Covered in Luos

[Elizabeth Ross]

Hi All –

I have a patient who is covered in Luos – there is almost no place on her body that isn’t marked with spider veins, large and small, though there are not nearly as many veins visible on her arms. She is in her 50s, has had many surgeries, has many digestive issues and missing part of her stomach, and is seeing me mainly for joint pain/hypermobility and more recently for stress management due to her husband’s alcoholism and cirrhosis. I have performed two Luo tx on her based solely on the overwhelming emotional ssx she walked in with – full UB and HT – which were very helpful. I read in the other forum topics that Luos are not indicated for joint pain, but in the ability to handle the pain (thank you Hannah and Ann). When you see someone’s body covered like that where do you start, with Divergent? I have difficulty needling her in many areas because she is so fully covered in surface veins and I don’t want to cause bruising. I don’t have her chart in front of me (not at my office) so I can’t remember off hand what her pulses are like.

Additionally, I have another patient who is similarly covered, but with lipomas/nodules instead of veins. She is in her 60s and has some type of undiagnosed/likely untreated (due to religious beliefs) schizophrenia (thinks her neighbors are targeting her brain and spying on her with a satellite) – when and how do you decide if/when it is appropriate to address these – for example if the mental issues were not present? Or would you treat partially because of the mental issues?

Thank you for any advice.

[Ann Cecil-Sterman]

Hello Elizabeth,
I’m sorry we’re late answering. Not sure how we missed your interesting post.
With luo vessels, you can very effectively treat all that you describe including the paranoia. Yes, the mental issues will be treated along with GI issues. Find the areas that are most heavily populated and work out which Luo trajectory they appear on. Bleed that luo point first, and then bleed the darkest, most congested luo vessels on the trajectory. Then move to the next most congested area. You’ll be amazing by the change in the mental and emotional states. I wouldn’t start with divergents, no. And don’t worry about bruising. The benefit will be so profoundly felt that the patient is usually not at all bothered. Be sure that they have signed and initialed your regular disclaimer acknowledging that they accept that bruising may occur. This is standard, as you know. Let us know how it goes, Elizabeth and how we can help further.
Very warmly,
Ann

[Elizabeth Ross]

Hi Ann,

Thank you for your response! I think I must have worded it awkwardly above – I was talking about two different patients, one with all the spider veins and GI issues, and the other with the nodules/lipomas and mental issues.

Last week, right after I watched the last Ann Chat I found the question Luo Q&A section in your book where you discussed bleeding the Qiaos for people with lots of spider veins – great to connect that with the part in the chat where you discussed the same. Would you also use that technique for all the nodules – bleeding and moxa on the qiao points? Additionally, in terms of the nodules – how exactly do you break them up? I’ve tried needling and gua sha, but I’m not certain how aggressive to be in one treatment or if there are specific techniques to use depending on the size of the nodule. I have not had success in getting them to change at all and it’s been uncomfortable for the patient.

Thank you so much!
Liz

[Elizabeth Ross]

If more detail is helpful, I just saw the woman with the nodules. She’s 73 years old, I was wrong – she is on an antipsychotic, but insists it’s just for sleeping. I tried to be very detailed with her pulse at her visit, but I am only just barely into Ann’s Pulse Diagnosis book so please forgive my newness – all pulses are between 3-4 beats per breath. The LU/LI pulses showed a present sinew pulse, and a slippery (whoosh) quality at the organ level (not sure if LU or LI or both), SP/ST is weaker and deeper, also slippery, KI yang/SJ/PC pulse is occluded by a nodule. HT pulse felt scattered and slippery and the SI did not feel pathological. LR/GB was stronger and slippery, UB/KI is narrow in height and width, only present between 6-9 beans.

She has nodules covering her arms and legs at various depths and highly variable sizes – the smallest I found was lentil size near her shoulder – maybe on the HT primary, and the largest at Feiyang on the left leg – it was maybe 2.5-3″ wide and 2″ long.

After her recent treatment (I did not attempt a Luo tx) it’s been loud in my mind that I don’t know how to bring up the potential for treating those nodules with her in an ethical way. She does not acknowledge her mental illness, other than to briefly discuss the effects of it – she thinks her neighbor is spying on her with a satellite that penetrates her brain. She states that when he “turns the electricity on” she experiences strong pressure in her head, but not her face, and said both that it’s so painful that she’s screaming and also that it’s not painful, it’s just pressure. Additionally, she says that her BMs are very hard and dry except when the “electricity” is on, which causes her to have diarrhea and fully empty out. She also complains that the right side of her body is painful, she has pain around her left breast (refuses to go to a doctor for a check up) and that she is itchy all over and presents with no skin rash or any other marks on her skin other than the occasional mole.

