Case Studies

Case Studies

Case Study 1

A Girl Who Could Not Speak and Eat….


Dr HemantBhargav, Mr Manish Ranjan, Mr Kuntal Ghosh, Dr Amit Singh, Dr R Nagarathna
Department of Yoga and Psychiatry, Division of Yoga and Life Sciences, Arogyadhama, S-VYASA Yoga University
Ms Arati K, 15 year female, student of 9th standard, resident of Bidar, Karnataka came to Arogyadhama, PrashantiKuteeram, S-VYASA on 06-01- 2014 with her mother with chief complaints of:
H/o partial hanaging 9 months back, Inability to eat food since 9 months, Inability to speak since 9 months, Incresaed irritability, reduced attenstion span, weakness and easy fatiguability since 9 months.
Her mother reported that patient tried to commit suicide because of failure in the 9th standard examination when nobody was there at home. Patient was rushed to the nearby hospital where she was admitted in ICU for 4-5 days. After discharge, gradually patient became more and more inactive and sad, within a few days stopped eating food, stopped speaking, was not even able to swallow her saliva. Because of this started losing weight and became emaciated. All the investigations done by neurologist could not find out the problem and diagnosis of psychogenic dysphagia and dysphonia was made. Patient was put on a ryle’s tube (nasal feeding) and was on a semi liquid diet since then till the time of admission.
Considering the cause to be psychogenic and no effects of medications; the patient was referred by the neurologist (Dr Rajesh Iyer: Vikram Hospital, Bangalore) to the holistic health center – Arogyadhama for treatment. Consultation with the psychiatrist at Arogyadhama brought out the diagnosis of Depressive disorder. In the beginning one week patient was very weak and could not do yogasanas, she was given only pranayama and relaxation techniques, still nasal feeding was going on. During counselling, our psychologist observed an excessive anger outburst from the patient in response to the following words: “Home”, “Teacher”, “Mother”, “SChool” etc. After this, the focus of treatment shifted mainly towards more and more socialization of the patient. She received motherly care from the therapist and counsellor and the students in the S-VYASA University started speaking ad encouraging her. Within a week patient showed remarkable improvement in her speech, was able to communicate her needs, was able to chant mantra and repeat whatever others say. In the next week with continued counselling and added Ayurveda “Nasya” nasal oil instillation of “vatanashak’ tailam such as kshirbala 101 and head and body massage patient started eating food as well. At present, with the ryle’s tube removed a month back, patient looks cheerful. Has gained 3 kg weight, can speak without dribbling of saliva and can eat food with less difficulty. Still difficulty in swallowing is present but patient tries to swallow and food goes in when she tries to speak. Patient has spent 2 months so far in prashanti and overall condition has improved by 70-80%. When asked to her mother; “what do you think has helped your daughter the most.” The mother said, “It is the love and friendship of the people in PrashantiKuteer that has helped by daughter the most”.
Next plan is to arrange for clinical hypnotherapy session for her to understand the cause of her anger and deep rooted psychological conflicts. Now, our aim is to make her eat freely without any difficulty. And turn her into the same active, cheerful and dynamic girl once again as she was before.


Case Study 2

A Cancer Patient with Multiple Skeletal Metastases who continues to Survive and Improve…!


