Table 1.
Timeline of the case
| Date (mo/d/y) | Status | Conventional therapy | Alternative therapy |
|---|---|---|---|
| 2004 | Patient experiences insidious onset of shortness of breath | Weekly acupuncture initiated targeting spleen dampness | |
| Mid-2005 | Patient’s shortness of breath well controlled | ||
| 4/30/2007 | Thoracic CT scan: Pattern consistent with usual interstitial pneumonia; obese BMI; peripheral oxygen saturation stable at rest, decompensated with movement | Flow rate of 4 L/min supplemental oxygen used for ambulation | |
| 5/31/2007 | Results of autoimmune, electrolytes, kidney function tests, and echocardiogram within normal limits; pulmonary function test results: Severe restrictive lung disease and decrease in diffusing capacity without obstruction | ||
| 9/6/2007 | Biopsy specimen of right lung confirms idiopathic pulmonary fibrosis with usual interstitial pneumonitis histology pattern | N-acetylcysteine, 600 mg/d; prednisone taper, 20 mg every 2 wks from 60 mg/d to 20 mg/d; azathioprine, 150 mg/d | |
| 4/2/2010 | FVC and DLCO show moderate improvement since diagnosis; CXR shows moderate progression of fibrosis since 2007; psychiatric breakdown with multiple suicide attempts; massive weight loss during hospitalization | Removed from lung transplant list because of psychiatric concerns; weaned off prednisone therapy | |
| 9/10/2012 | CXR scarring and pleural thickening unchanged since 2010; moderate decrease in DLCO and FVC; patient declined to be on lung transplant list | Discontinued azathioprine regimen | Acupuncture treatment focus shifted from spleen dampness to lung qi deficiency |
| 7/31/2014 | URI causes tachypnea and hypoxemia; patient experiences decompensation at rest, a steady increase in symptoms, and a decline in pulmonary function; weight loss | Supplemental oxygen initiated at rest; oxygen flow rate increased for activity | |
| 3/24/2016 | Patient initiated naturopathic herbal treatment targeting DHEA secretion | Tincture targeting adrenal function: Equal parts Panax ginseng, Rhodiola rosea, Schisandra, Epimedium, Dioscorea villosa, and Glycyrrhiza glabra: 15 drops in water 3× daily | |
| 9/5/2017 | Increased dyspnea at rest | Oxygen increased to 8 L/min at rest and 15 L/min ambulatory | |
| 2/27/2018 | Patient found deceased at home |
BMI = body mass index; CT = computed tomography; CXR = chest radiograph; DHEA = dehydroepiandrosterone; DLCO = diffusing capacity of the lungs for carbon monoxide; FVC = functional volume capacity; URI = urinary tract infection.