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JAHC 2013:
Meeting The Challenge
Weak Kidneys
and
Frequent Urination:
Three Simple
Remedies
by Karen Allen CCH
Roadmap for Our
Training Session
• Urinary urgency – facts and figures
• Seeing the forest and the trees
• Thought constructs to evaluate symptoms
• Finding the pattern in each case
• Therapeutics... and adjuncts for clients!
• Let's Meet Our Clients for Today
Case Example 1
57 yo female: Urinary Incontinence
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I have a history of kidney stones, and my biggest problem now
is that I have to pee all the time. Even if I just went to the bathroom 15 minutes ago, I will feel urgent need to urinate again.
This has been getting worse over the past 5 years since I hit
menopause.
I also have had bone spurs on my ankle and shoulder – they
were surgically removed twice
I don't sleep well because I have to get up several times every
night to urinate – at least hourly. So I am always tired.
I have been on several different medications for this – they
cause side effects I can't live with, so I want to try homeopathy.
Case Example 2
19 yo female: Urinary Tract Infection
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I have had terrible urinary tract infections for the past 3 years.
Each time I get an infection, I have the feeling like I need to pee
all the time. And I get a terrible cramping pain at the end of urination.
I usually am given antibiotics by my doctor. And then the infection goes away. But for weeks afterward, when I sit down, I will
often leak a little bit of urine – just enough that I always have to
wear a panty liner in my underwear.
I have had at least one UTI each month for the last 2 years
Case Example 3
38 yo male: Kidney Weakness
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I had a bad kidney infection 6 years ago. I was a thri-athlete,
competing, and I got badly dehydrated. We were competing in
extreme heat at high altitude, and I just could not drink enough
water to stay hydrated. I passed out after I finished the last leg
of the competition, and woke up in the hospital on IV fluids.
Ever since then, I have had a problem with urinary incontinence.
With any physical stress, like when I cough or sneeze or jump, I
lose a little bit of urine. I always feel the need to urinate.
There have also been a few times when I have woken in the
morning and found that I have wet the bed a little.
This is really embarrassing to me – I have tried medications,
acupuncture, yoga, biofeedback without relief.
Dx: Overactive Bladder Syndrome
• Bladder can normally hold up to
2 cups of urine, and empty
every 3-4 hours/day
• Clients with OAB experience
– Frequent need to urinate
– Strong sudden urging
– Leaking (eeeeek!)
• 33 million, mostly women, (4044yo – 8%, 75+ - 31%)
OAB: Likely Causes and
Contributing Factors
• Psychosocial factors: Excessive drinking,
anxiety, habitual patterns
• Urological: UTI, overactive muscle, stones in
the bladder, Prostate issues,
• Gynecological: Pregnancy, bladder prolapse,
fibroids in the uterus, pelvic surgery
• Medical: Diabetes, stroke, CNS/Spinal
disease or trauma, Medications / Diuretic
therapy – be sure to ask!
OAB:
How Do We Get To This?
• Excessive production of urine causes
frequent urging and urination. Diabetes, high
blood glucose, hypercalcaemia, psychogenic
polydipsia, use of diuretics
• Reduced ability to hold urine prompts
frequent urging. Infection, musculature, reduced
space due to mechanical cause ( e.g. fibroid,
enlarged prostate, adhesions, prolapse, etc)
Hmmmmmmm....
With any pattern of symptoms reported by the
client, we must ask ourselves (BEFORE we
select a homeopathic remedy):
Is this symptom an expression of the Vital Force?
Or is this symptom arising from some other
exciting cause?
Why do we care about this? Why is it important?
Sam Says:
Maintaining Causes and
Obstacles to Cure
§ 208
The age of the patient, his mode of living and diet...
must next be taken into consideration, in order to
ascertain whether these things have tended to
increase his malady, or in how far they may favor or
hinder the treatment....
Sam Says:
Maintaining Causes and
Obstacles to Cure
§ 260
Hence the careful investigation into such obstacles to
cure is so much the more necessary in the case of
patients affected by chronic diseases, as their
diseases are usually aggravated by such noxious
influences and other disease-causing errors in the diet
and regimen, which often pass unnoticed.
Sam Says:
Maintaining Causes and
Obstacles to Cure
§ 261
The most appropriate regimen during the employment
of medicine in chronic diseases consists in the
removal of such obstacles to recovery...
