Guest guest Posted August 24, 2008 Report Share Posted August 24, 2008 I find I am having a difficult time thinking clearly about this case, partly because I am a very new practitioner (I graduated 6 weeks ago, and got licensed 2 weeks ago) and never saw anything like this in my clinicals (nor in my 10 years of being an Occupational Therapist/ Hand Therapist), but mostly because the patient is me, and it's tough to be objective when experiencing the physical and emotional aspects of disease. So, I am turning to you all, both so that I may learn and become a better practitioner and so that I can get clearer on the best way to treat myself herbally and return to health. I apologize in advance for how long this is, but I figure the more you know, the more you can help. Here's the background: I think I got bit by a bug (during sleep?) on the posterior part of my forearm, about an inch-and-a-half distal to the olecranon, just over 3 weeks ago. I first noticed it on August 1, 2008. I was on vacation at the time. I thought it was a pimple (it wad a whitehead), so just figured my body would take care of it and didn't think any more about it for almost 2 weeks (it was out of my consciousness because I couldn't see it without effort, and it didn't hurt when bathing/running a wash cloth over it). Then I noticed that the area hurt if I set my arm on a table, and I realized it was red and raised (about 1.25 inches in diameter). I started taking Lian Qiao Pai Tu Pian, which cut it down by over a half within the first day. That was August 13. I took the herbs for another day, but then life happened and I didn't take them again (I'm a better practitioner than patient). So, on August 17, I noticed that the inside of my elbow was tender to touch, and I realized my cubital lymph node was slightly swollen. I started taking the herbs again, which helped the area where the bite (?) was (as it was still raised and red), but not the lymph node. I felt I needed something that went deeper, so asked one of my former clinical supervisors for help (on August 19). He told me that I should just keep taking the same herbal formula, but also put very thin slices of garlic on the bite area, changing it as the garlic dried, for the rest of the day and also to sleep with it. My gut said the Lian Qiao Pai Tu Pian was no longer appropriate, but I figured he had so much more experience than I did that he must be correct. So, I did as he said. I knew the garlic would make the area under it blister, and it did, but it also completely got rid of the redness and swelling. That area is now healing well. However, my lymph node got worse (more swollen and more tender), and it progressed to the next proximal lymph node. My arm was painful (deep ache) from the level of Lu-3 to about the level of Li-10 with occasional numbness in my hand. So, on August 20, I consulted with another practitioner and shifted the focus of my herbs (mostly clear heat, relieve toxicity; some clear heat, cool blood and clear heat, dry damp, with some move qi and blood, plus herbs to balance all that cold stuff). I also started taking ibuprofen (which I hate doing, but the pain was making it impossible to sleep), and that--combined with the herbs--seemed to help the ache and the progression. It seemed to " pull back " to that cubital lymph node (the one proximal to it was still swollen, but not so tender). Then, 3 weeks after I initially noticed the " pimple " (i.e., August 22) I woke up with lymphedema around my inner elbow (the first time I had noticed it), despite the fact that the pain has pulled back to that cubital lymph node. So, I had an acupuncture treatment, and then saw my chiropractor who put on some kinesiotape, which I took off after about 5 hours because it made the lymphedema increase and pool about a third of the way down my medial-posterior forearm. My cubital lymph node also seemed really angry--the skin around it got hot and red for the first time and the node swelled even more, becoming very hard. I should mention that at no time during all of this have I had any red streaks up my arm, any fever, or any pitting edema. In addition, I continued to take the herbs. After sleeping with my arm elevated, the " pool " of edema went away, but the general lymphedema remained. My arm continued to be be warm in the area of the cubital lymph node at rest, but if I used my arm at all, it would quickly get hot and red, and it ached greatly (I'm sure because everything was being strangled by the swelling). I avoided using my arm because of the pain. Yesterday (August 23), I had a lymphatic drainage massage which helped a lot (80% reduction in pain within an hour). Her impression was that the lymph system was just backed up and the lymph was gelling so it couldn't flow, but it was more fluid after the treatment, and she expected it to continue to improve. I felt so good that I spent 2 hours re-filling raw herb jars and ordering raw, powder, and patent herbs. Within that time, my arm returned to the swollen, painful state it was in prior to my treatment, with the skin over the node being red and hot. I also developed a low-grade fever. The redness and heat mostly went away after I did some lymphatic self-massage, and the area got less taut and painful, though the node was still very swollen and hard and there was still pain. The fever went away with a dose of ibuprofen. I will see the massage therapist again tomorrow. Today I am unable to use my right arm for anything without flaring it up (tough, as