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After thought:
I forgot to say that it’s probably a good idea to find out what was happening in her life before the onset of the viral condition in her early 20’s. Some luo treatments could be applicable too!
Hi Ada,
I’ll give it a try, but for sure a tough case!
Obviously, her overall system must be pretty taxed in mediumship already given her history and everything. So, the way I see it, it’s a matter of building up resources any way you can. You could try sinew for couple of sessions to see if it would shift it, but it feels to me that this would require deeper work, either divergents to build up mediumship as well as addressing the arthritic condition. But as you haven’t done the training for that yet, then the 8ev’s look like a good option.Given that her chronic fatigue started after a viral condition and given that she never really recovered and this has been taxing her system, I would consider Yang Wei mai. The whole thing has a bit of Shao Yang feel to it; a lingering pathogenic condition. But the qiaos are definitely indicated too as you said yourself. Taking a stance for herself in life and wanting to start a family, but can not move forward due to lack of resources. You could also consider Yin Wei mai to boost resources.
* Could I massage her feet whilst the pins are in for EV?
I would say best to do a bit of massage first to loosen things up and then do the 8ev treatment. I wouldn’t do the massage while the needles are in when you are doing an 8ev. The needles are working on the Yuan level and you’ll be working on the Wei level simultaneously and that may confuse things energetically. But that’s just what I think.
* Theoretically, one could work the EVs to make deep changes, then use the Sinews to implement them? For musculoskeletal?
When I have seen Ann giving treatments and say there is a sinew pulse as well as an 8ev pulse, she would first quickly release the sinew channel, sometimes by simply putting the jing-well and then do the 8ev treatment in the same session. I am not sure if you meant doing these two approaches at the same time or a few sessions of one style first followed by the other. Anyway, same treatment for both is an option but sinew release should come first so you are not taking a superficial condition to the yuan level.
*Where does this tugging-pulling-coiling in come from? Is it ‘just’ cold?
Likely from the lack of mediumship. She must be very blood and fluid deficient so everything gets tight and spastic. The peppercorn/mugwort foot bath may work but it may also be a bit too warming and drying her more. I don’t know, depends on how much damp-cold is in her system.
*I also felt shaoyang and taiyang sinew pulses. How can you do sinew treatment when the patient is freezing?)
When you are doing the prep work for a sinew treatment, you can moxa Du 4, 14 after you Gua Sha them. And maxa Kd 3 on left to boost yang qi. For the actual sinew channels, if cold and flaccid, you can moxa along the channel on those points as well.
Hope this helps Ada.
Well Liz, your intention was in the right place and what mattered in the end. And sweating!!!!!? indeed that would be the famous healing crisis, especially in the context of your son feeling much better all around. So, things like smelly sweating, bowels, urine, and other exciting expressions would fall under the healing crisis category.
I’d say your reasoning for doing the 2nd confluence is pretty spot on. If you went by mediumship mobilization signs and symptoms and decided say that he doesn’t have enough blood, you could also rather than working with the 2nd confluence directly, work with the 3rd confluence to boost the 2nd. If I’m not mistaken, that would bring you to the St/Sp Div realm. You might consider this specially for the lingering symptoms perhaps.
Anyway, you are dong great job. Hope he comes back from his camping trip without too much drama.
Hi Suzan,
I have a few questions, rather than a definitive answer:
When you say the pulse was still there after the treatment, do you mean there was no change? Perhaps, there was an improvement but not completely gone which, in this case, might make sense given how full the dai mai pulse is as you are suggesting. So, if some lightening up of it, then it simply might mean more and more treatments.
Were there other pulses present that were perhaps more prominent than the dai mai pulse? If yes, perhaps working with those might yield a better shift.
Lastly, it might just be that the patient is simply not ready to let go of the dai mai baggage regardless of your good intentions for them to do so.
Just some thoughts.
Hi Liz,
Firstly, I think you can relax about being a complete beginner; most of us in this forum are:)
Great job on the sds treatment. I myself still don’t have the courage to do one. All my divergent treatments have been dsd so far. As far as I can piece together from my trainings with Ann, the healing crisis will likely happen at some point. It might just be that, you didn’t do the divergent treatments long enough, and had you continued, it could have happened.
