Nadia Bakir, ND, DHANPD.F., a forty-year-old mother of two and hairstylist, came to see me on August 9, 1993, complaining of psoriasis, joint pains, and mental confusion. The psoriasis began at age twenty-seven and had intensified in the past six to seven months. The eruption of psoriasis occurred only on her head: on her face around the nose, between the eyebrows, on the forehead, around the frontal hair line, and in patches on the scalp and below the ears. In appearance, it was pinkish with white flakes and scales. It itched and burned. The psoriasis was < when under stress (3), < one week before her menses (2), > on vacation (1), and, occasionally, > after the topical application of "homeopathic psoriasis cream" and cortisone.
I asked her if she experienced any trauma around age twenty-seven. At twenty-four, she went through a "painful divorce." Her first husband had an affair with another woman. She was angry (2) and blamed herself (2). She came close to having a nervous breakdown and lost a great deal of weight. The divorce affected her for years. She received therapy from a psychologist and, finally, recovered from it. She rarely thinks about her first husband now.
Her second chief complaint was about joint pains that she had experienced for the past two years. The joints involved were the right shoulder and left knee. The pain in the left knee started two years ago. She would experience a sharp pain behind the left knee < when squatting (2) or kneeling (2). She refused to take the anti-inflammatory medication that her doctor prescribed. The right shoulder pain began this year. It was a burning pain, < when reaching backwards, or pulling or lifting (2). There were no other modalities. Her car was hit by a truck seven years ago. The results were whiplash and an injured her left hip.
Her third chief complaint was a state of mental confusion evident in the past year. It usually involved using the wrong words. Words would come out that she did not mean to say (for e.g., she would say "staring" instead of "stuffed").
She is intolerant of the sun (3) and gets headaches and dizzy spells if she sits in it more than ten minutes. She had a sunstroke as a teenager. Before that incident, she could handle the sun well. She is warm-blooded and has a medium-to-lean build. In the past year she has been very warm when she wakes in the morning and cold when she goes to bed. She also gets cold if she is tired. She is < in hot humid weather. She does not perspire much. Her energy is > during exercise (2), > in fresh air (2), > one hour after waking in the morning, < from 2-5pm(2), < after work (2), > from 9-11pm (second wind)(1), < after eating sugar and refined foods (2), < if she is angry or upset (2), and < if she is hungry (1). When hungry she becomes irritable, shaky, and unfocussed; she can also get a headache which is > after eating. For the first hour after waking, she likes to be quiet and alone. If she is pestered in the morning, she becomes irritable. Perfume bothers and distracts her. She feels better after dancing (2) and singing (2). She laughs (1) and talks (1) in her sleep. She complains of cold feet and wears socks to bed. She prefers to sleep on the right side (2), even though it hurts her right shoulder. She likes to be cool with fresh air and lots of blankets when she sleeps.
She craves carbohydrates (2), pasta (2), onions (2), sweets (1) and has an aversion to milk (3). She is < after fried foods (2), coffee (2), and chocolate (2); beans give her gas (2). She cannot tolerate alcohol (even a few ounces) and wine makes her depressed (2) and weepy. In the past few years she has been urinating more frequently, and this is < few days before menses.
Her PMS symptoms include irritability (2), abdominal cramping (1), a bloated abdomen (1), and a craving for sweet (2). The first day of menses is characterized by an intense sharp pain in the rectum. It feels like a "severe hemorrhoid attack." When she gets it she has to sit on her heels or lie down on her back on the floor and lift her hips up. It is > with hard pressure (2). She also complains that her libido is diminished.
Her personality is happy, positive, and easy to get along with. She likes people. She is not assertive and feels "wishy-washy" sometimes, allowing others to make up her mind for her. She gives in because she is very sensitive to tension or bad feelings. At work she feels responsible there is tension between the workers. She is resentful if someone makes her feel inadequate. She is more sensitive before her menses; she takes things personally and cries easily. She does not like to cry in front of people because it makes her feel weak. She has difficulty dealing with anger and usually suppresses (2) it. She worries about her children (1), and she is "bothered" by authority because she likes to be "in control of what she is doing." As a result, she does not like to work for others. She becomes anxious if she has to speak publicly (1), but is less so if she is prepared (2). Her childhood was " not great." Her parents separated when she was 14 years old. She felt then the same intense emotion that she experienced when she discovered her husband’s affair. The feeling included anguish, despair, and fright. She was afraid of her father, an authoritarian (3) who used physical abuse to discipline his children.
She is sensitive to wool; it itches her. She does not like anything tight around her abdomen; it can cause a stomachache. She is also sensitive to antibiotics.
