This is a case of my former student, whom I had cured of Lichen Planus about 10yrs ago, with Lachesis. This time she came to me in Oct 2012 with H/O two abortions. The first abortion was on Oct 2011, in the 8th week of pregnancy and the second in May 2012 in the 9th week of Pregnancy. She was working as a Medical Officer in a hospital under a leading gynecologist in the town, ever since she had qualified. She was thoroughly tested after the 2nd abortion, including torch, lupus, anticoagulant, MTB, endometrial tissue, TSH , karyo typing for M & F.etc ., all of which were normal.
When she came to me, she was still working as Medical Officer with the same gynecologist. After graduating in Homoeopathy, she along with her friend and classmate had started general practice (allopathic) along with the job of MO. After 1- 1½ yrs she was not getting the expected response. Also her friend had joined the IT industry and my patient was worried about the investments made to start the clinic. Later she got married to her brother’s friend and continued her job as well. She then started a clinic in a new up and coming suburban area. She was hoping to generate a good income in the new clinic. She had planned not to have a baby for one year. A year later she was unhappy as she was not earning enough. Still, she decided to have a baby rather than delay her pregnancy. She thought she might as well have a baby and later restart her clinic.
She conceived, but then aborted in Oct 2011. She then decided to stop her clinic and continue the job and try for a second pregnancy. Again after the ninth week she aborted, which was in May 2012. She subsequently went for medical tests. By now she had lost interest in everything, including sex, but she still wanted a baby.
The Gynecologist had DNB Diplomate of the National Board of Medical Examiner students at her hospital, and the patient felt she was not getting her due respect from these students. Also, her pay was less than any other senior consultant. Now she was trying to get pregnant but kept miscarrying.
She said “Whatever I want or wish for, I do not get.” She was very irritable, but could not give any details! This was her life situation.
She had always carried a big water bottle everywhere, and said she might forget her purse but not her water bottle. She craved sour food and had a strong aversion to milk. Thermally she was neither hot nor cold. During a couple days of her menses she had severe cramp-like pains in her groin and lower abdomen. The pain was worse on motion and compelled her to remain still in bed and take pain killers. There were cramps in her uterine region even in between her menses, and these were worse on motion ameliorated by rest.
There was twitching, since many years now. She had “twitching” anywhere in her body at any time, and with marked aggravation after physical exertion.
She was mostly constipated and occasionally had severe flatulent colic relieved only by complete bed rest. During both of her miscarriages she had these cramps which kept increasing and resulted in labor-like pains ending in the miscarriage.
Two or three times a year she catches colds which linger for 1-2 months and end with a mild cough.
She had come to me on the first day of menses, though she had called me earlier, as there was no use in starting from middle of the cycle. “If I am starting the treatment I should get proper benefit of it”, she said. I told her that there was no use in planning for the next pregnancy until her uterine cramps stopped. Meanwhile, I suggested she do something which would make her happy, so she left her old job and took a diploma course in Hospital Management. I asked her to get her hormonal tests done, as this was not done earlier. Strangely she was not aware that these tests had to be done on the 2nd day of menses, even after working for many years in a maternity nursing home. I had USG done in 2012, but deliberately ignored following it up immediately.
Though she had graduated as a homoeopath she never could give me the details a homoeopath needs to prescribe. Her husband actually gave a better account of her symptoms.
I started with her treatment and it took almost one and a half years for the cramp like pain in the lower abdomen between and during menses, to stop. She had no dysmenorrhea and no inter-menstrual complaints by May 2014. Her twitching was infrequent.
I had to make her aware that after stopping barrier contraceptive measures, she may not immediately conceive. It was in May 2014 that I suggested she do a Hysterosalpingogram, which ended up indicating: “Unicornuate uterus with rt cornu , Rt tube partly filled”.
I also repeated her Hormonal tests and in the same month i.e. August 2014 she conceived. Initially her twitching had increased for a month and there was some heaviness in the lower abdomen with aggr on motion and when her bladder was full, but it later subsided. She was advised complete bed rest.
