10/06/2013
This is one of successfully handled chronic cases...........
42 yrs old male patients with the history of heavy travelling ( 150 km/day average) on two wheeler.
with c/o
1) right lumbar pain ( since 5-7 yrs)
- can't sit by bending/folded legs,(maandi ghaalun basataach yet nahi; rag laagalyaa saarakhe dukhate)
< on sitting
> in work; on lying down
(aggravated since last week.)
- PAIN IS SO SEVERE THAT HAS TO STAND UP TWICE WHILE HAVING MEAL OR HAS TO STRAIGHTEN LEGS.(PAAY TARI MOKALA KARAAVA LAAGATO)
2) pain in both knees specially left (since 10- 12 yrs)
- pulsating pain
< on lying down
> taking pillow under knees while lying; feels better after one hour of it.
No pain while walking
- due to one week there is increased in lumbar pain so he can't give attention to knee pain.
3) Acidity since childhood.
- used to feel nauseatic whenever got wet in rain; used to have sour vomiting in childhood.
now also whenever eats oily things acidity starts and sour vomiting occurs; head pains; vomits food particles. previously used to feel burning but not now, only sour vomiting occurs.
Headache - temples; giddiness on stooping, (andhaari aalyaasaarakhe) feels stupified(doka sunna jhaalyaasaarakhe waatate); whenever eats outside food, drinks excessive tea feels acidity.
Headache > by vomiting.
4) lumbar pains < whenever there is flatulance.
- flatus - noisy; < in morning
Past H/O:- 1) teta**s at the age of 14-15 yrs of age
2) Jaundice in 2003 (due to railway food)
3) once had attack of hypertension 4 yrs back
4) I am feverish usually, with 2-4 days exception there is always a fever. Headache and fever is there & always has temperature above normal limits.
5) there is some relation between me and rain, got wet in rain on bike then slept in car and was in sleep since morning 8 am to evening 6 pm. then got admitted in hospital.
6) there was attack of acidity previously continuous 2-2/ 3-3 days used to vomit now also whenever that incidence reminds feels nausatic.
Personal H/O:-
- Appetite:- loss of appetite when attempting to eat alternates with excessive hunger
- Craving:- Sweets; spicy; green leaf veg
- Aversion:- moth beans; sour things
- Bowels:- before 2-4 yrs there was bleeding during defecation(?haemorrhoids); do not feel any mass at a**s.
Twice and satisfactory, feels urge in one hour after dinner.
- Sleep: - Sleeplessness due to thinking, tensions, worries.
- Persp:- only on face; nose and forehead on weakness; there is always fever so whenever do any physical exertion weakness comes.
- Habit:- used to eat gutkha and drink alcohol also but not now.
- Thermally:- Towards Chilly.
- If anyone switches on fan during summer also feels body ache. Do not put A.C. on in car even.
- Do not wear sweater; do not have habit of it. Sleeps with upper body naked, can't bear sweater or muffler over ears. feels creeping something can't sleep then. Can't sleep even with wearing banion. In younger age used to work in farm where to avoid spoiling cloths with dirt he used to work and sleep only with underwear on, and since then it became his habit.
Mind:- Uneducated but intelligent. used to work in farm then joined one company and became supervisor. and due to this he has to travel a lot.
There is dispute of land and it's under judiciary.
No tension of money, it has earned enough as some people betrayed him. Did duty for money only......but it's our beginning only no! others already went ahead.
Can't bear if someone insults.
Gave repeated clearance about his habit.
I take precaution by my self to not to trouble anyone.
Can't bear lie.
My brothers are like that, if i don't get no matter but he also must not get anything and this annoys me.
Do not have much friend because no one is honest, back bites and keep all things secret and used to use only.
When was poor there was different attitude people used to show all went in head(sagale dokyaat basalet). then did all efforts and earned considerable(1-2 crore) outside(purchasedb land), i got more than whtever i desire.
Think continuously about work, do not like laziness or avoiding work.
Talks much but only truth, sometimes repents even. family members feels i talk a lot.
Likes to take challenges. If anyone is unable to do anything i like to do that thing.
(during case taking he was continuously plying with something on desk, like paper weight etc.)
Local Examination:- Back:- Pain at lumbar region right side
) ||0(
Knee:- Lt- crepts +
Investigations:- he said he lost his reports but did X-ray prior and had spondylosis detected.
-------------------------------------------------------------------------------------
Nothing else found in case as unusual, peculiar or characheristic so not written here.
-------------------------------------------------------------------------------------
on that day i gave NAT. MUR. 6X O.D. for 6 days and told him to come next day, meanwhile i'll repertorize case and find your remedy.
-------------------------------------------------------------------------------------
ON re[ertorization i got remedies.......
SULPH, NAT-MUR, NUX-V, CALC, PULS, LYC, BRY, PHOS, CHIN, AUR, PODO, RHUS, CAUST, LACH, KALI CARB.
I was thinking instead of giving Sulph i should give Nat-M but NM was already started in 6X potency so I prefer Sulph.
And given SULPH 30 ( O.D. one dose for 6 days.)
======================================
======================================
In follow up, i was prepared to hear that there in no much relief or no relief at all and prepared mentally what to tell to patient to continue with treatment. So i asked him to tell me in percentage so that whatever may be progress i can write it down and also can encourage him to continue........
But for my surprise his words was.......
1) Pain in Rt lumbar region Rt side 70-80% relived, only some sort of stitching pain is there.
2) Pain in knee specially Lt side relieved 98% (dava gudhaga ekdum thoda dukhato)
3) C/O Acidity - headache; didn't eat oily so can't say anything.
4) Flatulance 100% relived.
Prescribed- 1) SIL 6X (powder) (B.D. for 6 days)
2) S.L. 30 ( 4 pills O.D. for 6 days)
--------------------------------------------------------------------------------------
1) Pain rt side of spine at two points one above other.
- severe pulsating; can not raise from lying position.
- before it was vague now can point out at fingers.
2) Knee pain relived.
3) Acidity can't say.
4) Flatulance 100% relieved
Prescribed- 1) Sulph 200 (1 dose)
2) Arn 30 (1 dose)
3) S.L.30 (4 pills OD)
---------------------------------------------------------------------------------------
1) Lumbar pain 100% relieved
(< yesterday but then relieved)
2) Knee pain 100% relieved.
Prescribed:- No medicine.
