Wednesday, October 8th, 2008

One of the more frequent problems seen in general practice, this syndrome is characterized by weakness, pain and stiffness together with highly tender localized points in the upper limbs, trapezius and dorsal areas.

Having been in practice as a Chiropractor since 1981 and a Naturopath since 1984, I believe I have taken the case of hundreds of such sufferers. The fatigue and pain will become the focus of their lives. Perhaps the most debilitating part of this disease is the deficiency of validation it creates. The name doesn’t strike fear nor generally arouse sympathy until one becomes intimately familiar with the devastating results. I have seen (when the label wasn’t as high profile) lost careers and marriages simply because one could not proudly display an insurance acceptable diagnosis. Without this social stamp they simply did not have the right to be unproductive and unreliable and so were without benefits and without compassion. Amazing how lack of validation rises to become the chief complaint.

On the flip side, since its meteoric rise to public prominence coupled with the continued lack of useful knowledge, Fibromyalgia is a huge market. ‘New’ miracle products and treatments are exploding in number. Googling gives us a quick 6 million hits. Many experts, many theories, personal stories of triumph but no reliable result.

I know how negative my tone is. Yes, this focused activity and higher profile are more likely to become productive of some useable result. I should be viewing this as the beginning of a conscious evolution toward answers and not just focusing on the bottom feeding marketers that proliferate.

These are just the ramblings of an aging Naturopath who is bitter because so few are looking to the true gems already available to us.

Homeopathy and dietary management offer some amazing results to those practitioners willing to take a careful case, diligently investigate the literature and not give up sculpting the case because their first few prescriptions are incorrect.

Practitioners suffer a common fear. “I need to get a result quickly or the patient will leave.” This nonsense is often the drive behind prescribing a botanical, nutraceutical buffet and then of course dessert is the “all natural pain killer and sedative”. This is not Naturopathic medicine. It is substituted allopathy. It rarely works well.

When that first attempt at homeopathy fails, the beads of sweat on the back of the neck rise and this fear takes over. OK, one more try. It fails and out comes the combination remedy followed quickly by the usual cook book protocols. Then the patient leaves because he sees the doctor dangling on the end of his own rope.

In real life, understanding a person takes a life time. Even great psychologists will take months to come to a deep comprehension of a patients’ problem.

Homeopathy is no less demanding. It is our task to sculpt out a reliable case. First the disease - do we have the description exact? Do we clearly understand the modalities of the problem and have them prioritized, ie which are most determinative? The patient’s general case - is she very chilly or just mildly so? Are there any contradictions or contrasts to the thermal modality? For example some remedies are chilly but worse in a warm room and need cool air to sleep well (Lyc). Some are chilly but crave cold drinks which aggravate(Sil).How sensitive is the patient to the sun or the least draft?What about position or movement and the exact response to these?

We need to carefully listen to the patient, often over several sessions to be certain of characteristics like these. Once acquired, symptoms need to be verified through questioning.

For homeopathic purposes remember that we want the state described as it is, especially when the suffering is at its worst. Then the features will be clear.

The case will have some kind of form. There is a beginning (etiology), a rise (onset) and a pace for chronic diseases. Seeing this form will often help identify the remedy.

The point here is that building the case is like constructing a house. First we gather all our materials (symptoms, characteristics) and then we build carefully, watching to see if it follows the plan (materia medica). Unlike a house we wait for the materials to be given (case taking) or dig them up (questioning) like an archaeologist. Like the archaeologist, we need to be patient and dust off each symptom carefully.

Over the years I have found it necessary to take the position that the initial exam is not over until a good solid case is evident. This may take many sessions, occasionally years. Normally I prescribe as soon as I have some sufficient evidence for a prescription -usually the first visit. Hahnemann tells us in the Organon that if a case is not clear, prescribing the most indicated remedy will at least increase the clarity to the observing physician. Holding this course will yield unparalleled results.