Daniel: February 1, 2020, 6:12pm
I had a patient in yesterday – a woman in her 50’s who has been in quite a bit for several months now and has
benefited tremendously from these treatments – quite seriously it has turned her life around. Yesterday, she came in
complaining of insomnia and a shortness of breath – hallmark signs for us of GB excess. And then when I asked if
anywhere hurt on her body, she promptly pointed to her right IT band!!! and my needle finger got so super itchy, I
moved quickly to supplement PC. I stood back and watched and waited . . . . and she was getting a little relaxed but
not that much – I expected more and was beginning to reevaluate . . . . I had also been considering a Bladder
supplementing treatment as she is often hot, has symptoms that get worse with heat and is also quite a hyper
personality (but what confused me was that substernally, she was cool and tight which seemed conflicting – I have
written here about this conflict I very often find with this substernal palpation) . . . just as I was thinking about it –
but having said nothing yet, she spontaneously put her fist on CV14-15 area and told me when she presses there,
she finds her shortness of breath improves almost immediately!!! What a gift. I took the PC+ needles out, put in a
UB supplementing treatment – within minutes – her eyelids went half-mast and she sunk very deep. After the
treatment, she got off the table , drunken with bliss, face unrecognisable from twenty minutes before and declaring
to me it was the most radical treatment she’d ever had.
George_Mandler: February 1, 2020, 5:39pm
Daniel:
just as I was thinking about it – but having said nothing yet, she spontaneously put her fist on CV14-15 area
and told me when she presses there, she finds her shortness of breath improves almost immediately!!
Brilliant Daniel. I have not been paying much attention to Front Mu points in this system. And I don’t think I have
heard Toby talk about them diagnostically the way we’ve talked about back shu points for back pain. Your
synthesis of Kiiko and Sa’am is apparent.
KristinWisgirda: February 1, 2020, 10:57pm
Wonderful! This is what happens when you keep attending your patient fully. They reveal more and more to you
and help you understand.
1 Like30/01/2024, 11:49Great Example of Real-Time Dynamic Engagement – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/great-example-of-real-time-dynamic-engagement/864/print2/4
rappeports #4February 3, 2020, 8:56pm
I get the front mu of the heart, but seems to be heart deficient and not excess so I’m not clear why you chose
bladder.
Daniel: February 3, 2020, 11:42pm
rappeports:
why you chose bladder.
She is always hot and has a very hyper personality
these stand out the most in a very big way
(true – a cool and somewhat hard CV 14-15 area is somewhat contradictory!)
George_Mandler: February 4, 2020, 3:31am
I thought you did it because she pressed the Front Mu of the Heart and felt better – so you did BL/HT for the
connection based on more heat signs!
Daniel: February 4, 2020, 12:13pm
George_Mandler:
so you did BL/HT for the connection based on more heat signs
Heat signs (she is almost always hot) AND all very hyper personality – these two features are very prominent. If
you saw her, I am sure you would agree that Heart Excess is a big part of her picture. So yes. I was just describing
a (typical) clinical conundrum of considering two treatment possibilities at that moment – going with one (as we
must do!) – not really seeing such a convincing response in real time on the table – so just beginning to question my
choice – and THEN in that moment, she offered up a tipping-point gift by spontaneously telling me how her
breathing issue is always improved by placing her fist on the CV 14-15 area and lying on top of it – just how in that
instant, my own equivocations tipped to a refreshed itchy needle finger . . . .
rappeports #8February 6, 2020, 5:35pm30/01/2024, 11:49Great Example of Real-Time Dynamic Engagement – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/great-example-of-real-time-dynamic-engagement/864/print3/4
I was confused re this. She felt better with pressure so that’s Deficiency in the heart = UB excess?Is this
overthinking? or too much TCM? But then why did UB work?
KristinWisgirda: February 6, 2020, 5:51pm
Sometimes channel, sometimes quality.
But which channel, which quality?
In Daniel’s case, UB+ worked because
Daniel:
Heat signs (she is almost always hot) AND all very hyper personality – these two features are very prominent.
If you saw her, I am sure you would agree that Heart Excess is a big part of her picture.
Daniel can correct me, but my take is that the patient was pointing to the importance of the H/Ub dynamic when
Daniel:
she spontaneously put her fist on CV14-15 area and told me when she presses there, she finds her shortness of
breath improves almost immediately!!!
It wasn’t the better with pressure that informed his choice. The ren14/15 area wasn’t presenting as classic Saaam H
excess (soft and warm) anyway.
The area was just a pointer to the larger H excess dynamic. Does that make sense?
Daniel: February 7, 2020, 2:57pm
yes, Kristin is correct
sorry for the confusion!!
I did not – to be clear – interpret her pressing on CV14-15 area to mean deficiency or excess of anything – just to
point me to the UB-HT axis
I was in one of the clinical decision-making pivots that need action right away
with insomnia and shortness of breath and pain on right IT band, I had opted to treat GB XS by supplementing PC
– but with only mild observable response on the table
and also considering with equal weight
because she runs quite hot a lot AND has a very hyper / laughing / smiling / red-faced personality
to cool her down with a UB supplementation (HT XS), when in that very moment I was feeling ‘doubtful’ about
my PC supplementing choice, she just happened to mention that her breathing issue was always relieved by
forming a fist over CV14-15 and lying on top of it . . . .30/01/2024, 11:49Great Example of Real-Time Dynamic Engagement – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/great-example-of-real-time-dynamic-engagement/864/print4/4
the ‘gift’ in the moment that pushed my itchy fingers to take out the PC + needles and insert UB+ needles with very
very dramatic results!!!
I posted just to share such a great example of how in-the-moment and dynamically engaged with observations we
need to be using Sa’Am . . . .
regarding pressure on CV14-15 and what it precisely means?
sure, I understand a ‘TCM’ approach would suggest ‘better with pressure’ points to deficiency.
I’ve never liked that all that much to be honest.
If you think about it, it could just as easily be the case that the substernal area is very tense and tight (Heart
Excess??) and applying some pressure relieves the tension.
so to clarify, I just took the pressure on CV14-15 reporting of the patient to point me to the UB-HT axis and with
her heat and her hyper character – for me there was no question but to treat HT XS.