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Recurrent gout in 83 year old woman/Evocationer

Evocationer, I cant do the whole questionnaire right now but I hope to snag your attention to this post. My mother is 83, Caucasion, in Southern USA with recurrent gout. Previously in right big toe but now has jumped to left wrist. Wrist and hand are swollen with area of redness on underside which is warm. Also middle joint of middle finger is large and distorted. But that finger joint is not painful. Wrist is hot and hand is swollen and painful all the time, worse on touch and motion but painful all the time.

I have tried numerous homeopaths over the last few years. Most recently a well known Sensation Method practioner. No results. Please take case on physicals. She has extremely poor short term memory and cognitive impairment.

Physicals: thirstless. Doesnt like water. A struggle to make her drink. Will drink lemonade but not Arsenicum type. Not super neat. Not a germophobe. Not afraid of being alone.

Gout. Many times in right big toe. Also very bad bunions. Very distorted big toe nails. Right big toe nail removed a few months ago due to it growing sideways into second toe.

Fingernails grow long and beautiful and perfect.

Urinary incontinance. All day and all night. Very strong odor of urine.

Hearing loss. Gunk in ears. No remedy ever given has ever purged the ears and caused ear gunk to purge.

No short term memory. Can remember hardly anything. But erratic and sporatic. Sometimes remembers; sometimes doesnt. But mostly doesnt.

Cataracts. Threatening glaucoma(as in opthamoligist requires her to take eye drops for high eye pressure.)

Disposition is sweet and very caring towards others. Sympathetic. When aware of memory loss says Hates being out of control. Mostly just sweet and better for company. She definitely brightens in company. Now whether its just a distraction from her pain or she wants to hide her pain, I do not know

Please reply. Thank you.
Ruth
 
  ruth45 on 2014-10-29
This is just a forum. Assume posts are not from medical professionals.
Shoot. I forgot to tell you a gave her a dose of Phos Acid 30c about 2 weeks ago. You probably hate hearing that.

Could it have caused new episode of gout in wrist? I dont know.

Gout was previously in right big toe and now had surfaced in left wrist.

Ruth
 
ruth45 9 years ago
Also a chronic cough. Non productive. Worse for taking a deep breath. Urinary incontinence began with coughing and sneezing . Now all the time.

Tip of nose is purplish red.

Also history of Bells palsy. 3 times.

Ruth
 
ruth45 9 years ago
Leans toward chilly.

No particular fears, sleeping positions or cravings. She is not neurotic. Never has headaches. Has good appetite but doesnt drink enough. Sleeps well but too much. If she has no company, she will go back to bed and take long naps but still can sleep all night.

Sorry if all my addendums are annoying .
 
ruth45 9 years ago
Bags under eyes. Upper inner corners too.

Very puffy bags around eyes. And red/ purple nose.

Also very sensitive scalp. Ridiculously painful scalp.

Ruth
 
ruth45 9 years ago
Evocationer, I hope I didnt sound flippant about getting your attention. I would very much appreciate your taking the case. Her cognitive skills and short term memory are very poor so I think trying to get her to answer a full questionnaire would be too difficult and not even reliable.

Thank you,
Ruth
 
ruth45 9 years ago
No not flippant at all. Just takes me awhile to get around to each post because I am doing these between my own clients :)

Can you give me an idea of what she has been given so far, and any reactions you can recall?
 
Evocationer 9 years ago
Oh thank you. I didn't want to sound rude and entitled. I appreciate your willingness to help. I know you are quite busy.

To answer your question, I can't remember. Over the last 25 years I have taken her to two homeopaths in person and consulted two over the internet. Obviously they were spaced out over many years. I think the first one gave Pulsatilla because she was sweet and thirst less. Nothing. The second one I honestly cant remember except that it didn't work. I remember the third homeopath didnt do well on her constitutional but did manage to help on an acute respiratory illness and that was Bryonia. However, it was several days in and maybe she was getting better anyway. But it might have helped. My mother was also injured in a car accident at that time so there was a lot of Arnica, Symphytum and Rhus Tox given.

