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Hi Geoff:

 

Thanks for sharing this case.  First of all, it sounds like your results have

been really good so far.  Real migraines (and this sounds like a real migraine)

are hard to treat and your progress sounds very swift and positive.  Give

yourself some credit!

 

Please be aware as things continue to improve, she may be having rebound

migraines from her medication, or from changes in her medication, not any

shortcoming in your treatment.  If she is sensitive to weather changes, she is

probably also sensitive to atmospheric pressure changes in general ---- such as

traveling from one place to another.  Any change can cause a migraine.  So it

may take time.

 

It sounds like she has both blood deficiency and blood stasis.  So that's tricky

too.

 

But most of all, I'm glad you recognize her symptoms are " strokey " .  This is a

CNS problem.  It's a brain ache, not just a bad headache.  Du Mai.  Reducing SI

3 can frequently be helpful for the excess symptoms.

 

She may have phlegm but that doesn't sound like it has anything to do with the

migraines.  Nausea in a case like this is symptom of pressure on the brain, not

a digestive disturbance.

 

Low blood sugar or any type of dramatic change to eating patterns can trigger

migraines in susceptible people.  It may be part of the reason she's not

interested in losing weight. and it may be part of the reason she's gained

weight in the first place.

 

Her blood brain barrier is all messed up, which is to say she doesn't have much

of one.  She needs to be careful with caffeine and anything that rises up to the

head.   She needs to spend some time figuring out her dietary triggers - 

whether it be chocolate, cheese, nuts, etc.  It's hard to figure out because

most of the migraine triggers only trigger it some of the time --- but they're

still triggers and need to be avoided.   She absolutely needs to stay away from

alcohol (She probably already does).    She also needs to stay away from

artificial sweeteners (aspartame).

 

Oral contraceptives sometimes push women into Blood Xu.  Don't know if that is

true in her case or not.  But they can they force menstrual periods in women who

don't have the blood to give up, who would other normally just skip a period

occasionally if left on their own.

 

Does she have a history of a) head injury? b) excessive blood loss? c) donating

blood? d) CHEMICAL EXPOSURE?  e) anemia  f) pregnancy?

 

Hormones can also affect membrane permeability. 

 

Inflammation affects membrane permeability. Increased membrane permeability

leads to swelling, and that leads to pain, and in the brain that can lead to

nausea and vomiting.   It's kind of like having post traumatic arthritis in the

brain. 

 

My only other piece of advice is for her to " give up early " at the first sign of

pain and try to get some sleep, instead of pushing it.

 

Good luck to both of you.  It really sounds like you have helped her a lot

already.

 

best,

 

Gena

 

 

 

 

 

 

 

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The sensitivity to smells is a clue to the extent of the phlegm. Why not a

combination of the Xiang Sha Jun Zi and a Ban Xia (or Wen Dan Tang) formula?

Doug

 

 

 

>

> She is obese, has frequent nausea with the headaches, perfumes and many other

smells trigger headaches (sorry, I forgot to mention that earlier) and can also

break the headache. I've also come to conclude that considering her chronic

sinusitis/allergies (also forgot to mention that) with the weather changes

triggering the headaches, there is an element of stagnant phlegm in her head.

Finally, her personality is 'phlegmy' - sorta laissez faire-ish.

>

> One other tidbit - when we use a heavy dose of Ban Xia Bai Zhu TMT - she

expells phlegm in the stool. I've overdosed her before and she got dried out,

so when the phlegm calms down, we switch to something like Xiang Sha Liu Jun Zi

Wan.

>

> See above.

>

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" The sensitivity to smells is a clue to the extent of the phlegm. " Have never

heard or read this before. Can you give me any kind of Chinese cite? I'd like to

follow-up on this.

 

Bob

 

, " " wrote:

>

> The sensitivity to smells is a clue to the extent of the phlegm. Why not a

combination of the Xiang Sha Jun Zi and a Ban Xia (or Wen Dan Tang) formula?

> Doug

>

>

>

> >

> > She is obese, has frequent nausea with the headaches, perfumes and many

other smells trigger headaches (sorry, I forgot to mention that earlier) and can

also break the headache. I've also come to conclude that considering her

chronic sinusitis/allergies (also forgot to mention that) with the weather

changes triggering the headaches, there is an element of stagnant phlegm in her

head. Finally, her personality is 'phlegmy' - sorta laissez faire-ish.

