Chief Complaint: Facial Paralysis
Western diagnosis: Bell's Palsy
Medical History: This 46 yr old female patient came to me with a recent case of Bell's Palsy.(2 days). Complained of chronic low back pain, headaches, and a feeling of weakness for the last 3 months. Tried to eat conscienciously but often had little/no appetite. too tired to work out because work schedule was too intense.Complained of being cold easily.
Questioning exam: Upon further questioning we discerned that she had much stress with her job. When asked if she felt that she had "support" in her life she admitted that that was precisely her personal complaint. (Low back pain can sometimes be an indication that the patient feels that he/she is unsupported).
Pulse exam: Pulse was thin, weak, particularly on the rear positions. Complexion was pale.
Tongue exam: Tongue was pale with a slight white coating.
OM Diagnosis: This facial paralysis was due to external wind invasion on a basis of kidney yang and qi deficiency.
Treatment Principle: Dispel facial wind, open Du to relieve back pain, tonify Kd yang and Qi
Point Prescription: Patient was given 2 needling sessions. Lv3,Li4 to open 4 gates and dispel facial wind. Because invasion was still active no local points were given in the face. Patient was then given Si3 and Ub 62 to open Du, dispel back pain. With St 36 to tonify Qi and far infrared at mingmen Du4 to tonify Kd yang. Ear seeds applied before the patient left at: uriculotempo nervous point, nervous system subcortex, Shenmen, and occiput.
Lifestyle prescription: We discussed taking yoga classes to ease stress and relieve lower back pain and tonify internal strength. Discussed diet and supplements.
Results: Patient called the next day exstatic. Facial paralysis almost completely alleviated, patient had first good night's rest in months. No back pain. Coming back in 2 days for local facial points.
Tampilkan postingan dengan label CASES. Tampilkan semua postingan
Tampilkan postingan dengan label CASES. Tampilkan semua postingan
Rabu, 28 Januari 2009
Occipital neuralgia
Chief Complaint: Shooting pains in (L) occipital and parietal regions of the head, radiates to top of the head.
Western diagnosis: Occipital neuralgia
Medical History: 73 yr old status post surgery for throat cancer. Developed tingling and pressure sensation in occipital region which developed into severe shooting pains over a period of about 8 months. Shooting pains are rated at 9/10 level and occur 3-4 times/day. Patient has had 7 nerve blocks and surgery none of which helped to reduce symptoms.
PMH: Throat cancer 1997 treated with chemo therapy and radiation for 13 weeks. Developed inability to swallow due to scarring from radiation which required placement of gastric tube for feeding. Surgery to reduce scarring in the throat was unsuccessful.
Other surgeries: Hysterectomy, Hypertension
Meds: Neurontin, Darvocet, prilosec, Tylenol ES, Paxil, Catapress patch
Family history: Father died of cancer. Patient does not exercise and has liquid diet for tube feeding.
Questioning exam: Appetite: Poor Complains of frequent bloating.
Thirst: Always thirsty with dry mouth and throat. Sips water but is not allowed to drink thin liquids.
Energy level: Poor. Worn out from the pain.
Sleep: Takes sleeping pills, otherwise wakes constantly with pain
Eyes: frequent tearing
Always feels cold, palms of hands are red and feel hot at times.
Sweat: no
Urination: Frequent
BM: usually daily, tendency towards loose bowels.
Chest: Cough with dry yellow phlegm.
Dry skin, Bruise easily
Mental / emotional: worries a lot + easily angered or irritated
Pulse exam: Pulse: Thready, Slow
Very tender on palpation along spleen, liver, and gallbladder meridians.
Reduced range of motion in cervical spine with severe scarring in (L)occipital and parietal region. Very tight upper traps and SCM muscle.
Tongue exam: Tongue: Red, yin deficiency cracks, ulceration and dark red areas in the center and on the sides.
OM Diagnosis: Liver yang rising with underlying yin deficiency. Qi / blood stagnation in GB / UB channels.
The tongue, pulse, and symptoms such as; thirst, dry throat, shooting pain in UB/GB area radiating to vertex, teary eyes, irritability, HTN, all point towards yin deficiency with yang rising. The tingling sensation and shooting / stabbing pains point towards qi and blood stagnation.
Treatment Principle: Move qi and blood in the channels. Subdue liver yang.
Point Prescription: (L) HT4, 7, GB41
® KD3, SP6
This treatment initially gave great relief with less frequent attacks + reduced pain intensity. Patient was able to reduce pain medication. However when patient got angry or went through periods of stress the pain would come back. I tried some electrical stimulation and needled ashi points in the scalp which gave further relief.
Patient claimed 70% relief of symptoms.
Herbal Formula: Herbal Formula:
Bai shao 9
ge gen 9
yan hu suo 6
qiang huo 6
wei ling xian 6
tian ma 9
gou teng 9
long dan cao 6
mai men dong 9
shi hu 9
huang lian 6
wu zhu yu 2
hai piao xiao 9
mu li 9
chen pi6
fu ling 9
bai zhu 9
gan cao 6
After about one month of just acupuncture I added the above herbal formula to open the channels, subdue LV yang, and assist the digestive system.
The herbal formula did not give much relief and in the end we just continued with acupuncture treatments.
Lifestyle prescription: Tuina: Passive stretches neck / shoulder muscles. Loosen up scar tissue in occipital region. Traction. Taught patient to use acupressure points to control symptoms if experiencing a flare- up.
Results: Patients quality of life had much improved but she continued to have little flare-ups here and there at which time she would come back for more therapy. About 5 months after the initial start of treatment the patient had an MRI which showed a popcorn like bony tumor at the base of her skull partly in the UB channel distribution.
I started adding UB60 to her acupuncture prescription which made a big difference and she was able to go without treatment for about 5 months.
Synopsis: Recently the patient had some other medical problems after which the head pains started flaring up again.
I now use intradermals at UB60 and occasionally GB41 both on the left side. Whenever the patient has an episode she presses those points and her pain subsides within 1-2 minutes. Once every few weeks the patient comes back for an acupuncture treatment and this way she has been able to sustain a good treatment effect.
I believe the reason why this patient was unable to make full recovery is because of the tumor that is still there pressing on the occipital nerve.
Western diagnosis: Occipital neuralgia
Medical History: 73 yr old status post surgery for throat cancer. Developed tingling and pressure sensation in occipital region which developed into severe shooting pains over a period of about 8 months. Shooting pains are rated at 9/10 level and occur 3-4 times/day. Patient has had 7 nerve blocks and surgery none of which helped to reduce symptoms.
PMH: Throat cancer 1997 treated with chemo therapy and radiation for 13 weeks. Developed inability to swallow due to scarring from radiation which required placement of gastric tube for feeding. Surgery to reduce scarring in the throat was unsuccessful.
Other surgeries: Hysterectomy, Hypertension
Meds: Neurontin, Darvocet, prilosec, Tylenol ES, Paxil, Catapress patch
Family history: Father died of cancer. Patient does not exercise and has liquid diet for tube feeding.
Questioning exam: Appetite: Poor Complains of frequent bloating.
Thirst: Always thirsty with dry mouth and throat. Sips water but is not allowed to drink thin liquids.
Energy level: Poor. Worn out from the pain.
Sleep: Takes sleeping pills, otherwise wakes constantly with pain
Eyes: frequent tearing
Always feels cold, palms of hands are red and feel hot at times.
Sweat: no
Urination: Frequent
BM: usually daily, tendency towards loose bowels.
Chest: Cough with dry yellow phlegm.
Dry skin, Bruise easily
Mental / emotional: worries a lot + easily angered or irritated
Pulse exam: Pulse: Thready, Slow
Very tender on palpation along spleen, liver, and gallbladder meridians.
Reduced range of motion in cervical spine with severe scarring in (L)occipital and parietal region. Very tight upper traps and SCM muscle.
Tongue exam: Tongue: Red, yin deficiency cracks, ulceration and dark red areas in the center and on the sides.
OM Diagnosis: Liver yang rising with underlying yin deficiency. Qi / blood stagnation in GB / UB channels.
The tongue, pulse, and symptoms such as; thirst, dry throat, shooting pain in UB/GB area radiating to vertex, teary eyes, irritability, HTN, all point towards yin deficiency with yang rising. The tingling sensation and shooting / stabbing pains point towards qi and blood stagnation.
Treatment Principle: Move qi and blood in the channels. Subdue liver yang.
Point Prescription: (L) HT4, 7, GB41
® KD3, SP6
This treatment initially gave great relief with less frequent attacks + reduced pain intensity. Patient was able to reduce pain medication. However when patient got angry or went through periods of stress the pain would come back. I tried some electrical stimulation and needled ashi points in the scalp which gave further relief.
Patient claimed 70% relief of symptoms.
Herbal Formula: Herbal Formula:
Bai shao 9
ge gen 9
yan hu suo 6
qiang huo 6
wei ling xian 6
tian ma 9
gou teng 9
long dan cao 6
mai men dong 9
shi hu 9
huang lian 6
wu zhu yu 2
hai piao xiao 9
mu li 9
chen pi6
fu ling 9
bai zhu 9
gan cao 6
After about one month of just acupuncture I added the above herbal formula to open the channels, subdue LV yang, and assist the digestive system.
The herbal formula did not give much relief and in the end we just continued with acupuncture treatments.
Lifestyle prescription: Tuina: Passive stretches neck / shoulder muscles. Loosen up scar tissue in occipital region. Traction. Taught patient to use acupressure points to control symptoms if experiencing a flare- up.
Results: Patients quality of life had much improved but she continued to have little flare-ups here and there at which time she would come back for more therapy. About 5 months after the initial start of treatment the patient had an MRI which showed a popcorn like bony tumor at the base of her skull partly in the UB channel distribution.
I started adding UB60 to her acupuncture prescription which made a big difference and she was able to go without treatment for about 5 months.
Synopsis: Recently the patient had some other medical problems after which the head pains started flaring up again.
I now use intradermals at UB60 and occasionally GB41 both on the left side. Whenever the patient has an episode she presses those points and her pain subsides within 1-2 minutes. Once every few weeks the patient comes back for an acupuncture treatment and this way she has been able to sustain a good treatment effect.
I believe the reason why this patient was unable to make full recovery is because of the tumor that is still there pressing on the occipital nerve.
Right shoulder pain
Chief Complaint: Right shoulder pain
Medical History: Patient is a 54 year old female massage therapist seeing 10-15 people per week. She has been seeking help for this problem for the past 2 years with the results being that it takes the pain away yet it always returns. Her outlook is positive and she has healthy diet and exercise habits.
Questioning exam: The pain is worse stress and on palpations her whole right side is tender along that gallbladder channel. Patient has bouts of insomnia which have no particular cycle.
Pulse exam: Pulse in generally thin and weak, especially in SP and Ki Yin positions.
Tongue exam: Tongue is pale with a red tip.
OM Diagnosis: Ki Yin is weak since patient is post menopausal. The weakness of the spleen is not nourishing the muscles causing the inherent weakness.
Treatment Principle: Nourish SP Qi and Ki Yin
Point Prescription: Front tx: Ki 3, SP6, ST36, Ren4, GB 34, LI15, SI6
Back: LI16, SI13, Ashi, GB30, GB34, UB20, UB21, UB23
Strong stimulation til spasm to release muscle tension. Massage was incorporated after needles were removed to stretch the muscle. After 6 treatments, massage was added during needling to stretch the muscle as the spasm was being released.
Herbal Formula: Essential oils of Lavender and Clary Sage.
Results: On the 12th treatment, the shoulder girdle moved with an audible pop back into place. The next visit, patient was ready to deal with other issues.
Synopsis: Chronic long term pain has responded well to the combination of acupuncture, massage with theraputic-grade essential oils.
Medical History: Patient is a 54 year old female massage therapist seeing 10-15 people per week. She has been seeking help for this problem for the past 2 years with the results being that it takes the pain away yet it always returns. Her outlook is positive and she has healthy diet and exercise habits.
Questioning exam: The pain is worse stress and on palpations her whole right side is tender along that gallbladder channel. Patient has bouts of insomnia which have no particular cycle.
Pulse exam: Pulse in generally thin and weak, especially in SP and Ki Yin positions.
Tongue exam: Tongue is pale with a red tip.
OM Diagnosis: Ki Yin is weak since patient is post menopausal. The weakness of the spleen is not nourishing the muscles causing the inherent weakness.
Treatment Principle: Nourish SP Qi and Ki Yin
Point Prescription: Front tx: Ki 3, SP6, ST36, Ren4, GB 34, LI15, SI6
Back: LI16, SI13, Ashi, GB30, GB34, UB20, UB21, UB23
Strong stimulation til spasm to release muscle tension. Massage was incorporated after needles were removed to stretch the muscle. After 6 treatments, massage was added during needling to stretch the muscle as the spasm was being released.
Herbal Formula: Essential oils of Lavender and Clary Sage.
Results: On the 12th treatment, the shoulder girdle moved with an audible pop back into place. The next visit, patient was ready to deal with other issues.
Synopsis: Chronic long term pain has responded well to the combination of acupuncture, massage with theraputic-grade essential oils.
Diabetes Mellitus, Hypertension, Shoulder pain
Chief Complaint: Shoulder pain and reduced ROM
Western diagnosis: Diabetes Mellitus, Hypertension, Shoulder pain
Medical History: 69 yr old lady, sedentary, average american diet, slightly obese, mentally and socially well adapted. On Beta blocker, lasix, glucophage, and human insulin.
Questioning exam: Patient reported that she'd like to be off all her meds and would like to be able to used her shoulders which had gradually deteriorated over a period of 1 year.
Pulse exam: Crepitis in shoulders with very restricted active ROM, and pain elicited on passive ROM study. Pulse Wide, slippery, firm and forceful.
Tongue exam: Swollen, especilly perimeter.
OM Diagnosis: Bi syndrome(fixed), with overall excess condition. Damp. According to classical diagnosis through Color, Sound Odor and Emotion, Spleen is indicated.
Treatment Principle: To move qi, to move spleen qi and clear damp.
Point Prescription: All the following points were used, not all at the same treatment
LI 15 Disperse
SJ 14 Disperse
St 14 Disperse
St 38 Disperse
St 41 Disperse
Sp 3 Disperse
Sp 8 Disperse
Sp 9 Disperse
Treatment began twice weekly for about 2 months, followed by once a week for 2 months. She currently has treatment every 3 weeks.
Herbal Formula: None given
Lifestyle prescription: Walking around the block, especially when blood sugar is high. Swimming. Eat a diet guided by the glycemic index.
