Patient’s data was collected and edited by Nur Maisarah Izzati binti Omar
Bachelor of Homeopathy and Medical Science (BHMS)
University of Cyberjaya (UoC)
A 27-year-old married woman presented at the clinic with a diagnosis of ITP
27th April 2019
Her details are as follows
- On Prednisolone 5mg on alternate days.
(Prednisolone is a steroid medication used to treat certain types of allergies, inflammatory conditions, autoimmune disorders, and cancers)
- Platelet is 103 x 10^9/L. Patient still gets bruises and bleeding gums.
- Menses is regular
- Mental state:
+ Feels sad a lot and feels that people do not care about her.
+ She can cry or scream suddenly.
+ Husband is caring but she still feels alone even when there are people around her.
+ Anxiety when driving
+ Weeps when sharing her stories
History of Present complaint
In 2016, at 24 years old the patient developed spontaneous bruising on the legs. This was preceded by fever and a petechial rash. She nearly fainted 3 times at home during her menses that lasted for 15 days. The menses was very profuse with no clots.
She was admitted to the hospital and blood investigation showed a low Hb and platelet. She was then diagnosed with Chronic Idiopathic Thrombocytopenia with 5 g/dL Hemoglobin and 2 platelets. A normal reading for females should be between 12 to 15.5 g/dL for Hemoglobin and 150 x 10^9/L for platelet.
She became pregnant with her first child in 2017 while still on Prednisolone.
The pregnancy was complicated with Gestational Diabetes and also Hypertension. The fetus experienced IUGR (Intrauterine growth retardation) due to the changes in the blood vessels of the placenta caused by the hypertension in pregnancy,
LSCS (lower segment caesarian section) was done at 32nd weeks of pregnancy as the child stopped growing after the 26th week due to IUGR (Intrauterine Growth Restriction).
Family history: Hypertension, Diabetes Mellitus, Colon Cancer, Uterine fibroid.
Childhood history: Father married another woman when the mother was pregnant with her. Mother was also beaten by the father. When the patient was born, the father did not want to touch her. She was raised by her mother and was not close to the father until now. There is also a history of sexual abuse during childhood. She was raped by her father’s friend when she was 6 years old.
Prescription;
– Streptococcinum 200c weekly for a month: scarlatina-like complaints of purpureal rash, petechiae, bleeding, caused by virus or bacteria with a history of fever preceding the bruising is suggestive of streptococcal origin of the subsequent ITP.
– Ars Album 30c every 3 days for a month: anxiety, skin ecchymosis, purpura
– Carcinosin 200c weekly for a month: family history of Hypertension, Diabetes, Cancer. History of abuse. Autoimmune disease.
30th May 2019 – After a month of treatment
- Platelet level is 107 x 10^9/L. Bruising has lessened. No more bleeding gums
- Menses in small amounts and lasted for 7 days and not profuse like before which lasted longer.
- Still on Prednisolone
- Normal stool and appetite. Lost weight from fasting and baby is breast-feeding.
- Mental state improved somewhat:
+ Easily angry
+ No more anxiety during driving. No longer feeling sad and lonely.
+ Sometimes when she remembers her mother then she feels sad. But the brooding is not as much as before.
Prescription;
– Carcinosin 200c weekly for a month
– Arnica 30c on alternate days for a month as an organ remedy for the blood vessel
28th August 2019 – after 4 months into treatment, she has had no remedies since the end of June.
- Platelet level is 103 x 10^9/L. No more bruising.
- Floaters in vision increased
- Not much headache now
- Still on Prednisolone
- Gets hungry but there is no appetite. She will only eat when she is too hungry
- No longer feel fatigued easily but feels a lack of energy
- Mental state
+ Not nervous now but gets palpitations if she eats late
+ Easily gets angry when son gets into a tantrum
+ Anxiety over small things
Prescription;
– Arnica 200c weekly for a month
– Ars Album 30c every 3 days for a month
– Carcinosin 200c weekly for a month
15th November 2019 – after 6 ½ months into treatment, no remedies since the end of September.