I welcome any and all advice or insight. She is a very sweet older woman and it would be nice to be able to help her in any way I can, but I acknowledge this may be a case that is more academic than practical at the moment.

Thank you!

[Amy Matthews]

Elizabeth, it appears that you are not treating the woman with lots of nodules for her nodules or her mental condition. What brought her to you? Treating Luos can treat many other conditions, so it may be something you could offer without having to make her change her goals.

[Ann Cecil-Sterman]

Elizabeth, I’m not sure that there need be an ethical dilemma in bringing up the nodules because you’re not treating the nodules, you’re treating the emptying of the Luo channel into the primary channel. The nodules is simply a symptom of what you’re treating (Shen issues). So you’re bleeding the luo point and then moxa-ing the luo point which happens to have a nodule on it (Feiyang BL-58). All the nodules will be on a channel. Bleed the luo point of those channels and then moxa. Be careful-she might not feel the moxa. Use your fingers to gauge the heat. The pulses you describe indicate systemic dampness which is there to contain this blood based pathology. This is perfect luo territory. I’m sure you’ll help create major change here. Thanks for presenting such interesting cases, Elizabeth. Annx

[Elizabeth Ross]

Hi Amy – great question – it didn’t occur to me to explain that! I have seen her irregularly for about 5 years for different issues. Most recently, I’ve been seeing her roughly once a month for general wellness since she won’t go to the doctor. She scheduled in the beginning of summer for the first time in 2-3 years because she had been having an issue with pain around her left breast that was referring to her intestines – upon examination she has nodules around her breast tissue, or possibly fibrocystic breasts. She refuses to get an examination from an MD because she’d “rather not know if it’s cancer”. That issue has seemed to be quiet for the last two months. During her last visit she was complaining of knee pain and that she’d stopped eating sugar but feels like her legs are becoming swollen – she’s tried quitting sugar multiple times but every time complains of strange pains and digestive issues that instantly go away when she resumes eating poorly – probably a lot of complaining yeast.

Ann – is there any chance for adverse reactions with her medication? I’m also concerned about some of the healing events you describe in the book since I have no idea what kind of traumatic events might resurface in suppressed memories or in dreams. I’d want to explain to her that these things could happen and make sure that my explanation of why I’m choosing the luo treatment as the best way I can help her.

Thanks!

[Ann Cecil-Sterman]

Amy – Thanks for bringing that up. Great point. I hadn’t seen that before I pressed send on my comment.

Elizabeth – the pulses and the nodules around the breast are suggesting LU/LI divergent. Latency has been lost. Be sure to satisfy the law and refer her out in writing and also to document her refusal. Then work very seriously. You could work to restore yang qi using that confluence and then work back to THDC to restore qi to the digestive tract (which as you know has accumulated dampness) so that digestive qi is tonified and able to manufacture the mediumship needed to regain latency.

[Elizabeth Ross]

I see her tomorrow and will try the THDC. I will also heed your advice regarding the referral documentation. Thank you!

[Elizabeth Ross]

I tried bleeding the Yang Qiao on my other Luo patient – the one with all the spider veins – as the yang channels show more spider veins than the yin channels. What type of shift do you generally expect after bleeding one of the qiaos? Also, I only bled the right side of her body, is that necessary or is it okay to do both sides?

[Elizabeth Ross]

The full luo patient had to cancel her appointment because she’d just gotten a pacemaker. I will follow up once I see her again. Thanks!

[Ann Cecil-Sterman]

Elizabeth,
On intake forms in the USA there should be a line that requires initialing that says that the patient has been advised to seek the advice of a medical doctor. Also, when patients have urgent complaints, we are required by law to refer them. If they decide not to go, that must be noted in the chart. These laws have nothing to do with your being able to conduct an effective treatment for that same complaint. Nearly always, the patient make decisions in alignment with their seeking alternatives to that approach in the first place.

[Elizabeth Ross]

Shoot – I meant to say that the EMPTY luo patient had to cancel due to pacemaker implant. Sorry about that confusion.

Ann – I made my own intake forms so I am not aware of that line but am happy to add it to mine – good idea! I do write in my soap notes that I advised seeing her medical doctor and that she refused. I’m not sure if that is enough.

[Ann Cecil-Sterman]

That’s important but not sufficient. You might consider a separate page in which you say you advised them to seek medical advice and they refused and get them to sign and date it. You would say that it’s a requirement of your insurance company which of course it is. As the laws change we must always be functioning within the law. We must keep our licenses and keep the profession in tact and take care of the patient all at the same time. A

[Elizabeth Ross]

Will do. Would you advise seeking a template from another practitioner or from my insurance company, or is making a simple on that says just what you referenced above sufficient?

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