Fibromyalgia adebilitating disease having more of a subjective aspect i.e. the severity disease can be experienced by the patient but is difficult to be felt by others. A disease creating dependency which almost makes the patient helpless.
This is a case of a 55yr old male suffering from the same complaint.
His case history is as follows:
Complaints started since 5 -7yrs, with muscular pain and stiffness of extremities while doing his routine exercises. Thereafter Day-by-day the pain was increasing in intensity.
Within short time His condition deteriorated to such an extent that he would require help even to sit up or change his position on bed.he had lost about 4 kgs of weight.painkillers were part of his daily life.muscular wasting was also observed.
A mild degree of muscular wasting was also noticed in his thigh with swelling over extremities.
Fibromyalgia
Fibromyalgia is characterized by chronic widespread pain and a heightened and painful response to pressure.
Fibromyalgia is estimated to affect 2-4% of the population.
Symptoms:
- Tingling of the skin,Prolonged muscle spasms, weakness in the limbs, Nerve pain.
- Functional bowel disturbances and chronic sleep disturbances.
- cognitive dysfunction, like impaired concentration, problems with short and long-term memory, short-term memory
consolidation, impaired speed of performance, inability to multi-tasking, cognitive overload, diminished attention
span, anxiety, anddepressive symptoms.
- Temporomandibular joint disorder.
The most frequently cited factors perceived to worsen fibromyalgia symptoms are emotional distress, weather
changes, sleeping problems, strenuous activity, mental stress, worrying, car travel, family conflicts, physical injuries
and physical inactivity.
Treatment
There is no known cure or universally accepted treatment for fibromyalgia, and treatment is typically aimed at symptom management.
Prognosis
Most fibromyalgia patients report that their symptoms do not change over time.
Chief complaints -
1. Bodyache since 3 mths.
- A/f :Getting wet in rain & change of weather.
- Pain in posterior part of thighs, pain in calves, nape of neck & shoulder. Lt. > Rt.
- Muscular pain, continuous, severe pain with stiffness.
- Muscular wasting was also noticed in his thigh.
- Swelling over extremities.
< Lifting weight. > Hot water bathing.
< Exertion. > Lying on back.
< Evening. > Soft bed.
< Movement. > Rest.
< Squatting position.
< Lying on affected part.
< Pressure.
< Lying on hard surface.
< Air draft.
< Fanning.
His pain and stiffness were of such intensity that without taking painkillers, he was as good as a robot. Even for lifting a small thing, like his toothbrush, he would require both of his hands.
2. Lightening type of pain in Rt. lumbar region since 10 yrs.
3. Neck pain with stiffness since 5 yrs, unable to move his neck.
4. Weight loss about 4 kgs since 3-4 months.
Past History -
1. Hospitalized for Viral fever 2 months back.
2. Operated for Piles 8-10 yrs back.
3. H/o Sinusitis 35-40 yrs back.
4. H/o Typhoid 15 yrs back.
5. H/o Hairline # 5
th metatarsal (side?) 30 yrs back.
6. H/o Dog bite on Lt. leg 5 yrs back.
Family History -
Father : D.M.
Mother : D.M., Sinusitis.
Brother : D.M.
Physical Generals -
Diet : Veg. since 15 yrs.
Appetite : Good.
Desire : Sweets, Ice Cream, Milk, Bitter.
Aversion : Spicy, Tobacco smell++.
Head : Headache occasional.
Location : Forehead.
Character : Continuous heaviness in head.
< Fanning. > Pressure.
< Empty stomach.
Eyes : Spectacles for distant vision.
Nose :Occasionally coryza – watery discharges with throat irritation.
< Change of weather.
Tongue : Dry.
Thirst : Thirsty Patient.
Stomach : Acidity occasionally with pain in Lt. hypochondriac region along with headache.
< Tea. > Eating after.
< Spicy.
< Empty stomach.
Urine : 7-8 times/day. Once at night. Has to wait for a long to pass urine. Burning urination. Feeble stream of urine.
Skin : Brownish spots over chest since 20 yrs.
Perspiration : Moderate, all over body. Slightly offensive. Yellowish staining.
Sleep : 10 pm to 5-6 am. Sleepiness in the day time with sleeplessness after midnight. Snoring.
