rebeccajillparker: October 25, 2019, 5:57pm
I’m looking for some general advice, not necessarily specific to this case. I’ve been doing home visits for a 78 year
old man with Normal Pressure Hydrocephalus. It causes instability in his gait with difficulty balancing and some
urinary incontinence. We have had good success with his back pain, but have not improved his balance at all. The
only time anything close to a change happened was when I used Sa’am about an month ago to treat him for LU
excess since he has very dry skin and edema in his legs. He reported that after that treatment he had a headache that
was similar to when he had been getting treatment for the hydrocephalus that involved removing CSF from the
spine, which he had discontinued due to not wanting students to practice the procedure on him. He did not want to
repeat that treatment out of worry about “playing around with fluid levels in the brain” It did not make a difference
in his gait, but seemed to help the edema slightly.
My question is, should I proceed with treating LU excess? Toggle with +SI (my next choice)? The diagnosis seems
pretty clear to me. He is interested in trying again, though nervous because of the headache, but on the other hand,
that was the same sensation he had when getting it treated before, so our thinking is that perhaps over time it would
make a difference in his gait. Also, I am a very newbie, so I’m trying to proceed with caution.
I’m less looking for help with diagnosis, and more for advice on proceeding with a case like this involving balance
of cerebrospinal fluid in the brain or elderly patients in general. Has anyone treated anything of a similar nature
who can give me advice? Is there anything I need to watch out for in elderly patients with regards to how they
respond to Sa’am in general? He is not deficient overall. Thanks in advance.
KristinWisgirda: October 27, 2019, 8:38pm
rebeccajillparker:
should I proceed with treating LU excess?
If I read your post correctly, treating the Lung excess = Headache+ no change in gait+ only slight change in edema.
This doesn’t sound like a positive treatment outcome. I would not repeat this treatment any time soon, even if the
idea of it looks good on paper.
rebeccajillparker:
I am a very newbie, so I’m trying to proceed with caution.
rebeccajillparker:
I’m less looking for help with diagnosis, and more for advice on proceeding with a case like this involving25/01/2024, 11:30Advice needed for newbie: Normal Pressure Hydrocephalus – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/advice-needed-for-newbie-normal-pressure-hydrocephalus/705/print2/2
balance of cerebrospinal fluid in the brain or elderly patients in general.
With Saam, you safeguard your patient with correct diagnosis, correct treatment, and then carefully watching his
response. Patient response is the best indicator that you got it right. While other practitioner’s experience with
normal pressure hydrocephalus and unsteady gait might be interesting, studying your patient closely through the
Saam perspective is going to be more instructive on how to proceed. You are treating this individual patient, not the
hydrocephalus. Given his response to your Lung excess treatment, there is obviously more going on. Being a
newbie, it would be more helpful to write the case up and be sure that you have carefully considered all
possibilities with your diagnosis. Reading cases as moderator of the forum, I commonly see newbie practitioners
have blind spots in their diagnosis.
rebeccajillparker:
Is there anything I need to watch out for in elderly patients with regards to how they respond to Sa’am in
general?
The only generalization that Toby makes with the elderly is that it is common to need to toggle between SI+ and
K+ treatments. However, he rarely treats K+ first, instead preferring to clean up other areas first. This treatment
strategy may or may not be needed for your patient.
I am happy to look at your case with you. If I am uncertain about any aspect of information we share here, I always
ask Toby. Toby frequently scans the forum to be sure I am transmitting the tradition correctly, even though he
doesn’t frequently post.
rebeccajillparker: October 30, 2019, 3:53pm
Thank you, this is helpful. I will write up the case when I get a chance.