rachelle: August 21, 2021, 1:34pm
Pt: mid 30’s female short bubbly wide eyed very chatty
CC: lifelong inability to orgasm,
2nd complaint: difficult falling back asleep in the middle of the night after waking up to pee
3rd complaint: sore throat since 2nd covid vax 3 weeks ago
4th complaint: seasonal allergies getting worse over the past few years
Appearance and demeanor : good facial symmetry;warm and friendly +5; polite +5, animated talker+8, difficulty
with appetite and sleep with heat wave, self described very tightly wound, feels very tense in her body, also poised
to jump up any moment, self described doesn’t pay much attention to her body but when asked questions has
extremely detailed answers to everything ??, difficult to interrupt +7
Lifestyle: Super busy community organizer (+8), self worth tied to productivity levels and services for other +5,
just started a sport for the first time in life (despite being at peak business levels) +6
Body morphology and flesh quality: small frame, skinny; decent muscle tone despite not being athletic
Skin Quality: mixed sometimes oily sometimes dry
Body Temp: runs warm +4,
GI: daily bm, easy elimination, always on the wetter side, multiple looser stools pre-coffee
Respiratory: seasonal allergies, difficulty breathing when laying on back
Sleep: sometimes late bedtime because of many projects, socializing and drinks with friends in the evening,
difficulty falling asleep, wakes middle of the night to pee and can’t fall back asleep for 2-3 hours, wakes up at 7am
because busy but feels very fatigued. +9
Emotions: positive attitude, seems pretty flexible and optimistic, very warm and social, enjoys going out, very
librarian intellectual energy in relation to conflict +7
Urination: needs to pee extremely frequently, always thirsty, always peeing
** Gyn: 4 week cycle, ovarian cyst on the Right,
Other Body: sore throat for the past 3 weeks, lots of congestion and mucus during allergies
Excess Presentations:
Heart: warm friendly +5 sore throat? super chatty +7?
UB: frequent urination? +7
GB: very conflict avoidant
P: talks in circles very intellectual about conflict,04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print2/22
SJ: but also likes mood lighting sometimes +2
Liver: likes light to get organized +4, self described doesn’t pay much attention to her body +4
Lung: damp inside/dry outside (breathing obstruction?, sometimes dry skin, wet BM) +?
Stomach: sometimes mixed oily-dry skin?
LI: hyperactively project oriented +8;
Spleen: Spleen channel pain
SI: kinda low self esteem when not busy +1
K: casually dressed but wearing new clothes and mentions it +3, ovarian cyst +4, lowest self esteem is minimum a
5 out of 10: +4
The Grossest Thing(s) in the Room: hyperactive projected oriented doer, sore throat
Main treatment ideas: SP+ right, UB+ right, GB right
Other treatment ideas: ST+(breathing oppression on back, thin)
Treatments 1: Sp+
-slight breathing restriction when laying on back on table, racing thoughts initially, by the end of the tx about to fall
asleep, very relaxed but still got off the table quite quickly, improvement in sleep the week after, much slower
week, made fewer plans, noticeably less busy, went to bed earlier every evening, increase in appetite!, self esteem
slightly higher despite less productivity
-started sweating in the morning, waking up super sweaty,
Treatment #2: GB
· Still breathing restriction upon laying on back on table, noticed it when I started asking her to take big breaths
while I insert the needles, we adjusted technique to just regular or shallow breaths but timing insertion with
exhales, put the 4 needles in and within minutes she got really quiet and said she felt great and super relaxed, 7
minutes in fast asleep, 20 minutes in needed to be woken up, described really enjoying the tx.
-1st night post GB+: Very tired that night, slept very deeply, woke up at 330am to pee, difficulty falling back asleep
and much too hot but not too bad, woke up next morning feeling RESTED and FRESH!!
-2nd night post GB+: SLEPT THE WHOLE NIGHT until 6:30 am, for the first time in years!
-2nd day post GB+: has been out of breath all day, difficulty breathing has never been this bad, has had to stop
walking and talking multiple times and keeps on starting hyperventilation, feels similar to a panic attack but no
anxiety, just like lack of oxygenation despite not doing anything arduous. Doesn’t feel like there is a heavy weight
crushing chest, just as soon as she starts talking she is out of air immediately, it’s getting worse as the day goes on.
