Case Management

So, as I said, to manage a case, you’re going to need a bottle of water.  Here’s a youtube video that demonstrates the whole thing: 

 Put a pellet of your remedy into the bottle of water, begin with five succussions before each dose, take a dose/sip twice a day of the water assuming you’re on a low potency in a chronic case, stop when you see a striking improvement or an aggravation. If the aggravation is very bothersome, zap it (see “The Aggravation Zapper” article) and you will undoubtedly observe an improvement soon after that.

When the improvement starts to wane, redose; BUT, since the last dose caused an aggravaton, dilute it in more water this time, don’t dose directly from the bottle, pour a capful into a large disposable cup of water, stir lightly with a straw, and take a small sip, wait, make sure you don’t aggravate again. The idea here is, through trial and error, to find a dosing schedule (frequency) and dosage size–amount of water– that, without aggravating, moves the case forward, always repeating as soon as you see the beginning of a relapse, so that you’re always coasting and not crashing again and again, always having to start over. Try to keep yourself from constantly bottoming out!

Changing the frequency of repetition, the amount of water, the number of succussions, going to the next potency when the one you’re on stops working, will keep the case moving– coasting. Remember, a striking improvement precludes any further dosing. If you’re improving dramatically and you’re still dosing, you’re going to crash! Remember, these remedies cause what they cure–they’re double-edged swords! If there’s nothing wrong with you, stop dosing!

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3. “I haven’t been in touch with you because I got worse, and then this happened and then that happened, and then the other thing happened….”

You must stay in touch with your practitioner! Don’t let things get complicated! If you let too much time go by, chances are you won’t even remember what went wrong and be able to present it in a step-by-step fashion.

4. “I checked the Materia Medica and Belladonna sounded like a really good remedy for me so I took that, but I’ve been taking the remedy you gave me too….”

Yikes!  You can only take one remedy at a time! Otherwise, we have no way of evaluating the results. In every experiment, there can only be one independent variable! If you think for some reason there’s a better remedy for you, tell your practitioner. She may be able to explain why Belladonna isn’t for all fevers. Very often, a patient will look up a remedy in the Materia Medica and make a list of all the common symptoms and say, “This is just like me! Belladonna has colds, I have a cold. Belladonna has fevers, I have a fever. Belladonna has sore throats, I have a sore throat!”  No!  This is not Belladonna!  Belladonna has a very specific KIND of a cold!  The cold comes on suddenly, there is a high fever with dry heat eminating from the body but hands and feet are cold.  These are the details that have to be matched to a remedy. 

5. “I redosed because I figured I was relapsing because I got a rash.”

Don’t redose because something superficial happens!  We expect things like this to happen. We expect discharges, aches, pains and skin eruptions after a remedy. What we’re concerned about after a remedy is something we call “The Center Of The Case”. The center of the case is your sleep, your energy, your disposition, your sense of well-being and relaxation, your outlook, your restfulness and your appetite.  After a remedy, we want to see an improvement here. Your actual complaint may get worse for a time!  But if it’s the right remedy, you won’t even care! You may even put it in exactly those words! “I still have a headache, but I don’t care!” “I didn’t get much sleep last night, but, oddly enough, I feel more rested than usual!”  Redose when you see a relapse in “the center of the case”.

6. “Hi Elaine, remember me?  It’s Joe.  Yeah, I know, it’s been a long time; but…my remedy stopped working, what should I do now? Help!!!!”

First of all, Joe, no one knows who you are!  When you get in touch with your practitioner and you try to explain what went wrong, you have to recap your case!  The practitioner always needs to know what you’ve been doing and what has led up to the current situation you’re describing. Your conversation should be in the form of a time-line: “First this happened, then that happened and then that happened.” Everything has to be explained to the practitioner in chronological order. If you’ve been taking remedies, don’t say, “I’ve been taking Pulsatilla.” Say, “I’ve been taking Pulsatilla 30C in water every day, twice a day, with five succussions before each dose in the 1st cup, one small sip.” What your practitioner is trying to find out is when Pulsatilla stopped working and why or if it was even appropriate to keep taking it, once you knew you had the flu. Don’t make it hard for your practitioner to find these things out! She needs chronology and dosing specifics.  As a matter of fact, when people come to me complaining that something new or different is happening, and their inclination is to give me the case as THEY see it, which always resembles what you would say to a doctor, I always say, “Fill out the acute case questionnaire,” which I then send them a link to.  I know it often seems like the homeopath should be able to figure out a remedy based on what you’re telling him or her, but, in fact, the details you think are important are only of use to a doctor–things like blood pressure readings and blood test results.  The homeopath wants to know, “What’s the sensation of your pain?  Is it a sharp pain?  A dull pain?  Or does it cut like a knife?  What about your thirst, what is that like?  Craving any special foods?”  Most people would never think to volunteer this information, that’s why I say, fill out the questionnaire.  It’s on my website under A Flurry of Questions.

