A 32-year-old therapist and new mother presents with ongoing, dull, persistent pain in the left lower side (descending colon to sigmoid area) lasting several days after eating gluten. She describes the feeling as getting stuck in a cramp, not the acute part of the cramp, but it stays there, like a squeeze, an unpleasant squeeze. (Practitioner: What makes it better or worse?) It’s just there. She wonders who’s torturing her colon. (She bends left a little and presses on it.)
The patient has a crazy allergy list to follow since being tested, seemed like everything she was eating. Various tests tell her she’s allergic to corn, wheat, dairy, eggs, crazy things like quinoa and barley that she’s had maybe four times in her life.
Dairy has historically bothered her, but she was able to tolerate it when she was pregnant and now she’s having a hard time getting off of it. Starting at 12 years old she got really bad bloating, cramping and diarrhea from dairy. (She believes this to be a lactose intolerance.) But it hasn’t bothered her since her recent pregnancy.
She is left to eat rice, meat – because otherwise she might die – only chicken and beef and fish. All vegetables are okay, fruit is fine. Then there are other issues because she gets crazy heartburn, she would eat citrus and have a glass of water and get heartburn. (Always?) Nothing is always.
Her family has stomach issues, with an aunt, a cousin and her father diagnosed celiac. She has also had a positive blood test for celiac disease.
She likes to drink coffee, to eat light, to stay active. She feels very pitta and knows she needs a more kapha type of diet, but those foods make her feel sluggish. She feels off, imbalanced, polarized, discontented and disrupted. She feels energetic highs and lows, energy versus depleted energy, energized and active versus slow and sluggish. She gets a heavy feeling and must lie down, cannot keep her eyes open. That’s what Sundays feel like because she eats pancakes on Sunday mornings. She’s always trying to balance the energy.
She’s a real people person and if not talking to someone would probably fall asleep out of boredom. Socializing is her only hobby. She likes to be outdoors in nature. She used to work at a therapeutic boarding school for girls, which was very intense work, and people got burned out. It required very high energy.
She feels her ability to function is threatened. The purpose of life is not to be lying around, she says. People’s demands and expectations require her to be functioning. She’s not a person who lies around, although she kind of aspires to be able to lie around and read a book.
She remembers her childhood being heavier than you really want for a child. She remembers nothing before she was seven, when her parents got divorced. Divorce wasn’t so common then. It was really foreign and really scary, and there was a feeling of, Is it going to itch? Is it going to hurt? She wasn’t sure what was coming down the pipe.
There was a lot of rush, urgency, hurry, in her childhood. It felt business-y. She remembers a crazy brother, a lot of babysitters, a lot of strangers. Her father couldn’t be around the children. His displaced anger was burdensome, robbed her of an easygoing childhood. She wasn’t sure what to do with this black entity in her life. She would stuff it down so she could function. All of this made her introspective and heavy and aware.
As a small child in a large city she felt overexposed to things, if you watched the news there you didn’t feel safe, she says. When she moved to a small town she felt safer and became more extroverted. The children in her family were not disciplined. There were no rules and no laws. Her mother was chained to the kitchen sink then, but now her mother has become crazy modern woman.
She is afraid of blood. Her babysitter was cut badly when she was young, and when she turned the corner and saw the babysitter covered in blood, she fainted and fell down the stairs. She woke on the floor with her bathrobe open and felt gross that her brother had seen her uncovered. Her aversion to the color of blood is so strong that she does not eat tomatoes. Her dislike is primal. Tomatoes disgust her, she doesn’t like to touch them or have them around her in any form. She worries that her infant son will grown up and want to eat ketchup all the time.
Her mother would cover the patient’s eyes when anything was gory. Her mother convinced her that she didn’t like roller coaster rides, fed her the idea that she was fearful of rides, of walking around by herself, that she liked to go shopping. She remembers not wanting her mother to leave her when her mother went on dates. When she got a stepfather later on, she was really hard on him, super bitchy and mean. She would give away his presents in front of him as if to say, “This is trash to me”.
She has nightmares about loss, especially regarding her son. She used to have a nightmare about a doll that was naked and headless and would crawl onto her bed, stick-like, and beat her up. Barbie dolls represent so many things she doesn’t approve of. The doll was headless, she says, because her father was missing from her life. Another dream was about her brother being raped, one of being in a Scooby Doo episode, in a dark gray scary castle, and her cousins are being boiled in a cauldron. Someone scary is chasing her and her siblings and threatening to throw them into the boiling green stuff.
