* 38 years old
* 1st Consultation March 2004
Susan presented with a very flat demeanor. She had been suffering from anxiety and depression for at least the past 12 months. Susan said that she had an almost constant feeling of anxiety in the chest and stomach. She felt tired and lethargic, slept poorly and struggles to wake in the morning. Emotionally she was very teary, crying at the smallest thing and was very irritable with her children. The week prior to the onset of her menses and the evenings were her worst times. Never felt depressed when at work. Susan worked as a home care nurse – or when on holidays at the family’s beach house. She often played music to relieve her tension.
She had been on an anti depressant for 4 months with no change in mood, however, had found St. John’s Wort 30+ effective in relieving the anxiety and feared to ever stop taking it.
Since puberty Susan had also suffered from a variety of skin problems. She said that she had never had clear skin since then and that it was always worse in the week prior to her menses. Along with a scarring type acne she also has many bouts of boils and had had several cysts removed over the years. Ten years ago she went on a course of Roactin for these problems.
Top to toe summary revealed an enlarged pituitary gland, which was diagnosed 6 months prior to her 1st pregnancy. Symptoms at the time included weight gain, lactation, headaches behind her eyes and tiredness. This condition was monitored medically on a 6 monthly basis and she was on medication, which she was told would continue for her life time. Susan blames the course of Roactin for the enlarged pituitary gland.
Only other point of significance I could pick up was a bout of severe pneumonia at age 16 years for which she spent 2-3 weeks in intensive care and took a long time to recover from.
Susan loves the hot weather and craves sweets which she binge eats when depressed.
She has a love/hate relationship with her mother whom she describes as her biggest stress. Her mother also suffers from depression. Susan felt that her mother dictated to her all the time and that she could never please her no matter what she did. Her mother would often scream at Susan and degrade her in front of other people. Susan felt responsible for her mother’s happiness. Despite this Susan said she gets on well with her mother and that she couldn’t live without her.
Susan gave me some very good generals on which I could base my search for the appropriate remedy. I decided to use these and a couple of broad physicals in my repertorisation.
MENSES; agg.; before (109)
AIR; seashore air; amel. (27)
FOOD AND DRINKS; sweets; desires (101)
GENERALITIES; HEAT; vital; lack of (219)
OCCUPATION, diversion; amel. (51)
SKIN; ERUPTIONS; boils (156)
GLANDS in general, complaints of (46)
MacRepertory for Windows.
|Nose – ball
Asymmetry – chin, eyes
There being no clear dominance Susan was assessed as BROWN.
REMEDY AND DOSE
Brown remedies presenting themselves from the repertorisation were Silica, Carcinosin and maybe Ars Alb. Given that Carcinosin is a small remedy and unlikely to repertorise very highly and fitted the picture it was chosen over Silica. I was also going to use the rubric worse puberty but it had only 2 remedies (not enough to use with confidence) – one of which was Carcinosin (so added weight to my decision) and Pulsatilla.
Carcinosin 1M I dose.
15/5/04: Susan said that she felt really good for 2 weeks. Her skin seemed clearer. However, from that time on she seemed to drift back to the same condition as she was in when she first saw me.
Given the 1M level I was expecting the remedy to hold longer than 2 weeks. So I re assessed the case – could gather no new material. Re assessed the miasm and still considered her to be Brown. Decided to repeat remedy but at the 10M level to see if it would hold longer.
Carcinosin 10M 1 dose.
25/5/04: Phone contact. Susan is feeling a lot better – at least 80-85%. Watch and Wait.
Did not attend her follow up appointment.
18/11/06: Susan again consulted me complaining of anxiety and depression as well as a recent spate of skin problems especially boils. After listening to her reasons for consulting me I went through my previous case notes and we were both surprised as to how similar her current complaints were to her initial presentation. The only change was that the enlarged pituitary gland had disappeared and she is no longer on any medication. As far as I can ascertain this was discovered very soon after I last saw her. Her doctors are astounded and she undergoes annual checks just in case it comes back. In the 21/2 years since I last saw her Susan has been able to establish a much more comfortable working relationship with her mother and will not tolerate her mother demeaning her in any way.
Carcinosin 10M 1 dose
16/12/06: No further skin problems. Is feeling really good and looking forward to her summer holidays at the beach.
Dip Hom, Prof Memb Aroh, MAHA, Dip PE, HDTS