Michali: August 13, 2019, 6:47am
Hello friends,
I’d love to get your advice and feedback, the patient is me:
A 40 year old woman.
Chief complaint: Right ankle swelling and pain – almost a month ago fell and dislocated both tibia and fibula plus 3
fractures. The left ankle was sprained on both sides. R ankle underwent surgery the next day in order to stabilize
the joint and was left with a plate.
Swelling and discomfort in the R foot (and sheen) worsens as the sun sets, the toes feel numb. At first,
whenever I sat for more then 2 minutes a pulsating pain began, and the toes and what is visible of the foot
would darken and swollen.
Nowadays, I can leave the foot down for longer periods of time, but it will still swell and will get very
uncomfortable.
Body morphology and flesh quality: Short and round, overweight +8; soft flesh.
Skin Quality: Very light and sensitive, mixed – some parts dry, some wet\oily\sweaty. Moved a year ago from living
not far from the sea (suffered from the humidity) to the desert (and suffers from the dryness).
Body Temp: usually suffers from cold but also can’t function in hot weather or under the sun. Body temperature
and blood pressure are always low.
GI: Soft stools, gasy, hemorrhoids. Stomach and bowls affected by emotions. Easly nauseated or heartburned.
Respiratory: Dryness and tenderness in the nose since living in the desert. Neck lymph nodes tend to be swollen
and get infected.
Sleep: Poor sleep as far as I can remember. Occasionally waking up in the middle of the night and usually waking
up very early.
Emotions: Hypersensitive, challenged sensory processing.
Gyn: s\p 10 yrs donated eggs and reacted badly to the hormones (left ovary hyperstimulation, was unable to
function months after that). 2 planned abortions, 2 pregnancies with 2 beautiful children, 1 misscareage 7 weeks.
Other Body: varicosities (legs, mainly).
Main treatment ideas: SI+ L, LI+ R
Other treatment ideas: ST+ R, Pc+ R.
Treatments #1: SI+ L – since pain and purpling of the toes was prominent, right after surgery.
Immediately felt bad, nauseated with pressure at the throat. Didn’t try to needle any other combination at the time.25/01/2024, 12:14Broken ankle with pain and swelling – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/broken-ankle-with-pain-and-swelling/474/print2/8
Treatment #2: LI+ on L
Right ankle swelling and toes numbness and stiffness improved on the spot.
Treatment #3: Pc+ L
to help with anxiousness, which it did.
Treatment #4: LI+ on R
The Right foot dried dramatically, visibly (toes) and inside the cast, which was very uncomfortable, followed by
feeling of increasing annoyance.
Took out the needles and tried to balance it with St+L, which apperantly did nothing.
I was too worried to try SP+ or needle anything else.
Since then this extreme drying on the R foot happens every once in a while, and the skin is drier. It hasn’t seem to
affect the GIT.
My questions are:
1. What can be learned from a bad reaction to SI+ after surgery when there are clear signs of Blood stasis?
Could it be related to taking anti-coagulants?
2. What can cause such good reaction on the 1st LI+, and then a bad reaction on the 2nd treatment?
3. How can I fix it?
Would that kind of reaction teach me anything?
Is it safe to use SP+?
4. Could you recommend other strategies?
5. If there’s a clear bad reaction to tonufying X, would you automaticly use it’s counterbalancing pair?
George_Mandler: August 15, 2019, 10:23pm
Hi Michali – So sorry to hear. Ouch. I’ll give it a go since Kristin is away and others can chime in.
Michali:
Swelling and discomfort in the R foot (and sheen) worsens as the sun sets, the toes feel numb.
So swelling under the tissue and numbness… Gives a thought of SP excess.
Nowadays, I can leave the foot down for longer periods of time, but it will still swell and will get very
uncomfortable.
Body morphology and flesh quality: Short and round, overweight +8; soft flesh.25/01/2024, 12:14Broken ankle with pain and swelling – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/broken-ankle-with-pain-and-swelling/474/print3/8
I think Toby would be jumping at the bit here saying “my needle finger is getting itchy to supplement LI+”
Skin Quality: Very light and sensitive, mixed – some parts dry, some wet\oily\sweaty. …
Body Temp: usually suffers from cold but also can’t function in hot weather or under the sun. Body
temperature and blood pressure are always low.
GI: Soft stools, gasy, hemorrhoids. Stomach and bowls affected by emotions. Easly nauseated or heartburned.
Respiratory: Dryness and tenderness in the nose since living in the desert. Neck lymph nodes tend to be
swollen and get infected.
