A Case of Chronic Headaches and Nasal Obstruction

headacheDavid Nortman, N.D.

Intake October 2003. 12-year-old girl. Born in South Africa, moved countries twice (to Israel at age 3 and to Canada at age 8). After first move used to bite mother very hard, a behaviour which lasted several months.

Chief complaint:
Headaches beginning around age 6, became worse after second move. Was miserable because had no friends. Parents divorced shortly afterward. According to her mother, she was more bothered by the new social situation of being a child of divorced parents than by the divorce itself. She lives with her mother and her second husband whom she disliked initially but came to like over time.

Secondary complaint:
Chronic obstruction of nasal passages, since age 3-4 following multiple upper-respiratory infections treated with antibiotics. Affects speech and breathing.

Objective findings:
Pain below bridge of nose on palpation. Bilaterally inflamed/enlarged turbinates/septum (reddish, non-exudative). Reduced patency bilaterally. Sense of smell intact.

Investigating the key sensation of the chief complaint (headaches):
Hammering pain. Drowsiness, no energy. Cannot focus on fun activity. Drowsy feeling is heavy, not focussed on putting best effort into things. If focussed then can get things done better and faster. Opposite of drowsy is excited, energetic, focussed, wanting to do things. Doing things because I want to. Pain quality is sharp but not as a needle: like a blunt object hitting you. If I focus on it then there is additional pain at bridge of nose “like someone stepping on it and squishing it.” Hammering is as if “someone beating me up, flattening me.” When it fades the pain is “blown away by the wind.”

Investigating the feeling of being squished, beaten up, etc.

Used to get bullied a lot. People gossiping about me, also because of the way I speak [due to the nasal obstruction], saying bad things about me. Untrue rumours that I talk about people behind their backs. Some people are foolish and believe it; it takes days to convince them it’s not true.

In grade 3 was once hit by a girl. Pushed to the ground. Embarrassed: everyone surrounded us. Had to walk around school dirty after falling in mud. Everyone would laugh at me. Girl was biggest bully in the class. Made fun of me, gossiped about me, told me lies, played practical jokes on me. She betrayed me and used me. You are dependent on someone who breaks a promise. You cannot trust them, they make fun of people for their own entertainment. Embarrassing.

Embarrassment: Feel slouchy and shy. Afraid to do stuff. Avoid doing/saying things because scared of being made fun of. Try to keep quiet. Worst things it people laughing at you: sad, disappointed at them. Want to walk away from them. Sad because they are not true friends, not truly devoted. A good and true friend accepts you for who you are, is trusty, trusting and honest.

Slouchy: Crunched up, shy. Want to cry and get away from people, to be left alone. When you’re happy you’re straight and cheerful. When you get crunched up you feel safe, you have a shell on top of you. But when you’re happy you don’t need a shell. A shell gives you an unwanted feeling, that nobody wants you around except to make fun of you. They take you as a clown, as someone to entertain them, and not as a person. As a clown you’re there only for one reason: to do one specific thing, like a job. You entertain and then you leave. In return you get embarrassment and pain.

Investigating a recurring dream:
Dream of a big, green field. Small chair in middle with stairs leading up to it. I climb on the chair, then spin on it and fly around the say, seeing people going about their business underneath. Then crash in a window.

Feeling once spinning: Look up to the sky. Excited, happy. At first shocked when taking of. I can fly and nobody else can. Snobbish: I feel special. Have special abilities. Wave to friends. Mom screams at me from below; I pretend to listen but actually do not. I laugh at my enemies and drop things from the trees at them. Crash deliberately into window, slide on floor of someone’s house. I get to break something, tell friends that I broke through glass and didn’t get hurt. Fun to crash because you get filthy and are not perfect all the time. Glass pieces shatter away.

Excitement: new house, adventure, suspense. Cannot get caught: they can get mad at me and call the cops on me. I’ve gotten caught many times; lectures from my mom, irritating: “Don’t do this, don’t do that…” I would like to scream at her to leave me alone, to stomp on the stairs, slam my door – to get my anger out. I have anger inside. I want to scream at her that I can win the fight. Feel more proud. Feel important and special: win an argument with an adult, so that they think highly of you and not have a comeback. You feel special that you’re right. Adults have logical comebacks. A grownup feels special, has more respect, feels smart and logical: street-smart, not a loser, not pressured. When you’ve won you feel alone, not bothered.

Feeling snobbish: Feeling better about yourself. Opposite is putting yourself down, not having any self-respect: “Yeah, s/he’s better than me”. End up giving up lots of things. Having too much self-respect, though, gets annoying to people, in which case I take care [not to put people down]. Respect is thinking fully of yourself. Other people are annoying when they brag.

Case analysis:

The pressing-down headache (chief complaint) reflects an underlying sensation of being pressed down to the ground, abused, held down. The abuse consists not of the physical act as such but of the embarrassment that it causes, as the abuse typically takes place in public, prompting a need to defend one’s good name.

Embarrassment in public is also the theme of the secondary complaint of chronic nasal obstruction. This leads to a feeling of being used as a means for entertaining others or, more broadly, fulfilling others’ needs. This held-down state evokes a feeling of being crouched up in a protective shell that has long ago needed to be shed off.

The successful state of this pattern is apparent in the dream world: There is a need to break free and fly up high to escape the abuse and embarrassment down below. Moreover, there is a degree of vengefulness and desire to boast at one’s true nature which is noble, radically free, and powerful – a state arousing respect rather than laughter and mockery.

Rx: The case repertorizes to Falco peregrinus, a prescription supported, but not solely determined, by the clear animal theme running through the case, following the recent extensive proving by Misha Norland from which the rubrics were drawn in the repertorisation above.

Falco-p 200c was given in October 2003 (one series of three consecutive daily doses). Over the next few months 200c was repeated once every 1-2 months, and later 1M was given once every few months. The last dose was given in mid-2005. Overall followup period was two-and-a-half years (to early 2006).

Starting several weeks after the first dose, the frequency of headaches diminished significantly. In the months following the intensity of attacks diminished as well. One year later the patient was experiencing at most a mild headache once a month during periods of school-related stress, and become essentially headache-free since early 2005.

The nasal obstruction began to improve around the eighth month of treatment, and gradually cleared through the second year of treatment. The obstruction has cleared, while the voice improved significantly but retains a slight nasal tone, possibly as a feature of the normal speaking voice rather than remaining pathology. No follow-up physical examination was performed to determine whether any remaining abnormality was present, and whether it was due to inflammation or some scarring or deformation. Further improvement might have been obtained had active treatment been continued longer and higher potencies given.

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