I first saw this 32- year-old man in August of 2020. He had suffered a stroke four years prior, at the age of 28, and he and his wife came to me for help with recovery of his cognitive, emotional and physical function.
He stated: The things I’m experiencing now have always been part of me. The stroke has amplified it. I shake my leg all the time, and it takes enormous energy and focus to not shake my leg, has always been the case. Back in school as a boy, I’d try to stop biting my tongue and shaking my leg, which were nervous tics.
If I don’t like what I’m doing, nearly impossible for me to concentrate and that translates into mistakes. In elementary school it was the reason everybody thought I don’t care. But I want to always be on the move.
I was never diagnosed with ADHD. My concern is something very new. In India, they said it was behavioral issues, but I was timid. “If he focuses, this is curable, but he doesn’t want to do it.” I was constantly doing something. I bit my tongue, I moved my leg, and it was generally difficult for me, I was always punished. Impossible, for me to be still, I was always moving.
Maybe my personality, I’m outgoing. But things which I want to do even became more difficult. As I said, constantly on the move, fidgety. I look absent minded, so many things happening. Random thoughts flooding my brain, and my brain is overrun with everything. My wife has to say everything two or three times. Cacophony of noise. I’m trying to follow the storyline, not ridden with emotional baggage. I try to settle and center myself, sometimes I can. It takes an enormous effort, so much so that I can’t do anything else.
The tic increases when I’m under stress. Sometimes I’m so impatient to talk, I eat words. I can’t follow the chain of thought. I can’t wait for my wife to finish the story, get to the point!
A lot of people have impatience I know, but it comes between me and my productivity. Oh, that email? I don’t have the patience, just send it. Cooking, for example. I remember, my wife noticed, when I cooked something before the stroke, she liked it. Now after the stroke, she does not like it. I’m so impatient to get this thing done.
I don’t look fidgety right now, but it takes an effort. Shake the leg, chewing gums, nibbling things. Small things to eat, berries. Not fidgety, not nervous, would only chew once. Now up to 8, 9, 10 times.
Before stroke, stress eating, hog on food. Distraction, TV, music, movies. I know the amount of it, the volume of intensity of it is directly proportional to how I feel it.
Fidgety – what is it? Somebody talking with me at enormous speed, where I can’t make sense of what is happening. (makes noise of fast gibberish talking). My thoughts are so fast, can’t even pick one. Seamless transition, worried/stressed about something – the moment I’m worrying, the noise kicks in. I also feel cognitive fatigue.
Heaviness of emotion, when I feel fear, I feel it here (heart). When I don’t feel fear, I just worry. Sometimes I talk to myself, don’t worry, got this, then all that slows down. Tongue biting and restless leg is part of me as long as I have known.
I had convulsions when 10 months old and then one in tenth grade. In 10th grade, I bit through my entire tongue. I was going to take this test, had massive headache. I went to sleep, talked to my parents, don’t know what happened. Somebody’s having a rock concert in my brain. Then in my mouth, is when I bit – all blood, hospital, they did brain scan, couldn’t figure out why.
His wife chimes in to tell me about the stroke:
“His main carotid artery for right side of brain was blocked. Docs said if it blocks at once, whole supply would be lost, person would hardly survive. In his case, blockage has been happening either 10 or more years or since birth, over a long period of time, his brain was forming alternate pathways to supply right side.
It was almost completely blocked, blood supply trying to get through, formed clots, blood pressure was almost normal when reached ER, clots pushed inside into new places, that’s what caused disability of left side.
What I observed, because I met him long before stroke. He showed me his resume. What kind of resume is that? Basic grammar mistakes. Teachers thought he didn’t have a good attitude, make mistakes, missed exam questions. People around him think he is above average intelligence. He will not be able to do simple things but can think about very complex problems. Loves to gain knowledge. “
Patient continued: Before stroke, did not tire me. They’re amplified. The constant noise, mind chatter, takes energy from me. I could closely see correlation, missing questions. That was a very common occurrence growing up, learned to manage that.
