2.7.2002:
Mrs. TEF aged 67 years, consulted me
for the following complaints:
Growth in the left side of the nasopharynx since two years, with
epistaxis, headache and loss of hearing on the same side. She
gradually developed hearing loss on the right side. She also has
vertigo and ataxia. She complained of post-auricular pain radiating
to the neck and left shoulder. There was a history of sudden falls
three times due to ataxia. Diagnosed on CT scan as malignancy
of the nasopharynx.
She also complains of:
Breathlessness since one month even
while sitting, accompanied with pain in the right side of the
chest.
Her appetite is poor with weak digestion
since cholecystectomy done in 2001.
She feels a constant abdominal pain and distention. She cannot
wear tight clothes. She also feels extremely weak after the operation.
Past History:
After the delivery of the second child she developed rheumatic
fever with joint pains and itching all over the body especially
of the palms with erythema.
Hysterectomy after the delivery of
the second child at the age of 32 years followed by left oophorectomy
two years after that. After 1-1.5 years the right ovary was also
removed.
In 1998 developed adhesions in the
abdominal cavity was operated on and the colostomy done.
Cholecystectomy done in 2001.
She suffers from recurrent colds with
a loss of voice every six but not since the last 2 years.
Family History:
Mother had cancer of the stomach.
Father also had cancer of (?) stomach.
Two sisters have osteoporosis.
One sister was diagnosed with bone
cancer,
All brothers have ?? neurofibromatosis.
Life Space:
She stays with one of her sons, daughter-in-law
and two grandchildren. One son and his family stay separately.
Her husband died in 1992 due to cardiac arrest. “He was a very
nice man and even my children are wonderful.”
“I am a very “bindaas”
(bold) person. I like going out and partying. I am the live wire
at all the parties. With children I am like a child. Without me,
nothing gets done in the family. I love dancing and cannot resist
it. I am a very good singer, love music and am extremely fond
of dancing. Whenever I am tensed, dancing makes me feel better.
I am a follower of Suky Mahikari
a form a Japanese art, a form of spiritualism. I turned towards
it after my oophorectomy operation in 1988 but more so from 1997. It has
helped me a lot with my complaints. I once had a dream of sleeping
in an air-conditioned room and a hand coming over my head and
blessing me and then I perspired too much.” She views this as
a blessing and a call for her to join the Japanese temple. The
‘light’ she received helped her to feel better in all her complaints.
After this, her nature has changed. Previously she used to argue
a lot, but now she had become very tolerant of people and things.
“I am a practical and straight forward
person. I am always adjusting and never make a fuss. I value things
very much. I am not anxious.
After my husband’s death, there was
a robbery in the house and a lot of valuables were robbed. I was
very upset about it but now I feel it was something I had to go
through and have let go of it now. God is my good friend. We are
all here to enjoy life and be happy and make others happy. As
being taught in my teachings, I believe that spirits influence
our life. We should all be sympathetic and help others. According
to me, love is the most important thing in life. We should love
one and all.”
I like being in company. Since childhood
I am very helpful and generous. I have never been obstinate.
Previously I was a beautician and clients
used to share their problems with me and I never shared their
secrets with anyone. I love solving others’ problems. I try to
help the poor and give ‘light’ to birds, trees, plants, everything.
I want things to be done perfectly and always.
Of late, because of the unbearable
pain; I get irritated, otherwise I seldom get angry. Now, I am
fed up because of my illness.
I am very talkative and mischievous.
Even as a child, I was very mischievous. I never played with girls;
always with boys as I liked playing cricket, climbing trees, etc.
I was a free bird. I fell in love at the age of 13 years but got
married at the age of 21 years. My husband was very strict and
never allowed me to sing or dance.”
Dream as stated above.
Observation:
The patient was extremely friendly
and gives a hug to me and my assistant while leaving the room.
Physical Generals:
Appetite : Decreased. Loved food but now no appetite.
Thirst: Decreased.
Craving: Fruits2, spicy2 (but now avoids eating spicy as it
causes acidity)
Aversion: Not specific.
Perspiration: Scanty.
Thermals: Fan seasonal, Bath seasonal,
Covering thin in summer, thick in winter.