My game plan is to reverse this in the next hour, Looking forward to hearing yall’s thoughts
sincerely very beginner acupuncturist, baby Saam practitioner
rachelle: August 21, 2021, 2:33pm
UPDATE:
(the breathing difficulty was actually every 30 seconds being out of breath + palpitations, feeling like being
choked, emotionally quite calm despite scary sensation)
Tonified PC around 7 pm last night.
During tx the beginning of yawns forming which felt positive but still getting blocked, the frequency of being
blocked or out of breath slowly started to diminish around the 15-20 minute mark so I left needles in 30 minutes.
2 hours later: she described on the phone feeling 60-70% better (because the cycles were slowing down to every 5-
10 minutes and palpitations were decreasing)
This morning: disturbed sleep, kept waking up from blocked breathing, frequency has increased from last night and
is now resembling pre 2nd Tx levels of difficulty. She describes being able to regain her breath a little quicker (like
the sensation of being choked from the inside subsides faster but it is still happening every minute or two,
sometimes 5, often more frequently)
Now the question is where do we go from here? Maybe it is taking the body a little while to re-adjust because it
took us so long to reverse it (and she went so long without proper oxygenation?) If it gets worse do I try boosting
PC again? (even for just a 5 minute treatment?)
Any insight or thoughts would be very appreciated.
George_Mandler: August 22, 2021, 2:16pm
Hello Rachelle – Thank you for posting your case writeup. I see you have questions regarding next steps, but let’s
first breakdown your writeup as there is some conflation of ideas and miscategorizations which are extremely
common when first learning this heart centered Sa’am system. ( We tend to mix up Excesses with treatment
strategies.) I also have some questions.
rachelle:
CC: lifelong inability to orgasm,
How is her sex drive? Does she feel desire?
rachelle:
feels very tense in her body, also poised to jump up any moment,
She sounds anxious. She doesn’t sound timid from what else you share – FYI – It would give me pause to
supplement GB+.
rachelle:
wakes middle of the night to pee and can’t fall back asleep04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print4/22
rachelle:
Urination: needs to pee extremely frequently, always thirsty, always peeing
Frequent urination seems to be a theme here. But we don’t want to be fooled by it. If she is drinking at night with
friends that can be a cause. It also sounds like she has what @sweiz calls dispersion thirst. She drinks all the time
and doesn’t absorb it. So it may be be a BL dynamic but a lack of absorption.
rachelle:
Excess Presentations:
…
rachelle:
GB: very conflict avoidant
Conflict avoidant with an NVC kind of response would suggest PC excess. (I know you know this and just mixed it
up along with the ones below I pointed out). GB excess would be quick to respond in an aggressive way.
rachelle:
SJ: but also likes mood lighting sometimes +2
Not sure of your lead in question to her to tease this out, but she has SJ excess signs such as very externally
focused on being a community organizer. To do something like that I would imagine requires some detail
orientation.
What impression do you have when you look into her eyes – brightness coming back to you or sort of dull inward
energy?
She also sounds like a bright energy to me and may need some shielding given her “poised to jump at any
moment”
rachelle:
Liver: likes light to get organized +4, self described doesn’t pay much attention to her body +4
Again not sure of the lead in question about light, but I don’t feel so organized in the dark. Liver excess can be
so inward focused that they give every little detail about their body and are oblivious to the outside.
rachelle:
Lung: damp inside/dry outside (breathing obstruction?, sometimes dry skin, wet BM) +?04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print5/22
What is the quality of her thenars? As you note the damp/dry border is a bit of fuzzy logic. Skinny frame would not
be thinking Lung excess here.
rachelle:
Stomach: sometimes mixed oily-dry skin?
