A 42 years old lady, Mrs. S. B. with tremendous weakness and profound tiredness visited my clinic on 2nd August 2016 with her husband and her parents.She called from Delhi, India to the UK, following diagnosis of a life-threatening illness.Her predominant concern was tiredness, generalised muscle aches and pain, lethargy,chronic disturbed sleep, severe nausea and loss of appetite. She must force herself to eat. She also has episodic headaches with some anxiety precipitated with the diagnosis of hypertension. Her history revealed she had high blood pressure at the birth of her son, diagnosed as gestational hypertension.
She developed blurred vision and haziness around objects. Fine work is veryh stressful. She had a severe leg cramps which made her cry, along with pain in stomach and abdomen.Menses were irregular, black, profuse flow and severe Breast pain in mid-cycle. Unable to bear the touch of clothes.
She was given IBS (Irritable Bowel Syndrome)tablets but that didn’t work due to her abdominal pain and colic and flatulence. Sour eructation before and after food.
She had a severe tremor in both hands and was unable to hold a cup of tea. It could be due to weakness or fear of dropping things.
Emotionally, she very deeply disturbed and constantly crying while giving history, though her husband and her mother were with her. She had a great insecurity about her three children, “What will happen to them, if I die?”
Palpitation at any time, as if her heart is racing with throbbing headache leading her to develop blurred vision. Her GP had also ordered visual field testing.
Her BP readings at home were always random, sometimes very high and sometime normal. MRI and pituitary tests were ordered.
Her weight was 65.2 Kg. Since March 2016 to August 2016, she lost about six kg. weight, suggesting progressive weight loss. When she came to see me, she was 59Kg.
Immediately, the picture of Conn`s Disease strikes my mind, which I compared with NHS notes.
Clinical Notes from NHS Hospital:
Essential Hypertension BP: 161/89,
- Weight:65.2 kg Since March 2016 to August 2016, she lost about six kg.
- High Prolactin Level at 1,947 Mu/L.
- Low vitamin D Level at 32 nmol/L.
- Empty Sella syndrome with Hyperprolactinaemia? MRI was done.
She was prescribed by consultant at hospital:
- Vitamin-D replacement maintenance
- Potassium Tablets…. considering probable diagnosis of CONN`S DISEASE.
But despite of taking all conventional treatment, there was NO Relief.
|Miasm||Psoric and Sycotic||Fear of death Psychologically very fearful, sensitive, emotional, weeping, Likes sympathy and assurance,Overgrowth andexcessive secretion from Adrenals|
|Tubercular||Lean, Thin, Dark complexionConstant Sighing, Crying.|
|Diathesis||Tubercular diathesis||Tendency to lose weightSevere prostration|
|Very Chilly||With slightest exertion felt exhausted. Low immunity Easily tired and irritated|
|SusceptibilityLow Spirited||Hypersensitive to every changes in life style, Family matters||Never well since her last delivery
|Bad Effect of
|Anti-Hypertensive Treatment||H/O:Gestational Hypertension
|Fine and coarse, both types of tremors||Tremors intensified with anxiety with awkwardness.|
|No significant history of any major illness in family.||NIL|
|Disposition||Dark, Mild disposed to lose potassium-Hypokalaemia||Ionic Imbalance -Low level of Potassium.|
Investigations Done by Hospital:
- Routine Blood tests: Mild Anaemia Hb: 118g/L (11.8gm%)
- Kidney Function: Normal. FSH, LH, Estradiol normal.
- Prolactin Level: Very high: 1947 mU/L (< 501mU/L)
- Vitamin D: 32nmol/L
- Neurological examinations: NAD
Important Clinical symptoms Selected:
- Constantly Sighing. Oh, God! What happens to me!!! What happens, if I die?
- Never well since her last pregnancy or last childbirth due to gestational hypertension.
- Fear of Death and deep-seated effect of grief.
- Severe cramps everywhere in body-Stomach, muscles, back, fingers.
- Great Insecurity about family – What happens, if I die?
- Palpitation and anxiety – starts thinking about her complaints.
- Anxiety about Family. Herself and others.
- Anxiety with sleeplessness. Can`t Bend or lean.
- Severe throbbing pulsating headache, with blurred vision. Can`t bend or lean and if she does, then feels breathless.
Homeopathic Management of the Case:
Considering her complaints, symptoms and investigations in to the Homeopathic totality.
Homeopathic Treatment and Management of the Case was planned as shown:
|Stage:1 To relieve her anxiety, fear of death, palpitation, nervousness, trembling, spasms.*Once her Anxiety gets relieved, the adrenaline and aldosterone secretion will come under control.
Stage:2 To treat her Hypokalemia by finding the exact cause for potassium loss.
*Low level of potassium in the blood serum to prevent muscle weakness, high blood pressure
Stage:3 To control her cramps and tremors
*With the cramps, tremors, she was developing Awkwardness and was dropping the things from hand and unable to hold a cup of tea.
Stage:4 Tomake her gain weight.
By boosting up her immune system-Treating patient holistically.
Stage:5 To control her high level of Prolactin.
While considering her complaint – “Never well since her last child birth”-the prolactin derangement taken from that point alongwith her high blood pressure.
Her Medical Diagnosis of Conn`s Syndrome is a clinical condition where the adrenal glands produce excess aldosterone, resulting in low renin level.
I started her treatment considering all clinical symptoms with Ignatia, due to the emotional element and effect of the grief and worry and erratic character of her symptoms,
Ignatia 10 M One dose daily for one week and then one dose every week.
Taking reference from Frans Vermeulen, I found interesting information about Ignatia.
Medicinal activities of Ignatia: Stomachic, febrifuge, anti-choleric, tonic.
Medicinal affinities: Ignatius bean extracts cause a number of toxic effects, including anxiety, restlessness, enhanced reflexes, dizziness, drowsiness, delicate sense perception, excruciating seizures of the entire body, augmented muscle tension, breathing problems, renal failure as well as death.
Miscellaneous folklore: People in the Philippines customarily used the Ignatius seeds in preparing good luck charms and wore them as amulets to fortify and protect themselves from different ailments. In Malaysia and Java, people extracted the seeds of the Ignatius fruits and utilised them as an arrow poison for their blowguns.
Followed by Tab. Bromocryptinum Mesylatum 3X. One Tablet twice a day for One month, to control her Hyperprolactinemia.
Here are the Results:
|27-06-2016||Prolactin -Before my treatment||1947mU/L (<501)|
|02-08-2016||She consulted me.|
This very rare and complicated case of Conn`s disease was treated very successfully without any recurrence to this day Mrs. S.B“s entire family is very happy to see her symptom free and enjoying her normal life.