!"#$ SUMMERTIME... AND LYME TIME

24 !"#$% • HomeopathyCenter.org Summer 2019 !"#$ SUMMERTIME... A case of chronic

AND LYME TIMEby AMY ROTHENBERG, ND, DHANP

racticing homeopathy with one’s At other times, one of us will send the On the intake form, under Reason for life partner has its ups and downs. other a patient a#er having spent very little Today’s Visit, Sarah had written, “treatment PThere are difficult aspects to negoti- time with them. We do this when we per- for chronic Lyme disease.” Sitting in my ate, such as: Who will be on call? And who ceive that a patient or family might prefer office, she recounted her story. will oversee the running of the office? Like- to develop a working relationship with the Some three years before, Sarah had had wise, there are certain pleasures involved other provider. Our perception is naturally a terrible case of poison ivy, which wound with working as a team, including building subjective, but usually we are right on the up being treated with oral steroids. In the a practice together, spelling each other money. We have the liberty and freedom month following, she pulled an engorged during the early years of childrearing, shar- to do this in our intimate office, and we tick off her scalp a#er a camping trip. It ing successes, and helping each other with exercise it from time to time. took a long time for the bleeding to stop. A difficult cases. few months later, during her junior year of Periodically, Paul [Herscu, ND] and I Sarah’s story: Chronic Lyme disease high school, she developed severe, debil- will sit together with a patient, especially Sometimes, I wonder why Paul sends me a itating fatigue and generalized aches and when one of us feels we are not getting the particular patient, o#en a lovely person and pains throughout her body. By the winter of whole story or are missing key aspects to a pleasure to treat. Such was the situation that year, she was unable to get out of bed, the case. Invariably, the fresh pair of eyes when Paul referred 19-year-old Sarah to reflecting the intensity of the fatigue. At this and different ways of seeing will help us me. Large boned, tall, and lean, she had time, she was diagnosed with mononucle- get to a better remedy for the patient. It a strong, clear way about her, with her osis and depression. is generally true that two heads are better shoulder-length blond hair pulled back in a Sarah was put on an antidepressant, than one. loose ponytail and her athletic attire attest- which made her symptoms much worse. ing to her former strength and involvement Within a month, her platelet count had in the world of sports. dropped to dangerously low levels, and she was diagnosed with Immune Thrombocyto- penic Purpura, which meant her blood wasn’t clotting as it should because her immune system was destroying platelets. She was put on steroids to address the low platelets.

