今年三月底四月初到台灣工研院演講時,一位在科技及金融業知名的好朋友要我替他媽媽的病情給些建議,這位好朋友對科技市場與國際經濟有非常深度的了解,許多「科技大老」都向他請益,當然,我也常常抓著他問問題。所以,在好友請託之下,即使我在台灣的行程很趕,還是空出了20分鐘,在下榻的旅館和朋友媽媽碰個面,了解一下她的健康問題。

04/03/2015 台北首次見面

朋友的媽媽,七八十歲了,非常虛弱、精神狀態不是特別好、水腫、間歇性的發燒、大小便不易控制。台灣知名的xx醫院看診,認為可能是肺炎,給予抗生素,病人情況沒有改進。我認為水腫問題得先解決,不然病情可能會很快惡化,因此建議朋友給他媽媽服用五苓散及桂枝湯為主的中藥方劑。

04/09/2015 越洋連絡

我已經回到加州,朋友Facebook Messenger告訴我,她媽媽整體表現進步、水腫大多都退了、大小便正常、精神也好很多了。xx醫院仍然不確定病人為什麼間歇性的發燒 ,決定等到病人痰培養的結果出來後再說。我把治療重點從治療水腫轉向間歇性發燒等問題。

開方:柴胡、黃芩、人參、半夏、炙甘草、生薑、紅棗。

04/15/2015 越洋連絡

朋友媽媽的情況改進,但是又出現一點點輕微的水腫。我建議病人回頭服用一開始五苓散及桂枝湯為主的中藥方劑,但是劑量減半,等幾天後水腫消失後,再來服用前方。

04/23/2015 越洋連絡

朋友再次經由Facebook Messenger連絡,經朋友同意,我直接把他中英文夾雜、口語化的來函貼出來,如此比較「傳神」:

“Andy, just want to tks u again. W/o ur first prescription, my mom’s 水腫 & 排便 cannot recover. Her fever frequency is also from daily to every other day, and now expand to every 4-5 days. She is taking the 2nd prescription and in a steady progress mode now. Given the 2nd dose will reach the end, does she need to take few more as her X-rate shows her pneumonia is still there? Also her 排便又沒原來的順暢 after switching to the 2nd prescription from the 1st one. Also she feels 很虛弱, what kind of 補品 u would suggest for her 補氣?

Btw, my mom said u r 年輕有為的神醫. Haha

She has few other symptoms too

1) She is still taking 抗生素 from (xx醫院) till this weekend, so when she no longer takes the first prescription. 水腫 and 排便不順 resume.

2) She cannot sleep well even after taking 安眠藥. I guess it could be one of the key reason why she feels very weak.

3)she also feels 胸悶 and 胃痛, not sure it is due to taking too much 西藥.”

“Her 胸悶, 胃痛, 失眠 are likely caused by strong 抗生素.”

“Tks again. I guess 水腫 is also b/c she is still taking 抗生素, but this time 水腫 is still lighter than the very beginning. 西藥的副作用真的很大.”

開方:柴胡、黃芩、半夏、炙甘草、生薑、紅棗、桂枝、白术、茯苓、豬苓、澤瀉、 麻子仁、黃耆、 黨參、巴戟天、陽起石 、杜仲、炒酸棗仁、 川芎、遠志。

05/08/2015 越洋連絡

“Tks for your prescription on my mom’s case. She got improved a lot.

1)自4/17至今沒有再發燒。This is the most significant progress I think


2)筋骨不再酸痛


3)手腳水腫已經消除


However, we have stopped ur prescription for a week as we were waiting to see the doctor for the result of CT 電腦斷層 came out yesterday. Now my mom still suffers from the following symptoms:

1)肺部X光顯示仍在發炎,有浸潤現象


2)喘氣很厲害,走ㄧ點就喘


3)手指及小腿仍會僵硬


4)小便頻繁,每次ㄧ點點。大便也是ㄧ點點(第一帖對於改善這點最有效)


5)身體仍是虛弱

西醫目前無法肯定是何種症狀,推斷可能是TB,非典型肺炎,或肺腫瘤。但TB的痰細菌已經培養了五個禮拜,超過八星期若還沒有培養出來,就可排除TB。非典型肺炎已經試過多種抗生素,改善有限。目前已做過CT電腦斷層,自體免疫血液及尿液測試,肺癌的機會也很低。所以西醫已經不再開藥。西醫建議處置如下:


1)若要知道病因,做胸腔外科的肺切片,比較可以知道原因


2)先使用類固醇,看看其反應,但會有一定的副作用


3)繼續等下去,等TB痰培養超過八星期,以及一個月後再做X光,看是否有改善


I must say I feel so 無力 from 西醫的建議。After taking more than 100 抗生素 and X rate exam every single week,they still cannot find the reasons with good solutions on it。”