Her physical exam revealed dry skin on her shins. Her height is 5'4"; weight, 118 lbs. Her weight is heavy around the thighs and hips. Her hair is auburn and gray (40-50%). The gray started at age 27.
Rubrics chosen:
MIND;AILMENTS from; fright or fear*
MIND; AILMENTS from; anger, vexation; suppression*
MIND; MISTAKES, makes; talking, using wrong words*
SKIN; ERUPTIONS; psoriasis*
EXTREMITY PAIN; BURNING; shoulder*
GENERALITIES; SUN, from exposure to; agg. or ailments from*
HEAD PAIN; GENERAL; sun, exposure to; agg.*
GENERALITIES; WEATHER; warm and wet, sultry; agg.*
MIND; IRRITABILITY; on waking, agg.*
GENERALITIES; FOOD and drinks; sweets; agg.*
HEAD PAIN; GENERAL; fasting*
SLEEP; POSITION; on right side*
MIND; LAUGHING; tendency during sleep*
EXTREMITIES; COLDNESS; feet in bed, agg.*
GENERALITIES; FOOD AND DRINK; desires farinaceous and starchy food *
GENERALITIES; FOOD AND DRINK ; desires sweets*
GENERALITIES; FOOD AND DRINK; aversion to milk*
MIND; IRRITABILITY; before menses*
FEMALE; SEXUAL; diminished desire*
MIND; POWER; love of*
ABDOMEN; CLOTHING; sensitive to*Top remedies: lyc 38/18, sulph 28/17, sep 26/15, lach 25/14, puls 24/13, phos 23/14, nat-m 22/13
Assessment: Lycopodium fit the totality but, more importantly, it reflected the ailments from anger and fright to the need for control. The patient had many characteristic symptoms treated by Lycopodium, such as irritability on waking, sleeping on the right-hand side, aggravation from sweets, prematurely gray hair, and, particularly, the type of mental confusion she described. I felt Sepia also covered the case because she became sensitive to the sun after her sunstroke and because of she felt better listening to music and dancing. It could be a possibility in the future. I decided to go with a low dose of Lycopodium because she was new to homeopathy, and also because of her sensitivity to perfume, social tension, and antibiotics. I also wanted to reduce the chance of aggravating her psoriasis, since she is in the hairstyling business and is conscious about her looks.
Plan: Lycopodium 6CH BID
August 30, 1993: Lyc 6CH BID since August 9th.
The psoriasis became more flaky for one week after starting Lycopodium. Then the flaking was reduced and most disappeared. The redness is 80% less and there is no burning. In the first week she developed a small boil on her back that lasted one week. She remembers having a couple of similar boils as a young girl. She has been feeling anxiety in her stomach for the past two to three weeks. Some days she felt increased energy; others, she felt very irritable for no reason. Last week she felt "fluish" for one day, with swollen cervical glands and severe diarrhea. She has had the flu only once before in her adult life. The right shoulder was worse for the first few days, but the pain disappeared last week. The left knee pain has been better for the past two weeks. Her mental confusion is 50% reduced. She wakes up alert, early in the morning, and has been less irritable in the morning for two weeks. She still feels very warm on waking. Her energy level is 20% higher. Urinary frequency is reduced, but libido is still low.
Assessment: Initial aggravation of the skin followed by amelioration. The joint pains may have been the early stage of psoriatic arthritis, as their improvement coincided with that of the skin. There is a return of old symptoms and amelioration of general symptoms. The direction of cure is correct; Lycopodium is probably the Simillimum. Time will tell.
Plan: Lycopodium 6CH BID (increase to TID if there is a relapse).
September 20, 1993: Lycopodium 6CH TID for 1 and 1/2 weeks.
She increased the Lycopodium because she was beginning to feel lethargic and depressed. She has been under a great deal of emotional stress. Her energy increased two days ago. It had dropped to 2/10, and now it has returned to 8/10. LMP first week of Sept. PMS symptoms were less. Her breast soreness was 50-60% reduced and her breasts were 50% less lumpy (she had forgotten to mention these symptoms in the initial interview). She was not sure if she was less irritable; she had more cramping, and craved sweets less intensely. The sharp rectal pain came the second day of menses instead of the first. Libido was still low. Psoriasis was now 99% eliminated. The only remaining symptom was a slight scaling in the corners of the nose. The right shoulder pain was aggravated lifting weights, but is 80% better. The left knee pain is 75% better. There are relapses of mental confusion; e.g., she told her children to put on their bathing suits instead of their pajamas. Her energy on waking in the morning is decreasing and her irritability on waking is 50% less. She does not feel as warm on waking. She still craves carbohydrates. She has had increased gas in the last week, which is painful and < after "poor food combining." The frequency of urination is less but still < during PMS.