– history of spring hay fever
– gets sores in the creases of her lips
– five dental fillings, one root canal
– history of asthma, family history of asthma
– soft stools, once a day or every other day
– history of bladder infections that burned while urinating
– vasospasm in nipples during nursing with pain and blanching
– knees hurt going up stairs carrying child
– plantar fasciitis after delivery of child
– random hives on body
– itchy occiput, palms
– formerly torn L ankle ligament bothers her at night when lying
– averse to being wet, bathes purely out of social conformity
– doesn’t like to be cold, winters are difficult
– dislikes summer humidity, feels physically best in the desert
– loves wind and likes mountains and open air
– sleepy at 4 p.m.
– feels best midday
– sleeps curled up on side
– wakes perspiring after midnight, probably around 3 a.m.
– gets warm under arms when stressed or excited but does not perspire heavily
– desires sweets and chocolate
ANALYSIS: The physical symptom of pain in the left lower abdomen was not defined enough to yield good results in the analysis. Mainly, it had no modalities except for the aggravation from gluten. Her mental state, although not described in the clearest terms, seemed the most characteristic part of the case. With her strong fear of blood and tomatoes, her overall pitta-ness and desire for more pitta, and her childhood identification with her mother and her siblings (both her mother and her brother are crazy, just as her allergies are crazy), she started with Aluminum phosphoricum 1Q, drops daily. Of all the Aluminums, the phosphate seemed the closest match, both in symptoms and for someone so social.
Rx: Alum-p LM1, daily drops
ONE MONTH FOLLOWUP: Patient can’t put her finger on many improvements, not sure about her physical symptoms. Had wheat during the month and still got the pain in her left lower abdomen. There has been a lot going on in her life. One change is that her nightmares went away after about a week.
THREE MONTH FOLLOWUP: Nothing further has changed. The patient can’t tell if she’s improved physically. Her sleep has deteriorated. She is having a very stressful time with a client whose mother is dying. She’s started having horrible violent dreams, including one of her son being kidnapped.
Still focused on this fear of blood, but also on the feeling of strangeness in the case (to be honest, probably more the homeopath’s feeling than hers).
Rx: Nux-m 30C, drops every 3 days
FOUR MONTH FOLLOWUP: The horrible dreams have stopped, her sleep is much better. She has vivid dreams, but they are pleasant. Her night sweats have improved a little, but she still feels hot in the chest area a lot of the time. There seems to be some improvement in her general abdominal bloating and the pain she gets from eating gluten, maybe 30 percent. After starting the remedy, she had some heartburn like she used to have.
SEVEN MONTH FOLLOWUP: Patient can’t tell if there are any improvements in the bloating. The doctors confirmed that there is still inflammation of the bowel. She hasn’t been having heartburn, but the night sweats are drenching and have become one of her main complaints. They can happen anytime between midnight and 6 a.m. Her stress level is better, but her energy is unchanged, up and down. Her dreams are extremely vivid, and she feels the remedy is making them more vivid when she takes it. She still dreams about having to protect her son from kidnappers and others who would harm him. She sometimes feels a sadness while she’s nursing him. It’s connected with her client, 19 years old, who lost her mother recently. This same client had also lost her father a few years ago. This client is really heavy duty for her.
This next prescription felt like a real reach. The proving had a vaguely similar description of pain in the left lower abdomen and an emphasis on parasitic relationships. Of course, there is a strange, rare and peculiar symptom here that belongs to Sepia, the feeling of sadness when nursing. But sadness after the death of an acquaintance, even while nursing, can hardly be considered characteristic. Besides which, the case seemed very clearly not to need Sepia.
Rx: Clad-r LM1, drops daily
NINE MONTH FOLLOWUP: It becomes clear very quickly that the patient is experiencing the same symptoms she always has. She feels really heavy, heavy energy. Her dreams are even more disturbing than at the last followup, with dreams of having to silence her infant in order to avoid being discovered in a dangerous situation, dreams of being drugged and sexually molested by a beloved relative (she has never been molested in reality), feeling like an idiot, being taken advantage of, super betrayed and disgusted. When danger becomes real in the dreams, she wakes herself up. No one dies.
Her abdominal symptoms are just okay, she thinks mainly because she’s been eating all the dairy and gluten she wants. She’s not sure it affects her quite the same as it used to, but she’s vague about the change. All of the physical aches and pains are still there. Her son is getting bigger and harder to lug around. She blames all her aches on him.
She feels that time has really sped up. She doesn’t have the time for herself. She feels like she’s in a slow jog trying to keep up with her son. She would like to get better control over her diet and habits of life.
