Bach Flower Therapy in Obesity

Ishita worked for a software company and weighed 102 kg when she first reported to my clinic in 2008. Apart from the complaint of obesity, she also suffered with polycystic ovarian syndrome and hypothyroidism, both accentuating the weight-gain. She has had an excellent work record and was getting promoted on a regular basis. But due to the ever increasing weight, she could not sustain her physical stamina much and would fall into the pits of fatigue and depression quite often. The ovarian disharmony also posed a risk of infertility. She had tried all sorts of treatment options, including the liposuction, for getting rid of the extra weight. Finally somebody suggested her to try Bach flower therapy.

Bach flower therapy is a natural and thus holistic healing system that deals with regulating our emotional pattern by using flower essences. The modus operandi is to resolve the negative states prevailing in the mind by the administration of suitable remedies that can counteract those negative emotions. In other words, to provide a necessary positive quality, that can extinguish the negative mental state. For example, if a person lacks confidence in talking to a large group of people, and thus in spite of having necessary skills is not able to perform and grow professionally, a Bach flower remedy called Larch and Mimulus will help him to overcome those fears. Larch primarily provides self-confidence, while Mimulus deals with specific fears, in this case the fear of public appearance.

Thus you may have guessed it, there is no specific remedy for a particular disease, but one has to select the remedies as per the emotional state of the person regarding that ailment. If we are observant enough, the reactions of each and every person is unique and individualistic, let the stimulus be the same. For example, if a teacher scolds three students at the same time, not all will receive it the same. One may find it insulting to get reprimanded in front of all his peers, while the other might get frightened, or the third one will just ignore the scolding and will behave as if nothing went wrong. As per their individual sensitivity, they will receive the stimulus and naturally react to it accordingly. While selecting the medicine, one has to see the characteristic ‘receive-react pattern’ for that individual.

Coming to the case of Ishita, she had a very strong feeling of guilt added with inability to control when faced with sweets. She was prescribed Pine for the guilt and Cherry plum to gain the self-control. She was also treated with a suitable homeopathic constitutional remedy [calcarea carb]. Working together, it not only brought her thyroid levels to normal, but also made the ovarian cysts to regress. Her weight dropped to 88 kgs within a year, making her to find herself a new.

I can see a world-map on my tongue

Rohini, a television anchor and a news reader by profession, visited my clinic with a very strange complaint, she had never even heard about before. For the last few months, she was observing patchy white areas of yellowish white coat on her tongue. She first ignored it thinking it just due to the disturbed gastric schedule, but within a couple of months, she started getting burning or soreness in the tongue area on eating any citrus fruits like oranges or lemon. These areas were getting resolved spontaneously, but a new patch used to appear on the other region of the tongue, thus not letting the lesions resolve completely.

She had been to her local physician for the same, who first prescribed her local mouth wash, but instead of relieving the complaints, it aggravated the irritation further. She was then treated with antihistamines and topical steroids, without any significant improvement in the lesions. She was thus asked to continue a dose of multi-vitamin tablet, especially of b-complex vitamins.

Apart from the soreness, the major concern for Rohini was the dirty appearance of the tongue, which was prominently hampering her screen-image. She was once asked by the cameraman not to laugh with mouth wide open, since it made the appearance of the tongue much obvious. One of her friends then suggested her to take a homeopathic treatment and thus she came to me. Rohini suffered with what is called ‘Benign migratory glossitis’ or ‘Geographic tongue’.

Clinical features:

As the name suggests, the condition is benign [possessing very less morbidity and no mortality] affecting almost 4% of the human population across the world. It is mostly asymptomatic but patients can experience burning, irritation or soreness that gets aggravated by certain food items and astringent flavored items. Many patients also get swelling of the tongue along with the appearance of deep fissures on the tongue surface.

It is believed that it is more common in patients suffering with psoriasis, but it is insignificant to link the two ailments, since geographic tongue is seen commonly in non-psoriatic patients as well. It is also linked with hormonal changes withing the body, diabetes, smoking and spicy diet. It can be seen running in the family, but it is attributed more to the diet pattern than the genetic predominance. Females are seen getting affected more than males.

Treatment:

Ideally there is no particular treatment for this ailment. Mostly the lesions can resolve without any treatment, giving undue credit to the multi-vitamin or local steroidal preparations prescribed empirically.

Homeopathic approach towards this ailment is that of a constitutional disorder. Rohini was interviewed in detail for the constitutional assessment and was prescribed Natrum mur, which not only resolved her tongue patches but also relieved her recurrent migraine attacks.

Other significant remedies that can be useful are – Nitric acid, Rhus tox, Taraxicum, Arsenic, Kali bich and Mercurius.

Handling Syncope with Homeopathy

Syncope accounts for almost 40 percent patients visiting a clinic for the complaints of ‘sudden fall episodes’. It is a transient loss of consciousness associated with the loss of body tone. Most of the patients recover spontaneously. It may occur as a single event without any specific causation or can also be recurrent when it is associated with some organic pathology. The basic pathophysiology includes reduced cerebral blood flow.

An occurrence of syncope needs to be differentiated from a seizure episode, since it mimics the later very closely. A recurrent an d unexplained episodes of syncope need to be examined for possible structural cardiac pathologies, since it can lead to death if not attended in time. Most of the times, syncope occurs suddenly without any warning, but few patients can experience pre-syncope manifestations like light-headedness, dizziness, a feeling of warmth, nausea, and visual blurring.

