When the metaphor becomes embodied

cassiopeia: September 28, 2020, 8:29pm
I did SI+ on a well-groomed self-loving 46yo woman who had dizzy symptoms and loose stools worse before the
start of menses. also she had pain around SI 9-10. She settled well on the table, but a week later I got this email:
i wanted to let you know that since my treatment with you, I’ve pretty consistently had this feeling that my uterus
is sucking up all of my energy. I have felt sluggish and drained.
So… sounds like a sort of delayed adverse reaction, and she needs KD+?
The patient who is allergic to Saam

KristinWisgirda: September 28, 2020, 8:57pm
cassiopeia:
sluggish and drained.
That sounds like an adverse reaction. Of course, there might be more to the story.
In hindsight are there any SI excess signs that might have pointed you away from SI+?

Daniel: September 28, 2020, 9:54pm
Does she have actual menstrual pain? how bad? clots? fibroids? varicosities? Perhaps she has no blood stasis?
when in her cycle was this treatment given? what is her main complaint?

George_Mandler: September 29, 2020, 1:55am
I’d get her in ASAP for a KD+ treatment. We think of SI+ for vertigo, but dizzy can also be unconsolidated. Also
loose stools can be too depending on how they present. Take in the entire picture – is she running all over – her
energy spread in different places? I have successfully treated KD+ on people with KD excess signs to help bring
things together.
…and what Kristin and Daniel stated.05/01/2024, 12:06When the metaphor becomes embodied – Bothersome Clinical Problems – Qiological Community
https://forum.qiological.com/t/when-the-metaphor-becomes-embodied/1307/print2/5

michaelmax: September 29, 2020, 2:31am
cassiopeia:
I did SI+ on a well-groomed self-loving 46yo woman who had dizzy symptoms and loose stools worse before
the start of menses
when I think of well groomed I’m often thinking of a TB excess person. Of course KD excess people tend to dress
well too. The TB people tend to be more modest and the KD people, especially women, tend to dress in a way that
will draw attention to themselves, so can be a bit reveling.
With the loose stools… other signs dampness present? Dizziness can also be from dampness.
When you say “self loving” what are the specific things you are seeing or hearing?
And as @Daniel and @George_Mandler suggest, likely some adverse reactions (in particular the sluggishness
and feeling drained). One last thing, when she says her uterus is sucking up her energy… that is a nice metaphor,
but I’m not sure what it means.

cassiopeia: September 30, 2020, 1:48am
KD xs: dizziness 1-2d before and d1 of period; full medial heel 5+; symmetry 8+, into self 9+ (really fixated on her
health), grooming 8+, dysmenorrhea 3+, ovarian cysts 2+
SI xs: medial heel dry 2+, lack of varicosities; R face droops when tired (I just saw this; had it categorized under
ST xs in my notes)
@Daniel: tx given on 1st day of flow. she began to feel this drained sensation after period ended. Main complaint
is bouts of dizziness and loose stools that seem to be related to before/start of menses.
@George_Mandler: I agree! I have taken the dizzy=SI xu thing on blind trust. It makes no sense to me at all. If
KD is excess/too consolidated, shouldn’t we see lack of wind? a firmer rooting? I haven’t done KD+ much, since
Toby says to clean up other areas first. so I don’t have a good feel for when dizziness needs KD+… at all.
@michaelmax: good points re: TB excess. She def has that too, though last tx I did LV+ and she had a a lot of
anxiety afterward.
Surprisingly, the stools have been more formed and great, even given all this going on.
here are more clear descriptions of the sucky uterus:
–Body feels sluggish all over
–Literally feels like energy is draining from my limbs and my head toward my abbdomen
–My uterus area feels more bloated and heavy, sometimes almost pulsing?
–When this all started (right after my period) I noticed some clear sticky discharge that looked like ovulation; that
has continued a bit each day05/01/2024, 12:06When the metaphor becomes embodied – Bothersome Clinical Problems – Qiological Community
https://forum.qiological.com/t/when-the-metaphor-becomes-embodied/1307/print3/5
definitely sounding like unconsolidated, weak KD. she’s heading out of town so I gave her bu zhong yi qi tang.
will do KD+ asap next week. thanks for all the input.