Did you do the Gb divergent based on pulse diagnosis? My first go to would have been St/Sp divergent given the trajectory as well as overall indication. Also, given the overall weakness in mediumship and the length of time that he has been suffering from this, perhaps dsd might be a better option all around.
If I am not mistaken, in a divergent treatment approach what might end up happening is that you start with let’s say the 4th confluence and as the person improves and perhaps goes through a healing crisis, then the next step is to treat the 3rd confluence, then 2nd and then the first. I am not too sure about this theory and, of course, I have not experienced it clinically, but do recall something to that effect. The progression may not be orderly and confluence by confluence either.
But in terms of what you ended up doing in terms of a sinew channel towards the end, it makes perfect sense to me. Your sds treatments would have brought the pathogen to the surface and it was just lingering there, so all good in terms of sinew treatment to push it out the rest of the way.
Let us know what you have done since and thanks for sharing.
hi Antoine,
I have treated a few cases in the past but not using the complement channels, just with the primary channels! As far as the complement channels are concerned, I suspect it would depend on what stage of the condition they are coming in to see you.
If it’s early stage (acute, first couple of weeks), and blisters are still fresh red and popping, I would imagine a sinew approach would be indicated, especially if you find a sinew pulse as well. I would treat the sinew channel trajectory as well as where you find the sinew pulse. Likely, the blisters will be on Taiyang and Shaoyang (UB & GB). I would avoid the actual blister patches if in the acute phase and focus on reducing the rest of the affected channel trajectories. If it’s in the chronic phase, you could definitely address the affected areas as well.
If it’s a chronic case, like months of this condition and still in pain, most likely Shaoyang will be involved. I recall Ann saying in couple of her lectures that for chronic skin conditions, treat the Shaoyang. In this case you would treat both GB & SJ as you are addressing a chronic condition, as opposed to just GB for more of an acute condition.
When it comes to the pulses, given that this is not a movement related pain condition (muscleoskeletal), the pulse position would be the same as the sinew channel, so if you find a sinew pulse at the right cun, you would treat the LI or LU sinew channels as opposed to the Taiyang (represented by right cun). Hope this isn’t getting too confusing 🙂
Also, for chronic cases, you can do the divergents. I would pick one either based on pulse or based on the overall picture of your client. If they are really deficient (qi & yang deficiency), probably LI divergent, if less so, then Gb divergent (blood deficiency) could also be used, but these are chronic cases and the DSD approach.
One trick that has really worked for me in the past was to use a moxa stick and warm around the edges of a blister patch during an acute blistering phase and over the actual patch when no longer acute. You would do this until the skin gets slightly pink.
Hope this helps and hope others will give their insights as well.
Hi Antoine,
These are my thoughts and by no means are they necessarily right, just how I see it. Hopefully others will comment as well.
Shaoyin is only when you turn a limb medially towards the midline of the body. So, pouring tea from a pot or putting a leg over the other leg’s knee top in a seated position. If your whole body is turning at night on bed, I don’t think that is a Shao Yin situation. A lot of things are moving when that happens and I think we need to narrow it down to the specifics of the body part that is hurting when they are turning in bed at night.
When it comes to sitting, even though it feels like you are not moving, the muscles of the back are still holding you upright. This is considered an extension which would be tai yang (especially the bladder channel). Jue yin, is when the pain is present all the time, whether the person is sitting or standing or walking. Or, the pain is all over or there is numbness.
Just to confuse you even more, I read in one the posts that sitting also involves a tai yin situation, possibly because the knees are flexed and coming towards the chest. Something to think about.
With the night time confusion, once you figure out what part of the body is hurting, just get the client to mobilize that part for you in the clinic in different ways and then assess which is the worst, but not in the lying down position. So, if they say their shoulder hurts at night when they turn in bed, then see how the arm movements are in the seated position: if extension, or rotation medially or latter hurts. That should give you some clues about the shoulder too.
