Pulmonary Embolism and Herbal Medicine

As she came out of the airport one evening, Nina felt a gradual difficulty in breathing. She put it to tiredness as she had just attended a series of meeting in the capital city. The next morning the breathing difficulty worsened and she developed pain in her legs. Highly alarmed, she contacted a doctor friend who promptly advised her to go to the Emergency Department.  The clinical signs pointed to pulmonary embolism and the magnetic resonance imaging (MRI) confirmed it by showing multiple small blood clots in Nina's lungs and she was urgently  treated with an anti-clotting agent.

                                               MRI Suite 

MRI- Monitoring and recording images

                            

It was not known what caused Nina's condition, in medical jargon called pulmonary embolism or blood clots in the lungs obstructing breathing. The condition could be fatal. The pain in the leg was due to clotting in the dependent blood vessels irritating the nerve supply.

This condition has been described in women who take oral contraceptives but Nina was not taking this as she did trust the hormonal method to prevent pregnancy. She was frightened of the risk of cancer and other related side-effects such as thromboembolism (blockage of blood vessels). She told me the doctors who attended to her were baffled as she appeared not to have any risk factor for the embolism (blockage of structures in the body). Could her air travel contribute to this?  The condition could arise from long-distant air travel with prolonged inactivity. I doubt that because the air travel time was short and she had been traveling, on and off,  for about 20 years with no problem before this.

She met me one day and I asked her about her contraceptive method. You see, Nina is an attractive mother of 42 and she has already given birth to five children and she was not keen on having more children at her age as she wanted to focus on her career. She did not fancy "western medicine" so she opted for herbal medicine which  purported to protect from pregnancy.  She had been taking this herbal concoction: one of the ingredients called "manjakani" as a contraceptive since the last birth of her child three years back. Well, well.... whatever was acting as a contraceptive in the herbal medicine she had been taking was likely to have a similar effect as the "western medicine" she was afraid of.

Other women could have taken this as well with no effect  ( or no report of their condition?) as they might not have an additional risk factor of frequent air travelling that Nina did.

My advice to Nina is to stop the herbal medication or if she still wants to take it, she has to be regularly seen by a doctor just as she would, had she been on regular oral contraceptive.

Many think that herbal medicine is safe, simply  because they are plant-based but plant steroid can be just as potent and sometimes the manufacturer add some other chemical ingredients but fail to disclose on the package. And as this kind of herbal concoction is marketed as "food", they are not covered under the Drugs' Act.

Nina was lucky  this time because hospital facilities were  rapidly accessible and the clots were not large but the next time may not be so.

SunRise... Thank you God for a new day!