Dr Meghnath Verma, Dr Hemant Bhargav, Dr R Nagarathna
Arogyadhama, Division of Yoga and Life Sciences, S-VYASA University
Mr. M, 43 year old male, working as a professor presented with chief complaints of recurrent lower back pain since 2010. The pain was persistent and gradually kept increasing despite taking pain killers. He consulted an orthopaedic surgeon after 24 weeks of suffering from pain. Doctor advised him x- ray lumbar spine which showed nothing significant. He was prescribed physical exercises and lumbar belt. After taking the precautions and using the lumbar belt, pain did not subside and he could not concentrate on his regular work because of this pain. After 4 months, the situation became worse and pain became more intense. This time doctor prescribed MRI scan and a diagnosis of TB (tuberculosis) spine was made. He continued to take anti-TB medication prescribed by the doctor for one month, but there was no satisfactory improvement. He approached several doctors for a second opinion on this case.
Finally he approached NIMHANS in November 2012. There, he underwent CT guided biopsy of the spine that showed the lesion and the report revealed the shocking news of secondary metastatic carcinoma (metastatic squamous cell carcinoma- multiple enhancing lesions were seen over the lumbar spine and cauda equina).. This was revealed to the family members first and the patient was not aware of the same. He became frustrated and curious by the behaviour of the family members and wife. After one month, his wife shared the news with him. Realizing his responsibilities towards family, he decided to face the situation boldly with courage and patience.
In the meantime, from NIMHANS he was referred to Kidwai Memorial Institute of Oncology, Bangalore. There he underwent many investigations such as colonoscopy, endoscopy, bronchoscopy, ultra sound, and whole body CT scans. In spite of all possible investigations, doctors could not trace the primary source of the cancer and advised him for 6 cycles of chemotherapy. In November 2012, he underwent first round of 6 cycles of chemotherapy in Kidwai. Then, second round of chemotherapy in Shankara Hospital. After second cycle of chemotherapy on 11th February 2013, he was started on radiotherapy. In the same period first PET scan of spine was taken which showed 40% metastasis. The second report of PET scan was taken after the third cycle of chemotherapy was completed. This report showed a significant decline in the metastasis to 10%. The next PET scan was taken after the sixth cycle. This time the report actually showed an increase in the metastasis to 25%. By this time the patient lost his weight with poor appetite, developed severe constipation, hyperpigmentation of the skin all over and loss of hair after chemotherapy and felt terribly weak. He was told by the oncologist that he may not survive long (may be about 3-4 month) as the disease was not responding to the best of the available medicines and the disease was progressing rapidly. Hence, the patient decided to give up and resort to only self healing through yoga and alternative therapies which he was already doing during these therapies.
He knew about VYASAsince last 15 years.He was in touch with Dr. Nagarathna since last 4- 5 years and on her advice, he came to Prashanti Kutiram, Arogyadhama on 26 july 2013. Before coming to Prashanti, he was not able to walk without support, his muscles were wasted, skin and nails had blackish discolouration. He also had loss of hair, indigestion, knee pain and back pain. He was started with regular pranayama 3-4 times a day and Om meditation; his diet was changed to cleansing diet with fruit juices, wheat grass juice and daily enema. He gradually gained weight and started doing gentle asanas along with cyclic meditation (CM) and mind sound resonance technique (MSRT) regularly. He also started doing pranic energisation technique (PET) daily. Ayurvedic herbal preparations and anti-oxidants were also added to his routine: Aashwaganda (3 month daily after dinner), Wheat grass juice (for 3 months daily 7:20 am before breakfast), Gou mutra arka (Still taking daily 5:30 am), Ka-kambhi juice (for 3 months daily 10 pm), Silver biotics (for 2 months 5:30 am), Mixture of zeera (1/4) +pepper (1/4) + turmeric (2/4)+ honey ( 1 teaspoon) mix with 1 glass of water (Still taking 12 pm). He also took some Homeopathy medicine for 6 months after every 10 days interval 6 doses (May 2013-to October 2013).
At present, Mr M is surviving after 12 months of the declaration that he would survive only 3-4 months. He has improved muscle strength in his legs (can walk a few kilometers daily), hair have grown back, skin texture is normal, there is no pain in leg and spine, his bowel functions are normal, his Hb levels have improved (from 7 to 12 gm%) and he has gained 8-10 kg weight. Only problem he has is intermittent mild pain in spine which comes and goes. Recent MRI scan also showed that lesions in the spine have not progressed further. He is now working as a full time faculty in the dept of yoga and spirituality. Just completed the vidwat examination with good performance.
When asked about what helped him the most, Mr M replied that first thing is his perseverance in practice (3 hours of yoga daily in spite of his teaching work and earnings for the family); secondly, the faith he has on the ancient wisdom of our Nation and last but not the least: his indomitable will to serve the nation as a value based educator!


Case Study 3

Dr Kashinath Metri*, Mr Bikas Purohit, Dr Hemant Bhargav, Dr R Nagaratna
*kgmetri@gmail.com
Arogyadhama, Prashanti Kutiram, S-VYASA, University, Bangalore
A 57 year old housewife from Chennai, born and brought up in middle class family came to our Arogyadhama Prashanti Kutiram. She was complaining of breathlessness on exertion, orthopnea (breathlessness even on lying down), cough since 2-3 months and bilateral pedal edema since two years. Her sleep was disturbed because she could not sleep in supine posture. She was also having mild back pain. She was a known case of CKD, congestive cardiac failure, since one and half years. Hypertension was detected 1 ½ years back. Her previous investigations done on 16/12/2013 showed left ventricular ejection fraction of 39%, Hb 7.4mg% , Sr.Creatinine 6.2mg/dl and Ultra sound scanning of abdomen showed bilateral pleural effusion. She was on medication since 1 ½ years.

Table 1:

List of IAYT practices given

  • Sukshma vyayama
  • Breathing practices
  • Pranayama: Nadishudhi, Bhramari etc.
  • Om meditation
  • Deep relaxation technique (DRT)
  • Quick Relaxation techniques (QRT)
  • Sleep special techniques: after dinner 15 minutes walk, 27 rounds of Nadishudhi pranyama, 10 rounds of Bhramari and DRT practice on bed.
  • Diet: Renal diet (low in protein and low potassium diet more fresh fruits and vegetables )

After one week

Patient’s breathlessness reduced and she could sleep in the night without breathing problem, her sleep quality improved, pedal edema came down, blood pressure came down; she lost 2 kgs of weight and felt light and relaxed Sr. Creatinine level decreased from 5.7 mg/dl to 5.2mg/dl.

At the end of two weeks

There was a further improvement in her symptoms. There was clinically significant decrease in pedal edema, sleep quality and breathlessness reduced. There was significant change in all parameter

Table 2:

showing the changes in objective parameters after two weeks of IAYT.

Parameters Before yoga

[11/04/14]

After yoga
[02/05/14]
1 RR 38 22
BP 150/100 114/82
2 Pulse Rate 98 70
3 Weight 64.24 56.64
4 Symptoms score 8 2
5 Sr. Creatinine 5.7 4.5
6 Hb % 9.8 11.2
7 Urine albumin +++ ++

Conclusion

CKD is becoming a common a health problem these days especially due to large number of diabetics in India. Unfortunately, modern medical system has no permanent solution for this condition. This has increased awareness of other alternative therapies like yoga, ayurveda, naturopathy etc. IAYT (Integrated Approach of Yoga Therapy) is a holistic approach to treat the ailments. Where the all aspects of human existence like physical body, vital force, psychological conflicts and notional errors are considered and managed. This helps in removing the disease at its root. This case study has brought a new hope for the patients suffering from CKD. This case study finds preventive and therapeutic role of lifestyle modification through yoga way of life in chronic kidney disease.