Daniel: February 4, 2020, 12:01am
I have a 55 year old medical doctor – had lung cancer – had lung lobes removed. It metastasized to brain – had brain
surgery. They found a shadowy spot recently on spine around L4.
he is now on chemo very three weeks.
He is coming to me for low back pain!
He is also very fatigued and has significant peripheral neuropathy on palms and soles.
most of my Sa’am questioning has yielded quite unremarkable information – not hot, not cold, not dark, not bright,
not dry not damp, etc etc
the only remarkable thing aside from the low back pain and peripheral neuropathy
is that he has lost his taste for food
and mostly just eats because he has to.
of course, i am very nervous to do acupuncture given the metastatic situation.
and Sa’Am makes me very nervous give its ‘all in’ (‘non harmonising’) nature!!!
I have seen him twice and done pretty simple standard acupuncture things to try to bring some back pain relief – to
no avail
tomorrow is likely his last visit
i may try a Sa’Am, i dunno.
would peripheral neuropathy be ‘dampness’ in our system?
‘external’ stomach dampness?
his stomach 36 area is very empty feeling
and he has lost his taste for food
it was originally lung cancer and he has had lung lobe removal
do you think sa’am is too much?
he would also love some neuropathy relief.
George_Mandler: February 4, 2020, 3:28am
I don’t connect with the idea that doing SI+ is a bad idea with cancer. So we are moving the blood – to me it
doesn’t make sense that if a person needs it then it is bad just because there is cancer- you want to move the blood.
Why would improving physiology spread cancer? If there is data to back this up then I will humbly reconsider.
I have a Stage 4 endometrial cancer patient I started seeing 3 weeks ago 2x/week. She had finished her 4th round a
couple of weeks prior. I’ve treated her 6x with SI+ 3x, ST+ 2x and LI+. She started another round 12 days ago and19/01/2024, 10:55Cancer Patient Question – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cancer-patient-question/872/print2/6
told me this past Friday (3 days ago) that this is the best she has ever felt on chemo and she cannot believe how
well she is doing. Very little neuropathy and perhaps even her WBC count is doing better (although we also added
in other adjunct).
I would definitely Sa’am it. L4 pain – so maybe LI+ or SP+ with his lack of taste for food depending on how he
presents. Or SI+.
I’d love to hear more thoughts on this as I’ve heard it said on this forum and Toby say that cancer and SI+ is not a
good idea.
Daniel: February 4, 2020, 12:21pm
thanks George – much to think about. His three primary features are palm and sole numbness, low back pain (I
think its more L5-S1 level – ish) and loss of taste for his favourite foods (and fatigue). (and he has has lung lobes
removed, brain surgery and a shadow on low spine identiifed and on chemo now). Hot cold, moist dry, light dark
are all completely unremarkable. He is an opthalmologist – smart man used to high level functioning. Has five kids.
Speaks several languages. Clearly the numbness and taste for food point to something in the Stomach or Spleen . . .
. my question will be excess or deficient? On palpation, the Stomach channel is very empty. But the numbness
suggests Stomach excess. So do I supplement Lung? (his voice is weak and he has had lung lobes removed). Or is
it Spleen excess and I supplement Large Intestine (he is tired). I may have to just try one and observe very carefully
on the table in real time.
George_Mandler: February 4, 2020, 1:25pm
A heartbreaking case, hopefully he had kids young and they are young adults now.
Daniel:
But the numbness suggests Stomach excess
That would be SP excess for numbness.
But 5 languages an MD – clearly a lot of LI excess in his constitution.
Is the main thing he wants resolved the back pain?
Daniel: February 4, 2020, 1:48pm
yes, he came in for the back pain
and also speaks about the neuropathy a fair bit19/01/2024, 10:55Cancer Patient Question – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cancer-patient-question/872/print3/6
I have in my notes that numbness can be either Spleen of Stomach
no?
KristinWisgirda: February 4, 2020, 6:57pm
There are a number of cases of neuropathy on the forum. Are you sure his neuropathy is frank numbness or are
there paresthesias? Patients sometimes use “numbness” to mean a variety of sensations or lack there of. I notice
that it sometimes takes a couple of discussions before a patient can describe their experience fully and note
hold/cold/burning/tingling/sharp/etc.
Frank/dead numbness is sign of dampness in Saam. It can be treated with any of the strategies that address
dampness: LI+, St+, Lung+, SI+, H+.
Loss of taste is a kind of numbness as well.
My notes for cancer include consider LI+ for its detox aspect, if appropriate. It is something to consider for fatigue
as you noted.
Listing what you know for sure and relating it the 12 channels about this gentleman will be helpful so you can
build on what you know when you see him next…
Weak voice, missing lung lobes (and fatigue) point to Stomach excess/relative Lung deficiency.
History of surgeries, cancer point to Kidney excess/blood stasis.
Daniel:
i am very nervous to do acupuncture given the metastatic situation.
George_Mandler:
I’ve heard it said on this forum and Toby say that cancer and SI+ is not a good idea.
This is not my understanding but I will triple check with Toby on this. A hallmark of Kidney excess is
overconsolidation which classically manifests as hard masses in the lower abdomen but can be extended to masses
anywhere.
Ed Neal treats lots of advanced cancer patients and reports only good results treating around tumors.
Daniel:
tomorrow is likely his last visit
i may try a Sa’Am, i dunno.
This is a totally honorable approach, if you just aren’t sure.
