Guest guest Posted August 5, 2008 Report Share Posted August 5, 2008 Consider that some people tend to hide things. Fibromyalgia persons tend to bottle up things, also they are the type of people that is " good " in the sense that they really do not like to make mistakes. This may cause a person to be " normal " and " not " having som stuff they think is embarrassing. I suggest, treat what you see in the pulse and on the tongue, this smooth move tea may be because she had constipation, but she started 5 years ago, maybe that is what she means with constipation, that it was there 5 years ago and she is not now because of the tea and thinks she would be if she stop the tea. just some thoughts /Peter Chinese Medicine , " znelms " <znelms wrote: > > Has anybody ever seen anything like this? > I have a patient who complains that after she has a bowel movement, she > bloats up to where " she looks like she is seven months pregnant. " Her > abdomen slowly returns to " normal " after a few hours. She denies > excessive flatulence. This has been going on for about two years. > Five years ago she started taking " Smooth Move " tea with Senna. She > claims constipation, but her stools are rarely firm and are more on the > loose side. She's leaning towards Spleen and Kidney Xu with Liver Qi > Depression. > She has also been diagnosed with fibromyalgia and clinical depression. > > Any treatment suggestions? If any of you are familiar with Triphala, > do you think it is indicated here? > Zach > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2008 Report Share Posted August 5, 2008 Hi Zach, I have seen those a couple of times and s I have treated them as Large Intestinal Cold (reactive points treated LI 1, 4, 5, 6, 16, SJ 1, 4, 5, 10, Ren 4, 6, St30, reactive Bl points in lower back incl. the LI shu, Sp and Lu Shu). The symptoms seems like they are rooted in a Cold condition probably Kidney Yang Deficiency. 2-3 acupuncture treaments should be enough for symptoms.... If you have experience then use TeiShin and/or contact needling..... Check for neck tension, pimples between shoulderblades, spider nevi @ Du 13, 14 to check for Qi/heat trapped in upper Jiao - treat this succesfully and depression should start to lift rather quickly as well. It would help a lot if you could provide some " objective " findings such as Pulse, Abdomen, Reactive Mu and Shu, Channel palpation results, Tongue, complexion, Your impression of her Spirit, how you reached at the pattern you discerned Hope this helps! Kind regards, Thomas man, 04 08 2008 kl. 17:53 +0000, skrev znelms: > Has anybody ever seen anything like this? > I have a patient who complains that after she has a bowel movement, > she > bloats up to where " she looks like she is seven months pregnant. " Her > abdomen slowly returns to " normal " after a few hours. She denies > excessive flatulence. This has been going on for about two years. > Five years ago she started taking " Smooth Move " tea with Senna. She > claims constipation, but her stools are rarely firm and are more on > the > loose side. She's leaning towards Spleen and Kidney Xu with Liver Qi > Depression. > She has also been diagnosed with fibromyalgia and clinical depression. > > Any treatment suggestions? If any of you are familiar with Triphala, > do you think it is indicated here? > Zach > > > > > > -- Althea Akupunktur Albanigade 23A, kld. 5000 Odense C Tlf.: 31 25 92 26 http://www.ditlivditpotentiale.dk RAB: 2006059 CVR: 27322646 Frøslev Mollerup Sparekasse Reg.: 9133 Konto: 2050409 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2008 Report Share Posted August 6, 2008 Thanks guys for responding. Her pulse is thin and weak overall, with left Chi and right Guan deficient, both Cun floating, and slightly wiry in the left guan. Abdomen: flacidity below the navel, pressure pain around the navel especially left Kd 16 area, Ren channel above the navel is tight and tender, tightness and tenderness subcostally on the right around the St Channel, She also has a very large fat pad (10cm diameter)subcostally on the left. When she has the bloating, she feels pain just below the xiphoid process. Tongue: large, pale purple, swollen especially in the lung region, teethmarks, tip curls downward and is a little forked, central crack, and a gray greasy coat, She has tightness in the Stomach and LI channels. She claims tenderness at virtually every mu point palpated. Overall she has a dishevelled look. She is overweight, her shen is poor, she has low energy, and seems emotionally subdued. In fact, she and my other fibromyalgia patients all have that emotionally subdued feeling. They all seem like they are holding everything in. Her diagnostic pattern is very layered and the root is not clear to me. I too suspect cold in the LI and some underlying Kidney deficiency. There is clear Spleen xu, and the emotional constraint makes me suspect Liver Shi. I think that Senna abuse has played a role in creating her bowel condition. My point about the loose stools/constipation is that she has slow motility rather than heat induced constipation with firm dry stools. Once again thanks for the feedback. Zach Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2008 Report Share Posted August 6, 2008 Beware with senna, it should be used with care and to treat especific short term problems, because