Assessment: She is relapsing. Could Lycopodium have been a suppressant? Her skin is better, but her energy and emotions have relapsed. There is the possibility of suppression. Increase the potency. If emotions and energy improve, it is not a suppression; if they don’t improve, it may be a suppression.
Plan: Lycopodium 30CH every 4 days.
November 2, 1993: Lycopodium every 4 days.
Her psoriasis returned on the fourth day. Three weeks ago she had an outbreak of psoriasis after eating an orange. It cleared up in one week. She has had no psoriasis for the past three weeks. She has been busy and under stress during the past two weeks, yet she does not feel as though her energy is very low, even though she has not been exercising. LMPOct 28. No PMS! The sharp rectal pain came on the first day of her menses but lasted a shorter time (two to three minutes) and was 30-40% less intense. Her mind feels clearer. The left knee only bothered her once. No problem with the right shoulder. Energy = 8/10. Her irritability on waking is 70% less overall. There is no warm feeling on waking. She has been sleeping more on her back than her side. She still craves carbohydrates, and is hypoglycemic.
Assessment: Lycopodium is not a suppressant since her emotions and energy have improved, even though her psoriasis began to relapse. Her hormones are more balanced; she is dealing better with stress. Many improvements on different levels: physical. emotional, and mental. Lycopodium looking more and more like the Simillimum.
Plan: Lycopodium 30CH every third day.December 6, 1993: Lycopodium every two days. Psoriasis was beginning to return on the third day so she increased her dosage to every two days. It has been better since. She developed a new area of psoriasis under the right and left ear but < under the left ear. The front third of her tongue feels burnt. She had experienced this once before when she went on a yeast-free diet. For two days she has had sharp shooting pains in the breasts. Her energy has improved on waking (2) and during exercise (2). Rectal pain was 90% less intense with the LMP Nov. 25. On the first day of menses, she felt a pressure, like the sensation of a fist coming through the vagina. She had experienced this during labour with her second child. LMP was heavier in flow, with almost no PMS. She is eating less bread (2). Hypoglycemia has decreased (2).
Assessment: Continues to improve with some return of old symptoms. Need to increase the frequency of the remedy as her sensitivity is decreasing.
Plan: Lycopodium 6 CH every 2 days.
January 17, 1994: Lycopodium 6CH every day for two weeks because the psoriasis was starting to return. Now the psoriasis is 100% gone. She felt good, and her energy is high, despite a lack of exercise. Left knee is bothering her less. No pain in the right shoulder. LMP Jan 14 came on suddenly with no PMS, except a craving for sweet ice cream. Rectal pain with menses was very mild and lasted one minute. No pressure in the vagina. "Best menses in a long time."
Assement: Her progress appears good, but she needs to increase frequency of Lycopodium.
Plan: Lycopodium 6CH QD
April 25, 1994: One dose Lycopodium 200CH
Mar 14. Psoriasis on the scalp erupted and flaked, then cleared up after Lycopodium 200CH. She has been "very, very busy." Last week she woke up with a burning red scalp; the irritation extended along the sides of the neck to the jaw line. She took Lycopodium 30CH QD bid for a few days, and it cleared up. She had a chest cold for a couple of days two weeks ago, and she still has a mild cough. Pulsatilla helped. LMP, end of March. No rectal pain! She had the bearing down pressure in the vagina for the first day only. PMS was slightly more than the previous month. The varicose vein on the left calf (she forgot to mention before) has much improved. She has been feeling chilly < when tired (1) but warm on waking (1). In the last few days, she has craved sweets, especially chocolate. She revealed that she was a "chocoholic" in her 20’s. She felt hung over after eating chocolate. Her energy is good. There is no swelling of the fingers on waking. Her mid-thoracic burning pain was better but returned in the past few days.
Assessment: May need Sepia soon because of the increased chilliness when tired and warmth on waking, the bearing-down pressure, and the craving for chocolate, but Lycopodium can also address these symptoms. Stay with Lycopodium.
Plan: Lycopodium 200CHSummary from Oct., 1994 to August, 1996:
I continued to treat D.F. until August, 1996. She continued to improve on Lycopodium. She needed an intercurrent remedy, Sulphur, for a few months (which worked well), and then she went back to Lycopodium. The last dose of Lycopodium was 10M. Her psoriasis continued to improve and the intervals between lapses increased. I was surprised how easily her psoriasis responded to homeopathic treatment. Most of my psoriasis cases are more resistant to treatment, even when the patient’s overall health improves. I told D.F. to return whenever she felt the need. I have seen her for the treatment of her two children but she has not needed to consultation for herself since August, 1996.Incidentally her younger child did exceptionally well on Lycopodium and his chief complaint was anxiety and dyslexia.