> >

> > One other tidbit - when we use a heavy dose of Ban Xia Bai Zhu TMT - she

expells phlegm in the stool. I've overdosed her before and she got dried out,

so when the phlegm calms down, we switch to something like Xiang Sha Liu Jun Zi

Wan.

> >

> > See above.

> >

>

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On Feb 9, 2010, at 11:34 AM, pemachophel2001 wrote:

 

> " The sensitivity to smells is a clue to the extent of the phlegm. "

> Have never heard or read this before. Can you give me any kind of

> Chinese cite? I'd like to follow-up on this.

>

I was curious about this too-- clinically when there is acute smell

sensitivity I'm often either finding a L.I./GB dynamic, or a L.I./ST

dynamic. The L.I./GB folks are more dry, usually-- hypersensitive,

responding by going ballistic with a migraine (GB excess response)

because wei qi is weak. When it is more the ST/L.I. types, it's

usually more of a disgust response, ST rebellion. I usually see this

with exit/entry block between L.I. 20 and ST 1 although if it is very

strong I'd follow that up with ST 45.

 

I was thinking, if there is a lot of phlegm, that would actually cut

down on the sense of smell, right?

 

interesting stuff--

 

Thea Elijah

 

 

 

 

 

 

 

 

>

> Bob

>

> , " "

> wrote:

> >

> > The sensitivity to smells is a clue to the extent of the phlegm.

> Why not a combination of the Xiang Sha Jun Zi and a Ban Xia (or Wen

> Dan Tang) formula?

> > Doug

> >

> >

> >

> > >

> > > She is obese, has frequent nausea with the headaches, perfumes

> and many other smells trigger headaches (sorry, I forgot to mention

> that earlier) and can also break the headache. I've also come to

> conclude that considering her chronic sinusitis/allergies (also

> forgot to mention that) with the weather changes triggering the

> headaches, there is an element of stagnant phlegm in her head.

> Finally, her personality is 'phlegmy' - sorta laissez faire-ish.

> > >

> > > One other tidbit - when we use a heavy dose of Ban Xia Bai Zhu

> TMT - she expells phlegm in the stool. I've overdosed her before and

> she got dried out, so when the phlegm calms down, we switch to

> something like Xiang Sha Liu Jun Zi Wan.

> > >

> > > See above.

> > >

> >

>

>

>

 

 

 

 

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This is something that Zteen Clavey discusses in his Fluid Physiology

and Pathology text.

 

-Steve

 

Sent from my iPhone

 

On Feb 9, 2010, at 10:34 AM, " pemachophel2001 " <bob

wrote:

 

> " The sensitivity to smells is a clue to the extent of the phlegm. "

> Have never heard or read this before. Can you give me any kind of

> Chinese cite? I'd like to follow-up on this.

>

> Bob

>

> , " "

> wrote:

> >

> > The sensitivity to smells is a clue to the extent of the phlegm.

> Why not a combination of the Xiang Sha Jun Zi and a Ban Xia (or Wen

> Dan Tang) formula?

> > Doug

> >

> >

> >

> > >

> > > She is obese, has frequent nausea with the headaches, perfumes

> and many other smells trigger headaches (sorry, I forgot to mention

> that earlier) and can also break the headache. I've also come to

> conclude that considering her chronic sinusitis/allergies (also

> forgot to mention that) with the weather changes triggering the

> headaches, there is an element of stagnant phlegm in her head.

> Finally, her personality is 'phlegmy' - sorta laissez faire-ish.

> > >

> > > One other tidbit - when we use a heavy dose of Ban Xia Bai Zhu

> TMT - she expells phlegm in the stool. I've overdosed her before and

> she got dried out, so when the phlegm calms down, we switch to

> something like Xiang Sha Liu Jun Zi Wan.

> > >

> > > See above.

> > >

> >

>

>

 

 

 

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Whooops...typing too fast. That should read Steven Clavey.

 

Sent from my iPhone

 

On Feb 9, 2010, at 11:02 AM, Stephen Bonzak

<stephenbonzak wrote:

 

> This is something that Zteen Clavey discusses in his Fluid Physiology

> and Pathology text.

>

> -Steve

>

> Sent from my iPhone

>

> On Feb 9, 2010, at 10:34 AM, " pemachophel2001 " <bob

> wrote:

>

> > " The sensitivity to smells is a clue to the extent of the phlegm. "

> > Have never heard or read this before. Can you give me any kind of

> > Chinese cite? I'd like to follow-up on this.

> >

> > Bob

> >

> > , " "

> > wrote:

> > >

> > > The sensitivity to smells is a clue to the extent of the phlegm.