Results: After 6 weeks of treatment this patient had no pain in shoulders with full range of motion. After 8 weeks she had no need of the glucophage, insulin and lasix. She has stable blood sugar levels 80-110. She has much more energy, a much greater sense of well being. She no longer is edemic. She has lost 20 lbs. These improvements persist after 35 treatments in eight months. Her blood pressure is still elevated whenever she reduces her beta blocker.
Synopsis: Not only did this patient respond very well to acupuncture, she has been an ideal patient in following our recommendations to the letter. In her case an in many, not only did the main complaint resolve, her general health is much improved, with some progress still to be made, but her well being and mental alertness has been susbstantially benefitted by the combination of treatment and changes she has made in her lifestyle.
Western diagnosis: Diabetes Mellitus, Hypertension, Shoulder pain
Medical History: 69 yr old lady, sedentary, average american diet, slightly obese, mentally and socially well adapted. On Beta blocker, lasix, glucophage, and human insulin.
Questioning exam: Patient reported that she'd like to be off all her meds and would like to be able to used her shoulders which had gradually deteriorated over a period of 1 year.
Pulse exam: Crepitis in shoulders with very restricted active ROM, and pain elicited on passive ROM study. Pulse Wide, slippery, firm and forceful.
Tongue exam: Swollen, especilly perimeter.
OM Diagnosis: Bi syndrome(fixed), with overall excess condition. Damp. According to classical diagnosis through Color, Sound Odor and Emotion, Spleen is indicated.
Treatment Principle: To move qi, to move spleen qi and clear damp.
Point Prescription: All the following points were used, not all at the same treatment
LI 15 Disperse
SJ 14 Disperse
St 14 Disperse
St 38 Disperse
St 41 Disperse
Sp 3 Disperse
Sp 8 Disperse
Sp 9 Disperse
Treatment began twice weekly for about 2 months, followed by once a week for 2 months. She currently has treatment every 3 weeks.
Herbal Formula: None given
Lifestyle prescription: Walking around the block, especially when blood sugar is high. Swimming. Eat a diet guided by the glycemic index.
Results: After 6 weeks of treatment this patient had no pain in shoulders with full range of motion. After 8 weeks she had no need of the glucophage, insulin and lasix. She has stable blood sugar levels 80-110. She has much more energy, a much greater sense of well being. She no longer is edemic. She has lost 20 lbs. These improvements persist after 35 treatments in eight months. Her blood pressure is still elevated whenever she reduces her beta blocker.
Synopsis: Not only did this patient respond very well to acupuncture, she has been an ideal patient in following our recommendations to the letter. In her case an in many, not only did the main complaint resolve, her general health is much improved, with some progress still to be made, but her well being and mental alertness has been susbstantially benefitted by the combination of treatment and changes she has made in her lifestyle.
S/P stroke (Left cerebral)
Chief Complaint: Stroke
Western diagnosis: S/P stroke (Left cerebral)
Medical History: 51 year old female, CVA 9/99 due to hypertensive bleeding. Sustained right sided paralysis (about 90%), with cognitive difficulties. Underwent extensive rehab. Is currentloy on proper diet and medications.
Questioning exam: She cannot exercise, walked with a cane, favors right side. Could not use hand to grip (claw hand). Had almost total disuse of right arm and leg. Foot turned inward. She could not extend her fingers.
Pulse exam: Weak, sinking Chi Xe pulse, wiry
Tongue exam: Pale, petechiae at tip, thin white coat, scalloped
OM Diagnosis: Channel and network wind stroke, wind-phlegm static blood, impeded/obstructed vessels and networks
Treatment Principle: Transform phlegm and extinguish wind, quicken the blood and free the network vessels
Point Prescription: SI3 with Bl62: opening point of DuMai with coupled point on Yang Heel Vessel. LI16, LI15,LI11,LI4: Drain yang-ming energy level without detriment to source Qi, etc. GB34: gathering point for sinews and invigorates Qi, blood.GB39: gathering point for marrow and, nourishes marrow, and eliminates wind, epecially chronic interior wind. GB38: indirectly eliminates wind by subduing liver-yang. Scalp UE & LE motor areas. Applied 1000 Hz TO LI16-LI11;LI4-LI14,GB34-GB39 to expel wind.
Herbal Formula: da Huo Luo Dan initially
Lifestyle prescription: Blood pressure medications.
Results: After 3 sessions, congnitive abilities (short term memory, concentration)returned. After 12 sessions, strength and voluntary movements improved significantly. Can move her foot and walks better, without a cane. Can extend fingers better and hold things in right hand, although not for long.Acupuncture continuing.
Synopsis: 51 year old with stroke and significant disability, told by conventiopnal doctors that she would not improve. Has made remarkable progress despite date of stroke. Continues to make progress with additional treatment once a week.
Western diagnosis: S/P stroke (Left cerebral)
Medical History: 51 year old female, CVA 9/99 due to hypertensive bleeding. Sustained right sided paralysis (about 90%), with cognitive difficulties. Underwent extensive rehab. Is currentloy on proper diet and medications.
Questioning exam: She cannot exercise, walked with a cane, favors right side. Could not use hand to grip (claw hand). Had almost total disuse of right arm and leg. Foot turned inward. She could not extend her fingers.
Pulse exam: Weak, sinking Chi Xe pulse, wiry
Tongue exam: Pale, petechiae at tip, thin white coat, scalloped
OM Diagnosis: Channel and network wind stroke, wind-phlegm static blood, impeded/obstructed vessels and networks
Treatment Principle: Transform phlegm and extinguish wind, quicken the blood and free the network vessels
Point Prescription: SI3 with Bl62: opening point of DuMai with coupled point on Yang Heel Vessel. LI16, LI15,LI11,LI4: Drain yang-ming energy level without detriment to source Qi, etc. GB34: gathering point for sinews and invigorates Qi, blood.GB39: gathering point for marrow and, nourishes marrow, and eliminates wind, epecially chronic interior wind. GB38: indirectly eliminates wind by subduing liver-yang. Scalp UE & LE motor areas. Applied 1000 Hz TO LI16-LI11;LI4-LI14,GB34-GB39 to expel wind.
Herbal Formula: da Huo Luo Dan initially
Lifestyle prescription: Blood pressure medications.
Results: After 3 sessions, congnitive abilities (short term memory, concentration)returned. After 12 sessions, strength and voluntary movements improved significantly. Can move her foot and walks better, without a cane. Can extend fingers better and hold things in right hand, although not for long.Acupuncture continuing.
Synopsis: 51 year old with stroke and significant disability, told by conventiopnal doctors that she would not improve. Has made remarkable progress despite date of stroke. Continues to make progress with additional treatment once a week.
Tinnitus
Chief Complaint: Tinnitus
Western diagnosis: Tinnitus
Medical History: 43year old caucasian male patient had an oral surgery on his left side of his jaw 5 weeks ago. Since then he was hearing high pitch ringging sound in his left ear. Patient was healthy until this condition. He also complains of tenderness around the surgical area, and also suffers from insomia and depression since. Healthy diet and exercises regularly.
Questioning exam: Do you have insomnia because of pain or sounds? Sounds(tinnitus)
Any medications? Taking anti-anxiety medication and took antibiotics for 2weeks after the surgery.
Pulse exam: Left Heart (full, rapid)
Liver (Full,wiry)
kidney (deep,weak)
Tongue exam: purple body,red tip,scanty coating, swollen
OM Diagnosis: Heart fire, liver yang rising, kidney yin deficiency.
Treatment Principle: Tonify kidney yin to harmonize the Heart
Soothe liver yang.
Point Prescription: tonify Lu8, Liv4, Liv3, Sp3, St36
sedate H8, Liv2, GB2, 3, SJ17
Herbal Formula: none
Lifestyle prescription: suggested yoga to relax himself
Results: Sound has diminished with two consecutive days of TX.
With 7 more TXs. every other day, the ringging was completely gone.
Sleeps normally, pain on face is gone.
Western diagnosis: Tinnitus
Medical History: 43year old caucasian male patient had an oral surgery on his left side of his jaw 5 weeks ago. Since then he was hearing high pitch ringging sound in his left ear. Patient was healthy until this condition. He also complains of tenderness around the surgical area, and also suffers from insomia and depression since. Healthy diet and exercises regularly.
Questioning exam: Do you have insomnia because of pain or sounds? Sounds(tinnitus)
Any medications? Taking anti-anxiety medication and took antibiotics for 2weeks after the surgery.
Pulse exam: Left Heart (full, rapid)
Liver (Full,wiry)
kidney (deep,weak)
Tongue exam: purple body,red tip,scanty coating, swollen
OM Diagnosis: Heart fire, liver yang rising, kidney yin deficiency.
Treatment Principle: Tonify kidney yin to harmonize the Heart
Soothe liver yang.
Point Prescription: tonify Lu8, Liv4, Liv3, Sp3, St36
sedate H8, Liv2, GB2, 3, SJ17
Herbal Formula: none
Lifestyle prescription: suggested yoga to relax himself
Results: Sound has diminished with two consecutive days of TX.
With 7 more TXs. every other day, the ringging was completely gone.
Sleeps normally, pain on face is gone.
Sports sprain
Chief Complaint: big toe hurts, neck pain
Western diagnosis: sports sprain
Medical History: a football athlete from Steelers, his left big toe hit the ground straight when playing football. No pain killers. Regular diet, no regular rest, a lot of competition
Questioning exam: Q: How long did you hurt your big toe?
A: About a month ago.
Q: What is the pain level and how often?
A: About 7-8, hurts all the time
Q: Does the ice or heat make a difference?
A: I'll say ice makes it feel better.
Q: How is sleeping and digestion?
A: Fine.
Q: Lots of stress?
A: Not really.
Pulse exam: (left)heart slow and strong,the other two are normal (right)normal, typical athlete pulse
Tongue exam: red tip(in summer), pink tongue with slight white coating
OM Diagnosis: Local Qi and Blood stagnation(big toe area and related liver-spleen meridian),based on injury history and no internal organ imbalance pattern
Treatment Principle: improve circulation in related area and meridian, support energy flow in the toe and neck
Point Prescription: neck: only TuiNa with rolling and one-Finger technique
Toe: Liv3(L), sp1(L),Sp2(L),Ashi points.Combined with moxa everyday and TuiNa
Herbal Formula: TNJ for energy
Lifestyle prescription: Eat balanced diet, reduce or stop coffee, not a lot alcohol. Stop ice, more heat to the affected area. TNJ to affected area if needed.Avoid position to touch it incorrectly and wear comfortable shoe
Results: after 1st acupuncture treatment and TuiNa, neck pain is gone. Toe is better, still hurts. I asked him to use moxa everyday, each time 10 mins at least; after a week, his toe much better. He is now in competiton again.
Synopsis: note: moxa is the best solution for soft tissue injury
Western diagnosis: sports sprain
Medical History: a football athlete from Steelers, his left big toe hit the ground straight when playing football. No pain killers. Regular diet, no regular rest, a lot of competition
Questioning exam: Q: How long did you hurt your big toe?
A: About a month ago.
Q: What is the pain level and how often?
A: About 7-8, hurts all the time
Q: Does the ice or heat make a difference?
A: I'll say ice makes it feel better.
Q: How is sleeping and digestion?
A: Fine.
Q: Lots of stress?
A: Not really.
Pulse exam: (left)heart slow and strong,the other two are normal (right)normal, typical athlete pulse
Tongue exam: red tip(in summer), pink tongue with slight white coating
OM Diagnosis: Local Qi and Blood stagnation(big toe area and related liver-spleen meridian),based on injury history and no internal organ imbalance pattern
Treatment Principle: improve circulation in related area and meridian, support energy flow in the toe and neck
Point Prescription: neck: only TuiNa with rolling and one-Finger technique
Toe: Liv3(L), sp1(L),Sp2(L),Ashi points.Combined with moxa everyday and TuiNa
Herbal Formula: TNJ for energy
Lifestyle prescription: Eat balanced diet, reduce or stop coffee, not a lot alcohol. Stop ice, more heat to the affected area. TNJ to affected area if needed.Avoid position to touch it incorrectly and wear comfortable shoe
Results: after 1st acupuncture treatment and TuiNa, neck pain is gone. Toe is better, still hurts. I asked him to use moxa everyday, each time 10 mins at least; after a week, his toe much better. He is now in competiton again.
Synopsis: note: moxa is the best solution for soft tissue injury
Yeast infection/candida
Chief Complaint: yeast infections
Western diagnosis: yeast infection/candida
Medical History: Patient complains of consistent vaginal yeast infections. She excercises regularly, eats a lot of sugar in her diet and is on the birth control pill. She is a first year lawyer and is under a great deal of pressure.
Questioning exam: Q:Are you on the birth control pill?
A: yes, for 5 years
Q: Do you have any digestive problems?
A: fullness in stomach, bloating
Q: How is your energy:
A: low, feel sluggish
Q: How often are you getting yeast infections?
A: once a month
Q: have you seen your dr. about this matter? have you had a recent hiv test?
A: yes and yes...I am healthy and negative for HIV
Q: do you have vaginal discharge? what color?
A: yes, white
Q: How is your appetite?
A: low
Q: How much water do you drink?
A: not much...drinks a lot of soda
Pulse exam: Pulse: right side: slippery, weak. left side: slightly bowstring
Tongue exam: pale color and greasy, white coating. Patient is slightly overweight. pale face
OM Diagnosis: Spleen qi deficiency with dampness
patient is suffering from a spleen qi deficiency which is leading to a decrease in the amount of transformation/transportation of fluids in the body. This is causing a dampness to occur. This dampness is affecting the middle and lower body giving her abdominal fullness, lack of appetite and yeast infections (with white vaginal discharge)
Treatment Principle: Expel dampness, tonify spleen qi
Point Prescription: ST 40, ST 36, Sp 6, PC 6
moxa on Kid 7 (great for yeast infections!)
Herbal Formula: Er Chen Tang (pill form): 8 pills 3 X day. For one month then, si jun zi tang pills 8 3X day for one month
Lifestyle prescription: I gave her the following information: Controlling Yeast Infections with Diet
In Chinese medicine we say the Spleen is in charge of digestion & transforming/transporting fluids throughout the body. If the spleen becomes deficient (common when the body is under stress), fluids are not transported and dampness in the body occurs. Symptoms of dampness include a general feeling of heaviness in the body, fatigue, phlegm, nasal congestion, yeast infections and even weight gain. There are many foods that make it hard for the spleen to function properly (especially when your body is prone to dampness). The following are some basic foods to avoid/add to your diet:
Decrease consumption of cold beverages/raw food:
The yeast and "dampness" creating foods are those which are cold in temperature, too sweet or salty, mucus-producing, and stale/rancid. Too much raw food can also affect your digestion leading to dampness.