So some mixed wet/dry here – maybe sometimes supplement ST+ since it has a downward action and you have
nausea. But the ankle swelling is still primary
Sleep: Poor sleep as far as I can remember. Occasionally waking up in the middle of the night and usually
waking up very early.
Emotions: Hypersensitive, challenged sensory processing.
Gyn: s\p 10 yrs donated eggs and reacted badly to the hormones (left ovary hyperstimulation, was unable to
function months after that). 2 planned abortions, 2 pregnancies with 2 beautiful children, 1 misscareage 7
weeks.
Other Body: varicosities (legs, mainly).
I see a mix of channels here – will ignore for now bc main issue is your ankle swelling and we have enough to start
with LI+.
Main treatment ideas: SI+ L, LI+ R
Main swelling is on the Right, so I’d go LI+ on Left
Treatments #1: SI+ L – since pain and purpling of the toes was prominent, right after surgery.
Immediately felt bad, nauseated with pressure at the throat. Didn’t try to needle any other combination at the
time.
Toby stresses in the beginning to only use 4 needles. I would adhere to that until you get a feel for the system. So
good that you did not do any other channels. If you started to feel nauseous right away I would have taken the
needles out and not retain it. A negative reaction like that is a clue something is wrong.
SI seems like a reasonable second choice in your case. Perhaps your body was not ready for so much blood moving
right after surgery.
Treatment #2: LI+ on L
Right ankle swelling and toes numbness and stiffness improved on the spot.
Yes this is the treatment I would do first. If still swelling I would do it again. Great that you saw it improve!25/01/2024, 12:14Broken ankle with pain and swelling – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/broken-ankle-with-pain-and-swelling/474/print4/8
Treatment #3: Pc+ L
to help with anxiousness, which it did.
Great! How far apart are your treatments?
Treatment #4: LI+ on R
The Right foot dried dramatically, visibly (toes) and inside the cast, which was very uncomfortable, followed
by feeling of increasing annoyance.
Took out the needles and tried to balance it with St+L, which apperantly did nothing.
Wow. It really dried you. Maybe ST in this case on the left may be an option?
I was too worried to try SP+ or needle anything else.
Definitely no Spleen supplementation for you. It sounds like it dried you out too much – LI is dry/dry – maybe you
needed something less drying on the exterior like ST+
My questions are:
1. What can be learned from a bad reaction to SI+ after surgery when there are clear signs of Blood stasis?
Could it be related to taking anti-coagulants?
I have no idea and would only be guessing. You can try again maybe in a week or so or after you are often the
meds and see how you feel. Maybe so close to surgery with meds was too much as you suggest.
2. What can cause such good reaction on the 1st LI+, and then a bad reaction on the 2nd treatment?
To quote Toby quoting someone whom I forget: “No problem stays solved in a complex dynamic system.”
What works one treatment does not always work the next. I think perhaps given your other symptoms if you did ST
maybe that would have helped, perhaps even treating LI+ on the Left since the problem is the right.
5. If there’s a clear bad reaction to tonufying X, would you automaticly use it’s counterbalancing pair?
You often do but need to look at the situation. LI seemed right for you, but perhaps because you did it twice? Also I
am not sure how many days apart you are needling. I’ve heard Toby say these treatments work for 48 hours. Maybe
you needed a ST treatment to get moisture to the skin.
I am not clear on what is going on inside the cast, but in your case doing a SP+ because of your reaction with the
LI+ doesn’t feel correct. That would be overshooting too far the other way. If you are feeling dry/itchy inside the
cast I’d consider ST+ on the Left.
I hope that helps.
George
1 Like25/01/2024, 12:14Broken ankle with pain and swelling – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/broken-ankle-with-pain-and-swelling/474/print5/8
amyjenner #3August 15, 2019, 11:25pm
I’ll add my 2 cents worth of experience of treatment gone wrong…I have found it helpful to look at what my
treatment did through the lens of the counter balancing official. For example, since SI was not good, could that be
explained by the fact that you are pulling on Kid? Seems reasonable in this instance where surgery was recent for a
broken bone that Kid may not have had the juice to give to SI at that moment.
michaelmax: August 16, 2019, 3:47am
I concur with @George_Mandler thinking here.
Definitely in the beginning use one channel as it is easier to track things.
Sometimes when several channels are low, you need to toggle between them to bring them each up in turn.