HomeopathyCenter.org • Homeopathy !"#$% 25 Summer 2019 By the summer of that year, Sarah was nize these as indicators of a Lyme infection. come to a standstill for her. Sarah had no diagnosed with Lyme disease. She was People suffering with late-stage Lyme further vertigo or headaches since the vita- put on an IV , which made many infection frequently have severe joint pain min therapy. of her symptoms worse. At that point, her and swelling, especially in the knees. most troublesome symptoms were fatigue, Numbness, tingling, and other pains in Still suffering joint pains, nausea, dizziness, and head- limbs, muscles, and tendons are common. She still struggled with general fatigue, aches. She remained on oral or IV antibiot- Severe fatigue, headaches, partial facial muscle aches, and chronic sore throats, ics for one and half years—with little to no paralysis, dizziness, memory problems, however, and this was why she had come improvement in her symptoms. heart palpitations, brain inflammation, and to our office. Most days followed the same other neurological problems are also pos- pattern: she would feel worse in the morn- Lyme disease sible. Conventional medical care for both ing and o#en took a three- or four-hour nap The engorged tick that Sarah pulled off her acute and late-stage Lyme disease involves in the a#ernoon. Then, she would perk up scalp was most likely a deer tick infected the administration of . as the evening came on. with or Borrelia may- She had stopped playing competitive onii, the bacteria responsible for Lyme Tough times sports, at which she had excelled, because disease in the U.S. Not all deer ticks are During the time when Sarah was grappling of her chronic low platelet count. Her infected with Lyme bacteria, and only a with severe fatigue and pain, she suffered hematologist felt she would be at risk of small portion of tick bites lead to Lyme the loss of a favorite dog as well as the serious bleeding, especially if she suffered disease. If an infected tick is attached to death of a close aunt. These two griefs any sort of head injury. you for less than 36 to 48 hours, chances compounded her problems and pushed Sarah’s sleep was good; she preferred of the bacteria reaching the bloodstream her further into fatigue and joint pain. to sleep on the le# side and stay covered. and causing infection are slim. But if you While grieving, she preferred to be alone, Her joint pains were sharp and moved find a tick on your body that has grown a and any comforting from loved ones made around from here to there. The pains were lot larger than its usual tiny, poppy-seed her feel worse. worse if she was not well rested and were size, chances are it has been feeding a She also struggled with poor memory generally better when she got enough while, as in Sarah’s case. and difficulty concentrating. She missed sleep. Even so, Sarah experienced some Within three to 30 days of a tick bite, most of the second half of her junior year and joint pain just about every day. She also (many, but not all) people who contract half of her senior year of high school because complained of random numbness in her Lyme disease will see a bulls-eye shaped she was home in bed. Miraculously, she did hands, feet, and legs that would come rash that expands outward from the site of graduate with her class, a testament to both and go. The numbness had been happen- the bite. Fever, fatigue, body aches, and her intellect and determination. ing since she was ill and was better if her swollen lymph nodes are common during extremities were rubbed. this period, but many people don’t recog- Small strides Sarah’s sore throats had begun a few Sarah’s family, seeking other approaches months back; sometimes, her throat hurt because the antibiotic treatment was not so much she could barely speak. She felt working, settled on a vitamin supplement pain whenever she swallowed (whether program. She was taking a multiple vitamin swallowing food or not), and she felt better along with high doses of Vitamins C, E, and sucking on a Popsicle. She thought that B12. She was also taking a botanical prepa- perhaps her sore throat was worse from ration of Ginkgo biloba, known to enhance breathing through her mouth, which she memory. With this protocol, Sarah finally did more now, especially during sleep, began to feel somewhat better and more due to her congested sinuses from mild able to rejoin the life that had previously allergies.

Sarah finally began to feel somewhat better and more able to rejoin the life that had previously come to a standstill for her.

