Sunday, February 19, 2012

Herbs and Acupuncture for Diabetic Neuropathy

Chief Complaint: Lower extremity numbness, tingling, and pain for 6 years
Western Diagnosis: Peripheral Diabetic Neuropathy
Medical History: 6 years ago the patient was diagnosed with type 2 diabetes; concurrent with his diagnosis he began to experience signs of peripheral neuropathy in his lower limbs which include numbness, tingling and pain in the ankles and feet. The pain pattern is as follows: the toes are numb, the top of the sole and the sole of the feet are numb, and a numb pain and feeling of thickness with pain are felt around the ankle joint. There is also heaviness of the foot. The patient also reports a dull pain in the knees. The pain is on the yin side of the legs and the UB channel. The pain is aggravated by walking and is worse in cold wet weather. The pain is reported as a 6/10. Alleviating factors are warmth and massage.
Questioning exam: sweat- The patient reports no unusual sweating.
head and body- The patient has occasional headaches which are fairly nonspecific. He has left shoulder pain and weakness and very occasional back pain.
stool & urine- The patient reports one daily bowel movement that is easy to eliminate. He reports a weak urinary flow and pressure during urination.
food and drink- The patient is not a vegetarian, He does not eat a large breakfast and reports eating a healthy dinner. He reports always being thirsty and sips water frequently.
chest & abdomen- The patient reports an occasional heartbeat and was diagnosed 6 years ago with hypertension. He reports that coffee and cigarettes both give him a rapid heartbeat.
hearing & vision- The patient wears glasses and reports an occasional blurry vision.
Thirst- The patient is constantly thirsty and frequently sips water.
Sleep- The patient reports much difficulty getting to sleep, he takes ambien and reports getting 5 to 6 hours of sleep a night.
habits/ lifestyle- The patient smokes ten to twelve cigarettes a day, drinks three cups of coffee, and reports very infrequent use of marijuana and cocaine.
Pulse exam: Pulse: 100 BPM
Overall: weak slippery
Left: thin, slippery
Right: slippery, weak
Abdomen: slightly distended
Tongue exam: Tongue
Body: dry, pale red with a dusky edge, slightly enlarged with small cracks in the center
Fur: slightly yellow on sides and rear.
Sublingual vein: slightly distended
OM Diagnosis: Channel and zang fu Diagnosis:
Qi and blood deficiency and stagnation in the channels of the lower limb with underlying yin deficiency with dampness.
Correspondence of symptoms and signs:
Qi and blood deficiency and stagnation in the lower limbs
Numbness tingling and pain in the lower extremities
Enlarged tongue with dusky hue
Yin deficiency with dampness
1) Knee weakness
2) Thirst with sipping of water
3) dry tongue
4) thin rapid pulse
5)heaviness in the foot
6)body type (pear shaped)
7)mallar flush
8)poor sleep
Treatment Principle: Supplement and move qi and blood in the lower limbs; tonify yin, drain dampness and clear heat.
Point Prescription: Acupuncture:
Ki 2 Ran Gu- ying spring fire point on the water channel- it functions to clear deficiency heat regulates the kidneys and regulates the lower jiao.
LR 2 Xing Jian- ying spring fire point on the liver channel – it functions to spread liver qi, pacifies liver wind, benefits the lower jiao.
SP 6 san yin jiao- meeting point of the spleen liver and kidney channel- it functions to tonify the spleen and stomach, resolve dampness, harmonize the liver and tonify the kidneys, harmonizes the lower jiao, calms the spirit and invigorates blood.
St36 zu san li- he sea water point- this point fortifies the spleen and resolves dampness, tonifies and nourishes blood and yin.
Ht 3 shao hai- he sea water point on fire channel- this point functions to calm the spirit, transform phlegm, and clear heat.
Ren 12- Zhong wan, front mu of the stomach, meeting point of the fu- this point tonifies the stomach and fortifies the spleen and regulates qi and alleviates pain.
The focus of this treatment was to locally move qi and blood, clear heat, nourish yin, resolve dampness, benefit the spleen and stomach, and calm the shen. Ht 3 and KD2 are the fire and water points on the fire and water channels they connect the upper and lower jiaos. Ren 12 was needled to help further establish this connection between the upper and lower as it is the zhongwan or central pivot on the middle jiao. KI 2 and LR 2 are also local points which move qi and blood.
*While the above analysis and acupuncture treatment was for a TCM zang fu based treatment, Electircal stimulation was also applied, with similar point prescriptions used with low frequency e-stim in both ba-feng and in 6 needles surrounding the ankle in a subsequent treatment.
Herbal Formula: Modified: Zhi bai di huang wan
Shu di huang 18 g- tonifies yin and blood of the liver and kidneys
Shan zhu yu12 g- tonifies the kidneys
Shan yao 12 g- tonifies the qi of the kidneys
Fu ling 9 g- drains dampness and calms the spirit
Mu dan pi 9 g- moves static blood and clears deficiency heat
Ze xie 9 g- drains dampness, clears heat but not to damaging to the yin
Zhi mu- 9 g- clears heat and nourishes the yin
Huang bai 9g- clears heat from the lower jiao
Niu xi- 9g- moves qi and blood in the lower limbs
Tian hua fen 12 g- transforms phlegm and generates fluids
Gan cao 6 g- guides the herbs to the twelve channels and alleviates pain
Shi chang pu- 6- aromatically transforms phlegm and clears the head
Lifestyle Prescription: a nutritional supplement recommendation that was given for Alphalipoic Acid to be taken -200 g 3 times a day
Alpha lipoic acid- alpha lipoic acid (ALA) significantly and rapidly reduces the frequency and severity of symptoms of the most common kind of diabetic neuropathy. Symptoms decreased include burning and sharply cutting pain, prickling sensations and numbness.(www.mayoclinic.com). In addition the patient was advised to quit smoking cigarettes and using recreational drugs.
Results: After 10 treatmentst the patient reported feeling a decrease of the numbness and tingling. but not a complete resolve of the symptoms.

