneumonia per the chest X-ray. Diagnosis was bacterial bronchopneumonia with full lung involvement. At this point we added probiotics and mustard packs. We also called in a script for antibiotics in case they chose to go that route; it was a safety net for the patient.
He followed up the next day for a slow IV Myer’s push. His lungs had improved somewhat, with friction rubs throughout and crackles mostly in the right-middle lung and lower edge of the upper lung, as opposed to throughout the lungs.
The Myer’s push was repeated 4 days later. One week after the push, his upper lungs were clear, although some wheezing in his middle lung, and crackles in his lower lungs, were still present. At this point he appeared to be getting headaches from the antimicrobial product and vitamin A. We discontinued both and started 3 homeopathic drainage products.
A week later, he was still having headaches despite stopping the antimicrobial and vitamin A, but it seemed he was also working too much. He was advised to rest and repeat the X-ray.
At the 6-week point, his X-ray was clear, lungs were clear, and he felt back to normal. They never used the antibiotics, since they never felt they needed them. This patient is now a complete believer in naturopathic medicine, perhaps more than the doctor herself at times.
The next time I saw him was for a severely abscessed bug bite, which I wasn’t sure how to treat without lancing (a procedure not within our scope); however, the patient was such a believer in our other tools that we successfully treated it with homeopathics and botanicals. Just when we might be overwhelmed by running a business, these patients often remind us and reflect back to us the heart and confidence of our amazing medicine.
Case Study 3: A Return to Her Roots
A 56-year-old female, with a predisposition to frequent upper respiratory infections (URIs), returned to the office with pneumonia that was unresolved after 3 courses of antibiotics. The patient’s rib cage was very sore from coughing. She had been coughing up yellow and green mucus, and cried in my office from exhaustion.
Physical exam revealed inspiratory and expiratory crackles throughout her lower lungs, but her upper lungs were clear. Each course of antibiotics would help for awhile but then stop; the pulmonologist told her that the infection was resistant to all the antibiotics they had tried, but that they would keep trying new ones. She reported that her boyfriend was worried about her, was very supportive, and would be willing to help her with mustard packs.
Impressions
This patient was a true believer in natural medicine. On top of the antibiotics prescribed for her at an urgent care clinic, she was trying some herbal mixtures suggested by a family member who was early in her studies at a naturopathic university. Her only obstacle to seeking follow-up care for an acute illness in my office was the cost.
Treatment Plan
The patient was instructed to do the following:
- Mustard packs: Mix 1 cup of flour with 1 tbsp mustard, and make a paste with water. Apply the paste to the back and watch for burning; pink is okay. Cover with a hot, wet hand towel. Leave on for 20 minutes; don’t get chilled.
- End with an icy cold rub with a washcloth.
- Do this twice daily, if possible, for 3 days.
- Saccharomyces boulardii while on antibiotics: 1 capsule daily until 3 days past finishing the antibiotics. Pause on the probiotics while taking the Saccharomyces.
- Antimicrobial product with vitamin A and 7-8 botanicals: If tolerated, take 3 times daily with food; otherwise, take 1 tablet twice daily with food.
- Vitamin A: 10 drops (50 000 IU) daily for 3 days
- Then 2 drops/d for 3 days, then 1 drop/d until a week past feeling healed
- Vitamin C: 2000-4000 mg daily
- Thyme tea was recommended
- Four homeopathic drainage products: 5 drops 3 times daily
- Consider nebulized glutathione for 3 days (estimated cost $200-300 plus the cost of a nebulizer)
- The patient was instructed to let us know how she was doing in the next 3-4 days
Follow-up
Four days later the patient reported by phone that she was very much on the mend and feeling much better. She was encouraged to follow up to have her lungs listened to and to get a repeat X-ray with her insurance-based doctor, due to the cost. This is just another shine for naturopathic tools in a failed pharmaceutically treated case of pneumonia.
Case Study 4: Graduation Day
A 16-year-old male presented with shortness of breath. Symptoms initiated with a fever 1 week prior, progressing to a cough (eventually with yellow sputum), headache, weakness, and fatigue.
On physical exam, his breathing was harder and faster than usual. His lungs had consistent crackles, both inspiratory and expiratory, throughout his lungs, sparing only his lower-left lung. His oxygen saturation was 80%, improving to 92% with deep breaths.
Impressions
This final case is of a teenager who was graduating from high school later that day but was so sick that he was concerned he wouldn’t be able to walk across the stage after sitting up front for the ceremony. He had missed several dance performances this week, but had also pushed through several. They had been to urgent care, been told it was a viral URI [influenza test was negative], and to watch and wait; however, he was not improving. They came to my office in a last-ditch attempt for help that could enable him to participate in graduation. We discussed how we might be able to find a middle ground for attending graduation, such as coming in at the last minute to walk; a doctor’s note was also offered to help make this possible. This was the first visit for this family.
Treatment Plan
The patient was given homeopathic Lycopodium to get him through graduation day. He was also instructed to do the following:
- Kali phosphoricum and Ferrum phosphoricum cell salts: 2 pellets of each product 2-6 times daily
- Vitamin C: 3000-5000 mg daily or to bowel tolerance
- Vitamin D: 3000 IU daily with food
- Berberis formula (equal parts of Berberis vulgaris and Berberis aquifolium): 1 capsule (50 mg) 3 times daily with food. Patient told to stop if side effects developed (eg, dryness, headache, breast tenderness, nausea), and to report back.
- Vitamin A: 5 drops daily (50 000 IU) until next meeting
- Warming socks; instructional handout given to patient
- Food: Soups, blueberry, pomegranate
- The importance of rest was discussed
- X-ray was strongly recommended; a written order was provided
Follow-up
I strongly encouraged them to follow up in 3 days; however, I was under the impression that if his illness resolved, I would likely not hear from them again. So I PARQ’d them as best I could (PARQ = Procedures, Alternatives, Risks, and Questions). We also scheduled an appointment, which they later cancelled by phone. I followed up by phone, leaving a message about the importance of having the lungs rechecked within 6 weeks and that complications that could occur. They called and left a message that graduation went very well and all was very good; they decided against a follow-up visit. I didn’t see them for a full year, at which time they presented for a physical for dance camp.
Conclusion
Honestly, I have not had a case of pneumonia in my office that our natural tools have not been able to heal. It may happen yet, but I can confidently look my patients in the eye and tell them that naturopathic medicine is gold for pneumonia. Our teachers have passed down powerful and effective tools for treating this problem. Hopefully this article has inspired you to do the same!
Shannyn Fowl, ND, is a graduate of NCNM and a naturopathic doctor in family practice at Journey of Health, in La Mesa, CA. She practices Docere for the general public at San Diego Community College, and teaches nursing CE classes, such as “Intro to Naturopathic Medicine” and “Hydrotherapy and Homeopathy for the Family”; she also teaches biology and chemistry via parental involvement in her son’s elementary classes. Dr Fowl is presently working on her book geared toward successful assistants in integrative clinics. She resides with her husband and son at a villa in San Diego, where they welcome like-minded visitors.
