KristinWisgirda: May 23, 2019, 8:02pm
A grossly obese woman in her 60s. Skin looks great but she moisturizes twice a day and dry brushes. She is bright,
observant, intelligent, and detail oriented. She runs hot but was gleeful to turn off her phone during treatment so no
one would bother her. Chief complaints: right shoulder pain and ptosis of left upper eyelid
Right shoulder pain started in February 2019 after falling off bleachers and catching herself with her extended right
wrist. MRI shows rotator cuff tearing and subluxed biceps tendon. Pain is in SJ and LI channels of her upper arm
(deltoid region) with abduction, horizontal adduction and internal rotation or any motion with weight added to it.
Range of motion is perfect but the arm tires easily and shoulder gets achy with repetitive motion. Since the fall, she
has pain in her right wrist and thumb LI5 and along the dorsum of her thumb. Palpation revealed a nodule at SJ14.
Ptosis of left eyelid started 6 months ago at the same time she had a sinus infection that she characterizes as
extreme dryness and pain in her sinuses. A neurologist diagnosed the ptosis as myesthenia gravis. At the onset of
the ptosis, she reports an increase in light sensitivity, which she has had to some degree all of her life. Sun exposure
without glasses and a hat make her head feel foggy. She has turned the light down on her phone. Medication for the
ptosis helps a little but causes abdominal cramping and gas.
With her shoulder, I considered supplementing LI (pain location + gross obesity), SI (trauma history and pain) or
Liver (pain location on SJ, nodule on SJ14, light sensitivity and demeanor). Not being sure, I palpated as many
points that I could with each pairing on the left and had her abduct her arm which is a painful motion for her. No
change was made when I palpated LI+ or SI+ points. Directed pressure at left Liv8, K10 and Lung8 improved her
pain by 40%, so I needled the full Liv+ on the left, keeping the treatment focused on the shoulder.
Getting off from the table, pain of the shoulder with movement was barely there . I didn t notice any change in
her left eye. It is interesting to think about the left eyelid ptosis as the body s attempt to shield hypersensitive SJ
excess eyes though I am keeping open to all options.
I ll let you know what happens.
pattycakes: May 24, 2019, 11:03pm
Good job with the palpation! So interesting. About the eye, maybe SJ excess >> Liver deficiency >> eye
weakness? Jun Youn s Saam book indicates Spleen for eyelid issues, for what its worth. I believe he references this
from Sa-am the monk himself.
michaelmax: May 31, 2019, 2:40am
Dang @KristinWisgirda this is a great job of blending Saam with the channel palpation.
So cool to palpate your way to the +LV and have it match up with her TB light sensitivity.31/01/2024, 11:26Shoulder pain and eyelid ptosis case – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/shoulder-pain-and-eyelid-ptosis-case/247/print2/2
I too would have first gone for LI as it was the low hanging fruit well apparently low hanging fruit.
Increasingly I am reconsidering my first ideas. Especially if they seem too easy
The EV folks talk about following what you feel, even if the theory making mind can t keep up. The hands are
reliable. Later we can see the path they took us along.
Keep us posted!
KristinWisgirda: May 31, 2019, 12:59pm
michaelmax:
I too would have first gone for LI as it was the low hanging fruit
My first thought was LI+ because her morphology could easily be seen to be the grossest part of her presentation.
Not trusting my mind or my understanding of Sa am, I like to rely more heavily on palpatory information and
getting some kind of response from the body before I put needles in. This is why I wrote the case up.