BLHood: December 7, 2019, 10:14pm
I recently took on a patient with diagnosed schizophrenia. She is not coming to see me for this but rather to help
her control her sugar regulation. She is a type 1 diabetic and recently had a sugar crash where her blood level
sugars dropped to 2.5 even though she is on an insulin pump. My concern is that if I use Sa’am to help stabilize her
sugar issues, it could destabilize the mental aspect.
History: Distant family history of type 1 diabetes (her Mother’s aunt), but in recent years her Mother and actual
aunt have developed type 2 diabetes. Px had a psychotic break in 2009 that lasted for several weeks. She went to
Cuba and while there, sat near a cemetery and meditated; following this she sat on the beach and cried
unconsolably. (Does Sa’am talk about this kind of stuff?) She returned to Canada stayed at her Mother’s in a
remote rural area for a few weeks and was able to normalize. She has had no such episodes since but takes
medication. She is, however, presently on medical leave from her job as a social worker due to a recent nervous
breakdown (no details on symptoms as yet). Following our first treatment (where I didn’t use Sa’am), she
confessed to me that she is now starting on a project to stop drinking everyday (no idea how much she drinks
everyday).
Considerations for Sa’am treatment: LV, PC, SP, KD
LV to provide more shielding (her sense of boundaries is poor. and this might help with the alcohol)
PC to stabilize the emotions and provide more protection for the HT
SP to stabilize Earth and give more grounding. This could also help with the sugar issues
KD to provide more consolidation
Is this a good way to think about the situation? Any suggestions from people who have more experience with this
style? Should I be concerned with the potential destabilization of the psyche if I were to employ Sa’am?
Thanks in advance
KristinWisgirda: December 8, 2019, 4:48pm
Hi @BLHood,
Thanks for your post. It is impossible to give you any detailed feedback without a real case study. Have you seen
this: Case Study Format
It provides tools helping you, and us, see your patient more clearly.
The Saam treatment that is going to be most beneficial and safest for your patient is one that follows a well
considered diagnosis, includes perfectly executed needling with adequate needle gauge, and then watching your
patient’s response closely on the table.
If you are new to Saam and aren’t feeling confident with the system, it might make sense to hold off with Saam and
use another style of treatment instead. Practicing Saam with more stable patients first will give you a better footing24/01/2024, 12:08Patient with Schizophrenia – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/patient-with-schizophrenia/778/print2/4
with the less stable patients later on.
michaelmax: December 8, 2019, 5:43pm
HI @BLHood
Great set of questions.
Here are a few thoughts…
First, I don’t think we really think about the PC as providing “protection” for the Heart with Saam.
I know that’s a popular Chinese medicine idea. But with Saam it is more about building up that quiet inner
discernment and intelligence. Because it is the counterbalance to the GB (oddly enough, clock opposite of Heart)
as it helps to regulate and direct the GB’s outward action in the world.
Again, we talk a lot in Chinese Medicine about the Earth being “grounding” but here we think more of Spleen as
the embodiment of the influences of Taiyin Earth. So it is strongly associated with dampness. If your patient is thin
with dry skin, you can consider boosting up the Taiyin Earth, but if she is (as we say in TCM ‘spleen deficient’,
overweight, excess dampness, lazy, muddleheaded or constantly lost in ruminative thought) then be very very
careful, because she’s actually Spleen Excess! You’d want to tonify her Lg Intestine to counter that. Yangming
Metal strongly dries Taiyin Earth, and if her blood sugar issue are from dampness, then Lg Intestine can be very
helpful.
As to your idea about the LV. That makes sense. But again, check to see if there are signs of San Jiao excess. Does
she have bright eyes? See well in the dark? Is she meticulous? Does have inward, rather than outward anger?
Slightly flushed cheeks…
San Jiao types usually have good boundaries because they are keenly aware of the outer world. Whereas the LV
types kind of bumble along because they really have little outer awareness. So again… let’s get that worked out so
you can be sure about your (Saam Style) diagnosis
Indeed a good idea to be aware of the possibility of destabilizing someone who is flirting with a condition like
schizophrenia.
Let’s keep working here to dial in the diagnosis. If you have that part down, then I think Saam could do her a lot of
good.
BLHood: December 8, 2019, 6:03pm
Thank you. I’ve made arrangements to see her once a week and will keep you informed as things progress
Cheers
Brenda24/01/2024, 12:08Patient with Schizophrenia – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/patient-with-schizophrenia/778/print3/4
BLHood: December 8, 2019, 6:06pm
Thank you for redirecting me to the Sa’am intake format. I can see how it would be helpful for Sa’am diagnosis.
I’ll see what I can do about getting more information and presenting it in this format.
Cheers
Brenda
dcvalley: December 9, 2019, 3:14am
BLHood:
She is not coming to see me for this but rather to help her control her sugar regulation. She is a type 1 diabetic
and recently had a sugar crash where her blood level sugars dropped to 2.5 even though she is on an insulin
pump. My concern is that if I use Sa’am to help stabilize her sugar issues, it could destabilize the mental
aspect.
I have nothing to offer you with regard to this patient and Saam. but having treated hundreds of diabetics of both
type one and two I just want to share a few experiences. Almost invariably my patients find their blood sugar levels
drop with the addition of acupuncture to their regimen, sometimes severely with them ending up in the literal ditch
having blacked out while driving. Those who are on insulin are now warned to be careful to watch for
hypoglycemia by symptom or blood reading and to lower their insulin proactively. Do modern insulin pumps
gauge current blood sugar levels? if not they could easily drive the blood sugar dangerously low. Low Carb diets
and fasting can have the same effect and if she hit 2.5 without being in ketosis the results can be dire. You don’t say
if the low blood sugar reading came after starting acupuncture, herbs or dietary changes so I can’t offer detailed
feedback but low blood sugar is worthy of caution and respect.
michaelmax: December 9, 2019, 5:43pm
Great point @dcvalley. I’ve seen the same thing. Some patients are happy about lower blood sugar. Some stopped
acupuncture because they did not want to change their meds.
Best to have a conversation with your patient about this before proceeding too far.
BLHood: December 10, 2019, 5:24am
Her precipitous drop in blood sugar drove her to come to see me and was not the result of acupuncture. I have
helped others with diabetes stabilize their blood sugar so I am not completely inexperienced in this regard, I have
just never used Sa’am style with such a patient. I just took the introductory course a the end of Oct, and with 2024/01/2024, 12:08Patient with Schizophrenia – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/patient-with-schizophrenia/778/print4/4
years experience using other styles, I have a lot to wrap my head around with this “new” system and some
unlearning to do as well if I want to really be able to use it. From all descriptions its is very powerful and so I was
hesitant to use it on her, especially as she is completely new to me. In our first and only treatment, she was only
able to give me 1/2 hour of her time (she showed up almost an hour early to boot! I suspect this is a pattern but we
will see). With regards to here actual case, I will know more after our next treatment where I will be able to spend
more time with her. I was hoping Sa’amers would have some insights into how emotionally unstable individuals
might react and how much care needed to bte taken. I was especially concerned given descriptions of making the
wrong choice of channel. Additionally, I was also hoping to get some idea of any Sa’am style “ghost point” like
treatment though I suspect there is none (more of my old style of thinking, I guess). Any feedback is greatly
appreciated as I begin my journey into this unexplored territory.
Cheers
michaelmax: December 13, 2019, 10:45pm
I’m not aware of an “ghost point” type treatments in Saam @BLHood.
That being said, there are plenty of ways of gauging a person’s spirit and psycho-emotive tendencies.
For me I check in with my own feelings. Does the patient have an energy that goes outward or inward? Are they
able to attend to their environment (TB type) or are they more obvious (LV type). Do they reason things out (PC
type) or are they trying to force their way (GB type)
Of course, these are broad brushstrokes, but you get the idea.
You can also in the beginning do your Saam DX and then some other method you know and are comfortable with
to treat that presentation you see, thus backing off on the firepower of the four needles, and at the same time testing
your diagnosis.
And remember, especially if someone is a bit volatile, if you get it right they will likely settle and if you don’t, they
should show some agitation pretty quickly, so you should be able to catch it if you’re off base with the diagnosis.
Keep applying your Saam eyes and you’ll find they see more clearly with practice!
jia you!