ronhubbs: September 8, 2019, 1:01am
(I reposted this because I first put it in the ‘Saam Clinical Insights’ before realizing that there was a separate forum
for Clinical Questions)
36-year-old female. Was in a severe car accident a couple of years ago that caused:
1. Very severe constant, debilitating pain: Headache / Eye pain (8-9/10), Cervical pain and stiffness, thoracic
back pain
2. Severe sensitivity to light / sound + difficulty with cognitive processing, dizziness, sometimes nausea
3. Severe Fatigue: Was debilitating, w/ px having to sleep 16 or more hours per day. After first few Saam txs
(Supp LV 2X), this got much better to where px didn’t completely crash after work and was able to be active
at night and on weekends. (Though pain persisted)
Px has recently resumed working at Nike as she was going to otherwise lose her job. She had not worked for nearly
2 years. She just shifted into full time hours over the past month and is struggling to keep it together.
CHANNELS AFFECTED:
Eyes / Head / Temples: GB, SJ, UB, ST, DU, LV?, H?
Neck pain: UB, SI, GB, DU
Back (thoracic): UB, DU
(Below are my cut and pasted Saam chart notes – Sorry for the all caps, but it’s easier for me to read & review
them in the EMR this way):
PULSE MODERATE RATE
TONGUE: RED TIP, FRONT AND SIDES, TOOTHMARKED, SWOLLEN, SL DRY YTC
BODY: soft, fleshy, with relatively normal skin (used to be really oily); px is former collegiate athlete, but body is
starting to degrade from being unable to exercise / be active
HX: FEET COOLER THAN HANDS (USED TO BE SEVERE) (BOTH FEEL WARM / NORMAL AS OF 9/3
after Saam tx)
DRY, PARCHED MOUTH (HAS GOTTEN BETTER AS OF 9/5/19) DESPITE DRINKING LOTS OF
WATER (STILL DRINKING LOTS OF WATER)
FEELING LIKE RUNNING PRETTY WARM, BUT NOT TOO HOT
BRIGHT personality and complexion 7/10 (which is considerable considering her very difficult ongoing
situation / condition)
HAS ALWAYS BEEN CLUMSY
Px had intense rage / anger outbursts after accident (which is difficult to believe as she is very polite and sweet);
She has been on lexapro and has not felt this way since
NO R/L-SIDED PAIN / PROBS TREND25/01/2024, 12:10Difficult Pain Case & Question about Shock (reposted from Saam Clinical insights) – Sa’am Clinical Questions – Qiological Comm…
https://forum.qiological.com/t/difficult-pain-case-question-about-shock-reposted-from-saam-clinical-insights/585/print2/3
NOT FEELING LIKE GETTING ENOUGH SLEEP (though feeling better energy and not sleeping nearly as
much as did before)
INSOMNIA: GOES TO BED EARLY BUT LAYS THERE AND DOESN’T GO TO SLEEP RIGHT AWAY;
RECENTLY (9/3) WENT TO BED 7:30 PM DIDN’T SLEEP UNTIL NEARLY 1 AM
NO SOB / SHALLOW BREATHING
LIBIDO: NORMAL
ONE SPIDER VEIN ON CALF;
SMALL SPIDERS ON SI CHANNEL AT NECK NEAR T1, 2
DARK BLUE/PURPLE VEINS UNDER TONGUE (not engorged but distinct)
HX: IN HIGH SCHOOL WAS HOSPITALIZED FOR TWISTED INTESTINE; was put on pain meds, woke a
day later feeling better; was very stressed in high school, had “sports bulimia (purging through exercise) /
anorexia: “I never felt like I could work out enough” “perfectionist”, counted calories to extremely low levels
(“a big problem within the culture of female athletes of the high school”. This continued into college until a
coach demanded she stop or be removed from the athletics
HX: ULCERS IN COLLEGE FROM EXCESS USE OF NSAIDs / PAIN KILLERS
ABDOMEN: SL CLAMMY, WARM & COOL IN SPOTS
HAD HEAT SYMPTOMS BUT IMPROVING
LU10: PRETTY NORMAL
FINANCIAL / RESOURCES: “HARDCORE SAVERS” – ALWAYS FEELS A SENSE OF CONCERN IF
DOESN’T HAVE AN ABUNDANCE OF SAVINGS (through this ordeal, much of their savings have been
wiped out)
SWEATS NORMALLY
SKIN IS NORMAL
T-ZONE OILY; BAD ACNE WHEN YOUNGER – TOOK MEDICATIONS
SWEET TOOTH
NUMBNESS EARLY ON IN INJURY (HANDS/ARMS, FEET/LEGS), BUT NOT AS INTENSELY NOW.
FEELS HEAVINESS SOMETIMES
NOT LAZY / TENDS TO FIND SOMETHING THAT NEEDS TO BE DONE
SA’AM DX:
EXCESS SJ
EXCESS GB
EXCESS K (PAIN / STASIS) (Now reconsidered as WRONG Dx)
EXCESS UB / H (mixed cold and heat signs; channel involvement; Shock?)
EXCESS ST
Treatments:
TX #1: SUPP P (Not much discernible effect; I started with this one bc I had not fully flushed out the Saam Dx and
the GB headache, insomnia, and history of rage / outburst seemed like the grossest thing at the time. The next
treatment, I settled on treating the excess SJ)
TX #2: SUPP LV (GOOD EFFECT)
TX #3: SUPP LV. (FURTHER GOOD EFFECT: Px reported having considerably better energy as mentioned
above; pain had not improved however)
TX #4: SUPP SI: Px GOT EXTREMELY STIRRED UP W/ PAIN FOR TWO DAYS AFTER TX; She was
overwhelmed and had to leave work early. I had px return for complimentary tx:
TX #5: SUPP LV + GB: I started with supplementing LV after pressing LV8 + K10 seemed to improve headache25/01/2024, 12:10Difficult Pain Case & Question about Shock (reposted from Saam Clinical insights) – Sa’am Clinical Questions – Qiological Comm…
https://forum.qiological.com/t/difficult-pain-case-question-about-shock-reposted-from-saam-clinical-insights/585/print3/3
and symptoms. After needling, improvement was minimal. I continued to test some points with acupressure and
supplemented GB which seemed to help more. The immediate effect was that the px calmed down and headache
improved, with her feeling better upon leaving; 2 days later, px says that pain levels are trending towards what they
were before Tx #4 but are still high; energy still seems better but not as good as before tx #4
So obviously supplementing SI was a bad move. I can see now that moving the blood that strongly was too much,
but since the fatigue had gotten so much better, I thought this was the best way to tx the pain and saw SI channel
going to eyes / temple, some signs of stasis and thought that it fit.
Now I am left thinking that supplementing UB is the best way forward (or possibly H if that doesn’t hit the mark),
but she doesn’t have anxiety, fear, or urinary problems and has mixed cold / heat signs. So I had some questions
about categorizing / treating PTSD / Shock. I’m a little confused as to distinguishing between UB / H (when there
aren’t overt Hot/Cold signs). Excess UB signs include Fear, while Excess H signs include Anxiety.
Aren’t Fear and Anxiety somewhat intertwined? Further, how would we characterize PTSD / Shock in Saam?
Thanks for considering.