I am right-handed). I have typed all of this with only my left hand except for one paragraph (and after that I had to stop to do the self-massage to calm it down). Through all of this, my tongue has been unchanged (swollen, teethmarks, light red, thin white coat, red prickles at the tip; my tongue has looked like this for over a year). My pulse on the right is thin, deep in the 1st and 3rd, and wiry. It feels constrained (not surprising). On the left it is thin and wiry. I have not seen a medical doctor, as I know all he will do is put me on a broad-spectrum antibiotic (which I feel I am taking the herbal equivalent of, plus anti-viral). Here are my questions: 1.) How does view the lymph system? This was never discussed in my schooling, and I cannot find anything about it in my books (even Fluid Physiology and Pathology in TCM). Is lymph fluid considered jin, ye, or something else? 2.) Does anyone have any experience treating lymphedema of the upper extremity? If so, can you please share insights? 3.) Herbally, what is best to treat this? The classic formulas for edema which I have looked at seem not to apply. As I said, I am not able to think clearly about this case because of how involved I am physically and emotionally. I greatly appreciate any help anyone can give. Thank you for taking the time to read all of this. Julie Espy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2008 Report Share Posted August 24, 2008 Hi Julie, A few comments. As the 2nd practitioner you consulted, noted it sounds like you have toxic heat from the insect bite. As it might be a tick, it would behoove you to get tested to see if you have Lyme's disease. (It's a simple blood test). BTW, Subhuti Dharmananda, the director of the institute of Traditional Medicine in Portland has a couple of articles that might interest you: one on Lyme's disease: http://www.itmonline.org/arts/lyme.htm and one on lymphadema: http://www.itmonline.org/arts/lymphedema.htm . In the article on Lyme's he giveas an example formulas such as Liang Xue Bai Du Tang. But in addition to any formula that you write to treat this toxic heat, you must also consider your constitution. It is important to note that from the thin wiry pulses and the prickles in the front of the tongue you should consider adding herbs to cool the blood, supplement blood, and calm the shen, such as Chi Shao Yao, Mu Dan Pi, Sheng Di Huang, Ye Jiao Teng, and Zhi Zi, for example (think Jia Wei Xiao Yao Wan) That should give you a good start. BTW, in the article on lymphadema, the author states pretty clearly that in the classic literature it was viewed as phlegm damp accumulation, TanYin. This is clearly pathological fluid, and so it is very different than Jin Ye. I don't know if the ancients were aware of the lymphatic system per se, but they empirically recognized lumps as phlegm nodules which they treated with the seaweeds like Hai Zao. (BTW the formula in pill form " Nei Xiao Luo Li Wan " specifically addresses lymphadenopathy and contains Hai Zao). Good luck and don't panic. Nuture and support yourself, educate yourself, and don't be afraid to keep looking locally until you find someone who you can look to as a mentor for support and guidance. Speedy and complete recovery, --- On Sun, 8/24/08, j_c_sp23 <jcespy23 wrote: j_c_sp23 <jcespy23 lymphedema case Sunday, August 24, 2008, 1:40 PM I find I am having a difficult time thinking clearly about this case, partly because I am a very new practitioner (I graduated 6 weeks ago, and got licensed 2 weeks ago) and never saw anything like this in my clinicals (nor in my 10 years of being an Occupational Therapist/ Hand Therapist), but mostly because the patient is me, and it's tough to be objective when experiencing the physical and emotional aspects of disease. So, I am turning to you all, both so that I may learn and become a better practitioner and so that I can get clearer on the best way to treat myself herbally and return to health. I apologize in advance for how long this is, but I figure the more you know, the more you can help. Here's the background: I think I got bit by a bug (during sleep?) on the posterior part of my forearm, about an inch-and-a-half distal to the olecranon, just over 3 weeks ago. I first noticed it on August 1, 2008. I was on vacation at the time. I thought it was a pimple (it wad a whitehead), so just figured my body would take care of it and didn't think any more about it for almost 2 weeks (it was out of my consciousness because I couldn't see it without effort, and it didn't hurt when bathing/running a wash cloth over it). Then I noticed that the area hurt if I set my arm on a table, and I realized it was red and raised (about 1.25 inches in diameter). I started taking Lian Qiao Pai Tu Pian, which cut it down by over a half within the first day. That was August 13. I took the herbs for another day, but then life happened and I didn't take them again (I'm a better practitioner than patient). So, on August 17, I noticed that the inside of my elbow was tender to touch, and I realized my cubital lymph node was slightly swollen. I started taking the herbs again, which helped the area where the bite (?) was (as it was still raised and red), but not the lymph node. I felt I needed something that went deeper, so asked one of my former clinical supervisors for help (on August 19). He told me that I should just keep taking the same herbal formula, but also put very thin slices of garlic on the bite area, changing it as the garlic