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#naturalmedicine

To Be [sick] Or Not To Be [sick] — That Is The Question

Pandora's Lost Gift@metametheus (66)2715d

I present this with the explicit purpose of generating a philosophical discussion. I am setting a bounty on this post (see below), and only truly thoughtful and engaging comments will be rewarded.


The following are two real-life cases of patients of mine when I was a professional health practitioner.

Both women described themselves as sufferers of Rheumatoid Arthritis (RA), and had been receiving Chinese Medicine (TCM) treatment for the condition, as well as mainstream Western Medicine (WM).

Sarah — 60yo female

Sarah is a chronic sufferer from RA. She has recently begun a treatment of Actemra , a new drug which is very difficult to get, requiring a rigorous series of attempted treatments before being accepted on the program. This is a drug which costs the Australian taxpayer $30,000 per year, the program lasting indefinitely. 
After 3 treatments, the markers in her blood have gone from an "incredibly high level to almost non-existent”. Her specialist Rheumatologist is very pleased, as is she. This drug is considered a breakthrough in the treatment of RA. 
I ask her how she feels. She says there is still some stiffness in her hands, which is causing her a little pain, but she attributes that to the new air-conditioned office she is working in, at a desk working at a computer. However, after a few months this increased, although the blood tests continue to show all markers as being at relatively normal levels.

Mary — 90yo female

Mary has suffered from arthritis "all her life" (her words). She began seeing an experienced TCM practitioner a little over ten years ago. She claims, albeit her age, that her arthritis has never been better. She claims to have suffered from extreme pain, swelling, and stiffness considerably when she was younger, but the TCM management has been working incredibly well. She has continued to use the same mainstream WM , the only thing different now is the Acupuncture sessions fortnightly, and daily Chinese herbal medicine.

She has reduced swelling, reversal of the rheumatic nodules on her fingers, less pain, and less stiffness. Pathology tests however show no change in the levels of the markers in her blood.

What is Rheumatoid Arthritis (RA)?

RA is defined as autoimmune disease that causes chronic inflammation of the joints. Typical presentation is pain, stiffness, and swelling of the joints.

Blood tests can also reveal the presence of Rheumatoid Factor (RF) antibodies, ANA antibodies, and higher levels of blood sedimentation rates and and C-Reactive protein. These are not unique to RA, and can also be found in other auto-immune disorders.

The question

Given this definition, who is suffering from arthritis?

On one hand, there is clear objective, quantitative data to show that Sarah doesn't have arthritis; but she still experiences pain, stiffness, and swelling.

On the other hand, we have a woman using natural medicine to reduce and manage pain, stiffness, and swelling, and yet her blood tests reveal the continued presence of the factors which led to her initial diagnosis in the first place.

Sarah truly believes her RA is being managed, even though she still experiences the symptoms; Mary believes her condition is managed because she doesn't experience the symptoms even though according to the medical diagnosis she still suffers from the condition.

My intention is not to suggest one treatment method over another; but to ask the question raised: which of these two have RA?

What, to you, does “sick” mean?

The TCM paradigm does not concern itself with 'diseases'; instead, practitioners seek to determine a “pattern of disharmony” from the signs and symptoms that a patient presents with clinically.

While in WM illness is defined nowadays by the values found in pathology tests (objective data), in TCM the patient’s experience of symptoms (subjective) matters more.

To be eligible for a share of the bounty set on this post, please address the following questions for discussion:

  • Which of these two patients has RA?
  • When you imagine your health own complaint, how do you characterise it, how do you represent it?
  • When you are sick, do you believe you have an illness, or merely suffering from a number of symptoms?

Image courtesy of Kira auf de Heide at Unsplash

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Comments · 17

  • @redheadpei(72)· 2708d

    I believe they both have arthritis . The 90 yr. old is using mind over matter and helping keep it under control. Jesus or another great philosopher said.” Physican heal thou self.” I like to use as much mind control as I can to keep healthy but when illness strikes I wonder about food I have eaten and contact with others that carry flu germs.

  • @shari-loveurlife(50)· 2709d

    Thank you @metametheus for creating a post that really makes you contemplate about your perspective, in this case what sickness/illness means to you and how you would characterize it.

    For question #1: Which of the patients has RA? Response: They both do. I know I'm not picking one or the other, but I believe that they both do have the medical condition of Rheumatoid Arthritis. Each patient is different and unique especially in the treatment of their medical ailment. One is being treated with WM and the other is using a combination of WM and TCM. Even with the advancements in medicine through science there is still a lot we don't know. I think that a combination of quantitative and qualitative factors should be considered in the diagnosis of a patient. Both had initially shown the same observable symptoms through subjective and objective observations (stiffness and pain). I would ask was their any deformities in either patient's hands? As well as were there any imaging test done to see the physical change in bone structure or etc. I know that imaging test are not necessarily a definite tool in the prognosis of the medical condition, but it can help with the monitoring of the progression of the condition over time.

    Question #2: When you imagine your own health complaint, how do you characterize it, how do you represent it? Response: When I see my primary care physician (PCP) I tell her about the symptoms I was feeling. For instance most recently, about a 2 weeks ago, I saw my doctor and I told her this is exactly "For the past couple of days I have been experiencing body-aches, fever on and off for a couple of days, feeling very lethargic...super tired, coughing, my throat is sore, I'm producing dark yellow-brown mucus, chills, head & chest congestion, and I have a headache. I've been taking Tylenol for the fevers and OTC DayQuil syrup for the cough and sore throat." I try to be as descriptive to my physician as much as possible when I present to her "how I'm feeling".

