amyjenner: July 24, 2019, 12:39am
CC: 35 yr old female, complaining of migraines. They come with light/sound/smell sensitivity. Sometimes nausea.
More frequently Rt sided but can be lft. Pain at the base of skull wraps around over cheek bones to cover eye and
forehead. Worse with changes (stress, weather, hormones, slp…),stress, grinding teeth, caffeine. Better with
meditation, darkness, cool room/warm blankets, quiet, sometimes movement.
Appearance/demeanor: She is nicely dressed, attractive, simple. She is warm and friendly. Tall and thin. Speaking
softly and focusing on the questions as she is having a migraine at the time of intake. She answers the questions
thoughtfully and thoroughly.
Lifestyle: Grad student at UC Berkley. A lot of stress. About ½ through a 7 year program.
Skin: dry, moisturizes after every shower. Can have eczema at times
Temp: always cold. Has Raynaud’s, cold hands and feet
GI: some gas and occasional constipation
Urination: no issues
Respiratory: no issues
Slp: poor, grinds her teeth which triggers H/A
Emotional: Has experienced depression, though now it is more anxiety. Can get OCD behaviors.
GYN: has Skyla IUD, low hormone variety = very little bleeding. Before IUD, did not experience issues with
menses.
Musculoskeletal: general neck and upper back tension
Other Body: few spider veins at the knees
Tongue: purple with red spots. The tongue is pretty purple. +7. It is not dusky so I’m thinking there is red under the
purple.
Abd: warm, tight/tense/ticklish
EXCESS Presentations:
HT:
UB: channel pain +8, cold +5
GB: channel pain+8, ww stress+8, insomnia +7, red tongue spots =626/01/2024, 11:3835 yr old female w migraine – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/35-yr-old-female-w-migraine/406/print2/3
PC: grad student +5,
SJ: bw darkness/light sensitive +8, better with cool +8
LIV:
LU:
ST: Rt sided pain, channel pain +8
LI: skinny and dry +7
SP:
SI:
Kid: pretty +6, purple tongue +7
The Grossest thing(s): Pain
Main Tx ideas: Liv, Pc, SI
Other Tx ideas: I wonder about heart because if the cold, maybe once the migraines are resolved. Lu because they
are typically rt sided. SP because of her body morphology
Would love some thoughts/impressions…
LU+ and Hesitant urination
KristinWisgirda: July 24, 2019, 6:01pm
Hi Amy,
Thanks for your case.
Your case brings up a number of challenges I have been noticing with my patients.
Migraines (or other symptoms) that are accompanied by light sensitivity versus those that are brought on by light
sensitivity: I have had a couple of patients in the former camp, Liver+ was not a good match though I wasn’t
treating them when they were having migraines. In hindsight, other symptoms of SJ excess weren’t so strong.
Those in the later camp, where symptoms are clearly brought on by bright light exposure, seem to do much better
with Liver+.
Mybias of that experience and the strong cold part of her presentation puts Liver+ lower on the list for me. Maybe
she will present differently when not having a migraine and show you more SJ excess signs. I am curious if the
heat signs are part of her migraine presentation- yang out of right relationship.
The sleep issues, teeth grinding, and OCD reactivity push GB excess more to the forefront.
The Kidney excess situation is interesting with her. She is somewhat pretty and has a few spider veins, but her
period were perfect? before the iud. I think of iuds causing some stagnation but maybe it isn’t a big deal if the flow26/01/2024, 11:3835 yr old female w migraine – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/35-yr-old-female-w-migraine/406/print3/3
is just scanty and not painful or problematic in any other way. This picture puts SI+ lower on the treatment list. Did
you ask about dizziness?
The underlying cold and double dryness are things that I would watch closely at the next visit.
What did you end up treating and how did it go?
amyjenner: July 25, 2019, 12:30am
That’s interesting. I’ll ask further about the light sensitivity when I see her next. I went with SI Lft because of the
pain and the purple tongue. The pain dulled and receded from her face and then sat at the base of the skull as a dull
pressure. Being honest here, I palpated points of my next ideas to see if there were a 2nd combo that would get it to
go completely. PC got the best response, and made sense because of GBxs, so I added that on the right. By the time
she left she had some residual tightness and tenderness in the back of the head. I checked with her this morning and
she said that her upper back was still tight and she was going to have a massage today. The migraine had gone
though. I realize I missed the opportunity to see what would unfold with just SI. I felt I had to balance that with her
suffering. I will ask into some of these areas more deeply when I see her next week. It was hard to keep
questioning when she was clearly in crippling pain. I want to ask more about the period and get a better sense of
her skin. she says she has to moisturize after showers, but I want to see what that really means. Her skin is pretty
buttery to the touch. Also, want to find out how she is funding a PHD in Berkley…I’ll keep you posted.
amyjenner: July 31, 2019, 12:54am
I saw her again today. She reported that after the last tx, the pain moved out of her head and got stuck in her upper
back. The next day it migrated from right to left and the intensity went way down.
I asked if the light sensitivity was all the time and she said just during migraines. Confirmed that her skin really is
dry and she uses lots of lotion. I diagnosed LIxs and GBxs . She is also cold a lot, worries about and plans for cold,
and has Raynaud’s. Treated PC+ rt today. Had the needles in before remembering that pain is primarily on the
right, but just left them. She reported a sensation of warmth spreading up and over the rt side of her face and
warmth spreading from a spot in the center of her body (she indicated pointing to her heart but said it was in the
middle of her body) I asked if it felt like the back of her heart. She said that was it. So…We will see. I’m interested
in HT+ and SP+ as well
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