Difficult patient case - help would be appreciated!

[Guest guest]

Hi all!

 

I would be most thankful if someone could give me some advices on how to

proceed with the following patient, since I seem to be stuck....

 

Patient: 38 year young female

She has problems with facial tics (spasm) on left side of face, both

cheek and eye.

Has had the problems for 3 years, has seen several western doctors, but

all they can do is to inject a substance to num the facial nerves for a

few days

Tongue is pale with tooth marks and red-yellow sides and red tip (HE

area)

Pulse has " normal " strength, except for KID yang and SP which are week

and deep

She has to go very often (once every hour) to urinate and the urine is

pale, she has to go directly, can not wait. Often fells cold and has

none perspiration, cold hands and feet's.

" Regular " irregular menstruation cycle. Bleeding max 3 days and not much

blood, and clots in the blood.

 

My diagnosis is Liver wind because of deficient liver blood, combined

with deficient KID yang and also obstruction of the facial left side

meridians (mostly ST) because of dampness and cold.

 

My strategy has been to try to strengthen the KID, SP and LIV to improve

the Liv blood def. to expel the wind and the SP and KID to battle the

dampness and use moxa stick to her face to expel the cold. I treat her

once a week and use only acupuncture and moxa.

 

I have, after 5 treatments improved the liver blood def. so that her

menstruation now is much better, both in terms of days she bleeds (now

5-7) and the amount. The facial tics have however not improved. She

could feel a slight improvement after 3 treatments, but this did not

last and now it is back to the way it was before (that is up to 20-30

tics attacks per day lasting several minutes).

 

All good advices would be most thankful!!!!!! Especially if someone have

had this kind of patient!

 

Thanks and BR

Carl

 

 

 

 

 

[Guest guest]

You can try drtanshow.com, medical, drtan's forum. You have to page

through the emails. I did a search and didn't come up with anything.

But there may be something there in the email. Dr. Tan mirrors the hand

on the face with the left side of the face being the TH and SI

meridians. You could check for tenderness at TH 2 and SI 2 and proximal

points. Also you mention the ST meridan. He would use the LI meridan

as an opposite side to needle. So this is my limited knowlege and I

would try it, but you may want to refer to his website. Sounds like you

have done a lot to help her already.

 

Carl Henryk Wallmark wrote:

 

> Hi all!

>

> I would be most thankful if someone could give me some advices on how to

> proceed with the following patient, since I seem to be stuck....

>

> Patient: 38 year young female

> She has problems with facial tics (spasm) on left side of face, both

> cheek and eye.

> Has had the problems for 3 years, has seen several western doctors, but

> all they can do is to inject a substance to num the facial nerves for a

> few days

> Tongue is pale with tooth marks and red-yellow sides and red tip (HE

> area)

> Pulse has " normal " strength, except for KID yang and SP which are week

> and deep

> She has to go very often (once every hour) to urinate and the urine is

> pale, she has to go directly, can not wait. Often fells cold and has

> none perspiration, cold hands and feet's.

> " Regular " irregular menstruation cycle. Bleeding max 3 days and not much

> blood, and clots in the blood.

>

> My diagnosis is Liver wind because of deficient liver blood, combined

> with deficient KID yang and also obstruction of the facial left side

> meridians (mostly ST) because of dampness and cold.

>

> My strategy has been to try to strengthen the KID, SP and LIV to improve

> the Liv blood def. to expel the wind and the SP and KID to battle the

> dampness and use moxa stick to her face to expel the cold. I treat her

> once a week and use only acupuncture and moxa.

>

> I have, after 5 treatments improved the liver blood def. so that her

> menstruation now is much better, both in terms of days she bleeds (now

> 5-7) and the amount. The facial tics have however not improved. She

> could feel a slight improvement after 3 treatments, but this did not

> last and now it is back to the way it was before (that is up to 20-30

> tics attacks per day lasting several minutes).

>

> All good advices would be most thankful!!!!!! Especially if someone have

> had this kind of patient!

>

> Thanks and BR

> Carl

>

>

>

>

>

[Guest guest]

Hey Carl,

 

Could we have an idea of what your treatments (points

and tx.nt-method) have been?

Obviously, a 3 year old problem has had a previous

etiological period, unless it is Bell's Palsy, and

will take longer to reverse.

However, since you have nourished Liver-blood, you may

consider concentrating on expelling wind or seeing the

patient more frequently.

David Tarlo, L.Ac.

 

 

--- Carl Henryk Wallmark

<carlhenryk.wallmark wrote:

 

> Hi all!

>

> I would be most thankful if someone could give me

> some advices on how to

> proceed with the following patient, since I seem to

> be stuck....

>

> Patient: 38 year young female

> She has problems with facial tics (spasm) on left

> side of face, both

> cheek and eye.

> Has had the problems for 3 years, has seen several

> western doctors, but

> all they can do is to inject a substance to num the

> facial nerves for a

> few days

> Tongue is pale with tooth marks and red-yellow sides

> and red tip (HE

> area)

> Pulse has " normal " strength, except for KID yang and

> SP which are week

> and deep

> She has to go very often (once every hour) to

> urinate and the urine is

> pale, she has to go directly, can not wait. Often

> fells cold and has

> none perspiration, cold hands and feet's.