Acupuncture Treatment of Post Shingles Neuralgia

Chief Complaint: Post Shingles Neuralgia
Western Diagnosis: Uveitis
Medical History: 93 y.o., female, complaining of paresthesia around left eye with inflammation in left eye following a Herpes Zoster attack which manifested on the upper left quadrant of the face a few months ago. Western treatments with acyclovir, prednisone (eye drops) and ciproflaxin (eye drops) were ineffective for 2 months. Ets 2-3 meals with adequate caloric intake and digestion is ok with no diarrhea. Sleeps a lot- 10+ hours per day. Good disposition.
Questioning exam: Localized symptoms (paresthesia), general frailty, withdrawn.
Pulse exam: red eye(left), swelling around left ankle, thin pulse.
Tongue exam: pale tongue, with dry white coat.
OM Diagnosis: Damp-Heat in GB channel overlying a constitutional pattern of Qi & Blood deficiency with damp due to yang/Qi deficiency.
Treatment Principle: Clear Heat and Toxin, move Qi and Blood, and later strengthen Qi/yang to strengthen digestion.
Point Prescription: GB1, GB14, Taiyang, St 2, St8, Bl2, Sp9 on left side and L.I 4 – Lv3, St36, Ki3, Sp6 Bilateral), GV20, CV4, CV6. TuiNa around Face/neck (GB20) and around left shin/ankle and some similar work on the right side also for balance.
Herbal Formula: Not used initially, due to frailty of patient and concurrent use of western pharmaceuticals,as noted above.
See below for tonifying (Xi yang Shen, Rou Gui) teas added later in the treatment, after cearing of the eye. Ming Mu Di Huang Wan also added later into Tx.
Lifestyle Prescription: Breathwork, warm water for drinking and foods with more liquids- soups, stews, and green, leafy vegetables (cooked).
Results: Redness in eye started decreasing with the first Tx with complete clearing in 3 weeks at 2 visits per week. Opthalmologist was amazed at the subsequent visit on the sudden improvement after 2-3 months of being in a refractory state. Glaucoma Sx resolved spontaneously. Eyesight improved.
Synopsis: This patient’s weak constitution prevented her from clearing the damp heat pathogen. Due to her frailty, minimal herbal Tx wre used initially. After 3 weeks, she started on a regimen of Xi Yang Shen and Rou Gui as single herb teas, once a day, to boost Yang/i and Yin.

