Digest Number 104

[Guest guest]

I posted this case with my introduction, but didn't get any responses, so

I'm going to post it again:

 

A woman, late forties, obese. Lifetime depression/irritability/loud,

cutting sarcasm. Sciatic pain, occ. HA, irritable gallbladder w/occ.

severe pain. Some skin itching/eczema. Often has diarrhea, occ. constip

(thinks related to ST medicine), hates extremes of weather... lots of

stress. More depressed for several years due to husband's death.

 

Acupuncture (using very few needles, as she's quite sensitive) has been

very effective at reducing her sciatic pain (she says 95% improved),

shoulder tension, and HA. During the sciatic tx, (SIJ, top liao, BL40,

occ. BL23, mild stick moxa), she often enters into a deep meditational

state (words stop, perceives light). She doesn't get into the same state

from the shoulder tx.

 

For herbs, I decided to try Xiao Yao Wan to start with. We started Golden

Flower Free/Easy Plus, but she says she's very sensitive to tumeric

(gallbladder pain), which is part of the 'plus' in the formula. We moved

to bulk herbs, as she specifically said she is sensitive to ginger,

tumeric, and hates licorice of any sort. The modified formula was very

effective in relieving irritability (within minutes/a couple hours of

taking). Her teenage daughter praises them and hates the thought of her

mother going without them. Due to concerns about blood pressure (and

fats), we added Crataegus/Shan Zha to the formula. She has taken that

happily for months (oh, I substituted Hei Zao for the licorice), and

doesn't like the idea of making any changes, as her gallbladder is so

sensitive. However, recently, she began to complain a bit about the

slightly bitter taste and how it burns her mouth and stomach a bit, and

that her gallbladder's been getting a bit irritated. I had her toss in a

handful of rice during the preparation, and she has reported that it

improves the taste/burning/irritation significantly.

 

My question is, what about this gallbladder issue? What modifications may

treat the gallbladder irritation/pain without *causing* irritation/pain.

She's fairly certain she doesn't have gallbladder stones... I guess she had

an Xray several years ago. She's upset with the medical profession for

treating her differently than men... They won't take out her gallbladder

for her w/o evidence of stones/severe pain, but her brother merely

mentioned a constant pain in the region and they took his out...

 

My clinic is on the 4th floor of the building, and if I modify her formula

and cause gallbladder pain, I'm afraid she'll throw me out the window. <G>

 

Any thoughts or suggestions would be appreciated.

 

--Kevin O'Neil, L.Ac.

Klamath Falls, OR

Ancient Way Acupuncture & Herbs

www.AncientWay.com

[Guest guest]

Kevin,

Your case sounds like liver fire with qi stagnation and/or Lv.GB

dampheat but it is very hard to differentiate this w/o tongue and pulse.

Modifications of long dan xie gan tang and/or huang lian wen dan tang

come to mind but additional info is needed here.

 

Mark