26 Homeopathy !"#$% • HomeopathyCenter.org Summer 2019 A WHOLE PERSON

Revelations alone when she was feeling low. Her fastid- APPROACH TO In her medical history, Sarah reported that iousness, as a self-described “neat freak,” Lyme Disease in the third and fourth grades she suffered fit the remedy profile, as well. In addition to giving a constitutional with anxiety, chronic worrying, and low This was a pattern recognition case homeopathic remedy to people with chronic self-esteem. She was even put on Prozac for me; she looked like, sounded like, Lyme disease, I use many other supportive for a period of time, which made her much and acted like a person needing Natrum therapies to help the body fight infection and worse. Sarah was eventually helped by a muriaticum. As is taught in any medical or get on a more balanced footing with immune psychologist, who taught her relaxation naturopathic physical and clinical diagno- function. Here are just a few of the natural techniques. Sarah also described a history sis course: If you hear the sound of hoofs, medicines I tend to employ: of irritable bowel syndrome with rectal don’t think zebras. In other words, when ! FLAX SEED OIL as a general anti- bleeding some years before, though not weighing the evidence to make a diagno- inflammatory recently. sis, think first of the more commonplace ! GINSENG, which can enhance attention and Sarah craved sweets, salt, and fish and diagnostic categories over the more exotic memory was averse to meat. She drank a lot of ones, since the probability of a common ! ECHINACEA AND GOLDENSEAL to water. She had no problems with her uri- diagnosis is much higher. This is drilled into support immune function nary tract or skin. When outdoors, she did students because novices tend to gravitate her best to stay in the shade rather than in towards making more exotic diagnoses ! DANDELION AND MILK THISTLE to full sun, since she felt better there. (perhaps because unusual diagnoses help cleanse and build healthy blood and as general liver support. Sarah claimed she was a neat freak, lik- are more memorable). For homeopaths ing everything in order. She loved all types deciding on a remedy for a patient, the For more about the naturopathic approach to of music though she described herself as adage translates as: Think first of our most treating people with acute or chronic Lyme tone-deaf. frequently used polychrest remedies over disease, I recommend the article, “Lyme Disease: A Whole Person Approach,” by my colleague Sarah’s mother, who accompanied her the lesser known and used remedies. Darin Ingels, ND, FAAEM, on the Naturopathic to the appointment, offered the following: Natrum muriaticum is a remedy that is Doctor News and Review (NDNR) website. In it, used o#en and successfully by homeo- “Before I knew I was pregnant with Sarah, he lays out many other naturopathic modalities my father died. I was in a horrible grief- paths for all kinds of patients with all kinds and approaches to Lyme disease in an evidence- stricken state, which I held in entirely. Then, of complaints—when a person’s symptoms based way. His recommendations include: I found out I was pregnant. It was a melan- fit the remedy profile. A history of deeply ! EATING an anti-inflammatory, alkaline-heavy felt yet silent grief and/or ailments arising choly time for me.” diet that eliminates processed foods, sugar, a#er grief are o#en found in patients and coffee and reduces animal protein to 20% Don’t think zebras needing this remedy. Certainly, Sarah had of the overall diet In selecting a homeopathic remedy for experienced plenty of grief in her young ! SUPPORTING intestinal health with natural Sarah, I considered a number of possibil- life, with the loss of her dog, her aunt, and medicines and foods, in order to promote even her grandfather when she was in her ities. Lycopodium came to mind because motility and rebalance gut flora, possibly of her general weakness and fatigue in the mother’s womb. including probiotics, magnesium salts, a#ernoon, her sore throats, and her history glutamine, curcumin, and fish oils, depending of anxiety and insecurity. I also thought Helping people with Lyme on the individual’s needs Over the last decade, I have seen numerous about the remedy Silica because of her ! TREATING active infection with herbal ongoing weakness and her tendency for patients struggling with the long-term effects protocols (e.g., Dr. Zhang’s Modern Chinese illness, as if she could not fight off infec- of Lyme disease (also called post-treatment Medicine protocol and Dr. Lee Cowden’s tions. And, of course, with her history and Lyme disease syndrome), and in my experi- protocol) her family’s history of loss and deeply felt ence, they generally do well with homeo- ! IMPROVING lifestyle habits with high grief, the remedy Ignatia came to my mind. pathic constitutional prescribing. quality sleep, plenty of exercise, and stress But, she lacked key elements indicative of In addition, as a licensed naturopathic management Ignatia, including irritability and a fault-find- doctor, I employ many supportive ther- ! CONTROLLING environmental factors, such ing nature, and she did not have spasms apies to help the body fight infection as avoiding mold toxicity in the home and and get on a more balanced footing with or cramps anywhere, as I would have workplace expected to see. immune function. For Sarah, I tailored my In the end, I prescribed Natrum muri- suggestions on diet, lifestyle, and natural ! DETOXIFYING, if indicated (saunas can be helpful for this), and supporting immune aticum 200c based on Sarah’s overall medicines to her individual situation, as I function through various immune-enhancing demeanor of being somewhat reserved do for all my patients. See “A Whole Person therapies but also direct, clear, and precise in her Approach to Lyme Disease” at right for the manner of sharing information, as well as general idea. her physical general and mental symptoms: Find the full article at: https://ndnr.com/autoimmuneallergy-medicine/lyme- she liked her salt, she did not care to be Expectations disease-a-whole-person-approach/ in the sunshine, and she preferred to be I asked Sarah to return in six weeks. What

HomeopathyCenter.org • Homeopathy !"#$% 27 Summer 2019 the -like feeling in her back. One of Natrum muriaticum, and she might week prior to this visit, she’d also had a have bounced back from the stress of the headache, much like the ones she used to hamstring injury on her own. Alternatively, get when she was in the thick of the Lyme because of her recent small setbacks, I disease. could have either given her another dose Mentally, however, she felt very well, of Natrum muriaticum in the same potency