SO.... talk with your clients about medications,
supplements, alcohol consumption! Identify the
maintaining causes. Encourage them to speak with
the prescribing physician for medications.
Who is most likely to
present with urinary
issues?
Urinary disorders involve the kidneys, ureters,
bladder and urethra
–
Both genders, all ages, incidence increases with age
–
Predisposed: Diabetes, hypertension
–
Race is a predisposition for : Black / Indian / Asian
–
Sycotic miasm
–
Post-partum women, women with (recent) new sex
partner
–
Let's look at some statistics from NIH / CDC
Who is leaking (eeek)?
In 2002, a study reported:
32% of UK women
34% of German women
32% of French women
15% of Spanish women had
symptoms of urinary incontinence in the prior 30 days.
http://www.urosource.com/fileadmin/user_upload/european_urology/PIIS03022838060111
6X.pdf
Urinary Incontinence Prevalence
Overactive Bladder Prevalence
http://onlinelibrary.wiley.com/doi/10.1002/bjs.4796/abstract
UTI incidence per 1000
OAB: Conventional Therapeutics
• Medications such as Toviaz, Enablex,
Vesicare, Sanctura; main side effects are dry
mouth, constipation, allergic reactions
• Surgery: bladder augmentation
• Progressive/Integrative approaches: physical
therapy; pelvic floor physical therapy
What can we offer clients
who have OAB?
Remember that disruption of the vital force involves BOTH sensation/function AND physical
tissue change
– Homeopathy can improve sensation/function
– In cases with tissue change (eg scar tissue from a
surgery) homeopathy can help to break down adhesions tissue
– Homeopathy can relieve predisposing and etiological
factors (subacute infection, prostate enlargement,
bloodsugar dysregulation, hypercalcaemia, fibroids,
etc)
Sphere of Disturbance
Sensation
And
Function
Organic
Tissue
Change
Oh, Yeah....
please remember...
For our clients, we represent a source of encouragement and support – you are SO MUCH
MORE THAN A REMEDY FINDER
– Clients may feel shame or despair, need to talk.
– Connect clients with resources like www.nafc.org
and www.continence-foundation.org.uk
– Identify and counsel about maintaining causes and
obstacles to cure
WHO Says:
Incontinence is largely preventable and
treatable condition.
“CERTAINLY NOT AN
INEVITABLE CONSEQUENCE OF AGING”
Encourage your clients to seek solutions
that are robust and address all of the
options available.
So... The client comes in...
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We trained for just this moment!!!
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We take the case carefully and fully...
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We choose a remedy...
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The client takes it...
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And comes back or calls in...
(drum roll please.......)
What if it doesn't
work????
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Client improves generally, but urinary symptoms do not change
Urinary symptoms change, but remedy does not touch other
aspects of the case the client wanted to address
Remedy acts but does not hold, frequent repetitions bring lawof-diminishing-returns response
Remedy does not act... nor does the next choice... nor does the
next choice... nor does an intercurrent nosode... nor does another
remedy after that... reasonable remedies!!! Not even partial
credit!!!
Oops. #%#$&.
The Quintessential Question:
Why didn't it work?
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Mystery when well indicated remedies fail to
act or do not hold
Our assumption is that we were mistaken...
Constitutional remedy concept is the moral
high ground, expected to solve everything
This is a more recent point of view; there are
homeopaths from the past who provided
other options of assessment for this
Maybe a New (Actually Old)
Idea to work with?
"Homeopathy may be said to be based upon organopathy,
for a drug to cure the heart of its disease specifically must
necessarily affect the heart in some manner.
But the homeopath specializes, and says further: The drug
that is to cure the heart must affect the heart... but that is
not enough;
to be curative the natural disease of the organ (nosological organopathy) must be like in expression to the
therapeutic organopathy or drug-action."
(James Compton-Burnett, Diseases of the Spleen)
Is It Possible to Predict When a
Constitutional Remedy is Unlikely to Act
in a Specific Sphere?
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Burnett: British homeopath who practiced
1860s – 1900, “Cooper Club”
Remedies with affinity for specific organ or
organ system
Health and action of the vital force exists
at the level of cell, tissue, organ, body
system, person, family, genus epidemicus
Some remedies have shown remarkable
affinity to specific organs – use this to our
advantage
Cure occurs only when the remedy has an
affinity for the locus of the disease
“Specificity of Seat”
All disease begins on the level of the vital force. But it
does not stay there!
Disease progresses from sensation and function into
tissue manifestation.
