Guest guest Posted November 17, 2006 Report Share Posted November 17, 2006 I could use some help with the below patient. She has been to some of the top doctors our country has to offer and nobody can figure out what is causing the mucous hardening. I'd love to give her some herbs but I would also like some outside advice on this one. If you have any questions let me know as I'm happy to dig through the files for it. 39 year old female with m/c of sinusitis, year round allergies, chronic bronchitis. Before the age of 11 patient remembers no major health issues. While a young teenager her brother became very ill which negatively impacted her family life. She had minor seasonal allergies throughout her teenage years. While a sophomore in college patient had a difficult course load combined with too much " partying " . Was diagnosed with double pneumonia and had to leave school for the semester. The following year patient was diagnosed with a mucoseal in the sinus cavity. It had to be surgically removed as it was a solid mass. Shortly after patient reports seasonal allergies worsening. By her senior year in college her allergies extended beyond the season. Patient's condition continued to worsen and was frequently diagnosed with sinus infections which were treated with prednisone to prevent her sinus infections from entering her lungs. She has also been on many rounds of antibiotics and allergy meds such as Claritin. Patients condition continued to worsen and in 2000 had nasal polyps removed as well as a deviated septum straightened. She became pregnant in 1998 with her son and developed asthma during the first trimester. She has been tested post pg for asthma and results are negative. Post first pg her allergies felt as if they had returned to seasonal episodes. She became pg again in April 2000 and was given medications to control her allergies. Post birth of her second child she noticed that she broke out in a rash at her abdomen and inner thighs while ovulating. Rash is comprised of small red bumps. They are not weepy or severe in color. They do cause itching. In August of 2002 she became pregnant with twin girls. The rash was gone her entire pg however her allergies worsened. She had constant clear nasal discharge throughout. Patient came to me in the fall of 2003. Her allergies were constant and s/s were clear nasal discharge, lack of smell, screeching in ears, frequent sinus infections/bronchitis/pneumonia. She has improved dramatically with acupuncture in that she only suffers from 1-2 sinus infections per winter. However in the past two winters she has had her lung collapse on at least 4 separate occasions (different lobes too). She had a large impacted glob of mucous removed from her lung in the summer of 2006. It is unclear when the mass developed however it was definitely post at least 2 of the lung collapses. She also had kidney stones post surgery this summer. Her doctors have diagnosed her with excess mucous production that doesn't easily clear from sinus cavities which leads to a blocking of the airways as well as potential hardening. For birth control she has an IUD that uses a small amount of progesterone. This keeps the rash from appearing. She does not menstruate with the IUD and is looking to switch to the non-hormonal type. She suffered a miscarriage in her 7th week of pregnancy during the summer of 2005. Patient is fit and active. Her diet is pretty good, avoiding junk food and high calorie foods. She does not drink alcohol or smoke. She tries to stay hydrated however finds it difficult as she is not thirsty. Patient feels as if she runs warmer than most people when she is active, however enjoys heat at rest. She suffers from seasonal affective disorder that is worse in the fall. Patient's lifestyle is busy and has somewhat frequent air travel. Her tongue is puffy with a midline crack. Less coating on sides with a somewhat thicker whitish coat in center. Her pulses vary depending on her medications so I don't find them a reliable indicator. They are present in all positions and aren't particularly weak or deep. Currently her medications are as follows: Advair 2x/day Nasonex: 2 squirts in each nostril 2x/day Celexa: 10mg/day. Any advice is appreciated. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 17, 2006 Report Share Posted November 17, 2006 Leukotrienes are implicated in the inflammatory cascade leading to asthma and most chronic inflamation. Which lead to airflow obstruction, increased secretion of mucus, mucosal accumulation, infiltration of inflammatory cells in the airway wall Patients who get red around the needle insertion area usually have this leukotrienes problem. You can also scrape there shin with your nail and see if a red line is made in the skin. Try to leave the needles in for a long time, perhaps an hour. Should clear them right up. Kelvin DeWolfe www.1stdefense.info Chinese Medicine , " ashewan2 " <ashewan2 wrote: > > I could use some help with the below patient. She has been to some of > the top doctors our country has to offer and nobody can figure out > what is causing the mucous hardening. I'd love to give her some herbs > but I would also like some outside advice on this one. If you have > any questions let me know as I'm happy to dig through the files for it. > > 39 year old female with m/c of sinusitis, year round allergies, > chronic bronchitis. > > Before the age of 11 patient remembers no major health issues. While > a young teenager her brother became very ill which negatively impacted > her family life. She had minor seasonal allergies throughout her > teenage years. While a sophomore in college patient had a difficult > course load combined with too much " partying " . Was diagnosed with > double pneumonia and had to leave school for the semester. > > The