Well, Kelly, how has your family favored us with illness this time?
Elaine, you will be happy to know that my husband stepped on a rusty nail!
Oh no! Not another foot injury! Kelly, I’ve played “Get on the Good Foot” by James Brown three times!
Are you sure you’re not exaggerating?
Do you remember your “Excruciating Foot Pain”?
Do you remember when your daughter stepped on a spinning coin and severely injured her foot?
And remember the “Really Bizarre Foot Pain” you had in June?
OK! OK! I get the picture! But what are we going to do?
Lucky for you, Kelly, I happen to have a client with ulcerative colitis.
Oh wow! You’re really moving up in the world, Elaine! We’re going to have an ulcerative colitis case?
But you just said….
His son has a cough.
Kelly, I assure you that this cough lives up to our most stringent Hpathy Quiz Quality Standards of “riveting and exciting”!
This I gotta see!
Just hold on to your seat for this one! So this is the case of Jayfee. His father advised me that his son would make a great quiz case. Here’s our conversation:
My youngest son has a nagging cough. Jayfee initially started coughing in September on and off and the doctor told us he had ragweed allergy and will go away after sometime. His coughing is dry, no runny nose, watery eyes, no phlegm, no gurgling sounds. The cough has been on and off for about 2 and 1/2 months. Doctor insists there is nothing wrong with him and constantly wants us to give him cough syrup. His cheeks are cold to the touch and he doesn’t like the cold weather. Of course Boston at this time of the year is nothing but cold. He coughs less in the night time and more during the day. When the cough attack starts he is less energetic. Only thing unusual with his cough was he asked me to get him Jalepeno chips. These are very hot and Jayfee usually doesn’t go near anything spicy or hot. He doesn’t run a fever, and doesn’t complain of headaches or anything else.
Good heavens! He has a cough and he’s better for spicy Jalepeno chips?! Now I’ve heard everything! Let me ask you, does your son have red cheeks?
YES YES we thought it was dry skin, he surely has no fever.
Let me ask you, does he tend to get homesick?
Oh YES. He always wants to be home. We call him the home-body.
Is he better in open air or closed rooms?
He doesn’t like to go outside but when he does, he doesn’t cough much, hmmm. He coughs more in closed rooms, I guess he’s better in open air.
He has had numerous health problems in the past such as a high fever-related seizure when he was 3 1/2. He would then get high fevers and start shivering and shaking. I spent countless nights putting him in the bath tub and giving him tylenol or advil eventhough I know it was toxic to his body but it would bring his fever down and make him more coherent. We just thought he was a homebody, always wanted to go home and every year late in the fall he would develop this cough that would hang around for a while. Hopefully you can find a remedy that will work for him, it kills me to give him robitussin or any other cough syrup.
You should probably fill out the Acute Case Questionnaire:
Acute Case Questionnaire
1. Did your complaint come on suddenly or gradually? Describe the complaint or complaints in your own words in as much detail as you can.
The cough starts in Aug/Sept time frame. Usually it is a low level cough, sometime it feels like he is trying to clear his throat. Every now and then it flares up and he might get a runny nose, if it is cold he’ll sneeze a few times. He does complain about being sensitive to cold weather. He gets rosy cheeks but for most of the time has no fever or at least is not noticably warm. Occasionally his eyes will get red and watery. The cough has no time related pattern i.e. sometimes he’ll cough in the daytime sometimes in the night. This summer though he also had tachycardia, his heart was beating at 137 beats per minute. The doctor dismissed it by saying he was dehydrated and kept him under observation in the hospital til his heart beats return to normal.
2. Etiology–meaning, what was the cause, if you know. What was going on at, or around, the time of the occurrence? The answer may be obvious if you were stung by a bee or fell out of a tree; but, less obvious etiologies would include things like unusual weather, suppression (“I was very angry but said nothing.”, “I had a rash and suppressed it with some sort of cream.”), over-studying, receiving good news or bad news, having to put up with rudeness, loss of vital fluids–from diarrhea, nursing a baby, bleeding, etc.; loss of a loved one, loss of property, jealousy, fright, use of drugs–prescription or otherwise– never recovering completely from an infection like the flu or other illness, loss of sleep, surgery, too much alcohol, humidity, getting the feet wet, drinking cold water on a hot day, embarrassment, breathing in dust, over-exertion, exposure to toxins, vaccinations, etc.
The cough started 2 years ago (so this is the third fall season). We had just moved into our current house so it made sense that he played outside a lot and got exposed to ragweed (that’s the doctor’s theory). However, by late October and early November the weather hits freezing mark in MA so ragweed is inactive.
3. Sensation–describe the pain or other feeling. Does it extend anywhere, does it shoot anywhere? For instance, “It feels like there’s a crumb in my throat, I’m constantly trying to swallow. The pain shoots to my left ear.”
I asked him if his throat hurts and he says no but sometimes it hurts on the top of his head as he pointed out. Not forehead but the top of his head.
4. Appearance–what does the person, or the part that’s bothering the person, look like; anything remarkable? Red skin, droopy eyes, etc.?
When it gets bad he gets rosy cheeks, sometimes red watery eyes.
5. Location–where on the body is your complaint located?
Throat I guess or his sinus track maybe
6. Modalities–that means things that make the complaints better or worse–and we don’t mean aspirin or tylenol! Consider: heat or cold, bathing, warm rooms, fresh air, drafts, motion, time of day or night when you get worse, the position that makes you feel best/worse; stimuli: conversation, noise, light, touch, pressure, massage, music, company, consolation, etc.
Better sleeping if he can sleep.
7. Concomitants (additional symptoms that come with the complaint)–for instance, pain with crying; pain with lachrymation; pain with nausea, chilliness, sweating, drooling, etc.