7. “Homeopathy is making me worse!”

My first thought is that you’re overdosing or on too high a potency. My second thought is, you’re having “return of old symptoms”!  Ask yourself, “Is this an old symptom?” We fully expect that your case is going to “roll back” the way it came! You might find it litereally “unwinding”!  If you have a “return of old symptoms”, this should be temporary and only last a short time. You should consider it a very good sign if you see this. A client I had once with a very bad cold said, “I couldn’t believe it, it literally went back the way it came with the last symptom to go being the first one that I had when the cold started three weeks ago!”

8. “I’m feeling better, but, I’ve still got this and I’ve still got that…..”

You will not get well all at once so just forget about that ever happening!  What we expect is that the Worst Thing in the case, or the last symptom in the case, will resolve first, and having so resolved, it will “move out” to a less threatening area and keep moving until it’s gone; so, you might have a person with a mental illness sounding normal for the first time, but simultaneously breaking out in a bad cold, giving the impression that he’s getting worse!  Au contraire! He’s getting better! His mental illness is now a runny nose and a sore throat!  Isn’t that better? Hooray!  It’s not unusual to observe that the patient gets better here and worse there; you have to evaluate the DIRECTION the case is going in. Is he better in a more significant area than the one that’s suddenly “worse”? Then all is well; this is what we’re looking for!  After that we expect that the next “worst thing” will resolve and so on.  Keep in mind that in general, the first response to a correct remedy is a lifting of the spirits.  If this happens to you, jump up and down for joy!

9. “I still have my chief complaint, homeopathy doesn’t work!”

People come with some cosmetic complaint but it means a lot to them.  They don’t care that their constipation is gone, their anxiety is gone, their insomnia is gone! I would call this a success!

We can’t pick the “disease” we want gone and just treat that. We have no remedy for this or that disease. We have remedies for the person, the whole person; in that sense, homeopathy is truly “holistic”! My teacher, Robin Murphy, always says, “Don’t change a remedy that’s working in General for one that appears to fit a local complaint!” If you’ve got a remedy that’s helping a patient in general, stick with it!

Now, there are exceptions. When a person has a life-threatening local symptom like asthma, you have to take the case of that. But even the asthma will have a “whole” picture that goes with it; and your remedy will have to cover the whole state, including the mental/emotional concomitant that’s part of it.

10. “I didn’t tell you I had the flu because that’s not what you’re treating me for.”

Announcement: Homeopathy treats everything!

You’ve got to understand that conventional drugs are mischief-makers, toxic, rarely curative and are actually at war with your body!  Have you ever asked yourself what principle of healing modern medicine is operating on?  What are its laws?  Its law of cure?  We have no trouble answering that question: Homeopathy is based on the Law of Similars–like cures like–and, “the Minimum Dose”. What’s modern medicine’s hypothesis?  Do they have one?  If they were forced to answer, they would probably say, “We suppress symptoms.”

And in fact, that is what they do. 

There’s just one problem with that. It’s your immune system they’re suppressing!

It’s your immune system that’s creating the fever to incinerate bacteria and viruses, it’s your immune system that’s causing the diarrhea and vomiting to get pathogens out of your body.  Your body is trying to save you by getting rid of things–morbid matter!  And then along comes a drug that paralyzes the bowels or stomach or lowers the fever and what happens to the morbid matter?  It’s unaddressed!  It’s left to its mischief! This kind of reasoning would suggest that when the oil light starts blinking in your car, the mechanic should just unscrew the bulb–voila! problem solved! No one would appreciate such a mechanic, but we let people like this take care of our bodies!

There is no point in hiring a homeopath if you’re going to continually sabotage your immune system with suppressive drugs!  Don’t assume that homeopathy can’t help with your allergy or flu or injury or any aspect of ill-health that comes along during your treatment.

11. “I can’t understand why my constitutional remedy stopped working! I raised the potency and it’s still not working!  Oh, by the way, I have a really bad cold.”

Do not keep taking your consitutional remedy if you have an acute that’s altered your whole picture! The constitutional remedy, more than likely, bears no relationship to the acute you’re having at all! If you’ve been injured, you probably need Arnica, if you have a sinusitis you probably need Hydrastis or Kali bich., if you have a stomach flu you may need Nux vomica. When your symptom picture changes, you have to change with it; this is another aspect of case mangagement. Stop taking your constitutional remedy if you have a cold or an injury. Call or email your homeopath and find out what remedy you should take, or consult your acute prescribing book.

When the acute resolves, and your chronic picture hasn’t changed, go back to your chronic remedy.

Let me be quick to add, however, that, as I mentioned before, after a good constitutional remedy, you will find yourself feeling calm and at ease while at the same time experiencing discharges, maybe aches and pains, skin eruptions and other symptoms which might make you start looking for a “cold remedy” or “pain remedy”, etc. when actually this is a part of the curative process, and you’ll know because your mental state will have improved or something on a deeper level will have improved. These new symptoms should go away soon on their own; plus, some of them might be symptoms of days-gone- by which is a good sign–you’re not getting worse! These too should be only temporary but if they’re too much for you, tell your homeopath and she’ll give you a remedy for them.