The most recent homeopath we consulted does not reveal the remedies sent so I have no idea what he prescribed. We tried 2 remedies but as I said, he didn't even ask about physical symptoms but the remedies didn't seem to give any improvement . I watch pretty closely. I think I would have noticed.

Im the only one who believes in homeopathy in my family so there isn't a lot of support for pursuing it. I still have hope that homeopathy can improve my mothers quality of life.

Two more things: her eyes are very small, almost like slits (as she has aged and lost memory ) and I think her Mother was Gelsemium as she told me she used to have to run to the bathroom before going somewhere, like church. That may or may not be helpful.

Thanks so much,
Ruth
 
ruth45 9 years ago
Are you able to get the LM potencies? I would like to start her with Benzoicum acidum 0/1. If not, get 6c instead. Preferably in liquid form (oral dosing liquid or similar).

Dosage instructions will be more or less the same either way.

If you instead have pillules or pellets, you will need a small bottle and a dropper to make your own liquid dose. Mix water and alcohol into this small bottle to the ratio of 5:1. Dissolve 3 pillules/pellets into this bottle. All doses will be made from this bottle.

If you already have a liquid dose just start from step 1.

1. Hit the bottle 5 times firmly against the palm of the hand

2. Place 3 drops into 100mls of clean fresh water

3. Stir very thoroughly

4. Take 2 teaspoons out into the mouth and hold for 20 seconds, then swallow.

This is one dose and the same steps should be taken for any further doses, unless I ask you to change them in some way.

If any old symptoms reappear, or any current symptoms worsen, this is a GOOD sign in most cases. DO NOT SUPPRESS them with other kinds of medication unless you are in real danger (which is a highly unlikely reaction to a remedy).

However, if you are on regular medication it is also important that you do NOT stop taking this. Once it is determined the medicine has acted beneficially, we can look at reducing such medication if safe to do so.

One dose would be taken each day. Repeat each day for 5 days and then report the changes.
[message edited by Evocationer on Fri, 31 Oct 2014 01:01:48 GMT]
 
Evocationer 9 years ago
:). Glad to know we are on the same page. This is my previous post. I prefer your expertise on potency. The wrong potency can mess up a case and I would rather be safe than sorry.

What potency Benzoic Acid for gout?

From ruth45 on 2014-09-20
2 replies
Actually its for reducing uric acid levels which cause recurring gout in right big toe.

This is for an elderly person who may not be able to take several doses per day due to poor memory. It would be better to have a simple dosing schedule of just once or twice a day.

I've seen Benz Ac 30 , 5 drops in water recommended but I dont know if that is 30x or 30c.

Please advise on potency, dose and repetition. I'm pretty sure of the remedy but dont want to start high and risk an aggravation.

thank you ,
Ruth
 
ruth45 9 years ago
The LM 1 remedy came in today and I gave her the first dose. Will follow your instructions and keep you posted.

Thank you,
Ruth
 
ruth45 9 years ago
Ok great. One dose each day, diluted in water, until there is some kind of reaction. Stop the moment there is.
 
Evocationer 9 years ago
I have not noticed any changes at all. I was expecting some change in the odor of her urine but its as strong as ever. (I very gingerly sniff her incontinence pads before I throw the bathroom trash away. )She was getting over gout and that has improved but she was taking allopathic medication for it. Should I continue?

Ruth
 
ruth45 9 years ago
Yes keep going. LMs work very slowly and we may need to hit the right saturation point to see the improvement start (the point of aggravation).
 
Evocationer 9 years ago
Still no evidence of improvement. Urine still smells strong (as I sniff her incontinence pads as I take them out to the trash.). I give her the remedy 5 days out of 7. I cant get over to her house every single day and she doesn't have the mental capacity to prepare it and take it herself.

Her lack of thirst and not drinking enough is worrisome. I did the pinch test on the back of her hand today and the skin stayed pinched. I try to get her to drink and leave notes reminding her to drink but she just doesn't like water and doesnt drink enough even though she has milk and lemonade and sports drinks in the refrigerator.

I appreciate your help.