The vital force is NOT RANDOM IN ITS CHOICES about
where pathology arises!
Specific tissues or organs or body systems are targeted
and disrupted in a way that is consistent with the state
of the organism.
IF so...
then we can conclude...
If the reasonable remedy we chose does not act.... then before we
decide we were mistaken.... we should...
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Look at SEAT OF DISTURBANCE... and AFFINITY of remedy
If the remedy we select has no/small demonstrable affinity for the
seat of the disturbance (urinary tract in this context) in the case, then
we may see no response or partial response
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This should not surprise us – we are wiser when we can understand and predict which remedies are / are not likely to act – even
when all match the presenting symptomatology
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If we pay attention to this, we will be able to predict what 'should' act
and adjust our remedy choices to ensure success
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“Specificity of Seat”
Let's Review:
Remedy states show specific preference for
particular body parts.
When those particular body parts have organic
tissue pathology, the remedies that act most
strongly are those with an affinity!
The constitutional remedy may not have affinity
for the tissue or organ that is compromised...
Breadth of Locus
PRIMARY ORGAN WEAKNESS: predominant
constraint that is the full case of the client. This
is like the full book, the complete story
SECONDARY ORGAN WEAKNESS: the
symptoms are tangential, an “also” feature,
rather than central to constraint. This is like a
little sub-plot in the client's story.
Finding a Constitutional
Remedy to Repair This
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A good constitutional remedy CAN (MAYBE)
resolve this organic tissue pathology...
Remedy selection is based on the overall
presenting state of the client, together with
personal and family history
The constitutional remedy matches the state
of the client... which may or may not be a
close match to the 'seat of disease'
Complex Case Management
CONCEPTS: Voice of the Client
Points of Entry in the Case
Matrix of Constraint
There are multiple voices for us to hear each time the client comes
into the consulting room. It is as if we are sitting at a dinner party
with the client, their life experiences and adaptation, their miasma
(inherited and acquired), various pathologies, organs and toxic
burdens. Each of these can have a voice in the consultation.
We will get the best results with the client by listening for the voice
of greatest constraint. Let's explore this further...
Dr. Francisco Eizayaga
There are multiple aspects of each case
Not all aspects of a case are equally accessible
to us for therapeutic intervention
The vital force has its own agenda in repair and
we are not able to assign/direct this
The end products of disease respond differently
to the stimulus of a remedy than the initial
disturbance of sensation and function
James Compton-Burnett
on Hydrogenoid Constitution
“ I have held with Eisenmann, Hahnemann, Grauvogl, Wolf,
Goullon, these twenty years, and I will just say here that I
believe the malady in question has a very decided
influence on the organism, being contingently capable of
generating a constitutional state which cannot be
distinguished from the uric acid diathesis. My
conception of the thing is that the gonococcic virus so
poisons the organism that acid dyspepsia is set up, and
then we have what cannot be distinguished from the uric
acid diathesis. So often have I seen this state set up in
the wake of the gonorrheal infection, that I have almost
come to the conclusion that the typical gouty attack is
a child of gonorrhoea.”
What is Uric Acid Diathesis
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Paracelsus: “Each organ has the power to
separate the hurtful from the harmless, and
when in this faculty it goes astry, there we
get tartarus.”
“Tartarus” is that residue which should have
been excreted – acid, stone, gavel
Characterized by pH balance problems,
formation of stones and calculi, water
retention, gout, kidney pain, recurrent
urinary distress
Uric acid diathesis can arise from the liver,
spleen, pancreas, kidneys or bowels
When Uric Acid Diathesis is present,
clients will report:
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Chronic urinary infection
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Stones in kidney, ureters or bladder
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Gout pain / uric acid diathesis
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Atrophy of kidneys
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Localized chronic kidney pain
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Reduced function, especially in the elderly
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Chronic asthma and bronchitis
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Nerve irritation – interstitial cystitis
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Urinary issues with Chronic vaginitis
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Osteoporosis – calcium management issues
Let's Listen To The Clients:
What voice is speaking to us?
Where is the greatest limitation? What is in the
critical path to healing? Forest / Trees?
Where is the most suffering / the greatest
disturbance to the vital economy = greatest
constraint!
Questions on the concepts presented so far?
Case Example 1
57 yo female: Urinary Incontinence
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●
●
●
●
I have a history of kidney stones, and my biggest problem now
is that I have to pee all the time. Even if I just went to the bathroom 15 minutes ago, I will feel urgent need to urinate again.