Decrease consumption of carbohydrates:
Foods rich in carbohydrates must be used moderately since they are usually somewhat mucus- and acid-forming, and therefore any small excess can contribute to yeast conditions.
Decrease consumption of sweeteners/fruits:
All refined and concentrated sweeteners (e.g., sugar molasses) and fruits help propagate yeast in the body and should be avoided.
Avoid milk/dairy products:
Most milk products, eggs and red meats can also promote yeast and are not recommended. (fish and chicken are okay)
Increase intake of Garlic:
Garlic has exceptional anti-viral/fungal properties and does not damage the healthful intestinal flora. (you can eat �? clove of garlic twice a day before meals or get garlic pills at the health food store)
Increase amounts of cooked/warm foods:
I highly recommend you eat mostly cooked foods. Lots of soups that are warm and even a cup of hot water (with or without tea) before bed at night to help your digestion (spleen/stomach).
Increase amounts of chlorophyll:
Chlorophyll promotes the growth of beneficial intestinal flora. Parsley, kale, collard, watercress, romaine lettuce, cabbage and micro-algae, wheat grass all contain significant amounts of chlorophyll. (Go to the juice bar and get lots of fresh wheat grass!)
These are simple things to take into account with your diet to avoid and decrease the amount of yeast infections in your body. In Chinese Medicine, we believe that everything should be done in moderation, so don秒t feel that you have to eliminate any foods all together. You should just watch the amount of damp-causing agents that you take into your body AND increase the amount of Spleen-aiding agents.
Results: Results were great! Her yeast infections stopped once on the er chen tang. And her stomach discomforts are relieved and appetite is back! Sometimes when she feels she is getting another yeast infection, she comes in for a preventative acupuncture treatment.
Synopsis: Since her yeast infection consisted of white discharge, I didn't have to clear any heat in her system. However, this is an important fact to consider. Cleansing her dampness with acupuncture and herbs AND making some very important dietary changes can make a huge difference in this scenario.
Western diagnosis: yeast infection/candida
Medical History: Patient complains of consistent vaginal yeast infections. She excercises regularly, eats a lot of sugar in her diet and is on the birth control pill. She is a first year lawyer and is under a great deal of pressure.
Questioning exam: Q:Are you on the birth control pill?
A: yes, for 5 years
Q: Do you have any digestive problems?
A: fullness in stomach, bloating
Q: How is your energy:
A: low, feel sluggish
Q: How often are you getting yeast infections?
A: once a month
Q: have you seen your dr. about this matter? have you had a recent hiv test?
A: yes and yes...I am healthy and negative for HIV
Q: do you have vaginal discharge? what color?
A: yes, white
Q: How is your appetite?
A: low
Q: How much water do you drink?
A: not much...drinks a lot of soda
Pulse exam: Pulse: right side: slippery, weak. left side: slightly bowstring
Tongue exam: pale color and greasy, white coating. Patient is slightly overweight. pale face
OM Diagnosis: Spleen qi deficiency with dampness
patient is suffering from a spleen qi deficiency which is leading to a decrease in the amount of transformation/transportation of fluids in the body. This is causing a dampness to occur. This dampness is affecting the middle and lower body giving her abdominal fullness, lack of appetite and yeast infections (with white vaginal discharge)
Treatment Principle: Expel dampness, tonify spleen qi
Point Prescription: ST 40, ST 36, Sp 6, PC 6
moxa on Kid 7 (great for yeast infections!)
Herbal Formula: Er Chen Tang (pill form): 8 pills 3 X day. For one month then, si jun zi tang pills 8 3X day for one month
Lifestyle prescription: I gave her the following information: Controlling Yeast Infections with Diet
In Chinese medicine we say the Spleen is in charge of digestion & transforming/transporting fluids throughout the body. If the spleen becomes deficient (common when the body is under stress), fluids are not transported and dampness in the body occurs. Symptoms of dampness include a general feeling of heaviness in the body, fatigue, phlegm, nasal congestion, yeast infections and even weight gain. There are many foods that make it hard for the spleen to function properly (especially when your body is prone to dampness). The following are some basic foods to avoid/add to your diet:
Decrease consumption of cold beverages/raw food:
The yeast and "dampness" creating foods are those which are cold in temperature, too sweet or salty, mucus-producing, and stale/rancid. Too much raw food can also affect your digestion leading to dampness.
Decrease consumption of carbohydrates:
Foods rich in carbohydrates must be used moderately since they are usually somewhat mucus- and acid-forming, and therefore any small excess can contribute to yeast conditions.
Decrease consumption of sweeteners/fruits:
All refined and concentrated sweeteners (e.g., sugar molasses) and fruits help propagate yeast in the body and should be avoided.
Avoid milk/dairy products:
Most milk products, eggs and red meats can also promote yeast and are not recommended. (fish and chicken are okay)
Increase intake of Garlic:
Garlic has exceptional anti-viral/fungal properties and does not damage the healthful intestinal flora. (you can eat �? clove of garlic twice a day before meals or get garlic pills at the health food store)
Increase amounts of cooked/warm foods:
I highly recommend you eat mostly cooked foods. Lots of soups that are warm and even a cup of hot water (with or without tea) before bed at night to help your digestion (spleen/stomach).
Increase amounts of chlorophyll:
Chlorophyll promotes the growth of beneficial intestinal flora. Parsley, kale, collard, watercress, romaine lettuce, cabbage and micro-algae, wheat grass all contain significant amounts of chlorophyll. (Go to the juice bar and get lots of fresh wheat grass!)
These are simple things to take into account with your diet to avoid and decrease the amount of yeast infections in your body. In Chinese Medicine, we believe that everything should be done in moderation, so don秒t feel that you have to eliminate any foods all together. You should just watch the amount of damp-causing agents that you take into your body AND increase the amount of Spleen-aiding agents.
Results: Results were great! Her yeast infections stopped once on the er chen tang. And her stomach discomforts are relieved and appetite is back! Sometimes when she feels she is getting another yeast infection, she comes in for a preventative acupuncture treatment.
Synopsis: Since her yeast infection consisted of white discharge, I didn't have to clear any heat in her system. However, this is an important fact to consider. Cleansing her dampness with acupuncture and herbs AND making some very important dietary changes can make a huge difference in this scenario.
Depression
Chief Complaint: depression
Medical History: 35 year old female with a history of depressive episodes for 6 years. Recent weight gain of 20#s. Reports lack of interest in life, lack of exercise, and diet that includes large amounts of sugars and refined flours.
Questioning exam: Premenstrual breast distension
Constipation alternating with diarrhea.
Irritibility and anger
Heavy menstrual flow with dark clots
Resltess sleep with strong dreams.
Pulse exam: right guan: vacuous and soggy
left guan: fine and wiry
right and left cun: short and slightly wiry
Tongue exam: swollen around edges.
Pale body with redder sides
Wet and think coating.
OM Diagnosis: Liver depression qi stagnation
Depressive heat. (harassing the heart)
Heart/Spleen disharmony (vacuity)
Blood stasis
Treatment Principle: Course the liver, rectify the qi. Clear heat. Supplement the Spleen & boost the qi
Point Prescription: Lv2 through to Lv3 R
P6 L, LI4R, H7, S36, Du24, Ear Shenmen
Lifestyle prescription: Greatly reduce sugar and refinded carbohydrates. Initiated an exercise program.
Results: After 8 treatments of twice per week for 4 weeks the patient reported significant improvent in both mood and sleep.
Synopsis: I am always surprised at how effective a simple acupuncture protocol can be when combined with support for proper diet and lifestyle.
Medical History: 35 year old female with a history of depressive episodes for 6 years. Recent weight gain of 20#s. Reports lack of interest in life, lack of exercise, and diet that includes large amounts of sugars and refined flours.
Questioning exam: Premenstrual breast distension
Constipation alternating with diarrhea.
Irritibility and anger
Heavy menstrual flow with dark clots
Resltess sleep with strong dreams.
Pulse exam: right guan: vacuous and soggy
left guan: fine and wiry
right and left cun: short and slightly wiry
Tongue exam: swollen around edges.
Pale body with redder sides
Wet and think coating.
OM Diagnosis: Liver depression qi stagnation
Depressive heat. (harassing the heart)
Heart/Spleen disharmony (vacuity)
Blood stasis
Treatment Principle: Course the liver, rectify the qi. Clear heat. Supplement the Spleen & boost the qi
Point Prescription: Lv2 through to Lv3 R
P6 L, LI4R, H7, S36, Du24, Ear Shenmen
Lifestyle prescription: Greatly reduce sugar and refinded carbohydrates. Initiated an exercise program.
Results: After 8 treatments of twice per week for 4 weeks the patient reported significant improvent in both mood and sleep.
Synopsis: I am always surprised at how effective a simple acupuncture protocol can be when combined with support for proper diet and lifestyle.
Depression, generalized anxiety disorder
Chief Complaint: depression
Western diagnosis: depression, generalized anxiety disorder
Medical History: 42 year old female. Extreme despair every morning, characterized by great anxiety, terror of organizing her life, suicidal thoughts, fatigue.
Questioning exam: The patient revealed that she vomited bile on many mornings and she had had a cholecystectomy 3 years previously. She was intolerant of fat.She had struggled with weight gain and was overweight, gaining 60lbs. in three years.She had a very large scar under the right rib cage from the surgery.
Pulse exam: pulse was slippery bounding and full on the surface at the guan position and deficient in the cun and chi positions.
Palpation of the belly showed tightness around the Liver and at CV.14 and 15.
Tongue exam: The tongue was surprising in how normal it looked!
OM Diagnosis: Gall Bladder Qi Deficiency. Gall Bladder Damp Heat. Liver Qi Stagnation. Heart Yin Deficiency
I don't know if you can have both Gall BLadder Qi Deficiency and Damp Heat simultaneously in strict TCM thinking, but I think this patient had both! I think she was Gall BLadder Qi deficient giving rise to the extreme fear of Life and paralysing fear when having to decide anything. I think she had Gall Bladder Damp Heat as there was an urgent, excess, agitated quality underlying the depression with the suggestion of rash action. There was also the vomiting of bile 3-4 times a week and the wight gain and intolerance of fat.
Treatment Principle: Purge Gall Bladder Damp Heat, strengthen Gall Bladder functioning.
Point Prescription: Needling around the prominent cholecystectomy scar.every treatment. GB 34 threaded 4" to just below Sp.9 bilaterally every treatment.
CV.6, 12, 14
Herbal Formula: 7 Forests 'Taraxogen'
which consists of:
Dandelion extract - Pu Gong Ying
Lotus Leaf extract - He Ye
Lysimachia extract - Jin Qian Cao
Artichoke leaf extract
This formula is very cholagogic i.e. it improves bile flow, and it aids in the elimination of fats, and it is cooling, so we can etrapolate that it clears Damp Heat.
I later put her on 7 Forests Lysimachia 3 in addition to the Taraxogen (contains Jin Qian Cao - Lysimachia, Hai Jin Sha Cao-lygodium spores
Ji Nei Jin - Gallus)
I used this formula, designed for dissolving Gall Bladder stones, as I figured that she probably had micro crystallizations of bile stone formation that were contributing to the three diagnoses. Obviously the cholecystectomy was just attacking the symptoms.
Fish Oil. 3-5 tablespoons a day.
Once she went on the two previous formulas she could tolerate the fish oil with no problems.
This last addition
Lifestyle prescription: Moderate exercise. She tried to do some walking every day.
Her diet was pretty clean.
Results: For the first 5 weeks that I treated this patient I missed the obvious imbalance staring at me in the form of this giant cholecystectomy scar. I concenmtrated my treatments oon the patients Heart and Shen and Liver, to no very great effect. It was very hard to witness this patients extreme mental anguish and not to be able to help her very much. THe first breakthrough was the Taraxogen formula whish shifted her from breakdown and suicidal despair to holding her depression in the context of something she could get a handle on. The effect was dramatic. The Liver Qi Stagnation did not respond to the usual Xiao Yao variations, nor to Shu Gan etc. It responded dramatically to addressing the Bile function. THe next big breakthrough was putting her on a high dose of Fish oil. There is a lot of recent research into the anti-depressant effects of Omega three fatty acids and DHA oil, a component of fish oil. I suspect that her Gall Bladder blockage, or micro crystalization in the bile ducts of the Liver was impeding her ability to utilize fat, which gradually caused an underlying Heart Yin deficiency and Shen disturbance. Once fat reabsorbtion was facilitated the symptoms abated, and in this case, to a dramatic extent.
Western diagnosis: depression, generalized anxiety disorder
Medical History: 42 year old female. Extreme despair every morning, characterized by great anxiety, terror of organizing her life, suicidal thoughts, fatigue.
Questioning exam: The patient revealed that she vomited bile on many mornings and she had had a cholecystectomy 3 years previously. She was intolerant of fat.She had struggled with weight gain and was overweight, gaining 60lbs. in three years.She had a very large scar under the right rib cage from the surgery.
Pulse exam: pulse was slippery bounding and full on the surface at the guan position and deficient in the cun and chi positions.
Palpation of the belly showed tightness around the Liver and at CV.14 and 15.
Tongue exam: The tongue was surprising in how normal it looked!
OM Diagnosis: Gall Bladder Qi Deficiency. Gall Bladder Damp Heat. Liver Qi Stagnation. Heart Yin Deficiency
I don't know if you can have both Gall BLadder Qi Deficiency and Damp Heat simultaneously in strict TCM thinking, but I think this patient had both! I think she was Gall BLadder Qi deficient giving rise to the extreme fear of Life and paralysing fear when having to decide anything. I think she had Gall Bladder Damp Heat as there was an urgent, excess, agitated quality underlying the depression with the suggestion of rash action. There was also the vomiting of bile 3-4 times a week and the wight gain and intolerance of fat.
Treatment Principle: Purge Gall Bladder Damp Heat, strengthen Gall Bladder functioning.
Point Prescription: Needling around the prominent cholecystectomy scar.every treatment. GB 34 threaded 4" to just below Sp.9 bilaterally every treatment.
CV.6, 12, 14
Herbal Formula: 7 Forests 'Taraxogen'
which consists of:
Dandelion extract - Pu Gong Ying
Lotus Leaf extract - He Ye
Lysimachia extract - Jin Qian Cao
Artichoke leaf extract
This formula is very cholagogic i.e. it improves bile flow, and it aids in the elimination of fats, and it is cooling, so we can etrapolate that it clears Damp Heat.