Ruth
 
ruth45 9 years ago
Hmmm....alright I would have expected some kind of reaction by now, at least some kind of aggravation.

I suspect I do not have enough information to make a proper prescription. Can you answer my normal list of questions about her and let me see what else comes up.

CASE PRESENTATION FOR CLASSICAL HOMOEOPATHIC PRESCRIBING

General Guidelines:

1. Try to be as descriptive as possible. When describing pains or sensations use descriptions along the lines of ‘feels as if someone is squeezing it with their hand’ or ‘it is like an insect crawling around inside’ or ‘it is as if someone is standing over me threatening to kill me’. Long descriptions are always better than short ones. One word answers are difficult to use successfully.

2. Another important part of symptom description for homoeopathy are the ‘modalities’. These are situations, events, activities or conditions which modify the symptom in some way. We usually refer to this as what makes them ‘better’ or ‘worse’ (amelioration/aggravation). The situation may actually provoke the symptom into appearing, make it vanish altogether, or just increase or decrease it in some way. Modalities are vital information for prescribing.

Modalities are typically related to (but not exclusively) the following situations:

A. Temperature, weather
B. Time (day, night, specific times, frequency, periodicity, season)
C. Position, activity
D. Emotions, thoughts
E. Food and drink
F. Drugs, medication

3. How the symptom is perceived is important too – odour, appearance, sound, touch. What colour is it, what is its texture? For gestures, describe what it looks like the patient is doing, or what you feel you are doing while making the movement eg. ‘they look like they are swatting flies’ or ‘I feel like something is pushing my hand upwards’ or ‘it is like I stick a fork in an electrical outlet which throws my body backwards’. Description – it is key to accurate prescriptions.

4. When did the symptom or set of symptoms start? The apparent cause can be useful in determining the remedy, although it is not of the same importance as the previous factors. It may have been a specific event, a disease, an accident or even an emotional experience.

5. Use your own words. Do not copy phrases or descriptions found in our various remedy pictures. Try not to use other people’s ideas or thoughts or words. If you are reporting on behalf of someone else, report their exact words, however you can also report your own observations of them (not opinions).

6. Does the symptom occur alongside another specific symptom? Do particular symptoms only occur together? Does a particular symptom occur with a particular thought or emotion? For example, a headache that always comes with visual disturbances, or stomach pain that appears alongside anger, or anxiety that makes you feel like running down the street screaming.

7. Each complaint should be described fully before going on to describe another complaint. Try not to mix different symptoms or complaints together. Each modifying feature must be clearly attached to a particular symptom/set of symptoms. Any mistake you make here is a mistake the homoeopath will also then make.
 
Evocationer 9 years ago
MENTAL AND EMOTIONAL DESCRIPTION



(Please spend the most time on this section and give DETAILED answers - the homoeopathic remedy is very often decided on the basis of the mental and emotional state of the patient !)


1. What are the issues in your life that bother you the most. Not physical issues but mental or emotional ones. List each one separately and describe why each one bothers you so much.

2. What emotions are the most troublesome for you? What situations provoke these emotions. How do these emotions make you act? Do you feel any ill effects from expressing or not expressing these emotions.

3. What incidents in your life have had a deep impact on you? Describe each incident in detail and how they made you feel? What did you do in those situations? What effect have they had on your life?

4. What are you afraid of? Especially important are phobias, but it might be objects, situations or events that just produce a high level of anxiety. How do you manage your fears? How do you react when confronted with these fears? What would be the worst situation for you to be put in that would provoke these fears? You may need to talk about each fear/anxiety separately.

5. What hobbies do you have? Why do you like each of these activities?

6. Do you have any persistent thoughts, ideas or beliefs that are difficult to stop or cope with? What are they?

7. Do you have any unusual gestures or movements of the body? Do you feel any unusual sensation or pain throughout your body? What exactly does it feel like is happening in your body?

8. When you experience your fears, persistent thoughts, or difficult emotions, what kind of sensation or reactions do you get in your body?

9. When did you feel at your best in your life? What was that like for you? If you imagine the complete opposite of this feeling or moment, what would that be like?