I’d put this in the inconclusive category and ignore it.
rachelle:
LI: hyperactively project oriented +8;
If dry skin with wet stools and given her many projects she does sound like she LI excess.
rachelle:
Spleen: Spleen channel pain
But don’t forget to put this into the LI channel excess category.
rachelle:
SI: kinda low self esteem when not busy +1
I think this has to be flushed out more. Unless there were no finding so you didn’t include. No tenderness of
masses in lower abdomen. You said she is symmetrical. How are medial heels? Sex drive?
rachelle:
K: casually dressed but wearing new clothes and mentions it +3, ovarian cyst +4, lowest self esteem is
minimum a 5 out of 10: +4
Low self esteem as you mentioned above can suggest SI excess.
rachelle:
Main treatment ideas: SP+ right, UB+ right, GB right
I’d say SP+ feels like a candidate. Although warm.
UB+ if you feel she is dry – how are her pulses? If rapid then it would add some weight, she does seem to have
some HT excess – love for others for sure. But can the anorgasmia be a sort of hypo function, in which case it gives
less weight to considering BL+
GB+ I have concerns about this. Even though intellectual I would be cautious as being a community organizer she
is definitely not timid.04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print6/22
Given her breathing issues and being skinny I probably would have gone LU+ first for her if the SI/KD dynamic is
not strong one way or the other. (I am thinking of her MC and although I have not treated anorgasmia I have had
reported increased sex drive with both SI+ and KD+). In addition it sounds like there is anxiousness and there is a
good bet there is some emotional involvement. I want to consider treating LR+ for her – especially given the
trajectory of the LR channel around the genitals.
rachelle:
Other treatment ideas: ST+(breathing oppression on back, thin)
We want to supplement the LU+ if thin! ST/LU is the most common archetype mixup!
rachelle:
Treatments 1: Sp+
…
-started sweating in the morning, waking up super sweaty,
Interesting isn’t it!
rachelle:
Treatment #2: GB
…
-1st night post GB+: Very tired that night, slept very deeply, woke up at 330am to pee, difficulty falling back
asleep and much too hot but not too bad, woke up next morning feeling RESTED and FRESH!!
-2nd night post GB+: SLEPT THE WHOLE NIGHT until 6:30 am, for the first time in years!
Supplementing GB+ on her for the second session is taking my breath away. I don’t have a good explanation for
her sleeping the entire night or feeling refreshed after 48 hours.
Overall it sounds like she is disconnected from her body even though you say she reports in details. She may need
more internal focus.
George_Mandler: August 22, 2021, 2:24pm
It is great that she was able to come in right away. You supplemented PC+ on the opposite side – left correct?
rachelle:
Now the question is where do we go from here? Maybe it is taking the body a little while to re-adjust because it
took us so long to reverse it (and she went so long without proper oxygenation?) If it gets worse do I try
boosting PC again? (even for just a 5 minute treatment?)04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print7/22
You do not want to supplement PC+ again because in your writeup you made a case for PC Excess. You did it once
and it had some effect to where she was before the mistreatment of GB+ but it is extremely unlikely an addition
PC+ push will change things.
I’d consider LU+ – given the breathing issues and being skinny. How are her resources/finances? She sounds well
resourced with friends and community so maybe not LU+. Also allergies can respond well to LU+ treatment for
some.
I still like to consider supplementing LR+ given she sounds anxious and the trajectory of the channel. Does she
have cold feet?
I’d also look closer at the SI/KD dynamic and see if anything shakes out for you.
Also confirming she has never had an orgasm vs was able to at one point.
rachelle: August 22, 2021, 7:44pm
Hi George thank you for the feedback, I will clarify below:
R: CC: lifelong inability to orgasm
G: How is her sex drive? Does she feel desire?
R:Lifelong inability to orgasm: has never ever had an orgasm, describes
wanting to have sex sometimes, enjoys having sex in the right
relationship, has tried everything on her own, all the toys, very problem
solving type of energy towards the problem, can have significant
pleasure with genitals but has never climaxed or experienced anything
like how people describe orgasms. Sometimes is frustrated but seems
mostly just curious, wonders if there was ever any trauma early in life
but has no memory or reason to believe anything happened.
R: feels very tense in her body, also poised to jump up any moment,
G: She sounds anxious. She doesn’t sound timid from what else you share
– FYI – It would give me pause to supplement GB+.
