Elise is 60 years old

Monday, September 24th, 2012

Elise is 60 years old.As she sits in the chair opposite me I get the sense that she is tensed and anxious. This lady has carefull put down a buttock support in the chair and is struggling to find just the right angle for sitting in it.

According to the intake form she is complaining of chronic muscle pain and anxiety. She is currently taking Lorazepam and Cymbalta. There is a history of recent hip fracture and repair. Her first menses were at 15 years of age.

Her chief complaint comes from her”sit bones”. There is pain from just under the sit bones. It is worse sitting and can extend to the low back. This began in ther summer of 2010. The pain is worse going up and down stairs. It also gets worse from stooping.

Just as an interesting aside Elise mentions that she did notice that when she allowed herself to just cry the tears afforded some good relief. However since her diagnosis with depression and subsequent medication the tears have dried up so this outlet is no longer the case.

There is as well soreness in both shoulder joints extending into the pectoral area just under the clavicles and then to the upper arms. These pains are of more recent onset and are since the hip fracture where she had to “hoist herself around”.

By 430 pm every day the pain becomes intense and Elise must go lie down. By then there are tears. It necessitates Lorazepam.

The lower back hurts from having to stoop. The shoulders hurt from lifting. “I live with the pain all day. It becomes overwhelming. When I go into the kitchen and think about preparing a meal-it just takes over.”

The next complaint is hot flushes. “If I get a hot flush I get an electric charge-as if an electric current were running through my body.” It starts at the feet and ascends.

Further questioning yielded a history of emotional distress related to her work environment. Elise felt socially isolated there. There was conflict with a fellow employee. Just knowing there was conflict in the room and the proximity was too much. Soon she was ready for a change and left. The anxiety takes its origin here.

Radiologic report of the cervical spince reports a disc osseous bulge at C4-5 causing a mild central stenosis and foraminal narrowing.

The most striking and peculiar symptom in the case is clearly the amelioration of pain by weeping. The rest of the case does show extensive support for Pulsatilla as a remedy.

Pulsatilla 6 was prescribed every third day. The reason being my concern for the patient’s emotional state.

I just finished the first follow up(it is true this is only a presumptive improvement). Elise reports the walking and sitting are much improved. There is less tightness in the hips.

Elise went for a walk in the forest this past weekend. She dare not even attempt this before. 6 months ago she tried and just at the outset of that venture she needed to turn back due to a sensation of coldness in the hips and tight soreness in the upper thighs which reduced mobility. These sensations were much improved.(Pulsatilla is not noted for coldness in the hip joints and if we continue to get reliable improvement in that symptom I need to consider adding it to the repertory.)

I question Elise regarding the absence of her buttock support. She said she has not needed it since shortly after last being here even for the hard seats in her vehicle.

“Yesterday I noticed for the first time that if I remain busy around that 430 time and if I do not need to prepare a meal I feel that there is no need for the usual Lorazepam.”(Is this an improvement in mood due to the Puls which is indeed worse at 5 pm or an insight from observation and experimentation in life-either way an improvement).

The hot flushes are less and do not have that electrical charge.

She sat for a moment after reflecting and then exclaimed “yesterday I did not need to be around people to feel ok-I always need to be around people –that is very different.”

To me it seems I have some reason to feel happy with the prescription even at this early 2 week mark.

What has happened in this process?

I have relied on a law of nature-“Similia similibus curanter”. On the previous observations of Hahnemann regarding his instructions in Aphorism 153 where he tells us to pay attention especially to the most characteristic and peculiar elements in the case-in this individual case of disease.

I have relied on the reproducibility of proving and repeated clinical observations of Hahnemann’s provers and Hering in his Guiding Symptoms.

All this is reflected in my explanations above and in the repertory chart.

Science is all about observation experiment reproducibility and vulnerability to falsification.

Each careful Homeopathic prescription carried out with the precision of the Organon’s methodology adhered to is as scientific as it gets.

We have a crisis in modern Naturopathy-an identity crisis. We really want to be Medical doctors.

Some Naturopaths advertise themselves to be “evidence based”. Their god is the “protocol”.

If what we want is to centralize our practice in “green allopathy” we will deservedly disappear as a profession.

Where is wholism and individualizing treatment and where is the responsibillity of our schools to this creed?