michaelmax: September 30, 2020, 3:50am
cassiopeia:
here are more clear descriptions of the sucky uterus:
–Body feels sluggish all over
–Literally feels like energy is draining from my limbs and my head toward my abbdomen
–My uterus area feels more bloated and heavy, sometimes almost pulsing?
–When this all started (right after my period) I noticed some clear sticky discharge that looked like ovulation;
that has continued a bit each day
The heaviness makes me think about dampness, and with the sticky discharge perhaps look into dying the interior.
Also a heavy sluggish body makes me think LV excess, but she sounds too well put together for that. Still… the LV
tonification made her anxious.
What has my attention at the moment with this case is the energy pulling into the center of her body. I’m always
cautious around boosting the GB , but perhaps that would be useful in getting the qi to move up and out.
George_Mandler #8September 30, 2020, 12:38pm
cassiopeia:
so I don’t have a good feel for when dizziness needs KD+… at all.
I do agree – most of the people we see may not be SI excess so it is hard to spot. But seeing signs where
consolidation is needed – cold sweat, bleeding too much, deficient and clear lack of any oketsu (R or L).
I am sure Kristin or others can expand on my terse thoughts.
Here are a couple of cases where I used KD+ for patients that typically need SI+ – I hope it is helpful.
I have a patient, many clear KD excess signs (pretty, strong, endometriosis, well groomed) who always responds to
SI+ supplementation when she needs it. One day she came in after traveling all over and said she felt pulled in so
many directions. I motioned with my hands bringing them together to mimic consolidation and asked if that is what
she needs. “Yes!” she replied. The KD+ supplementation worked amazingly well and she still occasionally
references that treatment with a “Wow remember that time…”. It is the only time I did KD+ on her.
Yesterday I did a KD+ supplementation on a long time patient 8 months after her 4th child (she only wanted 2 very
fertile!). She has other KD excess signs and SI+ supplementation has served her well, although ST+ is what her
body mostly loves. Her main complaint was a pain in the lower right in the area of the fallopian tube. When
palpated there was a strong pain response, almost nerve like she said that radiated to her lower back to the SI joint.05/01/2024, 12:06When the metaphor becomes embodied – Bothersome Clinical Problems – Qiological Community
https://forum.qiological.com/t/when-the-metaphor-becomes-embodied/1307/print4/5
You could sometimes feel a little pebble, but it would move. I did SI+ supplementation last week to address it but
there was no response. Her CV3,4 were completely hallow as was the rest of her abdomen besides this one spot. I
went with a KD+ supplementation (apprehensively) because this is called a practice and she is a patient that if it
went sideways she would be fine with it. After the treatment she said “that is the deepest I’ve ever gone” (she has
received at least 25+ Sa’am treatments) and said the pain was much less. I emailed to find out how she is today and
will report back. (EDIT: Patient reported back… She is still in pain and now it feels more swollen. But she said she
feels great and the treatment felt great. So I see it that she needed the KD+ but it was too much for whatever is
going on (cyst?) and consolidated it too much. Fascinating I say.)
For your patient it sounds like SI+ was not right and maybe it is in the spectrum of damp as Micheal stated. Loose
stools – maybe when people mean dizzy they an also mean foggy? Not sure but also maybe an LI+ to help focus.
Hard to say about this case, but looking elsewhere than in the KD/SI pairing.

cassiopeia: September 30, 2020, 2:00pm
Thanks George/Michael (!)
those examples are very helpful. My newbie brain goes bananas when trying to sort through the dynamics of
constitution/morphology vs what’s-needed-right-now. Yesterday I got the ST/LU pair wrong on multiple occasions.
but as you say, George, it is called “practice”. and the patients have patience as long as I’m willing/able to see
when things aren’t right.

KristinWisgirda: September 30, 2020, 4:41pm
cassiopeia:
really fixated on her health),
This drive for self preservation can be mixed with so many other things, I wouldn’t call it a for sure K Excess sign.
Fear, feeling like you are falling apart, dull inner obsession can all play a part.
What other qualities come to mind with health obsession?
George_Mandler:
motioned with my hands bringing them together to mimic consolidation and asked if that is what she needs.
It helps to ask patient clear outright questions like that. I recently asked a K excess who was exercising too much
because of health fears if she felt she was having a hard time keeping it together. She said yes and had a lovely K+
experience.
2 Likes05/01/2024, 12:06When the metaphor becomes embodied – Bothersome Clinical Problems – Qiological Community
https://forum.qiological.com/t/when-the-metaphor-becomes-embodied/1307/print5/5
cassiopeia #11October 7, 2020, 1:23am
I convinced the patient to come in before leaving town last week, and did KD+. before the needles, she literally felt
the energy moving down and out through her uterus and feet. her abdomen felt puffy and bloated like not being
able to be held in. After needles were in, those sensations improved. She felt MUCH better within a couple hours,
and the “energy suck” through her uterus disappeared.
crazy.