Clinical Cases

A Case of Endometriosis

Kiran Shanbag
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Dr. Kiran Shanbhag presents a case of endometriosis in which a seemingly trivial symptom was the key to the case.

Mrs. D aged 29 years was diagnosed with endometriosis + sterility.  She had been               married for eight years.  She had taken Siphene, oestradiol, HCG, had surgery for endometriosis and adhesiolysis  1.5 years ago. She presented to me in July 2015.

Her husband’s sperm count was70.4 mill/cc.  She had severe dysmenorrhea, menses 25/6 days cycle. Pain in abdomen even without menses. Whole body muscular pain, low back pain, heaviness, giddiness, headache, weakness, lack of appetite, constant nausea , patchy darkness of face, nasolabial creases, overall allergic sensitivity of the skin (which considering all past the hormonal meds was not surprising).

She was a fashion designer by profession but now suffering from blocked creativity, slowness of thoughts, depression.  I have always seen her with an inverted smile, weeping during most of the narration.  She feels better in her parent’s house, as her husband is “aloof”, and always travelling. Her in laws displayed mild aggressive behaviour due to her “childlessness”, offering constant criticism.

I found her to be diligent, meticulous in narration, expansive and sad, as though woe had befallen her. Her major complaints were dyspareunia , hiccoughs after coition, teeth sensitivity to thermal changes, skin itching burning in sun, along with pigmentation problems.  Severe dysmenorrhea deep in pelvis, aggravation sitting, with fever, giddiness vomitting, LBA.  Weakness and trembling of legs.

Choking < from dry food and lump sensation in throat.  Bruxism at night,

Diarrhea, cold feet during menses, intolerance of tight clothes around

her chest, suffocation with giddiness > open air, chronic constipation> hot drinks.

Headache occipital< perspiration, as though water in the head<< tying any hair bands, constant discomfort Bil iliac fossae,  foot pain on first movement,

involuntary clenching of jaws.

Her mother underwent hysterectomy for DUB, fibroid. Father- IHD, Dyslipidaemia. No other major illness in family.

Patient dreams of ghosts, people turning into ghosts

Dreams of being locked in dark room.  The feel in the dream is as if frozen, cant move, with choking in throat.

I was left with a large number of symptoms ( for the sake of brevity I have listed only striking ones)  but not synthesizable into any portrait. These depressed patients give us wonderful mouthwatering rubrics, alas they cannot be found in any repertory nor do they converge into a simillimum.  Her complaint was that nobody understands her ( and neither did I ).

My first prescription (July 2015) was Nux V 1m 1 dose and placebo for a month    ( based on the extreme pain and to antidote effects of all hormones).

No change in any symptoms

Second prescription was Cimicifuga 10M

(early Sept 2015) hoping to give her some relief at least from pain, uterine and rheumatic, and also for her pessimist depressed affect. This prescription had no effect.

In October I sat again with her, determined to find some key at least. She exhibited the same clenched mandibles, unnerving inverted smile, weeping thru narration. After about 25 minutes of more grilling she mentioned she needed some help for her sensitive teeth. I asked her to describe that in detail. She said, she had this habit of clenching and biting her teeth during pains, be it dysmenorrhea, dyspareunia, muscle pain, headache, or even when she is in her regular mental blues. This constant friction might have led to erosion of enamel hence the sensitivity

Voila!! At least one key

I read Phytolacca in Boriecke MM

Aching soreness joints

Glandular inflammation (ovary)

Muscular Rheumatism

Acts on scar tissue ( endometriosis adhesions)

Melancholy

Predominantly “Desire to bite teeth together”

Throat narrow sensation

Stiff back

“Dysmenorrhea with sterility”

Feet soreness stepping

Lower lip drawn down, lips everted also mentioned,, explaining her inverted smile

Almost all her symptoms were covered by Phytolacca.

Rx:  Phytolacca 200C QID × 3 days and a month of placebo. She skipped her menses in Nov. and confirmed her pregnancy in Dec 2015. August 2016 she gave birth to a healthy baby girl.

She had called me about a cough during her pregnancy, but otherwise volunteered no complaints.The child is three months old and I haven’t seen the patient, as she lives three hours away.

This case taught me that trivial symptoms most evident from day one may get overlooked. We unconsciously look for remedies we had successfully prescribed in a given pathology. Phytolacca was never used in my 18yrs of practice for endometriosis, because it’s not mentioned under the clinical rubric.

About the author

Kiran Shanbag

Kiran Shanbag

Dr. Kiran Shanbhag received her BHMS from Government Homoeopathic Medical College, Bangalore, where she has been practicing for the last 18 yrs. She says that the journey has been very rewarding and she is deepening her understanding all the time. Her other interests include Indian philosophy and spirituality and equity markets as a mode of investment.

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