dried, for the rest of the day and also to sleep with it. My gut said the Lian Qiao Pai Tu Pian was no longer appropriate, but I figured he had so much more experience than I did that he must be correct. So, I did as he said. I knew the garlic would make the area under it blister, and it did, but it also completely got rid of the redness and swelling. That area is now healing well. However, my lymph node got worse (more swollen and more tender), and it progressed to the next proximal lymph node. My arm was painful (deep ache) from the level of Lu-3 to about the level of Li-10 with occasional numbness in my hand. So, on August 20, I consulted with another practitioner and shifted the focus of my herbs (mostly clear heat, relieve toxicity; some clear heat, cool blood and clear heat, dry damp, with some move qi and blood, plus herbs to balance all that cold stuff). I also started taking ibuprofen (which I hate doing, but the pain was making it impossible to sleep), and that--combined with the herbs--seemed to help the ache and the progression. It seemed to " pull back " to that cubital lymph node (the one proximal to it was still swollen, but not so tender). Then, 3 weeks after I initially noticed the " pimple " (i.e., August 22) I woke up with lymphedema around my inner elbow (the first time I had noticed it), despite the fact that the pain has pulled back to that cubital lymph node. So, I had an acupuncture treatment, and then saw my chiropractor who put on some kinesiotape, which I took off after about 5 hours because it made the lymphedema increase and pool about a third of the way down my medial-posterior forearm. My cubital lymph node also seemed really angry--the skin around it got hot and red for the first time and the node swelled even more, becoming very hard. I should mention that at no time during all of this have I had any red streaks up my arm, any fever, or any pitting edema. In addition, I continued to take the herbs. After sleeping with my arm elevated, the " pool " of edema went away, but the general lymphedema remained. My arm continued to be be warm in the area of the cubital lymph node at rest, but if I used my arm at all, it would quickly get hot and red, and it ached greatly (I'm sure because everything was being strangled by the swelling). I avoided using my arm because of the pain. Yesterday (August 23), I had a lymphatic drainage massage which helped a lot (80% reduction in pain within an hour). Her impression was that the lymph system was just backed up and the lymph was gelling so it couldn't flow, but it was more fluid after the treatment, and she expected it to continue to improve. I felt so good that I spent 2 hours re-filling raw herb jars and ordering raw, powder, and patent herbs. Within that time, my arm returned to the swollen, painful state it was in prior to my treatment, with the skin over the node being red and hot. I also developed a low-grade fever. The redness and heat mostly went away after I did some lymphatic self-massage, and the area got less taut and painful, though the node was still very swollen and hard and there was still pain. The fever went away with a dose of ibuprofen. I will see the massage therapist again tomorrow. Today I am unable to use my right arm for anything without flaring it up (tough, as I am right-handed) . I have typed all of this with only my left hand except for one paragraph (and after that I had to stop to do the self-massage to calm it down). Through all of this, my tongue has been unchanged (swollen, teethmarks, light red, thin white coat, red prickles at the tip; my tongue has looked like this for over a year). My pulse on the right is thin, deep in the 1st and 3rd, and wiry. It feels constrained (not surprising). On the left it is thin and wiry. I have not seen a medical doctor, as I know all he will do is put me on a broad-spectrum antibiotic (which I feel I am taking the herbal equivalent of, plus anti-viral). Here are my questions: 1.) How does view the lymph system? This was never discussed in my schooling, and I cannot find anything about it in my books (even Fluid Physiology and Pathology in TCM). Is lymph fluid considered jin, ye, or something else? 2.) Does anyone have any experience treating lymphedema of the upper extremity? If so, can you please share insights? 3.) Herbally, what is best to treat this? The classic formulas for edema which I have looked at seem not to apply. As I said, I am not able to think clearly about this case because of how involved I am physically and emotionally. I greatly appreciate any help anyone can give. Thank you for taking the time to read all of this. Julie Espy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2008 Report Share Posted August 24, 2008 I see you're getting some herb advice already, so I'll try to contribute what I can which may be unique. As a primarily Japanese style acupuncturist, there is a trick which normally helps these type of things: Okyu, or direct, rice grain moxa. Use a VERY high grade Japanese loose moxa (the small red box type at a minimum. Chinese moxa is not pure enough, and burns too hot). Surround the area with rice grain, or even 1/2 rice grain size pieces, and place them right on the skin. You can use a little water on the skin to make it stick. Burn around, not on the lumps/swelling, and do about 3 rounds. Completely surround the area with moxa, not just one or two pieces. The theory is this: modern research has shown the heat from this type of moxa is infrared in nature. When