Clinical Cases

Uterine Fibroid in a Woman of 40

Written by Vitan Gosain

Dr. Vitan Gosain shares a case of uterine fibroid in a woman of 40. Rubrics used to find the simillimum included: absorbed, imagines misfortune, lamenting because he is not appreciated and dissatisfied with everything .

First consultation – Dec 2019 – The patient is a woman of 40 with uterine fibroids diagnosed through ultrasound (see at end).

Profuse and painful menstruation since menarche

Recurrent episodes of cold and cough as she was a chronic case of fronto-maxillary sinusitis ; << draft of air, drinking cold milk; cannot tolerate draft of cold air on the face ; maxillary region is swollen in the morning on waking; at times has pain in the throat that runs to the ears; becomes apprehensive when winters are about to approach as her troubles get worse.

  • Recurrent episodes of nausea and acid reflux ; << spicy food, fried food, drinking warm water
  • Recurrent episodes of constipation and bloating of abdomen ever since childhood
  • Recurrent episodes of headaches associated mainly with sinusitis and constipation ; <<draft of air, mental exertion, physical exertion, cold milk, closed room , sunlight; >>open air
  • Chronic low back pain since 10 years
  • Pain in right leg since 3 months << hanging the limb; >> letting the limb rest on the ground; >> supporting the leg with the hand; >> massaging the limb

PHYSICAL GENERALS

Thermal reaction – averse to extremes of temperature

Thirst – 5-6 lit/day, large quantities

Desires- cold drinks, sugar, sweets, coarse food

Aversion – egg, sour

Intolerance – milk ( gastric upset), chocolate (headache)

Sweat- scalp, face, axillae,  palms, feet(offensive); palms and soles habitually cold; earlier sweat used to stain linen yellow

Stool- tendency to constipation; diarrhoea from milk; constipation causes headache; sensation of incomplete evacuation felt in the rectum as well; constipation worse before menses

Urine- sensation of incomplete evacuation after urination

Sleep- minimum of 8 hours of sleep required otherwise feels lethargic throughout the day; on back mostly

General modality- >> open air

PAST HISTORY

  • Fronto – maxillary sinusitis (took homoeopathic treatments from various physicians but said that her complaint was never resolved)
  • Deviated nasal septum and nasal polyp
  • Menorrhagia , Dysmenorrhoea, Metrorrhagia – always had menstrual troubles since her menarche
  • Depressive mood disorder
  • Iron Deficiency Anaemia

FAMILY HISTORY

  • Diabetes mellitus
  • Hypertension
  • Schizophrenia
  • Tendency to early menopause

GYNAE/OBS HISTORY

  • G2P1A1
  • Delayed menarche
  • Last 4 days ; cycle 15-21 days
  • Excessive clots since last 13 years
  • Discharge per vagina especially before menses; occasionally offensive and thick; associated with backpain
  • Menstrual bleeding is so profuse that she is unable to move out of the house; slightest motion causes gush of blood
  • PMS- weepy 5-6 days before menses
  • Cramps in lower abdomen, back and thighs

PATIENT AS A PERSON

  • Introverted
  • Weak willed
  • Nervous temperament
  • Anxious especially when given a task
  • Indecisive, seeks for support in order to make a decision
  • Speech was hasty and had a lamenting tone
  • Hurried but physically too weak to do things quickly
  • Fear of monuments and lizards
  • Want of self confidence
  • Wants to be a perfectionist; When asked why so, she said so that she does not miss out on anything – insecure attitude)
  • Fixed idea that her body is immune to all medicines and she felt that she would never recover from her complaints
  • Physically too weak and exhausted; Exertion to go and get food from the kitchen; cannot lift a glass of water as hands feel very weak; contraction and tightness felt in limbs; at times wants to lie down the entire day
  • Oversensitive – runs through and through; oversensitive mood, everything affects and upsets her, be that her physical ailments or the atmosphere at home; oversensitive skin where any injury leaves a mark and takes a long time to heal; she said that she is very sensitive to energies and can sense the presence of negative energies accurately; oversensitive to odors especially perfumes and tobacco smoke
  • Restlessness because of her physical ailments
  • Occupation – earlier working in a corporate firm, now a homemaker
  • Domestic environment- lives with her husband and a 13- year-old son; Home environment is healthy just that her husband is short tempered and they do not get along very well because of different ideologies; averse to slightest discord at home; tries to please others at home.

ON OBSERVATION

  • Patient always used to apply very bright coloured nail paints. She also wore a lot of jewellery.
  • Always complaining and never showing any signs of happiness. On being asked about this trait of hers, she exclaimed that she had visited many psychotherapists for the same and never got any benefit. This patient had always been very morose.
  • Laxity of muscles
  • Sagging of skin (especially face)
  • During the interrogation the patient exclaimed that she has never been appreciated in life. Her father was very strict and uncommunicative and her mother was always involved in her own professional life. She was never appreciated in spite of her achievements. After marriage the husband also had a different ideology about life and he also never appreciated the efforts she put in to make him happy.

PRESCRIPTION

The lady was prescribed Calcarea Sulphurica starting Dec 2019 in ascending LM potencies. At LM 4 the fibroid dissolved (Ultrasound July 2020 )

Even during the follow ups, this woman used to say that there is no amelioration whatsoever. However, on asking about each individual symptom, she used to confess that they were all ameliorated (in accordance with her lamenting nature).

CALCAREA SULPH IN A NUTSHELL

  1. ABSORBED, MISFORTUNE, IMAGINES
  2. AVERSION, PERSONS, WHO DO NOT AGREE WITH HIM
  3. LAMENTING, APPRECIATED, BECAUSE HE IS NOT
  4. SADNESS, DESPONDENCY, DEJECTION, MENTAL DEPRESSION, GLOOM, BITTER
  5. ANXIETY, HEALTH ABOUT
  6. AVERSION, FAMILY MEMBERS TO
  7. COMPANY, AVERSION TO, PRESENCE OF OTHERS
  8. DESPAIR, RECOVERY OF
  9. DISCONTENTED, DISPLEASED, DISSATISFIED, EVERYTHING, WITH
  10. FEAR, HAPPEN, SOMETHING BAD WILL
  11. HURRY, HASTE
  12. HYSTERIA
  13. INDOLENCE, AVERSION TO WORK
  14. IRRESOLUTION, INDECISION
  15. LAMENTING, BEMOANING, WAILING
  16. SENSITIVE, OVERSENSITIVE
  17. TIMIDITY
  18. CONFIDENCE, WANT OF SELF

Ultrasound reports below:

 

About the author

Vitan Gosain

Vitan Gosain received his BHMS one year ago from Nehru Homoeopathic Medical College (Delhi University). Now there are two homeopaths in his family, as his father Dr. Bimal Gosain is also a homoeopathic physician, practicing for the last 30 years. Vitan has been sitting in on cases with his father regularly for the last five years. He also learned from Dr. L.M. Khan of Calcutta.

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