A Stroke in Progress

This is one of the first patients I had about 15 years ago, just after I opened my clinic in New Zealand.  Male patient in his late sixties, came upon verbal referral by his GP, accompanied by his wife. As he walks in, he heavily slumps in his chair; his first sentence is “my head is filled with cement!”.  His speech is slow but not really slurred. He seems to need time to understand each question and he takes time to answer, searching for words. Everything is slow about this patient, his answers, his walking, his response to commands.

Not much of a history but for high blood pressure, under treatment but he had not checked it for a while, some minor chest pain and shortness of breath, which he and his wife put on the account of getting older.  Extremely poor westernised diet, full of breads, glutens, carbohydrates, with some good meat and vegetables (he is a farmer).  The actual complaint started a few days ago, progressively and slowly getting worse.

Physical examination does not show any cardiac or carotid murmurs. BP is higher than ideal at around 160/95 (if memory serves well), lungs are clear, nothing else.

I was at the same time furious at the GP and scared, as my diagnosis was a stroke in progress, meaning that slowly but surely his brains’ arteries were thrombosing. In my opinion, he belonged in the hospital and needed thrombolytic therapy. Despite explaining clearly what was happening and what could happen, he and his wife refused to go to the hospital, trusting their GP fully that I could help him….thank you for the vote of confidence, but I really did not need the stress!

The patient clearly repertorised as Plumbum metallicum, which was also obvious without a repertory. He needed it now, clearly no time to order anything from the pharmacy. I only had a few globules of Plumbum 6C, so I prepared a liquid solution in a test tube, told him to take one drop 3 times a day for the next 3 days and call me every day to let me know what was happening.

That was on a Thursday afternoon.

Friday, no call.

Saturday, no call.

I became frantic with worry and phoned him. Got an answering machine.

A few hours later, his wife calls me, profusely apologizing. Her husband had been too busy mowing the lawn and tending to the animals to call me back. He was back to his normal self after the second drop of Plumbum 6C….should he come back to see me?

He did come back. I put him on a human diet, not sure he is really respecting it and gave him Crataegus tincture to take daily.  A few weeks ago, his wife called again to say that he was doing well but he had been taking the Crataegus religiously for the last 15 years, should he continue?

All is well that ends well….If we neglect the possible legal ramifications of such cases should things turn sour, we should not be afraid of treating difficult and problematic cases