I later put her on 7 Forests Lysimachia 3 in addition to the Taraxogen (contains Jin Qian Cao - Lysimachia, Hai Jin Sha Cao-lygodium spores
Ji Nei Jin - Gallus)
I used this formula, designed for dissolving Gall Bladder stones, as I figured that she probably had micro crystallizations of bile stone formation that were contributing to the three diagnoses. Obviously the cholecystectomy was just attacking the symptoms.
Fish Oil. 3-5 tablespoons a day.
Once she went on the two previous formulas she could tolerate the fish oil with no problems.
This last addition
Lifestyle prescription: Moderate exercise. She tried to do some walking every day.
Her diet was pretty clean.
Results: For the first 5 weeks that I treated this patient I missed the obvious imbalance staring at me in the form of this giant cholecystectomy scar. I concenmtrated my treatments oon the patients Heart and Shen and Liver, to no very great effect. It was very hard to witness this patients extreme mental anguish and not to be able to help her very much. THe first breakthrough was the Taraxogen formula whish shifted her from breakdown and suicidal despair to holding her depression in the context of something she could get a handle on. The effect was dramatic. The Liver Qi Stagnation did not respond to the usual Xiao Yao variations, nor to Shu Gan etc. It responded dramatically to addressing the Bile function. THe next big breakthrough was putting her on a high dose of Fish oil. There is a lot of recent research into the anti-depressant effects of Omega three fatty acids and DHA oil, a component of fish oil. I suspect that her Gall Bladder blockage, or micro crystalization in the bile ducts of the Liver was impeding her ability to utilize fat, which gradually caused an underlying Heart Yin deficiency and Shen disturbance. Once fat reabsorbtion was facilitated the symptoms abated, and in this case, to a dramatic extent.
Early morning diarrhea
Chief Complaint: Early morning diarrhea which is worse just before and during menses
Medical History: Generally nervous person, tends to internalize stress. Too much cold and sweet food. Exercises daily. Drinks wine several times per week. Previous antibiotic use with subsequent yeast infections.
Questioning exam: Symptoms worse with period.
Symptoms worse in the winter. Symptoms worse with stress.
Pulse exam: wiry pulse which is slightly slow, very thin
Tongue exam: Puffy, pale, thin white coat, slightly purple body
OM Diagnosis: Liver Qi stagnation overacting on the spleen, over time this combined with poor eating habits caused the Spleen yang to get week.
Treatment Principle: Regulate Liver Qi, Warm spleen Yang
Point Prescription: Right side: LI4, SJ5, Sp9, LV3
Left side: P6, St36, St37, GB41
Also: R6 with moxa cones
Herbal Formula: Herbal Pills:
1)Mu Xiang Shun Qi Wan - 8 pills 3x/day
2)Xiang Fu Li Zhong Wan -8 pills 3x/day
3)Pro Biotics - 2 pills daily
After symptoms were gone for 1 month, I replaced Xing Fu Li Zhong Wan for Dang Gui Teapills.
Lifestyle prescription: Eat warm, cooked foods. Minimize alcohol and sugar consumption.
Results: Excellent results. Over the course of two menstrual cycles the chronic diarrhea gradually reduced, and now, 3 months later, all symptoms are gone. She also has better periods, and more energy, and feels less nervouse.
Synopsis: Good Result.
Medical History: Generally nervous person, tends to internalize stress. Too much cold and sweet food. Exercises daily. Drinks wine several times per week. Previous antibiotic use with subsequent yeast infections.
Questioning exam: Symptoms worse with period.
Symptoms worse in the winter. Symptoms worse with stress.
Pulse exam: wiry pulse which is slightly slow, very thin
Tongue exam: Puffy, pale, thin white coat, slightly purple body
OM Diagnosis: Liver Qi stagnation overacting on the spleen, over time this combined with poor eating habits caused the Spleen yang to get week.
Treatment Principle: Regulate Liver Qi, Warm spleen Yang
Point Prescription: Right side: LI4, SJ5, Sp9, LV3
Left side: P6, St36, St37, GB41
Also: R6 with moxa cones
Herbal Formula: Herbal Pills:
1)Mu Xiang Shun Qi Wan - 8 pills 3x/day
2)Xiang Fu Li Zhong Wan -8 pills 3x/day
3)Pro Biotics - 2 pills daily
After symptoms were gone for 1 month, I replaced Xing Fu Li Zhong Wan for Dang Gui Teapills.
Lifestyle prescription: Eat warm, cooked foods. Minimize alcohol and sugar consumption.
Results: Excellent results. Over the course of two menstrual cycles the chronic diarrhea gradually reduced, and now, 3 months later, all symptoms are gone. She also has better periods, and more energy, and feels less nervouse.
Synopsis: Good Result.
Vertigo
Chief Complaint: Dizziness
Western diagnosis: Vertigo
Medical History: Weight training 2x a week. Eats lots of fatty foods, sweet cravings. Drinks a lot of coffee
Questioning exam: Migraine headaches for 6 months. Painful periods, clotting, heavy flow, ringing in ears, dry mouth, thirst for cold drinks
Pulse exam: Primary Liver deficient pulse, Wiry
Cross pattern abdominal exam
OM Diagnosis: Liver yang rising with an underlying Liver blood stagnation
Treatment Principle: Subdue Liver Yang, Move Liver Blood
Point Prescription: Manaka ion cord treatment - TW5 to GB41, PC6 to SP4
added: LV3, SP6, GV20, GB20,CV4,KID3,Taiyang,BL18,BL20,BL23
Lifestyle prescription: Suggested quit coffee. Patient started yoga. Changed diet to more warm foods, less iced drinks and sweets
Results: Dizziness cleared in three treatments. Migraines susided. Periods less painful, no clotting
Western diagnosis: Vertigo
Medical History: Weight training 2x a week. Eats lots of fatty foods, sweet cravings. Drinks a lot of coffee
Questioning exam: Migraine headaches for 6 months. Painful periods, clotting, heavy flow, ringing in ears, dry mouth, thirst for cold drinks
Pulse exam: Primary Liver deficient pulse, Wiry
Cross pattern abdominal exam
OM Diagnosis: Liver yang rising with an underlying Liver blood stagnation
Treatment Principle: Subdue Liver Yang, Move Liver Blood
Point Prescription: Manaka ion cord treatment - TW5 to GB41, PC6 to SP4
added: LV3, SP6, GV20, GB20,CV4,KID3,Taiyang,BL18,BL20,BL23
Lifestyle prescription: Suggested quit coffee. Patient started yoga. Changed diet to more warm foods, less iced drinks and sweets
Results: Dizziness cleared in three treatments. Migraines susided. Periods less painful, no clotting
Dysmenorrhea
Chief Complaint: Period pain
Western diagnosis: dysmenorrhea
Medical History: Patient was a young woman of healthy appearance. She is a student and works at a gym as a personal trainer. She is VERY active, and tries to eat healthily - mainly raw foods. She drinks eight glasses of water a day. The pain began about six months after starting her job at the gym. She also has considerable strain put on her through her studies, and her eating and sleeping can become erratic.
Questioning exam: The pain begins on the first day of her period and sometimes remains after the period has finished. It is a dull ache that radiates to the small of her back, and is worse when she sleeps at night - or when she just lies down. When asked she also experiences pain on the medial side of her left knee. Sometimes upon rising too quickly she feels dizzy. Urine is pale and frequent, although she does drink a lot of water. Her menses are light (colour and amount), with occassional clots, lasting four days. The pain responds well to pressure and warmth, esp. on her back. Vivid dreams but otherwise normal sleep. Defecation normal. Dull occipital headaches, but only occassionally.
Pulse exam: Pulse quality is generally deep and thready, and can barely be palpated in the chi position. Upon plpation the abdomen feels cool, with some guarding over the liver, the lower back is also cool and the muscles seem to lack strength.
Tongue exam: The tongue appears normal. It is pink with a thin white coat. On closer inspection the coat thickens slightly at the root, and the body is a little pale.
OM Diagnosis: As the pain occurs DURING and AFTER the period, this suggests deficiency, as does the scanty flow, and the relief offered through warmth and pressure. The scanty flow would suggest a blood AND qi deficiency. The back and knee pain, the dizziness, and the headaches point to the Kidney suffering some impairment, and the liver would also be expected as it regulates the menses, and abdominal palpation showed some organ distress through the muscle guarding. Her lifestyle and eating habits are also depleting her jing if she is not eating always correctly, and stress from study could also be compounding her physical problems.
Treatment Principle: Replenish the Qi, and tonify the Liver and Kidney organs to adjust menses and relieve pain.
Point Prescription: First: Sp6, Cv4 (warm-needling), St36, Kd3
then: Bl17, Bl20, bl23, bl18, (to reinforce the organs and for the yang effect of the back shu).
Herbal Formula: zou gui wan
Lifestyle prescription: She was drinking all that water chilled - so drinks at room temperature or warmer. No raw food (or very little if she can help it). No more wearing jeans that leave the lower stomach and back uncovered. add ginger to her cups of tea and/or cooking. try to relieve stress and not over-exercise.
Results: Vast difference to pain and energy levels (which she hadn't complained of initially and thought were fine). Kidney pulse now palpable. General pulse quality not as good as it should be.
Synopsis: This young woman found it hard to understand why her 'healthy' lifestyle had caused her such problems. Like most people her age she was the victim of western misinformation with regards to comsuming raw foods and excessive exercising, and western fashion with inappropriate clothing (a less important point obviously). It was hard for her to change the habits of a lifetime (and a culture) but the obvious change in her health and energy levels were enough of an incentive.
Western diagnosis: dysmenorrhea
Medical History: Patient was a young woman of healthy appearance. She is a student and works at a gym as a personal trainer. She is VERY active, and tries to eat healthily - mainly raw foods. She drinks eight glasses of water a day. The pain began about six months after starting her job at the gym. She also has considerable strain put on her through her studies, and her eating and sleeping can become erratic.
Questioning exam: The pain begins on the first day of her period and sometimes remains after the period has finished. It is a dull ache that radiates to the small of her back, and is worse when she sleeps at night - or when she just lies down. When asked she also experiences pain on the medial side of her left knee. Sometimes upon rising too quickly she feels dizzy. Urine is pale and frequent, although she does drink a lot of water. Her menses are light (colour and amount), with occassional clots, lasting four days. The pain responds well to pressure and warmth, esp. on her back. Vivid dreams but otherwise normal sleep. Defecation normal. Dull occipital headaches, but only occassionally.
Pulse exam: Pulse quality is generally deep and thready, and can barely be palpated in the chi position. Upon plpation the abdomen feels cool, with some guarding over the liver, the lower back is also cool and the muscles seem to lack strength.
Tongue exam: The tongue appears normal. It is pink with a thin white coat. On closer inspection the coat thickens slightly at the root, and the body is a little pale.
OM Diagnosis: As the pain occurs DURING and AFTER the period, this suggests deficiency, as does the scanty flow, and the relief offered through warmth and pressure. The scanty flow would suggest a blood AND qi deficiency. The back and knee pain, the dizziness, and the headaches point to the Kidney suffering some impairment, and the liver would also be expected as it regulates the menses, and abdominal palpation showed some organ distress through the muscle guarding. Her lifestyle and eating habits are also depleting her jing if she is not eating always correctly, and stress from study could also be compounding her physical problems.
Treatment Principle: Replenish the Qi, and tonify the Liver and Kidney organs to adjust menses and relieve pain.
Point Prescription: First: Sp6, Cv4 (warm-needling), St36, Kd3
then: Bl17, Bl20, bl23, bl18, (to reinforce the organs and for the yang effect of the back shu).
Herbal Formula: zou gui wan
Lifestyle prescription: She was drinking all that water chilled - so drinks at room temperature or warmer. No raw food (or very little if she can help it). No more wearing jeans that leave the lower stomach and back uncovered. add ginger to her cups of tea and/or cooking. try to relieve stress and not over-exercise.
Results: Vast difference to pain and energy levels (which she hadn't complained of initially and thought were fine). Kidney pulse now palpable. General pulse quality not as good as it should be.
Synopsis: This young woman found it hard to understand why her 'healthy' lifestyle had caused her such problems. Like most people her age she was the victim of western misinformation with regards to comsuming raw foods and excessive exercising, and western fashion with inappropriate clothing (a less important point obviously). It was hard for her to change the habits of a lifetime (and a culture) but the obvious change in her health and energy levels were enough of an incentive.
Bowen's Disease. AKA- Intraepidermal Squamous Cell Carcinoma
Chief Complaint: "Severe dysplasia of vulva and rectum". Secondary complaint of "recurring shingles due to weak immune system".
Western diagnosis: Bowen's Disease. AKA- Intraepidermal Squamous Cell Carcinoma
Medical History: This woman, age 42, works as a Hollywood talent agent, where intense stress is a minimum daily requirement. Her dysplasia issue began or was diagnosed 18 years prior to this treatment (10/9/01). She had received seven surgeries and/or laser treatment to excise the malignancy sites over that time. Her first malignancy operation was in 1984 with the other surgeries occurring periodically to 1999. As a young woman she had a history of menstrual problems, including "bursting" cysts and tumors (fibroid ?), had one ovary removed at age 19 and eventually a total hysterectomy in July of '99. She was taking Nexium to treat her job related ulcers. She had daily "migraine" headaches and was taking Imitrex. She had an overactive bladder and had a prescription for Detrol to treat that problem.
Exercise was minimal and because of her job pressures she drank a lot of Latte's and she smoked She recently started to eat junk food because she wanted to gain weight after losing 35 lbs. in a seven month period
Questioning exam: Because of her long allopathic medical history she brought her diagnosis to me, although no medical reports or test results were offered. I had to interpret that diagnosis in the TCM paradigm and prioritize my treatment to her most serious problems, cancer, headache, urination. At the time of our initial visit she said she wanted to "try anything" to improve her condition before her next visit with her oncologist in 2 weeks, so that, hopefully, she could avoid yet another painful surgery. The symptoms she complained of in addition to the previously mentioned were: shoulder/neck pain, palpitations, insomnia, loose stools, AM fatigue, weird red bruises on legs, worried about everything (life), pain in mid-back, low libido, PM fatigue but can't sleep, and stomach pain.
Pulse exam: The pulse overall was choppy with an irregular missed beat. The rate was generally 64 +- beats a minute, but the rate varied from a fast rate which would slow gradually to it's missed beat, then it would resume a more urgent pace. Both sides were wiry, the left side was thready and the right side slippery, with the Lung position superficial and the Spleen position weak/deep. She reported a history of low blood pressure -89/?.
Tongue exam: The tongue body was small and red, with a lurid red tip. The front/side 1/3rd swollen and wider than the back 2/3rds. The tongue coating was thick and yellow in the back 1/3rd.