> " Regular " irregular menstruation cycle. Bleeding max

> 3 days and not much

> blood, and clots in the blood.

>

> My diagnosis is Liver wind because of deficient

> liver blood, combined

> with deficient KID yang and also obstruction of the

> facial left side

> meridians (mostly ST) because of dampness and cold.

>

> My strategy has been to try to strengthen the KID,

> SP and LIV to improve

> the Liv blood def. to expel the wind and the SP and

> KID to battle the

> dampness and use moxa stick to her face to expel the

> cold. I treat her

> once a week and use only acupuncture and moxa.

>

> I have, after 5 treatments improved the liver blood

> def. so that her

> menstruation now is much better, both in terms of

> days she bleeds (now

> 5-7) and the amount. The facial tics have however

> not improved. She

> could feel a slight improvement after 3 treatments,

> but this did not

> last and now it is back to the way it was before

> (that is up to 20-30

> tics attacks per day lasting several minutes).

>

> All good advices would be most thankful!!!!!!

> Especially if someone have

> had this kind of patient!

>

> Thanks and BR

> Carl

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

 

 

 

 

 

 

Read only the mail you want - Mail SpamGuard.

 

[Guest guest]

Hi Carl,

 

In addition to acupuncture treatments ( I like to use some local points, maybe

mixing contralateral one with those on affected side) I also encourage my

patients to do some twice daily facial massage/tui-na techniques together with

some local self-acupressure. This really helps to get by with less treatments.

You might also suggest your patient try to do some relaxation/meditation

techniques in which they try to " sense " where this problem may spring from in a

body/mind fashion. - Matt Bauer

-

David Tarlo

Chinese Medicine

Monday, January 17, 2005 8:56 AM

Re: Difficult patient case - help would be appreciated!

 

 

 

Hey Carl,

 

Could we have an idea of what your treatments (points

and tx.nt-method) have been?

Obviously, a 3 year old problem has had a previous

etiological period, unless it is Bell's Palsy, and

will take longer to reverse.

However, since you have nourished Liver-blood, you may

consider concentrating on expelling wind or seeing the

patient more frequently.

David Tarlo, L.Ac.

 

 

--- Carl Henryk Wallmark

<carlhenryk.wallmark wrote:

 

> Hi all!

>

> I would be most thankful if someone could give me

> some advices on how to

> proceed with the following patient, since I seem to

> be stuck....

>

> Patient: 38 year young female

> She has problems with facial tics (spasm) on left

> side of face, both

> cheek and eye.

> Has had the problems for 3 years, has seen several

> western doctors, but

> all they can do is to inject a substance to num the

> facial nerves for a

> few days

> Tongue is pale with tooth marks and red-yellow sides

> and red tip (HE

> area)

> Pulse has " normal " strength, except for KID yang and

> SP which are week

> and deep

> She has to go very often (once every hour) to

> urinate and the urine is

> pale, she has to go directly, can not wait. Often

> fells cold and has

> none perspiration, cold hands and feet's.

> " Regular " irregular menstruation cycle. Bleeding max

> 3 days and not much

> blood, and clots in the blood.

>

> My diagnosis is Liver wind because of deficient

> liver blood, combined

> with deficient KID yang and also obstruction of the

> facial left side

> meridians (mostly ST) because of dampness and cold.

>

> My strategy has been to try to strengthen the KID,

> SP and LIV to improve

> the Liv blood def. to expel the wind and the SP and

> KID to battle the

> dampness and use moxa stick to her face to expel the

> cold. I treat her

> once a week and use only acupuncture and moxa.

>

> I have, after 5 treatments improved the liver blood

> def. so that her

> menstruation now is much better, both in terms of

> days she bleeds (now

> 5-7) and the amount. The facial tics have however

> not improved. She

> could feel a slight improvement after 3 treatments,

> but this did not

> last and now it is back to the way it was before

> (that is up to 20-30

> tics attacks per day lasting several minutes).

>

> All good advices would be most thankful!!!!!!

> Especially if someone have

> had this kind of patient!

>

> Thanks and BR

> Carl

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

 

 

 

 

Read only the mail you want - Mail SpamGuard.

 

 

 

 

 

http://babel.altavista.com/

 

and adjust

accordingly.

 

 

If you are a TCM academic and wish to discuss TCM with other academics, click

on this link

 

 

 

 

[Guest guest]

Hi Carl,

 

In the 5 Element style we look for main blocks before we move into the body of

our constitutional treatment. One of those blocks are what we call Entry / Exit

blocks. We look for these by feeling the volume as opposed to quality of the

pulses. They are perceived as an energy dam between the superficial flow of

energy (Wei Qi) around the body. They are found between the element pairs e.g.

Wood / Metal. You will feel a large volume of energy on the Wood pair and a

emptiness on the Lung/L.I. pair To clear the block you would tonify the Exit

point of Liver (Liv16) and the Entry point of Lung (Lu1) Left side, then right

side of the body.

