Orthostatic hypotension
forum post
I have a patient that I’ve been treating for pudendal neuralgia. This is his third bout of this groin nerve pain in the last three years. Along with the nerve pain the patient has been suffering some POTS like symptoms. This has happened in the past episodes but is much more server this time. His symptoms include feeling of brain fog and feeling like he is going to pass out after standing for about 15-20 minutes, fatigue, loss of appetite (and consequently weight loss), and dry mouth. He recently was given tilt table test which showed a significant difference (more than 20%) in laying heart rate and standing heart rate. He was diagnosed with Ortostatic hypotension. Constitutionally the patient tends towards Spleen and Kidney Qi Xu. While my patient’s pudendal nerve pain is almost gone and the dry mouth is greatly improved, the other symptoms persist. I do not have a lot of experience treating this and would appreciate any inputs for protocal (including body and ear points, and herbal formulas).
Thanks
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Comments / Discussions:
comment by "ChadD" (acupuncturist)
on Dec 2019
It would be best to start by describing in precise terms what you are currently doing and why, how many treatments you have given over what time frame, etc.
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comment by "rte"
on Dec 2019
Up until now I have been mostly treating the pudendal neuralgia as this has been the main source of pain. I have done points along the meridians that seem to be affected (mostly GB and Bladder), including GB 30, 31, UB 23-25. I also do local ah shi points and have used electrostim. Distally I have done LI4, Lv3, GB34, and sometimes Huato points on mid to low back (especially when the muscles are jacked up). I have also done some Ki / SP tonification as he seems to be constitutionally weak in these areas (Ki 3 or 7, Sp6 etc.). On his last treatment I have added ear points including shen men, point 0, Ki, Lv, and sympathtic. To be honest, I mostly treat musculo-skeletal problems so this is a challenge for me.
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comment by "rte"
on Dec 2019
Oh, I forgot to say that I have been treating the patient for about 7 weeks and have done 2-3 treatments a week.
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