Salina’s bright smile

Friday, September 4th, 2009

Salina walked into my office that afternoon with a bright smile. Her dark hair was stylishly done. My attention was drawn to large dark eyes and that magnetic smile. It was a few seconds more until I realized this lovely lady was very heavy for someone of her height and youth.

I examined her intake form. It was not surprising that the chief complaint was type 2 diabetes. It was shocking that her lab profiles indicated to her physicians that there was significant renal distress and in fact very low kidney function. She had been counseled that dialysis was a probable and rapidly approaching need.

Coming from a Mediterranean background her parents always emphasized food. Obesity was a problem even as a child. Having such a zest for her food had made dietary control of blood sugar very difficult. The lack of symptomatology allowed a kind of denial to go on. This was all changing. It was disheartening that the usual courses of meds and insulin were not helping the new symptoms or the renal function.

Exertion was becoming difficult. Salina knew herself as a vigorous young lady. As of late there was a shortness of breath with mild exertion. When sleeping she needed several pillows to ease her breathing.

Many nights there was significant perspiration of the chest, mostly between the breasts. Sleep itself was not satisfying. It had become very light. She would wake from slight noises in the house. Waking at 3am was characteristic.

It was noteworthy that Salina until recently was generally a warm blooded person. That is she was less comfortable in the heat or in, say, a warmer room. This had changed in an interesting way. Certainly she now enjoyed the warmth more and the sun but now if she was still for too long (sitting) she would become decidedly cold. This was improved by getting up and moving around.

There was a past history of headache. They could become so severe as to cause faintness.

More recently several skin issues have become prominent. Small round ulcers have appeared around the ankles and are slow to heal. The foot is developing more callous. Thick horny kinds of callous formation. There are skin eruptions, eczematous in appearance. They get irritated and aggravated by contact with perspiration.

It was alarming for her that recently her ankles and feet have become numb.

Low back pain has been a steady companion that very much limits her. The lumbar pain is worse after standing, even a short time and lifting aggravates as well. In the upper limbs there is cramping(occasional)of the fingers.

Consistently she has a chronic cough which is definitely worse while eating.

Certainly all this is a far cry from being asymptomatic. The timeline of onset of these complaints turned out to be quite coincident with a family dispute. The patient is very close with her family however recently a quarrel has put her on the outside of things. There is a strong feeling of separation from her previously close family. There is constant dwelling of the events which re enliven the feelings both of anger, indignation and desire for re union. For me what was most clear was the constancy of the mind dwelling on these issues and the sense of now being separated from the family.

In case analysis we are told by Hahnemann to select those symptoms from the list which are most characterizing in order to obtain several remedies to consider as a prescription. Further examination of the symptoms and provings will lead to a unique selection. Normally I collect symptoms (computer clipboard) in the order of their being rendered in the case. I then play (in different clipboards) with selecting a small characterizing genius until I am satisfied. Various combinations of symptoms are given a trial until something strikes me as being very resonant with this individual case.

Now is this case there 26 symptoms collected initially. My final group of genius symptoms were;

1.Lower back pain(lumbar) worse on standing.

2.Cough,worse during eating.

3.Skin eruptions parts perspiring.

4.Generalities worse 3 am

5.Dwells on past disagreeable experiences.

Four remedies emerged strongly.Rhus tox,Sepia,Sulphur and Thuja. It struck me that the repertorization was not satisfying. How do I account for the feeling cold at rest-I found the rubrics chill; motion ameliorates and chill; sitting aggravates. That’s more like it.One remedy emerges. Interestingly enough it is also in the rubric estranged from her family.

I gave Sepia 6c one pellet three times daily. It was about one month later on her return that she was not only asymptomatic but her Kidneys were much happier and really no one was talking about dialysis. Thank you Hahnemann.