online case RM/Feb.04

[Joy Lucas]

Dear Rochelle, I have been reading your case over the weekend.

I am wondering if there is a connection between the labrynthitis (otitis
interna) with the spells of fainting (or vice versa as the fainting came
first) - and a more obvious connection with the otitis externa if the
aetiology is from an infection picked up during swimming. Also from a
starting date point of view, where do the migraines fit in. Some consider
there to be a connection between otitis interna and MS.

Is the fainting some kind of mild epilepsy?

Much of her mental and emotional sx are not really part of the diseased
state. So she gets angry at sloppy work, tearful at unfair criticism, gets
emotionally involved with clients. She appears to be open with her emotions,
she is organised, active and tries to enjoy life - all good things really.
Even her fears are reasonably rational and don't dominate the case. Slightly
unbalanced on the harmony scale would be her approach to work - workaholic -
which seems to be creating some friction at home but she still chooses to do
it and so she has some compunctions of guilt.

She used to have a temper! Where has it gone?

Strategy and mediating - strong qualities but only applied at work? She
bends but can't bend. Yielding but not yielding. "I am trying to balance..."
she says.

Failure hits her hard - I would include this even though one could argue
that it hits most of us hard and again is quite rational.

Synthetic. Fear of failure = arg. nit; arn; cob.n; gels; iod; lac.c; naja;
nat.m; phos; sil; sulph.

Vivid dreams - very large rubric

Delusions on waking

This leaves us with some physical sx:-

Migraines - is there any more info for these?

Kent. Ear, discharges, r. watery = Silicea + others

Some food aversions and a sensitivity to alcohol.

The fainting definitely needs more details.

The clearest remedy that comes up for me is SILICEA

There is an imbalance between giving and not being able to give, flexible
and inflexible - the well known yielding nature and mixture of sand, glass,
flint. They like order and to organize to an extent which will cover up
their weakness and fear of failure. She attends to this image of herself at
work but at home wants to be laid back and relax that image, even though she
can't stop working.

Phatak - Silica affects the nerves - neurasthenic states. Suppurative
processes, abscess. Spasms and epilepsy. Faints while standing. Affinity to
the inner ear - caries of the mastoid process, itching, deafness, watery and
fetid discharge, crusty formations. Yielding and faint-hearted. Sensitive
and weepy, compunctions of conscience. Loss of self confidence - dreads
failure. Periodical headaches and migraines - easily get headaches from over
work. Intolerance of alcohol. Dreams of being pursued by animals and dreams
of falling (Sankaran). Chilly.

This is the nearest I can get with the time spent on it. I can see a couple
of other Rx but none as clear as Silicea.

Hope this is of some help.

Best wishes, Joy Lucas

[Rochelle]

Dear Joy,
Thanks for reading this case over and the work you have put into this.
I would doubt it because the fainting started at age 12 and only happens in
a "shock" type situation.
<

[Joy Lucas]

Dear Rochelle, just a few extra thoughts - you mentioned Phosphorous in your
original notes. As an after thought this is perhaps worth going back to -
very easy fainting (uncertain involuntary acts - Phatak), lots of visual
disturbances with fainting and epilepsy, vivid dreams and especially visions
on waking, very emotional and get involved with people - so sympathetic
towards others, alcohol agg. everything, difficult hearing, otitis medea,
mastoiditis (Phatak), migraines, craves acid (sour?). Just a thought. By the
way the Rx with fainting and loud loud voice and laughing (+ violent temper!
- she might have dealt with her temper), very busy and active, very sexual =
Moschus

Best wishes, Joy

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[Rochelle]

Thanks again Joy. I will look at Moschus. Spoke to her Mother today who said
that her voice has got louder with the hearing problem. Mum also mentioned
that the fainting occurs when she undergoes dentistry and was surprised when
she had all the ear ops without a problem.
I have enclosed the case again at the bottom of this post in case anyone
else has any ideas.
Regards,
Rochelle
www.rochellemarsden.co.uk

[Rochelle]

I have spoken to the patient today and asked about the first time she
fainted. She said it was in the dinner hall at lunchtime , with the sun
shining in and she can only presume she was too hot and was hungry. She also
said that since she saw me she has had to wear her hearing aid constantly
as her hearing is worse. Unfortunately none of this brings me any nearer to
coming up with a constitutional ready I am happy with, despite the work Joy
has put into this which I thank her for. I think I am going to look at
Scholten which is what I tend to do when really stuck. I will let you know
when I come up with anything and meanwhile further suggestions will be much
appreciated!!

Regards, Rochelle
www.rochellemarsden.co.uk