Insomnia in a Woman of 62

Initial consultation: October 29, 2018

The patient AA is a 62-year-old female who is experiencing signs and symptoms of sleeplessness. She also has prior symptoms of chronic eczema, constipation and a new symptom of bursitis. She approached me to aid with the primary issue of sleeplessness. She had been taking the following medications:

Zopiclone: A non-benzodiazepine hypnotic agent used in the treatment of insomnia

Melatonin: A hormone found naturally in the body. Commonly used in the treatment of insomnia and improving sleep
Senokot: Senna glycoside, also known as sennoside or senna, a stimulant laxative used in the treatment of constipation
Celebrex: A non-steroidal anti-inflammatory drug (NSAID) taken orally to treat pain and inflammation (in the case of the patient for the bursitis)
Voltarin: A non-steroidal anti-inflammatory drug (NSAID) taken orally or rectally to reduce inflammation and as an analgesic reducing pain in certain conditions. (in the case of the patient for bursitis)
Tylenol: A medication used to treat pain and fever. It is typically used for mild to moderate pain relief.

Once she settled and relaxed, I started the assessment with what were her priorities to focus on and what symptoms she is experiencing at the present time. She noted that she has been experiencing the sleeplessness off and on for the past 25 years and has been taking allopathic medications.

She decided to stop taking the medication for approximately 8 to 9 months prior to this assessment. She remains awake most of the night following the termination of the Zopiclone. She started using melatonin, up to 6 tablets, one hour prior to sleep and even then she remains awake for most of the night.

When prepares to sleep 9:30-10pm, brushes her teeth and gets ready for bed. While in bed, she meditates for about 15 minutes, then watches the news/CNN. She sleeps on her stomach. She will also use the phone to catch up on activities. While she is trying to sleep, she says that her mind is very active and she starts to worry about her kids, grandkids and family. She also worries about her deteriorating mother who at the present time lives with her.

She reports that at night she thinks that she hears her mother, will go downstairs to check up on her and this will happen several times during the night. She usually sleeps only 2 hours at a time. She never feels refreshed in the morning. Her mind is too active and she will hear her spouse snoring as well.

She was quite loquacious and it was difficult to keep her on track as she kept jumping from subject to subject.

Symptoms and rubrics chosen – Using The Complete Repertory

sleep, sleeplessness: thoughts, from:
thoughts: rush, flow of: sleeplessness: with:
Sleep, unrefreshing: morning:
Mind, loquacity:
Mind, sadness: evening: agg:
Mind, busy:
Teeth, grinding: sleep, during:
Hearing, ringing:
Head, pain, headache: pulsating, throbbing: forehead:
Extremities, eruptions: eczema: elbows:

Materia Medica analysis and reasons for the remedy selection:

Calcarea Carbonica, Lycopodium and Sulphur came up strong in this case. For this patient Calcarea Carbonica seemed to fit the overall picture. In the Materia Medica, Clarke mentions that “Calcarea Carbonica is somewhat sharply distinguished from Sulphur in that it is a chilly remedy, the patient seeking warmth, whilst the Sulphur patient is agg by heat, and amel by cold. Calcarea Carbonica has cold, clammy feet, Sulphur has characteristically hot sweaty feet. The “sinking sensation” common to all three is most marked with Sulphur at 11am, with Lycopodium at 4pm, with Calcarea Carbonica at any time”.
Nash also mentions “the Calc patient is constitutionally fat or strongly inclined to obesity. They are of torpid disposition, sluggish or slow in its movements. The Sulphur is almost the exact opposite quick, wiry, nervous active. There is none of the bilious swarthy yellowish appearance in Calcarea that we find in Lycopodium”.
Calcarea Carbonica has fears that something is going to happen to herself or those around her, she will lose her reason and people will see her confused state of mind. Also noting that these patients will dwell on insignificant issues.
Finally, this patient did not have any issues of flatulence, urinary or digestive symptoms that would direct me to Lycopodium or demonstrated the burning sensations, being hungry around 11am or any of the offensive body odour that one would expect from Sulphur.

This woman was one my first patients as a student.

The first prescription

Calcarea Carbonica 200c, 3 pellets, three times a week.
Some hygiene suggestions made:

Date: October 29, 2018

During the assessment, I noticed that She watches the news before bedtime. I suggested she not to watch the news, use phones or computers 2 hours prior to bedtime.
I suggested she read a book, go for walks or even do some yoga and or meditation before bedtime.
I suggested she reduce her coffee. The coffee was also acting as a diuretic for this patient.
I encouraged her to drink more water.
I suggested some exercise or physical activity.
I made dietary suggestions.
I suggested ionic Magnesium Citrate Powder one hour prior to bedtime, as it would aid in both relaxing her mind and help with her severe constipation issues.
I suggested she get blood work to determine if there was anemia etc.
She had a prior CT scan done for the sleep issues which did not show any pathology.

The first follow up: February 11, 2019

She reported that she forgot about the remedy over the holidays and was busy with her kids and grandkids.
She started the remedy two weeks ago and was consistent with taking it.
She reported that she felt more relaxed after taking the remedy and she was not as uptight as before.
She stated that she still finds it difficult in the evening but she feels much more relaxed.
She said that she has noticed that she has been going to the bathroom for her bowel movements daily without the use of senokot.
She said, she started to sleep better a couple of days after the remedy which was different for her.
She has not taken the Zopiclone or Melatonin as sleep aids for some time now.
She has also completed the medication regiment for Celebrex and Voltarin for the bursitis. Her inflammation and pains have improved. She has not experienced any pain for the last couple of weeks.
She mentioned that she has been going to the gym on a regular basis and she feels much better after being there.
She also stated that she has been taking the Magnesium Citrate as recommended.
She did get her blood work done and it was recommended she take B12 injections monthly which she has started.

The second prescription

Assessment: I suggested she continue with the Calc Carb 200c, 3 pellets, three times a week for a month.

The Second follow up March 28, 2019

She reported that she has been taking the remedy and feeling more positive. She reported that she felt more relaxed and calmer after taking the remedy. She was not as uptight as before.
She stated that she continues to have a little difficulty in the evening but overall she remains relaxed.
She has noticed that she continues being regular for her bowel movements daily without the use of Senokot.
She reported continued improvement in her sleep. She sleeps much better and stays asleep longer.
Her bursitis has improved and resolved. She has no pain at the present time and is able to walk without issues.
She continues going to the gym on a regular basis and feels much better after her workout.
She continues with the Vit B12 injections monthly.
She stated that she was surprised that she has not had any skin issues for the past couple of months.

She is going on a trip for couple of weeks.

The third prescription

Assessment: Continue with Calcarea Carbonica as the action of the remedy is demonstrating improvement.

The third follow up on April 29, 2019

She has been consistent in taking the remedy as recommended.
She reported that she continues to feel more relaxed since starting the remedy. She continues to be calmer and not as irritable.
It was quite evident that she did not demonstrate loquacity at this follow-up.
Her bowel movements remain regular and she continues taking the Magnesium Citrate only as she needs it, which has not been too often.
She reported a continued improvement in her sleep. However, she started drinking her coffee more often, which at times contributes to the timeline that she goes to bed.
She continues with her routine of the gym and really enjoys it.

The final prescription

The action of the remedy has been curative and the rate of improvement has been consistent.
Her primary complaint of sleeplessness has improved significantly.
She noted that her eczema showed a marked improvement.

Further follow ups