Case management issue

Dale Moss · Post by **Dale Moss** » Wed Feb 20, 2013 4:27 pm

I have a patient, a woman in her early 60s, who's in a difficult place right now. Her mother has dementia and needs round-the-clock care; the patient feels intense guilt that she cannot take care of her herself. Patient is depressed and overwhelmed, crying a lot, not taking care of herself, not doing her job well. She's also doing numerous things to help herself: acupuncture, herbs, Bach FE, and homeopathy.
She has received numerous remedies from her previous homeopath (whom she left because the homeopath failed to return her phone call). The pattern with those remedies was a prolonged aggravation without much, if any, amelioration.
I have given her four remedies to date, all well-indicated, and the reaction to mine was an initial amelioration, followed by a very quick relapse. With this patient primary and secondary reactions to remedies happen within HOURS, not days or weeks. This is something I've never seen before.
I'm not giving the details of her case because I don't have permission and because I'm not seeking advice on remedies. There is obviously a maintaining cause in her mother's state and her hyper-responsible (and controlling) response to it.
My choices at this point seem to be letting her go on pharmaceuticals and refusing to give any more remedies until her situation resolves. (I suspect a lot of that initial amelioration comes from simply talking her problems out.) Or I could try a w.p. of a low potency. I know that sounds counter-intuitive, given that her problems are mainly M/E, but I'm wary now of giving her even a 200c, given how she's been reacting to remedies.
Any thoughts?
Peace,
Dale

healthinfo6 · Post by **healthinfo6** » Wed Feb 20, 2013 7:23 pm

From what you describe, your patient is clinically depressed especially if "not taking care of herself" involves not showering/bathing, brushing teeth, etc. and does need intervention from a psychiatrist or equivalent if you can't find a remedy that alleviates her mental anguish which makes dealing with her situation even more difficult for her and her mother and others involved, and likely will worsen before it gets better. Though antidepressants aren't immediate acting, usually take a few weeks to build up in blood and work, so she won't get immediate relief unless there are newer generation ones. But a diagnosis from a psych could be useful.
Is there a history of depression over her lifetime from other situations, in her family, or is this the first time? This would point to more inherited miasmatic tendencies vs.solely from current situational issues and aging issues.
I've noticed, especially in some women after menopause, depression appears in later years.. It could be a result of aging and change/lack of hormones and/or general brain aging. There is much anti-aging research being done, with resveratrol being most hyped, but also with various flavones like quercetin, luteolin (not lutein) and others to stop brain aging and keep/restore cognitive function. One supplement I've recently started is non-fish oil DHA, Algol, made from algae, used both for cardiovascular and memory. I've noticed definite memory and thinking improvements with it along with ginkgo biloba, an herb known to increase brain blood flow.
What herbs, Bach FE, how many, often is she taking? I've used these, at times and find herbs can be very powerful and could confuse the picture. I'm cautious with herbs as with homeopathic remedies.
Though you view her problems mainly on the M/E level, speaking from my own experience, having inherited bipolar, having dealt with much depression, anxiety, worry, inaction more than mania, it is my constitutional remedy, an antipsoric, that has allowed me to stop taking lithium after 35 years plus a complementary nosode, currently TubK, that also works well in this way. Also, much M/E improvement has been gained vs staying on lithium in a palliative state.
So, if you know or can determine her constitutional remedy, that may be of help and from what you described in more frequent split water C dosing or LM. My remedy is not on any list for or associated with bipolar, etc, which further shows a change in thinking may be necessary when faced with these type of cases with so many possible rubrics to rep on arising from the depression which may be alleviated all at once with the proper remedy which could be constitutional.
Susan

lightspirals · Post by **lightspirals** » Wed Feb 20, 2013 8:29 pm

Dale,
Have you tried LM's? Might still be a slight tweak in the remedy/potency. But it can also be blocks/interferences that homeopathy can't reach and need resolution before the right remedy can work. I do a lot of work like that, write me to discuss further if you like.
Liz

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Dale Moss · Post by **Dale Moss** » Wed Feb 20, 2013 11:43 pm

Thanks for the responses, Liz and Susan. Perhaps my e-mail gave an incorrect impression. This woman is perfectly capable of taking care of herself on a daily basis. What's missing is the TLC toward the self that is needed in caretaking situations.
She's also someone professionally knowledgeable about supplements and herbs. My worry there is that all the other things she's doing may be clouding the picture.
What worries me most, however, is her weird response to the remedies I've given. She definitely is sensitive and responds to them energetically -- this is not just a placebo response to my listening skills. So why this quick see-saw between primary and secondary reactions? What's going on there?
Peace,
Dale

vtyekkir · Post by **vtyekkir** » Thu Feb 21, 2013 4:15 pm

Hi,

You may consider this rubric, if youlike.

good luck,

V T Yekkirala
GENERALS - REMEDIES - fail to act; well selected remedies - oversensitive state; when too much medicine has produced an: cupr. ph-ac. TEUCR.
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Dale Moss · Post by **Dale Moss** » Thu Feb 21, 2013 5:07 pm

Thank you, VT. I have a version of this rubric in my repertory, but my understanding is that it refers to physical irritability. The patient's aggravations are exclusively M/E.
I've considered many hysterical remedies, but nothing seems to fit. Will keep on evaluating.
Peace,
Dale

Tanya Marquette · Post by **Tanya Marquette** » Thu Feb 21, 2013 5:09 pm

why not work with LMs
t
From: vtyekkir
Sent: Thursday, February 21, 2013 10:15 AM
To: minutus@yahoogroups.com
Subject: [Minutus] Re: Case management issue

Hi,

You may consider this rubric, if youlike.

good luck,

V T Yekkirala
GENERALS - REMEDIES - fail to act; well selected remedies - oversensitive state; when too much medicine has produced an: cupr. ph-ac. TEUCR.
--- In minutus@yahoogroups.com, "Dale Moss" wrote: