Presentation/History:
A 45-year old female presented with a diagnosis of ACNES (Abdominal Cutaneous Nerve Entrapment Syndrome) in her left abdominal wall. She was also diagnosed with fibromyalgia and restless leg syndrome for years that was controlled by Amitriptyline 50mg and Temazepam 10mg. Additionally, she was diagnosed with IBS and colitis which was treated by taking Imodium every day. During the consult the patient admitted to drinking diet soda drinks and eating other sugar-free foods. This patient was referred to me by her pain management doctor that had successfully completed the SHAPE Program. His theory was that if his patient lost weight there would be less pressure on the abdominal wall and cutaneous nerves, thus decreasing pain.
Description Symptomatology:
Patient reported severe left abdominal pain 8/10 on a daily basis that was controlled by ice packs and monthly steroid injections. She also complained of muscle aches, joint pain, and loose bowels every day which made her nervous to leave the house for any long periods of time. She also could not fall asleep at night without Amitriptyline and Temazepam.
Clinical Assessment:
Although the patient had a formal diagnosis, I couldn’t help but think there had to be some food sensitivities, leaky gut syndrome, and mineral deficiencies. Additionally, I believed that removing all inflammatory foods would decrease the overall inflammation and agreed with her pain doctor that less pressure (weight) on the nerves would indeed help decrease her pain.
Method of Treatment:
Since the patient had a history of consuming fake sugar and had positive bilirubin on her intial UA, I decided to put her on the 7-day Orthomolecular detox as an added liver cleanse before starting the program. The patient was then put on the SHAPE protocol without being allowed to have the dairy protein options or the gluten cracker options. To begin healing the gut, I put her on one scoop of Orthomolecular Inflammacore with 8 oz of unsweetened almond milk, probiotics, and Candacid Forte for yeast killing. I also added 600mg of Mag/Glycinate at bedtime to help with the RLS symptoms. As always, I always put every patient on a multi-vitamin and fish oil.
Results:
After two weeks she had lost 15 lbs and her ACNES symptoms had decreased dramatically. After one month she felt comfortable enough to try going a day without Imodium and it was a success. It has now been two months and the patient has lost 26 lbs and her ACNES pain is a 0/10. She has continued to be gluten-free, however has added back the cottage cheese option with no issues. She mentioned, “Yogurt does not agree with me.” She states her fibromyalgia symptoms only flare occasionally. Her colitis/IBS symptoms are 100% improved and she no longer takes Imodium. She states her RLS symptoms have dramatically improved, however she still needs to take the amitriptyline and temazepam to sleep at night. She has cheated twice in the past month, which has resulted in a return of all symptoms for a day or so. It is important to note the patient has had no injections since starting the SHAPE Program!
I think before becoming a SHAPE practitioner I would have been chasing my tail as to what to start treating first. I love using the SHAPE Program as a forefront of treatment to decrease overall inflammation and change the patient’s lifestyle. I feel like it is then that you can really dive in and start peeling back the layers of the onion. This patient indeed did have some food sensitivities and leaky gut issues. Her reactions were much delayed (72 hrs) and if her diet was anything other than the SHAPE Nutrition Protocol on all the other days, I believe it would have been difficult to pinpoint the issue. I also believe the amitriptyline and temazepam is still a need more because it has become habit-forming and not as much for the RLS symptoms.
Submitted by Dr. Sheena Joseph
Dr. Todd’s Teaching Assessment
I’m always impressed with practitioners who use additional resources to heal the patient beyond the SHAPE Program. It is very important to try to treat all underlying issues. It was brilliant to do a liver detox program prior to starting the SHAPE Program. The treatment of the leaky gut (with Inflammacore) while doing the SHAPE Program had an obvious positive effect.
I’m impressed the patient was able to eliminate the need for steroid injections since starting the program.
I will forever be against artificial sweeteners. I feel they are a neurotoxin at the highest level and should never be consumed. Share the article Popular Artificial Sweeteners Are Not SHAPE-Approved with your patients!
