- Visit Jan. 11.2011
Male 47,
Oct. 09 was admitted to hospital with severe abdominal cramps, 3 feet of his small intestines had died off because of a congested vein and were removed.
Colostomy until April 2010, Total Parenteral Nutrition.
Removal of gallstones June 2010 (side effect of TPN), gall bladder is fine.
Between Jan. and March 2010 had 2 bouts of Septicemia and Hematoma on upper thighs, which required hospitalization.
Current meds: Warfarin, Pepsin and Acidopholus to aid digestion.
Since release from hospital after intestine was removed patient has been on Fentanyl patch:
Fentanyl is approximately 100 times more potent than Morphine with 100 micrograms of fentanyl approximately equivalent to 10 mg of morphine and 75 mg of Pethidine (meperidine) in analgesic activity.
Current dosage 12 mcg/h – lowest dosage available
Patient:
One patch is supposed to last 72 hours but after 48 hours I have severe withdrawal symptoms and need another patch. Even though I use it after 48 hours it means a sleepless night in agony. Patient describes himself as being an introverted hard working person. He has been healthy all of his life, is happily married with 2 boys. I never tried drugs in my life! There was no reason for the blood clot that could be found. I felt healthy until shortly before, then I had some abdominal complaints, kind of flu like. I haven’t had any pain since June 2010 and only use the patch because I am addicted to it. I tried to get off the patch, they gave large amounts of Oxycondone, when the withdrawal symptoms come I take them but they don’t really work. They continue to prescribe the Fentanyl patch because of my addiction. One time I lost a patch at lunch time. At night I couldn’t handle it anymore, went to the hospital and they gave me a Morphine injection.
Presenting symptoms:
Cannot relax, lower legs are constantly moving, trembling. Feel like I want to throw my arms around, extremely restless, cannot concentrate on reading or anything. I take everything very personally, things that normally don’t bother me, I become obsessed with. I will say things that I regret minutes later, very impulsive, up and down all the time. A simple thing I cannot let go, worry about everything for hours, even if it is the most common task. I feel like I am in a constant defensive attack. It is impossible to sleep, and if I do sleep it is very restless with terrible dreams. In the dreams, everything is dirty and disgusting, dog shit everywhere and I step into it. I am not actually active in the dream it is the surroundings that are very disgusting, I had these dreams when I was on high doses of Morphine in the hospital.
I have memory gaps, for days sometimes I don’t remember what I did. The day I lost the patch had hallucinations of a road worker with a shovel he was in front of the car. My eyes are very sore when on withdrawal, strange sensation almost like a headache. Temperature fluctuations: I feel hot and cold with shivering and perspiration when hot. I can manage a day at work, then I am done, I cannot do anything else. My bowels work normal. I am sensitive to onions, garlic and cabbage now, which I never used to before. I snore extremely since on the patch.
Neither Fentanil nor Oxycondone are available as homeopathic remedies. The closest homeopathic remedy available is Morphinum. The patient feels like a drug addict, the effect of the drugs and the addiction is what needs to be treated in this case. I looked at this as an acute situation rather than trying to find a constitutional remedy.
Rubrics:
Generalities: CRAMPS: MUSCLES: CONVULSIVE, SPASMODIC, INTERRUPTING SLEEP
Irritability: physical, excessive
Heat: flushes of: alternating with: chills
Mind:
Excitement, excitable: trifles, over
irritability: general.
Morose, sulky, cross, fretful, ill-humor, peevish.
Sensitive, oversensitive: general
Suspiciousness, mistrustfulness
Anger, irascibility: trifles, at
Hallucinations for many days (Allen)
Memory, weakness, loss of
Eyes:
Fullness
Sleep:
Very restless, no sleep all night (Allen)
Feb. 8.11:
Presc. Morphinum LM 5, 4 drops daily, 10 succ. Repeat 2 -3 x if withdrawal symptoms kick in.
Feb.15.11: ( 1 week)
Still have about 75 % of the withdrawal symptoms, sleeping a bit better, now go to sleep about midnight; before it was 3 a.m.
My moods are not quite as aggressive.
Eye pressure is gone
More tired in general
Still on patch every 2. Day
Morph. LM 5, 6 drops 15 succ. Regular days, 8 drops 15 succ. Withdrawal days.
Feb. 24.11:
Still problems with sleeping when the patch is changing, not as extreme as before, manage to stay in bed, doesn’t drive me up the walls anymore. Moods the same, but I do feel better inside, don’t have such obsessive thoughts anymore. I feel very positive there has been a definite change in 2 weeks. No more temperature fluctuations. Eyes are fine
LM 5 10/12 drops 15 succ.
