A Day in a Homeopath’s Clinic
We’re going to take a look at a typical clinic day for one of our homeopaths (Fran Sheffield). Before we do, there are a couple of things of which to be aware:
- The cases presented from this clinic day are ‘snap-shots’ rather than full cases. Anything that could identify the patients has been removed but the symptoms and complaints remain unchanged.
- Chronic conditions form the bulk of homeopathic practice. Most of these cases are repeat (follow-up) appointments for a chronic problem. The homeopathic treatment of chronic conditions takes time but with the correct prescription, patients can expect to see improvement with each appointment.
- Homeopathic remedies don’t control or medicate the body as do conventional medicines. Instead, they stimulate and strengthen the body’s innate ability to heal – the body decides in which order to deal with things but the most serious problem is always addressed first.
- All of the patients we’ll meet today have already seen a conventional doctor for their condition. Conventional drugs are either being used in conjunction with homeopathic treatment or, in discussion with the prescribing doctor, have been replaced by homeopathy as improvements have taken place during treatment.
- Remedies are chosen for the specific symptoms the person experiences rather than the name of the condition from which they suffer. For this reason it is possible for ten people with the same disease to each be prescribed a different remedy because of the differing symptoms they experience.
- Remedies are matched to the person’s symptoms while the strength and frequency of dose is matched to their sensitivity. This is the reason for a test dose being prescribed at the beginning of treatment for some of these patients.
- The names of the remedies prescribed have been omitted to avoid confusion as more was involved with their selection than information contained in the case synopses.
7.45am: Arrival at Clinic.
This is the time for a cuppa before opening – we settle in and plan for the day ahead.
8.00am: Phone-in Time.
Clinic opens! Between 8 and 9am patients know they can call for brief updates or guidance concerning their treatment.
8:02am the first phone call comes in. We receive eight calls this morning – a busy morning.
9.00 am: First Appointment. Depression, Lack of Energy, Eczema.
This is the fourth follow-up appointment for Mina, a 41-year-old woman. Mina moved interstate last year – this appointment is by Skype. She has a history of repeated episodes of depression, but doesn’t tolerate antidepressants. She lacked energy and motivation, had feelings of suffocation and suffered from eczema on her hands that cracked and oozed sticky fluid. Cracks and other injuries were slow to heal and were easily infected. Frequent belching. Craved chocolate and sweets, and experienced indigestion from fatty foods. Difficulty sleeping at night.
Impression and Treatment: Mina has progressed well. Many symptoms are now either improved or non-existent. The eczema on her hands is still a problem. Her remedy was changed at the last appointment to match changing symptoms with this eczema. Mina reports the eczema is better with the new remedy but flares for a day after each dose – a sign the dose is too strong for Mina’s sensitivity (see Tutorial 15: What to Expect for more information about this). Instructions are given on how to dilute the dose so improvement continues without aggravation. Follow-up appointment made.
9.30 am: Asperger’s Syndrome, Behavioural Problems, Food Avoidance.
Follow-up appointment by Skype for Jack, a 9-year-old boy who lives overseas. This is the third appointment with his mother who initially sought treatment for Jack’s tantrums, rages, and verbal abusiveness. Jack had difficulty with change, felt life was unfair, ate a limited range of food and had poor eye contact. His behaviour was affecting friendships and performance at school.
Since beginning treatment, Jack rarely has outbursts of anger and is much more reasonable. He can now look people in the eye when they speak to him and he eats a wider range of food. New symptoms at this appointment include: craving meat; sweating in sleep; shyness in company; itchy scalp with dandruff.
Impression and Treatment: The current remedy has done all it can do and a new remedy is needed to treat the emerging ‘symptom picture’ if improvement is to continue. A new remedy is prescribed according to his symptoms. I asked Jack’s mother to phone in one week if there is no improvement. Follow-up appointment made.
10.00 am: Unstable Angina, Osteoarthritis, Loose Cough.
Follow-up appointment for Irene, a woman in her 80s. Irene has been a long-term patient who first came 8 years earlier with a complicated medical history of cancer removed by surgery; heartburn, indigestion and nausea; osteoarthritic pain in neck, shoulders and hips; hot flushes; poor sleep; bronchiectasis; unstable angina; and episodes of faecal incontinence. She was also concerned about the number of prescribed medications she was taking.
Over the years, many symptoms have improved. She no longer has hot flushes, poor sleep, heartburn, indigestion, or nausea. With her doctor’s oversight she has now reduced many of the medications. The osteoarthritis is still present but pain has significantly reduced – it no longer disturbs her sleep. She hasn’t had angina for years. Brochiectasis (lung damage from decades of smoking) is still present but the cough is managed (as needed) homeopathically.