it penetrates the body, it causes a reaction in the white blood cells, and thus stimulates and harmonizes the body's immune response. This in turn balances the sympathetic/parasympathetic nervous system etc. Mizutani Sensei has complied a lot of this research in various articles of the North American Journal of Oriental Medicine. I have used this technique to clear up everything from plantar fascitis to sprained ankle pain, often in one treatment. In your case I would treat myself daily. Now, people will say, 'won't moxa add heat, and aggravate your toxic heat condition'? No, not if you use high grade moxa. By stimulating the healing response, you will actually stimulate the body to clear the congestion manifesting as toxic heat. A word of warning: this type of treatment can cause what we call a 'healing response', meaning you will get worse right after treatment, before the condition completely resolves. If that happens, don't freak out. Oh, I am assuming you know not to smother the cones before they burn the skin. This is not a scarring technique, though that might work as well, as a moa burn only forms pus if there are toxins needed to be resolved. I do not advocate that though, unless you know what you are doing. Please let us know how things go, and what does and doesn't work. best of luck. Henry j_c_sp23 <jcespy23 Sunday, August 24, 2008 2:40:25 PM lymphedema case I find I am having a difficult time thinking clearly about this case, partly because I am a very new practitioner (I graduated 6 weeks ago, and got licensed 2 weeks ago) and never saw anything like this in my clinicals (nor in my 10 years of being an Occupational Therapist/ Hand Therapist), but mostly because the patient is me, and it's tough to be objective when experiencing the physical and emotional aspects of disease. So, I am turning to you all, both so that I may learn and become a better practitioner and so that I can get clearer on the best way to treat myself herbally and return to health. I apologize in advance for how long this is, but I figure the more you know, the more you can help. Here's the background: I think I got bit by a bug (during sleep?) on the posterior part of my forearm, about an inch-and-a-half distal to the olecranon, just over 3 weeks ago. I first noticed it on August 1, 2008. I was on vacation at the time. I thought it was a pimple (it wad a whitehead), so just figured my body would take care of it and didn't think any more about it for almost 2 weeks (it was out of my consciousness because I couldn't see it without effort, and it didn't hurt when bathing/running a wash cloth over it). Then I noticed that the area hurt if I set my arm on a table, and I realized it was red and raised (about 1.25 inches in diameter). I started taking Lian Qiao Pai Tu Pian, which cut it down by over a half within the first day. That was August 13. I took the herbs for another day, but then life happened and I didn't take them again (I'm a better practitioner than patient). So, on August 17, I noticed that the inside of my elbow was tender to touch, and I realized my cubital lymph node was slightly swollen. I started taking the herbs again, which helped the area where the bite (?) was (as it was still raised and red), but not the lymph node. I felt I needed something that went deeper, so asked one of my former clinical supervisors for help (on August 19). He told me that I should just keep taking the same herbal formula, but also put very thin slices of garlic on the bite area, changing it as the garlic dried, for the rest of the day and also to sleep with it. My gut said the Lian Qiao Pai Tu Pian was no longer appropriate, but I figured he had so much more experience than I did that he must be correct. So, I did as he said. I knew the garlic would make the area under it blister, and it did, but it also completely got rid of the redness and swelling. That area is now healing well. However, my lymph node got worse (more swollen and more tender), and it progressed to the next proximal lymph node. My arm was painful (deep ache) from the level of Lu-3 to about the level of Li-10 with occasional numbness in my hand. So, on August 20, I consulted with another practitioner and shifted the focus of my herbs (mostly clear heat, relieve toxicity; some clear heat, cool blood and clear heat, dry damp, with some move qi and blood, plus herbs to balance all that cold stuff). I also started taking ibuprofen (which I hate doing, but the pain was making it impossible to sleep), and that--combined with the herbs--seemed to help the ache and the progression. It seemed to " pull back " to that cubital lymph node (the one proximal to it was still swollen, but not so tender). Then, 3 weeks after I initially noticed the " pimple " (i.e., August 22) I woke up with lymphedema around my inner elbow (the first time I had noticed it), despite the fact that the pain has pulled back to that cubital lymph node. So, I had an acupuncture treatment, and then saw my chiropractor who put on some kinesiotape, which I took off after about 5 hours because it made the lymphedema increase and pool about a third of the way down my medial-posterior forearm. My cubital lymph node also seemed really angry--the skin around it got hot and red for the first time and the node swelled even more, becoming very hard. I should mention that at no time during all of this have I had any red streaks up my arm, any fever, or any pitting edema. In addition, I continued to take the herbs. After sleeping with