naniec: January 12, 2021, 10:10pm
I had quite the scare with this case on 1/6/21 Wed. and would appreciate any feedback.
92 yr female (This is my mother who some of you met/treated during the SAAM class held in Tucson, AZ).
CC: episodes of fatigue and SOB after short periods of exertion. I know many will say that is normal for 92 years
but she can go days and sometimes weeks w/o these episodes. Episodes can last minutes to hours. The coming and
going of these episodes can last for a day or for weeks at a time. During the episodes she looks irritated and
nauseous. She says she does not feel nausea. Sometimes she gets a ‘foggy head” and sometimes a “heavy head”
She feels the fatigue mostly in arms and legs and then whole body. For the past week she has been getting
“annoying head aches” dull, frontal, occipital, come and go, no change with food or drink.
She says she just wants to be outside. “Outside in the sun is the only place I feel good and normal.”
2nd C : Difficult to regulate body temps. Core feels cold but when she puts on a sweater or blanket her limbs
quickly get hot and she gets uncomfortable and irritable. This has been happening on and off for few months.
Today 1/6/21 core feels cold but arms are getting hot with a sweater. Legs feel normal. It is a nice winter day in
Tucson – sunny warm about 70 degrees.
3rd C: Pain in left hand lingering at the tail end of a shingles outbreak. Whole hand pain but concentrated in 3rd
finger – PC.
Pain started about 3 weeks prior on left hand SI mrd. Traveled up arm to armpit and down to left breast. Blisters
formed on SI, LI, SJ mrds.
During this time, her mouth/tongue has been very sensitive. (See below)
Appearance and demeanor: looks fatigued and sounds frustrated, making an effort to be polite and keep sprits
up. (Day of trx was the first time I saw her in about 2.5 weeks.) dull eyes +6-7, pale, difficult breathing +2, sighing
+3.
Lifestyle: lives alone, still loves working in her garden daily, takes short walks, some cooking. Mentally
competent, tends to her own affairs and affairs of her mentally challenged sister. Memory is mostly good. Proud,
independent and stubborn, raised 8 children, retired teacher.
Since covid, only lets me and my sister in her house regularly. All her other kids live out of town. They come and
stay with her occasionally, more often during covid.
Body Morph/flesh: small, frail, curved spine (hunched forward) about 98 lbs.
Dry skin, eyes, mouth and nose. Mouth/tongue gets very tender/sensitive to foods/flavors – sour, spice, salt (dx
with sjrogren’s in her 40’s), thin hair, thin skin. Shuffles when walking. Eyes sensitive to light, degree varies
greatly. Uses prescription eye drops daily.18/01/2024, 11:06Wheezing after +SJ treatment – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/wheezing-after-sj-treatment/1460/print2/7
GI: Lately has been good. Generally she has easy bloating and low appetite. BM has been normal lately. Tends
toward constipation.
Sleep : “good” sleeps about 7 hours. Wakes about 4 am to urinate, back to sleep ok.
Sleep has greatly improved in past couple years since treating with SAAM. May also be due to age. She naps a lot
too.
Urination : frequent, +/- urgent, interrupted flow
Other Body : lots of varicosities, swelling and redness in low leg and ankle most of the time now sometimes itchy.
Severity varies quite a bit. On the days she says her legs are ok they still look red +2-3 and swelling +2-3. When
she complains about her legs the skin is usually tight, shiny, red and sometimes itchy.
T : generally glassy, multi cracks, red and usually moist when I see it bc she sips water all day due to dry mouth.
P : generally float, wiry, rapid
Excess Presentations:
SJ : difficult to reg temp+7, eyes sensitive to light+3, Channel pain+2-3, polite, anger directed at self, not
comfortable with attention, focus on detail. Desires to be in the sun. Feels oppressed in the house.
Lv: Cool body (core), dull eyes +6-7, Seems depressed but will not say she is. Frustrated by lack of ability to stay
busy and tired of feeling ill. Pathology on left. Complexion dull ashy pale ?
Shielded from world due to covid
P : Chan pain, librarian type,
GB : Chan pain, convex dse – blisters ?
Ht : body heat, outward love, cares for other over self, chan pain left arm
UB : cold core?, urgent & frequent U, weak flow, curved spine?
Ki : curved spin, deformed hands/fingers, varicosities, elderly
SI : small, thin, chan pain, very high pain tolerance – ?
Sp: weak bone, teeth & gums, sweet tooth, becoming more numb to the world (my impression)
LI : dryness inside and out, nature is hyper activity, creative, stubborn, Chan pain
Lu : SOB, sighing, good resources
St : skinny, dry
TGTITR:
Frustratin with the inability to feel normal – body temp, energy. Just wants to be outside all day but every does not
sustain her.18/01/2024, 11:06Wheezing after +SJ treatment – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/wheezing-after-sj-treatment/1460/print3/7
Main trx idea:
SJ on R – repeated desire for sun, chan pain
Other Trx ideas:
Lv on R – pain on left, difficult BTemp regulation, frustration
SI: HA, Pain
I decided on SJ due to her desire for sun (1/6/21). The prior trx I had given her on 12/19/20 was SI and bc after the
last + Lv trx on 12/9/20 she did not sleep good.
I put in +SJ on right, She settled and fell right to sleep. She said she started feeling restless a few minutes before I
took needles out. She looked agitated so I told her I wanted to counter the trx. She did not want to lay there any
longer and had to urinate so we got her up and to the bathroom. While she was still in the bathroom I could hear
her start to wheeze loudly +8. I took her to her recliner instead of back to her bed. She didn’t want to sit but agreed
to try the counter of Lv on left. After about 10 minutes the wheezing slightly started to calm. At 15 min she had to
urinate again so I took needles out. She was still agitated and wheezing when she came out of the bathroom. Again
she said she wanted to go out in the sun so we went for a walk. Within a few minutes she calmed down and
wheezing went from +6 to +1-2. Upon going back into the house her wheezing increased slightly to +3. After about
an hour the wheezing subsided. Since then the wheezing has returned on and off mostly at night +1-2 without
sound. Her energy has been low.
I will see her tomorrow for a treatment maybe. We will see what happens bc she is nervous about another
treatment. So am I.
I have been treating her with SAAM treatments for the last two years mostly with good results. Negative responses
have been very few. When they have occurred they have been not much of a response or restless sleep. One time I
do remember her complaining of less energy in following days. I generally treat her once a week so I will only
review the last couple of months of treatments. Unless otherwise noted, her response to the treatments are
something like this. “I feel better, my energy was back for a couple of days, my sleep is good, my legs are not
swollen nor itchy, BM are back to normal.” She mainly gages on her energy level. I have to probe for other
responses.
November
In November I toggled btwn Sp and Ki. Not as a plan. It just happened that way.
Sp helps a lot with her dryness, itchiness and energy.
Ki helps to decrease the swelling in the legs.
December
2nd: PC on R – PC chan pain – 3rd finger locking @ 2nd joint, feeling lethargic.
Post trx: energy very good for two days, finger stopped locking and eyes feel less grainy but mouth very dry.
Finger locking has been going on for a while only getting better and returning with past trxs.18/01/2024, 11:06Wheezing after +SJ treatment – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/wheezing-after-sj-treatment/1460/print4/7
9th: Lv onR – lots of dryness – mouth, nose, itchy skin.
Did not sleep good night of trx but since energy has been good. Itchiness gone, legs still swollen.
14th : +Lu on R – slight pain on left arm just showing up, legs swollen, loose BM.
19th : +SI on R – lots of movement in left arm, pain significantly less. At this point we did not realize this was the
start of a shingles outbreak. Noticeable pain SI mrd left hand.
Aside :
What I have learned is that I had better keep better notes for my mom.
Because she is my mom, I treat her at her home and until now treatments have gone well, my notes get sparse and
sloppy.
I feel like I’m missing something significant bc I don’t understand the wheezing response.
Daniel: January 13, 2021, 1:29am
A few rambling thoughts . . . .
first of all, at 92, someone is likely to need a lot of different Sa’Am treatments, so by its nature, the case is not
going to be simple or clear
I am not convinced the love of sun has to do with the light in a Liver-SanJiao sense
does she like the lights in the house to be bright? Is she oblivious (I prefer that to rude) to what is going on around
her? One thought – perhaps the SJ+ treatment removed shielding so much, her respiratory system became hyper
exposed to some allergens or mold or offending agents – leading to the quick and intense wheezing.
I have had several patients who really dislike indoor confinement and need to be out in the open, open air, sun, etc .
. . I interpret that as some internal constraint like dampness feeling extra oppressive in confined spaces (the Sp-LI
axis) . . . . or alternatively either as some compromised ability to push out, leading to an amplification of
confinement or a need to push out (the PC-GB axis).
I think with the wheezing and SOB, PC would really open her chest very effectively so perhaps try that – and it
might also be the ticket with her relationship to confinement – outdoorsunshine (which might also benefit from a
GB+ treatment?!?!)
I know she is dry, but she is also damp – a lot of teeth issues and numbness – and she may really like the dry warm
feeling of the sun . . . so perhaps a combination of LI+ and HT+ would really give her that dry warm feeling she
seems to be seeking
some thoughts
George_Mandler: January 13, 2021, 4:52pm1
8/01/2024, 11:06Wheezing after +SJ treatment – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/wheezing-after-sj-treatment/1460/print5/7
I agree with Daniels not to get caught up in liking sunshine to be a SJ deficient sign.
I also agree that as we get older the wheel really gets out of true and we need to adjust a lot of spokes. (which you
seem to have done)
naniec:
SJ: difficult to reg temp+7
Am I unaware of SJ excess being unable to regulate temperature?
(There are a few other categories I am not sure about – also I see a typo where elderly should be in SI excess.)
I am missing the damp part. I am itching to do LU+ on her again. What are her thenars like? flabby and empty?
Did you do a LR+ on the left after the SJ+ apparently went sideways?
It can be so challenging to treat family – especially when things do not go well – I hope she is open to a session on
Friday. I wonder what other’s that were in Tucson remember about your mom (Kristin?)
naniec: January 13, 2021, 4:58pm
Thank you Daniel,
This gives me more to think about. I really needed a nudge in a different direction here.
You are right, at one time or another I have used almost every treatment on her. Without digging deep into my
notes I can’t say that I have used LI nor Ht due to the heat and dryness. I will look at these from a different lens and
see how she presents. I do recall that she responded very well to +PC in the past which was a bit of a surprise to me
bc she seems so PC excess to me. I think this is part of the problem of treating people so close to us.
naniec: January 13, 2021, 5:46pm
George
SJ: difficult to reg temp+7
This is something that I heard from Toby. Judging from the way it is written in my notes it was not said in the
original SAAM class but an additional class or podcast.
Yes, you are correct on the “elderly”. I wasn’t sure were to place this bc I don’t see it as an excess. I see it as
most elderly can use some Ki.
Damp: mail seen in swelling legs, deformed joints, and some SP sx.
I too am drawn to Lu although she is split between LU/ST.18/01/2024, 11:06Wheezing after +SJ treatment – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/wheezing-after-sj-treatment/1460/print6/7
Lu: Dryness is mostly exterior, damp interior, shallow breath, resourceful, easy life, hobbies
ST: very thin, sunken chest, numbness, deflated Lu 10, current pain on Left
Yes, I did +LR on left after +Sj
Blockquote
Thanks for you input. I will see her this afternoon for a treatment. Will post results. I’m just learning how to use
this platform so I hope the block quote works correctly. If not see paragraph start with “I put in +SJ… for her
response to +Lv on left.
Thanks again. This process and your input is very helpful.
KristinWisgirda: January 13, 2021, 6:59pm
Hi Nanie,
Nice to hear from you. Glad to hear that your mom is benefiting from Saam.
The adverse reaction to SJ+ is the most reliable information about your mom’s system, more reliable than our ideas
and perceptions. It is a great learning opportunity.
I would have been tempted to try SJ+ given her declaration of loving the sun and her apparently dull eyes and the
poor sleep after the last Liver+. SJ+ going sideways is an invitation to question these findings and learning
something more about Saam and your mom. Like Daniel mentioned, maybe being outside isn’t so much about the
light. Could it be more the warmth and/or fresh air? Are her eyes really that dull? Does she have cataracts or heavy
lids that might make evaluating eye brightness more difficult?
How did she react to SJ+ in the past?
naniec:
my notes get sparse and sloppy.
Saam practice demands excellent note taking.
naniec:
Ki : curved spin, deformed hands/fingers, varicosities, elderly
SI : small, thin, chan pain, very high pain tolerance – ?
This is analysis is a little mixed up.
K excess signs are varicosities, SI channel pain
SI excess signs are age, SI channel pain. bone deformities
The other elements don’t belong under Si and K excess headings.18/01/2024, 11:06Wheezing after +SJ treatment – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/wheezing-after-sj-treatment/1460/print7/7
When you are ready to work on the potential depression and cold body you could consider H+ (with the addition of
Liv+ on the other side). I’m sure you have used UB+ plenty of times as a foundation. And it is winter.
George_Mandler:
Am I unaware of SJ excess being unable to regulate temperature?
SJ excess being so much more open to the environment, can have a harder time regulating temperature. Just as the
picture can present with heat above and cold below, it can also present with a narrow range of comfortable
temperature.