Migraine in a Woman of 31

 Case

Male, 31 years old, fair, redhead; trim, muscular build   Droopy, drowsy appearance of eyes. Works doing surveillance at local casino.  Newly married, lives with wife

Presenting Complaints:

Migraines, fear-comes with being stressed about when next one will be, where he will be when it occurs, how much pain he will have, and how to prepare for it.

Lack of confidence.

 

1. Duration: 20 years–1^st migraine age 11 whilst in school-started with blurry vision, couldn’t see; didn’t tell teacher or parents, was scared, didn’t know what he was experiencing.

 

2. Migraine 1x month, can have 2 back to back, 2 in a day or several in a week, then go a while before he has another. Unable to find a pattern, varied, changeable, no relation to time of day, weather, or season.

 

2. Onset: slow-begins with anxious odd, feeling like body feels out of place, then thoughts take over & mind races.

 

2. Right sided

 

3. Goes into visual aura-starts with dot 10-20 minutes, becomes a solid fuzzy green speck, fades out, bends vision, can’t focus; slowly dissipates after 30 min. Longer the aura, longer the pain.

 

4. Pain follows-pulsating/throbbing right temple pain, builds up over 1 ½ hrs. Sore eyes & sclera get pink or red during pain stage.

 

5. Pulsating doesn’t stop, throbbing with helplessness.

 

6. Some nausea without vomiting.

 

6. Head feels weird-sore, like mashed potatoes the next day. If he can get full rest, will feel okay

 

7. Better: dark; warm shower having water run over his head; urination or bowel movement; feels more secure at home (quiet, safe, he can control the environment).

 

8. Worse: sound, light.

 

9. Concomitants: Gets emotional, cries, anxious, angry, lots of worry, frustration. Stressed out-thinks about how he’s perceived, what others think, letting others down, can’t participate in things-misses out many events, especially family outings.

 

Others say he looks really, really pale and eyes are puffy during migraine. Both eliminations increase noticeably; bowels can be loose. During pain stage he can get cold, hands and/or whole body shaking.Will take warm shower to relieve pain, lots of covers in bed; will take shower 2-3x if pain persists.

 

10. Other treatments: tried blood pressure medications 10 years prior, none helped, taking ibuprofen for pain.

 

Had Cat scan & EKG. Dentist checked teeth/mouth for any jaw problems. Doctor wanted to do what sounded like very severe surgery, open him up and do some back surgery but patient didn’t completely understand what this procedure was; didn’t go back to this Dr. after that visit.

Head to Foot:

1.Eyes: Some fuzziness in vision until he focuses, thinks job related. Eyes seem veiny, bloodshot.  Age 18 hit/punched in eye.

 

2.Ears: has difficulty hearing people at times. Usually person is mumbling or he’s not giving them his full attention. Has white noise in ears-ringing, chime sound, low pitched.

 

3. Nose: Left side hit in karate class when in high school. Thinks there may have been done damage, not able to breathe as well out of left side.

 

4. Throat: clears a lot-may be hereditary-father does this too.

 

5. Heart: Small pain in rib area when twisting certain way. Had tendency to high blood pressure at times since his teens.

 

6. Lungs: Bronchitis 1-2x yearly. Starts as tingle in throat, goes to sore throat, then to head, sinusitis or goes into the chest with mucousy cough.

 

7. Stomach: heartburn since his 20’s. 1-2x wk when he easts acidic foods, if he overeats going to bed afterwards, can wake up & happen multiple times in the night.

 

8. Back-lower back pain, achy. Thinks due to work-slouching, sitting on his feet while in a chair. But can experience while standing, doing physical work, driving. >thinking about it.
9. Extremities: hands: come possible carpal tunnel symptoms-would hurt, rare now. Easily gets rash in underarm area-has to be careful type of deodorant he uses. <water washing Joints: knees, lower back, wrists can be sore upon waking. <pressure by standing up; >bed, being upright, moving about, rest.

 

10. Eliminations: Stool 2x day; Cheese causes constipation.

Skin: dry patches on elbows, flake, peel. <winter

 

11. Nails: smooth, slight sheen.

 Past Medical History

Chicken pox, measles, bronchitis multiple times, stitches on head 2x, allergic to sumac. Had all vaccinations, no reactions. Mom’s pregnancy with patient: due to 2 prior miscarriages, she had ring type device surgically placed in uterus to keep him in utero until full term.  He was born by C section.