my arm elevated, the " pool " of edema went away, but the general lymphedema remained. My arm continued to be be warm in the area of the cubital lymph node at rest, but if I used my arm at all, it would quickly get hot and red, and it ached greatly (I'm sure because everything was being strangled by the swelling). I avoided using my arm because of the pain. Yesterday (August 23), I had a lymphatic drainage massage which helped a lot (80% reduction in pain within an hour). Her impression was that the lymph system was just backed up and the lymph was gelling so it couldn't flow, but it was more fluid after the treatment, and she expected it to continue to improve. I felt so good that I spent 2 hours re-filling raw herb jars and ordering raw, powder, and patent herbs. Within that time, my arm returned to the swollen, painful state it was in prior to my treatment, with the skin over the node being red and hot. I also developed a low-grade fever. The redness and heat mostly went away after I did some lymphatic self-massage, and the area got less taut and painful, though the node was still very swollen and hard and there was still pain. The fever went away with a dose of ibuprofen. I will see the massage therapist again tomorrow. Today I am unable to use my right arm for anything without flaring it up (tough, as I am right-handed) . I have typed all of this with only my left hand except for one paragraph (and after that I had to stop to do the self-massage to calm it down). Through all of this, my tongue has been unchanged (swollen, teethmarks, light red, thin white coat, red prickles at the tip; my tongue has looked like this for over a year). My pulse on the right is thin, deep in the 1st and 3rd, and wiry. It feels constrained (not surprising). On the left it is thin and wiry. I have not seen a medical doctor, as I know all he will do is put me on a broad-spectrum antibiotic (which I feel I am taking the herbal equivalent of, plus anti-viral). Here are my questions: 1.) How does view the lymph system? This was never discussed in my schooling, and I cannot find anything about it in my books (even Fluid Physiology and Pathology in TCM). Is lymph fluid considered jin, ye, or something else? 2.) Does anyone have any experience treating lymphedema of the upper extremity? If so, can you please share insights? 3.) Herbally, what is best to treat this? The classic formulas for edema which I have looked at seem not to apply. As I said, I am not able to think clearly about this case because of how involved I am physically and emotionally. I greatly appreciate any help anyone can give. Thank you for taking the time to read all of this. Julie Espy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2008 Report Share Posted August 24, 2008 Thank you, Yehuda, for your feedback, advice, and support--all very helpful. It gives me a lot to think about and work with. Julie On Behalf Of yehuda frischman Sunday, August 24, 2008 9:05 PM Re: lymphedema case Hi Julie, A few comments. As the 2nd practitioner you consulted, noted it sounds like you have toxic heat from the insect bite. As it might be a tick, it would behoove you to get tested to see if you have Lyme's disease. (It's a simple blood test). BTW, Subhuti Dharmananda, the director of the institute of Traditional Medicine in Portland has a couple of articles that might interest you: one on Lyme's disease: http://www.itmonlin <http://www.itmonline.org/arts/lyme.htm> e.org/arts/lyme.htm and one on lymphadema: http://www.itmonlin <http://www.itmonline.org/arts/lymphedema.htm> e.org/arts/lymphedema.htm In the article on Lyme's he giveas an example formulas such as Liang Xue Bai Du Tang. But in addition to any formula that you write to treat this toxic heat, you must also consider your constitution. It is important to note that from the thin wiry pulses and the prickles in the front of the tongue you should consider adding herbs to cool the blood, supplement blood, and calm the shen, such as Chi Shao Yao, Mu Dan Pi, Sheng Di Huang, Ye Jiao Teng, and Zhi Zi, for example (think Jia Wei Xiao Yao Wan) That should give you a good start. BTW, in the article on lymphadema, the author states pretty clearly that in the classic literature it was viewed as phlegm damp accumulation, TanYin. This is clearly pathological fluid, and so it is very different than Jin Ye. I don't know if the ancients were aware of the lymphatic system per se, but they empirically recognized lumps as phlegm nodules which they treated with the seaweeds like Hai Zao. (BTW the formula in pill form " Nei Xiao Luo Li Wan " specifically addresses lymphadenopathy and contains Hai Zao). Good luck and don't panic. Nuture and support yourself, educate yourself, and don't be afraid to keep looking locally until you find someone who you can look to as a mentor for support and guidance. Speedy and complete recovery, --- On Sun, 8/24/08, j_c_sp23 <jcespy23 (AT) hotmail (DOT) <jcespy23%40hotmail.com> com> wrote: j_c_sp23 <jcespy23 (AT) hotmail (DOT) <jcespy23%40hotmail.com> com> lymphedema case @ <%40> Sunday, August 24, 2008, 1:40 PM I find I am having a difficult time thinking clearly about this case, partly because I am a very new practitioner (I graduated 6 weeks ago, and got licensed 2 weeks ago) and never saw anything like this in my clinicals (nor in my 10 years of being an Occupational Therapist/ Hand Therapist), but mostly because the patient is me, and it's tough to be objective when experiencing the physical and emotional aspects of