OM Diagnosis: Systemic Blood-Heat-Toxin, especially in Chong/Ren. Liver Qi/Blood Stagnation leading to Liver Fire. Xu of Qi, Blood, Yin, and Wei Qi. Damp-Heat Obstructing Lower Jiao.
Treatment Principle: Help her.
Point Prescription: There were four treatment sessions (10/9, 15, 19, 23) with 20-33 points needled, plus Ear points, each time. There was a problem with her ability to retain body needles for longer than 10 - 15 mins. due to her need to urinate, so not all points were needled bilaterally. Every treatment contained: LI-4, 10, Yintang, SP-4, 10, with some Liver, GB, and Stomach points. The variations, as symptom complaints changed, were: LI-11, LU-7, 9, SJ-5, Taiyang, GB-14, 34, 41, 43, Liv-2,3,5,8, SP-6, 9, ST-25, 36, 40, 41, K- 3, 27, UB-28, 32, and DU-14.
Ear points (5-10 per treatment) were selected from: Shenmen, Endocrine, Heart, Ext. Genital, Vitality, Thymus, Thalamus, and Rectum.
Herbal Formula: The first treatment I recommended Ba Zheng San patent 12 pills/3x. The next time I changed to Zhi Bai Di Huang Wan 12/3x because I thought it was more of a deficiency issue. I then wrote and ordered a custom powder formula from Qualiherb based on Yin Qiao Hong Teng Jie Du Tang which she got on her third visit. I named it "Linda's Latte'" and it contained:
Jin Yin Hua, Lian Qiao, Hong Teng, Bai Jiang Cao-20 (raw gram), Dan Shen, Yi Yi Ren, Xi Yang Shen-15, Chi Shao, Bai Shao, Tao Ren, Fu Ling-12, Mu Dan Pi, Yan Hu Suo, Chuan Lian Zi, Xiang Fu, Gan Cao, Sha Shen, Zhu Ling-9, Zhi Zi-6, Ku Shen-4. I recommended 9 gram spoons a day to start, and to gradually work up to 20 a day, 1 hour before eating.
Lifestyle prescription: None. Like many smokers she knows it's not good, but job pressures support her smoking or cause her to return after periods of no smoking.
Results:
Dysplasia: Unknown
Headache: Unaffected
Urination: Unchanged
Insomnia: Reports able to sleep 8
hours on night before 4th visit
Pulse: mild missed beat by third visit,didn't slow down/stop by 4th visit, also, not as weak in the Spleen position.
Tongue: less luridly red overall and less area of red around tip
Synopsis: Considering the drastic nature of her general health condition and the limited time schedule I can't complain about the results. In some ways she was not a good candidate for Acupuncture because she could not retain the needles for very long and because she was also paying a lot of cash to her numerous medical doctor specialists (insurance tapped out) she couldn't afford to continue with me, especially if I wouldn't "guarantee" the results with a percentage survival/improvement prognosis number the way her "real" doctors do. She also found the powder formula to be the worst tasting experience of her life, but reported that she took 6 spoons/3x in the four days she had it between visits #3 and #4. She was going to see her oncologist the next day after treatment #4 and did not return after that. She called 10/31 to report that the formula had caused a throat irritation, with redness and swelling around her uvula, which stopped when she terminated her herb intake. I did not ask her if she had any changes in her smoking habits in that same time period. Because it was clear that she was not returning or continuing with herb therapy no adjustments were recommended to her.
I like working with this type of difficult and challenging chronic case (although I like having a more cooperative person to work with) and was heartened by the improvements we were able to achieve in a limited time, with limited financial resources, and with a limited number of treatments.
Western diagnosis: Bowen's Disease. AKA- Intraepidermal Squamous Cell Carcinoma
Medical History: This woman, age 42, works as a Hollywood talent agent, where intense stress is a minimum daily requirement. Her dysplasia issue began or was diagnosed 18 years prior to this treatment (10/9/01). She had received seven surgeries and/or laser treatment to excise the malignancy sites over that time. Her first malignancy operation was in 1984 with the other surgeries occurring periodically to 1999. As a young woman she had a history of menstrual problems, including "bursting" cysts and tumors (fibroid ?), had one ovary removed at age 19 and eventually a total hysterectomy in July of '99. She was taking Nexium to treat her job related ulcers. She had daily "migraine" headaches and was taking Imitrex. She had an overactive bladder and had a prescription for Detrol to treat that problem.
Exercise was minimal and because of her job pressures she drank a lot of Latte's and she smoked She recently started to eat junk food because she wanted to gain weight after losing 35 lbs. in a seven month period
Questioning exam: Because of her long allopathic medical history she brought her diagnosis to me, although no medical reports or test results were offered. I had to interpret that diagnosis in the TCM paradigm and prioritize my treatment to her most serious problems, cancer, headache, urination. At the time of our initial visit she said she wanted to "try anything" to improve her condition before her next visit with her oncologist in 2 weeks, so that, hopefully, she could avoid yet another painful surgery. The symptoms she complained of in addition to the previously mentioned were: shoulder/neck pain, palpitations, insomnia, loose stools, AM fatigue, weird red bruises on legs, worried about everything (life), pain in mid-back, low libido, PM fatigue but can't sleep, and stomach pain.
Pulse exam: The pulse overall was choppy with an irregular missed beat. The rate was generally 64 +- beats a minute, but the rate varied from a fast rate which would slow gradually to it's missed beat, then it would resume a more urgent pace. Both sides were wiry, the left side was thready and the right side slippery, with the Lung position superficial and the Spleen position weak/deep. She reported a history of low blood pressure -89/?.
Tongue exam: The tongue body was small and red, with a lurid red tip. The front/side 1/3rd swollen and wider than the back 2/3rds. The tongue coating was thick and yellow in the back 1/3rd.
OM Diagnosis: Systemic Blood-Heat-Toxin, especially in Chong/Ren. Liver Qi/Blood Stagnation leading to Liver Fire. Xu of Qi, Blood, Yin, and Wei Qi. Damp-Heat Obstructing Lower Jiao.
Treatment Principle: Help her.
Point Prescription: There were four treatment sessions (10/9, 15, 19, 23) with 20-33 points needled, plus Ear points, each time. There was a problem with her ability to retain body needles for longer than 10 - 15 mins. due to her need to urinate, so not all points were needled bilaterally. Every treatment contained: LI-4, 10, Yintang, SP-4, 10, with some Liver, GB, and Stomach points. The variations, as symptom complaints changed, were: LI-11, LU-7, 9, SJ-5, Taiyang, GB-14, 34, 41, 43, Liv-2,3,5,8, SP-6, 9, ST-25, 36, 40, 41, K- 3, 27, UB-28, 32, and DU-14.
Ear points (5-10 per treatment) were selected from: Shenmen, Endocrine, Heart, Ext. Genital, Vitality, Thymus, Thalamus, and Rectum.
Herbal Formula: The first treatment I recommended Ba Zheng San patent 12 pills/3x. The next time I changed to Zhi Bai Di Huang Wan 12/3x because I thought it was more of a deficiency issue. I then wrote and ordered a custom powder formula from Qualiherb based on Yin Qiao Hong Teng Jie Du Tang which she got on her third visit. I named it "Linda's Latte'" and it contained:
Jin Yin Hua, Lian Qiao, Hong Teng, Bai Jiang Cao-20 (raw gram), Dan Shen, Yi Yi Ren, Xi Yang Shen-15, Chi Shao, Bai Shao, Tao Ren, Fu Ling-12, Mu Dan Pi, Yan Hu Suo, Chuan Lian Zi, Xiang Fu, Gan Cao, Sha Shen, Zhu Ling-9, Zhi Zi-6, Ku Shen-4. I recommended 9 gram spoons a day to start, and to gradually work up to 20 a day, 1 hour before eating.
Lifestyle prescription: None. Like many smokers she knows it's not good, but job pressures support her smoking or cause her to return after periods of no smoking.
Results:
Dysplasia: Unknown
Headache: Unaffected
Urination: Unchanged
Insomnia: Reports able to sleep 8
hours on night before 4th visit
Pulse: mild missed beat by third visit,didn't slow down/stop by 4th visit, also, not as weak in the Spleen position.
Tongue: less luridly red overall and less area of red around tip
Synopsis: Considering the drastic nature of her general health condition and the limited time schedule I can't complain about the results. In some ways she was not a good candidate for Acupuncture because she could not retain the needles for very long and because she was also paying a lot of cash to her numerous medical doctor specialists (insurance tapped out) she couldn't afford to continue with me, especially if I wouldn't "guarantee" the results with a percentage survival/improvement prognosis number the way her "real" doctors do. She also found the powder formula to be the worst tasting experience of her life, but reported that she took 6 spoons/3x in the four days she had it between visits #3 and #4. She was going to see her oncologist the next day after treatment #4 and did not return after that. She called 10/31 to report that the formula had caused a throat irritation, with redness and swelling around her uvula, which stopped when she terminated her herb intake. I did not ask her if she had any changes in her smoking habits in that same time period. Because it was clear that she was not returning or continuing with herb therapy no adjustments were recommended to her.
I like working with this type of difficult and challenging chronic case (although I like having a more cooperative person to work with) and was heartened by the improvements we were able to achieve in a limited time, with limited financial resources, and with a limited number of treatments.
Epigastric pain
Chief Complaint: Epigastric pain
Medical History: Male, 29
At age 16 the patient realized he couldn't eat fried, greasy or rich foods on the same day as playing soccer without experiencing a burning sensation from the stomach to the throat. Began taking pepsid with a little improvement. At age 21, while in Sri Lanka he ate some yogurt which made burning so bad that the pepsid did not work. Accompanying symptoms included slight fever, irritability, and profuse diarrhea with a fetid odor and a burning sensation. Upon return to the U.S. he was diagnosed with Giardia and Amoebas. Prescribed Flagal which stopped diarrhea. Prescribed Prilosec for reflux which helped. At age 22, he stopped Prilosec and began managing the reflux with Chinese herbs.
Questioning exam: Currently.
epigastric pain from stomach to bottom of throat. worse after eating rich, fried or greasy foods. worse with alcohol and stress. better with heat. no improvement with acupuncture. Sleep-good, urination-normal, bowel movements-loose, appetite-good, avoids irritating foods
Pulse exam: wiry, slippery
slow (55 bpm)
Tongue exam: TB: puffy, slt. purple,
TC: thin white,
OM Diagnosis: Liver invading Spleen w/ Stomach qi counterflow
Treatment Principle: calm liver, tonify relieve pain
Point Prescription: Lv 3, 13, 14 ; PC6, Ren 12, Sp 4
Herbal Formula: Chai Hu Shu Gan San
Lifestyle prescription: avoid aggravating foods.
manage stress level.
avoid overeating raw foods
Results: after 3 acupuncture treatment and two weeks with the herbs the diarrhea stopped and the epigastric pain was significantly lower. patient left for vacation and upon retun there was no pain.
Synopsis: this is a chronic disease and difficult to eliminate completely. perhaps the most important factors to prevent it's re-occurance are to make lifestyle and dietary changes.
Medical History: Male, 29
At age 16 the patient realized he couldn't eat fried, greasy or rich foods on the same day as playing soccer without experiencing a burning sensation from the stomach to the throat. Began taking pepsid with a little improvement. At age 21, while in Sri Lanka he ate some yogurt which made burning so bad that the pepsid did not work. Accompanying symptoms included slight fever, irritability, and profuse diarrhea with a fetid odor and a burning sensation. Upon return to the U.S. he was diagnosed with Giardia and Amoebas. Prescribed Flagal which stopped diarrhea. Prescribed Prilosec for reflux which helped. At age 22, he stopped Prilosec and began managing the reflux with Chinese herbs.
Questioning exam: Currently.
epigastric pain from stomach to bottom of throat. worse after eating rich, fried or greasy foods. worse with alcohol and stress. better with heat. no improvement with acupuncture. Sleep-good, urination-normal, bowel movements-loose, appetite-good, avoids irritating foods
Pulse exam: wiry, slippery
slow (55 bpm)
Tongue exam: TB: puffy, slt. purple,
TC: thin white,
OM Diagnosis: Liver invading Spleen w/ Stomach qi counterflow
Treatment Principle: calm liver, tonify relieve pain
Point Prescription: Lv 3, 13, 14 ; PC6, Ren 12, Sp 4
Herbal Formula: Chai Hu Shu Gan San
Lifestyle prescription: avoid aggravating foods.
manage stress level.
avoid overeating raw foods
Results: after 3 acupuncture treatment and two weeks with the herbs the diarrhea stopped and the epigastric pain was significantly lower. patient left for vacation and upon retun there was no pain.
Synopsis: this is a chronic disease and difficult to eliminate completely. perhaps the most important factors to prevent it's re-occurance are to make lifestyle and dietary changes.
Trigeminal Neuralgia
Chief Complaint: Facial Pain
Western diagnosis: Trigeminal Neuralgia
Medical History: Patient is a 50 years old male, well nourished. Physical examination revealed 135/95 blood pressure, otherwise appears to be in good health.
Blood Analysis: within normal range
MRI of the brain: Findings: the internal carotid and basilar arteries, proximal anterior and middle cerebral arteries are normal in caliber, contour and signal intensity. No congenital aneurysm or mass effect.
Impression: Normal examination.
Questioning exam: Patient suffers of severe attacks of facial pain (L) lasting for about 30 to 45 seconds followed by a burning sensation lasting 2 to 3 minutes.
The period of pain free after each attack was of about one hour. Any light touch or movement would trigger the pain at any time.
Pulse exam: Wiry and rapid.
Tongue exam: Revealed white thin coat with yellowish coat in front and red body.
OM Diagnosis: According to the nature of the pain and other signs, such as the yellow coat, red body of the tongue, a burning sensation in the face and a wiry pulse. The diagnosis was wind-heat invading the face.
Treatment Principle: Dispel wind-heat and treat the pain.