Causes:

The transient reduction in the cerebral blood flow is mostly due to three basic causes

1. Disturbance in the vascular tone or blood volume

2. Obstructive cardiovascular disorders and rhythm abnormalities

3. Cerebrovascular diseases

The disturbance of vascular tone or blood volume can be due to situations like cough, micturition, defecation or valsalva maneuver as well as due to carotid sinus hypersensitivity. Also due to orthostatic hypotension because of some vasodilator drugs, pure autonomic failure, peripheral neuropathy, and decreased blood volume. Cardiac rhythm abnormalities like sinus bradicardia, sinus arrest, atrioventricular block or atril flutter and fibrillation can also lead to syncope. Vetebrobasilar insufficiency or basilar artery migraine are one of the cerebrovascular diseases causing syncope.

Disorders that can mimic syncope are few metabolic disorders like hypoxia, hypoglycemia, anemia or hyperventilation or some psychogenic events due to anxiety attacks or hysterical fainting.

Neurocardiogenic or vasovagal syncope is usually associated with both sympathetic withdrawal [vasodilatation] and increased parasympathetic activity causing bradicardia. These are precipitated by alcohol consumption, severe pain, extreme fatigue, hunger, prolonged standing, exposure to hot or crowded environment, and during emotional situation.

Diagnosis:

The above mentioned pathologies should be ruled out by conducting diagnostic tests after a thorough clinical history – including serum electrolytes, glucose and blood counts. Electrocardiogram, cardiac enzymes need to be checked in case of cardiac causes. An electroencephalogram will rule out the possibility of a seizure activity.

Homeopathic treatment:

Sporadically occurring syncope attacks do not need any treatment if they are of vasovagal origin. Remedies like gelsemium, belladonna, conium and phosphorus have been most effective in treating recurrent episodes of syncope. The totality should be based on the precipitating factors like exposure to direct sunlight [as in belladonna and gelsemium] as well as the factors that modify the episodes such as getting aggravated on sudden rising, looking up, etc.

Symptoms that follow the syncopal attack too play a significant role in remedy selection. Gelsemium patient will have a drowsy and dull look with reduced thirst. Belladonna will show marked congestion of eyes along with throbbing headache after the episode. Arsenic album will have anxiety with frequent thirst for small quantities of water. Phosphorus patient will have intolerance of light, especially the artificial one. Of course, these symptoms will help to select a remedy for preventing the future attacks.

A well-selected deep-acting constitutional remedy will always have its role to restore the vital force back to normal, so as to treat the basic pattern.

Cure Epistaxis with Homeopathy

Almost all of us must have experienced bleeding from the nose at some point or the other. Medically it is called as Epistaxis. The nasal septum, the thin wall that divides to nostrils, has been highly supplied with capillaries, especially in the upper region. This portion is called as 'Little's area'. The walls of these capillaries are so thin and delicate that even a normal increase in the pressure within can make them burst open. The cause for this raised pressure can be just a small sneeze, boring the nose, or even slightest blunt trauma to the nose. The bleeding from such bursting usually stops on its own, and does not necessarily need any medical attention; but if it forms a regular pattern and/or if it does not stop on its own, it needs to be investigated for the underlying cause and the respective treatment plan.

The most common cause for recurrent nose bleed is anti-coagulant medication for the cardiac ailments. Almost all patients suffering with ischemic heart disease are given aspirin derivatives which keep the blood thin and does not allow it to coagulate easily, to prevent formation of the blood clot [thrombus] with the artery. If these patients start bleeding from the nose, it may not stop easily on its own.

As said earlier, a blunt trauma due to some object put in the nostril, or even a sneeze can trigger Epistaxis. Many children put beads, pencils, toys or their finger in the nose, which can irritate the sensitive areas in the nasal cavity, leading to vasodilation and eventually bursting.

Epistaxis can also be a common manifestation or presenting symptom of increased blood pressure. The raised blood pressure can lead to intermittent disruption of the nasal capillaries.

Any change in the normal process of coagulation can lead to epistaxis. There are certain infections [Dengue] that reduce the platelets count, leading to reduced coagulatory capacity of the body. Certain liver disorders lead to deficiency of Vitamin C and K, which are also significant influencers of the coagulatory process.

Generally, the bleeding stops if one applies firm pressure from the outside of the nostril, while breathing from the mouth for some time.

Common homeopathic remedies for epistaxis:

1. Ammonium carb: typical presentation of epistaxis while washing the face and hands in the morning. Usually from the left nostril. Aggravation after eating. Rushing of blood to the tip of nose while stooping. Offensive smell from the nose.

2. Bryonia: epistaxis as a symptom of vicarious menstruation. Nose bleeds when the menses should appear [also seen in Phos].

3. Hamamelis: passive, long-lasting bleeding from the nose with difficulty in clotting. Venous hemorrhage - dark colored blood.

4. Phosphorus: sudden and profuse bleeding from the nose of bright red blood. Mostly is aggravated after getting exposed to sun for even slightest time. Tendency of bleeding in pale and thin individuals.

5. Melilotus: bleeding from the nose preceded by intense redness of face with flushing and throbbing of carotids. Bleeding from the nose relieves the headache.

6. Lachesis: vicarious menstruation especially towards the menopausal period. Dark, clotted and especially from the left nostril.

Homeopathic treatment not only cures chronic epistaxis, but can also correct the underlying pathology by restoring the dispositional imbalance to its normalcy.

Do You Sweat a Lot?