Acupuncture and Chinese Medicine for Prickling Pain

Chief Complaint: Prickling pain the lower legs and feet and low back pain
Western Diagnosis: Ideopathic peripheral neuropathy, osteoarthritis, osteopenia
Medical History: Patient is a 64 year old female who suffered an anxiety attack five years ago and a TIA three years ago before being diagnosed hyperthyroid and underwent a radioactive iodine treatment. She is now hypothyroid taking supplemental levothyroid and a daily 80mg aspirin. Patient suffers from osteoarthritis in the knees, feet and hands with visible deformity. Patient also suffers from osteopenia and takes Fossamax weekly. Otherwise, patient has an excellent diet and walks regularly. Patient lives near her family and sees them regularly, she also participates in various classes for seniors at the local community center.
Questioning exam: Main symptom is pain. Pain in the lower legs and feet is pricking and electric. Pain is constant and is worse at night and makes it difficult for patient to sleep. Pain in the low back is achy, dull and constant. Pains are worse with cold damp weather and better with heat. Points also become swollen in damp weather. Patient also suffers hot flashes with no sweating, constipation, gas and indigestion. Some gluten sensitivity present in her family though she herself has not been tested. Patient is also constantly hungry and fatigued. Walks regularly by has difficulty walking, uses a cane.
Pulse exam: Right tracing along the Sp and GB channels of the lower leg produces pain in the legs and feet while pressure in the low back relieves back pain. Abdominal palpation shows tenderness along the CV channel from CV-12 to CV-4, tenderness on the right side just under the costal margin, tenderness at ST-25, ST-27, Sp-21, Lu-1 and Lu-3.
Tongue exam: Tongue exam: Tongue is slightly swollen in back and thin in the front. Tongue body is purple throughout Coating is peeled in front, thick white in back.
OM Diagnosis: Wind-Cold-Damp Bi Syndrome leading to Qi and Blood Stagnation. Underlying Kidney Yin and Yang deficiency. Abdominal palpation shows Mixed Yin pattern.
Treatment Principle: Expel Wind-Cold-Damp, move Qi and Blood to stop pain, Tonify Kidneys and Harmonize extraordinary vessels.
Point Prescription: Ion Pumping Cords: P-6 Black to SP-4(L)red and Lu-7(L)red to Ki-6 Black for 15 minutes, follow with:
(Tan)Left Ling-Gu/Da Bai
(Tan)SI-4
Bai Hui
St-25
Nei Xi Yan
Sp-9, Sp-6
Gb-34
Ba Feng
Moxa feet, knees and low back
Herbal Formula: TOPICAL:
bulk herbs
Hai Tong Pi 15g
Hong Hua 15g
Su Mu 15g
Wu Jia Pi 15g
Bo He 15g
Wei Ling Xian 15g
Huang Bai 15g
Ru Xiang 15g
Mo Yao 15g
simmer herbs in sesame oil for 2 hours, strain herbs, use oil topically to massage feet and knees at night before bed.
Results: Patient reports almost complete relief of pain in back after treatment for 2-3 days. Massaging feet at night with topical oil calms prickling pain to allow her to sleep at night, but prickling pain returns during the day though intensity is decreased.

Acupuncture Treatment of Reynaud’s Phenomenon

Chief Complaint: Cold hands & feet
Western Diagnosis: Reynaud’s Phenomenon
Medical History: 56 y.o. male with h/o mild HTN, BPH. Very active, a runner, healthy diet with vigorous exercise routine. On meds for HTN & BPH.
Questioning exam: Presented with c/o cold hands and feet, worse in cold weather. Hands appeared purple at distal portion pink on dorsal palms and white on proximal palms. Hands were very cold to touch.
Pulse exam: Hands & feet were otherwise soft and supple, sometimes moist and clammy. Pulses were normal except for SP/LV pulses which varied between slow to soggy for the spleen and wiry for the liver
Tongue exam: Tongue was moist and pink with a slightly thicker white to occasionally yellow coat at the base.
OM Diagnosis: Spleen qi deficiency with damp/phlegm, Lv qi stagnation.
Treatment Principle: Tonify the spleen, dispel damp, transform phlegm, freecourse liver qi
Point Prescription: 4 gates, ba xie, ba feng, sp 6, st 36, st 40 li 10 or li 11 (ashi)
ba xie and ba feng with moxa cones X3, alternating with e-stim from li 10 or li11 to ba xie & st 40 to bafeng
Herbal Formula: pt did not want to take herbs
Lifestyle Prescription: reviewed dietary habits and made some minor changes
Results: after six months of treatment, the pt’s hands were no longer purple and cyanotic looking but were pink overall, still slightly cold to touch but with noticeable improvements in temperature. the pt’s blood pressure had also improved from initial bp’s of 160/100 to 120-130/70-80. Pt’s also stated his cardiologist was impressed and did not wish to see him for 6 months, unless he felt the need to be seen.
Synopsis: By focusing on the overall circulation issues and making small dietary changes, this patient manifested significant improvement of his initial c/o cold hand & feet.