Family Medical History

Mother-high cholesterol, measles, obesity, shingles     Father-measles, appendectomy. Brother: appendectomy, measles, allergies. Paternal grandparents: grandmother-back problems, kidney stones, baldness, on blood thinner

Grandfather-diabetes, gall bladder removed, late Alzheimer’s. Maternal grandparents: grandmother-pacemaker, slow heartbeat, gall bladder removed

Grandfather-open heart surgery in his late 50’s, lost a kidney from gunshot suicide attempt alcoholic.

 Generals:

1.Food Desires/Aversions: craves pizza, chicken parmigiana; dislikes mushy foods-like papaya, avocado.

2.Hot foods

3. Prefers: sweet, savory, sour, bitter, salty Chicken, beef, eggs, fish
4. Drinks: water, cold or room temp. chugs a lot at one time, regularly
5. Perspiration: normal sweating, nothing notable.
6. Urine/stool: nothing unusual about either. 1-2x day stool.
7. Thermal Reaction: Prefers warm, not hot weather; likes cool breezes of late summer/fall.

Hates rainy weather of fall, cold/wet. Favorite season is summer. Would live in a cold climate for 5 yrs. Unbearable-humidity, not the hot temps of summer. Sleeps in underwear, kicks off covers in the winter. Prefers cool room for sleep; likes fresh air, some breeze on him.

 

8. Sleep/dreams: Sleeps average 6-7 hrs. Has fan on all year long to drown out any noise. Left side; has a lot of reoccurring dreams with similar themes 1x month-he can change them voluntarily, quite pleasant & loves his dreams, almost more than real life. Full of fantasy & exciting places to be.

Temperament: Amiable, artistic, competitive, creative, friendly, honest, humorous, loyal, planner, reliable, follows routine.

 Significant events/outstanding memories:

0-10 Held back in kindergarten, had speech classes in school

10-20 Migraines, wisdom teeth removed; parents moved away, he & brother moved in with grandmother in high school; grandmother’s friend punched him; death of grandfather.

20-30 Started working; dropped out of college, broke up with girlfriend; brief falling out with best friend over bills when they were sharing an apartment; moved in with girlfriend. 30-present Death of grandfather (dad’s father); marriage

Happiest memory: hiking with loved ones-family, wife. Anytime out in nature-happy, positive.

Saddest memory: death of grandfather 2 years ago; death of best friend’s father as he was a father figure to patient when parents moved away. Words to describe himself: hardworking, strives for good impression, enjoys being funny/ humorous, lovable, kind, creative.

Words others would use to describe you: dependable, humorous, easy going, loveable, cute. One thing to change: to be more confident so he can go after his dreams, things he wants.

Fears: suffocating, public speaking,  not being in control of things. Anxiety about health & money.

Life Story/anything else you’d like to include:

 Emotional griefs:

1. Recalls being sad in grade school & had hard time scholastically. Had to go to speech classes. Dreaded reading out loud, didn’t feel confident, afraid what others would say if he made a mistake. He felt like everything he did was bad when he was young.
2. Got picked on by older boys in his brother’s grade, called him names because he was pale, would cry.
3. Also changing schools in 5^th grade and again in 9^th grade caused sadness.
4. As a teenager caught stealing once, told parents before authorities. It was a very emotional distraught occurrence. Afraid mother would disown him. They both cried.

Disappointments:

1. Parents moved to another state to help start a church when he was 15 years old. He chose to stay with his grandmother; some fighting over this. He felt angry & abandoned by his parents.
2. Got punched in face by alcoholic friend of grandmother. She was helping this man who was abusive living with her. Patient felt she chose this man over him & he was family.
3. Dropping out of college; he felt he wasted time, money. Links this with his decision to go to that college where his girlfriend went & they later broke up.

Stresses:

1. Stresses over money/finances-needs to have a certain amount in savings or feels stressed.
2. Job related-works at a casino-internalizes feelings of jealousy of people who just waste their money on gambling without a care.
3. Talking-has hard time talking about stressors in general

 Embarrassment:

1.Embarrassed about teeth-used to have a pointy top tooth that was recently fixed-had routine checks in school he didn’t like. Letter sent home from school, didn’t want parents to know he might be hurting, afraid what they might think, threw letter away, very emotional.