R: She doesn’t appear anxious at all, she self describes as very tense but
she sits with legs wide open and appears pretty confident in body
language just maybe a little over caffeinated at all times of the day, she
isn’t jumpy or restless, but if somebody says lets go for a walk shes the
first to jump up and put on shoes (for example). I definitely didn’t think04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print8/22
about supplement GB initially and did not perceive her as PC excess, it
was a friend of her also studying Saam who described her as dealing
with conflict in a hyper intellectual non-confrontational way so I
decided to try it for the 2nd Tx
R:wakes middle of the night to pee and can’t fall back asleep Urination:
needs to pee extremely frequently, always thirsty, always peeing
G:Frequent urination seems to be a theme here. But we don’t want to be
fooled by it. If she is drinking at night with friends that can be a cause. It
also sounds like she has what @sweiz calls dispersion thirst. She drinks all
the time and doesn’t absorb it. So it may be be a BL dynamic but a lack of
absorption.
R: cool this is a helpful thing to remember, It sounds like the middle of
the night urination is ALWAYS regardless how little she drinks in the
evening (intentionally). so perhaps more of a Stomach excess condition
than BL excess or Heart excess
R:GB: very conflict avoidant
G:Conflict avoidant with an NVC kind of response would suggest PC
excess. (I know you know this and just mixed it up along with the ones
below I pointed out). GB excess would be quick to respond in an
aggressive way.
R: YES you are right that was a mix up, or intended to point out PC
excess and not GB excess
R: SJ: but also likes mood lighting sometimes +2
G: Not sure of your lead in question to her to tease this out, but she has SJ
excess signs such as very externally focused on being a community
organizer. To do something like that I would imagine requires some detail
orientation. What impression do you have when you look into her eyes –
brightness coming back to you or sort of dull inward energy? She also
sounds like a bright energy to me and may need some shielding given her
“poised to jump at any moment”04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print9/22
R: Her eyes are not dull and if they are bright it is not enough for me to
tell for sure, I initially also thought she might be SJ excess so I asked a
lot of questions and kept turning on the overhead lights and flashing
lamps at her to see if she would find it uncomfortable but she is quite
people pleasing- flexible it is hard to get a straight answer, although she
mentioned enjoying dimmed lighting sometimes so I included it. She
also described having a messy room at home and not minding messy
environments, she seems like more of a work horse than a perfectionist,
I feel concerned adding more Liver shielding will further disconnect her
from her body…
R: Liver: likes light to get organized +4, self described doesn’t pay
much attention to her body +4
G: Again not sure of the lead in question about light, but I don’t feel so
organized in the dark. Liver excess can be so inward focused that
they give every little detail about their body and are oblivious to the
outside.
R: hmm okay good point, I didn’t think LV excess would know anything
about their own body but I see that with the inward focus, she is
definitely more outwardly oriented than inwardly aware, just very
chatty about what she does perceive when prompted to look inwards
R:Lung: damp inside/dry outside (breathing obstruction?, sometimes
dry skin, wet BM) +?
G:What is the quality of her thenars? As you note the damp/dry border is a
bit of fuzzy logic. Skinny frame would not be thinking Lung excess here.
R: thenars= regular, not inflated, yep she definitely doesn’t have a Lung
excess frame, internal dampness blocking deep breathing was my only
theory in relation to the obstruction when laying on back… but maybe
its external and that explains the potential stomach excess
presentation04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print10/22
R: LI: hyperactively project oriented +8;
G: If dry skin with wet stools and given her many projects she does sound
like she LI excess.
R: except skin isn’t dry but yep definitely some type of LI excess
R:Spleen: Spleen channel pain
G:But don’t forget to put this into the LI channel excess category.
R: Oops ignore this! snuck in from the example I copy pasted from
Kristin
R: SI: kinda low self esteem when not busy +1
G:I think this has to be flushed out more. Unless there were no finding so
you didn’t include. No tenderness of masses in lower abdomen. You said
she is symmetrical. How are medial heels? Sex drive?
R:medial heels not dry, sex drive low-regular, low self-esteem didn’t
actually seem that low just relative to medium-high, I will palpate
abdomen next time, Left ovarian cyst causes pain during ovulation
R: K: casually dressed but wearing new clothes and mentions it +3,
ovarian cyst +4, lowest self esteem is minimum a 5 out of 10: +4
G: Low self esteem as you mentioned above can suggest SI excess.
