Patient Name: Tanya
Consultation Dates:
- July 18, 2020
- August 16, 2020
- September 20, 2020
- October 20, 2020
- January 18, 2020
- Tanya is a 26- year-old female, who came to me in July 2020, suffering from severe migraines. She has been suffering from migraines since she was 12 years old. The pain becomes very severe and it leads her to crying and continuous vomiting.
The only thing that could relieve the pain is Voltfast, an NSAID, taken at the instant she feels a migraine coming on, otherwise that also doesn’t work. Sleeps sitting in a dark room, closing her eyes and breathing only offer minimal relief.
She has seen an osteopath for a few months which helped a little but the migraines came back at the same severity and strength after she stopped the sessions.
The triggers are stress, alcohol and spending a lot of time in the sun. Aggravations are intense light, sound and spending a long time in front of a laptop screen.
Initial Consultation
The first thing I noticed about Tanya was her sweetness and sensitivity. The way she walked, carried herself and spoke showed this cuteness. She also cared greatly about the way she looked. She had full make-up on and dressed in a manner that showed off her looks. She also appreciated and expected many compliments.
Other than the migraines, Tanya’s face and body erupted with pimples in March/April 2019. When I asked her what happened around that time, she said, “Before I turned 24, I had no issues. Since I turned 24, I got pimples and a weird rash on my foot that comes and goes.” When I asked her again what happened then, she simply said that she was getting older. I guess only a 26 year-old would think they are old!
She treated these eruptions with antibiotics but they did not completely disappear, which bothered her as she cares so much about her looks. She always carried cream in her bag and once she saw an eruption she would suppress it with the cream.
Tanya’s menses were very light and her cycle was 35-40 days. She also gets severe cramps on the first day which she also takes Voltfast for.
Tanya had an eating disorder when she was a teenager and now she cares a lot about how much she eats. She prefers her food cold and she likes to eat easy finger food like crackers rather than have a proper meal. She likes milk but it bloats her and she gets hungry at night.
I repertorized the case using MacRepertory software, The Complete Repertory 2018
The remedies that ranked the highest were Pulsatilla, Aconite and Arsenicum Album. I chose Pulsatilla as it fit Tanya’s personality very well and the central essence of Pulsatilla is mildness, softness, timidity and shyness. Pulsatilla can also treat all forms of menstrual problems and it is ameliorated by eating cold food.
Plan: Pulsatilla 30C, dry dose of 2 pellets taken every 2 days
Follow up 1 – August 16, 2020
At first she got migraines more frequently. The worst was after she took the 2nd dose when she got 3 migraines in 1 day. After 2 weeks and due to the increased frequency of the migraines, I increased the spacing between the doses to every 5 days rather than every 2 days.
Then she started getting the migraines at a frequency of every 5 days and interestingly she would get them in the morning before she took the remedy but they were still with the same intensity as before starting the remedy.
She still took Voltfast when she got the migraines. From the moment she started the remedy she experienced premenstrual symptoms of increased appetite, cravings and bloating. These symptoms were at the beginning of her cycle not towards the end, where she normally experiences them. She also experienced lower back pain throughout the month not just before the menses. The only symptoms that were better were her skin eruptions.
I still believed that the remedy was correct but started wondering if her migraines were psychological as she was getting them only on the days in which she was suppose to take the remedy, before she took the remedy.
I decided to continue with the Pulsatilla but at a higher potency due to the fact that maybe with a 30C there was still some crude substance left and with the higher potency it is more energetic.
Plan: Pulsatilla 200C, dry dose of 2 pellets taken every 5 days first thing in the morning
Follow up 2 – September 20, 2020
After the first dry dose of Pulsatilla 200 Tanya still got a migraine, so I decided to change the dose to a water dose, taken every 5 days as she is clearly very sensitive.
In the following 3 weeks, she had 3 migraines. One was due to alcohol.
She was still taking Voltfast every time she got a migraine. During the second month of taking the remedy, her menses went back to the way it was before starting the Pulsatilla, very light flow with cramps on the first day and lasting for 3-4 days. She did not have any premenstrual symptoms.
As for her skin, she only had a couple of pimples that erupted just before the menses and the skin eruption on her foot was completely cleared. She also suffered from infrequent back pains that occurred in the morning upon waking. These pains did not improve with Pulsatilla.
Tanya’s symptoms were still changeable without a clear pattern which is very characteristic of Pulsatilla so I decided to continue with the water dose but at a higher frequency.
Plan: Pulsatilla 200C, water dose taken every other day
Follow up 3 – October 20, 2020
Tanya still got 4 migraines this month but they were not as strong as before and she was able to wait a while before reaching out for the Voltfast. Her menses was still very light but her cycle went down to 30 days from 40. The skin eruptions have completely cleared.
Her back pain symptoms changed slightly. The pain now moved from her back to her abdomen but were occurring on a daily basis. There was some improvement in the migraine but the back pain was getting worse so I decided to go back and take another look at the rep chart and reassess the case by adding the back pain symptoms.
Pulsatilla was still ranked the highest but I went down the list looking for a more appropriate remedy. Natrum Muriaticum caught my eye. It fit all the migraine issues and scanty menses that Tanya has. She also craves salt, is a perfectionist and is aggravated by the sun. All these are characteristics of Natrum Muriaticum. So I prescribed 1 pellet in dry dose to be taken every 5 days.
Plan: Natrum Muriaticum 200C, dry dose of 1 pellets taken every 5 days
Follow up 4 – January 18, 2021
I saw Tanya a few times before our next follow up and she said that she loved the Nat Mur and that she felt so much better. I was relieved! Finally! During our latest follow up Tanya showed significant improvement.
She no longer suffered from migraines even if she has had some alcohol or spent the day in the sun. She actually said, “I don’t remember when I got the last headache.” She also no longer got the lower back pains and her energy improved.
Her menses was still an issue though. After 2 months of being on Nat Mur, she still had severe cramps that required a pain reliever and it was still very light. The only difference was that it lasted longer, 5-6 days rather than 3-4 days.
I suggested she take 1 pill of Nat Mur every day the week before her menses and report back. During the last menses, she did not have the severe pain she usually had on the first day but the flow was still very light. Her menses remain regular at a 30-day cycle. We were definitely on the right track!
Plan: Natrum Muriaticum 200C, dry dose of 1 pellet taken every 3 days and 1 pellet daily the week before the menses.
During our conversation Tanya repeated, “The pain got worse at age 24.” During our first consultation she also said that her skin eruptions started at age 24 so again I asked, “What happened 2 years ago?” and this time she answered, “I broke up with my boyfriend 2 years ago and it was around my birthday. I went through a very bad break up. My period started shortly after that and my face started breaking out. I was very depressed. Then I decided to hang out with my high school friends again and I started to feel better and happy.”
There it was, the truth finally. That explained the case and why Natrum Muriaticum worked so well. It was disappointed love that led to a suppressed grief and this is a characteristic keynote of Natrum Muriaticum. Had I not asked the important question of what happened at age 24 more than once, I would not been able to pin point the correct remedy. Tanya was one of my first patients, and asking the right questions and then trying to extract the correct answer was still very difficult.