Ambithermal to chilly.
Urine: normal
Stools: Colostomy bag.
Sleep: Better since 8 days. Previously, she kept awake the whole
night. No worries, no thoughts, but still no sleep. Kept reading
the whole night and used to get sleep around 6 o’clock in the morning
and then slept till 9 a.m.
Obstetric History:
G2 P2 A0 L2: FTND.
Sons aged 41 and 38 years.
Menopausal. Uterus removed at the age of 32 years after delivery of second
child due to profuse bleeding. Ovaries were excised one after
another.
Investigations Done:
CT of nasopharynx (plain and contrast) on 14.5.2002
Findings are suggestive of malignancy
involving the nasopharyngeal mucosal space causing effacement
of left para-pharyngeal space. Small bilateral jugulo-digastric and submandibular
lymph nodes.
Xray Chest
– Senile changes in the lung with right-sided pleural effusion.
On Examination:
Chest: Air Entry decreased, on the
right side .
The following rubrics were appropriately
taken: (Complete Repertory)
Mind: Cheerful, gaiety
Mind: Affectionate
Mind: Company: desires for
Mind: Sympathetic, compassionate
Mind: Dancing: Ameliorates
Mind: Numerous, various things
Food Drinks: Fruits, desires
Chilly
On repertorization,
the following remedies prominently appeared: Ign,
Phos, Nat Mur, Puls,
Ars Alb, Nux
Vomica, Sepia, Nat Carb, Carc and Lach etc
Remedy Selection and Follow-up:
2.7.2002
Based on the above rubrics and the
family history of cancer, and the modality of Dancing >, CARCINOSIN
200 1 dose was prescribed.
19.7.02
Not >
Breathing difficult.
Slight forgetfulness.
Giddiness.
Left nose block ++.
No epistaxis.
Hearing SQ.
The patient says, “I want the cold to come on, only then, I will feel better”.
Rx SL
29.7. 02
No Change.
Case reviewed: Temperamentally
the patient seemed to be more sanguine than melancholic.
Carcinosin is predominantly melancholic, sanguine and choleric.
Hence Phos was considered instead.
Rx: PHOS 200C 1 dose.
16.8.02
Pain in the abdomen at the site of the operational scar.
Sleep SQ.
Nose block: SQ Rx: PHOS 1M 1 dose.
17.9.02
Sleep better; Headache and hearing >>.
Nose block SQ
Rx: SL
16.10.02
Pain in abdomen SQ. Rest all >
CT Naso-pharynx: 12.10.2002
As compared to the previous CT study
dated on 14.5.2002:
There is seen minimal regression in
the bulging left nasopharyngeal space lesion with good visualization
of the left fossa of Rosenmuller with clearing of the left mastoid air cells. Soft
tissue opacity is seen in the left maxillary sinus suggestive
of mucosal polyp/ retention cyst.
Rx:. SL.
17.12.02
The patient developed a cold.
She says, “Do not stop my cold, let it come out”.
Rest >>
Rx. SL
4.2.03
Nose block < more at night and hence sleep disturbed
Appetite low.
Rx: PHOS 10M, 1 dose
28.2.03
Itching ++ on the whole body, especially
on the palms with erythema (old symptom).
Rest >.
Appetite improved.
Rx: SL
1.4.03
Itching palms SQ.
Nose block persists.
CT: Paranasal sinuses (Plain+Contrast)
dated
29.3.03 shows:
Complete regression in asymmetrical left nasopharyngeal mucosal space; differential enhancement is
seen now as compared to given immediately previous CT study dated 12.10.02
Rx: SL
16.4.03
Severe nose block:
Rest >
Itching SQ
Rx: PHOS 10 M 1 dose
24.4.03
C/O yellow nasal discharge.
Itching palms SQ.
Nose block Better>
Rest >>
Rx: SL.
27.6.03
>> Nose block >>
Itching better.
Rx: SL
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Dr. Parinaz Humranwala MD (Hom)
583, Vipin Villa, Jame Jamshed Road,
Dadar Parsi Colony,
Matunga, Mumbai 400019.
Ph: 022-24165496, 022-24129990