disease. So, I am turning to you all, both so that I may learn and become a better practitioner and so that I can get clearer on the best way to treat myself herbally and return to health. I apologize in advance for how long this is, but I figure the more you know, the more you can help. Here's the background: I think I got bit by a bug (during sleep?) on the posterior part of my forearm, about an inch-and-a-half distal to the olecranon, just over 3 weeks ago. I first noticed it on August 1, 2008. I was on vacation at the time. I thought it was a pimple (it wad a whitehead), so just figured my body would take care of it and didn't think any more about it for almost 2 weeks (it was out of my consciousness because I couldn't see it without effort, and it didn't hurt when bathing/running a wash cloth over it). Then I noticed that the area hurt if I set my arm on a table, and I realized it was red and raised (about 1.25 inches in diameter). I started taking Lian Qiao Pai Tu Pian, which cut it down by over a half within the first day. That was August 13. I took the herbs for another day, but then life happened and I didn't take them again (I'm a better practitioner than patient). So, on August 17, I noticed that the inside of my elbow was tender to touch, and I realized my cubital lymph node was slightly swollen. I started taking the herbs again, which helped the area where the bite (?) was (as it was still raised and red), but not the lymph node. I felt I needed something that went deeper, so asked one of my former clinical supervisors for help (on August 19). He told me that I should just keep taking the same herbal formula, but also put very thin slices of garlic on the bite area, changing it as the garlic dried, for the rest of the day and also to sleep with it. My gut said the Lian Qiao Pai Tu Pian was no longer appropriate, but I figured he had so much more experience than I did that he must be correct. So, I did as he said. I knew the garlic would make the area under it blister, and it did, but it also completely got rid of the redness and swelling. That area is now healing well. However, my lymph node got worse (more swollen and more tender), and it progressed to the next proximal lymph node. My arm was painful (deep ache) from the level of Lu-3 to about the level of Li-10 with occasional numbness in my hand. So, on August 20, I consulted with another practitioner and shifted the focus of my herbs (mostly clear heat, relieve toxicity; some clear heat, cool blood and clear heat, dry damp, with some move qi and blood, plus herbs to balance all that cold stuff). I also started taking ibuprofen (which I hate doing, but the pain was making it impossible to sleep), and that--combined with the herbs--seemed to help the ache and the progression. It seemed to " pull back " to that cubital lymph node (the one proximal to it was still swollen, but not so tender). Then, 3 weeks after I initially noticed the " pimple " (i.e., August 22) I woke up with lymphedema around my inner elbow (the first time I had noticed it), despite the fact that the pain has pulled back to that cubital lymph node. So, I had an acupuncture treatment, and then saw my chiropractor who put on some kinesiotape, which I took off after about 5 hours because it made the lymphedema increase and pool about a third of the way down my medial-posterior forearm. My cubital lymph node also seemed really angry--the skin around it got hot and red for the first time and the node swelled even more, becoming very hard. I should mention that at no time during all of this have I had any red streaks up my arm, any fever, or any pitting edema. In addition, I continued to take the herbs. After sleeping with my arm elevated, the " pool " of edema went away, but the general lymphedema remained. My arm continued to be be warm in the area of the cubital lymph node at rest, but if I used my arm at all, it would quickly get hot and red, and it ached greatly (I'm sure because everything was being strangled by the swelling). I avoided using my arm because of the pain. Yesterday (August 23), I had a lymphatic drainage massage which helped a lot (80% reduction in pain within an hour). Her impression was that the lymph system was just backed up and the lymph was gelling so it couldn't flow, but it was more fluid after the treatment, and she expected it to continue to improve. I felt so good that I spent 2 hours re-filling raw herb jars and ordering raw, powder, and patent herbs. Within that time, my arm returned to the swollen, painful state it was in prior to my treatment, with the skin over the node being red and hot. I also developed a low-grade fever. The redness and heat mostly went away after I did some lymphatic self-massage, and the area got less taut and painful, though the node was still very swollen and hard and there was still pain. The fever went away with a dose of ibuprofen. I will see the massage therapist again tomorrow. Today I am unable to use my right arm for anything without flaring it up (tough, as I am right-handed) . I have typed all of this with only my left hand except for one paragraph (and after that I had to stop to do the self-massage to calm it down). Through all of this, my tongue has been unchanged (swollen, teethmarks, light red, thin white coat, red prickles at the tip; my tongue has looked like this for over a year). My pulse on the right is thin, deep in the 1st and 3rd, and wiry. It feels constrained (not surprising). On the left it is thin and wiry. I have not seen a medical doctor, as I know all he will do is put me on a broad-spectrum antibiotic (which I feel I am taking the herbal equivalent of, plus anti-viral). Here are my questions: 1.) How does view the lymph system? This was never discussed in my schooling, and I cannot find anything about it in my books (even Fluid Physiology and Pathology in TCM). Is lymph fluid considered jin, ye, or something else? 2.) Does anyone have any experience treating lymphedema of the upper extremity? If so, can you please share insights? 