Impossible Back pain

[Guest guest]

Hi Everybody!

 

I have a patient returning on Wednesday who suffers from excruciating back

pain. MRI shows many protruding disks, protruding in the anterior

direction, very deep pain. I referred him to a really good chiropractor and

she sent him back, saying he was an impossible case. He is very obese above

the waist and he *will not* lose any weight. I have tried and tried to find

Ashi points on his back, but there are none, the pain is on the *front* of

the spine. Only one of my thirteen treatments so far has worked for him,

but when I repeated that treatment a second time, no effect. He comes to me

because all the other doctors have written him off. I see him, but I am not

helping, except for that once.

 

He is diabetic, has peripheral neuropathy, has had cancer surgery, disc

surgery, surgery to repair an aortic aneurysm and has another aortic

aneurysm which he is too weak to have repaired. The pain is worst when he

stands up - probably because his huge belly weight compresses the

protruding disks and puts more pressure on the nerves, so he sits or lies

down almost all the time, belly supported by his thighs or by the bed. He

loves to eat sugar, cookies, ice cream, cake . . . addicted to the stuff.

 

His wife says he will eat a whole package of cookies at a lick. I told her

there is a thin line between encouragement and nagging. They eat every meal

" out " because she is retired and doesn't cook any more. Alas, there are no

" healthy " restaurants.

 

He is so debilitated and so heavy that he barely can get on the table. I

think this time I will treat him straddling a chair and do both back shu

and front mu in the same treatment.

 

This is driving me crazy, to say nothing of how *he* feels.

 

Any ideas? How about some TCM pain pills? I have Tien Tzat and China Tung

Hsueh in stock and I have not tried these with him yet, any others? I tried

to tonify him with Liu Wei Di Huang Wan but he didn't take all of them

because they weren't a magic bullet on the pain.

 

From my differentiation notes:

 

Patient number: 114044849 Date of birth March 11, 1926.

 

Starting with the " Observe " Examination:

 

Unhealthy complexion. Yes. (no spirit)

Dark or unclear face color. Yes. (no spirit)

Breathing with a readily noticeable sound. Yes. (no spirit)

Slow or no movement. Yes. (deficient cold, usually spleen)

Tremors or convulsions. Yes. (interior wind of the liver)

Green face color (indicates a Liver pattern, interior Cold, pain or

interior Wind)

Large chest & epigastrium. Yes.

Fat body. Yes. (Central obesity)

Clear thin phlegm, cold pattern

earlobe is heart.

lack of movement, slow movements Yin, Empty (deficient) Cold.

Observe the lips. Purple.

Healthy color around wrists and ankles. Yes.

Pale nails. Yes.

Observe the Thenar Eminence. OK

Tongue color. Red on purple side.

Tongue shape. Fat.

Tongue coating. White.

Tongue moisture. Moist

 

Inquire Examination

 

Time of day that there is sweating. (When low sugar)

Severe giddiness, everything seems to sway, loss of balance. Yes.

Slight dizziness with a feeling of heaviness in the head. Yes.

Sudden onset of dizziness. Yes.

Sharp stabbing pain usually in a fixed location. Yes. (blood stasis)

 

Listen & smell Examination

 

Crying. Yes. (related to metal, lung deficiency)

Foul, rotten nauseating odor like rotten meat or rotten eggs. Yes. (Kidney

or bladder damp heat, or heat in any organ)

Rancid or goatish, wood; Scorched or burning, fire; Fleshy or rank, metal

and Rotten or putrid, water (or heat in any organ)

 

Palpate:

 

Systolic blood pressure (Optimal <120; 117

Diastolic blood pressure (Optimal <80; 60

Heart rate. 83

Sinking pulse. Yes. (yin, internal disharmony or obstruction)

Itchy skin. Yes. (wind)

 

Patterns: No spirit; deficient cold; interior wind of liver; blood stasis;

internal deficiency; lung deficiency; Kidney bladder damp heat.

 

Organs: Liver, spleen, kidney, Heart, bladder.

Back pain due to multiple disk protrusions (visible on MRI) pressing on

nerves, aggravated by overweight.

 

Starting points: Sp 6; St 36; LI 4, 11; Lu 7. Back shu & front mu of

various organs, as convenient.

Liu Wei Di Huang Pian (Kidney, liver)

(Fratkin) 12Hx

Weight reduction would be helpful.

 

Regards,

 

Pete

[Guest guest]

--- Pete Theisen <petet wrote:

 

Hi, Pete.

 

I Would think and try

Food stagnation

Tonify Spleen

Clear stagnated St Heat

Reduce Weight (his own commitment?)