Wife: Stress? We were on visa, have to get it stamped. 6 months ago, had to get visa stamped, was going to do it alone, filling out the form. She looked at it and it was terrible. She re-did it. Sit down, pacing yourself like this! Why so much nerves, chewing gum, full of processed sugar. My parents are diabetic.
Tell me more about I always want to be on the move:
If I move, the stress wouldn’t catch me. The sitting there and doing nothing, the big thing. Meditating takes a lot of energy and willpower. Fighting this 24/7 is exhausting, Sitting and doing nothing, have to do something. Drink tea, have a conversation. Weekends, nothing to do. Don’t know what to do during that time.
That’s how I’m programmed. Fidgety- craving, a pizza and coke, a brownie, or donut. Crave – any junk!
Before stroke, I didn’t like sweets, spicy – after stroke, something sweet, mostly chocolate. I would drink tea or coffee constantly. Desire caffeine and no change after caffeine. Drinking coffee or tea doesn’t give me any sort of up.
Aversion?
Seafood. Anything from the sea. Not even seaweed.
Drink alcohol?
No. Used to, even back, not a big drinker.
10th grade, I was sleeping, got up, no memory how I got to the hospital. Waking up in ambulance, really hurts me in the tongue. Half of my body was on the bed, half of it was on the ground, at home.
Fears? Massive fear of failure. Say I have something coming up, any sort of examination, any possibility of a negative outcome. Even if most simple thing. That is the base feeling of most of my stress. Fear that I’m not good enough.
I do remember going to high places, limited protection – scared of going to the corner, feeling I’d flip over. No motivation to jump, just standing there.
Wife: Pre-stroke, go swimming, he did go deep in the sea, and drive really fast, wasn’t scared of anything.
I don’t have fear of death. I don’t know why, unique in me. Every rational guy should have fear of death.
Reckless behavior? Yeah.
Wife: He amplifies numbers – 100 miles, he’d say 1000. When admitted to the hospital, he made his salary so high. I said, you’re not making millions! With numbers, exaggerates.
Dreams? Weird dream – alien attack when I was a kid, killed everybody, movie, I was so scared. Titanic was released, extreme fear of drowning. I wouldn’t close my eyes in the shower. Usual thing is I usual don’t have any fear. For me it is the other way around.
Perspire easily? Yes, everywhere. Mostly on my stomach. Sweat if it’s warm, not all the time.
Headaches? Usually a big deal if I get it. Every time I had a headache, I had a seizure or stroke, something of that magnitude, otherwise I don’t get. None since stroke.
What do you love doing?
Maths! I’m a certified geek. I can talk half an hour about this. I think God is a mathematician. If you see nature, you see math. Fractal, self-repeating pattern. Poetry right there. Gets my juices going. I get excited!!
Analysis
In my analysis of this case, I saw at the center, extreme restlessness. He repeatedly said he wanted to ‘be on the move’ and stressed how difficult it was for him to not fidget, to appear normal, and to stay with the thread of the story.
Rubrics:
- Extremities, Restlessness, legs – I weighted this rubric with a 2
- Mouth, biting, tongue
- Mind, mistakes, makes, writing, in
- Generalities, food and drinks, fish, aversion
- Hurry and Haste – I combined the following:
Mind, hurry, haste, ailments from, agg
Mind, hurry, haste, exhausting
Mind, hurry, haste, restlessness, with
- Cramping: I combined a few cramping rubrics to make:
Extremities, cramps in legs
- Generalities, weakness, left
- Fear of failure – I combined:
Mind, fear, failure, of
Mind, fear, failure, of, business or work, in
- Mind, thoughts, rush, flow of
If you are wondering why I didn’t use ‘stroke’ rubrics, I did. I had multiple repertorizations, but this was my final one, as I figured I could look for stroke symptoms in my remedy comparisons AND he had stressed at the beginning of his intake that the stroke “amplified’ these pre-existing symptoms.
Remedies that came up that interested me were Zincum Metallicum, Argentum Nitricum, Nitric Acid and Hyoscyamus, (I earmarked it for that immoderate dancing/laughing that he’d expressed). After much consideration, I decided upon Zinc LM3 daily for a month.