R: I kinda interpreted 5 out of 10 as low to be quite high, and she is not
always at her lowest, therefore more a KD excess… but perhaps most
patients I have seen are on the much lower side.
R:Main treatment ideas: SP+ right, UB+ right, GB right
G:I’d say SP+ feels like a candidate. Although warm.
UB+ if you feel she is dry – how are her pulses? If rapid then it would add
some weight, she does seem to have some HT excess – love for others for
sure. But can the anorgasmia be a sort of hypo function, in which case it
gives less weight to considering BL+
GB+ I have concerns about this. Even though intellectual I would be
cautious as being a community organizer she is definitely not timid. Given
her breathing issues and being skinny I probably would have gone LU+04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print11/22
first for her if the SI/KD dynamic is not strong one way or the other. (I am
thinking of her MC and although I have not treated anorgasmia I have
had reported increased sex drive with both SI+ and KD+). In addition it
sounds like there is anxiousness and there is a good bet there is some
emotional involvement. I want to consider treating LR+ for her – especially
given the trajectory of the LR channel around the genitals.
R: gotcha thank you
R: Other treatment ideas: ST+(breathing oppression on back, thin)
G:We want to supplement the LU+ if thin! ST/LU is the most common
archetype mixup!
R:Treatment #2: GB
> -1st night post GB+: Very tired that night, slept very deeply, woke up
at 330am to pee, difficulty falling back asleep and much too hot but not
too bad, woke up next morning feeling RESTED and FRESH!!
> -2nd night post GB+: SLEPT THE WHOLE NIGHT until 6:30 am,
for the first time in years!
G: Supplementing GB+ on her for the second session is taking my breath
away. I don’t have a good explanation for her sleeping the entire night or
feeling refreshed after 48 hours.
Overall it sounds like she is disconnected from her body even though you
say she reports in details. She may need more internal focus.
R: Ok thank you so much for your feedback (and your time). I hope I have clarified some of the intake information.
What I am looking for input at this point on is what to do when PC+ is not reversing the breathing problems that
seem to be caused by GB+ . It has now been nearly 48 hours since I tried to reverse GB, PC+ helped initially but it
didn’t last and she is still out of breath at the slightest effort, when talking too much.
George_Mandler: August 22, 2021, 8:20pm
Thank you for the clarifications.
FYI – The Qiological forum is the most awesomeness forum board I have ever used as it is so easy to use. You do
not have to copy and paste responses, just highlight them in the original post and a Quote box will appear and it
will put in in the active box you are typing in. Pretty cool. Like this…04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print12/22
rachelle:
What I am looking for input at this point on is what to do when PC+ is not reversing the breathing problems
that seem to be caused by GB+
I am confused as I thought she had breathing problems to begin with. On the first treatment supplementing SP+ she
had breathing issues. Is that the first time in recent weeks she had any breathing issues?
I am not suggesting your placement is wrong but just want for all us to be aware of getting the correct point. I
wonder myself when a treatment does not work if my point location could be off. I cannot stress enough the
importance of correct point location with this beautiful system. I am now very precise in my point location (thank
you Toby). Last month I had a patient with difficult breathing from allergies this past May. Supplementing PC+
worked beautifully a year prior. I supplemented PC+ again as it fits her well. No change. What?!? I checked my
points and slightly modified KD10 where it felt better to me – almost immediately she yelped “Oh my gosh my
chest just opened up I can get a deep breath again”. She talked about that experience in next month’s treatment.
That was a cool lesson for me.
A while back I rushed a supplement ST+ treatment in my LU excess patient. (MC is tight chest and breathing
difficulty on right side) It always works for her. I came in to take out the needles and my stomach sank when I
realized that ST41 was on the medial side of the hallicus longus ligament I knew it would not work. I had her come
in 2 days later and correctly needled her and she got her positive change.
So check your location, location, location. Also Toby feels needle size makes a difference. This can strongly factor
into whether the treatment we are giving a patient is really the treatment we think we are giving them.
Back to your case…Consider her financial resources. Toby likes to see what kind of car they drive – I often look at
their keys on the table before questioning.