- Platelets went down to 78 x 10^9/L. Still has bruising
- Stopped steroid under doctor’s supervision. Body ache after steroid withdrawal.
- Mental state
+ Gets angry easily when the house is messy
Prescription
-ACTH 9d every 3 days for a month; stimulation of her adrenal gland to increase her natural cortisol production after steroid withdrawal
-Ars Alb 200c weekly
-Arnica 6x alternate days for a month
1st January 2020 – after 8 months into treatment, no remedies since mid-December 2019
- Platelet went down to 57 x 10^9/L and bruising has started this week
- Menses are normal. Headache before menses better by vomiting.
- No more body ache
- Stool on alternate days
- Energy feels okay
- Still have floaters in the vision
- Mental state
+ Brooding about the patient’s mother who has a history of abuse by the father
Prescription
– Pituitary gland 30c every 3 days for a month as headache before menses may be caused by hormonal imbalance. The pituitary gland is also known as the ‘master gland’ as it monitors and regulates many bodily functions through the hormones that it produces
– Nat Mur 30c every 3 days for a month for brooding and ailments from
abuse
– Carcinosin 200c weekly for a month
– Arnica 6x alternate days for a month
– Vitamin K2 D2 daily for a month to help in blood clotting
26th February 2020 – after 10 months into treatment
- Platelet increased to 74 x 10^9/L
- Still poor appetite during menses
- Stool daily or on alternate days
Prescription
– Pituitary Gland 30c every 3 days for a month
– Nat Mur 30c every 3 days for a month
– Carcinosin 200c weekly for a month
– Vitamin K2 D2 daily for a month
14th May 2020 – after 1-year ½ month into treatment. No remedies since the end of March 2020
- Platelet increased to 95 x 10^9/L
- Bruising worse after the fasting month
- Stool daily but less in fasting month
- Appetite still poor during menses
Prescription
– Pituitary Gland 30c every 3 days for a month
– Nat Mur 30c every 3 days for a month
– Carcinosin 200c weekly for a month
– Vitamin K2 D2 daily for a month
20th August 2020 – after 1 year 4 months into treatment. No remedies since Mid-June
- Platelet went down to 52 x 10^9/L. No bruises
- Severe headache during menses which gets better by vomiting
- Appetite is okay
- Likes to sleep on the abdomen
- Still have floaters in the vision
Prescription
– Medhorinum 200c every 5 days x 10 doses for headache during menses and sleeping on the abdomen
– Nat Mur covers all present symptoms. Given in different potency to benefit from the remedy acting on different levels.
– Nat Mur 6x alternate days for 2 months
– Nat Mur 30c every 3 days for 2 months
4th November 2020 – after 1 year 7 months into treatment
- Current platelet count at 67 x 10^9/L
- Hb 12.5 g/dL
- No more headache during previous menses
- Currently pregnant. Dizziness during early pregnancy but now is okay
- Still have floaters in the vision
- Mental state
+ Now can accept that the house is messy because of the first child
+ Easily get hungry leading to being angry
- Thermal: can tolerate cold now
Prescription
– Sulphur 30c every 3 days for a month because now can tolerate cold, gets hungry easily and anger from hunger. Sulphur is also at the end of treatment to remove any Psoric miasm or symptoms related to hereditary diseases.
– Medhorrinum 200 weekly for a month for headache during pregnancy and prefers to sleep on the abdomen.
Discussion
In retrospect, Arnica for this patient does not act as an organ remedy only but it is also indicated as the mother was beaten during pregnancy which is a strong indication of Arnica. A few more doses of Arnica through her current pregnancy may help prevent the vessel disease she experienced in her previous pregnancy.
In general, it seems that the condition has improved greatly and she is now off drugs for her ITP. Treatment is still ongoing and while she does not consult every month, she does know when to consult again. A note to the patient for closer follow ups during the pregnancy may be needed as pregnancy may bring out any problems still unresolved in this case.
The patient does not need to be on homeopathic medication all the time. This is because once the medicine has been taken, the medicine will act on the body which makes the patient feel better in general. Therefore, consultation and repetition of medicine will be needed if new symptoms arise. The medicine will stimulate the vital force to get back to a healthy state.