10. Do you feel like you are stuck in a pattern of behavior, especially when trying to deal with your problems? What is this pattern? THIS IS AN IMPORTANT QUESTION PLEASE CONSIDER CAREFULLY AND GIVE DETAILS.

11. What difficulties or problems do you have in relationships? Talk about your family, your romantic relationships, your spouse or partner, your friends, and your work colleagues. You may need to talk about all of these separately.

12. List 5 positive things about yourself. Are there any situations where this positive attribute becomes negative (is a problem)?

13. List 5 negative things about yourself. Are there any situations where this negative attribute becomes positive (is useful)?

14. Do you have any reoccurring dreams? Describe them in detail, including any feelings that come while dreaming. Dreams are very important in unlocking the deepest truth of a patient’s case, but it is not enough to simply describe them in a sentence. Give as much information as you feel comfortable doing.

15. Did you have any reoccurring dreams as a child, or earlier in your life? Describe those in detail including any feelings that came with them.

16. What were you like as a child, your character, your personality, your fears, your dreams, your problems?

17. What kind of environment did you grow up in? What problems where there at home, with your family, with your parents, with your siblings, with school?
 
Evocationer 9 years ago
GENERAL SYMPTOMS

(Symptoms that don’t fit anywhere else, but are things that tend to affect all of you as a person, but are not emotions or thoughts)

1. Sleep - what position do you tend to sleep in?
- what position can you not sleep in?
- do you do anything unusual in your sleep?
- any problems with going to sleep, staying asleep, or waking up?

2. Appetite - What foods do you crave/desire strongly?
- What foods do you hate eating (have an aversion to)?
- What foods have a negative effect on you or cause symptoms?
- What foods have a positive effect on you or seem to improve your health or symptoms in some way?

- What is the effect of hunger or fasting on you?

3. Thirst - What drinks do you crave/desire strongly?
- What drinks do you hate to take (are averse to)?
- When are you most thirsty?
- When are you least thirsty?

4. Stool - Do you have any problems with your bowels or passing stool?
- What is the shape, color, odor of the stool?

5. Urine - Do you have any trouble passing or retaining urine?
- What is the color, odor of the urine?
- Do you have any sediment or debris in the urine?

6. Sweat - How do you feel about the amount of perspiration you have?
- Where do you have the most sweat?
- What is the odor?
- What color does it stain clothing?
- Does anything in particular cause you to sweat abnormally?

7. Sexuality - Any problems with your sexual desire?
- Any problems with your sexual ability or function?
- Any history of sexually transmitted diseases?

8. Menses (Women)
- How many days is your cycle?
- How many days does the flow go for?
- What is the appearance of the flow?
- What is the odor of the flow?
- What kind of stain does the flow leave?
- Any discharge before, during or after?
- Any pain before, during or after the flow?
- What symptoms come before the flow?
- What symptoms come after the flow?

9. Environment – How does the weather affect you?
- How does the temperature affect you?
- How does the season affect you?
- What physical
 
Evocationer 9 years ago
Hi, After I posted that there was no improvement, I began to suspect that she was having some good days after taking remedy. I couldnt go over to give it to her every day and she doesnt have the mental capacity to prepare and take the remedy herself but I started to notice that after a dose she had a good day. And by good day I mean she had more energy and better mood.

To try a higher potency, what should I order?

Thanks,
Ruth
 
ruth45 9 years ago
Interesting. So you think she wasn't preparing it properly, or taking it every day?

I would continue daily dosing with the 0/1 for the time being. What we are waiting for is the moment she actually aggravates. This is a sign to stop and wait to reassess, before moving on to a new potency/remedy.
 
Evocationer 9 years ago

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Information given in this forum is given by way of exchange of views only, and those views are not necessarily those of ABC Homeopathy. It is not to be treated as a medical diagnosis or prescription, and should not be used as a substitute for a consultation with a qualified homeopath or physician. It is possible that advice given here may be dangerous, and you should make your own checks that it is safe. If symptoms persist, seek professional medical attention. Bear in mind that even minor symptoms can be a sign of a more serious underlying condition, and a timely diagnosis by your doctor could save your life.