By Erin Douglas, Homeopath and CCHM Graduate
Patient Profile: Gender: Female, Age: 52 years, Occupation: Currently unemployed due to illness; previously was a president’s secretary
Case start date: 21 December 2013
History of Present Illness: Patient arrived bearing a diagnosis of Systemic Lupus Erythematosus (SLE) and presents many of the common symptoms including intense fatigue, aching joints and skin rashes on face.
Etiology: Patient has never been well since receiving a series of vaccinations before going to Honduras to participate in missionary work. She received hepatitis A & B, tetanus, influenza and the meningitis vaccinations together. Two months after the vaccinations, she became so ill that she had to cancel her trip to Honduras.
Major Presenting Symptoms: She has experienced unexplained weight gain (40 pounds in one month), aching joints, severe body pain, vertigo with nausea, hot flashes, swelling in both legs (right worse than left) and intense fatigue that prevents her from getting out of bed. She is sleeping eighteen hours a day and still wakes feeling unrefreshed.
Mind/Mental Attitude: While in the past she always needed to be in control, she has “now turned to God and is trying to learn to let things go”. Even before her sickness, religion was a large part of her life. She is currently on anti-depressants, but has expressed a desire to come off them when she feels more stable.
Vertigo: Vertigo comes with nausea and appears completely random; it is debilitating to the point where she has to cancel everything for the rest of the day if she suffers an attack which occurs 2-3 times a week.
Body Pain: On a pain scale of 10, she says her pain is a 9; feels as though she has “been run over by a truck every single day”.
Hot Flashes: On a scale of 10, she is experiencing hot flashes of 9 which appear to come randomly and travel upwards. If she is unable to get outside to someplace cooler, she “will feel like I need to throw up”.
Extremities: She suffers with ingrown toenails on both big toes and claims to have had them for “as long as I can remember”. She displays swollen legs from the calves downwards; the right leg is noticeably worse than the left.
Stomach: If she does not eat around 11:00 a.m., she experiences slight nausea. She also looks for food between 8:00 p.m. – 11:00 p.m. every evening. She is very sensitive to wheat products; her stomach becomes hard and distended after eating.
Skin: The patient displayed lots of brown moles all over the skin. She cannot handle wearing wool as it makes her “incredibly itchy”. Since being sick, the patient will sometimes get a rash on her face – right side by her nose – from too much sun.
Body Temperature: She is constantly hot and will sleep with the windows open even in minus 30 degree weather; being in hot and humid climates will make her sick.
Thirst: The patient is very thirsty and always has a bottle of water around her which she finishes several times per day. She prefers to take big swallows, not sips.
Sleep/Fatigue: She is sleeping eighteen hours a day and does not wake feeling refreshed; she feels intense fatigue.
Rubrics:
Generalities, heat, flushes of, upwards
Generalities, lassitude
Generalities, pain, pressing, load, as from
Generalities, vaccination, after
Vertigo, nausea, with
Mind, religious, affections
Additional – I also suspect that the patient may suffer with gluten intolerance. I have asked her to try removing gluten from her diet for the next three weeks as a test period to see if she feels better.
Remedy Differential:
Silicea Terra – Covers most of the presenting symptoms nicely with the exception of the upward movement of her hot flashes. Silicea also tends to be a very chilly remedy; does not fit with the current case.
Arsenicum Album – Covers many of the presenting symptoms, though the thermals are wrong. In addition, the patient does not fit the mental picture of restlessness and fastidiousness so common with arsenicum patients.
Sulphur – Covers all of the presenting symptoms nicely, including the ill effects from the vaccinations and other general symptoms.
Remedy:
- Sulphur 200CH – dry dose, 2 pellets.
- Additional dose of Sulphur 200CH, dry dose, 2 pellets, one week following first dose.
Follow up #1
20 January 2014:
Overall: The patient is very happy with the remedy and its affect on her symptoms. She reports that she did feel an aggravation the first day after taking the remedy, but since we had discussed it, was able to deal with it. She also felt significant improvements in many of her symptoms, though she did notice that her symptoms started to return the last couple of days, although not as intense as before.
Mind/Mental Attitude: Monday was the one year anniversary of the patient’s father’s death, so it is a tough time. Despite this, she feels relatively good and did not realize until taking the remedy that she “felt like she was walking through a fog all of the time”. She has consulted with her doctor who has agreed to cut her dosage of anti-depressants.
Vertigo: The patient reported that the bouts of vertigo and nausea that used to hit around 11:00 a.m. have stopped since taking the remedy.
