This is the case of a 74-year-old woman whom I personally have never met. She lives in North America but we are in different time zones, hence all our consultations were done on video calls, thanks to modern technology.
On video she comes across as a pleasant cheerful person, smiling and laughing through the online consultation. I’m presenting the case ad verbatim. Here are some are her replies to the questions I put forth during case taking:
Arthritis since 6-7 years. <right knee. On both knees, shoulders, ankles. It is manageable with physical therapy. Weather doesn’t affect me, even if it is too cold or too hot. Now I take Tylenol (OTC painkiller) if I am in too much pain.
Now my knees are clicking quite a bit. Pain < long distance travels like in a plane. Last night it was in my knee. First it started on my right knee, then my left knee after a few years, then the ankles started bothering. Sometimes shooting pains in the legs. Starts on the shins and spreads all through the leg, even on the calves and ankles, it is a cramping pain, then it’s hard to put the leg down, starts getting better as I drink water.
Once I stand up, I cannot walk right away, I have to stand up for a bit and then I start walking. I drive long distances; I take my granddaughter to school. Pain < walking too much. I avoid walking too much, then I get really tired and the legs start hurting.
I had cancer of the right breast in 2013, it was a very early stage and didn’t have any symptoms, they surgically removed it. Sometimes I get a little tired but it’s not that I am too tired or anything,g as I am going on with my activities quite okay.
I also have gout since 5-6 years. Mostly get it on my right big toe. It starts getting very red, swelling starts taking place, it gets tighter and very painful. I cannot put my foot down, it is not constant, it is a burning pain, it stays in the area. If I put my foot down and walk it hurts, >raising my foot. I don’t take any meds for uric acid levels. In my family all my brothers have been suffering from gout. I have cut down on spinach, red meat, but occasionally I take them. I took shrimp one day and the next day I had gout.
I have BP, so I take meds for it. After 9/11, my children were in Canada, so we moved to Canada from the US. We gelled into the system very well; I was driving school bus and worked in the airport driving big coaches. Even when we moved from India to America it was not a cultural shock. We grew up in Bombay, India, studied in convents, knew English.
My grand mom was a Homeopath, she was magical, treated us with Homeopathy. I grew up with it and I just love it. We come from a loving home; we didn’t have any want as a family. I am a very adjustable kind of person, I can live in any circumstance, it doesn’t shake me up much.
I am very enduring. I can endure anything going around me, if there is something going on in the family. There were ups and down in my marriage. My hubby was from the air force, he used to drink a lot. My kids would be very upset, at one point he was like an alcoholic. He has had a strong temperament, he would anger easily.
I am married now for 53 years. I wasn’t a Christian before marriage, my husband is a Christian. I always loved Jesus, and I grew up in a convent. When my son was born, my husband was very abusive, I had to protect my son. My husband would beat me up, I was very submissive then, I never backlashed.
I had no one to talk to. (Smiling as she is talking about the domestic violence she had been subject to) My father cut me off from the whole family as I had married against his will. I was very upset as I was very attached to my siblings.
They consider me to be almost like a mother. My father was also very abusive and my mom was very docile. We were 10 siblings; I am the second oldest. My grandma and myself would take care of the kids . From a young age I was responsible. I am the kind of person who feels it is my responsibility to take care of things, I can’t just stand around and look. I have to take care of my grandkids, I put others first, and I have always been like that. (Laughs)
I live with my daughter but I tell her you don’t have to worry about anything. My son lives close by, sometimes I go and cook for them if his wife has not cooked. My grandkids love me to death. I am thoughtful, mindful and always caring. When my father cut me off from my family, I was very lonely, I would tell my grandma occasionally about my problems.
My grandma would give me money if I needed, she was the most generous, sacrificing person I have seen. She is like a mom to me; I lost the most precious thing in my life when she passed away. It so happened I was there in Bombay when she was dying, she went into a coma and went away. I was hurt, I felt I lost a part of my own self. I cried, I felt lost.
My parents and grand mom were very concerned for me, as I was married out of my religion and my husband was not doing too well. Losing my grandma was the worst thing that happened in my life. I felt her walking away that night she passed away, and then I got a call from the hospital that she passed away.
