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| Hpathy Ezine - Feb. 2004 | ||||
A Case of Crotalus cascavella-- Dr. Deborah Gordon |
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D.M., a 33 year old woman, first consulted me on August 1993. She was simply dressed in practical clothing, quite obese, intelligent, direct and cheerful. 'I have renal failure. I have a mental illness, and I was taking Lithium for three and a half years when they noticed that my blood pressure went up. By March my creatinine had gone up to 1.8 (normal to 1.6). When I was on the table for an angio, they had to cancel it when they found out my creatinine had gone up to 2.7. I saw a nephrologist who diagnosed that I have Lithium-induced renal failure, which is unfortunately irreversible, progressive, and extremely rare. I got a second opinion which was exactly the same.' 'I am depressed, my life is short. This stuff wasn't supposed to hurt me. I have been mentally ill all my life. I was sexually and physically abused until I was thirteen years old. I seemed fine until January 1988 when they took out my gallbladder, then in April I went into a severe depression, which happened once before when I was twenty five, due to birth control pills. I was suicidal, I just didn't want to live, I kept thinking of different ways of suicide, shooting myself, driving off a cliff. It is worse when I haven't slept for a while. I get violent (3), angry, my mind races (2). I feel pretty good without sleep for a few days then I get depressed and crash into a deep black hole. I was hospitalised to get me to sleep, then some jerk of a nurse woke me up. I promise you, if you ever wake me up, I'll hit you (2). I punched the refrigerator (2), I throw things (2), I pound nails, I have to do something physical.' 'Sometimes I cannot eat. Or I cannot get clean enough. I take showers all the time. I hate the noise in my head (3), it gets much worse if people are around (2). I hear a white noise, or conversations I wish I would have. I don't want more memories to come. My parents divorced when I was three years old, my mother remarried when I was five. Both of my stepparents are assholes. My stepfather's father raped me when I was five, and told me not to tell. I remember my stepfather's abuse, it was brutal, he used objects (she later recalled that it was bunches of broken sticks inserted into the vagina). He once left us in the care of some transient who raped me also. I hate Christmas, I was raped then. I've asked myself if I'm nuts. My stepfather hit me in the eye, nobody asked, nobody cared. I learned to play baseball and was good at it. My grandmother swears I would have killed my oldest brother if I had been allowed to. I would fight back to his teasing by strangling him. I was also responsible, like a surrogate mother, for my younger half-siblings.' Viral pericarditis at the age of twelve. Severe chest pain (2). Pneumonia's as an infant. 'I almost died.' Ear infections and pneumonia at the age of twenty three. My gallbladder gave me chest pain too. There was a sharp constant pain. 'I get palpitations when I have any kind of pain, worse from being nervous and from stress. I work as a respiratory therapist in a hospital. I always knew I wanted to do something medical. It's not too bad except when kids die. My opinion is that we are here to protect children (2). I'm a mean, horrible person inside, otherwise pretty gentle. I scare myself with what I am capable of. I'm violent, or capable of violence, but I take anger in and don't project it out, most people don't have any idea of the feelings inside. I believe I have to do everything for myself (2), if something is not right, it is my fault (2). I don't trust anyone. I love water, the ocean is calming, any water, the sound of water.' Warm, worse from hot weather. Sinus trouble especially shooting pain in right ear (3). Foods desires: ice cream (2), meat (2), milk, fruit, cheese (1), spicy (2). Foods aversions: fish (2), salt, eggs (3), tomatoes (3), squash (2). Thirsty for cold water (2). Some gas (2), also some reflux, probably from all the drugs. Sexuality: I tried it once with a boyfriend, but could not do it. Masturbates for sexual release. Blood Pressure: 180/120 previous to medication. Medications: Vasotec and Tenormin for hypertension secondary to renal failure. Tegretol and Doxepin for 'bipolar disorder', Restoril for sleep, Iron for anaemia, also due to the renal failure. Laboratory Values in 1993: Creatinine 4.2 (0.6-1.2), Creatinine Clearance 15.7 ml/min (88-128) Hgb. 10.4 (12-16), Hct 31.9 (37-48) with normal indices. Uric acid 12.1 (2.6-6.0) |
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