3.) Herbally, what is best to treat this? The classic formulas for edema which I have looked at seem not to apply. As I said, I am not able to think clearly about this case because of how involved I am physically and emotionally. I greatly appreciate any help anyone can give. Thank you for taking the time to read all of this. Julie Espy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2008 Report Share Posted August 24, 2008 Very interesting idea--not something I would have considered, nor something I have much experience with. That, coupled with the fact that I would be trying to do something so skillful with my non-dominant hand alone, makes me think it would be better to find someone locally who has the good moxa and knows how to use it. Does anyone know someone in Austin, Texas who would be good? Thank you. Julie On Behalf Of Henry Ahlefelder Sunday, August 24, 2008 9:24 PM Re: lymphedema case I see you're getting some herb advice already, so I'll try to contribute what I can which may be unique. As a primarily Japanese style acupuncturist, there is a trick which normally helps these type of things: Okyu, or direct, rice grain moxa. Use a VERY high grade Japanese loose moxa (the small red box type at a minimum. Chinese moxa is not pure enough, and burns too hot). Surround the area with rice grain, or even 1/2 rice grain size pieces, and place them right on the skin. You can use a little water on the skin to make it stick. Burn around, not on the lumps/swelling, and do about 3 rounds. Completely surround the area with moxa, not just one or two pieces. The theory is this: modern research has shown the heat from this type of moxa is infrared in nature. When it penetrates the body, it causes a reaction in the white blood cells, and thus stimulates and harmonizes the body's immune response. This in turn balances the sympathetic/parasympathetic nervous system etc. Mizutani Sensei has complied a lot of this research in various articles of the North American Journal of Oriental Medicine. I have used this technique to clear up everything from plantar fascitis to sprained ankle pain, often in one treatment. In your case I would treat myself daily. Now, people will say, 'won't moxa add heat, and aggravate your toxic heat condition'? No, not if you use high grade moxa. By stimulating the healing response, you will actually stimulate the body to clear the congestion manifesting as toxic heat. A word of warning: this type of treatment can cause what we call a 'healing response', meaning you will get worse right after treatment, before the condition completely resolves. If that happens, don't freak out. Oh, I am assuming you know not to smother the cones before they burn the skin. This is not a scarring technique, though that might work as well, as a moa burn only forms pus if there are toxins needed to be resolved. I do not advocate that though, unless you know what you are doing. Please let us know how things go, and what does and doesn't work. best of luck. Henry j_c_sp23 <jcespy23 (AT) hotmail (DOT) <jcespy23%40hotmail.com> com> @ <%40> Sunday, August 24, 2008 2:40:25 PM lymphedema case I find I am having a difficult time thinking clearly about this case, partly because I am a very new practitioner (I graduated 6 weeks ago, and got licensed 2 weeks ago) and never saw anything like this in my clinicals (nor in my 10 years of being an Occupational Therapist/ Hand Therapist), but mostly because the patient is me, and it's tough to be objective when experiencing the physical and emotional aspects of disease. So, I am turning to you all, both so that I may learn and become a better practitioner and so that I can get clearer on the best way to treat myself herbally and return to health. I apologize in advance for how long this is, but I figure the more you know, the more you can help. Here's the background: I think I got bit by a bug (during sleep?) on the posterior part of my forearm, about an inch-and-a-half distal to the olecranon, just over 3 weeks ago. I first noticed it on August 1, 2008. I was on vacation at the time. I thought it was a pimple (it wad a whitehead), so just figured my body would take care of it and didn't think any more about it for almost 2 weeks (it was out of my consciousness because I couldn't see it without effort, and it didn't hurt when bathing/running a wash cloth over it). Then I noticed that the area hurt if I set my arm on a table, and I realized it was red and raised (about 1.25 inches in diameter). I started taking Lian Qiao Pai Tu Pian, which cut it down by over a half within the first day. That was August 13. I took the herbs for another day, but then life happened and I didn't take them again (I'm a better practitioner than patient). So, on August 17, I noticed that the inside of my elbow was tender to touch, and I realized my cubital lymph node was slightly swollen. I started taking the herbs again, which helped the area where the bite (?) was (as it was still raised and red), but