He gets tired. Sometimes gets the dark circles under his eyes even if he is hydrated. Dry peeling lips. Lots of ear wax. Very stinky sweat. None of my other kids have a sweat with that odor, not even me and I sweat a lot.
8. Discharges–color, odor, consistency. (A discharge is anything liquid that’s coming out. So, for instance, runny nose, diarrhea, lacrymation and so on.)
Sometimes gets diarrhea.
9. Generals–these are all the symptoms that begin with the word “I”: I’m hot, I’m cold, I’m thirsty, I’m tired, I’m sad, I’m irritable, I’m hungry, I want pickles, etc.
He feels a bit thirsty.
10. The mentals: Are you any different from normal either mentally or emotionally? Think about irritability, panic, anxiety, weepiness, self-pity, confusion, dullness, apathy/indifference, cheerfulness, and so on.
He wants to be babied or pampered.
11. What have you been saying? For instance: “I’m fine, leave me alone.” “Don’t leave!” “I wanna go home!” “I want ice”, etc.
He ALWAYS wants to go home even if we go somewhere he likes he eventually wants to go home.
12. What are you doing? For example, tossing and turning, pacing, fidgeting, moaning and groaning, calling people on the phone for support, etc.
13. Thirst–are you thirsty, not thirsty, what temperature do you want your drinks, what kind of drinks, just sips, or gulps, frequently or infrequently?
He does not like refrigerated water, room temperature liquids are fine with him. He sips not gulps
15. Sweating? When does the sweating occur? Where on the body? Does it leave a stain of a particular color?
During the day and night. No particular stain .
16. Odors? Are odors an issue, such as bad breath, foul or unusual odors of any sort? Any identifiable odors–like sulphur, onions, etc.?
bitter smell, pretty strong.
17. What is most striking about your condition or most peculiar?
18. Is there a diagnosis? For instance, flu, teething, etc.
19. Describe your energy; are you nervous, quiet, restless, agitated, sleepy, dull, prostrated, collapsed, stuporous, anguished, desperate, active, cheerful, energetic, etc.
energy is good and then lethargic.
Any bad breath?
How does he feel about open air and drafts?
OK as long as it is not too cold
Does he tend to be warm or chilly?
Chilly when he is not doing well
Does he have any burning pains, such as the lips, throat, etc.?
Any feelings of soreness or constriction?
no but he says sometimes there is mucus he swallows and feels better??
Is he better all covered up in blankets, etc.?
When he is sick he likes to be covered
What’s his personality like? For instance, lazy? Stubborn? Sensitive to insults? Easily offended? Changeable moods? Oppositional, etc.?
Sensitive to insults, easily offended, comic relief — always wants to make everyone laugh, extremely competitive
When he coughs, is it painful in distant parts other than the chest?
Sometimes on top of his head
Thursday, November 29, 2007
How is he after the remedy?
His coughing went down, he has a runny nose but previously it was stuffy but now he says he doesn’t feel congested and can breath fine. He also has been sneezing but doesn’t feel miserable. His cheeks though are still rosy. He seems to be more energetic and of course was also playing on the computer. His eyes are not red, they have cleared up but are still a little bit glassy.
The following is what I have observed,
1. The cough is no longer continuous, it is breaking down into small spells, maybe three or four.
2. His cheeks are no longer dark rosy, occasionally a tinge of color appears but then it is gone.
3. He is more energetic and less lethargic.
4. He is still jocular and wants to sing.
5. His eyes become glassy and slightly red with the coughing spells.
I forgot to ask–how is the homesickness?
He actually volunteered to stay at a friend’s house for 3 hours after school on Wednesday. If that’s an indicator then he is not homesick like he used to be.
You’re saying that even spending three hours with a friend in the afternoon would trigger an attack of homesickness for him, nevermind spending the night?
Half an hour at tops, that’s what it used to be
What about his disposition? Easy to anger, thinks he’s being insulted, etc.?
He has been pretty laid back and lovey dovey. He hasn’t fought with his brother lately. He gets or feels insulted very easily, we thought he was over- sensitive. This would lead to him fighting with Asad (his older brother).
He has been sleeping well and getting up in the morning without any complaints. He didn’t like getting up in the morning and would snooze a couple of times after being woken up.
He has been always very intelligent and we just thought esoteric behavior is a part of it. He taught himself computer games and operation by age 31/2, geometric sequences by age 5, had perfect scores on his achievement test by age 6, and started non-planar geometry at age 7 1/2. We had multiple opportunities to put him in the gifted children programs at Stanford, Cornell, and John Hopkins but didn’t avail due to my health and the older two kids. We just thought his behavior was normal as he was a little ahead of his time. His social skills are great as he is jocular, well liked by his teacher, and all kids in his class like him. Of course he also referred to himself as the “King”. However, we never understood him being homesick all the time but never really raised the flag until the cough.
Jayfee’s cough is down to 20%. It is awesome NOT to see him cough!!!!!!!!! I have been giving him _________30C twice a day and as long as he is showing progress, I don’t want to increase it to three times a day. I can live with a little bit of cough for now, what do you think??
December 12, 2007
I’m baffled. I gave him _________ again and his cough has pretty much vanished!!!!! No more coughing!! His cheeks are not rosy!!!! On and off he had the cough for three years. And consistently coughing this time since September. The change is fantastic, no cough syrup for three weeks!!!! I feel great that he is healing naturally without allopathic medication. Thanks, and Thanks again…………..
December 13, 2007
He is in a great mood, sang lots of KC and the Sunshine Band–“Shake Shake Shake….” needless to say, he is a trouble-maker!
Jay-Fee, you are all right with me! Just for you, here’s Kay-Cee (KC and the Sunshine Band):
Elaine Lewis, DHom, CHom takes online cases. Visit her website at: elainelewis.hpathy.com