Acupuncture and Herbs for ADD

Chief Complaint: short attention span, procrastination, lack of presence
Western Diagnosis: ADD attention deficit disorder
Medical History: 15-year old boy in good overall health, strong constitution.
Questioning exam: Will begin going somewhere and then within 1 minute forget where he was going. Cannot pay attention to schoolwork for longer than 1 minute. Procrastinates with schoolwork constantly. Has good long-term memory. Has no problem memorizing or remembering information.
Constant, visible jerking and twitching of the hands, arms and upper body. Has lost consciousness twice in his life for no apparent reason. Gets headaches that feel like pressure gathering in the parietal areas of his head. (Internal LR wind / slight yang rising)
Not easily startled. Does not have dreams he can remember or that disturb him. (No settle spirit worse than anyone else)
Always hungry. Hungry for food and hungry for adventure. “I don’t feel right if I don’t have some scrapes and bruises.” Gets thirsty but ignores it. No acid reflux or regurgitation. No heavy limbs, heavy head, or excess mucus. (ST yin deficiency, ST heat, no dampness)
Notices heart palpitations when lying down but not during activity. Dizziness upon standing. No blurry eyes or floaters. (HT blood deficiency stemming from LR blood deficiency).
No shortness of breath, no feeling of weakness in chest. No cough. (No HT qi def or LU qi def)
No fatigue except with over-exertion (riding his bike for half the day). (no overall qi def.)
Malar flush (yin def.), earth body type (SP/ST), inside of eyelids is pale with some red lines (LR blood def with some heat in blood). Tends to be hot rather than cold, but not excessively. No sweating except upon exertion. (HT)
Pulse exam: Pulse thin and slight pounding overall (yin def., blood def., some heat). ST position has strong pounding and is thin, verging on razor-like (ST yin def., ST heat). LR was tense and bounding (LR qi stag., wind). HT was soft and deficient. (HT blood def.)
Tongue exam: Normal length, Normal texture, Normal thickness, Wide, Deviated (LR wind internal), peeled in front and middle areas (yin def. in upper & middle jiao), yellow coat in back with red dots (lower jiao, KI heat), midline crack in ST area with red dots around it. (ST yin deficiency causing ST heat)
OM Diagnosis: LR Wind, HT blood deficiency and LR blood deficiency are main patterns to treat for attention span difficulties. ST heat, ST yin deficiency and slight KI yin deficiency are also there.
Treatment Principle: Clear Wind, Harness yang rising, Tonify LR & HT blood, Tonify ST yin, Clear ST heat
Point Prescription: For wind: Dispersed: GB 20, GV 16, GV 20, BL 62, LR 3.
For LR/HT blood def: Tonified: SP 10, SP 6, CV 4, BL 15, HT 7, HT 5. Also did direct moxa on all of these points.
For ST yin def., ST heat: Dispersed: ST 45, CV 12. Tonified: ST 36, ST 44, SP 6.
Herbal Formula: Tian Ma Gou Teng Yin + Suan Zao Ren for the wind for 6 weeks.
Lifestyle Prescription: Neck & shoulder massages to help let go of the wind. Energy work to help let go of the spirits attached to the wind.
Results: Good results.