    Question #3: When you are sick, do you believe you have an illness, or merely suffering from a number of symptoms? Response: I think it's a combination of the both. For instance, if I have the flu then unfortunately I will be suffering from the symptoms that are associated from that illness. Symptoms are merely a physical expression of how your body is coping or trying to deal with the foreign organism or virus within yourself. Like a fever, it occurs because your body is trying to kill the viruses or bacteria that are sensitive to high temperatures.

    Just to put it out there, I'm not a medical professional like a physician, PA, ARNP, EMT, or etc. These are just my personal opinions based on my experience in the medical field as an Administrator in a private medical practice and assisting the doctor when needed over the past decade.

    Thanks again @metametheus for the great post :)

    Source Link to Heart & Stethoscope Photo

  • @akomoajong(66)· 2710d

    Which of these two patients has RA

    I think that both of them still have RA. It might be in different forms and it is difficult to say that RA was completely eliminated from their bodies or can be eliminate at all.

    When you imagine your health own complaint, how do you characterise it, how do you represent it?

    When doing a health complain, I only talk about what I feel and not what others think or suggest or have experienced

    When you are sick, do you believe you have an illness, or merely suffering from a number of symptoms?

    To me an illness is just fever and headache. Any other thing, I take it to be a symptom.

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  • @rmsbodybuilding(68)· 2711d

    I have never been sick in 8 years

  • @improv(73)· 2711d

    Which of these two patients has RA? Maybe both and maybe neither. It's worth noting that, when I got Lyme disease and did research into it, I discovered that chronic Lyme, along with many other diseases, present symptoms so similar to RA, that they are often misdiagnosed as RA.

    • When you imagine your health own complaint, how do you characterise it, how do you represent it? I don't understand this question. Could you rephrase it?
    • When you are sick, do you believe you have an illness, or merely suffering from a number of symptoms? Um, I guess it depends on what's useful. When, for example, I had the symptoms of Lyme disease, and was able to show the bullseye rash to doctors and say, "I think I have Lyme disease" that was useful, because catching Lyme early with antibiotics is the best way to prevent chronic Lyme. But when my back hurt, it wasn't useful to the physical therapist to figure out what had first caused the pain. We couldn't pinpoint it for sure anyways. Better to treat the symptoms so that I could get better. Of course if we later find out there's something deeper wrong, I'll wish we had identified the illness, but that seems unlikely.

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  • @chupapic(41)· 2711d

    Im someware in the middle but they are winning but I still think we haave some time left if you like abstract art check me out @chupapic hope you like my art I followed and upvoted yeeah great posts keep up the good work

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  • @discernente(77)· 2714d

    I think that a medicine that pretends to be scientific cannot rely solely on subjective experience of symptoms. I needs to have a more consistent basis for its conclusions.

  • @discernente(77)· 2714d

    I think that a medicine that pretends to be scientific cannot rely solely on subjective experience of symptoms. I needs to have a more consistent basis for its conclusions.

  • @chireerocks(75)· 2715d

    @metametheus, I think in perspective of Spirituality. Some people take the help of Advanced Treatment and some take Natural Treatment and in my opinion in both of the cases sickness stays as cured and uncured. No matter where we take the treatment, can we see someone's faith, belief, focus and thoughtful energy helps to come out of sickness works with the combination of treatment? In my opinion there are lots of UNKNOWN aspects behind the healing of Human Beings. Stay blessed.

  • @helpiecake(55)· 2715d

    Hello!

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  • @porters(73)· 2715d

    I feel that Sarah still has RA for she is still dis -at -ease. To me it is unimportant if you have the markers or not if you have a complaint you can label it with the name of a disease (or have a diagnosis) It's funny but sometimes when you get a diagnoses it can make things worse for all the concepts you have about that disease will come rushing in. Personally I don't really want to know if I have some disease but I do like to have some remedies to ease my suffering. Love this idea to post for creating discussion!

  • @steemitboard(66)· 2715d

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  • @artemislives(74)· 2715d

    I believe neither suffers from RA actually. They are like sets and subsets we learned about in Grade 3 math. An overlapping set of symptoms from two differing circles is labelled as RA. At a given point in time, they both APPEAR to have the same condition.

    Personally I try NOT to attrubute a name to a set of symptoms, nor to ever use the word "my" in relation to them. I view them as transient, passing symptoms to be managed, while the health and physical integrity of the WHOLE BEING are regained.

    I choose to consider myself temporarily out of balance, rather than owning or claiming any pre-packaged set of symptoms.

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  • @hockney(62)· 2715d

    From your description, Sarah has been diagnosed as suffering from RA, while Mary 'claims' to have it. So I'd say the former has RA, while the latter might have RA. The symptoms of stiffness, swelling etc. can just be down to age. I don't think I have arthritis, but I feel stiff in the joints at the age of 51. Lifestyle is a factor as well.

    For myself, I've been prescribed asthma medicine as I used to suffer from shrtness of breath and do suffer allergies - cats and grass, mainly. The inhalers have made a difference, but so did banning the cat from the bedroom. I don't consider myself to have asthma, just suffer from asthmatic symptoms occasionally.

    People experience symptoms, but they can often be psychological. Doesn't diminish the effect, but there have been countless studies over the years where a placebo has an effect. I can see acupuncture having an effect on the symptoms described - after all arthritis impacts the nerves to create pain, while acupuncture is also triggering nerve reactions, so there may well be some intermingling of reaction. Chinese traditional medicine is certainly closer to the scientific method than homeopathy (let's water down medicine until it's undetectable and let the placebo effect kick in) and the doctrine of signatures (a rhino tusk looks vaguely penis-shaped, so it MUST be an aphrodisiac), so I think it's a viable route to take. BUT, double-blind testing, etc. is a known way of assessing the efficacy of treatment. Check the studies and check the rigour of the studies...

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  • @partiko-promoter(46)· 2715d

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