its prolonged use causes a " lazy intestine " this is: no senna, no normal bowel movement. It is also known to eliminate instestinal flora... Juan On Mon, 04 Aug 2008 13:23:51 -0430, znelms <znelms wrote: > Has anybody ever seen anything like this? > I have a patient who complains that after she has a bowel movement, she > bloats up to where " she looks like she is seven months pregnant. " Her > abdomen slowly returns to " normal " after a few hours. She denies > excessive flatulence. This has been going on for about two years. > Five years ago she started taking " Smooth Move " tea with Senna. She > claims constipation, but her stools are rarely firm and are more on the > loose side. She's leaning towards Spleen and Kidney Xu with Liver Qi > Depression. > She has also been diagnosed with fibromyalgia and clinical depression. > > Any treatment suggestions? If any of you are familiar with Triphala, > do you think it is indicated here? > Zach > > -- Using Opera's revolutionary e-mail client: http://www.opera.com/mail/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2008 Report Share Posted August 7, 2008 Hi zach, I know you know all of this, but I'll break down anywayz so you can follow how I think about the patterns. Since I practice Japanese Acupuncture / Classical NanJing style Acupuncture there will be differences in differential diagnosis and might not be 100% applicable to herbal meds. > Her pulse is thin and weak overall, Def in Blood - if 5 beats pr. breath or slower then a Yin disorder w. cold if 6 beats or faster then Heat is also present in the Yang (the fu, the TaiYang layer and/or in the skin (Lung)) > with left Chi and right Guan > deficient, Right Guan : Lu Left Chi : Kid This is typical of a Kid def pattern w. Cold > both Cun floating, and slightly wiry in the left guan. Cun floating : Heat in upper Jiao left guan slightly wiry: Gb overcontrolling St > Abdomen: flacidity below the navel, Kid Yang def w. Cold (Lower Warmer Yang def) > pressure pain around the navel > especially left Kd 16 area, Sp def / Cold stagnation > Ren channel above the navel is tight and > tender, tightness and tenderness subcostally on the right around the > St > Channel, ChongMai disorder (proper regulation of Sea of Blood) > She also has a very large fat pad (10cm diameter)subcostally > on the left. Maybe " Fat Qi " ? a Liver Qi accumulation " that stands for a long time and does not heal by itself. " Severe Liver Stagnation - could very well be due to cold - if the pad is soft then dampness is also affecting Liver > When she has the bloating, she feels pain just below the > xiphoid process. Heat accumulation in either St fu or in upper jiao due to PC not nourishing Sp (propably because Water isn't controlling Water separating Fire mother from Earth Child) I Often see this in fibromyalgia patients as a secondary to Kid def w cold - if there's a lot of heat trapped in the YangMing it can be easy to misdiagnose the patient. The heat in the YangMing will speed up pulses so it looks like a heat condition when it really is a " False Heat True Cold " condition > Tongue: large, pale purple, swollen especially in the lung region, severe stagnation of cold Dampness in the Lu (and LI in 5E model) > teethmarks, > tip curls downward and is a little forked, central crack, Kid Yang def w Cold affecting Sp > and a gray greasy coat, Damp Cold in intestines > She has tightness in the Stomach and LI channels. Heat or cold stagnation - is it cold or hot to the touch? hard or soft nodules? > She claims tenderness at virtually every mu point palpated. systemic Cold stagnation > Overall she has a dishevelled look. She is overweight, her shen is > poor, she has low energy, and seems emotionally subdued. Lu Yang def > In fact, she > and my other fibromyalgia patients all have that emotionally subdued > feeling. They all seem like they are holding everything in. ' Usually du to impairment of Lungs spreading function. > Her diagnostic pattern is very layered and the root is not clear to > me. > I too suspect cold in the LI and some underlying Kidney deficiency. > There is clear Spleen xu, and the emotional constraint makes me > suspect > Liver Shi. The root here is definitely one of Kid Yang def w. Cold trapped in upper Jiao Seconday patterns are Sp Yang def w. Dampness, Heat trapped in foot Yang Ming channel and a pattern of Liver def Cold. If this is correct then secondary patterns should resolve by themselves even though you were only to treat the Kid def Cold with points such as Lu8, kid7, Bl 13, 23, and tonifying scatterneedling to the upper back. Be careful not to overstimulate. moxa is a possibility, but chances are that the patient will find it uncomfortable due to the Heat trapped in YangMing, but have a go > My point about the loose stools/constipation is that > she has slow motility rather than heat induced constipation with firm > dry stools. absolutely indicative of a Cold condition Hope this helps.... Best regards, Thomas > Once again thanks for the feedback. > Zach > > > > > > -- Althea Akupunktur Albanigade 23A, kld. 5000 Odense C Tlf.: 31 25 92 26 http://www.ditlivditpotentiale.dk RAB: 2006059 CVR: 27322646 Frøslev Mollerup Sparekasse Reg.: 9133 Konto: 2050409 Quote Link to comment Share on other sites More sharing options...
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