> > Why not a combination of the Xiang Sha Jun Zi and a Ban Xia (or Wen

> > Dan Tang) formula?

> > > Doug

> > >

> > >

> > >

> > > >

> > > > She is obese, has frequent nausea with the headaches, perfumes

> > and many other smells trigger headaches (sorry, I forgot to mention

> > that earlier) and can also break the headache. I've also come to

> > conclude that considering her chronic sinusitis/allergies (also

> > forgot to mention that) with the weather changes triggering the

> > headaches, there is an element of stagnant phlegm in her head.

> > Finally, her personality is 'phlegmy' - sorta laissez faire-ish.

> > > >

> > > > One other tidbit - when we use a heavy dose of Ban Xia Bai Zhu

> > TMT - she expells phlegm in the stool. I've overdosed her before and

> > she got dried out, so when the phlegm calms down, we switch to

> > something like Xiang Sha Liu Jun Zi Wan.

> > > >

> > > > See above.

> > > >

> > >

> >

> >

>

>

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from Clavey:

 

" ...piercingly strong fragrant odors such as petrol and perfume will break

up phlegm because of the yang-expanding nature of fragrance. This is used

even in herbal treatment as a principle of damp treatment: fragrance to

disperse damp and phlegm. Here, though [i.e., in cases where odors trigger

headaches], the effect is from the environment and therefore uncontrolled.

Once the phlegm is broken up by these odors, the yang nature of the

fragrance starts it on its rise upward, and then the phlegm is lifted with

the normal flow of clear yang to the head, obstructing the orifice of the

mind, and bringing on dizziness and headaches... "

 

(Fluid Physiology and Pathology in Traditional , p. 287)

 

On Tue, Feb 9, 2010 at 11:34 AM, pemachophel2001 <bob wrote:

 

>

>

> " The sensitivity to smells is a clue to the extent of the phlegm. " Have

> never heard or read this before. Can you give me any kind of Chinese cite?

> I'd like to follow-up on this.

>

> Bob

>

>

> --- In

<%40>,

> " " wrote:

> >

> > The sensitivity to smells is a clue to the extent of the phlegm. Why not

> a combination of the Xiang Sha Jun Zi and a Ban Xia (or Wen Dan Tang)

> formula?

> > Doug

> >

> >

> >

> > >

> > > She is obese, has frequent nausea with the headaches, perfumes and many

> other smells trigger headaches (sorry, I forgot to mention that earlier) and

> can also break the headache. I've also come to conclude that considering her

> chronic sinusitis/allergies (also forgot to mention that) with the weather

> changes triggering the headaches, there is an element of stagnant phlegm in

> her head. Finally, her personality is 'phlegmy' - sorta laissez faire-ish.

> > >

> > > One other tidbit - when we use a heavy dose of Ban Xia Bai Zhu TMT -

> she expells phlegm in the stool. I've overdosed her before and she got dried

> out, so when the phlegm calms down, we switch to something like Xiang Sha

> Liu Jun Zi Wan.

> > >

> > > See above.

> > >

> >

>

>

>

 

 

 

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One has to get to the root of this problem - obesity, and probably poor diet

and nutrition. In general, you can use the herbs and acupuncture to treat

the problem, but the main thing is get her on a diet and exercise program.

 

I might suggest Liv 2,3, GB 43, 41, Sp 2, 3, St 36, 40 and Rx's Tian ma gou

teng yin and Long Dan Xie Gan Tang...

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Thanks Sara, it's a concept I've used in the clinic for a long time but when Bob

asked I couldn't remember the source.

Doug

 

 

, Sara Anllo <sara.anllo wrote:

>

> from Clavey:

>

> " ...piercingly strong fragrant odors such as petrol and perfume will break

> up phlegm because of the yang-expanding nature of fragrance. This is used

> even in herbal treatment as a principle of damp treatment: fragrance to

> disperse damp and phlegm. Here, though [i.e., in cases where odors trigger

> headaches], the effect is from the environment and therefore uncontrolled.

> Once the phlegm is broken up by these odors, the yang nature of the

> fragrance starts it on its rise upward, and then the phlegm is lifted with

> the normal flow of clear yang to the head, obstructing the orifice of the

> mind, and bringing on dizziness and headaches... "

>

> (Fluid Physiology and Pathology in Traditional , p. 287)

>

> On Tue, Feb 9, 2010 at 11:34 AM, pemachophel2001 <bob wrote:

>

> >

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