PHOTO COURTESY OF LAUREN ALI PHOTOGRAPHY with improved academic performance at as before or given her a dose of that rem- school. (She was attending a local com- edy in a higher potency. I decided on the munity college because she was not well latter option, as Sarah was just about to Natural enough to go away to school—a big disap- embark on a big change, and although she pointment for her.) was greatly looking forward to going away PEST CONTROL Also, she had not had any sore throats to school, I knew it could be a great stress Guinea fowl are an effective and natural over the past five weeks—a major change to her system overall. So, she could likely solution to yard and garden pest control. from the months of painful swallowing use the extra support of a dose of Natrum Wild guineas eat mainly insects, but she’d endured. muriaticum in a higher potency. domestic guineas can consume large This was an excellent initial report, I asked Sarah to call me if any of her amounts of insects without affecting considering that Sarah had felt poorly for symptoms returned or if she got any sort of garden vegetables or flowers. Guineas can more than three years prior to coming to acute illness that did not resolve on its own be used to control ticks and insects such as see us. She had responded well to the within two to three days. She is not out of grasshoppers, flies, and crickets. Guineas homeopathic remedy and supportive natu- the woods entirely yet, but she is well on can reduce keepers’ risk of Lyme disease ropathic treatment, with improved her way. Homeopathy has a beautiful way by consuming deer ticks, which carry the disease. Guinea fowl also eat slugs, and and focus for four weeks and no joint or of gently going where other medicines flocks have been known to attack snakes. throat pain. Her energy had recently taken cannot and turning around a longstanding a dip, however, and she’d had a bad head- problem, such as Sarah’s struggle with the -Homeopathy Today staff ache along with some back pain; this indi- long-term effects of Lyme disease. cated that her response to the remedy was probably declining, so I gave her another Tailored to fit dose of Natrum muriaticum. Do I think Paul would’ve found the same remedy for Sarah? Probably. Would Sarah would I like to see in those six weeks? A bright future for Sarah have been as open and comfortable with I would like to see Sarah’s energy level I spoke with Sarah by phone three months him as with me? Probably not. Do I think he improve, perhaps to where she did not later when she shared that she had felt would have enjoyed this straight-shooting, need naps anymore. I’m not against the wonderful, until about ten days before confident young woman as much as I did? idea of napping or siestas. But in her case, this call. (This was the same pattern as Probably! Regardless, I enjoy the possibil- it interfered with her life. Napping was last time—I began to feel that I should set ity of tailoring the physician, a bit, to the not a choice, she had to lie down! I would the follow-up appointment for about two patient at hand; sometimes, it is essential. like to see her joint pains and numbness years away!) She was playing sports again For instance, I will almost always send my decrease or go away altogether. And, because her platelet count had returned to emotionally “closed” adolescent boys to lastly, I would like to see her sore throats the mid-normal range, and her energy was Paul, and he likewise sends his “closed” abate. good! But, she had had a hamstring injury adolescent girls to me. Sometimes, it’s I spoke with Sarah about these expec- playing soccer. Since the injury, she felt the just a feeling, but it is those kinesthetic tations. I find it a good habit to make a fatigue creeping back in, nowhere near experiences of our patients that lead us to list of those things I would like to see a as bad as it was, but she worried about it ask pertinent questions—and it’s there that remedy address at the end of my charting returning. many a clue to the correct homeopathic and o#entimes to share that with patients. Sarah had not had any problems with prescription is found. Then, we are on the same page during the headache, nausea, dizziness, sore throat, follow-up visit and have reasonable expec- or her memory. The numbness in her ABOUT THE AUTHOR tations of the action of the remedy. hands and feet was also gone, and her digestion remained good. Her overall feel- Amy Rothenberg, ND, practices On the upswing in Northampton, Massachusetts, ing of well-being was excellent, and she where she spearheaded the Upon her return five weeks later, Sarah was excitedly preparing to begin her next effort to license naturopathic reported: “I felt great, it was like I was nor- physicians (NDs) in the state. semester of college away. She is a founder and principal mal again. I had tremendous energy, and At this point, because she was doing teacher for the New England I had no joint pain at all a#er the first three School of Homeopathy: www. so well overall, I could have “watched nesh.com. You can find her days. And then last week, I started feeling and waited,” giving her no further doses writing on The Huffington Post, worse again.” Her main complaint now was Elephant Journal, Thrive Global, and Medium.

28 Homeopathy !"#$% • HomeopathyCenter.org Summer 2019