Minutus

I apologize that this is an elementary situation, but I need some
help.

My friend was painting a ceiling in late May (reaching overhead
stretching and pulling, etc.). He developed a deep, drawing pain in
his right back shoulder with numbness running down top quarter (25%)
of arm to tip of thumb. It appeared to me to be classic rhus tox,
i.e. gentle motion ameliorated, hot shower relieved stiffness,
pressure ameliorates, arm numbness worse lying on it. The only
exception was thumb numbness which doesn't list rhus tox in the
repertory.

On June 12, two doses of rhus tox 30C relieved symptoms entirely.
Symptoms returned the following weekend but he couldn't find his
remedy ampule. He then tried another few doses of 30c the following
week, which I believe relieved the pain symptoms but perhaps not all
the numbness.

On June 24, he reported rt. shoulder pain again plus sporadic
tingling and prickling in the rt. arm along the numbness line which
again starts in the thumb and runs up the length of the arm. He had
woken up the previous night with a great deal of pain in the
shoulder. He then got a prescription for allopathic pain meds plus a
6-day course of steroids. Not from me, of course!

On July 2, he took rhus tox 200C at 8pm. As a matter of note, he was
very, very tired that evening and went to sleep immediately, waking
once briefly at 1am but sleeping til morning. He took a couple more
doses over the holiday weekend. The pain did not go away entirely;
instead, he now has two intense pressure points, one at the left
start point of the original back right shoulder pain and the other at
the top of the arm where one would receive a shot. The numbness
receded down the arm, then down the forearm a bit, but he has two new
sensations in the remaining numb part; a rubber band contricting
sensation on the forearm and a vibrating sensation like he's holding
a vacuum. Both of these come and go occasionally. Lastly, if he tries
to operate the computer mouse, his hand cramps up. I interpreted this
as writing aggravates, since he is left-handed and rarely uses this
right hand for fine manipulation tasks.

So, here's my question. Is this as new remedy picture, or should I
try rhus tox 1M? I repertorized the new symptomology and rhus tox
still appears well indicated EXCEPT for now, the two intense pressure
points are relatively painless on waking and get progressively worse
as he moves during the day until getting pretty bad around 3 or 4pm
til bedtime. He sleeps well. He doesn't think that motion or warmth
ameliorate anymore, because he doesn't have the stiffness.

Any advice about how to proceed?

Thanks, Janet

Janet-
No apologies, there is nothing elementary here. All of us face tough
choices even with the simplest problems. Good of you to acknowledge
that it is hard and to post it here.

My 2 cents:

1) If Rhus tox is still indicated probably you can try with it. But
Rhus tox will always seem indicated one way or other, for all
straining and spraining at all times. So you need to be aware of
that.

2)I think you need to work on the new symptoms. I think the Rhus tox
of July 2, acted since it changed the symptoms. If the indicated
remedy is near simillimum ( which at this point Rhus tox is) it will
relieve somewhat and bring out new symptoms for prescription.

3) So first, in view of the new symptoms, if you have access to
fuller materia medicas - first refer to the symptomatology of Rhus
tox. If the new symptoms are there - it might be a proving of Rhus
tox. If not, ( even then it might be a proving) it is an indication
for the next prescription. Personally I feel it is an indication
for a new remedy.

4)The shaking of the hand, numbness and weakness shows that there is
some nerve involvement.
Conium has the numbness, weakness, h/o spraining, and also the band
sensation in upper extremities. Please refer to Sensations as if by
HA Roberts. Conium is one of the remedies for this band sensation.
Also it is one of the remedies that follow Rhus tox well.

5) Other remedies I would consider are Strontia carb, Calc.carb,
Ruta, ?Carb.anim. ( all of which are indicated for either chronic
conditions after sprains or for easy straining etc.)

6) The afternoon < and Rhus tox like symptoms always make me think
of Pulsatilla. That might be a possibility as well.

Let us know how it goes.
--- In minutus@yahoogroups.com, "jumpthreex" wrote:
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Roger,

Thanks for your thought-provoking reply. I should have included in my
post that I had fully repertorized the new case (Synthesis 9.1) and
narrowed things down to Lyc and Rhus Tox. Rhus Tox covered all of the
new symptoms such as sensation of vibration, constricting band
sensation on forearm and numbness of forearm, pressing pain in the
shoulder and the hand cramping/tingling while operating the mouse.
However, it did not cover the thumb numbness or the pressing pain in
the arm, and it no longer covered the classic Rhus Tox modalities to
a "T."

Since I didn't get a quick response from the group, I had the novel
idea to call the patient for an updated report. It was interesting.
He no longer has the left pressure point on the right back shoulder.
Now it's just the arm. The numbness is better. He was able to use the
mouse just fine. The "rubber band" on his forearm is looser now.
Three Advil at 4pm (allopath's Rx) take care of pain for the day. He
is sleeping well, which is unusual because he often reports early
morning insomnia. Interestingly, he is a restless person by nature,
so I wonder if Rhus Tox helped addressed this innate issue. In
summary, he has shown decided improvement over the last two days, so
I advised him not to do anything unless things regress noticeably and
in that event, take Rhus Tox 200C, because it seems to be working,
albeit slowly. I am going to rethink that latter recommendation in
light of your response, Roger.

In retrospect, when he first reported pain, I should have given him
the 200C potency immediately after his first relapse. It was a
classic Rhus Tox case in terms of causation (raising arms high to
lift things), sensations and modalities. And Rhus Tox works well in
the high potencies. When I did finally recommend the 200C, I should
have advised him to take one dose only. Because I think what you said
about him proving the remedy could indeed be the case. Yikes!

Conium did not stand out from my most recent repertorization because
out of 12 rubrics, it only showed up under three: complaints of
forearms (way general), constricting band on forearm and pressing
pain in the arm. It was missing some things that I considered
essential to the case, e.g. vibration sensation, numbness, lying on
numb part aggravates, etc.

I appreciate your response and the alternate remedy suggestions. If a
relapse occurs, I will look at those more closely. I will also look
into getting the book on Sensations as if by HA Roberts that you
recommended.

Roger, thanks again for your advice.

Janet

--- In minutus@yahoogroups.com, "rogermassey_homeo"
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Janet, Thanks.

Just make sure that the vibration is a sensation and not shaking of
the hand due to weakness; if it is weakness, then weawkness might
become more important-

Regarding numbness, the modality you have is good - lying on numb
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