KristinWisgirda: September 9, 2020, 8:31pm
This is the first post COVID case that I have been able to treat with Saam. I’m so thankful that she has gotten such
quick relief. Her response to UB+ is a particularly interesting reminder that you can use UB+ in a patient with no
real heat signs.
42 year old nurse’s aide
Diagnosed with COVID on 4/2. Active covid symptoms included body pain, malaise, fever, lack of appetite, erratic
bowel movements, abdominal pain. Denies respiratory involvement. Hasn’t been able to work since because of
disabling symptoms. Chief and secondary complaints are all s/p COVID.
Chief Complaints:
· Body pain and pressures- all symptoms bilateral, in constant pain but location changes through the day
sharp pains travelling through her limbs
intense pressure on UB36 area bilaterally when she sits or lays flat
none when standing and moving
pressure at occiput- Cut off all of her hair to facilitate frequent warm showers which give relief. Warm water
creates a minty tingle on her scalp.
worse with eating- eats then feels pressure rising from her stomach that then aggravates pain
worse when she notices her hands get wrinkled as if they are dehydrated
all pain better with movement- walks 4 miles a day even though this is exhausting
Pain disturbs sleep: hard to get comfortable and waking every 2 hours.
· Glomus: Uncomfortably full in entire abdomen after eating 9+. Low appetite and afraid to eat because
aggravates body pain. Heartburn eliminated with omeprazole. Has lost 30 lbs since COVID.
· Bowels: erratic, dry stools that are hard to pass or loose with undigested food, can skip days; feels strong
vibration 8+ down both legs during bowel movements
Secondary complaints:
· itchy papular rash on forehead and cheeks- comes and goes, notices in conjunction with increased abdominal
noises; feels tight
· Loss of smell- gradually returning but not 100, 1+
· exhausted 5+
· infrequent hot flashes, mild sweats or chills 1+
· body vibrations 3+; dizziness with position change 3+, feels movements in her head
Appearance and demeanor: pretty 5+, attention to appearance 5+; quiet voice 8+; polite 6+, great reporter 10+.
Lifestyle: unable to work, mother of 3 children under 18yo
Morphology: sturdy frame, thicker flesh 3+, normal weight
Skin: dry coarse 5+, sweats normally29/01/2024, 12:11Post COVID Syndrome – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/post-covid-syndrome/1274/print2/11
Body temp: normal when not having infrequent hot flashs/chills
Thirst: not thirsty but drinks lots of water because of the hand dehydration symptom; prefers room temperature
water
Emotions: even tempered
Respiratory: fine
Urination: clear to light yellow, denies problems
OB/Gyn: monthly period with normal to flow that is light pink brief and scant; denies dysmenorrhea or problems.
After giving birth to twins via c-section10 years ago, went into a coma for several days but doctors are unsure of
cause. Coming out of coma she had body pain similar to the pain she is currently experiencing
Tongue: light purple, thin body, normal moisture and coat; curled up edges and tip
Pulse: thin
Abdomen: deep empty epigastrium 10+ on an abdomen with otherwise good muscle tone; pressing on right lower
quadrant and K16 recreates the vibration she feels when having a bowel movement
Treatment 1: SI+ on the right; herbs- gui zhi tang + chen pi, ban xia, ma huang, fu zi
All symptoms are at least 50% better-the UB36 and occipital pressure are now the most troublesome areas.
Sleeping like a baby. Glomus is better and is able to eat more but is still afraid of eating. No more undigested food
in stools, stools are now dry and is skipping days. Epigastrium is still strangely cavernous. Tongue is no longer
purple but still has curled up edges and tip.
Treatment 2: UB+
Symptoms are 90% gone. Light pressure sensation at Ub36 and occiput are the most troublesome along with
constipation with hard dry stools. Epigastric are has more tone. Eating much more with only occasional sense of
fullness after eating. Energy and smell “almost normal”. Papular rash on face comes and goes but less frequently.