Body Pain: She is feeling much less pain, especially upon waking.
Hot Flashes: While she is no longer sweating, her skin still gets red. In addition, the patient noticed that now the hot flashes subside almost as soon as they begin; before they would last around five minutes.
Extremities: She has noticed a dramatic difference in her stiffness and her ankles are not as swollen; she can now “move her ankles properly as they are not so puffy”. The patient also reported that she no longer has any ingrown toenails.
Stomach: She had a “weird episode with a bit of gluten free toast, vomited it out and then felt fine”; no repeat occurrences.
Skin: She reports having a rash on her face that flared up for a week or so after taking the remedy and then it went away.
Body temperature: Similar to before, the patient is still hot; “the sun is still not my favorite thing”.
Thirst: Her thirst appears normal for her, she continues to drinks large quantities of water in gulps.
Sleep/fatigue: While the patient is still sleeping eighteen hours a day, she is waking up with less body pain and feeling more refreshed when waking. “I feel better upon waking. There is still pain, but not as intense. It doesn’t feel like I have been run over by a semi-truck, maybe just a little truck”.
Additional: She has stuck to a gluten free diet and wants to continue it for another month to see how she feels.
Remedy: Based on the fact that the majority of the symptoms were reduced but had started to reappear in the last couple of days, I recommend a repeat of the previous remedy with a longer duration until the next follow-up.
- Sulphur, dry dose, 200CH, 2 pellets with a follow up in four to five weeks.
Follow up #2
27 February 2014
Mind/Mental: She continues to work with GP to reduce anti-depressants; her pharmacist was surprised that her dosage has been cut in half. Despite this, the patient has experienced no issues with decreased focus or feeling overwhelmed.
Vertigo: No issues.
Body Pain: The pain and stiffness in the patient has reduced and she has started walking three times a week with her husband, “only about a kilometer or two”. The patient has noticed a bit of stiffness in her ankles and hips after getting home from these walks.
Hot Flashes: In the first three weeks of taking the Sulphur, the patient only had one hot flash every three days; yesterday she had three. She has deduced that the nausea is linked to the hot flashes which the patient noticed when the Sulphur was not working as well and she experienced a prolonged hot flash.
Extremities: She reports that she no longer suffers from in-grown toenails. She “doesn’t know where they have gone… very unusual but great”. In addition, the swelling in her legs is better, though she has noticed that her hands are swelling and cramping.
Stomach: She has had no digestive issues. She has also noticed that since taking the remedy and going off gluten, she is not as hungry. She has been craving eggs.
Skin: The patient is currently displaying no skin issues.
Body Temperature: She tells me that she feels hot all of the time.
Thirst: She has been very thirsty recently and is drinking lots of water.
Sleep/Fatigue: She has been sleeping “amazing…I am now sleeping through the whole night and stopped taking afternoon naps about two weeks ago”.
Additional: She has stuck to a gluten free diet and says she has no intention of returning to eating gluten. She will be traveling back to Honduras to complete more missionary work in a couple of weeks and will be getting a vaccination for traveller’s diarrhea.
Remedy:
- Sulphur 200CH, dry dose, 2 pellets.
- Instructions to take additional dose while travelling:
- 15 April 2013 – Sulphur 200Ch, dry dose, 2 pellets (day after returning home from Honduras).
Follow up #3
16 June 2014
Mind/Mental: She returned from her trip and claimed it was “totally awesome”. She is still coming off all of the anti-depressants and has an appointment in May with the rheumatologist to have blood work done.
Vertigo: The patient reported no issues with vertigo.
Body Pain: She has been having “slight joint pain”; mostly felt if she has not stretched before walking.
Hot Flashes: The patient reported that her hot flashes are pretty severe now and in the last couple of weeks she is having up to 5-6 per day.
Extremities: During her time in Honduras, she was “very swollen”, though since returning, the swelling in her hands and feet has come down to the point that her “wedding ring flew off of her finger”. She continues to have no in-grown toenails.
Stomach: She had a couple of stomach issues while in Honduras including “some diarrhea with vomiting after eating some very rich creamy foods”. She is currently sick with the flu and has no appetite.
Skin: While in Honduras, the rash on her right side came back; she took the remedy upon returning and it went away.
Body Temperature: She is still hot; but had “no real issues” in Honduras “as long as she wore a hat”.
Thirst: Her thirst has remained unchanged.
Bowel Movements: The patient reported that she had “diarrhea from rich, creamy rich foods” while in Honduras.