My husband was only abusive with me, never with the kids. I was a teacher at that time. I used to cry a lot, I used to protect my kids so that they would not develop a dislike to their father. I would just tell them that don’t worry daddy is not sick, I would try to keep them away from that. They have great respect for their father. Later I started getting a little more bold, outspoken and started giving back to him.
I am still very tolerant. The only reason I stayed in the marriage was because I didn’t want my parents to say ‘I told you so’ and by then my son was also born. (Laughs). I tend to hold my emotions inside and show a smile to the world. I am talking to you now from my walk-in closet, this is where I hide, this is where I pray and cry (Laughs).
Even now I don’t show my sadness to anyone, my daughter will feel bad. Even now I hold on to the family and marriage, so I don’t want to break down in front of them. I have made a lot of mistakes, my husband has a habit of going back to the past, that brings issues between us.
We argue very often, most of the time I try to keep it in our room, I don’t want my daughter to see that. We live in a joint family, I don’t want disturbance, one thing leads to another.
I don’t have a temper unless somebody pokes me to the extent where I can’t hold it anymore. Now off late, if it is taken to a level I can’t control it anymore then I just talk it out or reason it out. I used to always cover up other’s mistakes and my grand mom called me a lid. Even with the grand kids I try to cover up for them.
For me love is the most important thing. I want to love and I want to be loved.
I have students who write letters to me and I just want to love, that’s all. I feel love is such a beautiful thing, and it can calm the biggest monster. I think it has come from my grand mom, she was a very stern person but she had an amazing love in her heart. She was ever ready to give.
I have no fears. I am not afraid of dying, I am willing to accept death when it comes. I don’t want to become handicapped and make other’s life miserable.
I feel cold more easily. I like warmth, when it is around 60-65.
I sweat a lot when it gets hot. When I was in India I would perspire like crazy. I like to eat sweets; I love apple and blueberry pies. I like eating lots of butter and ice cream.
My hubby knows I am consulting with you. I don’t want to tell my daughter yet as she gets so worried when I am sick. She gets really worked up and concerned so I am afraid for her. She does a lot for me; I don’t want her to pay for me. I have savings and I have stipends for old age.
I am religious. I am a believer in Jesus and I pray every day and go to church regularly.
I hate to sit around. I even do the laundry at home, nobody told me. I feel that I should be useful, otherwise I feel what is the point of my existence, others come first. I have fairly good stamina. I am developing right shoulder pains nowadays. I let hot water run on my body and that helps the pains.
My Analysis
The things that stood out for me while taking this case were: Her over affectionate nature to the point of being self-sacrificing for her family. She was considered a mother figure among her siblings and doing everything in her measure to protect/shield her siblings, children and grand kids.
She protected her children from her husband’s violent nature when they were growing up and took all the brunt on herself. Also, she adopted a new religion so easily to blend in with her husband’s faith. She adapted easily to new situations like moving from the USA to Canada and settling in the new environment with her children and being very productive and useful to her family even in old age.
Another thing that really felt strange to me was that she was smiling when she was describing all the domestic abuse she has gone through in life! She says she is cheerful, never shows sadness to the outside world. Hides in her closet to do the consultation so that her daughter doesn’t get worried about her health or pays the fees for her consult.
The closet also is her hiding space to cry alone or pray! She’s always keeping herself active and productive in the family. Always giving to the point of sacrificing herself for others.
She believed that love is everything was so passionate about it (I could feel her passion and strong emotion as she was describing the importance of love).
Physically, her problems were affections of the big joints due to arthritis and the gout related issues. I needed a remedy that takes into consideration all those factors.
I took some of these symptoms for repertorization to give me a general guideline on the possible suitable remedies. It is pretty common for most of the polychrest remedies like Sulph, Puls, Calc to come up frequently as the topmost indicated remedies in almost all the repertorization charts.
Small remedies are not so well proved and hence will not come up frequently, even if they are the most suitable for the case. It is therefore very important to really think if the most common polychrest remedies are really the most suitable for a given case.
