Clinical Cases

Patent Ductus Arteriosus with Laryngomalacia with Adenoids

Rajiv Peres
Written by Rajiv Peres

Dr. Rajiv Peres presents a case of Patent Ductus Arteriosus with Laryngomalacia in a baby girl.

Miss I. S. was first seen by me on 12th July 2015 when the child was one year old. She presented with skin eruptions on the back, left shoulder, left aspect of nostril since last 3 months. < Shower.  Dx: Atopic Dermatitis. A skin specialist informed the mother that this child would be her permanent patient.

The child’s face had a serious expression with watchful eyes. The mother informed me that she was a restless baby and makes a scene if she doesn’t get what she wants. During feeding her lips used to become red. She desired sweets and had aversion to milk.

Stool was once every morning as soon as she woke up.

This child didn’t sweat much. Never cried and was happy all by herself. Showed interest in animals (pets).

She had a peculiar difficulty in swallowing solids which was investigated by an ENT surgeon and diagnosed as laryngomalasia (congenital laryngeal stridor).

At birth she was 2.8 Kg and on the 3rd day a cardiac murmur was identified. Upon further investigation it was found that she was suffering from P.D.A. but could not be operated on as she was too small.

Family History: Both parents are apparently healthy.

Paternal Grand Mother – Asthma

Maternal Grandfather – Early Onset Type 1 D.M. and expired at 50 years of age as a result of kidney and liver failure.

Maternal Grandmother – Hypothyroidism

Due to predominance of left sided skin lesions SULPHUR 200, 1 SINGLE DOSE was administered. (First Prescription on 12th July 2015)

Follow up – On the second day of starting homoeopathic treatment the eruptions on the face worsened and began to itch. She passed an extra stool.

Follow Up – 20 days later skin eruptions reduced by 50 percent with occasional itching.

On 29th August 2015 the child presented with dry cough worse at night, however sleep was not disturbed by the cough and lots of sneezing in the mornings. Coryza with transparent discharge. These complaints were since last 2-3 days. The child was active, very irritable and would cry for slightest things. This would keep all the members of the family on their toes. Better by moving about or when taken for drive by car. She was worse by touch. No sweating. She was prescribed NITRIC ACID 200, 1 Single dose.

Follow up – The cold passed off and the child improved. Nitric Acid was my choice especially because it is a strong anti-sycotic medicine.

Next Follow up was on 2nd December 2015. Eruptions completely absent, but sometimes itching without eruptions. Sweats on head. Child was observed to be possessive about her things. No medicine was prescribed.

Next follow up on 9th of April 2016

Presenting complaints of dryness of skin over the sheen. It was observed that this child reacted badly to certain foods like dal, Rawa (recent onset). Therefore her mother stopped feeding her these food items. At this point her behavior had changed. She opened up to others; for example she would sing for others and become the center of attraction. She would clean up things and throw them in a dustbin; she would smell everything before eating. Also she would tell people that they are smelly and insist they go away, clean up and return. She desired spicy foods and developed an aversion to sweets. Thirst was for sips of water. I prescribed her ARSENIC ALBUM 200, 1 Single dose. Arsenicum Album type exhibits great sensitivity to foods.

Next Appointment was on 8th of September 2016

She had chief complaints of running nose alternating with blockage at night. This would wake her up from sleep at 3am. (sycotic timing). There was a lot of sneezing since last 2 days. She behaved rudely to others. She would say “Shut up and get out”. Would quickly become angry and cool down. Thermal – Hot. Appetite was small with no thirst. I selected LYCOPODIUM 200, 1 Single dose.

Next Appointment was on 2nd January 2017

She reported with loose cough which prevented her from sleeping. A day before at night she had vomited phlegm after which she was relieved. Coryza in the morning used to be yellow and daytime would be transparent. Often the nose would be blocked nightly. She had problems in going to sleep, would be restless and playing. Sought attention from everybody. I prescribed PULSATILLA 200, 1 Single dose.

Next Visit on 16TH March 2017

She came with complaint of watery coryza and sneezing which does not relieve. Had difficulty in breathing at 1 am, which was better after sitting up. Appetite was poor. Not much of thirst. I chose ARSENIC ALBUM 1M, 1 Single dose.