March 15 11:
A lot less withdrawal symptoms, sleeping a lot more now. Restless legs are much better. I had my last patch 5 days ago, Oxycontin 20 mg. Every 12 hours instead.
(Patient decided to cut them in half and only every 24 hrs). After 3 days the withdrawal symptoms (restless legs only) started to come back, I took 12 drops of the remedy and had no problems after that, then took nothing again for 24 hrs. I am very happy and excited about this progress; it has been absolutely amazing for me. I am in the best shape since a long time.
LM 5 10/12 drops 20 succ.
March 24.11:
(GP prescribed Oxycontin 10 mg, patient cuts them in half. 2 x a day)
Still progressing well, sleeping well. I am really happy to have a life again, after work enjoy my relaxing time. Feel better overall less tired. Moods are better, nicer again, family says there is huge improvement. Few obsessive thoughts still but much less. No more weird dreams
LM 8, 5 drops, 10 succ.
April 12.11:
Oxyc. 5 mg now, cut in half, 2 x a day, LM 8, 8 drops, 15 succ.
April 28.11:
Had a couple of days with withdrawal after switching to 5 mg. But now back to feeling good.
May 12.11:
Oxyc. 2.5 mg 2 x a day
LM 9, 5 drops 10 succ.
June 15.11:
Some withdrawals symptoms after cutting Oxyc. In half
LM 9, 8 drops, 10 succ. Feeling good overall, energy levels about 70 % from before surgery
July 8.11:
Hospitalized with kidney colic from kidney stones.
Unfortunately patient didn’t not get in touch with me. They gave me pain killers. They didn’t work so they put me on Morphine for 3 days! Home after 4 days still sever pains, needed more Morphine, patient is discouraged because of returning withdrawal symptoms.
Back on Oxycontin 5 mg twice a day
Morph. LM 9 8 drops 10 succ. Twice a day
Aug. 11.11:
I haven’t been able to reduce Oxycontin, still sleeping well but bad moods and some restlessness have come back.
LM 9 10 drops, 15 succ.
Oct. 11.11:
Had 2 bouts of kidney stones and gall stones again too, bladder infection and prostate infection. Anti-biotic treatment and also Morphine again in the hospital 5 mg a day.
LM 10, 5 drops 10 succ. 2 – 3 a day
Oct. 17.11:
Kidney/ Bladder colic’s are back, this time patient does not go to the hospital and instead contacts me.
Presenting Symtpoms:
Kidney, pain extending, testes to
Kidney, pain extending, thighs to
Kidney, pain, colic left
Kidney, pain urination, agg. Before
Kidney, pain, region of
Bladder, pain burning
Bladder, urging to urinate, morbid desire
Bladder, pain, urinating before
Urethra, pain, urination before
Presc. Berberis 200 C
Oct. 18.11:
Pain in kidney and bladder almost all gone. Patient decides to stop taking Warfarin,
Berberis 6 CH daily.
Nov. 8.11:
No more kidney/bladder problems
Oxycontin 5 mg a day
Morph. LM 10, 10 drops, 10 succ.
Dec. 13.11:
Feeling quite well. Will try and reduce Oxycontin again
Morph LM 11, 5 drops 10 succ.
Feb. 14.12:
Jan. 19.12 I stopped taking the Oxycontin, continued the remedy for another 7 days and then stopped that too. Had a couple of nights where I felt funny but then I was fine. Occasionally I have a few seconds where I feel like I am on withdrawal but it passes quickly. No more kidney or bladder problems. Feeling very good emotionally as well as physically still get tired sometimes. Food sensitivities are much better too.
Plan: wait and look at a constitutional remedy in about 2 months.
April 4.2012:
Patient continues to feel well, energy levels have increased even more.
Visit to GP and patient reports that he went off Warfarin. GP denied the connection to kidney stones so patient decides to take Warfarin just to see what happens, after a few days the kidney symptoms come back, he stops Warfarin again.
Presc. Berb. 200 CH
At this point it appears that Berberis is a really good constitutional remedy for my patient and we will continue with a monthly dose of 1 m.
Berberis:
Kidney and bladder symptoms
Responsible family orientated individuals
Hard working responsible (iron series)
Feeling of danger and problems coming from all sides which can make them feel restless and on the edge.
Del. Night terrifying
Del. Dirty he is
Restlessness, nervousness general
My thanks to the author for sharing a very nicely worked case. There’s much to be learned here.