The remedies that felt appropriate for her case from the topmost displayed on the repertorization chart seemed to be:
Carcinosin– They try to please others all the time, can be self- sacrificing, taking up adult responsibilities early on in life. I have used Carcinosin in many of my patients earlier and her nature seemed far more ‘giving’ and ‘self sacrificing’ than the typical Carcinosin types I have experienced so far.
They also tend to be controlling of their environment and situations which I did not see so much in this patient. I thought of keeping it as a back up remedy if I couldn’t find a better choice.
Vanilla– It isn’t a well proved remedy but despite that shows up in the top 20 remedies on the chart, which was totally unexpected! I looked up Vanilla planifolia from the limited information we have about it in our materia medicas – it covers benevolence, affectionate, sympathetic nature and is known to treat severe skin related issues (which is not an issue for our patient).
Prunus spinosa– This belongs to the Rosaceae family of remedies and doesn’t show up in the repertorization chart at all! Commonly known as ‘blackthorn’, a flowering shrub that is native to certain parts of Europe, Asia and Africa. It has blackish bark and thorny branches and was effectively used as a wall to keep animals and intruders away.
People needing this remedy tend to be extremely loving, generous and caring; sacrificing themselves for their family to the point of neglecting oneself, like this patient shielding her kids from their father’s abuse and taking the brunt on herself. There is a need to keep doing, serving and keeping people around them happy.
The books talk about Prunus being useful for various neuralgias, bladder affections like cystitis, heart problems like congestive heart failure leading to edema especially of the feet. Dr Massimo Mangialavori mentions this remedy being extremely useful in joint affections, especially of the large joints and puts it on par with Rhus tox in these aspects.
I also found this symptom- ‘Pain in the first joint of the big toe, as if it were pulled out’ in Lippe’s textbook of Materia medica and a couple more (=gout like affections).
Remedy prescribed: Prunus spinosa LM1 for 3 weeks
Follow up 6 weeks later
(Cheerful, laughing and smiling through the session)
I think the remedy did a good thing for me. I used to take Tylenol for arthritis very often earlier. After starting this remedy I just took Tylenol once because I had to walk a lot. Earlier was taking Tylenol every second or third day.
I am feeling very good. I used to feel very tired often, now I don’t feel so tired. More energetic, more comfortable in my body, don’t feel weighed down. I used to feel heaviness inside, I used to have heartburn when I ate.
I couldn’t eat lentils at all, now a little bit of lentils doesn’t bother me. I even had spinach once and it didn’t cause gout. If I indulged in spinach and lentils, or if I drank wine or black label I would feel the gout is coming. Even if I took one meal of spinach, I would feel the redness and pain coming up earlier.
Last gout attack was 3 months ago. I used to have one every 3 months. I would have to curtail my eating habits. I love spinach. I used to get cramps in my legs and in my shin, calves, ankles and this time I have had it only twice.
Arthritis is much better.
(Shows me a bunion on the right big toe, and one on the second toe of the right foot). I think it is because of the arthritis, I have osteo arthritis. They are not hurting. When I wear my boots sometimes it hurts. Ankle pains are much better. Only my right knee is painful from time to time, that is where the arthritis originally started, it used to hurt every day earlier.
I don’t want to be a burden when I grow older. I want to stay healthy as long as I can. (Laughs). Sleep like a baby always. I noticed the positive changes around 10-11 days into the remedy. Biggest thing was that I could stop taking Tylenol. My kidney readings have improved.
I am emotional but I can control my emotions. I have temperament of enduring things. I do get sad at times when something happens to my grandkids, but I know god will take care of it, so I just pray. I feel a little happier, earlier there were certain things that would bother me like how the grandkids would say something rude to me when they are angry, then it would hurt me and I would feel offended, now I don’t take it personally.
I am taking care of myself. Sometimes it’s good for me to get away from here and be on my own, when I drop my granddaughter at school, I just get away to the mall or hang out on my own, I don’t feel guilty about it now, earlier I would think I should get home immediately and put the food on the table, now I am like the food will get on the table when it has to.
