Alternative medicine and EMS

[harold1981]

I am curious if any of you has had calls involving the side effects or complications of any sort of alternative therapy? To name a few: chiropractic, neural therapy, acupuncture, Ayurveda, naturopathic medicine, chinese medicine, orthomolecular medicine, self-treatment with food supplements, etc. etc.

I have two cases that I would like to share:

1. A man with severe flushing and itching over his whole body. He was literally red as a tomato, especially on his face and back, and he was experiencing nausea and diziness. His complaints started shortly after taking a food supplement, called Niacin (which is Vitamine B3), to self-treat an outbreak of Herpes labialis. We believed that he was having an allergic reaction to Niacin, and treated him with adrenaline and clemastine. Later we learned that the reaction is typical for Niacin, which causes vasodilatation. There was no allergic reaction and the condition is self-limiting and harmless.

2. A man was treated for chronic neuropathic pain in his leg, by a neural therapist, with an injection of procaine in his lumbar spine. On his way home he has a syncope in the car and at home be becomes worried about loss of sensation in both legs. After examening him thoroughly and reassuring him, he is able to stay home.

 

[Jason]

I have had little, true cases of "alternative therapy" cases which required 911 intervention. With that said, alternative therapy is definitely a type of "medication" that needs to be documented, as reactions can occur.
1) Niacin does have a common reaction causing redness and flushing. Enough so, that he should have known this if he is starting it.
2) Your neural therapy case is more interesting. The loss of sensation in his legs could be from the injection. Certainly doesn't happen to everyone getting a Lumbar injection, but enough that it should have been covered as a possible risk. The syncope on the other hand is concerning. Not knowing enough information about the time of the incident, it could be several possibilities. My top two reasons, right off hand, would be cardiac or neuro in nature. Not being there, hard to say.
Good luck in the future and keep in mind that alternative therapy should be documented and considered when assessing for problems.

 

[luke_31]

One thing I didn't see listed is workout supplements, some of those if not used properly can wreck havoc on the body. Being that my patient population is typically young, healthy adult males we have seen a fair amount with elevated blood pressures and high heart rates at rest. The only factor that we could find that could cause this was the use of supplements with working out to build muscle mass and for losing weight.

 

[wilderness911]

There are a number of well documented cases of death, paralysis, or permanent brain damage resulting from chiropractic cervical spine "adjustments". Never had such a patient personally, but I have dealt with so much quackery as a wilderness paramedic treating snakebite patients in Africa. Over 90% of my patients went to the witch doctor before coming to the hospital, and received a treatment involving dozens of incisions made with a non-sterile and rusty blade, followed by the topical application of mixture of dung and dirt to the wounds. Great idea, right? I ended up prescribing a ton of cloxacillin and ampicillin to treat the resulting infections.

On another note, if you want to have a good laugh look up the history of chiropractic get on the evidence-based medicine blog. It involves a magnetic healer, a patricide, and the first case of fraud ever prosecuted by the federal government if I remember correctly. You can't make this stuff up!

 

[jwk]

I am curious if any of you has had calls involving the side effects or complications of any sort of alternative therapy? To name a few: chiropractic, neural therapy, acupuncture, Ayurveda, naturopathic medicine, chinese medicine, orthomolecular medicine, self-treatment with food supplements, etc. etc.

I have two cases that I would like to share:

1. A man with severe flushing and itching over his whole body. He was literally red as a tomato, especially on his face and back, and he was experiencing nausea and diziness. His complaints started shortly after taking a food supplement, called Niacin (which is Vitamine B3), to self-treat an outbreak of Herpes labialis. We believed that he was having an allergic reaction to Niacin, and treated him with adrenaline and clemastine. Later we learned that the reaction is typical for Niacin, which causes vasodilatation. There was no allergic reaction and the condition is self-limiting and harmless.

2. A man was treated for chronic neuropathic pain in his leg, by a neural therapist, with an injection of procaine in his lumbar spine. On his way home he has a syncope in the car and at home be becomes worried about loss of sensation in both legs. After examening him thoroughly and reassuring him, he is able to stay home.

Niacin has legitimate use for lowering triglycerides/cholesterol. If you start out at low doses and slowly build up, the side effects usually aren't a problem. But if you start with a high dose, or even change brands in some cases, the itching SUCKS! (personal experience). It's the main reason people stop taking it.

Not sure WTH a "neural therapist" is - but it sounds like your patient essentially got administered a spinal, or more likely an epidural anesthetic. The syncope in the car could easily have been from the drop in blood pressure common with the sympathetic blockade from spinals or epidurals (when your patient is lying flat it's not as much a problem), and of course the loss in sensation in both legs would be from his neural blockade at whatever level this "neural therapist" injected him.

 

[Gurby]

One thing I didn't see listed is workout supplements, some of those if not used properly can wreck havoc on the body. Being that my patient population is typically young, healthy adult males we have seen a fair amount with elevated blood pressures and high heart rates at rest. The only factor that we could find that could cause this was the use of supplements with working out to build muscle mass and for losing weight.

I was taking creatine for a while, randomly decided to check my blood pressure and found it in the 140's?!?!?!! Normally between 110-120/80. Figured maybe I was stressed, ate a lot of salt, whatever. Checked pressure again over the next few days and was consistently high 130's. Discontinued creatine, back to normal blood pressure. Could definitely see people with underlying HTN to begin with having issues. Creatine is one of the most-studied supplements, widely regarded to be safe, and I still had this issue...