Radhika came to my clinic for the complaints of excessive sweating of palms and soles. She almost used to have cold clammy palms throughout the day, more pronounced while she studied for her exams. She had stopped using an ink-pen since the sweating used to bloat the writing. She had hyperhydrosis. It is a condition that leads to excessive sweating - either on the entire body or on specific parts.

It was very embarrassing for her to shake hands with anybody since the immediate reaction from the opposite person used to be removing the hand as early as possible and wiping it. She had marked chilly response to the environment, fanning and would need more woolen garments than her friends. She was prescribed Silica in infrequent doses [weekly one dose]. Within two months, her perspiration reduced significantly and she could perform her daily chores without any discomfort.

Homeopathy has always proved itself as the best therapy for hyperhydrosis. The modern medicine does not have anything to offer to these patients. Homeopathy treats this complaint as a dispositional derangement. Thus assessing the emotional - intellectual - physical composition of the individual to select a suitable constitutional remedy is the key to success.

To aid this, here are the indications of few prominent remedies that cover excessive sweating as a symptom. To help locating an individual remedy I have italicized their names:

The patient of calcarea carb constitution sweats profusely while sleeping - almost wetting the pillow, like the patients of silica or sanicula. There is also perspiration on the back of the head, neck and chest. Mostly sweats in the upper part of the body. The sweat has a sour smell and the sweating is more during sleep. Conium also sweats more during sleep; almost as soon as one sleeps or even when closes eyes to sleep. Exactly opposite is seen in Sambucus - where there is a profuse sweat over the entire body during waking hours, while on going to sleep, the dry heat returns.

If calcarea sweat smells sour, the sweating of Bovista smells like an onion. Offensive sweating is a characteristic of many remedies including Alumina, Graphites, Psorinum, Phosporus, Sanicula, Thuja and their leader Silica. Among these, phosphorus sweat has the odor of sulphur fumes, while thuja smells like honey. Most of these also show a tendency to sweat more on palms and soles.

If we are discussing the smell of the perspiration, the taste should not be left un-noted. The remedy Caladium has a unique quality - the sweating of this remedy is sweet in taste, so much that it can even attract flies. It has got yet another characteristic - the patient of caladium sweats profusely after any acute diseases, so distinctly that we can even say that the profuse sweat relieves all sufferings in caladium [also in Natrum mur].

Thuja shows sweating only on uncovered parts, or all over except the head. These patients also sweat a lot of sour smelling or fetid sweat during sleep.

The prominent remedy for cholera, Veratrum album has cold perspiration on the forehead with nearly all complaints. Tabacum has it all over the body.

Isn't it interesting to know the various characteristic features that a remedy can throw just in the pattern of sweating? Knowing all this will not only improve our remedy selection but also our case-taking. We would only ask those questions, whose probable answers we expect already.

Don't you have any pain-killers in Homeopathy?

Acute pain is one of the leading ailment for which a patient presents as an emergency in a private practice. The pain can arise from multiple organs and locations ranging from ear, teeth, and head up to abdomen and spine. The type of pain also can be varied - from colic to neuralgias. In such situation of acute pain, patients always necessarily need a remedy that can give them immediate relief from the painful crisis. To obtain it, they usually opt for allopathic analgesics, but always with a caution since they are known to cause some adverse effects. This gives rise to a pertinent question from patients visiting homeopaths, "doctor, don't you have any pain-killers in homeopathy?"

The answer is yes, we do have. In this article, we will discuss the approach to select an appropriate remedy for acute pain.

Generally the acute painful situation is seen in patients suffering with some underlying chronic ailment that is characterized by acute exacerbations, such as sciatica, renal calculi, cholecystitis or cholelithiasis, angina, dental caries, chronic otitis media, migraine, prolapsed inter-vetebral disc, gout or pelvic inflammatory disease. Prescribing a suitable homeopathic remedy for these acute exacerbations is difficult unless we explore the individual symptomatology comprehensively. Homeopathic practice that rests on the philosophical platform of individualistic remedy selection does not allow a general remedy for all patients, even if they suffer with the same ailment. This is because each and every patient is unique in presentation of the ailment with respect to the cause, manifestations and conditions of aggravation or amelioration. A single remedy cannot cure everybody. Considering this, we usually face two kinds of situations in case of patients presenting with an acute pain.

1. Patient visiting your clinic for the first time - directly in an acute pain situation

In such patients, one needs to take a quick history comprising of the location, sensation, modalities and concomitants, if any. The advantage of this situation is easy to get the entire symptomatology, since the patient in pain is available in front of you, detailing all the symptoms as well as for the observations that are key indicators towards certain remedies. For example, a patient who needs chamomilla for acute pain often presents with uneven congestion on face with one cheek red & hot while the other pale. Belladonna patients often show marked congestion on face, earlobes and eyes. Since patient is in pain, we can ask the patient about various kinds of modalities. If patient has not observed them, you can ask him to check it by actually trying various postures or conditions.

2. Patient presenting with a chronic ailment that pose a risk of developing an acute exacerbation

In this case, the patient is not in pain, but poses a risk of acute pain, or might have experienced it in past. History taking in these patients should ascertain the dispositional features as well as an acute totality that is based on the presenting symptomatology recollected by the patient from his past experience. While we prescribe a deep-acting constitutional remedy, we can also give a set of corresponding acute remedies to keep in stock. By doing this, we can even manage acute pain situation on phone, by selecting an appropriate remedy from this stock, based on the situational manifestations.