Acupuncture Treatment of Sudden Tinnitus

Chief Complaint: tinnitus
Western Diagnosis: vestibular-cochlear outlet syndrome
Medical History: 27-year male c/o tinnitus in Left ear for years. Born with Right-sided deafness. Seen by MD’s (inc. Mayo clinic), Chiropractors with no resolution or result of any kind. Patient is otherwise healthy with no other complaints and is otherwise unremarkable.
Questioning exam: Tinnitus had a gradual onset that was not high-pitched. It only occurred in L side and progressed over a period of 6-8 years from an occasional nuisance to causing dizziness 1-2 times/week. There was no discharge. Patient had no preferences for warm or cold and did not exhibit any specific deficiency signs. No complaints of low back pain or nocturnal urination. No dry eyes, floaters, conjunctival injection. Dreams sleep was unremarkable. Patient lives with his fiance and has a healthy but not excessive sex life. No GI complaints. Eats well without any cravings. No constipation or diarrhea. No history of EPI prior to onset. Pt presented as otherwise unremarkable.
Pulse exam: I first saw this patient in November in MN
Right: pulses tended to be wiry, full generally “bing mai” . Stronger on the R than the L Lung: bing mai deep
Spleen: wiry-slippery, full
Kidney/Pc: deep, wiry
Left:
Heart: deep, wiry
Liver: forceful, bing mai
Kidney: deep
Tongue exam: narrow, red with little coat, multiple horizontal cracks -tongue never changed over the course of Tx
OM Diagnosis: The Ears are the sensory expression of the Kidneys. They are also fed by the San Jiao and GB channels. Given the nature of his tinnitus, it fit more with a Deficiency rather than an Excess-type pattern. However, there was a lack of evidence pointing to other pathological causes such as blood deficiency or Ki-yin/yang deficiency. Given the total picture, the pattern defined itself as a local channel obstruction vs. Ki xue deficiency
Treatment Principle: 1. clear channels 2. tonify kidneys
Point Prescription: K-3, Ki-6, SJ-5, SJ-17, SJ-21, SI-19, GB-2
Later Ht-1 (in & out) was added for 2 treatments with a profound effect.
Herbal Formula: none used
Lifestyle Prescription: 1. reduce sex to 3-4 times/week 2. no other recommendations were warranted as patient was already eating & exercising appropriately
Results: Within two treatments there was a dramatic stabilization of symptoms and a reduction of the volume of tinnitus. Over the course of treatments (12) the tinnitus never fully resolved, but the patient was grateful that the symptoms responded positively for the first time. The stabilization has remained with an occasional (tune-up) every 4-5 weeks.
Synopsis: Tinnitus is a notoriously difficult symptom to resolve, especially the Deficient type. This patient was unique in that the tinnitus was virtually his only complaint and apart from what may be seen as a slight Jing-deficiency (in the form of R-side deafness from birth) the patient was otherwise healthy. Treatment has appeared to optimize his condition.

The Treatment of Polyneuropathy with Acupuncture

Chief Complaint: headache, finger & feet numbness, asthma
Western Diagnosis: degenerated inflammatory polyneuropathy
Medical History: hepatitis, allergy, asthma, high blood pressure,liver removal surgery, in-born one kidney, vegetable diet with dairy products, little exercise, obesity
Questioning exam: -How long you have these symptoms?
-Asthma since a little child. Hepatitis since surgery. Headache for about 10 years.
-How is your sleeping?
-not good. Because my headache is right after midnight.
-How is your appetite? Any diarrhea or constipation?
-Good. Sometimes constipation.
Pulse exam: both kidney pulse very weak. Liver pulse wiry and spleen pulse slippery. Very big belly. With pre-cancer spots on the left forearm. No open sore or ulcers.
Tongue exam: Tongue is red tip, white and very greasy coating. Pale face, and walks slowly, can’t stand too long.
OM Diagnosis: Kidney Qi and blood deficiency, phlegm syndrome, liver Qi stagnation
Treatment Principle: tonify Qi and blood, setting balance between liver and spleen, remove phlegm
Point Prescription: Du20, Du14, LI4,LI11, Liv3, Ashi points, CV17, CV4, DU10, BL17, BL13, BL23, GB39, St40
Lifestyle Prescription: reduce caffeine, dairy products. Not too sweet food (boost yeast production), walking after meal, seaweed, high fiber
vegetables, low calorie food with a lot of organic greens
Results: High blood pressure get controlled after one 4 treatments, headache improves, numbness much better.