not the lymph node. I felt I needed something that went deeper, so asked one of my former clinical supervisors for help (on August 19). He told me that I should just keep taking the same herbal formula, but also put very thin slices of garlic on the bite area, changing it as the garlic dried, for the rest of the day and also to sleep with it. My gut said the Lian Qiao Pai Tu Pian was no longer appropriate, but I figured he had so much more experience than I did that he must be correct. So, I did as he said. I knew the garlic would make the area under it blister, and it did, but it also completely got rid of the redness and swelling. That area is now healing well. However, my lymph node got worse (more swollen and more tender), and it progressed to the next proximal lymph node. My arm was painful (deep ache) from the level of Lu-3 to about the level of Li-10 with occasional numbness in my hand. So, on August 20, I consulted with another practitioner and shifted the focus of my herbs (mostly clear heat, relieve toxicity; some clear heat, cool blood and clear heat, dry damp, with some move qi and blood, plus herbs to balance all that cold stuff). I also started taking ibuprofen (which I hate doing, but the pain was making it impossible to sleep), and that--combined with the herbs--seemed to help the ache and the progression. It seemed to " pull back " to that cubital lymph node (the one proximal to it was still swollen, but not so tender). Then, 3 weeks after I initially noticed the " pimple " (i.e., August 22) I woke up with lymphedema around my inner elbow (the first time I had noticed it), despite the fact that the pain has pulled back to that cubital lymph node. So, I had an acupuncture treatment, and then saw my chiropractor who put on some kinesiotape, which I took off after about 5 hours because it made the lymphedema increase and pool about a third of the way down my medial-posterior forearm. My cubital lymph node also seemed really angry--the skin around it got hot and red for the first time and the node swelled even more, becoming very hard. I should mention that at no time during all of this have I had any red streaks up my arm, any fever, or any pitting edema. In addition, I continued to take the herbs. After sleeping with my arm elevated, the " pool " of edema went away, but the general lymphedema remained. My arm continued to be be warm in the area of the cubital lymph node at rest, but if I used my arm at all, it would quickly get hot and red, and it ached greatly (I'm sure because everything was being strangled by the swelling). I avoided using my arm because of the pain. Yesterday (August 23), I had a lymphatic drainage massage which helped a lot (80% reduction in pain within an hour). Her impression was that the lymph system was just backed up and the lymph was gelling so it couldn't flow, but it was more fluid after the treatment, and she expected it to continue to improve. I felt so good that I spent 2 hours re-filling raw herb jars and ordering raw, powder, and patent herbs. Within that time, my arm returned to the swollen, painful state it was in prior to my treatment, with the skin over the node being red and hot. I also developed a low-grade fever. The redness and heat mostly went away after I did some lymphatic self-massage, and the area got less taut and painful, though the node was still very swollen and hard and there was still pain. The fever went away with a dose of ibuprofen. I will see the massage therapist again tomorrow. Today I am unable to use my right arm for anything without flaring it up (tough, as I am right-handed) . I have typed all of this with only my left hand except for one paragraph (and after that I had to stop to do the self-massage to calm it down). Through all of this, my tongue has been unchanged (swollen, teethmarks, light red, thin white coat, red prickles at the tip; my tongue has looked like this for over a year). My pulse on the right is thin, deep in the 1st and 3rd, and wiry. It feels constrained (not surprising). On the left it is thin and wiry. I have not seen a medical doctor, as I know all he will do is put me on a broad-spectrum antibiotic (which I feel I am taking the herbal equivalent of, plus anti-viral). Here are my questions: 1.) How does view the lymph system? This was never discussed in my schooling, and I cannot find anything about it in my books (even Fluid Physiology and Pathology in TCM). Is lymph fluid considered jin, ye, or something else? 2.) Does anyone have any experience treating lymphedema of the upper extremity? If so, can you please share insights? 3.) Herbally, what is best to treat this? The classic formulas for edema which I have looked at seem not to apply. As I said, I am not able to think clearly about this case because of how involved I am physically and emotionally. I greatly appreciate any help anyone can give. Thank you for taking the time to read all of this. Julie Espy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2008 Report Share Posted August 24, 2008 what you have is a clear infection. I would not worry about lymph, treat the infection the swelling will resolve 400 29th St. Suite 419 Oakland Ca 94609 alonmarcus Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 26, 2008 Report Share Posted August 26, 2008 heat from this type of moxa is infrared in nature. >>>>by the way all heat is infrared in nature alon Quote Link to comment Share on other sites More sharing options...
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