Thus, although homeopathy bases its prescription on individual basis, it is not difficult to relieve a patient in an acute painful situation.

Treating Ganglion with Homeopathy

Quite a number of patients visiting a surgical unit end up with a diagnosis of a ganglion. It is a small and semi-hard bump situated above a muscle tendon or in a capsule that encloses a joint. It is also known as synovial hernia or a synovial cyst. All ganglions are non-cancerous.

A cyst means a fluid filled cavity. Ganglions are filled with a thick, jelly-like fluid. Ganglions particularly are seen in patients within the age group of 20 to 40 years of age. Mostly they are fond on the hand or wrist thus are easily noticed and can set the alarm within. They are more common in those who use those group of muscles more - like in case of wrist or hand ganglions, it will be more common within handball, squash or tennis players or those bikers who ride their bikes accelerating the throttle constantly. Runners or athletes can get them on the foot muscle tendons, since those are the group of muscles they need to use more often.

The cause is usually mild sprains or repeated injuries to the tendon causing irritation or tearing off of the thin membrane covering it. Once torn, the vitalizing fluid leaks into the sac that swells up and takes form of a ganglion. They are usually painless but can limit the range of motion at the affected site. Though they may not give rise to any pain, they definitely can produce a discomfort. Ganglions also can be internally developing, thus causing just some soreness or a dull aching sensation, but not making the mass palpable during the examination. Calcification of a ganglion is very rare.

The diagnosis of ganglion is usually easier through a physical examination to aid to clinical features. Imaging techniques like ultrasound or x-ray or at times a magnetic resonance imaging (MRI) may be required for the suspected internal ganglions. The fluid within the cyst can be aspirated and evaluated for cytological assessment.

Most of the ganglions will disappear without treatment and on the other hand, many will reappear despite treatment. Surgical excision is needed if the cyst is causing pressure over the adjacent vital structures like nerves or blood vessels.

Homeopathically, I have found remedy 'Ruta' helping me in almost 90% of the cases. Given in 200th potency in thrice daily regimen can reduce the cyst within few weeks, thus avoiding the surgical correction. Increasing the muscle strength and flexibility by regular exercise is yet another way of avoiding the recurrence of the lesion. Warming up or cooling down around the exercise schedule also decrease the rate of developing ganglions

Samavedana – Providing Hope, Help and a Healing hand

In last few decades, medical science has seen enormous advancement in terms of diagnostic, therapeutic and rehabilitation techniques. But unfortunately it has increased the overall cost of the medical facilities, making it unreachable to a majority of the population. Unlike other services, medical service can neither be substituted nor neglected when the need occurs. In developing countries, where many families find it difficult to get enough food for the day, how can they afford expenses of the medical treatment if their earning member needs an urgent operation or a costly treatment regimen? This question has haunted me for a very long time, since I got admission to the medical school. But recently, I came across an organization called Samavedana that not only provides hope to poor and needy patients, but in other way supports the existence of the entire family, as well.

Internationally acclaimed neurosurgeon Dr Charudatta Apte and his associated have been working hard for last six years to provide not just financial assistance to the poor and needy patients, but at times free medical treatment as well. The group that started with an aim of providing neurological treatment to the poor, has now expanded its activities to cardiology, hematology, pediatrics and ophthalmology, through a team of around 30 doctors and more than 2600 donors.

With a motto to ensure that non a single patient is left untreated due to the lack of financial resources, till date, Samavedana has provided help to almost 250 patients, providing medical facilities worth 12 million rupees. All with the help of donors and Sahyadri Hospital [that contributes around 3% cost per patient] administration. Doctors who work for the organization, treat patients completely free of charge, owing to their responsibility towards the society.

The organization works with complete transparency with the donors, where each donor, even if he makes a contribution of Rs 100, is given a detailed feedback on how and where his money has been utilized. The donor gets a report of the patient along with the case-history and details of the surgery, to ensure that the money has been spent in the right way. The donations get tax-exception under 80G. Being a trust having a Foreign Contribution Regulatory Act [FCRA] certificate, it is eligible for accepting donations from foreign sources as well.

Not only doctors, but few patients have also joined the movement, by becoming volunteers – that can help by spreading the message by word or mouth, or contacting prospective donors, and not the least, talking to patients with a soulful heart.

As it is aptly said, God realized that he can’t be present at every place to help the poor and the needy, and thus he sent his messengers – like Samavedana. Cheers to their work and hats off for their dedication!!

If you need any further information about the movement called ‘Samavedana’ you can reach them at www.samavedana.org or just dial +91-9673338052 [Priti Damle, the chief co-ordinator].

Dacryocystitis - The Tear Duct That Cannot Cry

The apparatus for creating and draining of the tears from our eyes consists of a tear sac or lacrimal sac, little tube-like canaliculi, and the nasolacrimal duct. The tears drain into little opening situated at the inner corner of the eyelid, called puncta, from there they travel through the canaliculi to the tear sac and finally taken to the nose by the nasolacrimal duct. Dacryocystitis is a condition where the tear sac gets inflamed and consequently blocked.

It is usually caused by the blockage of nastolacrimal duct, thus stopping the passage of excess tears into the nose. This flow of tears from eyes to nose is needed to get rid of the excessive tears; and that is why we do have to blow our nose while we are crying aloud. When the draining gets blocked, the accumulated tears provide a suitable medium for the bacteria to grow, adding a bacterial infection to the earlier inflammatory response.