Who knows what he will reveal tomorrow? Today, I was dreading the return of a couple of patients because not
much change had been happening. (And 1 is a combo of GB and P excess that makes me want to hide.) I was
relieved to find that they both were feeling better and were able to give me more insight into their situations.19/01/2024, 10:55Cancer Patient Question – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cancer-patient-question/872/print4/6
KristinWisgirda: February 5, 2020, 12:52am
Here is what Toby wrote, when asked about this situation. All words below are his.
“First, my teacher never spoke directly about cancer and its relationship to the SI and Kid qualities. My current
understanding is that there should be some slight hesitation to supplement both SI and Kid for cancer cases. The
slight hesitation to supplement SI is that metastasis is a movement from the primary tumor site to other tissues in
the body and theoretically supplementing SI might aid this. The slight hesitation to supplement Kid is, like you
mentioned, associated with consolidations especially in the lower abdomen. In this system, these masses are not
differentiated between benign and malignant. Again, theoretically supplementing Kid might aid the consolidation
of malignant masses in the lower abdomen (or elsewhere).
All that being said, I have supplemented SI and Kid countless times for CA cases.”
Daniel: February 5, 2020, 1:43am
Thank you for all your input and insights and for consulting Toby on this. So he came in today. With no new
information beyond my points above. yes, it is frank numbness. Here is what I did. First I tried supplementing SI. I
watched and waited for 5 minutes. There was ZERO change in his face, his eyes, his demeanour – I even asked if
he was feeling relaxed – absolutely no response. I took the needles out. Then I tried a Lung supplementation
(thinking the numbness was external – dry the outside, moisten the inside) – again – 5 minutes and zero response. So
I took those needles out and tried one more thing – Large Intestine supplementation – maybe its dampness inside
and out (oh! I checked his pulses and they were clearly very slippery but with an ease to push through) – and
again!!! – NO response on face, eyes, demeanour or patient experience. (and by no response, I also mean no bad
response either – no agitation or worsening of anything) – I left the LI supplementation treatment in for a full
treatment. And that was that. I really don’t know what to make of that.
KristinWisgirda #9February 5, 2020, 3:46pm
Please let us know if he gives feedback on this treatment.
Clinic is HARD!
pattycakes: February 7, 2020, 9:20am
19/01/2024, 10:55Cancer Patient Question – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cancer-patient-question/872/print5/6
I had a patient with advanced diabetic neuropathy I treated for a while. He was very obese, and had a terrible diet
with no self control, chief complaint was numbness and constipation. I tried LI+ several times with zero success.
Later, I realized he was Liver excess – he was so oblivious to what was going on, both outside himself, and inside.
He routinely did things that were inconsiderate, and refused to take responsibility. Unfortunately he wasn’t my
patient by this point.
Perhaps your doctor has been oblivious to what is going on inside and out, with the result being his advanced
cancer? I see refusal to be introspective and give thoughtful responses to diagnostic questioning as a kind of
rudeness.
Daniel: February 7, 2020, 3:38pm
Excellent points! we never know.
This is chemotherapy induced neuropathy
but its certainly worth a try!
I resonate a LOT with your understanding of ‘rudeness’
I have decided for myself, its better to not think of it as rudeness but more completely as you put it, as an
oblivousness to the external (certainly can present as rude, but not at all necessarily).
In the same way, I prefer to not so much think about the Lung-Stomach axis pertaining to money in particular – but
more to resources in general.
In his case, one very relevant context to your suggestion . . .
he is an immigrant to Canada from Libya with 5 children
and in my experience with immigration to Canada, the process can be soooooooo profoundly overwhelming in
terms of the constant ‘stimulation’ of external stimuli (new culture, new norms, new customs, new language, new
bureaucracy with many years of new procedures and protocols, etc etc etc) – I think the very process of
immigration can provoke and overstress the mechanisms involved in that axis of attending to external details
versus shielding to protect our internal stablity.
So this aspect of his ‘emotional physiology’ may well be supertaxed.
KristinWisgirda: February 7, 2020, 5:16pm
Daniel:
its better to not think of it as rudeness but more completely as you put it, as an oblivousness to the external
(certainly can present as rude, but not at all necessarily).
In the same way, I prefer to not so much think about the Lung-Stomach axis pertaining to money in particular –
but more to resources in general.19/01/2024, 10:55Cancer Patient Question – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cancer-patient-question/872/print6/6
This is consistent with how Toby teaches these channels. He then goes on to give examples, gross and fine, about
how you may recognize the excesses. That is where rudeness gets tied to Liver excess and easy money gets tied to
Lung excess. Going back to the class powerpoint will keep refreshing your understanding of the core qualities.
Liver excess is “shielded”. Lung excess has “plenty of qi and external resources”.
Daniel: February 8, 2020, 12:12pm
yes, this past year – my own experience of entering the Sa’Am clinical world has been a great experience of
iterating the basics with the ever increasing subtlety of clinic. I keep going back to the basic powerpoint and to
livestreamed introductory classes repeatedly – there is a bottomlessness to the basics being continually inter-
juxtaposed with the real world complexity of clinic.
turiyahill: November 1, 2020, 7:30pm
Daniel .I am only aware of 2 livestreamed intro courses available…one available through Healthy Seminars and
one through Qiological. Are there any others that you know of.? Thanks.
Daniel: November 5, 2020, 11:38am
Turiya . . . . No – I don’t know of any others. To really engage and develop your skills in this system, the only
option really is to take anything and everything offered here online or live with Toby and to engage in this forum
regularly – that IS the ticket.