A Case of Rheumatoid Arthritis

A 38 yrs old female patient came with severe pains in her small joints of both hands and toes for several years. She is a known case of Rheumatoid Arthritis and has taken allopathic treatment with methotrexate and steroids for some time and later switched to Ayurveda. Her pains were still severe and not relieved completely.  Her son was under our treatment for ADHD and was doing extremely well, hence she opted for homeopathic treatment. She complaints of pain in small joints like finger and toes along with swelling of ankles. Pains are tearing, violent. The pain moves from one joint to other. It moves in different directions. It is more when in motion. It feels like there is irritability of the tissues, soreness. Sensitiveness to touch, sensitiveness to motion; bruised feeling of the joints and of the whole body. Touch and motion bring on a painful sensation in the body as if electric vibrations.

Her joints are very sensitive to cold weather, she feels better by heat or wrapping up, rest. All the pains are followed by great exhaustion.

Case History:

The patient directly went to her emotional issues and the focus was on what she was going through mentally, and RA pains were in the background.

Patient started narrating, she can’t control her emotions. She easily cries and gets angry. She is very sensitive. She doesn’t like to socialize much. She has issues with her son who is hyperactive and doesn’t listen to her. She gets irritated and angry. She tries to tolerate with her patience levels, but she still gets bouts of anger. She feels she is unable to control him.

(theme of control, anger, sensitivity)

Pregnancy history: She is staying in joint family with mother In-law and sister in law. She feels she was blamed for everything. She had bed rest for few months during her pregnancy, she was taunted for that instead of being cared for. Later, after delivery she was blamed for her son’s hyperactivity.  Everything happened to her was wrong during this time.  And she feels it like a “hindrance to her life”.

(is the in-laws an enemy like animal kingdom? It will be too early to judge. However, the issues are around family, relationship. This is important to note which sphere of life the issues are)

She is working as a Project Manager in a leading Pharma company and takes her work very seriously and is very dedicated to it. Her issues with her senior management also affect her a lot. She felt she was not given deserved promotion inspite of working so much. So, her growth curve is affected too.

(her position in her environment is important to her)

She cries easily and easily gets anger bouts. She is oversensitive to anything happens to her. She doesn’t socialize much.. When her son was diagnosed with ADHD, he used to throw a lot of tantrums and never used to talk to her. He never used to listen to her. She says “He tries my patience and makes me extremely angry, I try to tolerate it to my maximum capacity. I just feel like crying all the time. I want to control my emotions but cannot do it. Why is all this happening with me, I am trying to let go, but I am just unable to. Because of all of this I am unable to move forward in life and career!”

(the theme of control and let go. Sensitivity of how she is coping with the external impressions are strong)

She feels very sad about this and gets easily hurt. She feels all bad things happen to her. She says “Everybody feels it’s always the mother’s fault. I have to listen to everything that my mother in law tells me and I am unable to do anything about it” She keeps it in her mind, and does everything for everyone but feels, there is no value of her in house She feels she is left out. “I think they are all ignoring me. I am not included in any important discussions or decisions that are taken in the house” She feels isolated and alone in the world.

(this gives us a hint of how she perceives people are treating her. At this point it could be an “Animal- they did this to me”, a plant “on how I felt because of being ignored..it is not yet clear. Lacs esp. Lac Can would have this feeling- of being treated unjustly. We park this and move forward)

She narrates one incidence where one of her colleagues got promoted instead of her. She felt this is a male dominated society. People just do “buttering”. On asking how it made her feel, she says “I felt extremely sad. I just left office that time.” It got affected her so much that she started looking for another job as soon as she reached home. She felt betrayed, cheated and expelled out of the group. She did everything but did not get acceptance and recognition. She felt “I am failure at personal level and professional level too”. She used to cry a lot with eyes swollen. She feels very weak after the episode. Her entire body starts paining and weak. She feels internal pain and aching.

(In the above incident about promotion more than the feeling of me vs you or feeling revengeful- the issue of how hurt she felt with it. What it made her feel and how she couldn’t react to it. How it affected her emotionally and mentally)

She keeps everything in her mind, piling the emotions up (this is the suppression of feminine principle) She wants to be constantly busy to avoid those sad thoughts. “I was very social initially. Although I had limited friends, I would go out and interact with them” However, she doesn’t go out now, doesn’t socialize much. She used to feel compulsion to do it with fear of people not accepting her.  She wants people to behave nicely with her.

During pregnancy she felt nobody pampered her. She feels she never got the love from her parents. They used to treat her as a third person. She feels her expectations are not met. She feels it’sa “give and take” relationship.

(By now, we can rule out mineral kingdom as issues of structure are not coming. We also know the entire themes are around her- how she is feeling in response to everything that is happening around her. As if the whole world is about it. We have narrowed down our search to Plant or Animal Kingdom. Also, we need to find a remedy for whom the world is all about herself.)

She feels she is very skillful and excellent at her work. Upon asking her on what her qualities are that makes her good at work, she says “I have eye for details, I am very organized, I am good at planning, monitoring and control. If I am successful and reach some position where I get respect & authority, people will want to be with me and I will be included in everything”

(She needs to have recognition, respect and feeling part of the group.)

D: what will you feel without your mother?

P: I will feel devasted, emotionally broken down.