There are cases presenting with failure of the nasolacrimal duct to open on its own in the infantile stage, a condition called dacryostenosis. Like infants, it gets more common in the elderly or adults who are above 40 yrs of age. In adults, it is usually associated with inflammation and/or infection in the nasal region. It can be acute with sudden onset, or it can be long-standing with the symptoms occurring over the course of weeks or months.

The presenting symptoms are pain in the region of orbit with other inflammatory manifestations like redness, and swelling. The area looks swollen and shiny due to stretching of the delicate skin around the eyes. A gentle pressure over the swollen area can lead to a purulent discharge from the punctum. It is usually unilateral, that is occurring in single eye at a time. The eye looks watery.

Diagnosis can be made clinically through signs and symptoms. It can also be supported with lab tests where the white blood cell count is raised indicating acute infective origin [which is mostly normal in case of chronic variant]. In some cases, a procedure called dacryocystography can be done to locate the blockage area, by injecting a radio-opaque dye into the duct.

Treatment includes warm compress and antibiotics. Homeopathic medicines like Belladona, Apis and Arsenic have shown remarkable effect on this particular ailment. Surgical procedures are often required to release the blockage of the duct, in case the patient does not respond well to the medication.

Vitiligo Cured With Homeopathy

Which is the most un-homeopathic question asked by most of the current homeopaths? Well, it is – “What are the homeopathic remedies for XYZ disease?”

Visit any homeopathic discussion websites or forums on social-networking websites where people discuss homeopathy, and you will find only one question – tell us ‘the remedies’ for a particular disease. Believe me, the process of homeopathic remedy selection has not stopped surprising me even after practicing it everyday for more than a decade. We definitely can narrow down our remedy repertoire for a particular disease to 15-20 remedies, but in spite of that, not more than 50% of cases get the benefit of it. Finally one has to understand the case in its individual aspect and prescribe a suitable remedy for it.

The cases of vitiligo [Leucoderma] have always proved tricky to treat, for me. I have tried all sorts of specific remedies [no need to mention], but without any good effect. I only got results in 3 cases [out of 8] and in all of them, the key was the constitutional remedy. I would like to present a recently treated case here:

Vitiligo before and after

Ms KS, age 7 years. Daughter of a rickshaw driver.

Chief complaint:

Skin: Vitiligo since 2 years, spreading rapidly. Earlier she was slightly better with homeopathic treatment, but discontinued treatment as she could not afford it.

It started with the left forearm as a 50 paise-coin sized round patch, which has now enlarged to a diameter of almost 3 cms.

She then got a few patches on her forehead and scalp – left side.

Family history: father has widespread vitiligo almost covering 80% of his body.

Dispositional features:

Ambithermal-Hot; Perspiration ++ especially over the scalp;

Cravings or aversions – nothing specific.

Developmental milestones – normal; No history of dentition aggravation;

Nature:

Emotionally not much affected with the lesions. Continued socializing with friends with the same ease, and without any awkward feeling. She does feel the patches should get resolved. [buoyancy]

Overall she is quite bold and doesn’t have any kind of fear.

She has a tremendous pain tolerance; mother can hardly remember patient crying due to pain, although getting injured is an everyday ritual.

Remedy selection:

Constitutional = Calc Fluor

[Totality: Left sided + Scalp perspiration + Ambi-Hot + buoyancy + pain tolerance]

In my experience, the fluoric element provides a tremendous amount of ‘tolerance’ to the personality. It can be a tolerance to pain or reprimands or criticism or exertion or for that matter anything which generally we cannot tolerate much.

16^th April 2009: case defined Rx: Syphilinum 1M [1]

Placebo BD x 1 month

[syphillinum was given as an anti-miasmatic start, considering the extensive spread of vitiligo in the father’s case, and with appearance of lesions in the patient’s case at a very early age]

20^th May 2009: status quo with all lesions Rx: Calc flour 30 QID

23^rd June 2009: Forearm patch reducing from the periphery;

Face patches – one patch totally gone, others >>; Rx: ct all

22^nd July 2009: Reported to be better – patches resolving Rx: ct all

21^st Sep 2009: Forehead patches gone completely;

Forearm patch – almost 40% better Rx: ct all x 2 months

2^nd Dec 2009: Face patches all gone;

Forearm – 80% better Rx: ct all x 1 month

10^th Jan 2010: Father reported ~100% resolution of forearm

Patches. Patient could not visit. Rx: ct all x 1 month

Update 3/30/2010 : Thanks to her sincere and regular efforts in giving follow-ups and taking the medicines religiously, almost all her vitiligo patches over the body have disappeared in one year.

Being An Unprejudiced Observer

“Did you see that thin tall guy? He seems to be a typical Natrum mur, isn’t it?,” one of my colleagues started a usual debate with one of his quick-bites. “But he also can be a Phosphoric acid, a Silica, or for that matter a Phosphorus…” said the other listener. “Impossible! Just see his mannerisms and facial expressions. If he enters my clinic, I will take his entire case-history only if Natrum mur fails to cure him.”

Don’t we hear such words of confidence around us? You may call it an ‘intuitive prescribing’ or ‘snap-shot prescribing’ or anything, but we often come across homeopaths trying to hit the bull’s eye from as far as possible. Since based on natural laws, homeopathy does not fail to surprise us and makes us re-evaluate the case for a more thoughtful prescription. Unless we learn from our deeds, we will never grow as professionals, but every time we do so, we are one step closer to becoming an unprejudiced observer. Believe me, it’s a tough job. Even after 10 years of practice, an acute case can also make you aware of your prejudices. I would like to share a case with you, which did exactly that.

