A difficult case study:my wife seizures with Parkinson's

[Guest guest]

Dear Z'ev and Doug,

 

Forgive me for throwing everything together in one big mish-mash, but I

was alluding to a specific point, that her syndrome was one of constant

change. A little background to set the table: We married in ''79 and

previous to that she had had a very difficult life: including a botched

up missed abort where she almost bled to death, severe physical

deprivation, pursuing 2 careers, constantly on the run, very high strung,

inadequate sleep, grabbing fast food, hating to drink fluid, tremendous

stress, constant headaches, and muscle spasms. There is much more but

I've given you a taste of the background leading up to a scenario of

liver qi yu and liver blood xu, and setting in motion the tragic domino

effect leading to her present condition. Furthermore, she " lived " on

tylenol which further damaged her liver. She is now post-menopausal, and

over time the liver blood xu advanced to become kidney and heart yin xu

as manifested by very red tongue tip, and a thready, slippery and rapid

pulse and, of course, low back tenderness as well as hearing loss. Along

with this, her tongue presented with a thick dry and dark yellow, and at

times even black coating, which quivers. Which brings us to the next

aspect, the liver blood xu has engendered wind, and the liver qi yu has

overacted on sp causing sp xu, which over time transformed into phlegm.

And of course, the same factors engendering the phlegm also led to the

wind. The phlegm followed the wind upward obstructed the channels,

misted the heart and caused the seizures, whereas the wind itself is

manifested as parkinsons. So even though the top Neurologists at UCLA

had said that PD and seizures don't go together, from a CM perspective,

it was quite feasible. Now to answer your other questions, as far as the

heat syndrome, she presented with phlegm fire, as manifested by extreme

anger, hyperactivity, insomnia and at times manic behavior, this usually

pre and immediately post seizures when her tongue presented with the dry

black coating, and at other times, complete exhaustion, red cheeks,

terrible lower back pain, nightmares, poor memory, anxiety, frequent

urination, constipation, dry mouth but rarely thirsty (phlegm).

Interestingly, the seizures have always been accompanied by drooling of

thick clear phlegmy saliva, and phlegmy breathing. I hope I have

described to your satisfaction her zang fu and differential diagnosis.

In answer to your question, Doug, about using blood moving herbs, that

has indeed been a piece of the puzzle, but with simultaneously,

nourishing the blood as well. So after a little over a year, this has

been the strategy: Always use a small dose of Da Huang in capsule form,

as for the first time in her life, she is regular, with soft well formed

stools. As well, use quan xie and wu gong also in capsule form to

extinguish wind and sedate the tremors. Also, always use gui ban, bie

jia to nourish yin and anchor yang. The rest of the herbs change

depending on where we are in the cycle. Immediately after we are sure

that the seizures are over, we tonify qi and blood,and calm the shen,

in addition to nourishing yin and extinguishing wind. When she has

recovered somewhat, for week 2 the emphasis is on tonifying yin, and

still, but to a lessor degree tonifying qi, while again concerning

ourselves with the other factors. Week three, from around 16 days, on

towards when the next seizure would be expected, the strategy changes to

aggressively, cooling and transforming phlegm fire, using reducing herbs,

while again at the same time making sure to nourish yin. The good news is

that for the first time ever, over the past 3 months, for a period of a

few days, about 2 weeks after the last seizure, her tongue has had a

lovely light red body, with a thin white coating. But then the insidious

phlegm heat manifests itself with insomnia and manic behavior, and

slippery, slightly rapid pulse, though it may not show in her tongue.

One last thing, over the past month, Dr Zhang has added 3g of Hu po, to

be taken at bedtime, on nights when seizures are expected.

 

Phew! how was that? Anyway, my next report after our next session, this

Thursday night.

 

Yehuda

 

 

 

 

Yehuda,

This sounds like a short-hand diagnosis. Can you fill it in with

the pathomechanisms., zang-fu, and more detail? Being a complex group

of zang-fu patterns, it sounds like five-phase theory may also be

necessary to explain her condition in terms of pattern differentiation.

Specifically, can you differentiate 'excess fire' from vacuity heat?

How are they 'mixed together'? Can you be more specific on the yin

and blood vacuity? Which one derives from the other? Which zang have

the vacuity? From what factor does the liver wind develop out of?

Where is the phlegm accumulation, and what is causing it?

 

Take care,

 

 

On Jan 10, 2005, at 2:36 AM, Yehuda L Frischman wrote:

 

> It is my hope

> that as the fine-tuning process continues, the seizures will cease.

> In

> summary, her condition has consisted of excess fire, mixed with

> deficient heat, yin and blood deficiency, liver wind, and phlegm

> accumulation.

>

>