A TCM challenge.

[Guest guest]

Dear group:

 

I'm not usually one to post cases on groups like this, preferring to puzzle

them out myself. Usually this works well for me. However I have a major

challenge for all of you TCM Sherlock Holmes out there.

 

One the surface, this lady's case seems fairly clear to me, however she not

responded to almost any attempts to help her out. She has been coming to

see me weekly for 1 1/2 years --- and frankly I'm not sure why. Only a few

of her complaints have been addressed.

 

I throw myself on the mercy of the group. Here is her case:

 

Twenty-nine year old female, appears to be fit and of healthy weight.

Complexion is healthy. Extremely stressful job, made worse by her innate

anxiety.

 

Main complaint at presentation --- endometriosis and ovarian cysts.

 

Accompanying complaints: Almost constant fatigue (worse with stress,

exercise, before and during her period), occassional night sweats (~2 a

month, no pattern), joint pain (especially knees, but wandering throughout

her body), sleep is often fitful with problems falling asleep and problems

waking up througout night (made worse with stressful situations at work),

headaches which occur 3-4 times a week with 2-3 times a month very severe

(no correlation to period), sinus allergies, stomach is easily upset by

food ( " sour stomach " ), rare refux, nausea fairly frequently, alternating

constipation/diarhea, appetite is normal to slightly reduced, constant

thirst, often feels hot during day --- but occcassionally is

inappropriately chilled, dry itchy 'yeast' infections around her period,

anxious --- often inapproprately (Xanax and the like haven't helped, but

neither have herbs), easily bloated througout her whole body (occassionally

worsened by her mestrual cycle), and frequent urination.

 

Her pulse is text book wiry and not really that deficient feeling. Her

tongue is slightly long, red at the tip and with an appropriate thin white

coat.

 

Despite the welter of complaints, she doesn't come across as a whiner. She

is very stoic, engaging and friendly. I only point this out to separate

her from that certain type of acu-client who lives for their symptoms.

 

I immediately saw the strong preponderance of LV Qi stagnation issues:

invading into the stomach and the spleen, and holding strong sway over her

mestrual issues. Most acu-herbal therapies to date have centered around

that organ. Of course SP deficiency seemed to be a given as well. In

addition I saw a bit of Kidney yin deficiency here and there --- which I

never really treated via herbs due to there cloying effect upon the SP.

 

In granular form, TCM dosages, I administered fairly textbook formulas for

harmonization of LV/SP/ST. No results. Administering variations on this

herbal theme for periods of 1-2 months each (to give them ample time to

work)) produced no meaningful results. I monkeyed with the formulas,

adding damp/Phlegm dispelling herbs, trying to clear damp heat. The most

significant improvement that she saw was upon taking the Health Concerns

product 'Quiet Digestion' which helped a great deal with the stomach

issues, but not the spleen problems.

 

I am a desperate man. Any ideas or help would be appreciated.

 

Thank you in advance.

 

Sincerely,

 

Mark Reese, L.Ac.