Mrs. S, came with complaints of chilliness with body-ache, that had started four days back. This was followed by a high grade fever with marked chilliness starting from the feet. Surprisingly, there was marked knee pain only during fever, with severe burning in both eyes. She was running 103’F fever when she visited my clinic. On examination, there was an irregular distribution of heat with palms and soles hotter than the rest of the body.

Remedies started coming to my mind and it made me more and more confused. I started thinking of ARSENIC and EUPATORIUM and WHAT NOT!! I had a case in front of me with many characteristic concomitants, and thus was in apprehension of whether I would be able to give full justice to them by prescribing a simillimum. The confusion was mounting and I was unable to come to a prescription with assurance. At this moment I thought of referring to the repertory on my PC. Boenninghausen was a clear choice looking at the characteristic concomitants.

I searched for the rubrics and clicked for the result. Here is what I got to my surprise:

PETROLEUM ???

I had not used this remedy except for treating dry cracked skin or motion sickness. The patient was running a high grade fever. There was no trace of my “FAVOURITE REMEDIES” in the repertorization result. It put me into a totally different dilemma. My understanding about Petroleum did not assure me about giving relief from a high grade fever, but the repertory was confident to indicate this remedy to me.

To be really frank, I thought of taking a chance and prescribing PETROLEUM 200. But before that, I referred back to my materia medica text on petroleum and discovered that Petroleum does have symptoms of fever and those other indications. So the repertory guided me to the materia medica and I decided to prescribe Petroleum. To my disbelief, the lady called within 3 hours to announce 80% amelioration of all her symptoms. She recovered totally within a day.

Petroleum for a fever? I had just tried to follow the available TOTALITY and followed the direction it showed me. Dr Kent came to my rescue in this state of “want of reason”. He says in his lesser writings (Pg 213-214), “. . . We have asserted, as our belief, that the only true guide for a prescription is the totality of the symptoms and the proven drug. Let us not, then, prescribe upon any other basis; it cannot be homoeopathic nor wise to do so.” I had just experienced it! That’s the reason we call these stalwarts MASTERS.

A lesson well learnt and my prejudices and favoritism towards remedies exposed. It was another step taken towards becoming an unprejudiced observer.

Plantar Fasciitis - Heel Pain That Hits the Head

I have been treating patients of plantar fasciitis since I started my clinic a decade ago. At first there were patients mostly coming from the professions that needed long periods of standing, like those of teachers or professors or advocates. Recently, one of my happy patients wrote a testimonial in a reputed daily newspaper and that followed a huge number of patients reaching my clinic to get relief from the most troublesome ailment of their life. Let's discuss few things about it.

Our feet are made up of almost 25-30 small bones that are arranged in an arch-shaped manner. Every time we put a step ahead, we put our whole weight on a single foot. This weight bearing gets divided at the knee-joint, the ankle-joint and finally the arch of the foot. To keep the bones in place and to add a buffering or spring-like function, we have got a thick fibrous band, called plantar fascia, that extends from the heel bone till the balls of the foot. It not only helps to reduce the impact but also maintains the curvature of the sole. If due to some reasons it gets overstretched or if it gets weak, due to age or poor health, it starts getting inflamed, resulting into the condition called plantar fasciitis.

The radiograph of many patients suffering with this ailment also show a spike like overgrowth at the base of the heel-bone, popularly called as calcaneal spur. It is a result of the normal wear-and-tear of the bone due to walking on it for our life time and the subsequent healing by calcium deposition by the body. Since it's a repair without absolute rest, it doesn't attend the smoothness it requires and results into a thorny shape. Presence of such spur can result into an additional bothering factor for the inflamer fascia.

As regards the symptoms, the patient of plantar fasciitis typically complains of excruciating pain in the heel region, especially when s/he steps out of the bed first time in the morning or starts walking after a long period of rest. The pain is so severe that the patient almost limps for some time. The pain gets relieved once you walk a few steps. It also gets relieved with cold compresses. Few patients also get pain if they stand for long time or sit on a high-chair with their legs hanging down.

The usual treatment options are giving some pain-killers or anti-inflammatory drugs, that give a temporary relief. If you are aiming for a permanent cure, the best relief can be obtained by trying out homeopathic remedies. I have been treating patients with homeopathic drugs like Calcarea flur, Valeriana, Natrum carb, Cimicifuga and Rhus tox, prescribed as per their individual indications. Once there is more than 80% amelioration in the pain, one should start doing plantar exercises that should be continued for few years to give a better load-bearing capacity to the plantar fibrous tissue.

GM Diet: My Experiments with the Truth…

You may love it or you may hate it, but I am very sure, if you are seeking for weight-loss methods, you can never ignore it. General Motors Diet or popularly known GM Diet, ranks highest in the most-sought diet charts. Surprisingly, I have yet not found any information about GM Diet on any of the official sites of General Motors (update me if I have missed any).

Various sites, blogs and forums have discussed about GM diet, but in a scattered manner. My primary intention behind this post is to represent various facets of this diet plan and to give a comprehensive overview, based on the experiences of my own as well as of my friends.

Background:

This diet plan was introduced at a general meeting of General Motors Corp. on 15^th August 1985, initially intended for the use of the employees of General Motors company, to facilitate wellness and fitness. It was granted by the United States Agricultural Department and the FDA, further tested by the Johns Hopkins Research Centre.