Talking in sleep occasionally.
Thermally : Towards Chilly patient
Mind:
1. How was your childhood?
During my childhood, our family’s financial condition was not sound.
I have 3 brothers, one elder and 2 younger to me. We all had to restrict our desires due to the limited financial
resources.
My elder brother was irresponsible, so I had to take up the family’s responsibility at a very early age. At the age
of 18, I joined Army.
I was quite short tempered especially when any of my siblings back-answered to my mother. I did not like it
when they showed disrespect towards her.
2. Tell me about your nature now?
Basically I am a calm person. I just love reading. I do get angry sometimes, when I see indiscipline or injustice
and express it by talking. But at times I don’t express my anger and keep it within me.
As such I am not talkative but can have a very good conversation with someone if it is about a topic like
philosophy, etc.
I am extremely sympathetic especially towards victims of natural calamities. I go out of my way to help them
I like people around and helping them whenever they need my help. But I am a very much disciplined person.
I enjoy my work. I don’t like sitting idle.
His wife added that even at home, he keeps doing some or the other electrical work and never sits quietly in
one place.
3. Tell me about your tensions and worries?
I’m much worried about my family.
Both my brothers are ill. One of them had undergone amputation of one leg and I’m extremely anxious about
him.
My mother had adopted a female child in 1972 and we all were attached to her. She died of blood cancer in
2005.
Later I got to know about the discord between my 2 brothers and became very upset about it. The respect my
family had earned in 40 years in my native place has been lost since my father expired.
Also recently I was quite tensed about the 12th std. result of my younger son and his admission after that.
During the same period, my elder son had to buy a flat which was beyond my capacity. But still I had to do it.
There was so much stress and overexertion, which took a toll over my health.
Sometimes I start weeping because of my pain.
In all these situations, my wife has been a great support for me.
4. What about your work place?
Previously I had worked as an electrical technician for aircrafts in the Army and later as a clerk in a bank for
about 14 yrs.
I always felt that I deserved much more than this and would sometimes get very frustrated but had to suppress
my frustration.
But now, since 1 year, I am working as an Officer in the bank. The promotion was a great relief. But I was
transferred to Mumbai from Ahmednagar. So every 15 days I had to travel between Mumbai and Ahmednagar
to come home and this was tiring. ·
Response:
The patient was admitted after consultation. All the pain-killers he required to take were withdrawn immediately.
When the patient was admitted, I observed that he required his wife’s help for every work he had to do. He was
not able to carry out any activity on his own due to severe restriction of movements.
After few days of admission, the intensity of his pain gradually decreased and so did his stiffness.he could then
carry out his day to day simple activities independantly.he could raise his arm over the head which he earlier
couldn’t.he could ascend few steps without being fatigued which was difficult earlier.
Steady improvement was seen in his overall general condition. He started carrying out his daily activities and
could now walk almost 2 kms without any distress as compared to not even being able to lift his leg
earlier.
Previously he couldn’t even lift a toothbrush and now he could pick up a bucket full of water. He could even
ascend upt to fourth floor comfortably. And all this, totally on his own.
All these improvements took place within the duration of 11/2 to 2months.this is one of the many examples to
prove wrong the misconception that homoeopathy take long time to heal.
Such a sustained progress is another of the innumerable proofs of the efficacy of Homoeopathic Medical
Science.
D/D:
RHUS TOX- Rhus tox comes very close to Dulcamara according to the characteristic totality of the case.
Symptoms common to both drugs in the case are;
· Left→Right
· < Change of weather
· < Exertion.
· < Weight-lifting
· Restlessness
But the differentiating features include the following:
|
RHUS TOX |
DULCAMARA |
|
· <Rest. |
· > Rest. |
|
· Desire for tobacco. |
· Aversion to smell of tobacco. |
|
· Sleeplessness before midnight. |
· Sleeplessness after midnight. |
|
· Mostly Tubercular and syphilitic miasm. |
· Mostly Sycotic miasm. |
|
· Restlessness more marked. |
· Restlessness less marked. |
|
· Less sympathetic. |
· More sympathetic. |
|
· Not marked. |
· Brown spots over chest. |
|
· Ambithermal. |
· Towards chilly. |