Point Prescription: The first and second treatments were to the right side of the face (opposite to the pain)
ST-4 toward ST-6 with a retention time of 30 minutes - even
ST-6 toward ST-4 with a retention time of 30 minutes - even
SJ-17 with a retention time of 30 minutes - lift and thrust for 1 minute (reduction)
LI-4 to remove qi and blood stagnation - lift and thrust for 1 minute (reduction)
LU-7 to remove qi and blood stagnation - lift and thrust for 1 minute (reduction)
GB-20 to dispel wind, retention of 30 minutes
LIV-3 - retention 30 minutes
The next treatments were to the left side (side of pain)
ST-4 toward ST-6 with a retention time of 30 minutes - lift and thrust for 1 minute
(reduction)
ST-6 toward ST-4 with a retention time of 30 minutes - lift and thrust for 1 minute
(reduction)
SJ-17 with a retention time of 30 minutes - lift and thrust for 1 minute (reduction)
LI-4 to remove qi and blood stagnation - lift and thrust for 1 minute (reduction)
LU-7 to remove qi and blood stagnation - lift and thrust for 1 minute (reduction)
GB-20 to dispel wind, retention of 30 minutes
LIV-3 - retention 30 minutes
Herbal Formula: List of herbs taken for TN and HBP
Da huang 4gms
Huang lian 2gms
Huang qin 2gms
Wu gong 1.5gms
Chan tui 6gms
Tian ma 6gms
Gou teng 6gms
Shi jue ming 15gms
Zhi zi 3gms
Yi mu cao 5gms
Du zong 6gms
San ji sheng 6gms
Fu shen 6gms
Chuan niu xi 6gms
Decoction, 3 cups 3 times a day - 3 wks.
Lifestyle prescription: No alcohol, no caffeine, fat free diet, reduction of intake of red meat. Take Vitamin B complex, B6, C.
Results: Western medical doctors were not able to detect the reason of the trigeminal neuralgia. To minimize the pain and reduce the high blood pressure, the patient was prescribed TEGRETOL AND ATENOLOL for life, with increments of dosage as needed.
Acupuncture treatments:
The first treatment was with no results at all.
The second treatment stopped the pain for about 4 hours, then pain came back about every 2 hours.
After the third treatment the attacks of pain came back every 3 hours more or less but with an intensity of only 20% and only in the day time. His blood pressure remains stable 130/85
Synopsis: The patient was taking medication for the trigeminal neuralgia and high blood pressure. Now he is almost pain free. Once in a while the pain cames back but with an intensity of 3 to 5 % only.
Patient remain in treatment once a month and he is not taking TEGRETOL any longer neither ATENOLOL.
Blood pressure stable 130/85. currently taken Tian ma gou teng yin.
Decoction, one cup a day.
Western diagnosis: Trigeminal Neuralgia
Medical History: Patient is a 50 years old male, well nourished. Physical examination revealed 135/95 blood pressure, otherwise appears to be in good health.
Blood Analysis: within normal range
MRI of the brain: Findings: the internal carotid and basilar arteries, proximal anterior and middle cerebral arteries are normal in caliber, contour and signal intensity. No congenital aneurysm or mass effect.
Impression: Normal examination.
Questioning exam: Patient suffers of severe attacks of facial pain (L) lasting for about 30 to 45 seconds followed by a burning sensation lasting 2 to 3 minutes.
The period of pain free after each attack was of about one hour. Any light touch or movement would trigger the pain at any time.
Pulse exam: Wiry and rapid.
Tongue exam: Revealed white thin coat with yellowish coat in front and red body.
OM Diagnosis: According to the nature of the pain and other signs, such as the yellow coat, red body of the tongue, a burning sensation in the face and a wiry pulse. The diagnosis was wind-heat invading the face.
Treatment Principle: Dispel wind-heat and treat the pain.
Point Prescription: The first and second treatments were to the right side of the face (opposite to the pain)
ST-4 toward ST-6 with a retention time of 30 minutes - even
ST-6 toward ST-4 with a retention time of 30 minutes - even
SJ-17 with a retention time of 30 minutes - lift and thrust for 1 minute (reduction)
LI-4 to remove qi and blood stagnation - lift and thrust for 1 minute (reduction)
LU-7 to remove qi and blood stagnation - lift and thrust for 1 minute (reduction)
GB-20 to dispel wind, retention of 30 minutes
LIV-3 - retention 30 minutes
The next treatments were to the left side (side of pain)
ST-4 toward ST-6 with a retention time of 30 minutes - lift and thrust for 1 minute
(reduction)
ST-6 toward ST-4 with a retention time of 30 minutes - lift and thrust for 1 minute
(reduction)
SJ-17 with a retention time of 30 minutes - lift and thrust for 1 minute (reduction)
LI-4 to remove qi and blood stagnation - lift and thrust for 1 minute (reduction)
LU-7 to remove qi and blood stagnation - lift and thrust for 1 minute (reduction)
GB-20 to dispel wind, retention of 30 minutes
LIV-3 - retention 30 minutes
Herbal Formula: List of herbs taken for TN and HBP
Da huang 4gms
Huang lian 2gms
Huang qin 2gms
Wu gong 1.5gms
Chan tui 6gms
Tian ma 6gms
Gou teng 6gms
Shi jue ming 15gms
Zhi zi 3gms
Yi mu cao 5gms
Du zong 6gms
San ji sheng 6gms
Fu shen 6gms
Chuan niu xi 6gms
Decoction, 3 cups 3 times a day - 3 wks.
Lifestyle prescription: No alcohol, no caffeine, fat free diet, reduction of intake of red meat. Take Vitamin B complex, B6, C.
Results: Western medical doctors were not able to detect the reason of the trigeminal neuralgia. To minimize the pain and reduce the high blood pressure, the patient was prescribed TEGRETOL AND ATENOLOL for life, with increments of dosage as needed.
Acupuncture treatments:
The first treatment was with no results at all.
The second treatment stopped the pain for about 4 hours, then pain came back about every 2 hours.
After the third treatment the attacks of pain came back every 3 hours more or less but with an intensity of only 20% and only in the day time. His blood pressure remains stable 130/85
Synopsis: The patient was taking medication for the trigeminal neuralgia and high blood pressure. Now he is almost pain free. Once in a while the pain cames back but with an intensity of 3 to 5 % only.
Patient remain in treatment once a month and he is not taking TEGRETOL any longer neither ATENOLOL.
Blood pressure stable 130/85. currently taken Tian ma gou teng yin.
Decoction, one cup a day.
HIV Positive
Chief Complaint: Fatigue, nausea and loss of appetite.
Western diagnosis: HIV Positive
Medical History: Male, 33 years of age, 5'10", 175 lbs., full time student/part time bartender. Diagnosed HIV positive in 1989 remaining healthly with no complications. Currently (2002) and since 1996 patient on triple drug therapy of Indinovir, 3TC and AZT due to high viral load. Current viral load measures 200,000 copies per militer. Most notable side effects are cheif complaint of fatigue, nausea and loss of appettite. Irregularly exercises, meditates and practices Qi Gong daily. Eigth hours of sleep consistently but restless with dreams most nights, Excellent organic non vegitarian diet, mealtimes at regular hours 3x daily. Exposure to smoke daily.
Questioning exam: Extremely low energy, Patient tends to feel warm flashes and sweats easily. Feels a desire to vomit before and during meals, Little or no appetite, no taste, abdominal distention and borborygmus constantly, fatigue accompanied by dull headache, feels sleepy frequently and needs to nap in middle of the day, bowel movements twice daily soft but formed and foul smelling diarrhea two to three times week.
Pulse exam: Wiry and a little slippery. Both Kidney Yin and Yang seem weak and empty. 60bpm.
Tongue exam: Slightly dark body (light purple), slightly swollen and moist with teeth marks and thick white coat in lower jiao.
OM Diagnosis: Spleen and Stomach Qi Deficiency; fatigue, sleepiness, easily sweats with no exertion, no appettite, loose stool, abdominal distention, weak/empty pulse. Stomach Qi Stagnation; nausea, lossof appettite, decreased taste, loose stool, borborymgus. Dampness; looses stool, nausea, no appetite, moist tongue; Heat; tendancy to feel warm, chronic dry lips, darrk tongue body. Kidney Deficiency; aversion to cold weather, lassitude, apathy, poor appetite, loose stool, decreased sex drive, weak Kidney Yang pulse.
Treatment Principle: Tonify Spleen and Stomach Qi, Clear Damp Heat, Support Kidney Yin and Kidney Yang.
Point Prescription: LI4; tonify wei qi, eliminate heat in LI.
ST25 - regulate intestinal function, clears heat. Ren6 - Sea of Qi, tonifies Qi and Yang.
SP6 - strengthen SP and transform Damp.
PC6 -nausea.
ST40 - calms mind, essential for Phlegm and Damp. LI11 harmonizes ST, cools heat, relaxes patient.
Ren8 -Salt Moxa to tonify KD Yang. Yintang - calms patient.
Herbal Formula: Patient prefers patents due to time restraints and is more compliant with patent. Prescribed Health Concerns formulas Source Qi to address fatigue, nausea and loss of appetite, Marrow Plus which counteracts AZT side effects of supporting bone marrow, Clear Heat which is equivalent to an antiviral and treats the epidempic toxic heat of the virus.
Lifestyle prescription: Less smoke exposure would be very helpful. Adequate iron supplementation such as Floradix liquid iron. Stop coffee and soft drinks.
Results: Patient has reported an increase in energy and a lowered viral load since protocol began a year ago. Appetite had increased and the constant warm feeling has evened out.
Western diagnosis: HIV Positive
Medical History: Male, 33 years of age, 5'10", 175 lbs., full time student/part time bartender. Diagnosed HIV positive in 1989 remaining healthly with no complications. Currently (2002) and since 1996 patient on triple drug therapy of Indinovir, 3TC and AZT due to high viral load. Current viral load measures 200,000 copies per militer. Most notable side effects are cheif complaint of fatigue, nausea and loss of appettite. Irregularly exercises, meditates and practices Qi Gong daily. Eigth hours of sleep consistently but restless with dreams most nights, Excellent organic non vegitarian diet, mealtimes at regular hours 3x daily. Exposure to smoke daily.
Questioning exam: Extremely low energy, Patient tends to feel warm flashes and sweats easily. Feels a desire to vomit before and during meals, Little or no appetite, no taste, abdominal distention and borborygmus constantly, fatigue accompanied by dull headache, feels sleepy frequently and needs to nap in middle of the day, bowel movements twice daily soft but formed and foul smelling diarrhea two to three times week.
Pulse exam: Wiry and a little slippery. Both Kidney Yin and Yang seem weak and empty. 60bpm.
Tongue exam: Slightly dark body (light purple), slightly swollen and moist with teeth marks and thick white coat in lower jiao.
OM Diagnosis: Spleen and Stomach Qi Deficiency; fatigue, sleepiness, easily sweats with no exertion, no appettite, loose stool, abdominal distention, weak/empty pulse. Stomach Qi Stagnation; nausea, lossof appettite, decreased taste, loose stool, borborymgus. Dampness; looses stool, nausea, no appetite, moist tongue; Heat; tendancy to feel warm, chronic dry lips, darrk tongue body. Kidney Deficiency; aversion to cold weather, lassitude, apathy, poor appetite, loose stool, decreased sex drive, weak Kidney Yang pulse.
Treatment Principle: Tonify Spleen and Stomach Qi, Clear Damp Heat, Support Kidney Yin and Kidney Yang.
Point Prescription: LI4; tonify wei qi, eliminate heat in LI.
ST25 - regulate intestinal function, clears heat. Ren6 - Sea of Qi, tonifies Qi and Yang.
SP6 - strengthen SP and transform Damp.
PC6 -nausea.
ST40 - calms mind, essential for Phlegm and Damp. LI11 harmonizes ST, cools heat, relaxes patient.
Ren8 -Salt Moxa to tonify KD Yang. Yintang - calms patient.
Herbal Formula: Patient prefers patents due to time restraints and is more compliant with patent. Prescribed Health Concerns formulas Source Qi to address fatigue, nausea and loss of appetite, Marrow Plus which counteracts AZT side effects of supporting bone marrow, Clear Heat which is equivalent to an antiviral and treats the epidempic toxic heat of the virus.
Lifestyle prescription: Less smoke exposure would be very helpful. Adequate iron supplementation such as Floradix liquid iron. Stop coffee and soft drinks.
Results: Patient has reported an increase in energy and a lowered viral load since protocol began a year ago. Appetite had increased and the constant warm feeling has evened out.
Fatty liver and poorly controlled NIDDM
Chief Complaint: fatty liver and poorly controlled NIDDM
Western diagnosis: as above
Medical History: 55 yr old caucasion male. Morbidly obese.
First appointment on March 2004 pt's labs reflect triglyceride level of 1105, cholesterol of 230 and elevated AST (50's) and ALT (80's). Pt's record of blood sugars indicate his blood sugars were consistently in the high 230's. Pt was not (and is not) on any western medications. Even though pt had dangerously elevated triglycerides and blood sugars he consistently refused western medications. His MD finally referred him to acupuncture in the hopes that something could be done to stabilize the patient.
Patient does not drive and does not cook. He reports excessive appetite He either buys perpared meals at the deli counter of grocery store or goes out to eat. His only exercise was walking to the public bus.
Questioning exam: Chronic right flank pain. Chronic pain over kidneys. Wakes frequently and frequent night sweats. Short of breath with dry cough. Chronic fatigue. Verbalizes anger/frustration as well as fear of death (realistic considering his elevated labs).
Pulse exam: Pulses thin, tight and slightly rapid. Left sided chi pulse consistently the thinnest and weakest. Left sided guan pulse consistently the most prominent, however, often right sided cun pulse quite prominent too.
Abdmoninal diagonosis: exquisite tenderness in areas of Liv 13 and Liv 14, dull ache in area of GB25.
Tongue exam: Tongue body red. Anterior 2/3 peeled. Posterior 1/3 with dryish slightly yellow coat. Vertical cracks on the anterior 1/3 of tongue, bilateral (that is on both the left and right side of the tongue in the lung region). Tongue body shape normal (tongue is not swollen, scalloped or long). Slight quiver to tongue.
OM Diagnosis: Constitutional lung deficiency (vertical cracks lung area)
Stomach and lung yin xu (and by association kidney yin xu, though yin xu of kidney likely result of long-term lung yin xu) as evidenced by the red and peeled anterior 2/3 of tongue, the dry cough, night sweats, frequent hunger, slightly rapid pulse.
Liver qi stagnation as evidenced by reports of anger/frustation, fatigue, right flank pain, tenderness at Liv. 13 and 14, tight pulses, most prominent in left guan position, and abnormal liver enzymes. Some element of damp in lower jiao as evidenced by yellowish coat posterior 1/3 of tongue and high cholesterol and triglycerides.
Treatment Principle: Nourish yin, especially of lung and stomach, course liver qi, and drain damp accumulation in lower jiao. The damp accumulation in lower jiao is thought to be primarily a consequence of the depressive heat caused by the combination of the liver qi stagnation and the lung and stomach yin deficiency, so the treatment plan did not emphasize draining damp as once yin xu and liver qi stagnation is addressed it is likely the damp heat will more easily resolve.