 

2.Quitting college & breaking up with girlfriend at age 25, super stressful, was almost suicidal.

Patient wanted to add in addition:

At time of 1^st migraine in school, grandfather died and he went to the funeral. His 1^st experience of death. Recalled specifics-the coffin, wondered who this guy was & seeing him dead. Also, going through his grandfather’s house-odd smells there, it was weird, frozen dinners in the freezer that had freezer burn, smelled bad, recalls the strong smells.

Asked patient to tell me more about the funeral: it was creepy, scary. Funeral home was scary with fear of the unknown, having no control & anything can happen-like someone you shouldn’t be like a hospital-being a place of suffering, hurting, scary, where things are out of your control and nothing you can do.

House and basement were dark, creepy with old moldy smells. He associates moldy smells with that event. He stated he was young and couldn’t comprehend it all. Patient also said he had just spoken with his mother before the case taking and relayed some things she said: that he doesn’t share his feelings, would bottle things up inside when he was younger. He wouldn’t cry at times and man it up. Was very shy, internalized everything, was independent-because he was alone a lot & didn’t have many friends.

Mental Causations: Abandonment, anger from neglected childhood, professional jealousy, joy, rudeness of others, emotional stress.

Miasmatics: Psora+++   Sycosis+++   Syphilis+   Tubercular++

Scores: Mental 6      Physical 7     Sleep 4       Appetite 10      Temperament 8   Overall 7

Prescription: Gelsemium 200C/1M

Follow up:

1. Felt really good after taking Gels. Almost a month with no migraine, now several in a row. Possible retracing, is past pattern.
2. Patient noted since treatment migraines seem to begin in the morning.
3. Aura lasted longer-but intensity & pain stage shorter. More like regular headache, not as overwhelming. Got thru the pin better.
4. Didn’t have the drained feeling with weakness he usually has afterwards.
5. New awareness-at beginning of aura, he tried to calm himself & what was happening & noticed all of a sudden, the visual aura stage cleared. Anxiety, pain & racing mind all shut off immediately & he felt better. This made him feel stronger within himself, sense of personal empowerment he didn’t have before.
6. Heartburn much improved.
7. Achy knees,joints-hasn’t noticed.

Scores: Mental 8   Physical 9   Sleep 4   Appetite 8   Temperament 6     Overall 7

Graph: Going up   He said he felt better, like a normal person not worrying so much about his migraines. A bit on the down side since he was having several migraines in a row at present. He believes medicine has helped with stress.

Prescription: Boost & Melilotus Q SOS 6-8 drops in wm water 8-12 hrly.

 Follow up:

1. String of migraines ceased. Had 1 migraine-aura same, pain more acute, sharp. Melilotus didn’t touch the pain.
2. Another new awareness-able to calm himself when migraine is developing. Now aware of a physical response-sweaty palms, a catch in his breath, heart pounds-like fight or flight response. Didn’t notice this before.
3. Anxiety a lot less now. He wonders if the anxiety might be a migraine trigger.
4. Stress-able to let go of it a lot easier.
5. Sleep improved-didn’t hear all the noise around him that he usually does.
6. Heartburn-excellent improvement.

Scores: Mental 9    Physical 8   Appetite 8   Sleep 8   Temperament 8    Overall 8 or 9

Graph: Still improving even though pain stage with recent migraine was more intense. Emotionally doing much better, having more awareness of anxiety, body responses.

Prescription: Boost, watch and wait

 Follow up:

Couple months gap in appointments, patient cancelled

1. Had 4 migraines in several months. He said this was improvement, usually he’d had several in a row which hasn’t happened.
2. He didn’t really feel there were any real changes from last visit-migraines were not worse
3. Anxiety doing ok
4. Stress handled better now
5. Still has some anxiety he would like to address. Heartburn-not really a problem

Scores: Mental 9   Physical 8   Appetite 9   Sleep 8   Temperament 8  Overall 8

Graph: Still going up

Prescription: Boost Kali Phos 6x tissue salts 4 tablets in warm water every 8 hrs as needed.