It was designed as a ‘De-toxification diet program’, to improve ones metabolism through its cleansing systemic effects, reflected by an improved disposition and a feeling of well being. As an end-result, a weight loss of 4-6 kgs was expected within the program-week.

The plan:

Here is the day-wise diet plan and its dietary significance. I have added few things from my experience and experiments, which worked.

Day 1:

Fruits of any kind (except bananas) in any quantity. The most preferred fruits are the melons and cantaloupes, due to their high water content. In addition, you should drink at least 10 glasses of water.

By eating fruits, you are preparing your system for the upcoming program. Fresh fruits are nature’s perfect food, providing all essential elements needed to sustain life. Fruits are also a good source of antioxidants and are fiber-rich. Fruits are also considered as a negative-calorie food, thus burning more calories for its digestion than those provided.

Believe me, I have done GM diet twice and have found this day the most difficult one. Firstly because of the sweetish taste of all fruits, and further due to an intense craving for bread or spices, that one develops towards the end of the day. The solution for this is the Soup to break the monotony of the fruity taste.

Day 2:

The day can start with a large baked potato with one pat of butter for breakfast. It definitely fills you with complex carbohydrates to start your day after the first sweety-fruity day.

For the rest of the day, you should eat all sorts of vegetables of your choice, raw or cooked. Vegetables have very less calories, high in nutrients and fiber. There is no limit on the amount. This should be added with drinking at least 10 glasses of water.

One can also mash a baked potato, add some onion & curd, and spice it up with chaat masala & red chilli powder and pinch of salt.

Day 3:

This day consists of a combination of fruits and vegetables of your choice, except banana & potato. In addition, you should drink at least 10 glasses of water. Potato is avoided on this day since the carbohydrates are available from the fruits that you eat.

One can do varieties of salads mixed with fruit slices. If you take more cucumber and melons, it’s more likely to lose weight than any other vegetables or fruits. Adding a curd to vegetable salad, in a ‘raita’ form will make it more palatable towards the evening, when it gets monotonous.

Day 4:

A day when you can eat nothing but eight bananas coupled with three glasses of milk. It is not mandatory to eat 8 bananas; you can have less as well. In fact, you might feel satisfied within 4-5 bananas within the whole day. This is the day when you can clearly feel your food-craving diminishing significantly. It feels divine, to get over your ‘desires’. Do not forget to drink at least 10 glasses of water, as always.

Bananas will act as a provider of carbohydrates that is easy to digest, coupled with sodium and potassium reserve.

Day 5:

This is considered as a ‘Feast day’, where you should eat up to two portions of lean beef (10 oz.) combined with six whole tomatoes – as a source of fiber. On this day, you should increase your daily water intake to at least 14 glasses. This is to cleanse your system of the uric acid getting produced. You will experience colorless urine on this day.

Beef is a source of proteins & iron, and thus an alternative can be paneer (tofu – soya paneer for better results) coupled with mushrooms for the vegetarians. Many people have recommended rice as a replacement to beef, but if one considers the nutritive contents, rice can not be the right surrogate.

Day 6:

Another day with beef and vegetables. Today you can eat any amount of beef combined with cooked or raw vegetables. Keep your daily water intake to 14 glasses. You can add the Soup to add some spice to your day.

Iron and proteins from the beef or paneer-mushroom combination, while fiber and nutrients from the vegetables. Till this time, you must have experienced an energetic feeling and an awareness of the power of natural food items.

Day 7:

The food intake on this day should consist of a bowl of brown rice with fruit juices and any vegetables you want to eat. Drink 14 glasses of water.

The juices will break the fast (?) providing the essential nutrients along with the vegetable stuffing. The brown rice provides the carbohydrates.

Now you must be at least 4 kgs lighter than day one, yet more energetic and free from the cravings for high-calorie stuff.

The Soup:

The following soup is a modified version of the GM Wonder Soup since it is not possible to get the Lipton Onion soup mix everywhere, as suggested in GM Soup. The modified soup goes parallel to the ‘rassam’ or ‘saaram’, served in south India. This soup is allowed to be consumed in large quantities throughout the program. It is intended as a supplement to your diet.

Boil few large-cut onions, tomatoes, cabbage, and celery in water. Add the sambhar masala for the taste. You may also add tomato-puree (but with the skin) instead of tomatoes to make it thicker. One can season it with herbs and flavorings. You may also add: asparagus, peas, corn, cauliflower, green beans or finely chopped mushroom.

General instructions for all days:

• You may squeeze a lemon to flavor the water that you drink every day.
• No alcohol of any kind since it adds empty calories.
• Salt should be used as less as possible.
• Use artificial sweetener, in case you can’t stay away from the sweet taste.
• No fruit juices till day seven.
• Black coffee or tea is allowed.

You may repeat the schedule, if you want further weight loss, but it is suggested that you should take a gap of at least two weeks in between two schedules.

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Now the most important part: the doubts, accusations and myths.

“It works just by losing the water content of the body and not actually a fat loss.”

• Firstly, there is no mention of restricting the water intake on any day. How can one lose only water if we are consuming at least 10-14 glasses of water every day, added with the unlimited quantity of soup and the water contained in the melons, fruits and vegetables?
• It basically acts on the principle of ‘negative calorie foods’ where you are consuming certain foods that demand more calories to burn themselves than what they provide themselves. High-fiber food stuffs you but doesn’t provide the required calories, instead demands more calories to burn themselves, which is derived from the stored energy-deposits.

