Wrestling the Rooster

“I used to be strong, I wrestled the bull”, Sumner Ball said, “but now I can’t even wrestle the rooster”.

On the far side of eighty years old, he looked lively and trim, and his weathered face hinted at a smile as his blue eyes peered straight into mine.

“I think these cholesterol pills are hurting my muscles”, he declared. “I don’t think they’re good for me”.

“Is it your back?”

I scanned through his last few visits and saw he had mentioned some low back pain while gardening this summer.

“No, Dr. Tom took care of my back”, Sumner said, referring to our local chiropractor. “My arms and my legs hurt, even my shoulders hurt.”

Years ago, Sumner had developed polymyalgia rheumatica, and it took almost two years to get him through it with the help of gradually decreasing steroid doses.

“Let me get a blood test, and why don’t you stop the cholesterol pills for a while and see how you feel”, I offered. We agreed to have a follow-up visit in a few weeks.

Three weeks later, Sumner Ball was a changed man. His faint smile was now a big grin.

“I knew that medicine was not good for me. I feel better now, not so many muscle aches. And I stopped the other one too. It was making me dizzy.”

“What about the blood thinner?” I asked.

“No, that one I take. I know it can keep me from having a stroke. But I know my body, and I know what my body needs, just like when I had goats and horses – they knew what to eat and not to eat.”

“My goats don’t always know the difference”, I said. Sumner grinned as he continued, “and we didn’t have the vet come out all the time. We treated them with herbs, good feed and common sense.”

His blood pressure was still OK, but his pulse rate was just under 100, a little high for someone with atrial fibrillation.

“Your diltiazem was keeping your heart from going too fast”, I reminded him.

“I feel good now. I like to stay this way. Do you think I am making a mistake?” His penetrating, small blue eyes told me he didn’t want me to disagree with him.

“Your heart could start racing”, I warned him. “Let me see you in a few weeks to make sure you’re not going into heart failure.”

Two weeks later, Sumner had gained five pounds. His legs were swollen, he was short winded and his irregular pulse was 130.

“Your heart is missing the diltiazem”, I said.

“I can’t take it”, Sumner answered. I knew he had already tried a beta blocker a few years ago, and his pulse had dropped to 40 on the lowest dose.

“How about trying something natural?”

His eyebrows rose. I continued: “There is an old herbal remedy, made from foxglove, called digitalis. It may slow your heart down enough to get you out of trouble.”

A week later, Sumner looked like he’d take on something much bigger than the rooster again. His pulse was 80 and his weight was back to its baseline. Leaning back in his chair, he said:

“The third day I took your medicine, I could feel my heart slow down. I knew that herb medicine would be good. You do all right by me.”

“I figured something more natural might work for you”, I answered. “Besides, it was the only other thing I could think of.”

“I like you. You have common sense”, he said as he offered me his large hand.

It was the firm handshake of a man who had worked hard all his life.

4 Responses to “Wrestling the Rooster”

  1. 2 Catherine Oliver January 27, 2014 at 2:27 am

    What a great story. We must always treat our patients as individuals.

  2. 3 jane January 30, 2014 at 8:39 pm

    When my husband had atrial flutter, he was loaded down with carvedilol to the point where he could hardly stand yet remained at a high rate; his -ologist was about to push on him yet another dose doubling (when he was already, I later learned, at the maximum dose listed in the European AF guidelines). His primary care physician gave him a tiny dose of digoxin – I presume you’re actually pitching a single-compound pill as “herbal” given the greater safety of exact dosing in that case – and wham, in a week his rate was down around 70.

    The “experts” we saw insisted that digoxin doesn’t work for rate control, but in fact, this claim seems to be derived from a study that reported that people who took beta blocker with or without digoxin were slightly more likely to achieve the demanding rate control goal than people who took only digoxin – a deliberate skewing of the results. The two types of drug are actually effective in equal numbers of people. The digoxin also countered the toxicity of his then-high dose of beta blocker so that he could rise from his couch without stopping to sway for a couple of minutes.

    By the way, when my husband suffered a recurrence of chronic flutter and we were stymied in getting him a cardioversion, we got him acupuncture instead, using points that were effective against atrial fibrillation in two studies, and he converted right after the second session. He’s been going every two weeks since and remains in sinus rhythm; he says it also helps his sinuses.

    Now, if you don’t mind a wee bit of criticism, why on earth would you put an octogenarian on a statin in the first place?

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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.



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