Guest guest Posted March 10, 2003 Report Share Posted March 10, 2003 Greetings all, My 22 y.o. male patient who sustained injuries to his spincal cord following a compression fracture at C7 is no longer on Coumadin and can take herbs. He is almost 4 mos. out, following his accident, and has motor function in his right arm/hand, and about 80% in his left arm/hand. HIs trunk control is pretty stable and getting stronger each day. Presently, he is receiving acupuncture two to three times per week and as he is no longer on coumadin, is ready to start taking herbs - his goal is to walk again. He is now moving his toes independently and has had pain sensations in his knee/hip. Otherwise, he has no independent movement in these areas. He can feel when people are touching his legs/feet, and has felt the needles at Liv 3. . . His pulses are thin and thready, sometimes slippery. His tongue is a pale purple, with a thin white coat in front and thicker/greasy in back. His energy is relatively good, altho sleep is disturbed due to spasms in his legs (involuntary - muscles contract/legs flex) and having to catherize his bladder twice night. THe muscle spasms seem to be quite bothersome and show no pattern to the frequency/intensity. These are mostly in his lower extremities, but sometimes occur in his upper. HIs bowels do not move smoothly and this has become a source of concern for him. Does anyone have suggestions on formulas to use? He is presently taking muscle relaxants to try to control the spasms, and is taking stool softeners to help with bowle movements. He is also taking neurontin for nerve pain. I feel that there is phlegm stagnation as well as blood/qi stagnation, as well as deficiency (from surgery to hospital food to worry to . . . ). ANy and all suggestions would be welcomed. THank you all in advance. Best regards, Susan Froehlich, LAc Hood RIver, OR Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2003 Report Share Posted March 10, 2003 On Monday, March 10, 2003, at 09:33 PM, SusFro wrote: > His pulses are thin and thready, sometimes slippery This seems strange. Slippery pulses are replete, very different from thin and thready. I'd look and see why and when there is such a variance in pulse rhythms. Neurotin seems, in my experience, to make pulses more rapid and slippery. I feel that there is phlegm stagnation as well as blood/qi stagnation, as well as deficiency (from surgery to hospital food to worry to . . . ). These would seem to be accurate. At the very least, blood and phlegm stasis, qi and blood vacuity. As well, look at possible vacuity of liver and kidney yin (and qi) over time, Damage to the spinal cord is a damage of marrow, associated with the kidney jing-essence. I would look at a modification of bu zhong yi qi tang as a working possibility, adding some blood movers (chuan xiong, yan hu suo), bai shao and shu di huang to supplement liver and kidney yin and blood. At least a working diagnosis and treatment here. Take it further, you have the details, the patient in front of you. I can only approximate and give some sense of direction. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2003 Report Share Posted March 10, 2003 On Monday, March 10, 2003, at 09:33 PM, SusFro wrote: His pulses are thin and thready, sometimes slippery This seems strange. Slippery pulses are replete, very different from thin and thready. I'd look and see why and when there is such a variance in pulse rhythms.Neurotin seems, in my experience, to make pulses more rapid and slippery.Neurotin is gabapentin a synthetic similar to the neurotransmitter GABA that acts as an inhibitor and is released from cells that bind opiates. But gabapentin is specifically an anticonvulsive and not to be used as an analgesic. It is a treatment for partial seizures. You may get a clearer reading by asking for it to be reduced or omitted from treatment. Consider treating the leg spasm by other means. Emmanuel Segmen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2003 Report Share Posted March 11, 2003 But gabapentin is specifically an anticonvulsive and not to be used as an analgesic. It is a treatment for partial seizures. You may get a clearer reading by asking for it to be reduced or omitted from treatment. Consider treating the leg spasm by other means. >>>>>Gabapentin (neurotin) can be quite useful for neuropathic pain as it works as a cell stabilizer. Although side effects of fatigue a quite common, it is very safe even in very high doses. It has also been shown to actually "heal" brain injuries seen in post concussion as well as changes in some chronic fatigue syndrome patients (as shown on functional MRIs and Pat scans). So here we see a pharmaceutical that has "healing"effects Alon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2003 Report Share Posted March 11, 2003 I agree with Alon's point of view. As a primary care provider and acupuncturist/herbist, I prescribe Neurotin for neuropathic pain very often, especially for herpetic pain. Ta-Ya Lee, CRNP, LAc Johns Hopkins Community Physician >>> alonmarcus 03/11/03 10:14AM >>> But gabapentin is specifically an anticonvulsive and not to be used as an analgesic. It is a treatment for partial seizures. You may get a clearer reading by asking for it to be reduced or omitted from treatment. Consider treating the leg spasm by other means. >>>>>Gabapentin (neurotin) can be quite useful for neuropathic pain as it works as a cell stabilizer. Although side effects of fatigue a quite common, it is very safe even in very high doses. It has also been shown to actually " heal " brain injuries seen in post concussion as well as changes in some chronic fatigue syndrome patients (as shown on functional MRIs and Pat scans). So here we see a pharmaceutical that has " healing " effects Alon Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.