Hello
Challenging case. 47 woman, starting menopause - cycles irregular - no NS. Red to Dark red bld with large clots.Light flow.No pain. 2 births.
Eyes, painful, weeping upon wind, twitching - open and closed from pain, light sensitive. Started in March 2011 as soon as she moved to her "dreamhome"
@ night mouth and throat very dry, chlorine smell in nose, migraines with weather change, slight dust allergies, history asthma, heartburn,
Lying down, bending over, 11 pm makes eyes better and twitching stops.
Sleep - trouble falling and staying asleep, for vivid dream (HT LR), energy ok. Loose to Diarr (SP). Sometimes burn urination (HT Heat - SI)
Tongue - dark burnt red, peeled coat in areas, wet
Pulse - Right DEEP, wiry Left DEEP weak - only heart pulse is up.
Dx - LR Blood Yin Dfcy stirring wind and faling to nourish Eyes. (Sp Qi dfcy and HT Heat - Si)
Ax - choose from LI4 LV 3 LU7 LV2 SP6 sST 36 KD6 BL67 GB37 DU20 Yintang BL2 Yuyao GB14 GB20 Sishencong HT7 BL62 Bl 15 17 18 20 21 23
Hx - Qi Ju Di Huang Wan
then to Zi Shen Mi Mu Tang
Then both together
Now to Xiao Yao san + Gao Teng
All neurological, blood tests done and clear. All possible allergens removed from the home. Antibiotics tried. Councilling. Had a serious loss 10 years ago.
ZERO improvement. Nothing has changed after 8 weeks of treatment. Nothing.
At a loss.
Would love your input.
Thanks
G
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comment by "archived-user"
on Nov 2011
If her tongue has red color, she is not liver blood deficiency, she should be Liver and Kidney yin deficiency, with Liver meridian heat dampness, because yin deficiency cause internal heat, with wind cause liver liquid come out of eyes. points: Lv3, Li4, Tai Yang, (Jing Ming), Sp6, Kd3, St2,8, Si18, Gb20,41, Ub18. comment: Jing Ming(Ub1) is a dangerous point, without high needling technique should not do it. Formula: Ming Mu Di Huang Wan.
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comment by "ChadD" (acupuncturist)
on Nov 2011
While I agree with most of what Feng says, minus that UB 1 is dangerous (it's not my preferred point, but it's far from dangerous), I would try a completely different approach as what you have done should have helped. Certainly with the new house, there are lots of issues that come up with newer building materials, molds from wrapping the house with tyvex, and many other formaldehyde issues from cabinetry and other things (basically the house itself, not anything in it that can be removed). The test for this is to go on an extended vacation or leave the house for a couple weeks and see if the symptoms improve. If they do at least you know what you are up against, you still have to work to strengthen the person so they don't react, but you'll have an idea that this may take many months to work with. Generally the house issues take time to clear from normal wear and tear and the construction materials expanding and contracting and releasing various levels of chemicals - over a few years this effect is usually less of an issue...
Herbally I think you tried all the right things... I just don't think they will help much beyond helping lower the stress of having to deal with these issues - which is still a good thing... I would probably keep her on Xiao Yao Wan during the day and Ming Mu Di Huang Wan at night. Another option, however, would be to do short runs of something like Yin Qiao, Yu Ping Feng Wan, or even Xiao Feng Wan to see if pushing something out (even without strong relevant signs) helps.
Treatment wise I would focus on her immune system more and some of the heat/yin signs rather than liver blood. A treatment I would do (we focus quite a bit on huatuo points and primarily treat only face down) might be as follows:
<ul>
<li>
Systemic Points - LU 7 with KD 6 and SP 6, LI 4, HT 6 or 7, GB 20.</li>
<li>
Huatuo at C3 - nerves that innervate the eyes</li>
<li>
GB 16 - visual cortex</li>
<li>
SI 16, SI 17, LI 18 (largely with tuina along with C3, but needling is ok) - sky window points, open head/body communication</li>
<li>
Huatuo at T1, T2 and T3 (strongly balance immune system, bone marrow, thymus gland and lung/lymph system respectively)</li>
<li>
Huatuo at T7 - all blood related issues</li>
<li>
UB 23 - Kidneys</li>
<li>
UB 40 - clear heat</li>
<li>
UB 60 - clear heat from head</li>
<li>
Then I would probably finish the treatment with strong tuina in the neck areas listed above and the upper back, cup the upper back (T1, 2, 3 and 7 areas) and then bloodlet the lung, large intestine and stomach meridians (LU 11, LI 1 and ST 45) </li>
</ul>
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comment by "Gina_Rino"
on Nov 2011
Thanks so much for your input!
With the the chemicals that go into homes these days, I am sure it is an allergic reaction to something there. I have seen this before with Migraines. Had great success with the migraines with Acupunture only.
I was thinking of Jade wind Screen as well to do a complete 180, and really approach from a completely different angle. I was also stumped as to if it was a shen disorder as well....she had a significat loss...
She is a great Patient and very "patient" with the treatments.
LR Bld Yin Dfcy was the Dx : ) All how we were taught wrt Dx.
Thanks, again. Great to have support and input.
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comment by "Gina_Rino"
on Nov 2011
After a week on the modified Xiao Yao, my patient had a couple good days of minimal blinking, pain, tearing. Then the winds from the South came up and it worsened again.
I have her on Jade Wind Screen now and will alternate between the two Formulas and maybe giving her Jade Wind 2X day and Xiao Yao before bed.
I am ecstatic! Beyond ecstatic.
Thanks again.
G
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comment by "Gina_Rino"
on Nov 2011
After a week on Jade Screen, things are still improving.
Very exciting. I see her well by the New Year.
G
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comment by "Simon_Light"
on May 2012
Try this as a concept: tearing from Heart Fire. You said that the only pulse that was up was the Heart.
Heart (Fire) over-controls Metal (Lungs), so Lungs are weak, which is why Jade Screen works. Lung and Spleen Qi Deficiency is another cause of tearing. Xiao Yao Wan soothes Liver aboveall by nourishing Spleen to generate Blood. So that might explain why Xiao Yao Wan helps. Spleen is Mother of Lung too.
But, if your lady tears when she looks into into the wind, it's an excess condition. Heart Fire is perhaps the last full condition you haven't considered. Heart Fire might also cover the emotional aspects as well. If this is the case, whack in Ht 8 Shao Fu with Lv 2 Xing Jian to finish things off?
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