SV: Difficult patient case - help would be appreciated!

[Guest guest]

Hi David!

 

Thanks for your reply!

 

I have used both local points (St2, St4, st6, st7, gb2, gb3, si18, si19,

all reducing) on the affected side and distal points to subdue wind

(du16, du14, Feishu, Fengmeng, all reducing) as well as points to

eliminate dampness (sp6, sp9, st40, st37, all reducing) and points to

move the blood (st36, liv3 and li4 all reinforcing) and strengthening

the liver blood (several back-shu points, all reinforcing).

 

I also use moxa from time to time on the points on her face.

 

The problem I have encountered is that, except from her getting better

steadily, her face will become sore at the local points I needle, even

though I try to alternate the points an only see her once a week. This

soreness does not really help getting things better.....so for a few

times I have stopped needling this point and only used moxa or flash

cupping to the face, but kept up with needling the distal points....

 

Not easy!!! What to do????

 

BR

Carl

 

-----Ursprungligt meddelande-----

Från: David Tarlo [d1tarlo]

Skickat: den 17 januari 2005 17:56

Till: Chinese Medicine

Ämne: 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]

>

>

 

 

 

 

 

 

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[Guest guest]

Hello Carl,

 

I really like Fengchi, GB 20 for wind pathogens;

depending on your style, and it looks like TCM, it

would fit well with Du 16, etc... also don't

underestimate Taichong, Liv 3. Other considerations

are to treat with the patient's emotional state, for

which Liv 3 is also ideal... emotions will lead to

qi-stagnation and internal heat or fire which

complicate the situation; and to use the deeper

recommended needle depth (not beyond safety) and

longer treatment time (leave the needles in a very

very long time). Gua Sha is another alternative to

consider as part of the treatment.

Also allergies, known or unknown, lead to similar

pathogenic outcomes (stagnation and heat/fire), etc...

 

 

David Tarlo, L.Ac.

 

 

--- Carl Henryk Wallmark

<carlhenryk.wallmark wrote:

 

Hi David!

>

> Thanks for your reply!

>

> I have used both local points (St2, St4, st6, st7,

> gb2, gb3, si18, si19,

> all reducing) on the affected side and distal points

> to subdue wind

> (du16, du14, Feishu, Fengmeng, all reducing) as well

> as points to

> eliminate dampness (sp6, sp9, st40, st37, all

> reducing) and points to

> move the blood (st36, liv3 and li4 all reinforcing)

> and strengthening

> the liver blood (several back-shu points, all

> reinforcing).

>

> I also use moxa from time to time on the points on

> her face.

>

> The problem I have encountered is that, except from

> her getting better

> steadily, her face will become sore at the local

> points I needle, even

> though I try to alternate the points an only see her

> once a week. This

> soreness does not really help getting things

> better.....so for a few

> times I have stopped needling this point and only

> used moxa or flash

> cupping to the face, but kept up with needling the

> distal points....

>

> Not easy!!! What to do????

>

> BR

> Carl

>