The Treatment of Fibrocystic Breasts with Chinese Herbs

Chief Complaint: fibrocystic breasts
Western Diagnosis: fibrocystic breast disease
Medical History: T., 47 year old female, came to me complaining of fibrocystic breasts. Gyn exam revealed lumpy breast tissue, with scattered fluid-filled cysts in the upper quadrants. There was no pain associated with the condition. Menstrual history is uneventful; general good health. She began menstruating at 11 years of age, had two pregnancies, one live birth, and one abortion. Her gynecologist suggested mammography, but T. wanted to try Chinese medicine first. T. exercises regularly, using weights, flexibility training, aerobics, and Qi gong. She also meditates daily, eats a wide variety of foods, and regularly takes vitamin supplements; she detoxes three times per year.
Questioning exam: T. reported that she had been cystic since her early twenties, and had a fibrous benign mass removed when she was 19 years old. Appetite was reported as normal; there were no digestive problems. Urination and bowel movements were normal. Energy levels reported 10 out of 10; no problems with sweating except a few nights before the period begins. Sleep is normal,8 hours, excepting the week before the period when she wakes at about 3 a.m. for about one hour before falling back to sleep.
Pulse exam: The pulse rate was recorded at 72, with even rhythm. Pulse quality revealed a thin, thready pulse, rather weak and superficial.Breast palpation revealed numerous lumpy areas. Meridian analysis revealed no tender areas.
Tongue exam: The tongue was pale, with a thin white coating, with some minor scalloping.
OM Diagnosis: Diagnosis was Kidney yin deficiency, Liver Qi stagnation, and accumulation of phlegm in the channels. When Kidney yin is deficient, the Liver is not properly nourished, resulting in a disruption of Qi movement. This disruption leads to stagnation. Since the fluids of the body are not allowed to flow freely due to the stagnation of Liver Qi, dampness accumulates and eventually congeals into phlegm. This phlegm resulted in cystic formations in the Stomach and Spleen channels.
Treatment Principle: Treatment was aimed at nourishing yin, soothing Liver Qi, and resolving stagnation, eliminating phlegm accumulation, and calming the shen.
Point Prescription: Acupuncture was not used for this protocol.
Herbal Formula: Liu Wei Di huang Wan (K’an Herbals), 2 tablets two times per day (to nourish Kidney yin and drain damp); Xiao Yao Wan (K’an Herbals), 2 tablets three times per day ( to soothe Liver Qi, relieve stagnation, and benefit the Spleen); one gram each of Hai Zao and KunBu in hot water three times per day (to resolve phlegm and reduce nodules). In addition, one capsule daily of Tyler Encapsulations Breast Phytonutrition was prescribed (contains: isoflavones, panax ginseng, curcuma longa, hesperidin methylchalcone, and rosemarinus officinalis).This protocol was followed for three weeks, with one week off during the menses. Then entire course of treatment lasted for three cycles.
Results: After three cycles, mammography revealed no cystic formations. Nine months’ follow-up revealed no return of the cysts.

The Acupuncture Treatment of Turner’s Syndrome

Chief Complaint: height stop growing after one and half years of age
Western Diagnosis: Turner’s syndrome
Medical History: The eight years French girl Leila C. came to see me on 07-10-99 along with her parents. She use to follow to the lower board of the normal height track since her was born. Between 1996-1998,her height did not be measured. June 1998, after her parents notice she was no more growing, She been sent to several specialist. She was been diagnosis with Turner’s Syndrome, but her reproductive system is well developed. Because Her Parents insisted to avoid the hormone replacement therapy. One of her doctor advised to try acupuncture.
Questioning exam: She is a healthy, active and shy girl. Because she did not speak English that moment, so all the communication is interpreted by her mother. She has no obvious complains, and she willing to use acupuncture by the kind explanation from her Mom.
Pulse exam: Pulse was normal pattern. these acupoints have been palpated with positive reaction: GUANYUAN, SHENGSHU, GANSHU,FENGCHI, BAIHUI,FENGFU, ZHUSHANLI.
Tongue exam: none abnormal sign been found
OM Diagnosis: To be honest, I have no clue of her condition at first. After reading more material of Turner’s Syndrome and join some chat room with some professionals throught internet. Her condition is considered as the result of deficiency of kidney yang.
Treatment Principle: enhance kidney energy & stimulating the pituitary gland
Point Prescription: all the positive points:GUANYUAN Ren 4, SHENGSHU UB 23, GANSHU UB 18, FENGCHI GB 20, BAIHUI DU 20, FENGFU, ZHUSHANLI St. 36 Plus Taixi Kid 3.
acupuncture Guanyuan and Zhushanli and acupressure rest of the points and the pituitary point on big toes according to reflexology.
in the first three month twice a week. then once a week. every six month have a break of one month.
Herbal Formula: N/A
Lifestyle Prescription: Her mother offer her more healthy diet with no specific instruction from any dietitians
Results: It is difficult to classify as good or bad. from the overall condition, she is more out-going, better cooperative with her sister and better sleep pattern. The Very Important is she is gaining 10 cm in past 17 month with acupuncture. She is still continuing the treatment, i will give your further report according to her treatment.