This has been getting worse over the past 5 years since I hit
menopause.
I also have had bone spurs on my ankle and shoulder – they
were surgically removed twice
I don't sleep well because I have to get up several times every
night to urinate – at least hourly. So I am always tired.
I have been on several different medications for this – they
cause side effects I can't live with, so I want to try homeopathy.
Ocimum canum:
Holy basil
Stock this remedy in several potencies; have it on hand. It
is not going to be available at your local health food
store for clients to pick up!
In my practice, most helpful acute remedy in kidney
stone and kidney colic in 30c/200c/1M
Also use when there is clearly uric acid disruption in the
case – give as a nutritive herb for the kidneys in 3x – 3c
potency daily. Use in 3 week alternation with nat sulph
cell salt or silver birch gemmotherapy tincture.
Case Example 2
19 yo female: Urinary Tract Infection
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●
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I have had terrible urinary tract infections for the past 3 years.
Each time I get an infection, I have the feeling like I need to pee
all the time. And I get a terrible cramping pain at the end of urination.
I usually am given antibiotics by my doctor. And then the infection goes away. But for weeks afterward, when I sit down, I will
often leak a little bit of urine – just enough that I always have to
wear a panty liner in my underwear.
I have had at least one UTI each month for the last 2 years
Sarsaparilla
Made from smilax
In my practice, this is the most
helpful OAB urinary support
remedy when subacute
urinary infection is the
likeliest factor
Give in 6x potency
morning/evening daily for 34 weeks
Re-evaluate urging, frequency,
leaking symptoms after 3
weeks
Case Example 3
38 yo male: Kidney Weakness
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I had a bad kidney infection 6 years ago. I was a thri-athlete,
competing, and I got badly dehydrated. We were competing in
extreme heat at high altitude, and I just could not drink enough
water to stay hydrated. I passed out after I finished the last leg
of the competition, and woke up in the hospital on IV fluids.
Ever since then, I have had a problem with urinary incontinence.
With any physical stress, like when I cough or sneeze or jump, I
lose a little bit of urine. I always feel the need to urinate.
There have also been a few times when I have woken in the
morning and found that I have wet the bed a little.
This is really embarrassing to me – I have tried medications,
acupuncture, yoga, biofeedback without relief.
Serum Anguillae
Anguillae Serosa
Deterioration / degeneration of the kidneys
Albumin in the urine
Used in a trial in India: clients on dialysis were able to
reduce dialysis frequency and some were able to stop
dialysis treatments completely
Uric acid diathesis
This is one of the strongest options: give in low potency
( 12X? 9C? Remember it is a venom, and it is toxic)
1-2-3 times daily for 3 weeks, then consider a switch to
an appropriate cell salt such as nat-sulf.
What Else (other than a well
chosen remedy) can help?
Review / adjust medications with prescribing physician
Reduce intake of diuretic herbs (dandelion, chicory, fennel, mint)
Manage fluid intake, avoid caffeinated/alcoholic beverages
Reduce contributing factors for UTI: good hygiene around sex,
underwear choices, diet. D-Mannose.
• Scheduled voiding: Urinary Bladder training
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•
•
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– Urination at same time each day/night
– Improves ability to reduce reaction to urging
• Pelvic Floor exercises: Kegels
– When urinary incontinence is associated with pain, refer to a physical
therapist who specializes in pelvic floor – kegels are contra-indicated here!
– Both men and women can benefit from kegels
Review of Strategy Suggestions:
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Listen for the voice of the urinary system in the client's intake,
remembering that there are both primary (local) and secondary
(distant or systemic) manifestations.
Consider options of working through the lens of the constitution, the
lesional complaint, the miasm, the organ weakness
Remember that the client is unconcerned about the philosophical
underpinnings of homeopathy – the client just wants to get better!
So use all the tools in your toolbox to relieve their suffering
Practice responsibly – know what you are working with!! Refer for
diagnosis; ask the client to obtain copies of labwork from his/her
physician. Clarify. Be safe.
Educate about suggestions given here for urinary hygeine, adjuncts
to help the client in addition to the remedy.
SO, are you ready? You can do this!
Remember Burnett and ideas about
specificity of seat
• Let me know how you do - if you have a successful
case, email me:
[email protected]
• Additional class materials are available on my website: www.karenallenhomeopathy.com
• Thanks for your attention and participation today !