D: tell more about this?

P: I would be like, dried up sapling without any water.

D: Describe more, about sapling without any water?

P: It is as if drooping down without any food. It will be lifeless. It will not be in erect position.

D: Describe this more? Lifeless, without food, drooping

P: It is as if a flower which is drooped, almost lost freshness and without any life.

D: Tell more

P:  It’s more like detached flower from the roots. Sad.

D: What visualization comes to you when you say this (Close your eyes and imagine)

P:  A tulip flower, who was very vibrant, dark color, smell has lost its freshness. Nobody is giving nourishment.

D: experience this more and describe?

P: It is, as if drooped and dead. Just like me.

Dreams:

1. She described her dreams to be very weird and absurd.
2. Dreams with full of worries and cares.
3. Animals like rats, snakes.
4. Frightful and nightmares.

Physical Generals:

Av: sweets.

Thirstless

Perspiration: increased with coldness of extremities.

Thermal: Chilly

Menses : Regular with dysmenorrhea.

Case Analysis

Kingdom Classification

Patient spoke of sensitivity issues. How deeply it has affected her. She narrates how deeply it affects her and her reactions towards that issue.  The main concept of sensitivity and reactivity in this case gives hints to plant kingdom. Her analogy to flower also give clue to plant kingdom. Besides, there were no issues of structure. While she had issues with family and at office, there weren’t issues of “he did this to me” the issue was “how hurtful it was”

The Lac remedies within animal kingdom can be easily confused with it. But, the energy was on her sensitivity.

Sensation

Patient felt left out as if they are ignoring her. She feels they didn’t pay attention to her. They don’t involve her, and she feels ignored. She feels very isolated and feels no one in this world, she is all alone. She feels she will be excluded from the family if she doesn’t meet the expectations of the family members. She will be expelled or cast away from the group. This gives hint to Liliflorae family.  Theme in the case is excluded and included. Initially it looked like a forsaken feeling/no love, but when probed deeper the issues are of inclusion and exclusion in THE GROUP (DD with Lac Can)

Miasm

In this case, patient feels unfortunate in having fixed weakness within himself this obstructs or hinders her that she cannot go ahead and from intermittently because of it. She perceives this as acute threat to her life. Her reaction to this situation oscillating between is accepting her condition with intermittent feeling of threat. There is constant fixed underlying condition with acute manifestations of emotions.

Malarial miasm.

Family Liliflorae

“Sensation of being squeezed and forced out, just as the toothpaste is squeezed and forced out of the tube. This sensation expresses as a feeling of extrusion, exclusion or abandonment. Reaction to this sensation is to hold on tightly, to grasp, need to be included in or be an integral part of something, need to move and show a lot of activity. Few common expressions of the sensation are religiousness (belonging to a religion, group or God), attractive behavior, attention-seeking behavior, vivaciousness, egotism, loquacity etc. Indulging in these gives them a feeling of being special, which is the opposite pole of feeling excluded, isolated (forced out) or excommunicated.”

If we review this case from the Personal Evolution Method by Dr. Mahesh Gandhi

Liliflorae belong to the monocotyledons.  Monocots are invertebrates from plant kingdom.

Everything is all about themselves. They live in their own world. Whole world is about them. They are not so differentiated hence they are oversensitive as well.  They feel small and archaic.

They are self-centered personalities. They cannot feel the other person and often find it difficult to be within a relationship.  For this patient the issues were of how sensitive she is with all the external impressions and her relationships at home and work.

Within the Monocots, Liliales are the 6th Subclass (Adult stage). They are strong individuals within the Monocots and the issues are around their relationship with the world, with others. Their place in the world/community- self-identity, image, and status in the world (e.g. how she reacted to lack of promotion).   Here, the feminine qualities are suppressed (our patient was not able to express and would suppress everything).

Remedy selected:  Colchicum Autumnal

Colchicum has a beautiful rubric

Hand: Weakness, hold anything cannot, in rheumatism.

This rubric explains her mental state and patient’s physical symptoms

Potency

Initially dosage was 30, weekly doses, which was later changed to LM potency 0/8 till the overall improvement was achieved.

LM potency was indicated as it was progressive pathology.

Daily dose was further reduced to once a week as patient improved.

Follow up 

1month

Within a month, patient started feeling less pain. Intensity reduced to 30 % with pain in small joints. There was no change in swelling of joints. Her sensitivity started reducing, she could handle work situations better.

Her sleep improved. she had acute episodes of pain which was manageable without pain killer and ayurvedic medicines were also stopped.

She started feeling very confident.

6 months

Intensity of the pain reduced further. The swelling reduced substantially. She started feeling very fresh. Situations at home were manageable for her. She started feeling strength within. Her sensitivity reduced further.

Her acute complaints of cold and cough recurred which was managed by same remedy.

1 Year

Her sensitivity and weeping started decreasing further. She felt calmer and more peaceful. She got promotion at work 😊

Pain and swelling reduced substantially.

Her general state improved. Acute episodes of pain were very seldom.

2 Years

After 1 year of treatment she did not have pain at all. Swelling was gone completely. Her overall health improved. The regular telephonic follow up shows the maintenance of the overall improvement. She was unwilling to repeat her blood reports as she was symptomatically better.