Hope this helps 😉
Thanks Liz! I’m glad I got you thinking;) Yes, the Jing connection makes sense, or rather teeth being a type of bone in a way and therefore related to the kidneys and by extension Jing. I guess I’m wondering if wisdom teeth in particular are meant to be left alone for the most part, unless they are causing all sorts of problems in which case they get yanked out. I know in Canada, there is a tendency to pre-emptively get them out with the understanding that they might cause problems down the road.
As far as your question goes, you could definitely address tooth pain or jaw issues with a sinew approach. I have done that on a number of occasions and with good results. If the pain is with the movement of chewing, then hmm, I think it is considered shao yang as it’s the hinge (or is that tcm thinking!?). The yang ming makes sense too, though strictly there is no weight bearing and if you are thinking flexion (which there is), then there is also extension (opening the jaw before closing). Either way, given that the area is covered by a bunch of channels (St, Li, SI, SJ), you’ll likely be covering yang ming and shao yang as far as trajectories go. And of course, you’d be paying attention to the pulse for the third angle of a sinew diagnosis.
Hope I haven’t confused you 🙂
Hi Liz,
Seems like they all have wind in common: sudden flare ups or symptoms coming out of no where, and the skin itching for sure. It is spring after all, so that might have something to do with it too. Self diagnosing and treating can be challenging for sure. I think this might be a sort of ying/wei disharmony and so keeping up with either GuiZhi tang or Chai hu gui zhi tang, which is what you took earlier is not a bad idea. For 2-3 weeks as long as things are improving, and then reassess!
Also, if sinew treatments don’t seem to take care of it, you could try divergents to boost mediumship. In this case, st/sp might be good fit or gb/lv.
Just brainstorming. Hope things settle down soon.
Hi Liz,
Sinews would work for sure as you obviously have gotten the results but yes it does seem that you want to get some yuan level support behind the work you have done on the sinew level. Seems to be more of a divergent case with one sided joint pain or other issues. I guess her latency is spilling out of the hip joint, so that would be a great place to start. Gb/Lv divergent comes to mind, DSD to build mediumship so as to support the latency again.
Once the hip joint is doing better after a few sessions with divergents, then you could probably do some 8evs. Of course, strictly speaking, it’ll all depend on the pulses, but I am not the best with pulses myself and so as long as there is no sinew pulses you could do some 8ev’s. The Qiaos come to mind to support her stance.
Armin
All of the above and just to keep working at it in terms of lifestyle (meditation, going to bed on time, having a peaceful home environment), dietary habits and the rest. The longer the client stays the course, the longer the results will last. I tend to keep it general unless I need to suggest specific recommendations for specific conditions.
Having said that, I find no matter how one delivers recommendations, most people tend to forget once they start feeling better. They’ll remember it while they are in a dire situation and then it goes out the door. Thankfully, there is a 25% that keep up with the recommendations and are serious. At least my experience.
Thanks Antoine! Great ideas. My challenge with the divergent and 8evs has been with the concern of driving the pathology deeper into the yuan level. When I take her pulse, generally right side is soft and weak, and left side is tight/wiry and superficial. I recall Ann saying once about this pulse presentation as not being a good one. We want to have the left side pulses deeper than the right side. I think Ann said that it means severe loss of mediumship, but am not certain. Makes sense given that the left is more about blood and yin. So when it’s more superficial and tight, it’s trying to hold on to what’s left of the mediumship.
Next week I’ll try to get a bit bolder and try some of the ideas presented here and very cautiously!!! It makes sense to boost her mediumship if nothing else through either divergents or 8evs depending on pulse.
She came in yesterday and was very emotional as her grandmother had passed away. She was very close to her and so had cried a lot which meant her pain levels were over the roof. Crying, coughing, sneezing and even chewing are all pretty painful in general. I didn’t want to try any new stuff with her and just supported her more on the emotional level.
Thanks again we’ll keep you guys posted.
Armin
Hi Liz,
Hope the tooth has been behaving since your last post.
