help with case

[Guest guest]

I have a patient who I've been seeing for almost a year, who is trying to

get pregnant. Initially she came to me for severe PMS, including migraines.

This has largely resolved. She no longer gets migraines and only

occasionally severe pre-menstrual discomfort. She is 29 years old and has a

history of severe nephritis in 1985, as a result of which she has had until

very recently, microscopic amounts of blood in her urine. Her last physical

exam revealed no blood in her urine but this time a small amount of protein.

 

She is in generally good health, eats quite well, exercises regularly. Is

moody, easily stressed and irritated and can tend toward depression but is

usually in good spirits when I see her, is quite happy with her life and

recent marriage.

 

Digestion -- constipated right before her period, soft stools once it

starts. Some bloating, gas, history of Stomach Heat (possible ulcer). This

is no longer a problem, however.

 

Sleep -- Depends on stress. light sleeper, occasionally trouble falling

asleep, wakes during night but goes back to sleep, sometimes vivid dreaming

 

Fatigue associated with menstrual cycle. Runs cold. Cold hands and feet.

History of dizziness, floaters but not currently.

 

Complexion -- pale, with pale to very slightly purplish lips.

 

Tongue -- currently pale purple, more purple in the center. Thin yellow fur

in the back, none in the front. Red tip and sometimes orangey along the

sides.

 

Pulse -- Overall deficient, moderate rate, middle-deep level, slightly wiry

in Liver position pre-menstrually and soft post-menstrually left and right

Kidney positions always very deep and weak/empty, Heart pulse thin, Spleen

soft and weak.

 

At this point her main health focus is on balancing and tonifying herself so

that she can get pregnant. Her husband recently had a sperm count performed

but I don't know the results yet.

 

My primary diagnosis has been Liver Qi Stagnation, Blood Deficiency and

Stasis, Kidney Yang and Essence Deficiency. Though there's also Heart and

Spleen deficiencies.

 

I haven't given her herbs in quite a while, as she has been working with MD

and taking a lot of supplements. She is now interested in resuming herbs.

She wants to either tablets or capsules.

 

I was thinking of the following, to strengthen Kidney and Blood and also

move Liver and Blood, but I'm really not sure as my main focus hasn't been

on herbs in my practice:

 

#1: for two weeks prior to ovulation:

This is a formula Giovanni mentions to treat Proteinuria from chronic

nephritis:

 

Sheng Di Huang 12

Shu Di Huang 12

Shan Zhu Yu 6

Shan Yao 12

Rou Gui 3

Huang Qi 12

Dang Shen 15

Bai Zhu 9

Fu Ling 15

Gou Qi Zi 12

Tu Si Zi 15

Jin Ying Zi 9

Lu Jiao Shuang 15

 

#2 Blue Poppy: Upbear Yng & Lift the Menses (Sheng Yang Ju Jing Tang) for

two weeks before menses

 

Huang Qi

Shu Di

Rou Gui

Bai Shao

Hong Hua

Dang Shen

Chuan Xiong

Du Huo

Qiang Huo

Gao Ben

Fang Feng

Bai Zhu

Dang Gui

Chai Hu

Tao Ren

Gan Cao

Bai Zhi

Fu Zi

 

TIA

 

Catherine