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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.
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!
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?
I see her tomorrow and will try the THDC. I will also heed your advice regarding the referral documentation. Thank you!
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!
Hi Everyone,
The second treatment unfortunately did not seem to have much, if any effect. It will be nice to see her in my office where I can use all methods to assure strength of Yang, especially.
Ann, thanks for the clarification on the yangming position for sinew pulses – so much to learn!
Best,
LHi Armin!
She sleeps on the shoulder that pains her, on her side? That seems like it would be yangming – it’s bearing her weight, and perhaps also jueyin like you’re thinking. Unless her arm is stuck in some specific position that you could connect to another motion?
Hi Armin, thanks for your input, I really appreciate it!
Last night (Sunday) she had a shift where she became able to bend the knee of her right leg while turning on her side. After the spontaneous movement while trying to roll over she was able to move it intentionally before fatiguing. Her left leg remains unresponsive but has been having more involuntary twitching. She is able to wiggle the toes of her left foot if light stimulation is applied to the underside of her toes, like a light tickling.
I returned for one last session this evening.
Armin, in regards to your suggestion regarding tonifying her sinews, I decided against that because she doesn’t present with flaccidity that I could tell – she has great muscle tone, which is being maintained medically. I think they hook up electrodes to her muscles and get them to fire – she biked 6 miles today during her PT/OT, prior to my visit. I read 0-3 beans on the right chi pulse as the san jiao/shaoyang, what is the yangming channel you’re referring to?
I repeated the treatment I did on Saturday, but on the right side of the body this time, just to see what happens. This time I added tianfu (LU3) and kongzui (LU6) to lieque (LU7) to get the LU pulse to disperse and added some guasha along her spine before releasing the KI channel. She became noticeably warmer during the treatment this time, her cheeks were rosy but no sweat expressed.
Heading back north tomorrow with her dad so any new treatment ideas will have to wait for Thanksgiving or for when she returns home, whichever is first!
Unfortunately there was no noticeable change after the sinew treatment. I was unable to get the LU pulse to feel like it was fully dispersing. I tried needling Lieque with my attempt at the flying technique, as described in the book, but I wasn’t able to boost it much. I went ahead and did PC/LR/KI on the more effected side (L) of her body. There were lots of twitches while I was doing the needling, very few noticeable resistant/obstructed areas to release other than just distal to Quze on her left arm. She was very cold to the touch and I don’t have any smokeless moxa with me so I was unable to warm her other than with a heating pad and keeping her as covered as possible.
I also did not attempt to needle down her spine at all because I wanted to see if just doing the KI channel would be enough. I’m not sure if that omission would be enough to make the treatment ineffective.
I did detect a thin – maybe tight? deep pulse in the guan and chi positions, but I annoyingly did not take notes and I realized on my drive that I don’t remember which side it was on – would that be indicative of Divergent or 8 Extra? Other than that her pulse was similar to yesterday with a wiriness in the PC sinew. The pulses on her left side were more full today.
Hi Antione,
Thank you for your timely response! I was wondering about the LR channel and how to assess PC vs LR against PC + LR, PC + KI, and PC+LR+KI based on her presentation. I’m heading over to treat her in about an hour and I am thinking to try the PC/LR/KI combo depending on what her pulses are saying and how her deficiencies present and respond prior to treatment.
I don’t feel comfortable diving into a divergent assessment/tx since I haven’t finished reading that section of the book and am really unsure how to make those decisions. I’m hoping that since her pulse is showing a sinew pulse that matches her presentation that the issue is still exterior and is therefore best treated with a sinew tx. But if someone with more experience tells me exactly what to do I am willing to try anything!
I’m excited and grateful for this opportunity and so happy to have this community for support!
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!
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