Sleep/Fatigue: The patient reported that she has been incredibly fatigued and claims that she “will never do a trip like that again without taking the proper time to recover from the stress it puts on my body”. The patient is also sick with a cold/flu and is sleeping a lot again.
Additional: She has been suffering with a pretty serious cold/flu and displaying lots of post-nasal drip and green mucus. She was given a steroid nasal spray two weeks ago by her doctor and has been using it three times a day. The patient has remained gluten free.
Remedy:
- Sulphur 1M, dry dose, 2 pellets.
- To assist her system with her prolonged cold, I also recommended:
- Olive Leaf Extract, 2 tablets per day, 250mg per tablet, 7 days;
- Probiotics, total bifido/lacto cultures 50 billion, 1 pill daily, 15 days.
Follow up #4
14 May 2015
She has been doing really well and is back to working full-time. She is now sleeping normal hours; eight hours per day with no more body pain. While she is still having hot flashes, they are not debilitating. In November the patient had a breast cancer scare and since then everything has “gone downhill” as for two months, the doctors seemed unsure whether she had breast cancer or not. During this time, the patient was “very scared and stressed out” and she conveyed that the incident brought up many memories of her father’s death. Thankfully, the patient does not have cancer, though she has been suffering with uncontrollable weeping and anxiety attacks since the episode.
Mind/Mental: She is “weeping all of the time and cannot stop; even the slightest thing brings on tears”. When she is feeling sad, all she wants to do is “curl up in a little ball and stay there”. Claims that she feels better after weeping especially when her “husband comes and gives her a hug”. Suffering from anxiety; fear of upcoming events; unknown circumstances stress her out. Will suffer flashes of heat during anxiety attacks.
Eyes: The patient reports that her eyes are “constantly dry” and she is always putting drops in them.
Vertigo: She reports no issues with vertigo.
Body Pain: No body pain issues.
Hot Flashes: She is having two hot flashes per day which appears to coincide with her anxiety attacks.
Extremities: While on the airplane, her “ankles swell slightly”; otherwise she reports no issues. The patient continues to have no in-grown toenails.
Stomach: She reports that “anxiety and heat will bring on intense nausea in stomach”.
Skin: No skin issues.
Body Temperature: Her thermals have changed slightly. When the air conditioning is on, she now needs to wear a sweater at work, though she still cannot handle being overheated which will bring on anxiety. She prefers to be in the open air.
Thirst: The patient claims not to be as thirsty as before.
Bowel Movements: She will get diarrhea from “rich creamy foods”.
Sleep/Fatigue: She sleeps the whole night; eight hours. She is now waking up “on her own” in the morning, feeling that it is time to get up.
*Based on the emergence of new symptoms (mind/mental, stomach, eyes), a change in remedy recommendation was necessary.
Rubrics:
Eye, dryness
Generalities, air, open, desire for
Mind, anxiety, flushes of heat, during
Mind, weeping, aloud
Stomach, anxiety
Remedy Differential:
Lycopodium Clavatum – Covers most of the symptoms well with the exception of anxiety during hot flushes.
Sepia Officinalis – Covers many of the symptoms, though body temperature is wrong. Sepia patients have a tendency to be chilly and seek the heat; this patient suffers with heat.
Pulsatilla – Covers all symptoms and satisfies all other generals (body temperature, digestion, etc). Main mental symptoms (weeping and relief from weeping) were covered nicely by this remedy.
Remedy:
- Pulsatilla, 30CH, dry dose, 2 pellets with instructions to call in a week for a follow-up.
Additional dosages:
- Dose of Pulsatilla 30CH dry dose, 2 pellets: 21 May 21 2014.
- Dose of Pulsatilla 200CH, dry dose, 2 pellets: 12 June 2014
Follow Up #5
10 August 2015
She called to say that she is feeling much better. Her weepiness has lessened and she has enrolled in a healing seminar to deal with any emotions that may still be lingering from her father’s death. The hot flashes are no longer an issue and her anxiety attacks have lessened in number and severity; she is only experiencing perhaps one short anxiety attack every three weeks which she suspects will disappear when she is finished the healing seminar. Her sleep is good and she feels no fatigue as long as she works within her limits; she is able to comfortably handle a forty hour work week, though if she works any more, she will experience intense fatigue. She has started thinking about what she needs to do to lose a bit of weight.
Conclusion:
Although a homeopathic cure for auto-immune conditions such as Lupus cannot yet be claimed, this case shows how considerable relief and a return to a functioning lifestyle can be achieved within the span of a year.