Past homeopathic treatment involved several changes of remedies as presenting symptoms changed, plus a specific remedy for the angina. At her last appointment a new remedy was prescribed for deep grief following the death of close friend – Irene said she was coping better within hours of taking a dose. The arthritic pain, faecal incontinence and loose cough are now returning.
Impression and Treatment: I advised Irene to stop the ‘grief’ remedy as it was no longer needed. As the symptoms from her chronic state were returning, we reverted to her chronic remedy. I asked her to phone in 3 days if the symptoms weren’t settling. Follow-up appointment made.
10.30 am: Psoriasis, Enlarged Prostate, Dry, Itching Skin.
Follow-up appointment for Ron, a middle-aged man who sought treatment for dry, itchy skin and psoriasis of feet. Other problems included: prostatic enlargement with frequent urination at night; feeling overly hot with excessive sweating; gastric reflux and heartburn; cramping in the thighs at night; fear of heights.
Now, after 3 appointments, Ron’s complaints are either mild or non-existent. Skin is much less dry. The psoriasis is the best it’s been for years.
Impression and Treatment: Symptoms are progressing well – no need to change anything. I told Ron to continue with the same remedy in the same potency. A new potency is supplied in case symptoms return before the next appointment. Follow-up appointment made.
11.00am: Morning Tea and Whooping Cough.
Kate brings me a cup of tea. I have a break for 30 minutes, but it is often shortened to return phone calls. Short acute appointments are also scheduled at this time – today I have a whooping cough case.
The mother explains that her daughter was swabbed and diagnosed with whooping cough one week ago by a doctor. Antibiotics were commenced but with no improvement. Cough is worse in warm rooms. It’s hard for her to draw breath; she gags, retches, and vomits with the cough. The mucous is thick and stringy.
Impression and Treatment: Coccus cacti – a remedy that suits the symptoms of this type of cough , whooping or otherwise – was prescribed. The mother was advised to give a dose every 4 hours, reducing the frequency of dose with improvement until doses were no longer needed. I also asked Mum to contact me if there was no improvement by 6 doses or if symptoms worsened soon after a dose; the first situation would indicate that the wrong remedy had been chosen while the second would mean that the dose was too frequent or too strong for what was needed and should be adjusted.
11.30 am: Sleepless, Clinging, Cross Baby.
New appointment for Rose, a 14-month-old baby. Rose won’t sleep unless cuddled by her mother; she wakes with angry screaming after one or two hours, wants to stay awake and only eventually goes to sleep if she is in her parent’s bed and cuddled by her mother. No sign of teething; she clings to her mother throughout the day; shrieks, screams and hits her mother if she doesn’t do what she wants; is frightened of men and male voices; has eczema in the creases of her joints. She also suffers from long-term watery, acidic bowel motions. Her mother is exhausted.
Impression and Treatment: Rose was previously checked by a doctor – there was no apparent cause for the wakefulness. My examination also reveals nothing unusual. A remedy is chosen according to her overall symptoms plus Rose’s angry rather than anxious behaviour when not getting her own way. I ask her mother to report by phone in 3 days how Rose has responded to the remedy. Follow-up appointment needed only if sleep, behavioural and bowel problems don’t settle.
12.30pm: Asthma, Heartburn.
Overseas follow-up appointment by Skype for Helen, a 48-year-old woman. Helen had a history of asthma and heartburn; waking at night; had to sit up in bed and use an inhaler to breath. Stressed by work colleagues who were too lax with responsibilities. She liked routine, structure and following the rules but had low energy.
Now, four weeks after starting homeopathic treatment, her asthma and heartburn symptoms are almost non-existent. She also reports that her energy is better and she is feeling happier at work.
But symptoms from years ago are reappearing – blisters on her finger-tips and cramping of her calves during sleep.
Impression and Treatment: Helen is progressing well – her symptoms are improving and energy is good. The reappearance of old symptoms is a good sign and should be short-lived. We’re continuing treatment with the existing remedy and potency. A new potency is supplied in case symptoms worsen before her next appointment. Follow-up appointment made.
1.00pm: Lunch Break and Middle Ear Infection.
Kate brings food and drink (thank you!). A homeopathic student, close to graduation, arrives to ‘sit in’ and gain clinic experience through this afternoon’s appointments.
I take a phone call from the mother of a child with otitis media (middle ear infection) who was seen yesterday for an acute appointment. Mother reports the prescribed remedy did not help. Symptoms reassessed – new ones have emerged indicating a different remedy. Mother is advised to use this remedy from her home-use kit and to phone tomorrow if there is no improvement.
1.30pm: Anxiety. Nausea. Hearburn. Insomnia. Dry Skin.