12. “I’ve decided to hold off on starting homeopathy because I’ve got some other health problems and I want to try to get to the bottom of them first.”

To the homeopath, this makes absolutely no sense, and if by “getting to the bottom of it” you mean getting a “diagnosis” or “curing” the “other” health issues first, as though all health issues are separate entities having nothing to do with one another, not springing from the same well, so to speak, you are only wasting your time. More than likely, one homeopathic remedy will make all your health problems go away; this is why we take a Complete Case, asking about your sleep, your digestion, your appetite, your mental/emotional state, etc. because we fully expect to find the same remedy indications regardless of which part of the body we’re looking at.

For example, we can see Mercury in your bleeding gums, your Irritable Bowel Syndrome, your angry disposition, and your excessive perspiration. It’s all one case to us, not four different cases.

The more drugs you put yourself on to “treat” the various “conditions”, the more you worsen your health by becoming addicted to these drugs and creating secondary diseases caused by the side-effects which then are treated with even more drugs and the inevitable downward spiral begins.

But I should add that diagnosis in itself can be a good thing and I encourage it. Many different conditions all present with the same symptoms!  There’s nothing like a diagnosis to help orient the homeopath in the right direction.  A diagnosis can be essential.

13. “I’ve been on the remedy for two days now, three times a day, and I’m no better.”

A homeopath shouldn’t accept this statement at face value; always ask the patient, “What about mentally/emotionally, is there any change there?” A good percentage of the time the patient will say, “Oh yes! There’s been a big change emotionally, much better, spirits much higher!” See, they won’t tell you this unless you ask them, they don’t think it matters, but to us it means everything, it means we found the right remedy–stay with it!  In homeopathy, the complaint improves on the mental/emotional plane FIRST.

14. “No, I didn’t refill the bottle with more water because I already refilled it once and there can’t possibly be anything left of any substance in it, so I went back to the pellets.”

Boy, is this ever a mistake!  People, the “water” is stronger than the pellets! If you go back to the pills or pellets, you’re going backwards! It’s like going from Extra Strength Tylenol to regular Tylenol, it’s not going to help you! I could explain how homeopathic remedies are made but it would only bore you. Suffice it to say, they’re made in water, more and more water as the process goes on. Don’t worry about the water!

“But there’s nothing in it!”

That’s not true. There’s energy in it. The energy of the substance that was originally dissolved in it. You know that law of physics that says, Energy can neither be created nor destroyed? You can’t dilute this energy away!  When your practitioner says to you, “Take your remedy in the 2nd, 3rd or even the 12th cup,” don’t worry, the remedy is still there!

15. “I have no idea what caused my complaint!”

Really? Gee, that’s too bad. No, really! I would encourage you to think very hard about this because if you can’t pin-point the cause of your complaint, I don’t care how good your homeopath is, your chances of cure will drop considerably!  Homeopathic prescriptions are often based on “etiology”–a fancy way of saying the “Cause”. We have a term for this in the Repertory: “Ailments From”: Ailments from grief, ailments from fright, ailments from humiliation, even ailments from moonlight! Yes! I remember a case where the patient’s mother suddenly realized that all her son’s problems started after he moved his bed to the window and he slept under the moon’s rays. “Luna” (homeopathic moonlight) cured the case. It’s doubtful this case would have been solved if the mother hadn’t given some deep thought to the cause.

16. “I think homeopathy is really dangerous!”

You’ll hear this from people who have experienced an aggravation or a proving during treatment. I always say: Homeopathy is like a car–a good driver can get you to the airport, a bad driver can take you right over a cliff–especially if the person trying to drive is YOU, with no experience and no license! But sometimes, despite having the best driver in the world, the unexplained and the unexpected lurk just around the corner, we can’t make promises!

But you as a health care consumer should remember this:

Your practitioner should be willing to answer your questions, explain his remedy choice, his choice of potency, his dosing rationale, his sense of how he plans to approach your case and if you’re ever not satisfied with the results, look for a better driver!

To recap…

Articles that you should read:

“Homeopathy: Frequently Asked Questions” (http://hpathy.com/homeopathy-papers/frequently-asked-questions/)

“The Aggravation Zapper” (See my website: www.ElaineLewis.hpathy.com )

“A Flurry of Questions…” (See my website)

Purchases:

Homeopathy: An A to Z Home Handbook by Alan Schmukler (www.amazon.com)

30C Emergency Kit from www.a2zhomeopathy.com

Subscribe:

Dr. Mercola’s free weekly newsletter:  www.mercola.com

The Hpathy.com free monthly e-zine:  www.hpathy.com

Good luck!

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Elaine Lewis, DHom, CHom