following year patient was diagnosed with a mucoseal in the sinus > cavity. It had to be surgically removed as it was a solid mass. > Shortly after patient reports seasonal allergies worsening. By her > senior year in college her allergies extended beyond the season. > > Patient's condition continued to worsen and was frequently diagnosed > with sinus infections which were treated with prednisone to prevent > her sinus infections from entering her lungs. She has also been on > many rounds of antibiotics and allergy meds such as Claritin. > Patients condition continued to worsen and in 2000 had nasal polyps > removed as well as a deviated septum straightened. > > She became pregnant in 1998 with her son and developed asthma during > the first trimester. She has been tested post pg for asthma and > results are negative. Post first pg her allergies felt as if they had > returned to seasonal episodes. She became pg again in April 2000 and > was given medications to control her allergies. Post birth of her > second child she noticed that she broke out in a rash at her abdomen > and inner thighs while ovulating. Rash is comprised of small red > bumps. They are not weepy or severe in color. They do cause itching. > > In August of 2002 she became pregnant with twin girls. The rash was > gone her entire pg however her allergies worsened. She had constant > clear nasal discharge throughout. > > Patient came to me in the fall of 2003. Her allergies were constant > and s/s were clear nasal discharge, lack of smell, screeching in ears, > frequent sinus infections/bronchitis/pneumonia. > > She has improved dramatically with acupuncture in that she only > suffers from 1-2 sinus infections per winter. However in the past two > winters she has had her lung collapse on at least 4 separate occasions > (different lobes too). She had a large impacted glob of mucous > removed from her lung in the summer of 2006. It is unclear when the > mass developed however it was definitely post at least 2 of the lung > collapses. She also had kidney stones post surgery this summer. Her > doctors have diagnosed her with excess mucous production that doesn't > easily clear from sinus cavities which leads to a blocking of the > airways as well as potential hardening. > > For birth control she has an IUD that uses a small amount of > progesterone. This keeps the rash from appearing. She does not > menstruate with the IUD and is looking to switch to the non-hormonal > type. She suffered a miscarriage in her 7th week of pregnancy during > the summer of 2005. > > Patient is fit and active. Her diet is pretty good, avoiding junk > food and high calorie foods. She does not drink alcohol or smoke. > She tries to stay hydrated however finds it difficult as she is not > thirsty. Patient feels as if she runs warmer than most people when > she is active, however enjoys heat at rest. She suffers from seasonal > affective disorder that is worse in the fall. Patient's lifestyle is > busy and has somewhat frequent air travel. > > Her tongue is puffy with a midline crack. Less coating on sides with > a somewhat thicker whitish coat in center. > > Her pulses vary depending on her medications so I don't find them a > reliable indicator. They are present in all positions and aren't > particularly weak or deep. > > Currently her medications are as follows: > Advair 2x/day > Nasonex: 2 squirts in each nostril 2x/day > Celexa: 10mg/day. > > Any advice is appreciated. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2006 Report Share Posted November 18, 2006 Patient does not get red around needle insertion. I also have left needles in for quite some time before. The asthma was only present during her first pregnancy. Given that she was mostly fine until getting sick in college I'm wondering if the antibiotics that she was put on somehow trapped heat in her lungs that has yet to be resolved. I feel like I've come almost as far as I can with acupuncture alone. Not willing to give up but any suggestions on herbs? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 19, 2006 Report Share Posted November 19, 2006 Hi, IMHO, two bits of information you give are revealing: 1. " Her allergies were constant and s/s were clear nasal discharge, lack of smell, screeching in ears, frequent sinus infections/bronchitis/pneumonia. " and 2. " Her tongue is puffy with a midline crack. Less coating on sides with a somewhat thicker whitish coat in center. " Add to that your most recent thought: " Given that she was mostly fine until getting sick in college I'm wondering if the antibiotics that she was put on somehow trapped heat in her lungs that has yet to be resolved. " Leads me to a different conclusion which I hope will be helpful: Allergies, chronic clear nasal discharge, puffy tongue and history of antibiotics tell me that rather than trapping heat, this is probably a case of cold xu (yang xu) and wei xu. About a year ago I treated a patient who clearly had a cold constitution and was given antibiotics for pneumonia. The patient went into shock (not anaphylactic shock, BTW), stopped eating by mouth, stopped talking, and constantly clenched her musc.es. Recognizing that the very cold antibiotics were responsible, I immediately prescribed warming herbs and had her nurse administer moxa, in addition to treating with acupuncture and craniosacral therapy. After 2 treatments, the change was remarkable, and she began talking and eating again. (they kept her alive with IV). In your patients case, too, treat her with moxa, warm and supplement the yang, use a formula like Yu Ping Feng San to treat the wei xu, and consider finding a BioSet therapist to test and desensitize to food allergies. Good luck. I hope that I have been helpful. All the best. Yehuda Frischman L.Ac., CST, SER