Treatment 3 (today): SI+ on the right and LI1+/ST36- on the left
All treatments relieved pain while she was on the table.
lauramcgraw: September 10, 2020, 4:21pm
Thank you for sharing this case! What was your treatment strategy with Treatment 3? From the points I see you are
helping the digestion, improving fluids and moving circulaton. Advanced jazz playing with Sa’am as George says:)
I have a few post covid patients as well and I see a deep fluid deficiency that leads to the patient having a lot of
dryness and a couple patients who have heart palpitations post covid. The bladder treatment has been very helpful
on these patients as well.29/01/2024, 12:11Post COVID Syndrome – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/post-covid-syndrome/1274/print3/11
Behind right eye and top of head migraines
KristinWisgirda: September 10, 2020, 6:57pm
Thanks for sharing your experiences too @lauramcgraw. I posted this case hoping to start a conversation about
how these patients are presenting. I am thankful that my patient freely reported all the strange details of her
condition. Other patients might not think to report certain things so sharing experiences will help us ask better
questions and look more closely to evaluate fluids and blood stasis.
Her deeply empty epigastrium was such an odd sign on the background of the rest of her presentation. Without the
Sa’am indication of H excess I might not know what to make of it.
lauramcgraw:
From the points I see you are helping the digestion, improving fluids and moving circulaton.
Thanks for articulating this @lauramcgraw. I considered using the regular UB+ for the third treatment but
hesitated to use ice cold water twice in a row so opted for partial UB+ and SI+ to keep bringing movement and
fluids to the UB channel since her dominant symptoms were there.
At the second visit, I considered changing herbs because of the bowel dryness but she remarked that they really
improved her appetite when she took them. At the third visit I changed her formula to be more moistening.
Other, please let us know what strategies work for these patients. I suspect we will be seeing more and more of
them.
jedwardian: September 11, 2020, 5:25pm
@KristinWisgirda, thanks for the case–just to clarify, is emptiness at the epigastrium a HT excess sign? I don’t
think this was mentioned in the intro seminar I took.
FWIW I’ve also had good results lately using UB+ in the absence of heat signs for channel-related issues (one case
each of headache and whiplash-related neck pain)
Jonathan
KristinWisgirda: September 11, 2020, 9:09pm
jedwardian:29/01/2024, 12:11Post COVID Syndrome – Sa’am Clinical Insights – Qiological Community
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is emptiness at the epigastrium a HT excess sign?
Technically, softness and warmth of the abdominal midline between rem15 and ren8 is the indication for H excess
that is included in the power point of the intro class. Tony describes it as 2 inch band.
The epigastrium is part of that real estate.
jedwardian:
FWIW I’ve also had good results lately using UB+ in the absence of heat signs for channel-related issues (one
case each of headache and whiplash-related neck pain)
Great! It is important that we don’t get fixated on channel or quality in our methodology. While we have to be
careful with the channels that double up on qualities, ie LI dry, Spleen damp, Heart fire and UB water- there are
times when the channel location is the most important indication.
cassiopeia: September 12, 2020, 4:22pm
my post-covid case was a woman I started seeing in late May; she’d been having symptoms since mid-March. The
main issues remaining were fatigue 6+ and shortness of breath 8+, both ww exertion. This was before I learned
Saam… with Kiiko-style acu and herbs (variations of Gui zhi tang, sheng mai san mod with hou po, xing ren, dan
shen, gua lou), all symptoms improved to 2-3+ level. Then I did Saam LU+, ST+; fatigue and SOB improved to
1+, but she could never get past that baseline feeling of something on her chest.
She is a retired accountant, rule follower, plus was repressing a lot of emotions as her husband was going through
health issues; so I did GB+ one week. The next time she reported in general doing ok, but during one walk, had
quite intense SOB along with a cold sweat. This was a more severe presentation than she’d had in weeks.
So on to PC+ and the next day she wrote to say her chest sensation had been “ZERO ZERO all day – never have I
been so happy to be a zero”
It’s been a stable zero for 2 weeks now, energy completely back to normal.
cassiopeia: September 12, 2020, 4:38pm
@KristinWisgirda and @lauramcgraw my question is regarding using UB+ in these situations. When you know
that someone’s current symptoms were caused by/followed a sickness from exterior pathogens, would that make
you put UB among the top treatments to consider, whether or not clear heat signs are present? I understand that
there’d need to be some quality or channel calling for UB+, of course. But do you consider UB+ to be a very
important (or even essential?) layer to address in post-exterior cases?29/01/2024, 12:11Post COVID Syndrome – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/post-covid-syndrome/1274/print5/11
For example, I’ve got a tricky case of 3-year chronic cough that’s not responded to LU, ST, SJ, SI; perhaps ww
GB, perhaps bw LV. Upon further digging, the patient had a very severe case of chicken pox at age 36, then a few
years later, acute intra-ocular herpes zoster that preceded the start of the cough. This string has made me consider
UB+ for him, which previously seemed inappropriate because he is typically so cold. I’m going to write up his case
to get feedback… but, would welcome your musing on UB+ in the meantime.