The Acupuncture and Herbal Treatment of Vulvar Vestibulitis

Chief Complaint: acute vaginal pain
Western Diagnosis: vulvar vestibulitis
Medical History: My patient has had the condition for 7 years. It first started as pain only on intercourse, then 2 years ago it became pain on arousal, and when she first came to see me there was constant pain. She is 28 years old, married, and a final year law student. The pain is predominantly on the right side of the vulva, it is a sharp pain that occurs with skin redness and inflammation, after the menses the pain will occur with itching. She is unable to have intercourse but the pain that is experienced constantly is a 6/10. The vaginismus only occurs on intercourse, but because the pain is so intense on arousal, it is not the immediate concern.
Previous Treatments Laser surgery which was unsuccessful, immediately after the surgery there was some loss of sensitivity and then the pain sensation returned. Topical cortisone. Antidepressants amitriptiline 150 mg/day, no change in pain but constipation, dry mouth, insomnia, weight gain. Biofeedback 6-7 months, no effect Next suggested treatment, surgery moon shape cut to remove inflamed tissue
Energy: 6/10, could be better Sleep: 7 1/2 hours, would prefer to sleep 9-10, fall asleep easily, 2 times a week wake up during the night, over thinking, one time nocturia commonly has night-frights always associated with fear, running away
Emotional: erratic tend to worry, low self esteem, tend to keep emotions in, has a tendency to be irritable with a short temper, and then times of melancholy. Stress- medium, many exams, pressure to find a job.
Appetite: eat often, small meals, crave sweet, sometimes salty, well balanced, quite a bit of dairy, enjoy spicy foods and coffee every day.
Digestion: good except diarrhea 1/week no pain, but urgency, strong odour.
Thirst: yes enjoy cold temperature
Urinate: 12 times a day short stream, medium yellow, no odor sometimes burning sensation on urination washes with baking soda,
Body temperature: very cold hands and feet Pains: headache occur on vertex slight throbbing, no vision is affected.
low back pain: flares up, dull weakness, with radiating pain
Menses: on birth control pill, Triphasil regular 28 day cycle, 8 years ago ovarian cysts now undetectable, when off bcp, severe cramps, heavy long menses (10 days).
menses started at 13 yrs, on bcp for 8 years, no pain at beginning of menses, but flow is very heavy with very big clots, dark in color. discharge: thick opaque, whitish yellow
PMS: tend to be overly sensitive Experiences tightness in chest, ache deep
Skin: very dry, dandruff, previous problem with eczema
Pulse exam: Pulse: slippery, thready with a very weak kidney pulse on the left
Tongue exam: tongue: very red swollen sides, thick yellow coat on middle to root, no coat on sides, veins swollen
OM Diagnosis: Damp heat in the liver meridian, with an underlying qi and blood deficiency, kidney deficiency due to the chronic condition
Treatment Principle: Treatment: Even though the pulse was weak I used an aggressive treatment protocol, to drain the liver and relieve the pain.
Point Prescription: Stage 1: Combination of points: liv-3, li-4, sp-6, sp-10, sp-9, gb-34, rn-2, rn-4, li-11, rn-9, liv-2
The pain went to 3/10, but the discharge was worse I added gb-26, du-20. st-36
Stage 2:kid-3, liv-5, liv-8
stage three using the extroadinary vessels balancing right lu-7, left kid-6. right gb-41, left sj-5, and mostly tonifying points, du-20, st-36, liv-3, li-4, sp-6, rn-6, rn-4, kid-3
Herbal Formula:
Stage 1: Long dan xie gan tang internally external wash of kushen, huang bai, huang lian, lian qiao, chi shao yao, dan shen, jin yin hua, mao she xiang
Stage 2: Formula Dan zhi xiao yao san ovulation to menses and liu wei di huang wan for 2 weeks after
Lifestyle Prescription: The patient eliminated dairy, sugar, coffee, and ate spicy foods in moderation Patient went off BCP Patient is practicing meditation
Results: The results were slow even considering how long the patient had the condition. She feels emotionally balanced, menses is regular off the bcp and comes so smoothly it is usually a surprise, the irregular bowel mvts have subsided, the headaches occur rarely usually at times of extreme stress. The day to day pain is 0/10. But the intensity of the pain on arousal is still there, and the strong desire to have a normal marriage and sex life is causing my patient frustration. The progress is now at a standstill. It has been 5 months.
Synopsis: I feel we have treated quite successfully with TCM but I now referred the patient out for counseling to address the psychological component.

