Daniel: October 15, 2020, 9:31am
I know the better part of the answer is that we’d have to know the whole case including all signs and symptoms,
main complaint, patient history, etc . . . and maybe that is really the only answer, but I do wonder – is there a point
at which a sign, particularly one from the primary list of GEMS, is so strong in its presentation that it carries not
only big weight to signify a treatment, but also big weight to contraindicate (or tread with very high level of
caution) a treatment.
Its not unusual for me to have a patient who is very cold in her experience and on palpation, substernally – is very
soft and very warm. Even when other factors in the case point so strongly to a HT+ treatment, I find the degree of
softness and warmth substernally has me really quite trepidatious.
I have patients where everything else lines up with a LU+ treatment, but the thenar eminence is big, very full and
very firm and I get the same apprehension.
Just curious to hear what thoughts run through your clinical mind under such scenarios.
KristinWisgirda: October 15, 2020, 1:13pm
Daniel:
trepidatious.
Daniel:
apprehension
I commiserate.
Daniel:
we’d have to know the whole case including all signs and symptoms, main complaint, patient history, etc . . .
and maybe that is really the only answer,
Yes. Of those two factors have more weight on the scales: The grossest thing in the room and the relevance of the
findings to the chief complaint.
Sharon Weizenbaum always points her students’ attention to what is there, rather than what isn’t there. In this
situation that can be a double edged sword but grossness and relevance seem to be helpful.12/01/2024, 11:39Is There a Point at Which You’d Consider a Strong Gem to be a Contraindication? – Qiological Community
https://forum.qiological.com/t/is-there-a-point-at-which-youd-consider-a-strong-gem-to-be-a-contraindication/1331/print2/3
cassiopeia: October 16, 2020, 12:42am
Daniel:
I have patients where everything else lines up with a LU+ treatment, but the thenar eminence is big, very full
and very firm and I get the same apprehension.
I have the same patient, @Daniel. thin body, greasy skin, acne, a red fungal-looking patch at st 42, lack of
resources. But the thenar eminence is HUGE, like what Toby calls a loaf of bread.
LU+ didn’t help the chief complaint (cough ww dehydration, sometimes aggravated by eating); ST+ didn’t do
anything either.
So, maybe in those cases, when the weight of the “negative gem” counteracts all the other signs, I’m going to start
by looking elsewhere.
KristinWisgirda: October 18, 2020, 1:57pm
cassiopeia:
when the weight of the “negative gem” counteracts all the other signs, I’m going to start by looking elsewhere.
Me too. Let’s all be on the lookout for when this happens and report back.
I recently had a new patient with interstitial cystitis consisting of inhibited urination with burning in her urethra,
pelvic pain, and nocturia 3-4x/night. Dry skin 6+, modestly overweight, great resources, full distended belly with
marked resistance and pain on pressure in the whole right upper quadrant, non-aggressively loud voice, plump
thenars. She didn’t settle wonderfully with ST+ but I was so conflicted about other treatment options I let her ride
it. The day after treatment was horrible for her- increased frequency of urination and pain. The next treatment, she
sunk right in with Lung+ and had a good response. What was it that I missed?
Back/hip/leg pain and migraines worse lying down at night
cassiopeia: October 19, 2020, 7:27pm
KristinWisgirda:12/01/2024, 11:39Is There a Point at Which You’d Consider a Strong Gem to be a Contraindication? – Qiological Community
https://forum.qiological.com/t/is-there-a-point-at-which-youd-consider-a-strong-gem-to-be-a-contraindication/1331/print3/3
What was it that I missed?
This is a question I often ask myself, and MOST often re: the Lu/ST pair. I would love a full seminar (or at the very
least, a crowdcast – hi @michaelmax!) with a few cases to shed light on the nuances of differentiation.
michaelmax: October 20, 2020, 1:55am
Hi @cassiopeia
yes that LU/ST pair!
We will be doing a Sunday clinical cases discussion in Nov, and that would be a great place for you to bring up the
topic so we can all dig into it together!
Sorry for the radio silence here lately, Been focused on some backend things with the website.
Get ready for Qiological 2.0!!