A case of thrombosed hemorrhoids.

Long-Standing History of Severe Hemorrhoids

Susana had been a patient of ours for 21/2 years. Her chief complaints had been anxiety and insomnia, for which Aconitum napellus had helped her the most. She had mentioned her history of hemorrhoids briefly during the initial two-hour intake. At that time, she recounted that she had suffered from thrombotic hemorrhoids with both of her pregnancies. The symptoms were so severe during her first pregnancy, seven years earlier, that at five months she received a spinal block and surgery. The pain was excruciating, and the surgery traumatic. This episode was followed by three recurrences within the first six months of her son's life, each one resulting in outpatient surgery. Susana experienced yet another recurrence a couple of years later during her second pregnancy, resulting in a surgery six weeks prior to delivery. In the follow-up visits over the next two-plus years, the subject of the hemorrhoids never came up again until recently.

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A Very Unwanted Christmas Present

We received a desperate call from Susana in early January. Although she could be anxious when she began homeopathic treatment, during recent months, Susana had been remarkably unflappable, even under circumstances that would have previously caused her to panic. This time, however, the terror in her voice was audible from the beginning of the conversation.

  I am so glad I could talk to you today. I really need your help!
  My thrombosed hemorrhoids are back. They started in my late
  twenties and thirties, but always went away with self-care.
  I had the flare-up during my first pregnancy at 41/21/2 months.
  My doctor sent me directly to a colorectal surgeon, and I had
  surgery a couple of weeks later. I have a high pain threshold,
  but it was unbearable. The surgeon found seven external and
  11 internal hemorrhoids. I had over 100 stitches and never was
  able to recover during the pregnancy.

  I gave birth to a 9-pound baby, and the hemorrhoids recurred.
  Two in-office excisions of two more thrombosed internal
  hemorrhoids followed, most recently in February of 1999.
  I was okay until I became pregnant with my daughter in 2001.
  Sure enough, at night months, just before her birth, I needed another
  excision, and still another following the delivery. They haven't
  given me any problem until now, seven years later.

  On Christmas Day I stood in high heels all day and moved around
  some heavy furniture. I ended up with an external hemorrhoid, just
  like at the beginning of the previous episodes. It's on the left side,
  and feels really tight and tender. The hemorrhoid is about
  one-half inch all the way around. I feel burning when I walk,
  some itching, and lots of tenderness. The burning is worse when
  I pee, and feels raw and tender during a bowel movement. But the
  overriding sensation is a tightness in the skin. Bending over is
  difficult, too. One area looks pink, another purplish.
  I had it examined and the doctor told me it was definitely
  thrombosed. My previous doctor had retired, and this doctor is
  low-intervention. All he told me to do was to soak. Stay in the
  tub all the time.

  What's odd is that I felt a tightness in my left hip before the
  hemorrhoid appeared. I can't seem to find a comfortable position.

A Deep Investigation of the Sensation

Since we use Rajan Sankaran's sensation method of prescribing, we went back to that main feeling of tightness.

  It's like my skin is going to pop. It feels pulled very tight. Like
  when you stretch Saran Wrap very thin. And it looks shiny.
  Squeezed tight. Overly extended. Stretched too thin. Barely
  holding on. It seems angry. Like the skin is on the verge of
  tearing. Really irritated. Kind of fragile. Raw and tender.
  Sitting makes the pain worse.

  The pain makes me cautious about moving. I could tear.
  Explosive. Like if something happened, it would explode.
  Overextended. Pulled too thin. Overextended. Too many people
  pulling from far too many different directions. Trying
  to make something go farther than it actually can. Trying to make
  too much with too little.

We found it fascinating that Susana would describe her hemorrhoids as overextended, explosive, and angry. This was a beautiful description of her general sensation, covering her mind and emotions, as well as the physical body.

To round out the acute case, we inquired about the hemorrhoid symptoms during the past occurrences, just to see if any other sensation(s) emerged, especially since this episode was only beginning and, without treatment, would likely get much more intense.

  Completely raw. Burning. Excruciating. The hemorrhoids made my
  whole body ache. Moving was so difficult. So were standing, sitting,
  walking, and laying down. It was cumbersome to move my body at all.
  I was very frightened. The pain was hot and searing. It was terrible.
  A part of your body that was supposed to be inside was outside.

  I am so scared. I know where this is going and that sitz baths aren't
  going to make a difference. Is there anything you can do to help me
  avoid all the pain and the surgery?

A Fascinating Acute Case

Susana's case is noteworthy for a number of reasons. First, there is a clear, intense sensation. Second, the sensation generalizes to her overall state. Third, the response was rapid and dramatic, just what we like to see, and do see so often in `, in acute cases. As in constitutional care, as we emphasize over and over in our book, Homeopathic Self Care: The Quick and Easy Guide for the Whole Family, the one most important task in acute homeopathic prescribing is to discover the most unique feature(s) of the case.

In Susana's case, the hemorrhoids were left-sided, they had worsened significantly in the past during pregnancy, and the area was very sensitive. Rawness, burning, and heat are not so unusual for hemorrhoids. But the words "explosive," "overextended," "too many people pulling from far too many different directions," and "a part of your body that was supposed to be inside was outside" were something we had never before heard in reference to hemorrhoids. The left-sidedness, explosiveness, and anger led us to prescribe Lachesis (bushmaster snake). Lachesis is a prominent hormonal and vascular medicine; and we had prescribed it years ago, with immediate improvement, for a pregnant woman near delivery with extremely painful, left-sided varicose veins. Anecdotally, Susana's reference to a part of the body being outside that should be inside made us think of how a snake periodically shed its skin. In addition to the homeopathic medicine, we recommended that she purchase locally and immediately hemorrhoidal suppositories containing Hamamelis (witch hazel), and a bioflavonoid supplement, as well as continuing the baths.

A Rapid, Dramatic Response

We instructed Susana to take Lachesis 30C from our home medicine kit, which she had on hand, up to every three hours; and we overnight-mailed her a dose of Lachesis 1M. We prefer to use high-potency, single-dose medicines in clear, acute cases.

  We spoke by phone with Susana eight days later.

  I am so much better. I think the Lachesis was exactly right.
  The 30C dose started to help very quickly. There was great
  improvement within 48 hours. I feel almost normal now.
  I was so scared. The improvement was 100%. I only had to
  do the suppositories twice. I stopped the sitz baths because they
  were wiping me out, making me feel like a limp dishrag. Before,
  I couldn't move without pain. Now my pain is zero. It was just
  amazing. That feeling that the skin would pop is gone. If I had
  found a doctor who would do an office excision, I would have just
  done it. This way I didn't even need surgery!

by Judyth Reichenberg-Ullman, ND, DHANP, LCSW, and Robert Ullman, ND, DHANP

www.healthyhomeopathy.com

Judyth Reichenberg-Ullman and Robert Ullman are licensed naturopathic physicians board certified in homeopathy. Their books include: A Drug-Free Approach to Asperger Syndrome and Autism; Ritalin-Free Kids, Rage-Free Kids; Prozac Free; Homeopathic Self-Care: The Quick and Easy Guide for the Whole Family; Whole Woman Homeopathy; The Patient's Guide to Homeopathic Medicine; and Mystics, Masters, Saints and Sages: Stories of Enlightenment. They have taught and lectured internationally, practice at the Northwest Center for Homeopathic Medicine in Edmonds, Washington, and live part time in Pucon, Chile. They treat patients by telephone, as well as in person. They can be reached at 425-774-5599 or online at www.healthyhomeopathy.com.