New appointment for Maria, a 32-year-old mother. Maria wakes frequently at night and has many anxieties about her children’s health, someone breaking in, developing cancer and catching AIDS. Poor appetite – very thin. Dislikes meat. Has regular migraines. Black spot in center of vision (scotoma). Frequent heartburn and afternoon nausea. Relatives say she is tense, driven and irritable.
Impression and Treatment: New appointments are longer than follow-ups (1 ½ hours compared to 30 minutes) so that a full record of medical history and symptoms can be collected. The success of future treatment is measured against this baseline. Many things should improve with a good prescription – not just the initial concern.
Maria was worried about her insomnia but her prescription was based on other symptoms as well. To assess how sensitive she was to homeopathy, Maria was asked to take a test dose of the remedy and phone in 3 days – the strength of her response would determine the frequency of dose (see Tutorial 15: What to Expect for more information). She was also asked to request further investigation of her scotoma from her doctor. While it is probably related to her migraines it may also be a symptom of something more serious. Follow-up appointment made.
3.00pm: Afternoon Break.
Right on time, Kate brings another cup of tea. Time to chat with the student about significant aspects of Maria’s case. Clinical experience for students could not happen without the generosity of willing patients. Confidentiality and patient permission is vital.
3.30pm: Frequent Colds. Enlarged tonsils. Poor Energy.
First follow-up appointment for Rachel, a 13-year-old girl. Rachel has a history of enlarged tonsils (since infancy), frequent colds with profuse yellow-green mucous, tiredness and forgetfulness. Very shy and emotional – dislikes being separated from her family; will not undertake activities if alone.
At this appointment her mother reports some progress – she is interested in friendships, managed a ‘sleep-over’ and has more energy. So far, no colds. She says her energy slumps two days before each dose is due. On examination, her tonsils are slightly smaller but still enlarged.
Impression and Treatment: Doing well with the remedy – no need to change prescription – but as her symptoms are returning before each dose, I advised her mother to give the remedy more frequently, two times a week rather than weekly. Follow-up appointment made.
4.00pm: Milk and Wheat Intolerance. Behavioural Problems. Hyperactivity.
A follow-up appointment for Anthony, an 11 year-old boy. Anthony used to fly into rages with his brother – he would insult, kick, punch, bite and swear but would also become distressed when reprimanded – he felt he was the victim. He would then storm off to his bedroom and refuse to talk. He was shy and quiet at school – few friends. Other problems included: gluten and casein sensitivity (behaviour would worsen); sour, acidic breath; ‘rotting’ flatulence and extreme restlessness.
One remedy in a range of potencies had been used over the course of Anthony’s treatment and now, 1 year later, Anthony has no sign of his previous symptoms. The remedy hasn’t been needed for over a month.
Impression and Treatment: Anthony’s symptoms were probably the result of food intolerances, gut dysbiosis (overgrowth of the wrong organisms) and ‘leaky gut’ effects, but treating these problems separately never gets deep enough to prevent their return once treatment stops. Once a remedy is prescribed according to its totality of symptoms, the body is stimulated to heal deeply so that the cause of these different symptoms is removed.
Initial improvements for Anthony were rapid, tapering off toward the end of treatment. His problems now seem resolved. No follow-up appointment needed. Mother was advised to rebook if new or past symptoms return.
4.30pm: Frequent infections. Tires easily. Profuse Perspiration.
Jason, a 32-year-old man. This is his first follow-up (prior appointment cancelled). He had a history of repeated infections since childhood – always catching colds, frequent gastric upsets and diarrhoea, and low stamina. He overheated easily – heavy sweating on minor exertion. He would snore loudly and wake gasping for air. He felt tired and often fell asleep during the day (possibly sleep apnoea?).
Jason reports that while he had been doing well at beginning of treatment (increased energy, less sweating, sleeping better, less tired) all symptoms had now returned in spite of taking the remedy.
Impression and Treatment: Jason cancelled his first follow-up appointment because of work commitments. Now, more than two months later, all symptoms had returned even though initial improvement had been good. I discussed with Jason that the body can build up a tolerance to a potency over time so that it is no longer effective and that chronic problems frequently need a series of different potencies of the same remedy if symptoms are to be permanently cleared. A new potency of the remedy should continue the initial improvement.
The same remedy in new potency was prescribed. His symptoms should be reducing by the end of the week. I asked him to phone if this was not happening. New follow-up appointment made.
5.00pm: Clinic Draws to a Close.
Time to discuss final cases with visiting student. Darcy brings the list of phone calls that still need a response. Folders are sorted, tables are cleared. Hopefully someone else at home is preparing the evening meal.