www.traditionaljewishmedicine.com ashewan2 <ashewan2 wrote: Patient does not get red around needle insertion. I also have left needles in for quite some time before. The asthma was only present during her first pregnancy. Given that she was mostly fine until getting sick in college I'm wondering if the antibiotics that she was put on somehow trapped heat in her lungs that has yet to be resolved. I feel like I've come almost as far as I can with acupuncture alone. Not willing to give up but any suggestions on herbs? http://traditionaljewishmedicine.com/ Sponsored Link Mortgage rates near 39yr lows. $310,000 Mortgage for $999/mo - Calculate new house payment Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 19, 2006 Report Share Posted November 19, 2006 On Friday 17 November 2006 13:52, ashewan2 wrote: Hi Ashewan! I have had good results with Zhu Li Da Tan Pian with hard mucus. I concur with Kevin on the long retaining times. When retaining for a long time pay special attention to patient comfort - pillows, warm/cool enough in the room, and the like. > I could use some help with the below patient. She has been to some of > the top doctors our country has to offer and nobody can figure out > what is causing the mucous hardening. -- Regards, Pete http://www.pete-theisen.com/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 20, 2006 Report Share Posted November 20, 2006 Hi Everyone, Thanks for the great suggestions. Yet another piece of information I should have included is that she overheats with even the mildest of doses of yang tonics. I tried her on a low dose of Yu Ping Feng San and she was feeling far too hot. Also her tongue can vary depending on what medications she is currently taking. -April Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 20, 2006 Report Share Posted November 20, 2006 April, You spoke about the tongue coating and the sides. What color is the tongue body and particularly the tip. Assuming that the heat she is showing is from vacuity, you might consider adding Mai Men Dong and Wu Wei zi to Yu Ping Feng San. Just an idea to consider. all the best, Yehuda ashewan2 <ashewan2 wrote: Hi Everyone, Thanks for the great suggestions. Yet another piece of information I should have included is that she overheats with even the mildest of doses of yang tonics. I tried her on a low dose of Yu Ping Feng San and she was feeling far too hot. Also her tongue can vary depending on what medications she is currently taking. -April http://traditionaljewishmedicine.com/ Sponsored Link Mortgage rates near 39yr lows. $310,000 Mortgage for $999/mo - Calculate new house payment Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 21, 2006 Report Share Posted November 21, 2006 Yehunda, Her tongue body color can vary depending on the medications she is taking. Before she was on the prednisone her tongue body was slightly pale and the tip was swollen. There was no remarkable difference to the tips color. The degree of swelling varies on her level of hydration and her current medications. Do you think the heat is from vacuity or is it possible for it to be true heat that has become constrained without giving many other indications? I only say this because she has received a lot of treatments from myself, and other practitioners before me, and I would have thought she would be showing more improvement by now. I'm just unclear as to why the mucous hardens into these masses which are having severe consequences on her lungs. Thanks to all for their help. April Chinese Medicine , yehuda frischman < wrote: > > April, > > You spoke about the tongue coating and the sides. What color is the tongue body and particularly the tip. Assuming that the heat she is showing is from vacuity, you might consider adding Mai Men Dong and Wu Wei zi to Yu Ping Feng San. Just an idea to consider. > > all the best, > > Yehuda > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 21, 2006 Report Share Posted November 21, 2006 Hi April, Steroids cause fluid accumulation,(which of course, is excess) damaging the liver and spleen. I would contend that with a longstanding problem such as this there most probably is excess and deficiency. The question is is damp heat or cold damp. And if it's damp heat is there more damp or more heat. Also, how is her elimination, both urine and bowels? These should help determine a direction to explore. Yehuda ashewan2 <ashewan2 wrote: Yehunda, Her tongue body color can vary depending on the medications she is taking. Before she was on the prednisone her tongue body was slightly pale and the tip was swollen. There was no remarkable difference to the tips color. The degree of swelling varies on her level of hydration and her current medications. Do you think the heat is from vacuity or is it possible for it to be true heat that has become constrained without giving many other indications? I only say this because she has received a lot of treatments from myself, and other practitioners before me, and I would have thought she would be showing more improvement by now. I'm just unclear as to why the mucous hardens into these masses which are having severe consequences on her lungs. Thanks to all for their help. April Chinese Medicine , yehuda frischman < wrote: > > April, > > You spoke about the tongue coating and the sides. What color is the tongue body and particularly the tip. Assuming that the heat she is showing is from vacuity, you might consider adding Mai Men Dong and Wu Wei zi to Yu Ping Feng San. Just an idea to consider. > > all the best, > > Yehuda > > http://traditionaljewishmedicine.com/ Sponsored Link Degrees online in as fast as 1 Yr - MBA, Bachelor's, Master's, Associate - Click now to apply Quote Link to comment Share on other sites More sharing options...
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