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case submission - bipolar d/o

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I am not soliciting advice, just sharing a success story

 

1) Chief complaint - hx of depression and hypomania, severe PMS mood

swings

 

2) Biomedical Dx and supporting lab tests - bipolar affective disorder

 

3) Relevant Medical History, include habits, diet, exercise, etc. - sx

since age 12, pt. now in mid 20's and was just dx a year ago.

 

4) questioning examination (subjective) - severe depression and bouts of

hypomania, sometimes cycling daily, mostly depressed though. worse at

PMS, with classic liver signs, cramping, irregularity, moodiness, breast

tenderness. Usually has cold hands and feet, but gets flushed and hot

with hypomania. Irregular bowel movements, fatigue with depression,

high energy with hypomania. Prescribed lithium, welbutrin and OCP.

Side effects of skin rashes and tremors were unbearable. Pt. stopped

lithium and OCP 2 months ago. Weaning off welbutrin when I met her.

 

5) pulse and palpation examination (objective) - very wiry pulse

 

6) tongue and observation examination (objective) - tongue reddish, dry,

with red dots, esp. on tip, slight cracking, scanty (but not absent)

coat, purple distended veins underneath

 

7) the pattern(s) and treatment principles you chose, including your

rationale (unless this is your question) (assessment) - liver constraint

with heat collapse, blood stasis, heart blood yin vacuity, blood stasis

 

8) herbs used (unless this is your question) (plan)

 

si ni san jia wei

 

dang gui -12

bai shao - 12

he huan pi - 18

suan zao ren - 18

bai zi ren -18

zhi shi - 18

zhi gan cao - 12

da zao - 3 pieces

mei gui hua - 18

dan shen - 18

 

weaned up herbs while weaning down welbutrin (under psychiatrist's

supervision). Patient usually gets severe flareup at PMS, but is stable

after achieving full dose of herbs. No depression or mania at this time

after three weeks of herbs and weekly acupuncture. Bowels normal. Has

never avoided severe depression during PMS since age 12 until this week,

unless heavily medicated.

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No depression or mania at this timeafter three weeks of herbs and weekly acupuncture. Bowels normal. Hasnever avoided severe depression during PMS since age 12 until this week,unless heavily medicated.Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

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---

<<si ni san jia wei

 

dang gui -12

bai shao - 12

he huan pi - 18

suan zao ren - 18

bai zi ren -18

zhi shi - 18

zhi gan cao - 12

da zao - 3 pieces

mei gui hua - 18

dan shen - 18>>

 

Splitting hairs here... shouldn't this be Si Ni San

Jia JIAN? I don't see Chai Hu anywhere.

 

pedantically yours,

Robert Hayden, L.Ac.

 

 

=====

Robert Hayden, L.Ac.

http://jabinet.net

 

 

 

Auctions - buy the things you want at great prices

http://auctions./

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, r hayden <kampo36> wrote:

>

 

>

> Splitting hairs here... shouldn't this be Si Ni San

> Jia JIAN? I don't see Chai Hu anywhere.

 

not splitting hairs at all. It should be jia jian. the original did

contain chai hu, which I later deleted out of concern for it inducing

hypomania. I used he huan pi because it calms and disperses. thanks

for the correction

 

 

todd

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