Not sure about why the +SI would give such a bad reaction, until I read @amyjenner’s remark about how if the
KD is very low, then the SI does not have enough energy to work with.
I would avoid +SP on you. But that being said, if you have a very bad reaction to +LI, then doing +SP to see if it
resolves would be a worthwhile experiment. But in general I’d stay away from +SP given what you’ve told us
about your digestion and the apparent SP excess.
It sound like you have some issues with temperature regulation. Do you have other signs of TB excess? If so, you
can consider +LV.
And finally, if there is a bad reaction to tonifying X, then yes… I’d move to the counterbalanced channel.
Michali: August 19, 2019, 3:38pm
Thanks guys for the great input!
I must have been unclear describing my own private Sa’am adventure, was definitely strict with myself regarding
supplementing only one channel in each treatment.
@gmandler – the treatments were a few days apart, can’t remember exactly when and how much.
I tried supplementing St on the left twice since, and felt nothing.
I can only hope the extreme dryness the last LI+ did really strengthened my bones 8)
I also supplemented Pc on the left again, thinking that it would help both in quality and channel-wise (for the right
GB).
Can the use of Pc+ be appropriate for the “convexed” ankle?25/01/2024, 12:14Broken ankle with pain and swelling – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/broken-ankle-with-pain-and-swelling/474/print6/8
@amyjenner – that certainly make sense, so should I have tonify Kid?
@michaelmax –
I have many signs of TW excess, but I overlooked it, partly because supplementing Liv (as well as Kidney) seemed
like a heavy and cloying action that I felt should be avoided.
Perhaps it’s the herbalist thinking, and I shouldn’t mix these ideas together.
As for avoiding SP+, while experiencing to much dryness with LI+ and St+ doing nothing – what would you
suggest?
Another question:
Is it possible that choosing the “wrong” side for treatment causes adverse reaction?
Or will it diminish the effect?
amyjenner: August 19, 2019, 5:21pm
Our instruction has been that if a treatment goes bad, then treat the opposite channel. So, in that instance, Kid+
would have been a good response. I’m wondering if then SI would have worked better for a couple of reasons. 1
being that you supplemented Kid and the other being time and healing having their natural consolidating effect of
putting you back together on all levels.
amyjenner: August 19, 2019, 5:22pm
I mean that after either time or a Kid+ treatment, SI would work better because at that point there is more to work
with
michaelmax: August 20, 2019, 2:22am
Michali:
I have many signs of TW excess, but I overlooked it, partly because supplementing Liv (as well as Kidney)
seemed like a heavy and cloying action that I felt should be avoided.
Perhaps it’s the herbalist thinking, and I shouldn’t mix these ideas together.
HI @Michali, yes this is herbalist thinking. I think the same way… with herbs. But with Sa’am and way we
consider the channels/organs, it’s different. That being said, +KD does tend to consolidate things. So not something25/01/2024, 12:14Broken ankle with pain and swelling – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/broken-ankle-with-pain-and-swelling/474/print7/8
you problem want to do with trauma that has blood stagnation and swelling.
Michali:
Another question:
Is it possible that choosing the “wrong” side for treatment causes adverse reaction?
I don’t think it would be adverse, it just would not be particularly powerful or helpful.
Michali: September 5, 2019, 10:00am
@KristinWisgirda
Would love to read your point of view
KristinWisgirda: September 5, 2019, 5:58pm
Hi @Michali,
Thanks for reaching out. I was overwhelmed with the number of posts when I got back from my break. Feel free to
draw my attention to any questions or posts, as you have just done.
Are there any particular questions that are lingering at this point? Have you treated yourself since the last report? If
so, what happened?
Michali:
As for avoiding SP+, while experiencing to much dryness with LI+ and St+ doing nothing – what would you
suggest?
When you have an adverse reaction, it is correct to treat the counterbalancer. Even if your overall picture looks like
it might be more damp, your body response showed that it is harmed when overdried. I’m not sure if it is
appropriate for you at the moment, but you can definitely consider a Spleen+ treatment if a reaction like that
happens again to LI+. Now you know you need to be cautious with drying.
Overall it sounds like you have a sensitive system, maybe needing all 12 channels at some point. Patients such as
yourself don’t respond well when treatments are repeated. So vary the treatment every time. It looks like you have
already been doing this.
I like @amyjenner’s idea abot using Kidney after the bad response to SI+.
I hope you are getting back up on your feet
3 Likes25/01/2024, 12:14Broken ankle with pain and swelling – Sa’am Clinical Questions – Qiological Community
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