f.nunnariTCM: October 20, 2019, 10:33am
This is the case I presented to Toby and the class in Sydney (September 2019), which we brainstormed together to
formulate a treatment plan…
Female 67yo
MC: “running piglet” (a sensation of upward rushing from belly button to chest, or to throat when
severe)accompanied with Tachycardia, and extreme fatigue (has to lie down, unable to do anything until it passes)
Triggered with emotional stress, certain foods especially iodised salt, exertion/bending or lifting.
When this occurs – bladder shuts down – dribbling or inhibited urination,SOB, LOA, also indigestion (belching)
and limping – due to pain of Right leg (around the greater trochanter). She also experiences her whole body tremor
(internal tremor), and can not sleep.
Pulse: overall hollow quality to pulse
Slippery left cun, rolling up, guan and chi wiry hollow, some length to chi
Medical dx: Hyperthyroidism always had strong aversion to cold – dresses multi layers and beanie.
4 children – always giving/helping her children/dividing her time to others until her body exhausts and she is forced
into rest.
Varicose veins
Dark under eyes
Pale face
Symmetry to face
Small frame
Has always been a light sleeper, but more recently has to sleep more due to exhaustion.
Sensitive digestion – prone to indigestion/belching
BM: sluggish
Worked hard whole life, always stress in life, but a survivor.
A worrier. Past few years due to life events – more anger and resentment is present emotionally, hold on to past
hurts/unforgiving?
History of fright/shock/trauma – father shot, son hit by a car, mother died of cancer when she was pregnant,
husband died or cancer…etc30/01/2024, 13:33Group Case Study with Toby in Sydney…update – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/group-case-study-with-toby-in-sydney-update/698/print2/3
Has a tendency to hoard.
Chinese herbal medicine has helped reduce the severity of the “episodes” but the frequency seems to have
increased, and once herbs are ceased symptoms return.
Top 3 organs (plus some):
1. SI – 4 children/fertility, dark under eyes, small frame, sluggish BM, fatigue, tachy, cold… Toby instructed to
watch- if heat rushes up – reacts poorly – Supp Kid
2. PC – safe – go to if have insomnia
3. Liv – before heart
4. Heart – double fire to correct heart.
…maybe kid down the track.
…maybe stomach if have to descend in the moment (but does not suit body type)
2 days after the group discussion in Sydney, I treated this patient – she was in the middle of an episode – pulse was
irratic/irregular, left cun superfx, slippery, voice was weak – chest heavy, epigastric discomfort – “like staring to
block” , can’t bend/lift – exasperates symptoms, no sleep the night before, bladder slightly affected as mentioned in
symptoms, energy 4/10, need to keep drinking warm fluids, sensitive to noise, potential to loose patience/vexed.
I thought it too risky to do SI first? (and with the pulse being superfx and irregular) and because she had no sleep
(plus SOB, less tolerable) I chose our second option + P.C … the calm was immediate, pulse became less irratic,
started to cough a bit (and I got worried) then breath became deeper, voice clearer when she spoke, fell asleep
during treatment.
Patient reported an increase in appetite and improved bladder function, and discomfort of aforementioned
symptoms continued to relieve after treatment.
Because I would not see the patient for a few more months I did a second treatment the next day before she left, I
was unsure if this was the right thing to do as she was already feeling recovered after the treatment and I didn’t
want to Fk it up…but it would be a long time before I would see her next and I wanted to do as much as I could…
plus the darkness under her eyes really stood out to me after the first treatment, so I supplemented the SI.
Feedback a few week after these two treatments is positive, reporting much stronger overall/improved energy
levels. Has had a couple of episodes since but without the same severity or duration ( resolving within an hour, as
opposed to 2 days).
Thank you Toby, and class for your patience in working through this case study with me, as it was my first case
using SAAM it was great encouragement for me to continue to use it in clinic.
(I would also note that the thickest needles I had on me for this treatment was .25)
KristinWisgirda: October 20, 2019, 11:13pm
30/01/2024, 13:33Group Case Study with Toby in Sydney…update – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/group-case-study-with-toby-in-sydney-update/698/print3/3
Nice job! Everyone benefits when you share a case study.
Jeffrey: October 21, 2019, 9:38pm
f.nunnariTCM:
(I would also note that the thickest needles I had on me for this treatment was .25)
sounds like you rocked it! strong intention, good point location, proper angle /depth and tonification/sedation of
each needle…sounds like you did fine w/25s. My biggest concern and therefore question is my diagnosis. I’m sure
thats the one we are all chasing, thats the ball that keeps dancing around in my head wondering…One thing we can
all have control of is walking out of the room and knowing if we had good relations and intention in our needleing,
and that it was correct. (I use 30s on body points and 25s on jing wells for what its worth)