Mood, Energy and Headaches Case

[Clint Cain]

Help with this case, please.I have been treating a 33 year-old female. She is coming in for anxiety-depression and fatigue that has been present most of her life, but has worsened within the last year. She also has some night sweats, headaches in her right eye during day one or two of her menses, and a history of infertility with one miscarriage, but she has had three successful pregnancies. She has no abdominal pain related, or not, to her cycle. She has also been having episodes of nausea and vomiting. Since we started our work together, she has been on GZJLGMLT + GZFLW, and GZRST + FLXRGCT + GG, but from 9/13/17 to 11/20/17 she had been taking TXS + DXWT with FZ 90 and – BS (she had an irregular pulse when she first came in). On 11/20/17 I switched her to TXS + DGSYS because the headaches weren’t budging (everything else was minimally budging). She came back in on 12/4/17 and reported that her fatigue had finally started to lift some (maybe 15%), but she had a very bad headache in her right eye during day two of her cycle. She also had nausea and vomiting with it, as well as some slightly looser (not watery) stools. Her pulses were L: 1 wiry tight, 2 and 3 deep thin faint, dong 1-2, rolling up, rapid; R: 1 faint tight fails to lift, 2 and 3 deep thin wiry faint, 2 slightly big, dong 1-2, rapid.I gave her TXS w/ FZ 90 + DGSYS – BS + CS 48 this time. What do you guys think?

[peterslipper]

The L cun tight/wiry with headaches makes me think of GG. I’m wondering whether the R D1-2 could be interpreted as slippery guan. Maybe Ben Tun Tang?

[Aaron]

As the problem is cyclical, I think harmonizing is always worth trying. Shaoyang type symptoms during menses makes me think XCHT. The blood is weak so the yang surges upwards to the head. It fits the nausea and vomiting.With the soft lower abdomen, she probably would end up needing something like SQW, but I think she needs harmonizing first. With the tight left cun I’d add GZGCLGMLT

[Clint Cain]

My brain started to wander off in that direction too. I am open to all possibilities at this point. However, I do think that a FZ formula, or FZ-GZ is necessary for her. During acupuncture treatments, her points always turn red when needled (even w/ my light Japanese style), and during the last treatment the soles of her feet were bright red but cold to the touch. Also, her lower abdomen is so flaccid and weak that I have a hard time needling there.

[Author]

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