lauramcgraw: September 12, 2020, 5:51pm
Cassiopeia,
I would be cautious to use UB+ in these situations. In the past I have used UB+ with a patient who had an acute tai
yang invasion with very early signs on the day they came in to see me, this is a new way of using UB for me and
am cautious with it.
Typically when I am treating a patient with Sa’am I look at what is happening in the moment, I do not put a lot of
weight on the past, nor on western diagnoses, as we know can be from many different chinese medicine patterns. I
have found with Sa’am that the patients symptoms can change dramatically especially after giving the body a big
shove in one direction so I need to be careful to re assess the diagnosis each treatment. I always hear Toby’s voice
reminding me to make a list of top three treatments and try my best to see what is needed in the moment, that can
change so fast!
Similarily with herbs, if I have a patient with left over symptoms of a cold/flu that have no current exterior
symptoms I would not use a Taiyang Rx to treat the patient, that would not be helpful for the patient, and could
actually harm them.
Typically with UB suppl I am looking for a person who needs cold water and the possiblity it is bothering the heart
function, the heart is in excess. A couple patient’s post covid symptoms that I have treated have a lot of fluid
damage, thirst, dry tongue,dry throat, dry feeling in chest, and burning pain. Some times pain is on the bladder
channel, sometimes not. The heart pathology I have been seeing has been varied, palpitations, angina, racy feeling
in chest. Ultimately to get the heart to relax with that cool water has been really helpful.
Adina_Kletzel: September 13, 2020, 8:21am
KristinWisgirda:
I considered using the regular UB+ for the third treatment but hesitated to use ice cold water twice in a row so
opted for partial UB+
HI,
Is this a concept that we can use in our treatments? IF we feel that using a full tonification of a certain organ would
be too much can we use half of it on one side and another full organ on the other?
KristinWisgirda #10September 13, 2020, 6:02pm29/01/2024, 12:11Post COVID Syndrome – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/post-covid-syndrome/1274/print6/11
Adina_Kletzel:
IF we feel that using a full tonification of a certain organ would be too much can we use half of it on one side
and another full organ on the other?
The only partial treatment that has been discussed on this forum is partial UB+= LI1+ and St36-. This is an
established partial treatment strategy and not just a choice of 2 of the 4 points. I don’t feel comfortable breaking up
channel pairs on my own. The advanced class will introduce other partial treatment options.
@cassiopeia I agree with @lauramcgraw on all of her points. I would want to see clear current UB+ indications
for channel/organ/location or qualities.
Adina_Kletzel: September 13, 2020, 8:04pm
KristinWisgirda:
The only partial treatment that has been discussed on this forum is partial UB+= LI1+ and St36-.
Okay. This is the first time I am hearing of this established partial treatment strategy for UB+. Can you please
direct me to where else is was discussed on the forum so that I can learn more about it?
Thank-you so much!
KristinWisgirda: September 13, 2020, 9:06pm
It was mentioned in a crowdcast. Please use the search bar and I am sure you will find it.
cassiopeia: September 17, 2020, 1:08am
HI @lauramcgraw I totally hear you about not jumping to using UB in these cases. I was thinking of it in the
context of remembering hearing that Toby had chosen to use UB+ when treating someone whose headaches began
after catching a cold. I don’t know enough about that case to know if they manifested symptoms showing a need
for UB+.
What I’m hearing is that UB+ is not indicated unless it’s indicated
KristinWisgirda #14September 17, 2020, 4:12pm29/01/2024, 12:11Post COVID Syndrome – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/post-covid-syndrome/1274/print7/11
cassiopeia:
Toby had chosen to use UB+ when treating someone whose headaches began after catching a cold. I
I saw T treat such a patient. He explained that the etiology was part of his decision making but the location on the
UB channel had to have helped too.
lauramcgraw: September 17, 2020, 6:37pm
Yes I have used it that way once, but I was very careful that the symptoms were only in Tai yang and it was the day
of the onset of symptoms. I remember Toby mentioning that you have to be careful as you are sealing up the
Taiyang surface after you treat it this way, if the pathology is in a different conformation or a combo it could make
it worse.
