6th Confluence?

[Erica Moffet]

Hello everyone, I am curious about the variation of severity of illness people can have while in the deeper divergent confluences. I have a new patient who makes me think of the 6th confluence but isn’t at death’s door. Is this possible and does that sound like a reasonable diagnosis for this guy?

He’s 65 years old, works full time at a job that he loves and that creates a lot of stress in his life because of MAJOR frustration/ anger with the people he works with. He’s had various health problems over the years, but they have all gotten much much worse in the last year. He’s coming for acupuncture on the advice of his chiropractor but is pretty hopeless that anything will help.
His symptoms:
-Intense pain in shoulders, arms and hands, both sides, worse with work (he does design work on a computer). Sometimes his hands swell up, sometimes they fall asleep at night. Trouble sleeping due to pain.
-Osteoarthritis in his neck and low back and lots of pain there too. Says it feels worse/swollen with heat, better with ice. But he also says he always feels freezing.
-Always feels freezing.
-Raynaud’s in left hand.
-Occipital HA that stabs through to BL1, left sided, sometimes waking him at night.
-Major prostatitis, his MD wants to operate, is worried he’ll end up in the ER for BL rupture.
-Alternating loose stools and constipation. Sometimes explosive diarrhea, major quality of life issue.
-Severe lower abdominal pain on and off on the left (ST25-27 area).
-Chronic GERD, currently much worse than usual
-Long history of depression, currently worse than usual
-Hypothyroid (on levo)
-Constant sinus congestion, with copious white and yellow mucus.
-Hives on and off. Mostly legs and shoulders. Sometimes because of new food allergies, sometimes unknown. Worse in the summer.
-Colon polyps

Pulse: moderate rate, LU is elevated and wide, very thin ST and slippery SP, deep & soft KD yang, tight & thin LR, very deep & thin KD yin but with some solidness. I think I feel 6th, 3rd and 2nd divergent pulses and no EVs.

Tongue: very puffy and scalloped, pale, horizontal cracks in middle, medium thick white coat with yellowing in the back.

Luos vessels: some KD, some ST

Many of his symptoms fits LI divergent (as listed in the Red book) and he is clearly jin and ye deficient already. And he is so cold along with the heat signs. But he is also able to work hard and keep his life together (although maybe just barely?). And his heat signs aren’t limited to the upper jiao. Any thoughts?

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