It was a case of Cancer of the Esophagus at the O.G. junction with metastasis in the spine. The histopathology report showed Grade 2 adenocarcinoma of the stomach with lymph nodes almost replaced by metastatic deposit. The patient had undergone esophagectomy and gastric pull up surgery in July 2004 along with chemotherapy that was also administered.
He had complaints of difficulty in swallowing solid food and malaena since 9 months along with pain in the upper part of the abdomen and retrosternal region. The patient was 70 years of age during the surgery.
After the treatment there was relief for 6 months after this he developed severe backache and difficulty in swallowing food. For this the patient underwent another surgery and esophageal stenting was done this gave some relief in swallowing. There was a recurrence of the neoplasm at the lower end of the esophagus again with metastasis in the spine. Bone scan showed increased tracer intake at D10 and collapse of the D8 vertebrae with partial lytic sclerosis.
By this time the patient developed very severe backache which didn’t respond to the normal course of treatment so the doctors advised that he should undergo radiation. Along with this another cycle of chemotherapy was started which the patient was unable to withstand. After this he became very weak and bed ridden and there was severe backache. So the treatment was stopped. At this point the family members thought of trying out homeopathy.
They asked if we can relieve the pain and anything can be done for the patient. So I had to go for a visit as the patient was not in a position to come to the consulting room. When I went to the patient’s house I saw a frail man lying on the bed with his legs flexed at the knees and drawn up. He was very cheerful and thanked me for coming to see him. He was well orientated and his memory was pretty sharp. He gave me the key note when he said doctor, “I am physically weak but mentally strong.”
Due to the surgery the voice had become very low pitched but he explained his symptoms he said he had severe burning pain in the back and also at the site of the surgery. The complaints were aggravated by sitting he was unable to sit even for 5 minutes, by walking the pain radiates to the left thigh. I asked him why was he sleeping like this with his legs drawn up he said this is the only position that gave him relief.
Pain was the main concern of the patient and he wanted to go out for his walks. There were also external growths on the scalp and one on the retrosternal region. These were painless and didn’t cause any trouble to the patient.
He said till 70 years of his age he has lead a very healthy life he has not suffered from any major illness except for the Typhoid and Smallpox that he suffered as a child. He said he has no worries and is quite satisfied as he has had a good life. He worked for an overseas bank as a chief officer. It was a transferable job but he liked the job very much. He used to work very hard from morning 7am till 11 pm at night. He liked to complete whatever job he took and when he retired he had 700 medical leaves pending. Overall he enjoyed his work.
As a person he is mild by nature and very sensitive if somebody said something wrong he got hurt emotionally and was unable to forget the event. After his illness he weeps very often when something hurts him emotionally.
In childhood he used to mix very easily with people and they stayed in a joint family. He was very much afraid of his father as he was very strict. He had 11 brothers and 1 sister then also he used to feel he had nobody. This was all I could get about his childhood.
Then he said he gets lots of dreams they are as follows:
â€¢ Vague dreams
â€¢ Dreams of flying in sky+3
â€¢ He is trying to run but cannot run
â€¢ Someone is chasing him and he cannot run
â€¢ Dream of examination and he is not ready for the examination
â€¢ He has to go to pass stools but he is unable to find the toilet
â€¢ His son has fallen in a pit and he is unable to save him.
â€¢ Dreams of dead people.
Grinding of teeth in sleep since many years
Diet: Mixed vegetarian /non vegetarian
Appetite: has decreased after the surgery and chemotherapy
Cravings: sweets +3, ice cream, salty food, eggs +
Sun: Doesn’t cause any discomfort
Covering: takes covers
Bath: Cold water
Stool: N flatulence +4
Father expired at 80 years of age Cancer Kidney
Mother expired due to old age suffered from Arthritis
Fungating growth black in color with bloody purulent discharge located on the sternum chest and on the scalp.
Horizontal furrows on the forehead. Graying of hair had started when he was very young.
P/A: No tenderness
Liver enlarged slightly
B.P: 130/88 mm of hg
Wasting of the muscles
1) Colocynth 30
2 pills 4 hourly
Stop when the pain is better
7 powders 1 at bedtime
|30/9/05||The pain was better. Tumor was increasing in size.
Discharge bloody from the tumors. Patient says pain is much better.
At this we gave him the constitutional remedy which was Lycopodium in the LM potency.
|1) Lycopodium 0/4
7 powders 1 every night was given once the pain was better.
2 pills 4 hourly
|21/10/05||Patient started walking
Discharge from the tumors offensive. Patient feels better on the whole.
Pain is much better
Continue the same treatment
|30/10/05||Patient was better
But he developed some Upper respiratory tract infection. Relatives put him on antibiotics as their doctor advised. The patient started to deteriorate. Pain was better.
This conversation took place on phone. Due to some reasons the medicines were not collected and the patient was admitted in hospital.
|11/11/05||I received a call from the son that his father passed away peacefully. He told me his father told him that he wanted to visit to the consulting room once as he felt obliged as his pain was much better. His son told they were happy as at least the last months were pain free. This was the only request the patient had made when I had gone to see him. He said just get me out of this pain. And when the right Homeopathic remedy was given palliation was achieved.|
Understanding of the case
The patient was given Colocynth as an acute remedy as the acute picture matched with colocynth. Lycopodium was his constitutional remedy but as we know when the susceptibility of the patient is low and advanced pathological changes taken place when the constitutional remedy is given the body sometimes cannot take in the initial aggravation. After the improvement in the pain the patient was given Lycopodium in the LM potency after reviewing the case once again. And the patient responded in a very good way and further improvement was seen.
It should be noted in treating terminally ill patient one has to be very careful in selected the potency and its correct application. We achieved palliation and we were able to relieve the pains of the patient which didn’t subside even after taking painkillers. I remember one case where there were multiple pathological fractures, patient was on morphine and then also the pain was tremendous in this case also the acute picture matched with Colocynth. Colocynth 6 was given and the pain was much better.
So perceiving the case is very important if we are to deliver what we promise.
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