Kristin do you have any more insight into what Toby said about this? Am I correct in this? Trying to remember his
exact wording.
KristinWisgirda: September 17, 2020, 9:52pm
All of my notes on Taiyang surface issues are worded such that UB+ releases Taiyang. It is highly likely that T
worded it this way. Notes go on to say that UB+ can release pathogenic factors from the exterior even if they are
old or incompletely released.
lauramcgraw:
I remember Toby mentioning that you have to be careful as you are sealing up the Taiyang surface after you
treat it this way,
I haven’t heard T say this but then again I haven’t been to every teaching event.
lauramcgraw:
if the pathology is in a different conformation or a combo it could make it worse.
For sure.
Here on my notes on the headache case mentioned above.
A internally/externally dry woman complains of UB channel headaches since catching a cold 3 months earlier. She
treated the cold with wind heat herbs.
The headache tends to be worse on the right but can affect both sides. She tends to be cold but since getting sick
she has been warmer than usual.29/01/2024, 12:11Post COVID Syndrome – Sa’am Clinical Insights – Qiological Community
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Toby treated UB+ on the left. During the treatment, the patient experienced symptoms similar to when she first had
the cold includign an earache.
I’m not sure about the outcome but the patient was one of our colleagues who attended an intro class last year.
lauramcgraw: September 19, 2020, 6:40pm
I just found the video where Toby talks about the Tai Yang bladder treatment for acute illness. The patient feels like
they are getting sick and it is very superficlal, still in the Tai Yang. He says it is risky because you are putting a cold
layer and sealing in the surface, locking it in. You are also completely releasing the surface and knocking the illness
away.
You can find the discussion on the Using Saam for acute illness video- starts at minute 2- til about 4minutes.
What a great reminder!
KristinWisgirda: September 19, 2020, 8:29pm
lauramcgraw:
He says it is risky because you are putting a cold layer and sealing in the surface, locking it in.
It makes sense that inappropriate application of ice cold water could block the surface or freeze up the function of
other areas too. But a flush of ice cold water can restore function for a body that needs it, especially if that area is
governed by the UB or Heart.
Thanks @lauramcgraw for sharing the crowdcast episode and time so that we all can hear Toby speak to this
directly.
cassiopeia: September 21, 2020, 3:00pm
KristinWisgirda:
The only partial treatment that has been discussed on this forum is partial UB+= LI1+ and St36-.
I submitted a case for the advanced class but will be seeing this patient on Thursday, and wonder if someone can
give input on the usefulness of this partial UB+ treatment for her.
47yo female with CC of migraines (pain). I’ve peeled back a few layers and a couple sessions back was ready to do
SI+. When the 4th needle (UB66) was inserted, it set off her chronic neuropathic pain in the R foot, and instantly29/01/2024, 12:11Post COVID Syndrome – Sa’am Clinical Insights – Qiological Community
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triggered a migraine. I removed all needles and did KD+ on L, which helped her to feel better on the table, but
didn’t do much for her overall migraine state post-treatment.
She had broken the R foot in 2009, it never healed well, and has RSD-like neuropathic pain: extreme sensitivity to
most kinds of touch. A similar kind of pain is mirrored in the L foot.
SI+ and UB+ seem to be the best fits for addressing her migraine pain (much trauma/injury/surgeries, located in
UB10-2 band, and hot hyperfunction all around). But I am afraid to do these treatments for fear of the neurologic
pain reaction.
so is partial UB+ the answer? could I do that as a first step to address the migraines AND calm down the
hyperfunction of the UB channel? Would those 2 points be the only ones she gets during one treatment?
Hopefully Toby will talk about this case next weekend, but if anyone can chime in in the meantime, I thank you in
advance.
fang
KristinWisgirda: September 21, 2020, 6:45pm
Since this is a class case study, I’m going to withhold comments. I would need more info anyway.
Shanlarson: September 21, 2020, 11:23pm
I’ve been treating a Covid “long hauler”. I thought I would share because her symptoms and what has helped her
has been different to Kristin’s. I thought it would be interesting.