ANALYSIS: Something clicked when she mentioned this feeling that time was speeding up for her. This symptom belongs to Lilium tigrinum, among other remedies. The plant order, Liliflorae, had come up repeatedly in the case, largely on the strength of Veratrum album, which has fainting at the sight of blood and which seemed clearly not to fit the rest.
Sankaran lists the sensation of this plant group as “squeezing,” which had always been the consistent sensation in her abdomen. (It is important to know that Sankaran’s group “Liliflorae” is very inconsistent in terms of its members, many of which are barely related to each other botanically.) However, the other sensations associated with this plant group are a feeling of being excluded and a need to move, to be social and not be left out. Other successful prescriptions from this group of remedies had always been for people with strong social lives.
In his monocot-dominated Colchicum-like group, Mangialavori describes the feelings of “heavy,” “burdened” and “dragged down.” Certainly, the first two feelings show up consistently here. Things had always been heavy and just seemed to get heavier the more remedies she took.
Within the Sensation scheme of miasms, the sycotic miasm seemed to be the closest match. She and her child were not dying in her dreams, and her approach to her symptoms in general was more one of tolerating them than taking some strong action like stopping gluten. (It may be worth noting that she sought homeopathic treatment during a celiac study in which treatment was provided for free.) Even in the traditional miasm scheme, the sycotic miasm remedies often have these feelings of time being too fast or too slow.
Searching for dreams of molestation led to a case by Dr. Linda Johnston in Sankaran’s Plants 1. It included elements of molestation and torture, as well as dreams of being pursued and in danger. Other cases of the same remedy included confusions of identity with her mother much like the patient had described from her childhood.
In the proving, there is a sensation of contraction in the left abdomen and pinching sensations with a desire to press. There were no squeezing sensations in the sigmoid or descending colon regions, but Boenninghausen did list “squeezing in external parts” as a more general sensation for this remedy. (Yes, quite a stretch.) With only 30C and 200C potencies on hand, she got the lower one. Remember the hay fever in spring!
Rx: Sabad 30C, drops every third day
TEN MONTH FOLLOWUP (one month after Sabadilla): Things are overall better, there are no more night sweats, she’s sleeping better, more soundly, and not having bad dreams. She feels better overall and feels more energy than before. Her abdominal symptoms are pretty good. Her side doesn’t hurt at all. She’s trying to be better about taking care of herself, but there are challenges, like a partner who has to be away a lot for work. She’s not sleeping more, but the sleep she gets is much more refreshing. She does sleep lightly and wake if the baby needs her, but she feels better in the morning.
She did read something about a kid near her who was murdered, and she’s been thinking about that. It disgusts her to her core. Things have been out of control since motherhood, but her stress level has been low this month.
She no longer feels lethargic from eating dairy. She’s been traveling and not eating as well as she would like, but her energy level is much better than it was. She had been lethargic and borderline depressed, lying around doing nothing all day. Much better now.
Her left knees feels weaker.
ONE YEAR FOLLOWUP: After three months on Sabadilla 30C, the patient feels her chief complaint is 70 percent better. She may still get some discomfort from eating gluten, but it is mild and more manageable. She no longer feels the need to avoid dairy. Her hot flashes are completely gone, and her dreams are mostly better. She might still get a nightmare now and then. When asked about the knee, she laughs and says it’s the baby’s fault for growing so much.
Rx: Sabad 200C, drops once a month
TWO YEAR FOLLOWUP (15 months after starting Sabadilla): The patient called because she had received two negative results on celiac blood tests. The first time it happened, the doctor didn’t believe it, so she had the patient eat some wheat before retesting a month later. Both blood tests were negative for gluten sensitivity. She is excited because her gastroenterologist had told her she’d have to avoid gluten for 12 years to see a negative test.
The patient feels her gut is totally fine. She still gets sluggish if she doesn’t eat well. She gets all the dairy she wants. Her sleep remains improved, but she’s still a light sleeper because of her son. She feels in sync with his sleep patterns and wakes up two minutes before he does. (Still some of this confusion of identity.)
Her dreams remain improved. The hot flashes are still gone. Her fears for her son remain to some degree, and horrible things happening to others still affect her. She feels rushed sometimes, and the stress of having a 2.5-year-old child is difficult. Because of the continued sluggishness from carbs and the mixing of energies with her son, she got a higher potency of the remedy to take if she needs it, no more than once a quarter.
Rx: Sabad 10M
Although it’s not a chronic cure rising to the homeopathic standard of 4-5 years with no relapses, it certainly rises to the allopathic standard of clean blood work.