Case Study #2 - MCTD


This is the second in a series of case study reports that share the experiences my clients have had while working with me. These case studies are designed to give you a little perspective on the types of people I see and what outcomes they experience. Each case study in this series starts with a description of the person’s condition and any relevant details they brought with them to their Health Assessment call. Next is a summary of key items on their Healing Strategy that brought them the most relief – and how long it took to get that relief. Each case study closes with a summary of the outcome and how their lifestyle updates have worked to continue their healthy, energetic life. I’ve changed any personally identifiable information to protect my clients’ privacy and security.

Sarah is a 35 year old mom who was diagnosed by a physician this year with Mixed Connective Tissue Disorder (MCTD). Her primary symptoms are joint pain, mostly in her hips and knees, but also her hands and feet. Her hands and feet would swell up so that she had difficulty using them and wearing shoes. She was also struggling with fatigue that kept her from being active with her family. At this point, Sarah has not received any other autoimmune diagnoses besides MCTD.

During Sarah’s Health Assessment call, we discussed her health history and lifestyle. Sarah started having symptoms about two years ago. First it was swelling in her hands and feet. Her doctor prescribed diuretics, thinking she was having some bloating related to her periods. Her blood pressure was normal, perhaps a bit on the low side. The diuretics didn’t help with the swelling, but did make her feel lightheaded and uncomfortable. Next, Sarah tried lymphatic massage, thinking maybe she needed to have some external support to get the swelling down. While the massage was helpful, it ultimately didn't get her the reduction she hoped for. As Sarah was working through these symptoms, she noticed that her hips and shoulders were hurting a lot more than usual, and she was feeling more tired than normal. Her doctor did several tests that were inconclusive. Finally, her doctor did an ANA screen that indicated she might be having an autoimmune response. Further testing identified MCTD. Since her diagnosis, Sarah has been taking steroids for her pain, and while it relieves the pain, the weight gain was undesirable.

Sarah told me that she’s been trying to eat a clean diet as much as possible. She cooks at home as much as she’s able, which is 4-5 times a week. Her partner helps out some nights as well. When she cooks, she uses fresh, organic food when it is available. Her family is a big fan of pasta, and they have it at least twice a week. It’s easy to cook, satisfies everyone, and often has enough leftovers for a second meal. Sarah used to exercise regularly, but her pain and fatigue have made exercise too challenging. She wants to save her energy and good movement hours to be able to spend time with her family.

As with all my clients, I suggested first that Sarah begin using her Health Tracking Log to keep records of her activity – her diet, exercise, symptom severity, and sleep. This will help us identify any patterns that might be causing pain, swelling, or more fatigue. I also suggested that Sarah begin to add a few minutes of movement each day. Walking seemed like too much to her, so I suggested a few stretches before getting out of bed and just before she goes to sleep. Gentle stretching keeps the muscles elongated and helps to move the lymphatic fluid around so it doesn’t accumulate. Plus, the gentle nature of the stretches wasn’t enough to create a problem for her energy level.

I applauded Sarah for her efforts to eat organic and home-cooked as much as she does. It’s unusual in our busy culture for a family to cook at home as much as hers does. That’s a great starting point for making adjustments to find food intolerances. I know Sarah’s family enjoys pasta and it’s a great meal that she feels that she can do for them without too much trouble. I didn’t want to make that a no-no for her, so I suggested she skip the cheese and do her best to avoid dairy for three weeks. Sarah felt that was a do-able suggestion. She could still make the foods her family enjoyed, but could just avoid cheese on her own plate.

I gave Sarah a list of some foods that are nourishing and supportive for her digestion, and suggested a few ways she can adjust her eating schedule to make sure she’s getting all the nutrients she can out of her food. As we were talking about food, Sarah told me that she’s always feeling like her hands and feet are cold. This is not an uncommon symptom in MCTD and can indicate Raynaud’s phenomenon. So, I created a warming herbal tea for her and suggested a warming salve she can use to feel more comfortable.

After three weeks without dairy and accommodating her new eating schedule, Sarah said she was having less pain. Her tracking log indicated her pain had reduced from a level 7 to a level 5, which was encouraging. Sarah felt like she wanted to try and do something else with her diet, and I suggested she look at either gluten or nightshades (tomatoes, potatoes, eggplant, and peppers) as a potential to eliminate. Those would be a lot tougher for her, especially with the pasta her family eats. I suggested she consider using a spiral vegetable slicer and create ‘zoodles’ or use spaghetti squash instead of the wheat pasta. (Being gluten-free myself, I find that ‘gluten free’ noodles just don’t cut it.) She can still use the same sauce her family eats, and the ‘zoodles’ cook quickly at the same time as the pasta. Spaghetti squash bakes nicely, so it could also be made with minimal effort. Sarah felt she could give it a try for another 3 weeks.

At our follow up appointment in 3 weeks, we reviewed Sarah’s tracking log and saw that her pain was down to a level 2 or 3, depending on the day, and she was feeling more energetic. She was sleeping better as well. I encouraged Sarah to talk with her physician about possibly reducing her steroids to see how she was feeling without them. I assured her that as she continued to avoid foods that were problematic for her, she’d feel better and better.

Sarah and I continue to work together and are currently focused on building her nutrient stores with foods that are rich in the nutrients she’s needing most.

Does this case sound like you? Do you see some similarities to what is happening in your life? I’d love to talk with you and see what we might be able to do to improve your health and find your way back to doing the things that are more important to you. Send me a note and let me know what’s going on for you, and we’ll take it from there.

This case study is intended to demonstrate the types of recommendations I make when working with a client and show the potential results. Every case is different, and results are not guaranteed. While these case studies are helpful and educational, they’re not medical advice and not a substitute for the guidance of a licensed medical professional.