Chinese Herbs and Acupuncture for PCO

Chief Complaint: would like to get pregnant
Western Diagnosis: Polycystic ovarian syndrome/Infertility
Medical History: History of excessive body hair growth and acne with polycystic ovarian syndrome. Took birth control pill for over 10 years, stopped taking BC 1.5 years ago. Had full fertility workup and did three rounds of Clomid- developed an ovarian cyst. Since cyst development and break from fertility treatments, menstrual bleeding has been heavier and longer, increased cramping, back pain, lots of tissue and clots, dark “tar” color, pink, dark read and brown.
Questioning exam: Prone to Spleen qi def and dampness- history of acne, digestive complaints (trouble eating raw fruit) occ diarrhea, yeast infections (prone to itchiness before period).
Liver qi and blood stagnation: history of depression and anxiety, occ anxiety attacks, self described worrier, cyst, heavy, dark, clotty menstrual periods.
Kidney qi and yin def: night sweats, ” tired, hard to catch up”, deep/weak KD pulse
Pulse exam: HT/KD pulses are weak/deep
Tongue exam: Tongue is red, swollen, with sticky white frothy coat.
OM Diagnosis: see #4
Treatment Principle: Strengthen ST/SP qi, nourish KD qi and yin, smooth and clear LV qi stagnation.
Point Prescription: Li4, Lv3, Ht7, Sp6, Sp8, Cv4, Cv12, YT
Extra pt- infert, Kd6
thread moxa
Herbal Formula: Gui Pi Tang/Xiao Yao Wan according to cycle
Lifestyle Prescription: Diet diary, stress management techniques (walking, increased exercise, breathing exercises), naturopath for quality supplements
Results: Just got a postcard in the mail yesterday- her baby girl was born on Jan 4th, 2006.

Acupuncture Treatment of Hot Flashes

Chief Complaint: Hot flashes
Western Diagnosis: Menopause
Medical History: A forty-nine year old patient, experiencing menopausal symptoms, was on Hormone Replacement Therapy for eight months. She felt great, had no hot flashes, but developed an ovarian cyst. The entire ovary had to be surgically removed. She’d been off of HRT for 11 months when she came in for acupuncture. Hot flashes were getting more frequent and more intense, moving from the groin up to her head. She did not want to take any medications or herbs. Her mother died of ovarian cancer. She had been on HRT since the age of 50.
Patient’s cycle was irregular. Her last period was 3 months ago and 4 months ago before that. She’d had normal, regular cycles before HRT: no pain, no PMS, moderate bleeding. She had had one pregnancy, no children. She had a low level headache for the last 2 weeks. Clenches teeth at night. She’s usually a highly energetic person, but was feeling fatigued from waking frequently at night from the sweats. She was getting anxious and angry. She was experiencing some discomfort just below rib cage.
Her diet included some protein (fish, chicken, eggs), vegetables only in salads and fruit. Very few fresh vegetables. Supplements included Calcium/Magnesium, a Multi, baby aspirin, Primrose Oil and Vitamin E. She drank plenty of water (room temperature). Her exercise included cardio or weights 6 times a week.
Questioning exam: Frequent and intense hot flashes, extremely stressful working environment, excess pulse
Pulse exam: The right was excess, full and wiry. The left was smaller, thin, wiry and tight.
Tongue exam: The tongue was bright pink, only the tip was red, shiny, swollen on the sides. Face had malar flush. Patient was tall and thin, very fit and healthy other than the hot flashes.
OM Diagnosis: Liver and Kidney Yin Deficiency with Liver Yang Rising
There was clearly a combination of excess and deficiency reflected in the pulses. Liver Yang Rising usually stems from a Yin Deficiency.
Treatment Principle: Reduce Heat, Nourish Kidney Yin, Soothe Liver Qi/Yang
Point Prescription: H6, K7, Ren3, Pc7, Sp6
S44, Liv2, Liv14 (varied with K3, Liv3), Yintang
Acupressure on K1, Ear: Shenmen
Taiyang, GB34, St7 or 8, GB2 for clenching
Herbal Formula: None. The patient did not want any medications or herbs.
Lifestyle Prescription: I taught patient to do mini meditations. Recommended 10 minutes every morning and some deep breathing breaks throughout the day. Recommended foods that nurture Kidney Yin (from Healing With Whole Foods) and to reduce intake of spicy, hot foods.
Results: Patient improved with first treatment and then the hot flashes gradually increased until the following week. By week 3, clenching was better, hot flashes still frequent. By week 5, only waking once a night with hot flash, greatly improved during the day as well. By week 8, no hot flashes at all. Treatments started in early October. By March, she still had no hot sweats.
Synopsis: It’s good to have first hand experience of the effectiveness of energetic rebalancing without the use of medications and herbs for such conditions as menopause.