Case study; Mrs van der P. (Angustura vera)
Alex Leupen
A woman of 67 years of age comes because of rheumatic complaints.
Since 10 months she has had increasing joint complaints. Blood test positive for rheumatic factors. It started with pain in the right shoulder, later on the left shoulder was also involved. The shoulder pain is worse with lifting (grandchildren), raising the arms (taking off the dress over the head) and in the beginning worse at night. Shoulder pain worsened by lying on the affected side. She was able to fall asleep, but woke up around midnight because of the pain. Sleep was restless, always turning in bed in order to find a more comfortable position. An electric blanket in bed reduced the symptoms. Later other joints joined in: left wrist, right thumb, hips, knees, toes. Stiff and stiff when standing up from a (low) chair, especially stiff feeling in buttocks and knees. As a result, the bus is afraid of not being able to reach the exit in time. The stiffness and stiffness is worse in the morning. Right knee painful when climbing stairs. Knee pain when kneeling on the ground (gardening), puts a cushion underneath. Tight and painful feeling in the (right) hollow of the knee, feeling "as if the muscles are pulled together".
Sitting on the gluteal muscles is painful.
The joint complaints are not dependent on weather or season. She has had 60 physiotherapy treatments without any significant improvement. She is currently using Diclofenac.
Previous history: Throat problems at the age of 16. She experienced a hunger winter in Amsterdam, very emaciated. On
..was jaundiced at the age of eighteen. A few years ago two times bladder infection with sharp cramping pain after urination. I have always been in good health.
Temperature: more chilly in recent years. Especially cold legs and feet. Gets headache from the sun. Does not inspire.
Preferences: striking was the strong need for coffee. The first thing she did after getting up was drink a cup of strong coffee, she drank 6 cups a day. Other desires: chocolate (3), whipped cream (3), mocha (3), buttermilk (3), vegetables (2), yoghurt (2), cheese (2), meat (2), fat (2), eggs (2), oranges (sweet) (2), milk (1). During her pregnancies, she had a strong need for tomato soup and soft boiled eggs. Thirst: on the lower side.
Dislike: savoury (3), fish (3), other fruit (2), (strongly) spiced (2), sour (2), pickles (1). Since Diclofenac stomach complaints of pea soup, sausage and spicy foods. Relief; daily, normal consistency.
Menses: three times pregnant without complications. Childbirth: prosperous. Used to suffer little from menstruation, regular cycle. In the menopause since her 52nd year, hardly had any flushes.
Sleep: can sleep well. Sometimes around midnight awake from shoulder pain. Sleeps on the right side, gets stuffy when she lies on the left side.
Dreams: the night after her father died she dreamt that he was waving on the station, he was completely normal (in reality he died of dementia).
The night after her mother died, she dreamt the following: her mother was walking with a little blond girl in her hand, the girl looked up to her, laughing.
Another dream: she saw her mother. They put their arms around each other, and they felt happy.
Psychologically: she has a helpful character. She has always taken care of her husband's parents, she brought the groceries. She went with me to the hospital for examinations. Strange people pour out their hearts to her. She has three grandchildren, she looks after them regularly. She is active in the Mennonite congregation, she visits the elderly at home. She is a figure in the background; as a child she was more shy, never the cock in front.
After both parents-in-law had passed away, a great deal of pressure fell from her. She had a strong sense of responsibility ("Am I doing it right?"). When the grandchildren are staying with her, she is worried that everything is going well. She also finds it physically difficult: lifting children, changing diapers.
Fears: fear of heights (2) and fear in lifts (2). Has ever
trapped in the elevator.
Choice of medium: The most striking thing about this case is the strong need for coffee. The main complaint is the shoulder pain, worse by lifting and lifting. Angustura has a pronounced desire coffee. Clarke calls it an aggravation by moving or lifting the arms. The prescription was Angustura vera M, a single dose. At the first dose, all symptoms gradually improved over the course of several months. She stopped 2 weeks after the Angustura de Diclofenac, after which she was no longer needed. The stomach problems disappeared after stopping Diclofenac. After a year and a half a second dose needed because of calf cramps and pain in the feet with positive results.