AKOM News
Contributed by Dr. Jewon Lee, Director of BM Korean Internal Medicine Clinic
: Peering into Internal Medicine, 21st
2025. 6. 18.
"The fracture isn't healing, and my father's kidney numbers also got worse."
An 80-year-old patient with a 7-year history of stroke was in trouble.
Five months after surgery for a femur fracture, he was told the bone was not healing but was absorbing.
To make matters worse, his kidney function (Creatinine) declined. His blood pressure medication was changed, and he subsequently developed severe leg swelling (edema).
Diffusion-weighted image (DWI) showing findings of an acute infarction in the left anteromedial medulla
Magnetic Resonance Angiography (MRA) confirming stenosis in the left vertebral artery and both internal carotid arteries
A Physician's Duty: Mastering All Tools
"A physician's duty is to be willing to master and use any tool... for the life and health of the patient".
In our Korean Medicine internal medicine clinic, we meticulously review all medical records, imaging, and prescription histories.
- Cause of Kidney Decline: Reviewing his chart, we found that 2 months after his fracture, his statin (Atorvastatin) dose was doubled and Ezetimibe was added. After that point, his Creatinine and CPK (muscle enzyme) levels began to rise.
- Cause of Edema: The newly prescribed blood pressure drug, Carvedilol, was the likely culprit for the swelling.
Diagnostic images of a left intertrochanteric femur fracture and post-operative images after percutaneous extramedullary reduction and intramedullary (IM) nail fixation
Carotid ultrasound examination observing moderate stenosis (60–69%) in the left proximal internal carotid artery and mild stenosis in the right
An Integrative Solution: Treating the Cause
A physician's philosophy guides the use of all tools. We designed a treatment plan to address the root causes.
- Kidney/Muscle Issues and Fracture Recovery: We had the patient reduce the dose of Atorvastatin and Ezetimibe, which could affect kidney and muscle metabolism. Instead, a Hanyak (Korean herbal medicine) preparation including 'Danshen' (Salvia miltiorrhiza) and 'Sanqi-gen' (Panax notoginseng) was co-administered.
- Edema/BP Issue: We stopped the Carvedilol that was causing the edema. To manage his blood pressure, we used a Continuous Glucose Monitor (CGM). By improving his blood sugar variability, his blood pressure stabilized without the extra drug.
Continuous glucose monitoring (CGM) results confirming improved glycemic variability after treatment
The Result: Healing the Fracture and the Kidneys
- After 4 weeks: His Creatinine level, which had been 1.51 mg/dL, normalized to 1.08 mg/dL.
- Other inflammatory and muscle (CPK, hs-CRP) markers also improved.
- His blood pressure remained stable without Carvedilol, and the leg swelling rapidly resolved.
- After 7 months: The fracture that had failed to heal was completely recovered.
If Heo Jun (author of Donguibogam) were alive today, he would undoubtedly use CGM, blood tests, synthetic drugs, and Hanyak to save his patient.
This is the essence of internal medicine by Korean Medicine physicians.
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Peering into Internal Medicine<21> - AKOM News
“'The fracture isn't healing, and my kidney numbers also got worse'”
For the life and health of the patient, it is the physician's duty to be willing to master and use any tool.
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