I sometimes ask about “when you were growing up do you remember hearing about money issues or was that
never a problem”. I have a patient with plenty of money but has a fear of spending it, LU+ works well on her. So it
can be perceived resources. If that fits I would consider supplementing LU+ given her thin frame even though skin
can be dry. A ST/LU dynamic seems clearer than a PC/GB dynamic for her. Also supplementing LU+ can certainly
improve breathing and the other Taiyin treatment seemed to help, though made her sweaty.
rachelle: August 22, 2021, 8:56pm
Thank you for the tutorial, I knew I was missing something formatting wise.
George_Mandler:
I am confused as I thought she had breathing problems to begin with. On the first treatment supplementing SP+
she had breathing issues. Is that the first time in recent weeks she had any breathing issues?
When I tonified Spleen she described a bit of difficulty taking a deep breath laying on her back, it is not a thing she
always experiences. At this point we have talked more in depth about it and she remembers experiencing it once in
a while as a kid but it resolved quickly and never prevented her from doing things or talking.04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print13/22
Approximately 36 hours after I tonified GB she started having SEVERE breathing problems, every minute or two
she would be completely blocked in her chest, feel as if somebody was choking her from the inside, or underwater
and not be able to inhale, have palpitations. 42 hours after GB she contacted me about it. She noticed that it was
worse if she was talking, walking up stairs, standing for a while, BUT it was also happening when she was relaxing
or sitting down reading, on her own. Approx 56 hours after GB we met up so I could tonify PC, at this point the
breathing attacks were happening every 30 seconds, quite similar to a panic attack but not accompanied with any
emotional stress in a any way. After about 20 minutes with needles in she started to settle and the breathing
blockages were happening much less frequently. I took out needles after 30 minutes. That evening she said she felt
60-70% better and the attacks were much more spaced out. The next morning (day 3 after GB tonifitication) it was
worse again and she was being blocked every 1-5 minutes, still not stressed about it but definitely concerning when
it feels like an adverse reaction to GB and I can’t reverse the effects! Today (day 4 after GB+) it is slightly better
but she needs to restrict physical exertion and not walk up stairs, the breathing attacks are now happening at a
frequency of 2-3 times an hour.
So I guess it is going in the right direction and we can be patient.
I am wondering if you or anyone has had difficulty reversing a treatment? the body reacts super strongly to being
pushed one direction and then the opposite isn’t strong enough to undo the negative effects? When does it warrant
giving PC another try? (that being said maybe my locations were off)
George_Mandler:
Consider her financial resources.
Will do! I will start looking at LU+ in the next day or two.
Sounds good thank you!!
George_Mandler: August 22, 2021, 10:00pm
rachelle:
but she needs to restrict physical exertion and not walk up stairs, the breathing attacks are now happening at a
frequency of 2-3 times an hour.
So if this extreme is totally new and she has not experienced it then I’d supplement PC+ asap. Given her seemingly
PC excess characteristics I am cautions, but the way you describe it, it is clear that GB+ was a mistreatment. If
giving the PC a boost is correct you should she a change within 5 minutes. I’d sit with her. If no change in
breathing then consider the supplementation of LU+ if it seems to fit.
For the record I have supplemented GB+ on patients where it was clear or I have seen for a quite a while.
Remember Toby’s example of his teacher supplementing GB+ on him?. PC/GB can be confusing and we need to
look beyond what we see on the surface.
If someone has a lot of hutzpah even in a positive way they can be GB excess.They need that GB energy to get out
and push and do the good fight. For someone to be a community organizer they need some GB energy and pick04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print14/22
their battles. I don’t know if this fits your patients work, but just wanted to point out that it is not always just anger.
rachelle: August 23, 2021, 1:36am
George_Mandler:
st is correct you should she a change within 5 minutes. I’d sit with her. If no change in breathing then consider
the supplementation of LU+ if it seems to fit.
Hi @George_Mandler
I think you missed the update I gave after my first post (aka my second post, same thread). So I did do PC on her
on Friday evening (GB was wednesday afternoon, which started going bad Thursday evening but then great sleep
and then really bad as of Friday morning)
rachelle:
Tonified PC around 7 pm last night.