When I saw him for his first follow up after one month, he reported no change at all. His impatience had increased, actually, and he was a bit more restless than usual. His prostration of mind was more exhaustive than ever, and he became quite aggravated,
I went back to my analysis and saw in clearer light, the left-sidedness, the fear of failure, the anxiety before an exam. I switched him to Argentum Nitricum 30c and had him take it once a day for three days. When we checked in two weeks later, he said there was major improvement on the days he’d taken the remedy, lasting only for a few days following his last dose.
He was eager to try it again, so I had him go back to Arg-nit 30c, this time every day, this time for 7 days. When I saw him a month later, he reported the following:
Follow up
Started taking remedy and there was an uptick in my cognitive fatigue, but then it reduced. I felt much more focused. But that dropped off when I stopped taking the remedy.
My brain is injured, so tired easily, but it’s starting to reprogram itself. It’s been four years. Everything is suddenly much better! In some tasks, I performed much better than expected. Much better – surprised myself.
Restless leg? I definitely see throughout, relatively reduced.
And tongue biting, reduced.
Fidgety- ness, on the move, all was better.
Improved cacophony of noise.
My eating my words improved!
Cramps in the calf muscles? Not that bad. Would end up really dehydrated but now not so much. Even typing improved again.
When first taking remedy, emotionally didn’t feel any big change. Cognitively yes.
At that time, not as frustrated, more calm. Again, that dropped off when I stopped taking the remedy.
Wife reported:
He’s better in these ways, but more aggressive/angry than he was before. Small things. Was better when he was taking the remedy.
At this point, I decided to move him up to a 200c potency, split dose. At his follow up one month later, he delightedly reported the following:
I experienced extreme improvement in cognitive – massive uptick in performance. Walked into grocery store, remembered all stuff my wife asked me to buy, remembered where it all was, even! That stuff was difficult for me. What used to take me 20 minutes, could do 10 minutes.
None taken in January. Still I didn’t feel the need. There’s a specific thing that happens when I realize I am going slow and the world is going fast, that cognitive decline. I haven’t felt that in over a month. I don’t feel the need to take a medicine.
The habit that has formed, I try to take my time. In my 30’s, taking more time. Not near that cognitive impairment. When that kicks in, following a conversation is difficult for me. Judging a lot of things; I have a toddler.
Sensory overload at the mall, that is fine. Most of it is normal, physical fatigue. That specific thing that happens has not happened yet. Not drunk or intoxicated, that feeling when I’m not in control, hard to describe but I know when I know. It’s like watching the world in slow motion view. Inclined to take the remedy again when that kicks in.
My leg, because of stroke, big toe stays up. Usually stays, I showed this to my allopathic doctor. Side effect of the stroke, muscles might be twitching or tensed. Usually it’s raised. Cars that have manual transmission, I tend to miss the clutch.
Left hand side, always improving. There are things I couldn’t do before, I can do it now, or things I could do before, not well, doing better now. That’s a positive.
Shaking leg, much better. Definite for me. The whole restlessness bit.
Wife – He is much more alert, more comfortable. There is some slowness that other people observe when he’s booking a cab or uber. He stares at it for some time. Looks at it, takes his time, takes a moment to figure it out. He’s able to do it, just takes a moment.
He’s also able to put his thoughts on paper together better, that is much better. But starting, full stop, missing periods, then using small letters to start a sentence, instead of starting with a capital letter. Those things, he forgets. Maybe a condition he has had since childhood. Slight things are still there.
His anger, he gets frustrated when a lot of tasks, but not that much as before, doesn’t affect us. those things are much better than before.
From Dec. 15 – January 6, I’ve been very good. I almost feel like I never had a stroke!
Conclusion:
That last line was the holy grail for me. I figured we’d found a remedy for this man’s state – not only his symptoms, for his whole state. They moved back to India that winter and are in touch for care for their son and the wife. He has recovered from his stroke symptoms almost completely at this point, and continues to rely on his Arg-nit 200c when he feels a backslide in that cognitive fatigue.
