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Case study: loose joints

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Group,

I need help please. A new patient came to my (new) practice today, and I'm

unclear if I have herbs that will help her...and hope the acup. does.

 

16 y.o. female, high school student

chief complaint: severe back and neck pain, 6/10 (10 worst), 7 years, no trauma.

Has tried chiro, massage, myo relaxer and had no relief lasting longer than a

couple days.

Subjective:

Pain: T12 area and L2-L4 mostly, but states it's upper, middle and low back,

plus neck. Worse in cold and rainy weather. Nature is dull, but severe. First

noticed when she was about 9yo in tumbling class, when " ribs would pop out of

place "

High stress: States high stress at school, mom was with her, relationship seems

very loving and supportive.

Menses: began age 13, very irregular-sometimes 2x month, sometimes >30 days. MD

put her on BCP to regulate to 28 days. PMS bad, with cramps, crying, depression,

irritability. Bleeding heavy at first, then moderate, red, sm. clots. 5-7 days.

Vision: Wears contacts, yet sometimes experiences blurry vision.

Joints: ankles crack loudly. hips, shoulders, knees -extremely hypermobile.

(says brother is double jointed in thumb and shoulder).

Digestion: IBS, mostly diarrhea when nervous (sings at school)

Headaches: Frontal, temporal, occipital 5 of 7 days weekly. these are slightly

better with pressure.

Migraines: Within last year has started getting migraines. Can't remember if

one sided, but worse with light. Last one lasted 3 days. Hasn't had one for 3

months.

In past 3 months:

MD ordered xray (at mom's request) - they read it to possibly have a slight

fracture, but not a new one. So they sent her to Children's Hospital in

Pittsburgh. They did an MRI - which they read as 'normal'. Back home, they

followed up with a bone scan. This showed some abnormality at T12, but

WNL.--nothing structural wrong, they say. The girl stood before me, popping

(probably dislocating)her hips, knees, and shoulders - they looked deformed when

she did it...the mom was watching, and was unaware until that time that the girl

could do this.

Objective:

Palpations of T12/L1-space is unusually large. GB20, GB31 painful. Needling

B18, B23 very sensitive.

Pulse: wiry , 68 BPM

Tongue: red, thin white, glossy edges---lacks good body--rather flaccid.

Assessment: (can't remember the word to use for deficiency)

Liver Qi stag/overacts on Spleen, Liver and Kid yin def causing liver yang

raising. Hypdermobility-tendons not nourished.

(I understand there's a lot of liver malnourishment and stagnation here, but am

unclear just what to call this.)

I can find herbs to relax the tendons, and reduce the stresses, but are there

formulas to nourish and tighten the tendons? Are kidney and liver tonics

themselves appropriate? PLEASE HELP. I feel the frustration of this family

trying to find relief for this girl.

 

Thanks for any insights!

Ruth Elder

 

 

 

 

 

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Joints: ankles crack loudly. hips, shoulders, knees -extremely hypermobile. (says brother is double jointed in thumb and shoulder).>>>She posibly has Marfan's or Ehlers-Danlos syndrome you should have her worked up

Alon

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