During tx the beginning of yawns forming which felt positive but still getting blocked, the frequency of being
blocked or out of breath slowly started to diminish around the 15-20 minute mark so I left needles in 30
minutes.
2 hours later: she described on the phone feeling 60-70% better (because the cycles were slowing down to
every 5-10 minutes and palpitations were decreasing)
rachelle:
This morning: disturbed sleep, kept waking up from blocked breathing, frequency has increased from last night
and is now resembling pre 2nd Tx levels of difficulty. She describes being able to regain her breath a little
quicker (like the sensation of being choked from the inside subsides faster but it is still happening every minute
or two, sometimes 5, often more frequently)
Now the question is where do we go from here? Maybe it is taking the body a little while to re-adjust because it
took us so long to reverse it (and she went so long without proper oxygenation?) If it gets worse do I try
boosting PC again? (even for just a 5 minute treatment?)
So now we are 48 hours post PC and I’m thinking about doing it again, I’m scared of doing Lung and that throwing
a new dynamic in the mix when I feel like the GB-PC axis is still out of whack.
George_Mandler:
If someone has a lot of hutzpah even in a positive way they can be GB excess.They need that GB energy to get
out and push and do the good fight. For someone to be a community organizer they need some GB energy and
pick their battles. I don’t know if this fits your patients work, but just wanted to point out that it is not always
just anger.04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print15/22
Gotcha yep that is helpful for my understanding
Michael_Max: August 27, 2021, 12:52pm
Hi Rachelle
Thanks for this interesting case. Here are the things that stand out for me:
Your patient seems pretty LI excess. She’s a doer, and often the LI excess type is very engaged in doing and
creating as it does indeed give them a sense of worth and accomplishment. So that’s a theme to keep in mind.
The inability to orgasm. Is this inability during sex, or can she orgasm if she masturbates? Is there any trauma in
the background here? As a first screen I’d think KD and perhaps KD/HT Shaoyin connection.
This connects some with the frequent urination, if indeed this is due to a UB excess, then treating the HT could
help, and perhaps by extension help with the orgasm issue, if orgasm issue is related to the Shaoyin as I’m
hypothesizing here.
As to her issues with conflict avoidance (talks and thinks, but does not act) indeed tonifying the GB can be
helpful for that. As can tonifying HT, if there is a strong component of fear associated with conflict.
Now as to the breathing issue. I’m not convinced it is from GB tonification as she responded well to that treatment
in the session, slept amazing well that night, and it was 50+ hours before she started having breathing issues.
What you’re describing rhymes with panic attacks. The body does not lie. She may not be connecting with feeling
panicked, but her body is saying that she is. I’m circling back to the orgasm issue. What is getting in the way of her
inhabiting the sensate experiences of her body?
Treating the PC was spot on, and it sounds like it helped. But also there are aspects of the GB that helped, so
indeed, not a cut and dried situation here. Damn… clinic is hard!
I’m curious to know more about this sore throat that she’s had since her second vaccine injection. How has that
shifted with this breathing issue?
She sounds dry on the inside (thin) so that points toward an issue with Taiyin fluids, and it sounds like she did well
with the SP tonification you did the first time. I think of thin people as being a bit like parched earth, if the earth is
too dry then water runs off. So adding some Taiyin moisture with either LU or SP can help her to absorb and hold
the fluids.
In that first treatment you mentioned that she had slight breathing restriction. Is this the first time she’s had
breathing issues. Can you determine when the breathing first started to feel off?
In terms of opening the chest and improving oxygenation, as you already know, tonifying PC is the way to go.
I’ve also found that when there is excess moisture in the lung, then tonifying ST reduces interior moisture by
bringing it more to the surface (I see it as kind of gentle venting the exterior) so that can help with the breath, and
especially if you’re seeing other LU excess signs. My teacher in Taiwan often added jing jie and fang fang to very
gently open the exterior, which would all the lungs to more fully expand. From the Saam view we can see that
perhaps some kind of constrain it preventing the chest from expanding. @George_Mandler suggested tonifying
the LU to help with breathing and that could be helpful here, as well as bringing some fluids to her dry interior.04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print16/22
You mentioned that you want to fix the GB/PC axis as it is out of whack, but do consider that if the issue is
somewhere else, then banging away on that relationship will not be helpful. And at the same time it could be
involved, but there are other things (in case lack of fluids) that need to be attended to first.