Include Ear points for Back and Food.

 

Hi Everybody!

 

I have a patient returning on Wednesday who suffers

from excruciating back

pain. MRI shows many protruding disks, protruding in

the anterior

direction, very deep pain. I referred him to a really

good chiropractor and

she sent him back, saying he was an impossible case.

He is very obese above

the waist and he *will not* lose any weight. I have

tried and tried to find

Ashi points on his back, but there are none, the pain

is on the *front* of

the spine. Only one of my thirteen treatments so far

has worked for him,

but when I repeated that treatment a second time, no

effect. He comes to me

because all the other doctors have written him off. I

see him, but I am not

helping, except for that once.

 

He is diabetic, has peripheral neuropathy, has had

cancer surgery, disc

surgery, surgery to repair an aortic aneurysm and has

another aortic

aneurysm which he is too weak to have repaired. The

pain is worst when he

stands up - probably because his huge belly weight

compresses the

protruding disks and puts more pressure on the nerves,

so he sits or lies

down almost all the time, belly supported by his

thighs or by the bed. He

loves to eat sugar, cookies, ice cream, cake . . .

addicted to the stuff.

 

His wife says he will eat a whole package of cookies

at a lick. I told her

there is a thin line between encouragement and

nagging. They eat every meal

" out " because she is retired and doesn't cook any

more. Alas, there are no

" healthy " restaurants.

 

He is so debilitated and so heavy that he barely can

get on the table. I

think this time I will treat him straddling a chair

and do both back shu

and front mu in the same treatment.

 

This is driving me crazy, to say nothing of how *he*

feels.

 

Any ideas? How about some TCM pain pills? I have Tien

Tzat and China Tung

Hsueh in stock and I have not tried these with him

yet, any others? I tried

to tonify him with Liu Wei Di Huang Wan but he didn't

take all of them

because they weren't a magic bullet on the pain.

 

From my differentiation notes:

 

Patient number: 114044849 Date of birth March

11, 1926.

 

Starting with the " Observe " Examination:

 

Unhealthy complexion. Yes. (no spirit)

Dark or unclear face color. Yes. (no spirit)

Breathing with a readily noticeable sound. Yes. (no

spirit)

Slow or no movement. Yes. (deficient cold, usually

spleen)

Tremors or convulsions. Yes. (interior wind of the

liver)

Green face color (indicates a Liver pattern, interior

Cold, pain or

interior Wind)

Large chest & epigastrium. Yes.

Fat body. Yes. (Central obesity)

Clear thin phlegm, cold pattern

earlobe is heart.

lack of movement, slow movements Yin, Empty

(deficient) Cold.

Observe the lips. Purple.

Healthy color around wrists and ankles. Yes.

Pale nails. Yes.

Observe the Thenar Eminence. OK

Tongue color. Red on purple side.

Tongue shape. Fat.

Tongue coating. White.

Tongue moisture. Moist

 

Inquire Examination

 

Time of day that there is sweating. (When low sugar)

Severe giddiness, everything seems to sway, loss of

balance. Yes.

Slight dizziness with a feeling of heaviness in the

head. Yes.

Sudden onset of dizziness. Yes.

Sharp stabbing pain usually in a fixed location. Yes.

(blood stasis)

 

Listen & smell Examination

 

Crying. Yes. (related to metal, lung deficiency)

Foul, rotten nauseating odor like rotten meat or

rotten eggs. Yes. (Kidney

or bladder damp heat, or heat in any organ)

Rancid or goatish, wood; Scorched or burning, fire;

Fleshy or rank, metal

and Rotten or putrid, water (or heat in any organ)

 

Palpate:

 

Systolic blood pressure (Optimal <120; 117

Diastolic blood pressure (Optimal <80; 60

Heart rate. 83

Sinking pulse. Yes. (yin, internal disharmony or

obstruction)

Itchy skin. Yes. (wind)

 

Patterns: No spirit; deficient cold; interior wind of

liver; blood stasis;

internal deficiency; lung deficiency; Kidney bladder

damp heat.

 

Organs: Liver, spleen, kidney, Heart, bladder.

Back pain due to multiple disk protrusions (visible on

MRI) pressing on

nerves, aggravated by overweight.

 

Starting points: Sp 6; St 36; LI 4, 11; Lu 7. Back shu

& front mu of

various organs, as convenient.

Liu Wei Di Huang Pian (Kidney, liver)

(Fratkin) 12Hx

Weight reduction would be helpful.

 

Regards,

 

Pete

 

 

 

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