In the words of the patient's mother:
When I first came to know about my daughter's kidney problem and blood pressure, I was extremely worried if she will ever be normal again. Today, she is leading a normal life and I'm indebted to Dr. Shah's treatment for renal failure and schizophrenia cure.
Female/ 17 yrs
Diagnosis: Renal Failure with Schizophrenia
A beautiful, tall, slim, teenage girl came for consultation along with her mother. Hers was a case of hypertension and renal failure and the doctors had advised her to undergo Kidney transplantation. She had Blood pressure since the last 2 years and was mainly worsened by examinations. Her Blood Pressure would also rise when others would happen to be discussing her. She would get most irritable by the sun and would feel better after vomiting.
In the past, she had frequently suffered from Malaria and was repeatedly treated with doses of Quinine. As her family traveled a lot, she was frequently vaccinated.
All through the interview, she had a smile on her face and appeared to throw her charm around, trying to impress everyone in the consulting room. Her father was working for the United Nations and they had to travel quite a lot around the world. As a result, she was exposed to different environments, different races with different cultures and food habits. She had to be trained in everything, which included table manners, proper etiquette and behavioral attitude. She was taught how to address people correctly and learn how to suppress her own personal emotions.
As a child, she was very difficult to manage. She lagged behind in her lessons and never had the courage to stand up for herself. She was sensitive and highly emotional. She had a liking for toys and was easily attracted to soft, stuffed colorful toys. She was good at dancing and could perform on stage without fright. Basically she was artistic, fun-loving and easygoing by nature. She hated hard work.
She had participated in several beauty contests and had won the titles of 'Navy Queen' and 'Miss India', etc. During the interview, it was observed that she was very proud of her achievements and only too aware of her beauty and good looks. She did her best to attract everyone's attention and kept on laughing all the time without any reason.
The patient was afraid of her father (who was a short-tempered man). She was scared of moths, cockroaches and rats. Her anxious nature caused her to check everything repeatedly; she was never sure of herself.
By temperament she was very excitable and had a tendency to weep easily; even a simple joke or a pun annoyed her and she would become depressed and start to brood on it for a long time. The patient was never satisfied until she could take her revenge. Basically, she was a day-dreamer, dissatisfied, envious and suspicious. She felt better when somebody rubbed her, patted her. She felt better after consolation.
She said she would stammer - mostly on the alphabets W and R. Whenever she would be worried, she would pull at her skin and bite her lips. She would laugh for no reason at all when she would feel troubled. She would feel most uncomfortable the moment a boy would sit next to her. Her mother mentioned one confidential point - her daughter had romantic attachment to other girls.
It was obvious that both her parents gave a lot of importance to external activities but subdued and suppressed her behavior. They encouraged her to participate in beauty contests, fashion parades and other similar contests of the exhibitionary type.
The girl had a specific auditory hallucination that the neighborhood boy is saying that she is pretty; he likes her; he loves her; he wants to give gifts to her; this boy is all the time talking about her. She would think that others are talking about her; they are passing comments about her; they are saying that she will fail in her exams. She said that she could hear them even if she put cotton plugs in her ears or closed all doors and windows. She had thoughts that she was beautiful and everybody appreciated her.
Her dreams were mainly connected with anxiety, insecurity, dance, death, dead bodies, diseases, examinations, failing to cope with tasks, frightful ghosts, marriages, missing a train, murder or being murdered.
The patient was very fond of sweets and sweetmeats, fruits and lemons and was averse to vegetables and sour foods. She also liked soft drinks, ice-creams, apples, sea-food and pastries. She would pass stools twice a day because of her anxiety. She would occasionally pass urine involuntarily. Her menses were regular and stained indelible. Her leucorrhoea would leave behind some stains.
She had suffered from Measles and Chicken pox in the past and both her parents were Hypertensive.
Investigations:
Antinuclear, antibody test (ANA) Positive
Blood urea: 50 mg% (15 to 40 mgs %)
Serum Creatinine: 1.3 mg% (0.8 to 1.2 mgs %)
Serum Bilirubin: 0.5 mgs % (0.5 - 0.8 mgs %)
Serum Glutamic Pyruvic Transminase: 11 Units / cc (0 - 40 unit/cc)
Renal Arteriogram:
Right Kidney: Atrophy and with blockage non-functional
Left Kidney: Functioning only 80%
Based on the above history, the girl was prescribed Platina 200. When she came for follow up after 15 days, she was feeling much better physically. Mentally, she seemed more subdued and less haughty. Smiling without reason had reduced now. Blood Pressure: 120/86 mm Hg.
On the next visit, she seemed more calm and composed. Now, she was not bothered about neighborhood boy spying upon her. Physically, she said she was feeling OK. After this, on the next visit, anxiety was almost absent and she was feeling very positive. Her investigations after a month were as follows: Blood Urea: 30 mgs %
Serum Creatinine: 01 mgs %
On the next visit, she was extremely cheerful with all round general improvement. Her sleep was better, with less dreams and anxiety not bothering her anymore.
On next visit her blood reports were as follows: Blood urea: 25 mgs %
Serum Creatinine: 01 mgs %
Next time the Renal Dynamic and static studies were as given below:
Right Kidney: Parenchymal functions normal. Arteriogram with prolonged excretory phase
Left Kidney: Normal Parenchymal Function
She was in the most positive frame of mind and emotionally stable. Now 12 years have passed and she has no trouble, no problems and no complications. She is leading a healthy life.
Note: It is advisable that the patient does not indulge in any kind of self-medication in uraemia cure and schizophrenia cases.