Point Prescription: Patient seen weeklyfor first 3 months and then twice per month there after. Alternate between back and front treatments and add or subtract points depending upon specific complaints, but core point used are: Liv 13 &/or 14, Liv 3, LI4, LI11, GB34, Sp 9, Sp 6, CV 17, Cv12, Lu7, K6, K3, ST 40, Huatou at level of T17, T18, T19, Bl23, Du 4, Ren 4, Ren 5 (again, not all these points are used all the time, but they are the core points, some of which are used in each treatment depending upon patient's complaints and tongue and pulse signs). Used during every treatment are the following ear points: liver region, right ear; pancreas region right and left ears alternately; spleen region, depression region, anger region.
Herbal Formula: Initially started on combinaton of Six Flavored Tea and Free and Easy plus, 1/2 cup three times day. Pt remained on this formula for approximately 4 weeks and was then switched to the Pacific Biologics "Diabet" capsules, three capsules, three times per day and Health Concerns "Ecliptex", 1 pill 3 times per day. During periods of increased right flank pain pt is instructed to stop the Ecliptex and to take either 8 teapills (Plum Flower Brand) Shu Gan Wan 3 times per day or 8 teapills Free and Easy Plus 3 times per day (whether he takes the Shu Gan or the Free and Easy is determined by the severity of the flank pain). He takes these formulas until pain resolved and then goes back on the base formula of the Ecliptx and Diabet(for those not familiar with Diabet it is a modification for Jade Fluid decoction, with other herbs added for their emperical usefulness in treating yin xu type diabetes.
Lifestyle prescription: Pt put on a diet and exercise plan. Given the fact that pt historically did not exercise it was important to not give him unrealistic goals. Pt was simply instructed to walk for at least 20 minutes per day, at a brisk pace, 3-5 times per week, two hours after eating, eventually working up to walking 40 minutes per day, 3-5 times per week.
He was given rather detailed dietary instructions: Limit caloric intake to 1800 calories per day. Eat 5-6 small meals throughout the day. 10% of diet from protein, 50-60% of diet from complex carb's (pt provided with written info on what constitues complex carb's), 30% from "good fats" and to entirely avoid trans fats found in most prepared foods. He was advised to spread carbs out evenly throughout the day and of the importance of food combining of carbs and protein at each meal, and advised of food groups that slow the rate at which carbs are converted to sugar.
He was instructed on how to perform simple breathing exercises and advised to practice these techniques daily.
Results: After 2 months of treatment his daily blood sugars checked twice each day (fasting and 2 hours after evening meal) remained consistently in the 107-150 range. Pt no longer experienced night sweats and reported better sleep. After three months of treatment pt's lab results indicated that his ALT and AST had completely normalized (pt's MD, in fact, called me stating utter disbelief that in such a short period of time pt would exhibit normal liver enzymes...), pt trigylcerides dropped to the 300's, still considered high, but not as high as when he started treatment, and his cholesterol was 213. At this point we decided to add krill oil to his herb mix to enhance the effect on lowering his triglyerides. The most recent lab work done in October indicates that pt continues to have excellent control of his blood sugars as his GHb was 6.6. Unlike the daily blood sugars which just give you indication of blood sugar control at that point in time, the GHb gives an historical picture of how well blood sugars are controlled over time. However, pt's trigycerides shot back up to the 500's and his cholestoral held steady at 213.
Synopsis: Pt continues to have bouts of right flank discomfort and his fatty liver disease seems quite stubborn to treatment, indiacting that perhaps more emphasis now needs to be placed on lower jiao damp heat and coursing liver qi. I am in the process of re-evaluating his base herbal regimen. Overall pt's affect is much brighter, he is less angry and generally more optimistic about his future. He no longer has night sweats, sleeps better, and has more energy. His diabetes remains well controlled, but we still have to find some way to impact his dangerously elevated liver enzymes. Thankfully pt is very dedicated to his treatment goals and disciplined about taking his herbs and following his diet.
Western diagnosis: as above
Medical History: 55 yr old caucasion male. Morbidly obese.
First appointment on March 2004 pt's labs reflect triglyceride level of 1105, cholesterol of 230 and elevated AST (50's) and ALT (80's). Pt's record of blood sugars indicate his blood sugars were consistently in the high 230's. Pt was not (and is not) on any western medications. Even though pt had dangerously elevated triglycerides and blood sugars he consistently refused western medications. His MD finally referred him to acupuncture in the hopes that something could be done to stabilize the patient.
Patient does not drive and does not cook. He reports excessive appetite He either buys perpared meals at the deli counter of grocery store or goes out to eat. His only exercise was walking to the public bus.
Questioning exam: Chronic right flank pain. Chronic pain over kidneys. Wakes frequently and frequent night sweats. Short of breath with dry cough. Chronic fatigue. Verbalizes anger/frustration as well as fear of death (realistic considering his elevated labs).
Pulse exam: Pulses thin, tight and slightly rapid. Left sided chi pulse consistently the thinnest and weakest. Left sided guan pulse consistently the most prominent, however, often right sided cun pulse quite prominent too.
Abdmoninal diagonosis: exquisite tenderness in areas of Liv 13 and Liv 14, dull ache in area of GB25.
Tongue exam: Tongue body red. Anterior 2/3 peeled. Posterior 1/3 with dryish slightly yellow coat. Vertical cracks on the anterior 1/3 of tongue, bilateral (that is on both the left and right side of the tongue in the lung region). Tongue body shape normal (tongue is not swollen, scalloped or long). Slight quiver to tongue.
OM Diagnosis: Constitutional lung deficiency (vertical cracks lung area)
Stomach and lung yin xu (and by association kidney yin xu, though yin xu of kidney likely result of long-term lung yin xu) as evidenced by the red and peeled anterior 2/3 of tongue, the dry cough, night sweats, frequent hunger, slightly rapid pulse.
Liver qi stagnation as evidenced by reports of anger/frustation, fatigue, right flank pain, tenderness at Liv. 13 and 14, tight pulses, most prominent in left guan position, and abnormal liver enzymes. Some element of damp in lower jiao as evidenced by yellowish coat posterior 1/3 of tongue and high cholesterol and triglycerides.
Treatment Principle: Nourish yin, especially of lung and stomach, course liver qi, and drain damp accumulation in lower jiao. The damp accumulation in lower jiao is thought to be primarily a consequence of the depressive heat caused by the combination of the liver qi stagnation and the lung and stomach yin deficiency, so the treatment plan did not emphasize draining damp as once yin xu and liver qi stagnation is addressed it is likely the damp heat will more easily resolve.
Point Prescription: Patient seen weeklyfor first 3 months and then twice per month there after. Alternate between back and front treatments and add or subtract points depending upon specific complaints, but core point used are: Liv 13 &/or 14, Liv 3, LI4, LI11, GB34, Sp 9, Sp 6, CV 17, Cv12, Lu7, K6, K3, ST 40, Huatou at level of T17, T18, T19, Bl23, Du 4, Ren 4, Ren 5 (again, not all these points are used all the time, but they are the core points, some of which are used in each treatment depending upon patient's complaints and tongue and pulse signs). Used during every treatment are the following ear points: liver region, right ear; pancreas region right and left ears alternately; spleen region, depression region, anger region.
Herbal Formula: Initially started on combinaton of Six Flavored Tea and Free and Easy plus, 1/2 cup three times day. Pt remained on this formula for approximately 4 weeks and was then switched to the Pacific Biologics "Diabet" capsules, three capsules, three times per day and Health Concerns "Ecliptex", 1 pill 3 times per day. During periods of increased right flank pain pt is instructed to stop the Ecliptex and to take either 8 teapills (Plum Flower Brand) Shu Gan Wan 3 times per day or 8 teapills Free and Easy Plus 3 times per day (whether he takes the Shu Gan or the Free and Easy is determined by the severity of the flank pain). He takes these formulas until pain resolved and then goes back on the base formula of the Ecliptx and Diabet(for those not familiar with Diabet it is a modification for Jade Fluid decoction, with other herbs added for their emperical usefulness in treating yin xu type diabetes.
Lifestyle prescription: Pt put on a diet and exercise plan. Given the fact that pt historically did not exercise it was important to not give him unrealistic goals. Pt was simply instructed to walk for at least 20 minutes per day, at a brisk pace, 3-5 times per week, two hours after eating, eventually working up to walking 40 minutes per day, 3-5 times per week.
He was given rather detailed dietary instructions: Limit caloric intake to 1800 calories per day. Eat 5-6 small meals throughout the day. 10% of diet from protein, 50-60% of diet from complex carb's (pt provided with written info on what constitues complex carb's), 30% from "good fats" and to entirely avoid trans fats found in most prepared foods. He was advised to spread carbs out evenly throughout the day and of the importance of food combining of carbs and protein at each meal, and advised of food groups that slow the rate at which carbs are converted to sugar.
He was instructed on how to perform simple breathing exercises and advised to practice these techniques daily.
Results: After 2 months of treatment his daily blood sugars checked twice each day (fasting and 2 hours after evening meal) remained consistently in the 107-150 range. Pt no longer experienced night sweats and reported better sleep. After three months of treatment pt's lab results indicated that his ALT and AST had completely normalized (pt's MD, in fact, called me stating utter disbelief that in such a short period of time pt would exhibit normal liver enzymes...), pt trigylcerides dropped to the 300's, still considered high, but not as high as when he started treatment, and his cholesterol was 213. At this point we decided to add krill oil to his herb mix to enhance the effect on lowering his triglyerides. The most recent lab work done in October indicates that pt continues to have excellent control of his blood sugars as his GHb was 6.6. Unlike the daily blood sugars which just give you indication of blood sugar control at that point in time, the GHb gives an historical picture of how well blood sugars are controlled over time. However, pt's trigycerides shot back up to the 500's and his cholestoral held steady at 213.
Synopsis: Pt continues to have bouts of right flank discomfort and his fatty liver disease seems quite stubborn to treatment, indiacting that perhaps more emphasis now needs to be placed on lower jiao damp heat and coursing liver qi. I am in the process of re-evaluating his base herbal regimen. Overall pt's affect is much brighter, he is less angry and generally more optimistic about his future. He no longer has night sweats, sleeps better, and has more energy. His diabetes remains well controlled, but we still have to find some way to impact his dangerously elevated liver enzymes. Thankfully pt is very dedicated to his treatment goals and disciplined about taking his herbs and following his diet.
Fibromyalgia
Chief Complaint: fibromyalgia and chronic fatigue
Western diagnosis: fibromyalgia Jan 2001
Medical History: A 50 year old female, health care professional and PhD candidate, sought Chinese medicine for the first time on May 11, 2001, with symptoms of fibromyalgia for one and a half years prior to formal diagnosis in January 2001.
Patient's physical activity had been limited, since exercise aggravated her symptoms. Symptoms were also aggravated by stress and inactivity. A physician prescribed Prozac, 10 mg on odd days, 20 mg on even days, Premarin 1.25 mg daily, and glucosamine chondroitin, dosage unspecified. The patient also took a daily multivitamin and calcium supplement. There was mild improvement in her condition on this regimen, but she was advised that she would "just have to live with pain."
Other Medical History: allergic asthma, sinus allergies, chicken pox, fatigue, headaches, reactive hypoglycemia, measles, mumps, a left arthotomy in 1970, and left knee osteoarthritis, as well as a family history of diabetes mellitus and stroke maternally.
Patient's intake consisted of cold or hot cereal with milk and fruit juice in the mornings; leftovers or a salad or cold sandwich for lunch; meat, starch and a vegetable for dinner. Snacks included cheese and fresh fruit, coffee or tea.
Questioning exam: Patient reported extreme fatigue (impairing her ability to work and causing her to routinely go to bed at 7 PM) and a feeling of muscle aches all over the body, like after a workout, but all the time. The pain would be more or less intense on alternating sides of the body. The patient reported feeling alternating sensations of heat and cold, skin sensitive to environmental changes in temperature, alternating constipation and diarrhea, and a tendency to spontaneous sweating. Patient reported one enlarged cervical lymph node. Patient reported a feeling of "brain fog" or clouded thinking.
Pulse exam: Floating in the left cun position; soggy in the left guan position; slightly vacuous in the left chi position. Floating in the right cun position; slightly vacuous in the left guan position; weak in the left chi position.
Tongue exam: The tongue body was of normal size and shape, slightly purple and trembling, with a shallow longitudinal crack in the Stomach region. The fur was thin, white, moist and evenly distributed. The patient's complexion was pale and dim, with dark circles under the eyes.
OM Diagnosis: The primary pattern was vacuity of Spleen Qi, leading to accumulation of Dampness and Phlegm internally, insufficient Wei Qi, and confusion of upbearing and downbearing. Dampness had eventually become Damp painful obstruction.
Treatment Principle: Boost the Spleen Qi, drain Dampness, transform Phlegm, and promote upbearing. When pain was prominent, the principle of overcoming Dampness or Wind-Dampness was employed.
Point Prescription: Points were selected from the Du, Yangming and Taiyin channels. Du 20 was always employed to promote upbearing. Lung 7, Large Intestine 4, Spleen 9 and 6, Stomach 36 and 40 were most often employed, with the occasional inclusion of Lung 5 if knee pain was prominent or Du 24 if "brain fog" was prominent.
Herbal Formula: The ruling formula was Bu Zhong Yi Qi Tang, adding Ban Xia. Herbs such as Qiang Huo, Fang Feng, Ge Gen and Wei Ling Xian were included when pain was prominent.
Lifestyle prescription: Patient was advised to keep a log of intake and avoid cold, raw, fermented, and dairy foods. Patient was instructed to apply indirect moxibustion to Stomach 36, three times weekly. Compliance was excellent, and the patient reported she felt this regimen was helpful to her.
Results: Pain and mental clarity were noticeably improved after one visit; after six visits, every week to every other week, all symptoms, including fatigue, were nearly gone. The pulse had become slippery and even over the three positions and the tongue had lost its purple cast. Patient continued to have periodic flare-ups of fibromyalgia and fatigue symptoms through April 2002 which she could usually ascribe to overwork or overindulgence. These were easily managed with follow-up treatments. Through journaling, patient was able to identify an interaction of five (!) foodstuffs that aggravated her symptoms. Thereafter, she avoided combining those foods in one meal and felt her condition was improved as a result. Patient is very satisified with the outcome and feels her health is at least as good as before the original onset of her fibromyalgia and chronic fatigue symptoms.
Synopsis: The case illustrates how loss of Spleen function can disrupt the Qi mechanism, and how the Qi mechanism can be levelled by means of lifting and boosting (Bu Zhong Yi Qi Tang), assisted by downbearing and transformation of turbid fluids (Ban Xia). As the sayings go, "when there is upbearing, there is downbearing," and "without upbearing, the clear and turbid lose their places.