05/10/2015 越洋連絡

“西醫給我們的三個options裡頭,my mom聽到肺切片就嚇壞了,因此暫時不打算做。因為目前尚不知道病因,所以my mom也不想立刻服用類固醇,以免沒治好副作用一堆。So she prefers to wait till TB 細菌痰陪養 result to come out in 3-4 weeks。She also wants to wait to take another X rate test in few weeks to see whether she can improve gradually。

Honestly I don’t think it is a good strategy and don’t believe the illness can be cured itself。就像昨天是Mother’s Day,my mom felt 酸痛 again,which is not a good signal。我們已經掛號一個月以後的胸腔科,as the treatment is pending now (has been pending for 2 weeks)。但醫生說中間如果情況有惡化,必須要隨時回診。I feel that 如果情況惡化again,可能西醫就更不知道如何處置。

我們可能會尋找是否(yy醫院)或(zz醫院),有更有名的教授級胸腔科醫師有在看診,但是由於my mom對於西醫已經有所疑慮,而且又害怕再來一系列的檢查及吃藥,會不斷地折騰以及產生吃藥的副作用,所以還在猶豫。So far my mom has not taken any western medicine for 2 weeks and ur prescriptions for 1 week. Since there will be no more tests and medicines from (xx醫院), we think 中醫 could be a good alternative.由於她對於你的藥(特別是第一帖藥)產生極大的信心,所以我們也想尋求中醫的藥方。

另外一個她現在比較持續的症狀是失眠。目前有看情形服用安眠藥,仍然睡不安穩,不知在中醫是否有類似幫助睡眠的處方?

So in conclusion, if u can, pls help to give me some advices on my mom’s following symptoms:

1)肺部X光顯示仍在發炎,有浸潤現象


2)喘氣很厲害,走ㄧ點就喘


3)手指及小腿仍會僵硬


4)小便頻繁,每次ㄧ點點。大便也是ㄧ點點(第一帖對於改善這點最有效)

5)偶而仍會筋骨痠痛

6)失眠


7)身體仍是虛弱”

開方:麻黃、白芍、 五味子、乾薑、灸甘草、半夏、桂枝、細辛、浮小麥、紅棗、炒酸棗仁、川芎、知母、茯苓、遠志。

06/17/2015 越洋連絡

“Would like to give u some update about my mom’s progress. After taking ur last prescription(12副), my mom has showed good improvement. She is no longer  喘氣,  feel 虛弱 and no more 大小便頻繁. In fact, she can take a walk in school 操場 everyday now.

Now she is still 1) 早上都會有一些白色的痰, 2)  手指及小腿仍會僵硬 or 抽筋, and  3)  偶而仍會失眠 which I think it may be due to 壓力 or 心理作用. 

Since her symptom now is minor, my question is whether she shall take more doses of your last prescription, or just leave as it is.  She will take the X-rate exam in 2 weeks in order to know whether her 肺炎 is totally cured. In past one month, she did not take any medicine but ur doses only. My mom said ur prescription is 完全對症下藥 and we would like to express our high appreciation to u.“

“Yes pls feel free to write the story and use my word of my mom’s case, which is another true evidence to prove Chinese medicine is better than the Western one. Tks again.“

這次我要朋友媽媽先停藥休息一兩週,看看她的身體可不可以自己調整,如果一兩週後那些小問題仍在,我再替她想辦法。有意思的是,現在中醫已經把病情治療的差不多了,xx醫院的醫生仍然還不知道病人生什麼病,更別說如何治療了。

後續:

06/28/2015 越洋連絡

My mom went to xx醫院 to take X-rate and see the doctor this morning. She was so nervous and cannot sleep last nite. The good news is the X-rate result shows her 肺炎 (or whatever it is) is totally cured. Her last X-rate was taken in early May and did not take any medicine from the doctor since then although the X-rate still showed her lung was infected. During this period, she only took ur last prescription. Although her symptom is getting minor after taking ur doses day after day, we cannot conclude she is totally recovered until today the X-rate result comes out. My mom and I want to take the opportunity to thank you again. U are the 神醫!

西醫診斷的「肺炎」好了,朋友媽媽仍有一些小問題,年紀大了,加上這幾年因為一些事情心情放不開,身體難免得多加關照,我會再想辦法遠距離幫忙,畢竟這年頭像這位朋友如此孝順的人已經很少了。至於「神醫」一詞,只是朋友的客氣話,沒有什麼所謂的「神醫」,所有好的醫療人員,都只是依照他們的知識盡力幫忙病人而已。然而,病人卻是醫生最好的老師,所以,我非常感謝病人及家屬對我的信任,讓我能從每一個病例上學習很多,對中醫經典智慧有更多的體會與了解!