“Skin gets dry and you may lose your hair during and after the GM diet

• At least I have not met anyone in my acquaintance complaining of this, but found this on few blog-posts. The reason can be insufficient amount of water intake and not supplying enough protein sources on specific days.

“It is a temporary loss and you regain all lost weight in couple of weeks.”

• Obviously, if you resume your high-calorie food once again. It is not difficult to lose weight, but to maintain it. Malvika, my wife who is a dietician, always recommends a maintenance diet program after the GM diet schedule as follows:
  • Only liquids in the form of soups, buttermilk or fruit juices for dinner on three consecutive days in a week. This should be followed endlessly, until you want your weight to bounce back.
  • Drink plenty of water as if you are on GM diet.
  • Exercise regularly.

“It’s just a Crash-diet and a Fad, nothing else!!”

• First of all, it is not promoted as a weight-loss diet, but a Detox diet that cleanses your system from within. Weight loss is just a by-product of it.
• Even if one looks at it as a ‘crash-diet’, it surely will not harm you, but will ‘move’ your weight in the least period, thus motivating many who tend to leave their regular diet and exercise regimens within first month, for not getting desired results. Once you can ‘see’ your weight dropping, it boosts your will to try further.
• As said above, it is futile unless you back it up with a maintenance program. You can not be on GM diet for lifetime, nor you can or should do it every month. Instead use is as an initial-motivator and switch to a liquid-dinner course later.

MY OWN EXPERIENCE:

I myself have done GM diet twice. The first time I was very sincere in following it. Thanks to my wife and my mother, who made all arrangements for the foods on each day. I lost 4 kgs towards the fifth day. I could not lose any further on the last two days and I presume that to the rice I ate, as a substitute to the beef. The lost weight remained there for a month, in spite of not maintaining it actively. I could have lost at least half a kilo more, if I would have stayed away from the rice, which in any case I do not like to eat.

The next time I started it, but had to leave it in between due to some unavoidable circumstances. But had seen significant change in my weight and the energy level for the four days that I followed it.

The most significant gain has been with my lipids coming down to normal. I have had really bad lipid levels for two years and after following GM diet twice, being on statins and taking self-prescribed homeopathic medicines for the same, the latest levels of lipids were perfectly within normal limits. The credit goes to the high-fiber rich GM diet as well.

THE CONCLUSION:

If followed sincerely, GM diet has a definite positive effect of its own on our metabolism. I agree that it is not an end in itself, and one needs to maintain the metabolism by appropriate food habits and exercise regimen. GM diet can not be a ‘quick & easy’ substitute to ‘efforts’, but surely can be a booster for those who have never seen their weight going downhill, providing a ‘kick-start’.

As Malvika says, ‘one should take a diet that s/he can follow for the lifetime…’ and that’s true! You can never have GM diet for everyday, since there are so many delicacies around to enjoy, but for that we need to have a balanced metabolism, so that we can give them their due justice.

For the Legs That Do Not Sleep Well at Night

Shobha came to visit my clinic with a complaint that for her was quite funny to narrate. She felt that though she gets good sleep at night, the legs do not. She had an unpleasant tingling sensation in the legs, especially in the calf muscles, which made her to move around or apply bandage tightly. She felt better by stretching the leg out, but still the uncomfortable pain did persist for some time. The intensity of the pain also prevented her to fall asleep or getting continuous refreshing sleep.

Shobha was suffering with nothing but 'restless legs syndrome (RLS)'. In this condition, one or both legs can get affected. Though the name suggests it being a disease of the lower limbs, some patients also complain of similar symptoms in the arms as well. Apart from the sleep, the symptoms can get precipitated while being in a prolonged position like sitting at a desk, driving a car, watching a movie. The symptoms appear abruptly and can have a pulse-wave pattern of recurrence, making it more troublesome.

The prevalence of this disease increases with the age and it is believed that almost 10-15 per cent of the population is affected by RLS. It has been reported to be one of the leading causes of sleep-loss or insomnia in elderly population. It is seen more often in women than men. Though rare, children too can get affected with it, but the diagnosis is made difficult and can lead to various hyperactivity disorders or growing pains.

It is believed that RLS runs in the family; and is triggered or aggravated by epochs like Pregnancy, or systemic illnesses like kidney failure, and anemia related to iron or vitamin deficiency. The insufficient iron, which is a common manifestation of the above conditions, can be the reason to have the basic lack of dopamine. The brain uses dopamine to control limb movements. The diagnosis is usually made according to the symptomatology and clinical presentation. There is an opinion to check the levels of iron in the blood, although many people who have RLS can have perfectly normal levels of iron but abnormal levels of iron in the cerebro-spinal fluid that bathes their brain.

The treatment primarily includes dopamine-like drugs, sedatives along with behavioral strategies that include stretching, taking a hot bath, or massaging the legs before bedtime. The patients of RLS are often asked to avoid caffeinated beverages to reduce symptoms. If required and documented by the blood level tests, one can be given iron, vitamin B12, or folate supplements. Some patients may even require mild doses of anti-convulsive therapy, while some do feel relieved with analgesics.

Homeopathic medications have found more effective in relieving the symptoms of RLS without causing any unwanted side effects that are seen with any of the above treatments. A constitutional medicine approach along with the acute remedial prescription based on the symptom-similarity is the best approach to deal with this ailment.