 

It is like undoing a dam and produces quite useful results for both emotional

and physical problems. The reason I mention this technique is that it sounds

like she may have a block between the SI and Bladder. When you would tonify SI19

and Bladder 1. If the S.I. feels like a 8/ 10 with a slight percussive quality

and Bladder is a 1-3 / 10 and feels it is only a shadow of a pulse. When

cleared you should feel the difference immediately on the pulse. Where the SI

would calm and the Bladder come up equal in volume to the S.I. both 4 -6 /10 in

volume.

 

It is good to check for any other blocks as now the energy is flowing is may

expose other blocks along the Wei cycle. You may occasionally expect some

emotional release after these are cleared. After these blocks are cleared you

should expect all the pulses to be even and you can continue with you more TCM

style work. This may be something you would want to consider if you are

comfortable with the idea,

 

All the best,

 

Gye

 

 

 

 

[Guest guest]

Great description, Gye. Yes I have found clearing entry/exit blocks to

be very powerful.

 

Anne

 

Gye Bennetts wrote:

 

>

> Hi Carl,

>

> In the 5 Element style we look for main blocks before we move into the

> body of our constitutional treatment. One of those blocks are what we

> call Entry / Exit blocks. We look for these by feeling the volume as

> opposed to quality of the pulses. They are perceived as an energy dam

> between the superficial flow of energy (Wei Qi) around the body. They

> are found between the element pairs e.g. Wood / Metal. You will feel

> a large volume of energy on the Wood pair and a emptiness on the

> Lung/L.I. pair To clear the block you would tonify the Exit point of

> Liver (Liv16) and the Entry point of Lung (Lu1) Left side, then right

> side of the body.

>

> It is like undoing a dam and produces quite useful results for both

> emotional and physical problems. The reason I mention this technique

> is that it sounds like she may have a block between the SI and

> Bladder. When you would tonify SI19 and Bladder 1. If the S.I. feels

> like a 8/ 10 with a slight percussive quality and Bladder is a 1-3 /

> 10 and feels it is only a shadow of a pulse. When cleared you should

> feel the difference immediately on the pulse. Where the SI would calm

> and the Bladder come up equal in volume to the S.I. both 4 -6 /10 in

> volume.

>

> It is good to check for any other blocks as now the energy is flowing

> is may expose other blocks along the Wei cycle. You may occasionally

> expect some emotional release after these are cleared. After these

> blocks are cleared you should expect all the pulses to be even and you

> can continue with you more TCM style work. This may be something you

> would want to consider if you are comfortable with the idea,

>

> All the best,

>

> Gye

>

>

>

>

>

 

 

 

 

[Guest guest]

Gye, How is your patient compliance on treating entry / exit on their first

visit. Speaking for myself as a TCM Practioner I usually look for other

alternatives to certain points just because of their locations.

 

Ed Kasper LAc. Santa Cruz, CA.

 

 

Tue, 18 Jan 2005 09:06:26 +1100

" Gye Bennetts " <five-element

Re: Difficult patient case - help would be appreciated!

 

 

Hi Carl,

 

In the 5 Element style we look for main blocks before we move into the body

of our constitutional treatment. One of those blocks are what we call Entry

/ Exit blocks. We look for these by feeling the volume as opposed to

quality of the pulses. They are perceived as an energy dam between the

superficial flow of energy (Wei Qi) around the body. They are found between

the element pairs e.g. Wood / Metal. You will feel a large volume of energy

on the Wood pair and a emptiness on the Lung/L.I. pair To clear the block

you would tonify the Exit point of Liver (Liv16) and the Entry point of Lung

(Lu1) Left side, then right side of the body.

 

It is like undoing a dam and produces quite useful results for both

emotional and physical problems. The reason I mention this technique is that

it sounds like she may have a block between the SI and Bladder. When you

would tonify SI19 and Bladder 1. If the S.I. feels like a 8/ 10 with a

slight percussive quality and Bladder is a 1-3 / 10 and feels it is only a

shadow of a pulse. When cleared you should feel the difference immediately

on the pulse. Where the SI would calm and the Bladder come up equal in

volume to the S.I. both 4 -6 /10 in volume.

 

It is good to check for any other blocks as now the energy is flowing is

may expose other blocks along the Wei cycle. You may occasionally expect

some emotional release after these are cleared. After these blocks are

cleared you should expect all the pulses to be even and you can continue

with you more TCM style work. This may be something you would want to

consider if you are comfortable with the idea,

 

All the best,

 

Gye

[Guest guest]

Ed: On entry exit blocks: My two cents: I don't do them on the first

visit. I do other blocks first. I wouldn't do Entry/Exists on the

first day unless absolutely necessary.

 

Ed Kasper LAc wrote:

 

> Gye, How is your patient compliance on treating entry / exit on their

> first

> visit. Speaking for myself as a TCM Practioner I usually look for other

> alternatives to certain points just because of their locations.

>

> Ed Kasper LAc. Santa Cruz, CA.

>

>

> Tue, 18 Jan 2005 09:06:26 +1100

> " Gye Bennetts " <five-element

> Re: Difficult patient case - help would be appreciated!

>

>