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Case Study

How much can I bear?
NATIONAL JOURNAL OF HOMOEOPATHY 2002 Nov / Dec VOL 4 NO 6.
Dr (Mrs) Aqsa Z Hansi
'Staph

Mrs KLB, 64, Hindu, vegetarian, uneducated housewife has 5 daughters and 1 son. All are married and settled in Warrangal. Patient is staying alone with husband (67), a Goldsmith in Bangalore since 1 year as climate suits her. Both brothers (whose?) aged 51 and 49 are in Warrangal.

Chief Complaints:

Location

Sensation

Modalities

Concomitants

Since July 2002
Pain in Rt Groin
à whole right leg

Severe shooting
Trembling pain
Heaviness
Stiffness

< AF sitting 12 hrs
car journey
< AF jerk
< getting up from sitting
< 1st motion after sitting
or standing
< Sour food
Climbing stairs
> hot fomentation/massage
> walk 2 to 3 steps slowly

Weakness
Swollen ankles
Stiffness

Since Feb 2001
Rt++ Knees
+ left

Pain gradually
Increasing
Swelling ++
Heat+ & red+

< 6-7 pm
< getting up
< movement
< extending leg

> pain killers
> calcium
> 3 physio
Osteoarthritis

Associated Complaints:

Fever since 4 months
Back
Since 7 months
Stomach
94-95
Bladder since 5,2001



Pain, stiffness
Gas formation
Heaviness, bloated
Control http://www.njhonline.com/images/square.gif
Strong smell 3

< pm as pain increases

< AF walk, weight gain
< spicy food, chana dal
< 2 hours after dinner
< food AM 1 in 3 hours



< AF allopathic med


HS 1½ hours

Patient as A Person:
Weight gain 5-6 kg in 1 year. Short, Fat,
Perspiration: 
Normal
Appetite: 
Normal.
Thirst:
 less.
Desires:
 spicy3 and sour3 and lemon.
Aversion:
 milk.
Stools: 
once a day satisfactory.
Micturition: 
increases with increased pain.
Dreams:
 FIL-MIL, Family HU anger,
Menstrual History:
 FMP 13 yrs. LMP 1980. Pt 52 Yrs.
Obs History:
 Tubectomy 1975. Deliveries: 5 FTND and 3 miscarriages.

Life Sequence:
1940 born in Warrangal, eldest of 3 and only daughter. Father was a Goldsmith, friendly, soft spoken with no anger. Mother friendly. Childhood very happy and pampered. Attached to the family, 1948: married at 8 years. Unhappy to leave the house but FIL insisted as not well. Husband was then 12 years of age. Strict, short tempered and dictatorial. Adjusted because of MIL. 1953 Daughter 1 born at age 13. Stayed for 1 year at parents house since did not want to go back. 1956 son born. Patient healthy. 1958 miscarriage in 3 months. Patient very depressed. 1959 FIL died, Husband became more aggressive and angry after he started running the business. 1960 two miscarriages, 1962 2nd daughter born; 1965 3rd, 1967 4th1969 5th ! 2 days after that the patient suddenly felt paralysed at hips and both legs, worse right and could not walk. Hospitalized with severe pain. Doctor said it was dislocation of pelvis due to injury during delivery. Took one month of allopathy and was fully recovered. 1974 miscarriage of 2 months and tubectomy. 1997 typhoid. Took allopathic for 1 month. 2001 Osteoarthritis of Knee July 2001 patient was travelling Bangalore http://www.njhonline.com/images/rtarrow.gif Warrangal when car broke down after a severe bump on the road. Got a jerk. Sat in car for 12 hours. Next day bed-ridden. Pain in the hips and legs. She is fully handicapped, can walk only with walker.

Investigations:
FBS 7/2/02 normal 24/4/01 MRI cervical-dorsal spine, cervical spondylosis, C5-C6, Thecal sac and transverse nerve root. 24/4/01 MRI Lumbosacral spine Lumbar spondylosis with central/lateral canal stenosis, L4 - L5/ L5-81, Focal PID impinge on the thecal sac and transverse nerve roots.

Mental Symptoms:
Mild, soft spoken, considerate, keeps problems to herself, reserved, likes company only of relatives, not complaining, suppressed anger for husband; no bitterness in words. Lately embarrassment and depression for her handicap and has lead to aversion to company; would rather be alone. ANXIETY health of Husband and Child. Fear of being alone, with brooding.

Physical Reaction: Bath, hot, cover- AV in pain climate > cool: Thermal C2H3

Past and Family History:
Typhoid, 3 miscarriages in 1st trimester of pregnancy, Tonsillectomy;
MO, MGF, MU -Arthritis

Remedy Selected:
Acute
Rhus-tox ConstitutionalStaph, Intercurrent: Thuj

Follow Up :

29/9/02 SLR Rt < 10 Lt. 40 BP 140/85, Temp 99.5 F

Rhus-tox 30 7P TID

7/10/02 >10% restlessness >pain x 1 hr after Rx, urine +
10% weakness SLR > 10, Rt. 40 Lt.

5PH 6x 2/7
200 7P TID
5PH 
6 x2/7

14/10/02
> 25% pain SLR rt. 20 lt 50
> 50% swelling, > weakness2+ >25% urine ½ hr, 1/3- 4 in day
28/10/02
Fever++ crying with pain, Trembling++
Since < 3 from Thuja therefore wait and watch
9/11/02


Thuj 200 [1]
Rhus-tox 200[6] TID



Placebo 200 [6] TID
Calc-phos 6X 2-2/7

> 40% pain, Gas++ Fever 2/15d SLR 40 Rt. 70 Lt
>80% weakness swelling 0
Urine 1/4 hrs. HS
1 /3 hrs day
10/11/02
Restless++, wants open air, shifted from bedroom to hall 
Want co++, calling relatives from Warrangal
> constitutional needed.
28/11/02
> 75% pain swelling & stiffness >80%
Pain upper back and knees+. looks Active
Fever 1/ 15 days and urine 1 HS
25/12/02 > pain 80% fever 1/21 days, urine normal,
Urgency is nil >3 soles, knee
SLR 70 rt 90 lt
17/01/03
> 80% in hips urine > 90% swelling 0 active
Happy, wants to work. Gas 0
Fever 0 SLR rt >70 lt, >80 total hip flexion
30/01/03
pain 0 trembling 0 patient walks without the walker
Very happy, anxious since walking again on her legs after 2 years

Rhus-tox 1 M[1]
Calc-phos 6X 2-2/7




Staph 200 [1]


Calc-phos 6X 2-2/7


OAN 200 [1] 
Calc-phos 6X 2-2/1 mth


Placebo 15 d
Calc-phos 6X 2-2/15 d


Placebo 15 d
Calc-phos 6X 2-2/15 d



Placebo 15 d
Calc-phos 6X 2-2/ 15 d