Next Appointment was on 22nd May 2017

Just before this visit, an echo of her heart was done by a Cardiologist which revealed the size of the P.D.A. at 3mm, restrictive PG 45mm with small L-R Shunt. A repeat follow up of echo was advised by him in order to decide on coil closure surgery to be performed at Bangalore. The family was in a panic state.  I consoled the mother with reassurance that homoeopathy will resolve this issue within the time available with us. This child was snoring badly at night and her sleep would get disturbed invariably at 2 am. The child preferred to lie down on her belly. X-ray done by ENT doctor showed Palatine tonsil and adenoid masses. This child used to love to socialize and desired to travel. She would suffer from anticipatory anxiety. She liked to eat oranges and grapes which would often result in a cold. This child had trouble in identifying colours; she knew only two colours blue and pink, which resulted in lower marks school.  This was the typical confusion and cross-connection we see in a Medorrhinum.

I saw that this was a good opportunity to introduce the anti-miasmatic remedy. MEDORRHINUM (200), 1 single dose. Regular monthly follow up was advised even if the child doing keeping well.

Next Visit on 18th July 2017

It was monsoon and she had come down with running nose with yellow coryza in the morning; later during the day it would be watery coryza. She also suffered from nose blockage that was worse in a warm room. She was cranky, stubborn, does not want to share her belongings with anyone. Crying all the time. Had a dominating nature. Putting everything in the mouth. Thermal: Hot and warm body. I prescribed SULPHUR 1M 1 Single dose. (Sulphur is a good complementary medicine to Medorrhinum)

Next Appointment was on 24th August 2017

Snoring problem was absent. But she was suffering from fever since 2 days. Continuous Fever with heat in upper part of body. Child was irritable, cranky when disturbed. She desired to lie down on her back. Felt worse after eating. No appetite, thirst for large quantities. I decided to give her BRYONIA 200 1 Single dose. Follow up- Fever resolved within 4 hours.

Next Visit on 13th November 2017

The child was taken to Goa Medical College (Asia’s Oldest Medical College and Hospital) Echo revealed that the Size of the P.D.A. has reduced to 1.5mm and murmur was not audible. The cardiac interventionist explained that the hole is so small, that a coil closure surgery cannot be done. So child will be monitored once in six months till the age of 5 years.

No medicine was given

Next Appointment on 6th February 2018

With complaints of enlarged tonsils and dry cough while asleep. Cough is improving after eating sweets. Does not obey. Puts things in her mouth. Eats things from others plate. Very naughty. Prone to cry if her demands are not met with. For example, cried in the morning because her grandmother filled her water bottle on half full. I prescribed Sulphur 10M, 1 Single dose.

Her mother says that she has become fair in complexion with homoeopathic treatment as compared to before, when this child suffered from atopic dermatitis. She has become like a tom boy in these 2 years. She wants to do all activities which boy’s do and use their toys, like playing with  football in the outdoors, and not with a doll indoors. Before she was not like that. Now she has become rough, fights a lot, cries a lot. Earlier she used to remain quiet all the time. Now she can name all colours accurately. This indicates the reversal of miasm from sycosis (introvert and silent) to psora (open, free and chirpy).

Previously, laryngomalacia occurred when she drank water. It used to go up into the windpipe and give rise to coughing while eating, followed by vomiting. The mother said that within the first eight months of homoeopathic treatment this problem disappeared completely. She likes to dance all alone everywhere. The Sulphur child’s charisma bends light waves in a room with their incredible confidence and self-esteem. They are always in action moving about.

A miracle? A coincidence? No. It is a logical chain of events that we can expect a cure if we treat the root of the problem. First we improved her then we cured her heart. Dr. Kent says, if surgery is necessary, give the constitutional remedy to tackle the miasmatic problem. We follow his advice and we try to do our best. Homoeopathy is growing rapidly among the masses due to the strong support of our patients. I am very grateful to my patients who contribute to the homoeopathic world in their own way.

About the author

Rajiv Peres

Rajiv Peres

Dr. Rajiv Rui Peres (M.D Hom) is a homoeopathic practitioner from Goa, India having eight years of experience. He was awarded the ‘Best Teacher’s Award’ 2010-11 by Shri Kamaxidevi Homoeopathic College & Hospital, Goa. He has done research on various health issues and organises free homoeopathic camps in communities about every six months. He has delivered health related awareness lectures to college students and has various publications to his name in ‘The Goan Review’ magazine. He has been actively involved with the Homoeopathic Medical Association of India, Goa. He has treated patients with various ailments from India and abroad. Shanti Homoeopathic clinic, Curtorim, salcete, Goa

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