Western diagnosis: fibromyalgia Jan 2001
Medical History: A 50 year old female, health care professional and PhD candidate, sought Chinese medicine for the first time on May 11, 2001, with symptoms of fibromyalgia for one and a half years prior to formal diagnosis in January 2001.
Patient's physical activity had been limited, since exercise aggravated her symptoms. Symptoms were also aggravated by stress and inactivity. A physician prescribed Prozac, 10 mg on odd days, 20 mg on even days, Premarin 1.25 mg daily, and glucosamine chondroitin, dosage unspecified. The patient also took a daily multivitamin and calcium supplement. There was mild improvement in her condition on this regimen, but she was advised that she would "just have to live with pain."
Other Medical History: allergic asthma, sinus allergies, chicken pox, fatigue, headaches, reactive hypoglycemia, measles, mumps, a left arthotomy in 1970, and left knee osteoarthritis, as well as a family history of diabetes mellitus and stroke maternally.
Patient's intake consisted of cold or hot cereal with milk and fruit juice in the mornings; leftovers or a salad or cold sandwich for lunch; meat, starch and a vegetable for dinner. Snacks included cheese and fresh fruit, coffee or tea.
Questioning exam: Patient reported extreme fatigue (impairing her ability to work and causing her to routinely go to bed at 7 PM) and a feeling of muscle aches all over the body, like after a workout, but all the time. The pain would be more or less intense on alternating sides of the body. The patient reported feeling alternating sensations of heat and cold, skin sensitive to environmental changes in temperature, alternating constipation and diarrhea, and a tendency to spontaneous sweating. Patient reported one enlarged cervical lymph node. Patient reported a feeling of "brain fog" or clouded thinking.
Pulse exam: Floating in the left cun position; soggy in the left guan position; slightly vacuous in the left chi position. Floating in the right cun position; slightly vacuous in the left guan position; weak in the left chi position.
Tongue exam: The tongue body was of normal size and shape, slightly purple and trembling, with a shallow longitudinal crack in the Stomach region. The fur was thin, white, moist and evenly distributed. The patient's complexion was pale and dim, with dark circles under the eyes.
OM Diagnosis: The primary pattern was vacuity of Spleen Qi, leading to accumulation of Dampness and Phlegm internally, insufficient Wei Qi, and confusion of upbearing and downbearing. Dampness had eventually become Damp painful obstruction.
Treatment Principle: Boost the Spleen Qi, drain Dampness, transform Phlegm, and promote upbearing. When pain was prominent, the principle of overcoming Dampness or Wind-Dampness was employed.
Point Prescription: Points were selected from the Du, Yangming and Taiyin channels. Du 20 was always employed to promote upbearing. Lung 7, Large Intestine 4, Spleen 9 and 6, Stomach 36 and 40 were most often employed, with the occasional inclusion of Lung 5 if knee pain was prominent or Du 24 if "brain fog" was prominent.
Herbal Formula: The ruling formula was Bu Zhong Yi Qi Tang, adding Ban Xia. Herbs such as Qiang Huo, Fang Feng, Ge Gen and Wei Ling Xian were included when pain was prominent.
Lifestyle prescription: Patient was advised to keep a log of intake and avoid cold, raw, fermented, and dairy foods. Patient was instructed to apply indirect moxibustion to Stomach 36, three times weekly. Compliance was excellent, and the patient reported she felt this regimen was helpful to her.
Results: Pain and mental clarity were noticeably improved after one visit; after six visits, every week to every other week, all symptoms, including fatigue, were nearly gone. The pulse had become slippery and even over the three positions and the tongue had lost its purple cast. Patient continued to have periodic flare-ups of fibromyalgia and fatigue symptoms through April 2002 which she could usually ascribe to overwork or overindulgence. These were easily managed with follow-up treatments. Through journaling, patient was able to identify an interaction of five (!) foodstuffs that aggravated her symptoms. Thereafter, she avoided combining those foods in one meal and felt her condition was improved as a result. Patient is very satisified with the outcome and feels her health is at least as good as before the original onset of her fibromyalgia and chronic fatigue symptoms.
Synopsis: The case illustrates how loss of Spleen function can disrupt the Qi mechanism, and how the Qi mechanism can be levelled by means of lifting and boosting (Bu Zhong Yi Qi Tang), assisted by downbearing and transformation of turbid fluids (Ban Xia). As the sayings go, "when there is upbearing, there is downbearing," and "without upbearing, the clear and turbid lose their places.
Fibromyalgia
Chief Complaint: Muscular pain/ achiness
Western diagnosis: Fibromyalgia
Medical History: Patient: female, 42 years old
Since February 2000, patient had experienced muscular pain. In April 2000 she was diagnosed with Lyme's dx and put on antibiotics. After no relief, a spinal tap and Tender Point Assessment test were performed. She was diagnosed with fibromyalgia in the summer of 2000. Significant medical history includes saline breast implants in 1983, gall bladder was removed in 1984 and in 1993 the patient was diagnosed with severe allergies and asthma. Medication at the time of visit included Arthrotec and Maxalt.
Questioning exam: The patient complained of constant, full body, muscular discomfort. Her body was achey and she felt a heaviness in her muscles. The most uncomfortable areas included her thighs, her feet, her neck and her arms. The discomfort was worse in the evenings when lying down and in morning upon waking up. At these times she felt stiff and tight and said she felt "like there were no fluids" in her body. In addition, the cold, damp weather made her symptoms worse. Other symptoms associated with her c.c. included extreme sensitivity upon palpation or pressure to the superficial layers of skin, poor circulation and a constant feeling of coldness. She was sensitive to pressure including fabrics on her skin. In addition she experienced one-sided headaches along the GB channel that occurred randomly and lasted from days to weeks at a time. Her vision had declined in the last four years and she experienced occasional blurry vision and spotted vision. Her mouth was usually dry, she had a very poor memory and often felt like she was "in a fog." She had SOB upon exertion, her energy was extremely low (3% of 100%), her sleep was disturbed, waking frequently at night and waking in the AM feeling tired, and her digestion was affected by cold,damp foods which would cause bloating, gas and nausea. She maintained a 30-day menstrual cycle with approxiamately 5 days of bleeding. Premenstrually, she would experience breast tightness on the sides (liver/ GB channel), her muscular pain got worse and she became emotionally sensitive
Pulse exam: Upon palpation, the lower spleen channel was tender especially at Sp 6 and 9. Her hands and feet were cold to touch. The pulse was 80 BPM, the left weaker then the right. The left was wiry and the chi position was deep and weak. The right side was slippery and the chi was also deep and weak.
Tongue exam: The patient appeared tired and weepy, her eyes were glassy and her palms, soles and complexion had a yellow hue to them. The tongue was pale-purple in color with a scalloped body. There was a thin white coat and the SLV were distended.
OM Diagnosis: The patient was diagnosed with Spleen Qi Deficiency with Damp Accumulation. The quality, the location, and the timing of the pain as well as the precipitative and palliative factors all point to this diagnosis. The quality of pain was expressed as achey and heavy. This could be interpreted as a damp accumulation or a bi-syndrome, in particular, a cold-damp-bi. However, since it was a full body muscular pain and not specific to the joints, I leaned more towards the damp accumulation. In addition, there was no actual swelling and although aggravated by the cold, damp weather, her symptoms were the worst in the summer. The fact that she felt "like there were no fluids" in her body, can emphasize this improper transport of fluids due to damp accumulation. The major characteristic of dampness is heaviness, which was her major complaint. Since this was a stagnant disorder, the pain was the worst at night and in the morning, when the patient was sedentary. The dampness could be seen in her tongue and felt in her pulse. Since dampness can injure the yang, her constant feeling of coldness and poor circulation could be due to the dampness hindering the ability of the yang/ qi to transport and warm. The spleen qi deficiency symptoms included her lack of energy, her inability to concentrate and her digestive problems associated with particular foods.
Treatment Principle: The treatment plan included tonifying the spleen qi and dispelling the damp accumulation. In addition warming was necessary to circulate the qi and warm the yang.
Point Prescription: Acupuncture was difficult at first since the patient was very sensitive to the needles. It included Sp 6, LI 4, Liv 3, St 36, Pt 0 in the ear and ear shen men. Each treatment consisted of lots of moxabustion, especially on points Sp 6, St 36 and Ren 4 and 6.
Herbal Formula: An herbal formula was not used due to her food allergies, which included most herbs.
Lifestyle prescription: It was mentioned to the patient that dietary factors play a major role in spleen qi deficiency and damp accumulation. It was advised that she eat more warming and cooked foods. A congee recipe was offered. In addition, I suggested that daily, light exercise and/or stretching would be helpful in her stagnant situation.
Results: During the initial visit, she was very sensitive to the needle insertion and it took 5- 10 minutes for her to feel the heat from the moxabustion, if at all. After the first visit, she felt much warmer and by the fourth visit the body aches were less severe and in more concentrated areas. By the second month, the aches and heaviness was much better, the patient was able to concentrate and go back to work, her energy was better and she was not as cold, to the point where she could wear lingerie to bed for the first time in a year.
Synopsis: My major concern for this patient was the fact that her health began to decline after her breast implants. I had a feeling that this was the cause of her problems and that she should really make sure there was no problems associated with them. I had asked her to have them checked for many weeks and it wasn't until the second month that she tried to contact the doctor who had done the procedure. Sure enough, the doctor was no longer working and my patient was told that many women with this procedure had complications. She immediately went to get them removed and it was found that one of the implants had leaked and caused this systemic reaction.
Western diagnosis: Fibromyalgia
Medical History: Patient: female, 42 years old
Since February 2000, patient had experienced muscular pain. In April 2000 she was diagnosed with Lyme's dx and put on antibiotics. After no relief, a spinal tap and Tender Point Assessment test were performed. She was diagnosed with fibromyalgia in the summer of 2000. Significant medical history includes saline breast implants in 1983, gall bladder was removed in 1984 and in 1993 the patient was diagnosed with severe allergies and asthma. Medication at the time of visit included Arthrotec and Maxalt.
Questioning exam: The patient complained of constant, full body, muscular discomfort. Her body was achey and she felt a heaviness in her muscles. The most uncomfortable areas included her thighs, her feet, her neck and her arms. The discomfort was worse in the evenings when lying down and in morning upon waking up. At these times she felt stiff and tight and said she felt "like there were no fluids" in her body. In addition, the cold, damp weather made her symptoms worse. Other symptoms associated with her c.c. included extreme sensitivity upon palpation or pressure to the superficial layers of skin, poor circulation and a constant feeling of coldness. She was sensitive to pressure including fabrics on her skin. In addition she experienced one-sided headaches along the GB channel that occurred randomly and lasted from days to weeks at a time. Her vision had declined in the last four years and she experienced occasional blurry vision and spotted vision. Her mouth was usually dry, she had a very poor memory and often felt like she was "in a fog." She had SOB upon exertion, her energy was extremely low (3% of 100%), her sleep was disturbed, waking frequently at night and waking in the AM feeling tired, and her digestion was affected by cold,damp foods which would cause bloating, gas and nausea. She maintained a 30-day menstrual cycle with approxiamately 5 days of bleeding. Premenstrually, she would experience breast tightness on the sides (liver/ GB channel), her muscular pain got worse and she became emotionally sensitive
Pulse exam: Upon palpation, the lower spleen channel was tender especially at Sp 6 and 9. Her hands and feet were cold to touch. The pulse was 80 BPM, the left weaker then the right. The left was wiry and the chi position was deep and weak. The right side was slippery and the chi was also deep and weak.
Tongue exam: The patient appeared tired and weepy, her eyes were glassy and her palms, soles and complexion had a yellow hue to them. The tongue was pale-purple in color with a scalloped body. There was a thin white coat and the SLV were distended.
OM Diagnosis: The patient was diagnosed with Spleen Qi Deficiency with Damp Accumulation. The quality, the location, and the timing of the pain as well as the precipitative and palliative factors all point to this diagnosis. The quality of pain was expressed as achey and heavy. This could be interpreted as a damp accumulation or a bi-syndrome, in particular, a cold-damp-bi. However, since it was a full body muscular pain and not specific to the joints, I leaned more towards the damp accumulation. In addition, there was no actual swelling and although aggravated by the cold, damp weather, her symptoms were the worst in the summer. The fact that she felt "like there were no fluids" in her body, can emphasize this improper transport of fluids due to damp accumulation. The major characteristic of dampness is heaviness, which was her major complaint. Since this was a stagnant disorder, the pain was the worst at night and in the morning, when the patient was sedentary. The dampness could be seen in her tongue and felt in her pulse. Since dampness can injure the yang, her constant feeling of coldness and poor circulation could be due to the dampness hindering the ability of the yang/ qi to transport and warm. The spleen qi deficiency symptoms included her lack of energy, her inability to concentrate and her digestive problems associated with particular foods.
Treatment Principle: The treatment plan included tonifying the spleen qi and dispelling the damp accumulation. In addition warming was necessary to circulate the qi and warm the yang.
Point Prescription: Acupuncture was difficult at first since the patient was very sensitive to the needles. It included Sp 6, LI 4, Liv 3, St 36, Pt 0 in the ear and ear shen men. Each treatment consisted of lots of moxabustion, especially on points Sp 6, St 36 and Ren 4 and 6.
Herbal Formula: An herbal formula was not used due to her food allergies, which included most herbs.
Lifestyle prescription: It was mentioned to the patient that dietary factors play a major role in spleen qi deficiency and damp accumulation. It was advised that she eat more warming and cooked foods. A congee recipe was offered. In addition, I suggested that daily, light exercise and/or stretching would be helpful in her stagnant situation.
Results: During the initial visit, she was very sensitive to the needle insertion and it took 5- 10 minutes for her to feel the heat from the moxabustion, if at all. After the first visit, she felt much warmer and by the fourth visit the body aches were less severe and in more concentrated areas. By the second month, the aches and heaviness was much better, the patient was able to concentrate and go back to work, her energy was better and she was not as cold, to the point where she could wear lingerie to bed for the first time in a year.
Synopsis: My major concern for this patient was the fact that her health began to decline after her breast implants. I had a feeling that this was the cause of her problems and that she should really make sure there was no problems associated with them. I had asked her to have them checked for many weeks and it wasn't until the second month that she tried to contact the doctor who had done the procedure. Sure enough, the doctor was no longer working and my patient was told that many women with this procedure had complications. She immediately went to get them removed and it was found that one of the implants had leaked and caused this systemic reaction.
Langganan:
Postingan (Atom)
