Leukemia in a Woman of 55

A woman age 55 presented on April 19, 2019 with her son at my clinic. She had been diagnosed with leukemia.

Symptoms

Appetite loss of with vomiting after eating

Extreme weakness such that she is unable to walk

Attempting to walk aggr backache

Extremities – pain +++

Pressure amel

Twitching sensation

Body ache with malaise

Cough with sneezing causing constant pain in ribs for the last month

Expectoration white

Dull continuous pulsating headache in frontal and temporal region since 1 month

Noise aggr.

No desire to talk

Stool – there is urge but it’s hard to pass.

Dizziness- aggravated from talking and noise.

Body restless

BP=100/60mmhg       Temp.=100.7F        Pulse =100

Past history:

Typhoid

Jaundice

Both eyes operated on

Diarrhea

Generals:

thermal = hot

thirsty

sleeplessness

Urine= Frequency ++

App.= No desire with vomiting. She like sweets and fruits very much

Bitter taste in mouth

Mentals – She is an angry and domineering lady, who likes to work constantly. She doesn’t like to sit on the couch and likes to finish her work on time.   If anyone contradicts her or asks questions repeatedly, she expresses anger. She doesn’t like consolation. She likes to talk but due to her illness she only talks when needed.

Investigations – 01/04/2019

In USG there was bilateral pleural effusion.

CBC       HB- 3.4gm/dl          RBC- 1.25      WBC- 2500

Neutrophills- 5.6     Lymphocytes – 3.8         Platlets- 65000

Bone marrow aspiration:

Comments –  markedly hypercellular bone marrow shows erytheroid and myeloid hyperplasia with presence of many (40%) abnormal cells with nucleas degeneration. Megakaryocytes are reduced in numbers.

Impressions – Bone marrow is infiltrated by atypical cells

D/D: 1. Metastatic carcinoma

2. Hematolymphoid malignancy.

Mental conflict:  On further questioning she revealed that there were multiple deaths in her family of those younger than she. She felt much anger about why they were all dying. “This is my age. I should die. Why am I living? Rather I should die not them.”

 Rubrics:

Mental – death desires

General- restlessness physical.

General- leukemia

Stomach- vomiting eating after aggr

Extreme pain – Twitching.

Fever- Periodically.

Two remedies came through in repertorition:  Arsenicum and China

I decided to give Chinum sulph.   WHY?

The sphere of action of China is more on blood and there is history of fever.  Also, arsenic is somewhat about fear and company desire of.  In this case she has anger more with no desire for company. Also pt has marked periodicity.

Rx:  Chinum sulph 200 -2 doses  od

Sl for 7 days

Follow up : 25 April 2019

There is nausea with no appetite.

Chill with fever.

Temperature rise mainly 5-6am and 4-5pm.

Weakness better .

Rib pain that is aggr when lying on painful side

Body stiff.

Dizziness

Stool – SQ

Urine – frequency decreased.

And mentally she is feeling better. (In what way “better”?)

The thoughts of death and anger reduced .

She started to talk again . She again felt good with family members.

Rx China sulph 200- 2 doses

Sl continue.

Follow up 21st May, 2019

Appetite towards normal. Nausea Amel.

No bitter taste

Sleeping better

Urine – normal

Dizziness amel

No fever

No Body ache

No weakness

No ribs pain.

Rx. China sulph 200-2 doses

Sl continue for a week .

Follow up 27th May

No other symptom except headache

Headache bursting 3-4 times

Appetite increased

Rx  China sulph 200-2 doses . Once in week.

Next report was done on 27th May 2019

CBC: Hb= 9.5gm/dl       PCV =31.8        Neutrophills = 74.0       Platelets= 2.84 lacs

Symptomatically she is absolutely fine with increased appetite, good sleep. No body ache, no headache, no nausea, no ribs, no pain, No weakness.

Follow up 10 June 2019

No complaints.

Appetite- N.

Sleep – N

No bitter taste of mouth.

No bodyache.

Rx  China sulph 200 -2 doses once a week.

Sl continue.

Follow up 24 June 2019. 

Patient has no problem.

Rx  China sulph 200 -2 doses once a week.

Sl continue for a month.

Follow up 25 July 2019.

No problem.

Rx China sulph 200 -2 doses once a wk.

Sl continue for a month.

Follow up 25 August 2019

No problem.

Rx  China sulph 200 .

Sl continue for a month.

Follow up 25 Sept 2019.

No  problem.

Rx  Sl continue for a month.

Follow up 20 Oct 2019

No complaint.

This last time I gave sl and the patient is cured completely.