The constant burden in my head, the guilt is not there, I am free now. I cannot go anywhere on a vacation on my own, it has to be with my husband, he is a very jealous man, he will not let me. A group of women are going on a tour, I want to ask my husband when he is in a good mood and go for it. Earlier I’d think what my husband would think all the time, now I don’t even think of calling him if I am late to get home.
The days when I feel more pain in my knee, sometimes it happens at night in sleep, the next morning then I take a dose of the remedy, and it helps immediately. Now on going down the stairs more free with my movements.
My daughter now knows I am taking treatment with you. I didn’t want to tell her first as she insists on paying for me and I don’t want that.
(We see significant improvement with her physicals, energy levels and emotional state. Her pathological need to keep serving that kept her unwell has come down to a healthier state of also caring for oneself and not feeling guilty about it. We decided to stay on the same remedy and instructed her to use a dose as and when she has her physical complaints aggravating. She continued to do follow up’s approximately every 2 months or so with continuous improvement).
Follow up 10 months into the remedy
Everything is fine. Arthritis has started bothering me a lot….when in awful pain, the doses help me with the pain, within an hour or so, it starts working and the relief lasts for 3 days or so and goes back to being bad.
The doctor said I don’t have sleep problems, it’s because of aches and pains. The knees hurt a lot especially right side, then it goes to the shin and all the way inside my bone. Most of the time when I go to sleep I feel nice and comfortable. I feel like wanting to go to the loo and if I try to control it the pain goes up, and then I go to the bathroom and the pain goes down.
Recently did a blood test, everything is fine. Kidney doctor said the tests are fine too. Creatine is low, he says it’s okay. Uric acid levels are good. Since last time I spoke with you more than 2 months ago, haven’t had the gout at all.
Have cramps in my legs and ankle, some days its really bad, cannot sleep. 2 days back it was bad, it went to my ankle, had to walk a lot to get rid of it. Almost 15-16 years. Gout was more recent than the cramps, gout has been for about 4 years. Arthritis started about 8 years ago.
Energy is good. Only certain days I feel a little worn out, tired. I have always been energetic, when I started with you I was getting very tired, that’s improved quite a bit. Was thinking the meds you have given is pretty good.
Mentally emotionally I have become stronger in my ways. Don’t get emotionally upset so fast. Anger is also not much. Before I used to always get angry with my husband, now when he gets angry, I talk to him very calmly later. I never was like that, because of his nature, I had to retaliate and protect myself. I am able to take time off for myself, I feel its time I do that, it gives me more strength to face situations.
My daughter tells me mom you have made every one of us handicapped, I do everything for them, I have to bear that blame (Laughs). I am the second oldest in my siblings. The older ones were step siblings, they lived with their mom. In this family I was the oldest, I took care of all my siblings. I would cover up for them, they all say I am more like a mother to them. I started taking care of them when I was 9 years old.
I have used about 5 doses so far in the past few months. Was telling my husband this remedy is good for me.
(We decide to stay with the remedy and use a dose as and when needed for acute exacerbations; no follow up was planned. A year and half goes by and I don’t hear anything from her all this while. I recently emailed her to find out how she has been doing)
2 years later (Email from patient)
Thank you my dear for your concern. I am fine and with God’s grace well and healthy. And yes, whenever I don’t feel good or really under the weather your prescribed remedy makes me feel better.
It is almost like an elixir in down times. My daughter and I bless you for your perfect remedy. Thank you. I had developed a chest choking cough but no fever, also body ache. I thought I was on the verge of corona virus infection but taking the remedy three days in a row saved me.
Got my blood test done, there was some virus but not this. Gout and arthritis are much better. It is almost a year I have not had gout. Thanks to you. I am so blessed that I approached you with my problems. God helped me to connect with you. Love you, stay well.
(This remedy, Prunus spinosa, slowly helped to build her immunity over time as it was the right constitutional for the patient. It worked from inside out also strengthening her state of mind and emotions so that she learned to care for herself too and not neglect herself. At the same time continuing to be loving and caring to the people around her.
It helped her deal with all the acutes, including the severe cough recently which resembled the deadly covid. Her main physical symptoms the gout and arthritis are more manageable and acute exacerbations more far apart. No follow ups planned, consult only if needed).
