Student Case/ Client respnses

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Student Case # One

 

Female

Age: 46

Height: 5'-7.5 "

Weight: 165

Resting Pulse Rate per/min.: 60

Blood Pressure (if known): not known

 

Some additional notes:

 

A 5 ft. 7 1/2 inch woman who weighs 165 lbs is not necessarily overweight.

She is by Hollywood standards and those of some highly suspect insurance

tables, but not by TCM standards and some other standards. Especially if

muscle tone is good, she's muscular, and the resting pulse is low. However,

unusual weight gain and cravings for carbs are symptoms of something not

being right.

 

Note the age - 46. As people age, Kidney function tends to decline. Both

Kidney Yang and Kidney Yin tend to lessen. Blood Deficiency and Blood

Stasis problems tend to increase.

 

" Primary Concerns: hormone levels flucuating, weight gain, sweats "

 

" Hormone levels flucuating " is a Western diagnosis, and can create analysis

problems if included in the primary concerns category. As much as possible

encourage clients to report just symptoms they experience as primary

concerns instead of Western (or prior TCM diagnoses). TCM healers identify

and treat TCM imbalances.

 

Clients often will use Western diagnoses as shorthand, assuming that the

healer knows all that this implies and also assuming that each and every

person with a particular diagnosis will have the exact same manifestations.

They won't. When Western diagnoses are used by clients as shorthand, very

often the person will not report certain key symptoms or will fail to

emphasize just how much of a problem the symptoms are.

 

Western-defined medical conditions very seldom correspond to TCM imbalances.

The vast majority of Western-defined medical conditions will have more

than one possible TCM imbalances as a Root. For example, I believe one or

more of 6 TCM patterns can underlie peptic ulcers. One or more of several

different TCM patterns can underlie what is called asthma in the West, and

what helps one asthmatic may do nothing for a second and even worsen the

asthma of a third. As Bob Flaws is fond of saying, " Same disease, different

treatments. Different diseases, same treatment. " In the first case, the

Western-defined medical condition is the same, but the underlying TCM

imbalances are different. In the second case, the Western-defined

conditions are different, but the same TCM imbalance is present in all of

them.

 

Let's take a look at how the client may fail to mention some very key

information if the person uses a Western-defined diagnosis as shorthand.

Take the example of peptic ulcers. Are the stomach problems worse if the

person doesn't eat and improves when the person eats? If so, this points to

a Deficiency problem. On the other hand, if the stomach problems become

worse when the person eats something, this points to an Excess problem.

This is the type of very important information that may not be given if the

person falls back on a Western diagnosis (or even a prior TCM) diagnosis as

shorthand.

 

Also, there is a tendency for people to attribute every problem they have to

that one diagnosis when there may be multiple things wrong. And because they

attribute all to this one diagnosis, they often fail to report information

they need to report.

 

In addition, there is another important reason for encouraging clients to

report symptoms instead of Western diagnoses. In the U.S. in particular,

the medical establishment gives a very clear message that patients and their

observations are not to be trusted. Patients who can report things in

details and make connections often are accused of being " obsessive " and of

being hypochondriacs. In reality, a person who pays attention to his or her

body and to what helps and what hurts has a far better prognosis than

someone who is not noticing things and who expects the doctor or TCM healer

to magically have all the answers and know what is wrong while the patient/

clinet waits patiently and totally passively.

 

Describing things in their own words and giving symptoms instead of falling

back on Western diagnoses will be very hard for some clients at first. You

can see the surprise in their eyes that someone actually thinks they have

enough intelligence to be able to know when something is wrong, trusts them

to be able to report it, and takes their reports seriously. The more people

learn to pay attention to their bodies and to how various things (weather,

diet, amount of rest, etc.) affect their health, the better the prognosis

and the more likely the person will obtain maximum health.

 

Do Western-defined medical conditions have a place in a TCM analysis? YES,

but in the medical history section. You will want to know if the client has

high blood pressure, heart problems, etc. because some herbs and acupuncture

points can have adverse effects in some cases. For example, some herbs will

raise blood pressure.

 

Also, if the healer knows the limitations of Western diagnoses but also

knows the the possible underlying TCM imbalances that can be present, this

can aid the healer in analysis. For example, " flucuating hormone levels "

suggests that the Kidneys and Liver be looked at more closely and imbalances

in those two systems ruled in or out.

 

Personally, I'd be looking at the possibility Kidney and Liver Yin

Deficiency in this particular case in addition to the primary analysis of

Liver Blood Deficiency. For one thing, there's the age. There are some

other things I'll go into in more detail.

 

There's also the factor in considering Western diagnoses that TCM

definitions are not the same as Western anatomical descriptions. For

example, Blood is not the same thing as blood. It is possible for a Western

blood test to be normal, but for the person to suffer from Blood Deficiency.

By Western standards, my kidneys are fine apart from an occasional

infection and some other minor things which are nothing out of the ordinary

by Western standards. But by TCM standards, my Kidneys were severely

imbalanced. Up until the time of that TCM questionaire when I answered

" yes " to about every question in the Kidney section, I would have sworn that

there was nothing wrong with my kidneys or Kidneys. At least not anything

important. I also remember the herbalist asking me to describe in my own

words and in deatil what was happening during a hypoglycemic episode. He

wouldn't let me fall back on any Western terms without explaining exactly

what the symptoms were and what I was experiencing. Thanks, Christopher

Gussa - for a lot of things.

 

Victoria

 

 

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In a message dated 03/19/2002 9:09:25 AM Pacific Standard Time,

victoria_dragon writes:

 

Victoria,

 

Thank you very much for all of the information you posted regarding this

case. As always ... you go well beyond the call of duty and it is very much

appreciated.

 

<< " Primary Concerns: hormone levels flucuating, weight gain, sweats "

" Hormone levels flucuating " is a Western diagnosis, and can create analysis

problems if included in the primary concerns category.

 

You brought up excellent points here and great suggestions for questions. I

listed this because this is what she reported ... but it was Greek to me

(hormone levels) and I didn't place any weight on it. I agree ... the signs

and symptoms tell the story.

 

<< Personally, I'd be looking at the possibility Kidney and Liver Yin

Deficiency in this particular case in addition to the primary analysis of

Liver Blood Deficiency. For one thing, there's the age. There are some

other things I'll go into in more detail.

 

I understand the reasoning here and in the follow up post .... but looking at

the whole picture ... there is the issue of breast lumps. Yin could become

deficient from long term stagnation yet ... wouldn't Yin tonics create more

stagnation? This seems like a cold syndrome (slow pulse, preference for warm

drink, pale urine, puffy eyes in the morning, stuffed nose, weight gain) even

though she has the sweats ... I asked questions about thirst and none were

checked as to being unusual.

 

Would lycii berry aggravate conditions of stagnation and cold? How does one

handle such a mixed bag of goods anyway? I suspect her scenario is quite

common.

 

I sent this woman Xiao Yao San last week and gave her a list of dryness

symptoms to watch for that could result from taking the formula. I told her

that if she experienced any ... to take the formula with a tsp. of honey (but

not to use the honey if it wasn't necessary). Honey is warming (according to

my sources) yet lubricating and I understand that it is used frequently to

offset drying principles of formulas?

 

In any event, I will follow up with the results of this protocol ... whether

I find it's a total bust ... or seemingly helpful.

 

Thanks so much again ...... Lynn