Follow up:

1.Recently had bloodwork, had high blood pressure, elevated cholesterol.

2. Tired, more fatigued. Had to work longer stretch on night shift.
3. Had a month with no migraines, then 2 in a week.
4. Has been taking Kali Phos tissue salts-states it helped him deal with stress & took it down a level.
5. Eyes-still some blurriness, stares at computer monitor, may need glasses.
6. Teeth-some sensitiveness to cold things.
7. New notice-had to leave work due to migraine-once he got outside in the cold winter area, had no pain. Pain>cold
8. Stutter-new-noticed this at work recently, around the time he had migraines.
9. Mental focus off some.
10. Sleep- sporadic, will sleep 4 hrs then will want to get up.

Scores: Mental 4   Physical 7   Appetite 9   Sleep 4  Temperament 6    Overall 7

Graph: Patient states things were going up, now going down, more stress.

Prescription: Arg Nit 200C/1M   discontinuing Kali Phos for now to see how new prescription addresses anxiety.

 Follow up:

 1.Had 2 migraines back to back & said this was new. Used ice pack which helped some.

2. Aura same; duration is shorter, pain intensity decreased.
3. Fell off his bike, rough fall, felt jarred.
4. Teeth sensitivity better
5. Heartburn good
6. Extremities no discomfort
7. Stressed more than normal-took Kali Phos
8. Woke up 2x with a headache but didn’t develop into a migraine.
9. Stuttered a couple times, no increase.
10. Some mental fogginess-can’t find the right word.
11. Increased stress due to grandmother’s death-he was close to her, some job related.
12. Sleep-better but still has some struggle, wakes up
13. Blood pressure continues to be high patient wants to address

Scores: Mental 6   Physical 8   Appetite 8   Sleep 6  Temperament 6   Overall 7

Graph: Going up some

Prescription: Boost   Crataegus Q 10-15 drops every 8 hrs

Follow up: *There was a gap of a year and a half since last appointment. Patient had stated he wanted to take a break from treatment but came back. (Appointments had not been every 6 weeks right along).

1. Felt frustrated-had a cluster of migraines-more than 1 day, 1 episode of 3 days, felt lousy afterwards.
2. Always has aura, can begin during sleep, lasts 30 minutes, eyes hurt, pressure. Ache the next day.
3. Pain in temples, frontal area, throbbing for 1 hour-head feels achy the next day. Better in cold air, cold application.
4. Brain feels sore, no nausea
5. Chilly, shaky, anxious
6. More calm now
7. Afterwards has loss of energy
8. Head feels cloudy-thought process takes longer, slower
9. Anxiety is 6, last year 9-new job. He thinks anxiety can contribute to developing migraine.
10. Blood pressure, cholesterol still remain high.
11. Head to Toe: Head-hair thinning
12. Better at multi tasking
13. Eyes- notices floaters
14. Having some headaches around 12:00 noon, gets really tired about 2:00 afternoon
15. Eating larger portions-wants to cut back
16. Heart some racing, <exertion
17. Skin had some acne
18. Lower back some achiness

 

Scores: Mental 7   Physical 6   Appetite 8    Sleep 6    Temperament 7   Overall 7

Prescription: Gelsemium 30C/200C-  Lower potency due to problem more physically related.

Crataegus Q, patient may decide to focus on high bp next

 Follow up:

 

1. After taking prescription, patient had a long headache, not migraine.
2. Anxiety lower than it has been 3/10
3. Blood pressure slightly lower
4. Heartburn ok
5. Concentration better
6. Going well on the job, multi tasking
7. Sleeping well; if he wakes up, can go back to sleep, wakes refreshed
8. Nothing else notable

Scores:  Mental 8  Physical  8  Appetite 9  Sleep 8   Temperament 8   Overall 8

Prescription: Boost   Continue Crataegus Q

**Patient cancelled follow up due to conflict with his schedule. He didn’t call back to reschedule.

I didn’t hear from him until much later when he contacted me for homoeopathic assistance with his infant daughter who was experiencing symptoms of colic.

Patient stated he hadn’t had another migraine since his last homoeopathic prescription.

Patient has not had a migraine in 6-7 years. Case of migraine cured!