She’s a 40 year old woman. She got sick in March. I started seeing her in August. The most debilitating symptoms
she was having when she started seeing me was severe panic attacks day and night and insomnia or nightmares
where she would wake up panicked and literally run out of her house in the middle of the night. I suppose you
could call them night terrors. The panic attacks were happening 2-3x a week. She also had extreme exhaustion,
inability to concentrate. She would forget words. She had no appetite. Her bowel movements were normal and she
had no bloating. She was getting headaches in the occiput area. She has been unable to work due to exhaustion.
Also since Covid she had hot joint pain in hands and feet. She has a history of painful periods. She has been
prescribed anti-anxiety medication but she feels it hasn’t made any difference.
Chief complaint: panic attacks
secondary complaint: exhaustion/ lack of concentration
Appearance and demeanour: pretty 5+, Polite 6+, fantastic reporter
Morphology: Thin frame
Skin: Very dry 8+
Body temp: usually cold but has been warmer since Covid
Thirst- moderate likes warm water
Emotions: fairly even temperature29/01/2024, 12:11Post COVID Syndrome – Sa’am Clinical Insights – Qiological Community
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Eyes- moderately bright6+
Sound sensitivity 9+
Respiratory – fine
BM- regular
Urination- after panic attack for 1-2 days will have excessive urination
Epigastric tension 7+
tension under left rib side 6+
My first treatment I did PC+ on right side and she felt a huge shift. She suddenly had a healthy appetite, Her joints
were less hot and painful. She hadn’t had a panic attack for the 4 days in-between the treatments. She was sleeping
better but would wake up and feel she couldn’t tell if she was sleeping or if awake. It could take her about 30
minutes for that to pass. That would give her anxiety and she would wake up her partner to sit with her.
Second treatment I started with LIV+ on right side but after I put in the third needled she already felt it wasn’t
right. I hesitated to do SJ+ because she said it’s not that she felt anxious or even that I saw a change in her
complexion or demeanour. She just seems very intuitive. I went back to PC+ and she fell asleep in 5 minutes.
A week later she said she was still getting better but the shift wasn’t as dramatic as the 1st treatment. She then
mentioned how she was having all these weird pains down her leg to ankle and they looked like they were on the
bladder channel on the right side. I decided to do HT+ on left. She immediate relaxed. She emailed me 2 days later
that she felt the most normal she has been since Covid.
The next time I saw her she was generally sleeping well. She has some anxiety that bubbles up a bit but never
grows into a panic attack but what had started since the last treatment were red itchy rashes on her arms. I decided
to do SI+ on right but it made her feel anxious about 5 min into the treatment. I took the needles out and did KID +
on the left. She said it felt better but really didn’t feel that was “it”. Normally I would have left it but I really felt
like she has a real sense of her body. I then looked at the rash and she had identical dry red circular rashes on both
arms at Lu 9. And the redness did look like it traveled up the LU channel. I did LU+ on Left. Her description at the
end of the appointment was it was “delicious”. I am seeing her again today.
She has been a really interesting case and fun to work with and it seems the SAAM is really making a huge
difference. I haven’t been giving her herbs because her naturopath gave her some herbal tincture and it caused a
panic attack and that scared her.
KristinWisgirda: September 22, 2020, 1:55pm
Thanks so much for the case @Shanlarson. Intuitive patients are really fun to work with and can be great
teachers.
Shanlarson:
weird pains down her leg to ankle
It pays to pay attention to everything. The weirder the better.
I wonder about the red rashes that popped up after H+, given that she is dry/thin and is warmer than usual post
COVID. It can be a challenge to evaluate new symptoms that pop up after a treatment that has had obvious benefit.29/01/2024, 12:11Post COVID Syndrome – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/post-covid-syndrome/1274/print11/11
The post COVID patient I mentioned continues to make progress. Yesterday she told me that she used her pulse
oximeter when she was having occipital pressure and a feeling of movement in her skull. Her Sp02 is 96 at those
times and breathing deeply helps relieve those sensations even though she has no sense of SOB. Her baseline Sp02
is 99. This finding gets some clinical weight but wasn’t enough to use P+ quite yet. She doesn’t have GB excess
signs and is more robustly P excess, but I will keep it in mind. This is inspiration to use my pulse oximeter
more.