Clinic Theater 2 - Class 5
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Course: Clinic Theater 2 Date: 8/15/08 Class #: 5 Initials/age/gender Alison B – new patient Chief Complaint Poor memory/poor concentration, low energy, headaches, concussion for 6 months. Current Assessment and Related Histories Concussion Jan 08 – fell off bike Also had concussion 1 yr before. Major memory issues (short term), trouble concentrating thru class. Can’t study longer than 15 minutes at a time. SOB in morning Headaches: Stress headache. Had headache x1week occipital to vertex. Also ache at top of maxillary sinuses but this seems to be allergies. Energy: generally fatigued, sleep a lot. Reduced physical activities. 6/10 right now. Sleep: sleeps a lot, lots of dreams, would probably sleep thru the night if she didn’t have cats. 10 hours sleep a night + 2-3 hour nap. Used to get 6 hours and be fine + workout. Dizziness/vertigo: Yes, easily – was worse in the past when she could turn head and feel it. Appetite: hungry, no desire to eat. BM: normal Palpitations: no Eyes: lights in front of her eyes sometimes Menstrual cycle: ½ way thru Ear ring: no Temp: colder than I should be, get cold easily – used to be the hottest person in the room Bleeding: none. Worse: study, sit in class, think, moving, shopping, watching TV, listening to music. Better: just laying in bed. Sacrocranial treatment helped her physical feeling, not energy. Dark circles under her eyes, pale complexion. Pulse Thin, slippery, weak in first position, both sides. Mild wiry on left. Irregular rhythm – rate can change according to inhale/exhale – inhale = faster, exhale = slower. Ask them to take deep, slow breath and feel again. If speeds up, this isn’t irregular or abnormal. More common in males – physiological sinoarrythmia. Tongue Pale, dusky, swollen. Vessels little distended and purple on edge. Crack in center, but not deep, not a lot of coating building up around it. Pattern Diff Heart Blood Xu Qi Xu (UJ/MJ) Local Qi/Blood Stagnation Disease Diagnosis Poor memory TX principles Nourish Heart Blood, Tonify Qi in UJ and MJ, Move Qi and Blood locally. Points/Therapies Chase the Dragon – GB 20(eyes of dragon), Du 14(mouth of dragon) Jiaji points beginning T1 – L5 unilaterally (start left side females) Sishencong Unilateral: SP3, GB 39, K4, BL 40 (China: Alzheimer’s – oxygenates brain cells) Needles used Clinic Theater 2 – Summer 2008 http://www.CatsTCMNotes.com Page 1 of 2
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Transcript of Clinic Theater 2 - Class 5
Course: Clinic Theater 2 Date: 8/15/08 Class #: 5 Initials/age/gender Alison B – new patient Chief Complaint Poor memory/poor concentration, low energy, headaches, concussion for 6 months. Current Assessment and Related Histories
Concussion Jan 08 – fell off bike Also had concussion 1 yr before. Major memory issues (short term), trouble concentrating thru class. