f.nunnariTCM: May 7, 2020, 2:02am
This patient had been referred to me by a practitioner who went on maternity leave.
We got in a couple of sessions before our clinic closed (due to Covidpanic) then we went to telephone consults.
I have not done Saam on her yet. She is currently taking Dang Gui Shao Yao San plus Tian Xiong San.
Any other recommendations would be appreciated. Forgive me, I’m a little rusty.
Occupation: nurse
Chief complaint: Endometrial cancer (patient decided against hysterectomy or conventional treatment)
2nd complaint: The following were complaints but have improved with her multi dimensional treatment plan:
leg cramps at night, difficulty to fall asleep (overactive mind)
Neck and shoulder tension
Worse with:
Better with: current treatment: Pilates and exercise program, nutritionist has put her on a ketogenic diet (patient has
lost >30kgs)
Appearance/demeanour: calm, grounded, positive outlook.
Pigmentation of skin
Lack lustre of skin
Lifestyle:
Balanced – exercise, Taichi, diet, mindset/meditation.
Body morphology, flesh quality: Still quite overweight
Flesh quality – soft
Skin quality: lack lustre, fair skin- lots of pigmentation
Hx of eczema behind ears, breasts, abdomen, scalp, nape, behind ears – but completely disappeared with change to
low carb diet.
Has condition called Lichen Sclerosis – treated with cortisone as prescribed by gyncologist
Body temp: na
GI: no complaints
BM: tendency to constipation – but has regulated with herbs (dang gui shao Yao san plus tian Xiong san)
Respiratory: no complaints
Sleep: improved since herbs/treatment
Emotions: seems very balanced.23/01/2024, 12:14Endometrial Cancer – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/endometrial-cancer/1025/print2/5
Urination: no complaints
Gyny: has been through menopause
Hx of traumatic C-section – became infected post surgery, lots of scar tissue (palpable especially LRQ)
Has slight vaginal bleeding – pink – bright, maybe once every 3 weeks.
Other :.Varicose veins
Pain:
None
Tongue:
Pulse:
Xs presentations:
Heart:
UB:
Gb:
Pc:
Sj:
Liv:
St:
Lu: skin, outer dry/lack lustre, inner damp? presents more on Right side
Li:
Sp: overweight but not unmotivated (very motivated and committed to her heath), yet dry stools…history of
skipping days/constipation – is that stomach? Is that the mass? Is it the high protein diet?
Si:
Kid: mass in lower abdomen
Varicose veins
The GROSSEST: mass in lower abdomen
Main ideas:
Treat Si
Perhaps SUPP Stomach?23/01/2024, 12:14Endometrial Cancer – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/endometrial-cancer/1025/print3/5
KristinWisgirda: May 7, 2020, 11:47am
f.nunnariTCM:
I’m a little rusty.
You are not alone. Hopefully, looking at cases will help sharpen our Saam vision.
Tian Xiong San is not in Bensky. It contains fu zi, bai zhu, gui zhi and long gu.
She doesn’t have many signs and symptoms to go on so you have to take a closer look. Your presentation is a little
confusing and makes it unclear what is current and what is better with herbs. Not sure if the stools are still dry even
with the herbs. Sleep is “improved” but is it perfect? It is better to treat patients as they present. If she isn’t
constipated now, then don’t make it part of the picture.
f.nunnariTCM:
lots of pigmentation
Does this pigmentation present along certain channels more than others? Is the lichen sclerosis in a visible area or
off limits in the genitals/anal area?
f.nunnariTCM:
Lu: skin, outer dry/lack lustre, inner damp? presents more on Right side
Not sure what is presenting on right side.
Spleen excess is damp inside and out. I’m not sure how dry “lacking lustre” is. Using a scale of 1 to 10+ can help
us see. Have you asked her about sweating and moisturizer use?
f.nunnariTCM:
lots of scar tissue (palpable especially LRQ)
Palpable mass in the abdomen is a strong kidney excess indication, even if the mass is scar tissue. Even more so if
you are able to feel the endometrial tumor. Varicosities add weight to that diagnosis.The presence of an abdominal
tumor that is only known by scan and not by palpation is a much weaker sign of Kidney excess.
f.nunnariTCM:
Perhaps SUPP Stomach?
You could, based on morphology, if the skin is clearly dry. But if the stools are really dry, St+ would be drying out
the inside even more, even though it has a downward direction.
1 Like23/01/2024, 12:14Endometrial Cancer – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/endometrial-cancer/1025/print4/5
f.nunnariTCM: May 8, 2020, 5:15am
I will have a better look next time, more on yangming from memory – face (especially forehead) forearms, legs but
I will have to make note when I see her next.
f.nunnariTCM: May 8, 2020, 5:17am
…Lichen sclerosis – vaginal.
f.nunnariTCM: May 8, 2020, 5:21am
Paplation wise- I feel more scar tissue on the right…The Fukushin blood stasis area is also more reactive (although
both are tender) The ultrasound also shows the mass more around this area on the lower right quadrant.
KristinWisgirda: May 8, 2020, 11:44am
f.nunnariTCM:
The ultrasound also shows the mass more around this area on the lower right quadrant.
Clinically weaker for Saam.
f.nunnariTCM:
Paplation wise- I feel more scar tissue on the right
Clinically stronger for Saam.
Telephone consults make clinic so much harder too! You aren’t seeing how bright or dull her eyes are. You aren’t
reading the body language that helps you believe or question the truth of what she is saying. She has made an
unconventional decision in deciding against conventional cancer treatment. Does her calm, grounded demeanor
feel really authentic to you? Or is the calm and grounded really scared stiff? My curiosity from a distance makes
me want to play devil’s advocate.
f.nunnariTCM: May 18, 2020, 3:10am
23/01/2024, 12:14Endometrial Cancer – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/endometrial-cancer/1025/print5/5
I saw this patient today, brightness of eyes does not stand out (+5) but they are not dull.
She looks really well.
She seems very grounded and as a nurse, she manages stress well. She is positive but not bubbly and jubilant.
I filled in a few gaps to the notes I was given from the previous practitioner.
She is 4th of 5 children, father passed of non-Hodgkins lymphoma and mother of motor neuron disease. Eldest
brother has melanoma.
Other surgeries include:
Tonsils, appendix and left breast parenthesis at 16yo (left breast did not form)