Paralysis – seeing 15 y.o. pt tomorrow

[Elizabeth Ross]

I saw her again yesterday – she is now able to independently move all of her limbs! Her left side continues to be on a slower trajectory. Her biggest struggle now is weight bearing. Since the last treatment she is now able to pull herself to standing and support herself – her leg strength is improving! She is still unable to try and walk without supporting herself – although she is now able to do so using crutches!

Her left hand is struggling to fully extend – especially the index and thumb, and to fully flex – especially the pinky finger. Is the flexion Taiyin? It’s just the movement, not trying to hold anything in her hand.

Interestingly, I did not feel any sinew pulses this time, I also did not note any other notable pulses, such as 8 extra, but her KI Yang was not strong and she was very cold to the touch. Her fluids seemed weak/thin and Lung was not dispersing, so I thought I’d work on the deficiencies and see what happened with the pulse. I also looked at her tongue this time since the pulse was different and it was very purple – especially the center, with bright red edges all around, no coating. Her body felt very tense and rigid but none of the pulses were showing that tension.

I started with moxa on Du 14 and 4, put cups on Jianzhen and Naoshu (sorry, don’t know the numbers) and GB29, per Ann’s suggestion and needled Ganshu (UB18), Weishi (UB21) and Feishu (UB13). Her pulses still felt deficient so I had her flip and I decided to just address the stagnation showing in the tongue. After that her L chi was finally showing a sinew pulse but time was up.

Does this shift in the pulse mean the pattern is moving internally or that she is getting tired, for lack of a better term?

[Armin]

Hi Elizabeth,

Thanks so much for keeping us up to date on this case. Super helpful.

My understanding of hand flexion is also that it’s a Tai Yin movement, although in this case you could also pay attention to the location of Shao Yin (pinky).

To me, given that I haven’t seen the patient, it seems to me the source of the stagnation you are referring to on the tongue might actually be extreme deficiency of the Yang qi, which is just not moving much in the body, hence the purple tongue. I think the focus should still be on the tonification of deficiencies, though addressing some movement with light cupping or what have should be good idea.

The shift in the pulse to me seems positive. Perhaps it actually has enough energy now to show the sinew aspect of the pathology.

As for her biggest challenge of weight bearing, how about Yang Ming sinew!!!? Just an idea!

Armin

[Elizabeth Ross]

Hi Armin

Thanks for the confirmation regarding the hand issues! I treated Yangming the time before this past treatment – for the weight bearing and because it showed in the pulse.

So the extreme deficiency of Yang Qi is potentially causing the stagnation and heat showing in the tongue.. I can get behind that. I see her again on 12/30 so hopefully she’ll be well rested and ready to release some sinews!

She is still progressing consistently, which is fantastic to watch. We’ve gotten 120″ of snow since November, so she has been sit skiing (putting her father to shame in a race) in addition to all of her PT and OT.

[Elizabeth Ross]

Progress has been steady in some areas and slow in other areas. For the last few sessions, I switched to tonifying the LU and occasionally the LI channels based on atrophy in her left hand and inhibition of movement.

This morning Du came up on the right side – first time an 8 Extra has appeared in her pulse. I chose 3rd and 4th trajectories based on the lack of sensation she has from below T3, her spasms, alternating weakness and rigidity in her limbs.

Regarding her lack of sensation internally – with the bladder and bowel sensation and control – would you see that as an extension of the LR/PC paralysis, as directly connected to the LI/UB channels, or as a completely separate mechanism altogether?

Thanks!

[Armin]

I would probably see it as a Jue Yin situation. I mean numbness in the limbs are Jue Yin for sure, same as pain all the time. In this case, bowels are controlled by wei qi, I think same with bladder. So working up the foot jue yin especially, and with moxa on the soft/cold areas, should get some sensation going.

[Armin]

Not sure how last post came out so fancy with italics and all!! It’s not a quote; just me thinking out loud.

[Elizabeth Ross]

haha, the fancy italics made the post really stand out 🙂

Thank you for the suggestion re: tonifying the jueyin, I will definitely try that when I see her this Friday!

Last time I saw her, her mother asked me if I knew any meditation or other internal work that her daughter could work on to try and get the connection through the inflamed part of her spinal cord. During her treatment I asked her to start trying to breathe energy from the top of her head down her spine, and then to alternately try breathing from the dantian down to the perineum and then up her spine – as starting points.

Does anyone have other suggestions for internal work for her? She will be 16 in 6 weeks (we have the same birthday 😉 ) so her interest is snarky on the outside, but hopefully open on the inside.

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