Complex Case
forum post
Submitted By: dumplin1010
female patient in mid 30s
MC: history of constipation (deficiency type), began in 2006 will have BM every 2-3 days but maybe as long as 7-10
was given a diagnosis of a "lazy hypothalmus"? low motility in colon and intestines
has tried all sorts of therapies. she follows a wheat free, low sugar no alcohol, vegetarian diet; takes probiotics; tested for parasites=negative
2nd complaint : Amenorrhea - periods were normal but ceased in 2007, does not create enough LH
now takes birth control (Loestrin) to mitigate progression of osteoporosis; this is the type of BC that causes patient to skip menstruation....
3rd complaint of low to non existent libido
pulse is deep and thin, tongue is swollen pale with teethmarks, thin white even coat
pale complexion, quiet personality and voice, listless
3-4 treatments so far and not much change
all treatments have been heavy on moving qi and some building of yang
any suggestions? thx!
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Comments / Discussions:
comment by "ChadD" (acupuncturist)
on Jun 2010
From a quick read of the case you have nearly all signs of serious qi and yang deficiency (libido, constipation, amenorrhea, etc.). It is difficult to "move" qi when it is deficient. You have to first strongly build the patient and then you can work to resolve some of the stagnation issues. In other words your treatment principle should be reversed from moving qi and some yang to building the qi/yang and some moving. Moxibustion would be called for and if it were my patient I would recommend (not that everyone follows this) the short term use of a few ounces of red meat 1-2/x week for a month or so. In the absence of meat you could use some building herbs and/or lentils and other dense vegetarian food (avoiding too much soy which is far too cooling and can cause hormonal issues if consumed too regularly).
comment by "dumplin1010" (acupuncturist)
on Jul 2010
chad-
thanks so much for your time and suggestions. as i was writing the case question down i noticed my mistake in the treatment principal and i really appreciate your advice. this has been a reminder to me not to go "auto-pilot" and take the time to write some of the more complex cases down to get a correct diagnosis.
comment by "rajk58"
on Jul 2010
Constipation - K 6 + TW 6 , PC 7 + TW 5 + TW 6 , St 36 + TW 6 , Sp 6 + St 36 + St 25 ( Front Mu Point of Li ) + UB 25 ( Back Shu Point of Li ).
Amenorrhoea - Ren 4 , Ren 5 , Sp 6 + St 36 + TW 6 + Li 11
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