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May 6, 2000

hey todd and group- i;m not sure if this is the proper procedure for

this but i have a case if anyone would like to respond to this, i would

appriciate it. pt is a 43 yo male, good health except for a persistant

case of chest pain and tightness, this has led to difficulty breathing

and anxiety. pt is a healthcare provider who stated he feels

overwhelmed sometimes dealing with people's diseases and distress. He

has a thick yellow coat in kid area, pulses are somewhat slippery. He

has a slight pain in his r- middle finger and L-middle toe. I dx this

as heat in the lower Jaio, with the heat harrassing the pericardium

channel, and livr qi stag. At first i thought the anxiety was causing

the chestpain, but we asertained that usually the chest pain evokes the

anxiety. i used bluepoppy dang gui and anemm- which is a qi tonic with

damp heat clearing properties. this didn't do much, althought the

tongue is showing some improvement, i also use 7-forest salvia and

amber, this helps with the sporadic pain, but not the constriction- i

also use a qi moving formula with gua luo pi and other qi moving

herbs. we have also notice that it is allergy season and that may be

causing the symptoms also. so with all these formulas the condition is

not improving - although there is sporadic relief- any suggestions

May 9, 2000

Hi Chet,

I hope you don't mind my asking for more information, but you didn't mention

what the Tongue picture showed other than thick yellowing @ the root, nor

what other risk factors this individual has (diet, exercise, weight, family

Hx, married/single, generally happy with his life and work, or not, any WCM

(Western Clinical Medicine) work up, etc).

While its impossible to dx your pt. on line, and the general dx you postulate

sounds reasonable, my concern here is that it has been my experience that

individuals who present with a syndrome like this, with chest pain,

tightness, and anxiety in their early 40's usually go on to develop serious

coronary events/CAD in their late 40's, or early to mid 50's (even if their

Western Clinical Med workups had showed nada at the time of onset). Even more

so if there is a lot of stress involved in their lives.

Definitely I would evaluate his diet, as well as instituting the nutritional

supplementation protocols (if not doing so already) for reduction of

Homocysteine. If utilizing nutritionals is verboten under your license where

you practice, you can always hand him some of the research reports on

Homocysteine, and make a suggestion something along the line of " you know, if

it was me... " )

Also, Blood Activators such as the combination of Dan Shen, San Qi, Shan Zha,

have shown in Taiwanese research to have definite effect when administered

long term, and daily, in preventing, and reducing arteriosclerosis and

restoring patency

to the coronary arteries. Since he complains of persistent chest pain

inducing the anxiety this would be a Major Consideration.

Also an EBCT (electron beam computed tomography) exam of his heart would

probably also be well worth his money to establish the actual current state

of his arteries (currently about $1000 to $1500 the last time I checked). The

one thing to be aware of with this is that if he gets scanned, and if they

find trouble, they may want to cut and do a by-pass right away. If it was me,

I think I would want to let the herbs, nutrition, and diet and lifestyle

changes have a chance to work first, if possible. It all depends on what may

be cooking in there already.

Other than that, the Dampness Heat in the lower Burner also often is a major

contributor to anxiety (in my experience) so clearing that, plus avoiding

sugar, and cutting down/eliminating caffeine containing drinks would also be

a wise step.

Often just eliminating, or significantly reducing (for instance Coffee in the

morning) can have a major impact on anxiety attacks, as well as reducing

future CAD risk.

Further, daily Magnesium supplementation, either from dietary supplements, or

from incorporating Magnesium rich herbs such as Long Gu, Long Chih, Mu Li,

Zhen Zhu Mu, Shi Jue Ming in his formulas etc. seems indicated, and can be

really helpful in chronic anxiety states.

Also, from what you wrote, it sounds as though your Bing Ren could have real

issues with his work, and I can tell you from personal experience, that if he

is starting to suffer " burn-out " , and is ignoring these signs and symptoms

(persistent chest pain, chest tightness, anxiety, feeling overwhelmed with

pts. and their distress) he can be setting himself up for real trouble.

You also mention allergy season as a possible causative factor, which

certainly could be a factor in the breathing problems, perhaps even in the

anxiety, but the persistant chest pain sounds more ominous than that, how

long has he been having this chest pain/tightness?

I would also think some serious soul searching, reviewing of his life plan,

re-evaluating his options, and figuring what he really wants to do, and get,

out of his life to be in order. If you, or he know a " good

counselor/therapist " (unfortunately, all too rare in my experience) then some

counseling could definitely be indicated.

In addition, you can Soften and Comfort his Liver, Dredge his Liver Qi, and

Soothe his Pericardium all day long (not that that's a bad thing to do for

him, acupuncture and herbs are great), but if the underlying problem is he is

really over stressed and burning out on his job, he won't really get better

till he faces and deals (one way or another) with those issues.

It's hard to be more specific right now, but do write us back with additional

details on your pt as mentioned above (including ingredients of the various

patent formulas utilized). There are some exceptionally " bright lights " here

on this list, and you will probably get (more than) several excellent

perceptions, insights, evaluations, and suggestions of where you might be

able to go diagnostically, therapeutically and herbally to further help your

pt.

Bruce

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In a message dated 05/06/2000 9:45:03 AM Pacific Daylight Time,

needlemedeep writes:

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05/06/2000 9:45:03 AM Pacific Daylight Time

needlemedeep (chet cardinale)

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