RUBRICS TAKEN FOR REPERTORISATION
- Disappointment, ailments from
- Greedy, avarice
- Desire, unattainable things
- Dullness mental
- Motion Agg (BBCR)
- Rest Amel (BBCR)
- Milk Aversion
- Sour Desires
- Pain in Uterus, motion aggr
Ars covers 8 Rubrics 14 marks
Aur covers 3 Rubrics 5 marks
Bry covers 11 Rubrics with 23 marks
Lycopodium covers 7 Rubrics with 13 marks
Nux. V covers 7 Rubrics with 16 marks
Puls covers 8 Rubrics with 18 marks
Sil covers 7 Rubrics with 15 marks
Sulph covers 7 Rubrics with 16 marks
REMEDY RELATIONSHIPS FROM BTBP
As Lachesis had cured her earlier, it was important to have a relatively similar remedy. The sensitivity of the patient to the chosen remedy will be proportional to the similarity of that remedy, as with the earlier remedy, which had cured. I looked in the chapter of Relationships Of Remedies in BTPB before finalizing the remedy.
Remedy Relationships of LACH
BRY covers 7 rubrics with 22 marks
PULS cover 9 rubrics with 29 marks
NUX.V covers 7 rubrics with 21 marks
Pulsatilla covered the mental rubrics but was not covering the marked general modalities of amel by rest and aggr by motion. Pulsatilla is RELEIVED by motion and WORSE during rest. Also Pulsatilla is thirstless, whereas patient has marked thirst.
The closest remedies are Nux.V and Bryonia Nux.vom is oversensitive physically and mentally. The patient is SLUGGISH like Bryonia and her state of mind NOT excitable like Nux.v.
Like Bryonia, the patient wants something but knows not what. She desires for things that cannot be had.
She has a bargaining attitude, as she does everything (including sex) with the intention of getting something back in return. She is always negotiating or expecting what the returns will be. The other side of this coin is avarice, though it is not necessary that the bargain be for monetary returns only. But wanting to have too much too soon is noteworthy. The desire for unattainable things has been deduced from the following:
- She wants a full-fledged medical practice within a year. The patient knows that the so called “waiting period” amounts to 3 to 4 years in this town. The patient is not acknowledging the reality.
- Doing a part-time job and expecting the salary of a consultant.
- Expecting respect (a very relative term) by DNB students in a maternity hospital on the grounds of seniority while doing a part-time job. We all know how allopaths tend to look down on Homoeopaths.
Dullness of mind as patient cannot give a homoeopathic case and could not tell when the first miscarriage took place. She had to calculate it and confirm it with her husband. I had to explain as if to a lay person that conception may not occur immediately after stopping the barrier method of contraception. Also, she did not know when to get tested for female hormones (after working under a Gynecologist for more than 8 years).
I saw Bryonia as the clear remedy. The patient‘s LMP is 4th August 2014. She is doing very well. Bry 200 was given three times a week for almost a year then sos. Presently she gets Bry 200 one dose HS once a week since Dec 2014.
Her last follow up was on 4th Feb 2014. She complained of slight discomfort in her abdomen after sitting for half an hour and walking for 15 to 20 minutes. She has been advised complete bed rest. Her BP was 130/ 80 mm of Hg, Pulse was 78/min. Overall increase in weight after conception is 7 Kg. She has no constipation and presently her appetite has increased. Was given SL
In her last follow up, 4/2/2015 there was no constipation and she now sits for half an hour comfortably. Her BP is 130/80 mm of Hg. Pulse 78/min. Weight gain is 7 Kg till now. There is some dull pain in abdomen if she moves or sits for long. The Gynecologist has given 11th May 2015 as her EDD.
To sum up, this was a case of “Irritable Uterus ”, which was not ready to hold the pregnancy. Students of homeopathy should note that even when the uterus is unicornuate, homoeopathy still works.
She delivered a baby girl on 30th April , by LSCS . As it was a high risk pregnancy and delivery the obstetrician suggested LSCS.
Please see Radiological and Ultrasonography reports below: