Adina_Kletzel: April 11, 2019, 6:12pm
HI,
I could really use some guidance on a case of a 35 year old woman who has been suffering from migraines for 10
years. Her migraines some on one side of the head near the temples. It is a sharp piercing pain that lasts for about
24 hours and can come as often as 3 times a week. On a good week it is a mild headache and on a bad week it is a
debilitating migraine. She is very skinny, dry – dry skin, dry mouth, thirsty, VERY hot with aversion to heat and her
migraines are worse with heat, she has insomnia, difficulty with anger, and doesnt deal well with going out to
much, taking trips, driving for too long… Also – she has 6 kids and works… I have tonified liver, PC, SP, BL, SI
for her – alternating over the past couple of months. She does have less migraines a week and they are generally
milder than they were and she is sleeping better. But after all of these months they area still around and she is still
VERY hot and dry. What am I missing?? I would so love so help relieve her suffering…
Thanks so much,
Adina
KristinWisgirda: April 11, 2019, 8:18pm
Hi Adina,
I have a patient with severe dry mouth from Sjogren’s who is clearly Heart excess- super hot, super loving.
Supplementing the UB with thinner needles didn’t so a thing. Supplementing the UB with thicker needles (.30 on
the body points, .22 on the wells), including threading the jing wells in the proper direction, immediately brought
saliva into her mouth. This patient taught me that needle thickness can make all the difference.
I just got some even thicker needles, .35 and .40 to experiment with. Thick enough Toby?
Something to consider since this patient could obvious use the ice cold water of the UB.
Please keep us updated. Real life cases are the best!
-Kristin
2 Likes23/01/2024, 11:59Stubborn migraine case – Sa’am Clinical Questions – Qiological Community
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sweiz: April 12, 2019, 1:12pm
Hi Adina, I was also wondering, of the treatments you have done, which have shown a benefit? Of course,
tonifying bladder sounds like the most obvious but the others make sense too. I am wondering if you follow
Kristen’s thinking and also do the channel that seems to help the most more than once. If you are seeing a good
change with the channel that helped the most, try it again and use that unless there is no shift after the needles are
in. Are you waiting after the needles are in to see if there is a good change and switching treatment if there isn’t?
Yes, keep us updated!
Adina_Kletzel: April 12, 2019, 2:04pm
HI,
Thank-you for pointing this out. You are saying that you saw NO DIFFERENCE when using the smaller needles
and a change with the thicker needles? I think this is the one point I did not want to hear… I have such a hard time
as it is using these sensitive points on my clients with the smaller needles… They really squirm on the tough
points… How much more difficult do the thicker needles make the treatment?
ON the flip side I have to admit that I am getting a bit frustrated that I feel that my diagnosis and treatment is
correct and I am not seeing any WOW results at all… Only here and there. Do you really think the needles make
all of the difference?
Thank-you so much!
KristinWisgirda: April 12, 2019, 2:52pm
Hi again Adina,
I too didn’t like Toby’s message about thick needles and strong stimulation. In the past I’ve been the kind of
practitioner who reacts viscerally when her patients wince. My patients have professed love for my gentle approach
but … what a bummer when they just aren’t getting results!
As I have been experimenting with the system, I started out with thinner needles and lighter stimulation with mixed
results but enough WOW experiences to keep me going. The experience with my dry mouth patient showed me
that needle thickness and stimulation really, really do matter. Changing to thicker needles and clear stimulation
made all of the difference with this patient. Now, I am not willing to mess around or waste time wondering if I
have given enough stimulation when I am confident with my diagnosis.
Toby says that effective treatment requires correct diagnosis + meticulous placement of all 4 needles + clearly
directed stimulation. If any of these are absent you are jeopardizing the clarity and the results that this style of
treatment offers.
ngmatthews: October 4, 2021, 5:15pm
23/01/2024, 11:59Stubborn migraine case – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/stubborn-migraine-case/83/print3/10
As I have said in other places on this forum, I am now using purple Seirins on most points. I got a bunch of the
15mm ones as well for Jings. Sometimes I’ll use Seirin Ivory 15mm on Bl 67 but mostly purples now. I tend to
thread most points about 1/2 inch, but do Jings a mm or two, again, flat to the skin threaded in the proper direction.
I am getting pretty amazing results with everyone. The purples really don’t hurt much. Soon I expect I’ll move up
to the browns, which I think are 28 g, at least for the main points. The tip profile of Seirins is so comfortable that
people don’t seem to mind at all.
Adina_Kletzel: April 25, 2019, 10:49am
HI,
Thank you so much! Can you possibly give me a bit more of a description of these needles because I am not
familiar with them. ANd maybe tell me where I can buy them? THanks so much!
Adina
ngmatthews: October 4, 2021, 5:15pm
The Seirin needle is a plastic handled needle. They are Japanese. I have been purchasing them since 1983 when
Tom Rhiimaki from OMS brought them to NESA for us to see. I have not tried every single brand of needle, but I
believe they are the most comfortable ones I have ever used. My teacher Miki Shima always used the light blue
and red handled ones, which I think are probably 36 and 38 gage. In Japanese acupuncture we often want to use a
needle that will not cause any pain to the patient at all, and which will not cause any negative perturbation to the
system. My teacher Susan Johnson used the reds back in the day. Chip Chase used the light green 30 mm for his
work. That is a 40 g needle. He said they were effective. And he was doing very subtle but powerful work.
Everyone has their favorite needles, and after nearly 3 decades of doing acupuncture I am in that camp. I’ve tried
other brands, but I guess it is just easier to keep with Seirin because there is nothing wrong with them. They do cost
about 10 cents each. However I purchase 5000 to 10000 at a time, so I get a discount to about 9.5 cents or
something like that. I really don’t pay much attention. Getting cheaper needles is not worth it to me because my
needle budget per year is less than my phone/internet bill. And I like to have my patients say “I didn’t even feel
that, is the needle in?” They do have a “pro-pack” which has only one tube for 10 needles and that is a little
cheaper, but that is only for the blue and red 30mms. You can get them from all the major acupuncture supply
houses these days I think. I get them from Lhasa/OMS, Crane Herb, or wherever I am getting herbs or other
supplies. Seirin has some lovely metal handled needles as well, which I have never used much. I think they are
called “laser”. The plastic handled ones are Type J. Type D is the 15mm without tubes, which I use for ears and for
Jing points. I would suggest you order them and see what you think. The purple and brown handled ones are what
I’m using for Saam. They are 32 and 30 g I believe. Hope this helps.
michaelmax: April 25, 2019, 10:57pm
23/01/2024, 11:59Stubborn migraine case – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/stubborn-migraine-case/83/print4/10
I’ve been using DBC needles, which are Korean. They are about half the price of Serins and also quite comfortable
as like the Serin they are coated with silicon. Problem is they don’t bind up the fibers in the tissue as well, which is
something the Sa’am system likes to do.
I’m currently talking with Lhasa about seeing if we can needles made on Toby’s spec. And I suspect the DBC
might already have what we want in Korea. I’ll keep you posted as I learn more
ngmatthews: October 4, 2021, 5:15pm
I want to clarify that Seirin needles are not coated with silicon and have not been for many years. I checked with
the people at Lhasa about this a few years ago. Just super smooth steel. As for DBC, I’ve used them a lot but my
patients find them more painful than Seirins so I went back. One thing is that the insertion tube edge on the DBCs
is quite sharp and it often startles patients before I even insert. The edge of the Seirin tube is quite rounded and
comfortable so they don’t feel it. This is certainly a Japanese thing. I used to collect spare Seirin tubes from 30 mm
needles and use them for all other brands of needles because of this. I think some other brands of Chinese style
needles have pretty soft edges as well.
I do freehand the 15mm needles when doing Jing points or Bl 66 or SI 2 so I can get a very accurate location.
Pretty soon I’ll start free handing the 30mm on other points.
michaelmax: April 26, 2019, 8:20pm
ngmatthews:
Pretty soon I’ll start free handing the 30mm on other points.
I’m thinking the same thing. I’ve relied on the tube because it is easy and am after all a bit of a lazy acupuncturist.
ngmatthews:
I want to clarify that Seirin needles are not coated with silicon and have not been for many years.
@ngmatthews thanks for the clarification. I thought the Serin’s were coated. I stand corrected.
Adina_Kletzel: May 3, 2019, 3:36pm
23/01/2024, 11:59Stubborn migraine case – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/stubborn-migraine-case/83/print5/10
I want to thank you so much for taking out the time to explain all about the Seirin needles to me. YOu were very
helpful. I am going to look into ordering them.
THank-you so much!
Adina_Kletzel: June 27, 2019, 8:08am
HI,
I want to update on this case. I have continued rotating the liver, Sp, Bl, SI, and PC with this client and she STILL
has at least one migraine a week and still cant handle going out much and is still VERY hot. NOw that the weather
is hot too she is feeling very tired and says that the heat makes her even more tired. I have gone up in needle gauge
to .25 on body points and .18 on well points. I am planning on ordering the .30 seirins on body and .22 on wells.
But shouldnt I be seeing more of an improvement with this client? We have been working once a week for the past
8 months. Is there anything that I may not be seeing?
THank-you
Adina_Kletzel: June 27, 2019, 8:30am
HI! Any news on needles based on Toby’s specs with Lhasa? I would like to place a large order of Toby’s spec
needles now (I am finally ready!!!) and I am looking to zero in on what exactly these specs are and where to order
them.
Thanks!
ngmatthews: October 4, 2021, 5:15pm
I think it might be OK to try doing UB a couple of days in a row to see if that is helpful.
KristinWisgirda: June 27, 2019, 4:53pm
Adina_Kletzel:
Is there anything that I may not be seeing?
Good question to keep asking. Are there any factors, besides summer, that would be keeping her so hot and dry? Is
she constipated? Are her periods heavy, too frequent, or otherwise problematic?
Have her other symptoms improved at all? In the first post, you mentioned insomnia and easy anger.
Does she respond better to some treatments than others?23/01/2024, 11:59Stubborn migraine case – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/stubborn-migraine-case/83/print6/10
Weak constitution and lifestyle can be treatment obstacles that are out of our control. Having 6 young children and
working sounds like a potential obstacle. Stay curious and keep getting to know your patient. Sometimes even long
time patients can surprise me with what they have never gotten around to telling me.
Adina_Kletzel: July 2, 2019, 5:57pm
HI,
if you are using the brown seirins so those are .30×40 mm long. Does that mean you use longer needles? I would
like to order the browns but they dont come 30mm long.
ngmatthews: October 4, 2021, 5:15pm
I use both 30mm and 40mm Seirin browns. And 15mm Seirin purples for Jing points because the 15mm do not
come in brown.
Adina_Kletzel: July 3, 2019, 5:05pm
I checked the lhasa website and they seem to only have the 30mm browns. Am I mistaken have you found 30 mm
browns on the lhasa website? If yes can you please send me the link? THanks!
ngmatthews: October 4, 2021, 5:15pm
They also have 40 mm browns. I just ordered a bunch.
Donley #21August 9, 2019, 3:39am
Any update for DBC’s larger needles? I’m having trouble finding .40mm anywhere that are not 4 inches long. I
don’t think my patients would appreciate that hanging out of a jing-well! Has anyone else had luck with finding
thicker gauge?
Lmgreenhough: August 12, 2019, 12:37am
This is off Eastern Currents website – where I purchase Seirin Needles:23/01/2024, 11:59Stubborn migraine case – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/stubborn-migraine-case/83/print7/10
The needles feature an easy-grip, lightweight plastic handle with a soft-touch top. These needles are made of high-
grade surgical stainless steel. The needle tips are machine ground offering a uniform and consistent needle tip
geometry. The needle shaft is partially lubricated. These combined features allow for near-painless and smooth
insertion, resulting in high levels of patient acceptance.
Does anyone know what ‘partially lubricated’ means?
I have studied Zhu Scalp acupuncture and there is a huge difference between the ‘slipperiness’ between Zhu’s
needles and Seirin. Zhu’s needles stay where they are put and I find Seirin needles are easy to come out when
placed on the scalp.
danosu77: June 19, 2020, 1:04am
@KristinWisgirda and/or @michaelmax Can you please tell me more about threading the jing well points? I
took the recorded classes on line and in the treatment, it didn’t seem like the needles were that angled. Am I
missing something?
KristinWisgirda: June 19, 2020, 11:27am
@danosu77 Welcome to the Saam community! We learn so much from each other, so please feel free to send
questions and share experiences. If you would like input on cases, please check this out first Case Study Format
The case study format contains tools that will help you sharpen your Saam senses in the process of writing up your
case.
danosu77:
it didn’t seem like the needles were that angled
In Saam all of the needles are as angled as severely as you can, with the handle resting as close to the skin as
possible. This is gives a clear message to the qi to move in the intended direction.
Jing wells needled shallowly are at risk for flopping around and changing direction. Threading, at least a little,
prevents that from happening and makes sure that the needle has a clear direction. Even if you typically use a tube,
I recommend free handing jing wells so that you can insert and thread in one swift motion. Doing so will have little
to no more sensation than just inserting. With fleshier Liver 1 and Spleen 1, I sink the needle pretty deeply on
everyone. Other less fleshy wells, the needle might not be sunk as deeply but it has a very clear direction and
severe angle.
This technique initially intimidated me, but with practice it became much easier. Even my most sensitive patients
tolerate threaded jing wells.
michaelmax: June 20, 2020, 12:43am
23/01/2024, 11:59Stubborn migraine case – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/stubborn-migraine-case/83/print8/10
Hi @danosu77
Welcome to the forum!
Yes, the needles are at a rather acute angle. I find my needles when well placed are roughly at a 20-25 degree
angle.
Using your osteopathic skills you’ll quickly get a good feel for what angle is best for that point and patient at any
giving time.
I also tend to use .5 inch needles for the Jing wells as they are easier to handle and less “weight” hanging off the
edge of a Jing well point.
George_Mandler: June 20, 2020, 1:01pm
@michaelmax What diameter are you using on your 15mm needles for the Jing wells? I’ve been using .35x30mm
for Jing wells and the acute angle usually works although sometimes it comes out. (and .40×30 for others),
With that said I still am playing with how important it is for a larger diameter needle than just say a 34 gauge thin
one. Thoughts on that anyone?
KristinWisgirda: June 20, 2020, 9:47pm
michaelmax:
I also tend to use .5 inch needles for the Jing wells as they are easier to handle and less “weight” hanging off
the edge of a Jing well point.
Me too. The shorties are easier to insert and sink in one swift motion.
George_Mandler: June 24, 2020, 10:43am
@KristinWisgirda What .5 inch needles are you using? I have a repulsive response to the single needle in a single
tube. Are there 10 pack .35 x 15mm?
KristinWisgirda: June 24, 2020, 11:22am
George_Mandler:23/01/2024, 11:59Stubborn migraine case – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/stubborn-migraine-case/83/print9/10
I have a repulsive response to the single needle in a single tube.
I understand completely. However, currently I am using .30 x 13mm Kinglis in a single tube and using up .25 x
15mm(?) DBCs which come 5 to a pack. With my robust people who need thicker needles I will use .35 x 30mm
on wells.
amyjenner: June 24, 2020, 3:51pm
This thread made me think of trying some of the needles I have that come in 5 packs for NADA. they are .22X13
michaelmax: June 24, 2020, 9:03pm
I use the DBC Orange Handled Detox needles. .20×13
George_Mandler: June 27, 2020, 1:53am
.20. Wow. I’ve been using .35 or .40 on the jing well and ying spring points,
Maybe that is why people are reluctant to come back in.
danosu77: June 28, 2020, 7:01pm
@michaelmax @KristinWisgirda:
I am getting confused. It sounds like both of you are using smaller needles for the jing wells, is this correct? What
about heart 8?
Does Toby use smaller ones for these or is it also bigger ones?
Thanks!
Dan
KristinWisgirda #34June 28, 2020, 9:29pm23/01/2024, 11:59Stubborn migraine case – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/stubborn-migraine-case/83/print10/10
When following Toby at his clinic, I only saw him use .35x40mm Myacu needles on all of the points including
wells.
danosu77: June 28, 2020, 10:22pm
@KristinWisgirda is that what you are using also?
KristinWisgirda: June 28, 2020, 10:57pm
I’ve tried out lots of needles in the last year so I am using up different sizes. There is no need to waste needles that
still get the job done. My standard needles are .35 or .40x 30mm or 40mm Dong Bangs, with .30 x15mm kinglis or
.25x13mm DBC for wells, with .35x30mm used on the wells of patients who need stronger stimulation. I don’t like
long handled needles for wells typically because the heaviness can be more irritating than need be.
I have some Myacu .35x40mm as well that I am using up too. The Myacu and the Dong Bang are of similar
excellent quality.
amyjenner: July 5, 2020, 6:48pm
I am also using mostly the .35 x 30mm with the some .40 x 30 or 40 Dong bangs. I have the longer ones for
heavier patients. Also needling BL 40 I find easier with the longer needle. just since reading this thread, I have
been trying the detox needles .22×13 from DBC. They seem to work fine on the wells.