Home Forums Diplomate Discussion Chronic Nasal Congestion Case

  • This topic has 11 replies, 1 voice, and was last updated 4 years ago by Clint Cain.
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    • #7128
      Clint Cain
      Participant

      Hello everyone. Here’s an update and some questions: I have concerning a patient I’ve been treating. I posted more details about her case elsewhere on this page if you’d like to search for it and take a look. She is a 59 year-old female who initially came in because of chronic nasal dripping. I’ve been seeing her since March of this year, and her nasal dripping was alleviated almost immediately when we began our work together. She’s taken BXXT, GCXXT, LGZGT, CHGZGJT, and ZSXBGZT at some point since we started. Sometimes when she comes in she has very little at all to complain about, and other times, like today, some symptoms seem to be relapsing. At her previous appointment she reported that she was breathing better than she had in years, and the facial pressure she had was gone. She reported a warm, slightly acidic feeling in her epigastrium, feeling gassy with the herbs I gave her, and some dry eyes. She was given BXXXT + LGZGT + XB. Today, she said that she was having mild clear nasal dripping, nausea and dull pain in her epigastrium, and a tight, achey feeling that extended all the way around her right ribcage to her back. Pulses: L: 1 slightly floating, 2 and 3 thin wiry, 2 slightly big, dong 1-2, roll up. R: 1 slightly tight, 2 weak wiry slightly big, 3 thin wiry. Herbs: I gave her ZSXBGZT with ZS 6, GZ 9, + SJ 9 to incorporate GZSJZST + LGZGT. I honestly wasn’t sure what to do with these pulses. I often feel the slight big quality in one or both guan. Thoughts?

    • #7639
      laurieayres
      Participant

      CHGZGJT + either ZSXBGZT or GZRST if the bowels are more dry or loose respectively. You can even add XX if the clear nasal discharge doesn’t resolve.

    • #7967
      Clint Cain
      Participant

      Thanks, Laurie. She’s been on CHGZGJT before, so not sure why I missed it this time.

    • #7640
      Clint Cain
      Participant

      TXS+FL maybe

    • #7641
      Clint Cain
      Participant

      Laurie Ayres, I wanted to update you and ask for your input. I saw her on 8/10/17 and she reported that her sinus pressure is 90% gone, but there is still some behind her eyes in the afternoon. She’s still having clear nasal dripping in the morning, which is what she originally came in for earlier this year. Her BMs have been formed, and there hasn’t been any rib pain, nausea, etc. L: all thin wiry, 2 big, dong 1-2, roll up; R: 1 slightly tight, 2 wiry slightly weak, 3 thin wiry, slight roll up. I gave her CHGZGJT again, + LGZGT + XB and GG.

    • #7968
      laurieayres
      Participant

      Is there any tension on the big L guan? And is it definitely big that you’re feeling on the guan or an extension of the dong? If it is big, what is the depth of the cun relative to the chi? And what is the size of the L guan relative to the right guan?

    • #7969
      Clint Cain
      Participant

      What do you think of these pulses? On 10/4/17 a 31 year-old female came into my clinic with a main complaint of stress that manifests as headaches and upper body tension. She is a very busy PhD student right now. Her headaches are in her eyes and at her anterior hairline. She has them on a daily basis, and they are a low level ache. She also has some difficulty concentrating, and some difficulty falling asleep. She was diagnosed with low grade Spondyloslisthesis at L5-S1. With this, she has some lower back pain, very tight hamstrings, and some tingling, numbness, and pain down her left Gb channel. She also feels some of these sensations on the very bottom of her foot. This has been going on for at least eight years. She also tends to get some seasonal allergies, mostly manifesting with dryness of the nose, eyes, and mouth. When she does come down with an acute illness, it manifests as nasal congestion and sinus pain. Her stress also causes some abdominal tension, not really pain, and she can have 2-3 BM/day that are loose when her stress is high enough. This occurs about three times per week. She is constipated before her menses. She has a lot of pain before her menses, and some very small clots with dark xue. She was sweating easily during the acupuncture treatment, and even felt a bit dizzy and nauseous at times, but nothing that was so severe that we had to stop. I practice Japanese acupuncture, and am always very aware of the amount of stimulus I am providing, so this says to me that she is quite sensitive. Pulses: L: 1 and 2 slightly deep thin wiry, 3 deep thin, dong 1-2, faint and slightly expiring overall; R: 1 slightly wiry tight, 2 thin slightly big expiring, 3 deep thin faint, slight rolling up. Herbs: I started her on CHGZGJT + ZSXBGZT. With the faint and slightly expiring pulses, I see the need to treat shaoyin and jueyin, but I am not sure how to approach it. Help please.

    • #7970
      laurieayres
      Participant

      If the shao yang wiry is there, then just keep harmonising.

    • #7971
      Clint Cain
      Participant

      With the formula I have chosen?

    • #7972
      laurieayres
      Participant

      If the R 2nd is bigger then, yes, CHGZGJT, and with the right R 1st and roll up, then definitely continue adding LGZGT. I would also continue to treat the dong if it’s still clearly there. I’m not sure if you need the GG, as the nose is dripping, not dry, but if you feel the sinus and eye pressure has an element of dryness, then it’s justified. With the wiry R 3rd, then you could also consider starting to move some blood as part of the movement out of shao yang.

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