Resolution to interesting case for solving. (case 109)

Today, I am going to let another practitioner tell of her analysis of the case. I have not shared ANY of the working out that I did, and as such, what you read is her methodology of what is important to her. She was NOT aware of the remedy I gave.

Discussion board for this case. Please apply to join. http://ihmforums.boards.net/thread/11/case-109

The case:

Presented with Neck and back problems. turning head sideways was very painful, back was tense down to lower back , shoulder pain down to both Scapulae. Manipulation gave relief for a few weeks but is a recurrent theme. Gets headache traveling up neck to temples when severe. History: Patient had hysterectomy age 28. (Fibroids and intense pain.) Urinates a lot and takes medication to control the urging. Has been taking hormones since hysterectomy. Pretty even disposition, get irritable only when in pain or if hormones run out.Other symptoms, Patient cannot help but to fall asleep within minutes if traveling in a vehicle. One other thing I noted is that patient does not perspire much even in intense heat.That is the case. It was a difficult one. The first medicine I gave did not work. See which are prescribing symptoms, and which are confirmatory, and which are not symptoms of the case at all.

Case Analysis:

Vera Resnick Homoeopath. I.H.M. D.hom.MED

Using the OpenRep SYNOPSIS Computer Program and the P&W Therapeutic Pocket Book 2015 Edition

This was the way I saw this case and how I worked with it using IHM methods.

1. I looked at the main certain presenting symptoms. Neck and back problems, aggravated by turning sideways, with headache involvement. Although frequent urination was not part of the main current complaint, it was clearly presenting so I included that. I also initially decided to take mind irritation. My first repertorisation looked like this:

2. Something bothered me about Belladonna being first, although at this stage all the others seemed like possible contenders. I looked for more head-turning rubrics, since the aggravation was specifically about turning the head, not the body. I added a larger rubric: Aggravation… head turning (rubric no.2483) to broaden the scope, while keeping the sideways rubric as perhaps more faithful to the reported symptom.

3. I looked further at Belladonna’s “sideways” issues and saw they included looking sideways – vision issues. Although Belladonna did not “sit right” for this case for me, I have seen in the past that it’s easy to rule something out through prior prejudice, so I just put it on one side and didn’t rule it out yet.

4. All this time I had noticed Kali-C creeping up in the repertorisation, but it did not cover the disposition to irritability. I decided to take out the irritability since I didn’t know if it was a current symptom. I knew that whenever I took something out of the repertorisation, I was not invalidating the symptom itself, merely not using it as a prescribing symptom for repertorisation. I knew that I would want to see irritability in the materia medica when checking the final group of remedies.

5. I was not sure about the falling asleep in the car, whether to see it as an aggravation or amelioration…and could not ask the patient. I’ve known many a sleepless adult or a peevish child who have really enjoyed a good nap while travelling – as long as they weren’t at the wheel I couldn’t automatically see it as an aggravation without asking further. I didn’t include it as a prescribing symptom.

6. I decided to add a rubric which, while not exact, would present something of the lack of perspiration during heat, as it was a constant symptom peculiar to this patient. I added Fever, Perspiration, Lack of (rubric no. 2085). My repertorisation now looked like this, and contained two rubrics reflecting the turning aggravation.:

7. At this point I started playing with the leading remedies in the reversed materia medica, putting in the travel issue, perspiration and anything else I could think of.   When I use the software I use the reversed materia medica for all ideas and directions I don’t want to repertorise as I feel they will throw me off track (I may also use one or two desktops for that purpose, keeping them separate from the more “serious” and focused repertorisation). I play with elements of the case through the reversed materia medica, and like to use the visual colour elements to show where there is a preponderance of rubrics in one or other remedy for a symptom I’m playing with.

8. I saw that Kali-C was looking good by this stage. On checking the proving of Kali-C I saw many of the issues reported in the case.

9. I did not include the hysterectomy or uterine fibroids in my repertorisation as they were not current and presenting. However, the hormonal issues were very much part of her present picture, so as with the irritability, I knew I would want to see a hormonal bent in the remedy of choice. I also took into account that if this was an actual case I was working on, it would probably be necessary at some stage to go deeper into the hormonal picture and the impact of the medicines the patient was taking.

Conclusion: Although I felt my case analysis was not perfect, and I was unsure whether to give preference to turning sideways (which pointed clearly to Kali-C) or turning the head (which opened up the field to many other remedies), based on my knowledge of Kali-C and confirmed by reading the proving, I felt confident in the choice of this remedy, and that is what I would have given this patient.

Interestingly, when I came to prepare this write-up, I looked at the case again, and repertorised before opening up my case notes. I took the two strongest presenting issues: the acute modality of turning sideways, and the frequent urination. This is the repertorisation:

 

Which confirms a central maxim of IHM teaching: Take what is absolutely certain and presenting when choosing prescribing symptoms. This together with Boenninghausen’s description of the TPB as a guide to the materia medica, since it was the materia medica reading which gave certainty to a choice of Kali-C in this case.

************************************************************************

I.H.M, G.W Postscript:

This is a full symptom analysis that I did, showing that KEY symptoms in a case, be it for prescribing or confirmatory. I personally had prescribed Sepia prior to giving Kali Carb. It worked for a week then stopped completely.

The Kali Carb cleared up 80% of the problems in two months….. the hormonal issues will have to be addressed and a reduction of the hormones inaugerated to get further prescribing symptoms.

 

 

 

 

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5 responses to “Resolution to interesting case for solving. (case 109)

  1. Its wonderful to see the system work! Thank you for writing these up so clearly, I learn something every time. More cases please!

  2. I’ll race you to the top of the hill! another thought, when the sepia stopped working, what was it that brought you to kali-c? also, what about a book of 100 or so cases, you could sell them at your seminars? I guess the coffee kicked in 🙂

    • The Sepia was given solely on the symptoms I arrived at regarding the menstruals or lack of… I did not consider the FULLNESS of the case on the first consultation. I “assumed” it was all hormonally triggered, and that assumption made for a wrong prescription at the time.
      The Kali Carb prescription was based TOTALLY on a proper non judgemental analysis after I slapped myself straight. Remember that a ‘paper case’ is a distilled version of what a practitioner wades through and I try and help by eliminating a lot of the superfluous symptoms in presenting the case.

  3. great! congrats.

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