Yes, it does appear that you were fighting off an exterior wind-cold type situation given your symptoms and the fact that the herbal formula did a great job. It does make sense to use the sinews channels for sure given the acute exterior nature of the condition. The trajectory would correspond to both bladder and stomach sinew, though we would normally think of stomach given the primary channel trajectory of stomach. However, I am not sure on how to account for the fact that it was only your front teeth. It seems that both the stomach and the bladder trajectories go over the jaws on the sides!!! It’s possible that they are still covering all the teeth not just the molars!!???
Anyway, it’s possible that you would have had a superficial sinew channel pulse at the time which likely would have been on the tai yang or shao yang positions (cun & guan, especially on right). Not sure if you took your pulse at the time. In this case, there was no pain with movement, only sensitivity to temperature, so we can only diagnose based on pulse and trajectory. I think you would be looking at mostly Tai yang bladder channel, possibly with some Moxa work on the local area or Du 14 & Kd 3 when doing the prep work. If by chance, it was hurting with the movement of chewing, then I think that would be a shao yang movement diagnosis (gall bladder). Also, I am thinking there might some neck, shoulder blockage going on too; like cold trapped there!
I hope this gives you some leads.
Armin
Hi Liz,
Yes, I do remember you. I have been on a divergent mode since;)
Thank so much for your input. Everything you said makes perfect sense. When I first started seeing her, she started making a lot of progress all around, even her range of motion, though not as much as other departments. Shortly after and as she continued with medical assessments, X-rays, and MRI’s, it was decided that surgery would be the best option for her given the extent of damage and that it had been a year and half since the accident already. The surgery is so specialized that the last six months her medical team has been trying to find someone to do it. There are only a handful in the world who do this type of surgery.
The upshot of that was that she resigned herself to the surgery as the only solution and then stated regarding our work simply as palliative, I guess on a subconscious level. Interestingly enough when her pain gets really bad, I don’t even treat the pain and simply help her emotionally with the treatments and she responds nicely. So you are absolutely right in the emotional component of things. Gallbladder has been a focus throughout but not on the head, so I may work with that, on the opposite side!!!
There are times that I think the whole left side is locked up as it’s protecting and stabilizing the neck given the extensive damage to alar ligament deep inside.
And ya, maybe I just need to be more present and really hold the space for her and give the local area a go. She’s probably locked up as a guarding from when the accident happened and has not been able to let go. This is a type A personality we are talking about here; go go go all the time. We have discussed how the accident happened for a reason and she has accepted that if the accident had not happened she probably would have been dead due to some kind of crazy health issues. She had had two close calls with septecimia and going into anaphylactic shock due to basically not listening to her body’s signs. So she knows what she is doing to herself but I guess she is just wired to be that way. Oh and she is like a full on professional athlete who has basically had to cut back on everything.
Anyway, I will try to work with that for now. Still open to others’ insights.
Cheers:)
Hi Lydie,
My experience with tinnitus in the clinic has been mostly with younger folks, but couple of older clients too. If the tinnitus has been there for some time, then we need to pay more attention to the internal aspect of things, mediumship, emotions and other imbalances. It usually starts when a person has gone through a period of stress or extra demand on resources. So perhaps the TCM way of looking at it from a liver or kidney deficiency is not too far off.
As far as the complement channels, the 3rd confluence comes to mind which addresses sensory orifices issues. But the 2nd confluence can also be applicable. With insomnia, thyroid issues, as well as hormonal issues in general, then 4th confluence; in fact, this might be a better place to start given her age and the overall health picture. Building up mediumship and working back towards the 2nd confluence over time.
Often I find people with tinnitus to also have a lot of neck and shoulder tension. To that end, I have good results with shao yang sinew releases for tinnitus, but in younger folks with not as much mediumship loss. However in this case, given the relation with post Achilles tendon surgery, there’s probably some sinew issues to explore there in tai yang and shao yang zones. Perhaps she could do some calf, hamstring stretches, along with some twisting stretches on the floor to open the shao yang.
So overall, I see this as depletion of mediumship or Yin with Yang being hyperactive.
Hope this helps.
Armin
