Path to healing in the journey of a 35-year rheumatology patient
Mrs. Jayasree at 35, she faced a harrowing challenge: excruciating pain in her right knee and elbow. Within days, the agony spread throughout her body, compelling her to seek help. The journey began at a local hospital, but her condition deteriorated, leading her to Manipal Hospital in Bangalore. There, Dr. Dharmanavel, a rheumatologist, diagnosed her with SLE after a positive anti-DS DNA test. Her ordeal intensified with pulmonary consolidation in her right lung. Over the years, she sought treatment at various renowned hospitals, including St. Johns Hospital and the Hyderabad Rheumatology Centre under Dr. Raj Kiran, battling relentless pain and suffering.
Her medical history was a testament to her resilience. She had survived typhoid as a teenager and battled viral fever during her college years. At 22, she faced mild pulmonary tuberculosis, treated diligently at SV University Hospital. Typhoid struck again at 25, necessitating treatment at Dinesh Nursing Home. More recently, she endured severe proximal muscle pain and swelling, requiring methotrexate injections. For over a decade, stress and overthinking plagued her, and sleep disturbances became a nightly struggle. Despite these challenges, she remained hopeful, seeking solace in every treatment and never giving up on her quest for relief.
| S.No | Present medication | Medication (After treatment) | Mechanism of the drug |
| 1 | Prednisolone- 2.5 mg (1-0-0) | TAPERED | It binds to the glucocorticoid receptor inhibiting proinflammatory signals and promoting anti-inflammatory signals. |
| 2 | Calcium carbonate – 1250 mg Elemental calcium- 500 mg Vitamin D3 – 2000 IU Methylcobalamine -1500 mg L- Methylfolate calcium- 1 mg Pyridoxal-5- phosphate – 20mg (0-1-0) | TAPERED | Supplements |
| 3 | Ferrous fumarate- 152 mg Folic acid – 1500 mg (1-0-0) | TAPERED | Ferrous fumarate elevates serum iron, aiding hemoglobin production. Folic acid supports red blood cell formation. |
| 4 | Hydroxychloroquinine sulphate- 200 mg (0-0-1) | 0-0-1 | Inhibits protein synthesis is susceptible organisms by inhibiting DNA & RNA polymerase. |
| 5 | Methotextrate- 10 mg (0-1-0) | Weekly once 0-1/2-0 | It promotes adenosine release and inhibits transmethylation reactions which reduces inflammation, alleviates pain, and slows disease progression |
MEDICATION TITRATION
Due to incorporating naturopathy and yoga into her treatment plan, the patient’s medication regimen has been tapered. Prednisolone is reduced to 2.5 mg daily. She continues with Calcium carbonate , Elemental calcium , Vitamin D3 , Methylcobalamine , L-Methylfolate calcium , and Pyridoxal-5-phosphate once daily. Ferrous fumarate and Folic acid are also tapered. Hydroxychloroquine sulfate remains at 200 mg nightly. Methotrexate is reduced to a weekly dose of 10 mg after lunch. This integrative approach aims to enhance overall wellness and reduce medication dependence.
| S.No | PARAMETER | Day 1 | Day 20 |
| 1 | HS CRP | 4 | 2.1 |
| 2 | TRIGLYCERIDES | 166 | 91 |
| 3 | HDL | 37 | 45 |
| 4 | FERRITIN | 231 | 191.7 |
| 5 | VITAMIN D | 41.48 | 92.86 |
TREATMENT FORECAST
Embracing naturopathy and yoga has led to remarkable health transformations in just 20 days. HS-CRP decreased from 4 to 2.1, indicating reduced systemic inflammation. Triglycerides dropped from 166 to 91, reducing the risk of cardiovascular disease. HDL increased from 37 to 45, enhancing heart health. Ferritin levels decreased from 231 to 191.7, suggesting reduced iron overload.Vitamin D levels surged from 41.48 to 92.86, supporting bone health, immune function, and overall well-being.