I would also consider tonifying the KD (back to the orgasm issue) but also because the KD holds the qi, and her
breathlessness seems to have this component as well. And due to the ovarian cyst, I’d be cautious with tonifying
the KD. but I’d use it once to see if helped with the breathing.
One more thing. This is NOT Saam, but something that I recently read in Breath by James Nestor. For people with
this kind of breathing problem, this feeling out of breath, it is sometimes because they are breathing very shallowly,
quickly and through the mouth. See if she can breath through her nose. If not not, then tonifying ST can help.
Breathing slowly through the nose and holding the breath a bit at the end of the exhale can increase CO2 in a way
that helps with oxygen exchange. It’s a bit counter intuitive, but has to do with regulating the parasympathetic
nervous system. Again, a little divergence but worth checking out with her.
OK, so this was longwinded. In summary you can consider:
KD to hold the qi of the breath
ST if there is nasal blockage and LU excess signs
LU, opposite of the above mentioned treatment. (I think the key here is to determine is the breathing issue more
due to deficiency or excess. If deficiency, then tonify the LU, if excess then tonify the ST)
And look into when the breathing issue actually began
And is there trauma in the background.
Hope that helps and keep us posted!
George_Mandler: August 23, 2021, 7:29pm
Rachelle
I got that you supplemented PC+ and she had improvement. I thought the breathing issues were there before the
GB+ treatment and you clarified it was new. So I am suggesting to supplement PC+ again. If it is right you should
see an improvement in 5 minutes or so.
I think LU+ is a safe bet for her given what you’ve shared.
1 Like
rachelle: August 29, 2021, 2:58pm
Michael_Max:
at when there is excess moisture in the lung, then tonifying ST reduces interior moisture b
Thank you for the wise words @michaelmax and @George_Mandler!04/01/2024, 12:03Can’t breathe post GB+?!? (despite beautiful reaction to tx initially) do I reverse? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/cant-breathe-post-gb-despite-beautiful-reaction-to-tx-initially-do-i-reverse/1614/print17/22
Just an update on where we are at today. I did a second PC+ treatment 5 days after the first (which initially helped
but 24 hours later she was back to severe breathing problems and palpitations.
She did not settle on the table during the 2nd PC treatment but she wasn’t uncomfortable either, I didn’t notice any
apparent changes in her breathing. Over the next few days her condition has slowly improved AND she has started
seeing the correlation between stress and these breathing blocages-palpitations. She is also being super cautious
about overexertion (hasn’t gone for a bike ride) and is moving slower and gentler to not trigger it. So at this point
we have identified that most of the time the episodes are caused by psychological stress but sometimes by physical
activity alone (walking up stairs too quickly).
Michael_Max:
I think the key here is to determine is the breathing issue more due to deficiency or excess. If deficiency, then
tonify the LU, if excess then tonify the ST)
George_Mandler:
I think LU+ is a safe bet for her given what you’ve shared.
Great advice, I am going to try Lung next, I will keep yall posted how that goes!
George_Mandler: August 30, 2021, 11:35am
rachelle:
she has started seeing the correlation between stress and these breathing blocages-palpitations.
She is aware that external causes, i.e. stress, contribute to her breathing issues. It seems this is leading to
internal/physical symptoms which is difficult breathing. But you said she is not anxious, although she is having
physical symptoms. From the sound of it I would explore whether the breathing issue is the internal/physical
manifestation commonly known as anxiety.
Her MC was anorgasmia. The Liver channel wraps around the genitals. I still think that is a good option for her.
rachelle:
sometimes by physical activity alone (walking up stairs too quickly).
Even though she is young maybe one treatment of supplementing Kidney. You stated low-medium sex drive and
she self reported low self-esteem. Seems she just has pain around ovulation perhaps from a cyst but no real
menstrual pain. Maybe consider on last days of bleeding or right after ovulation.
rachelle: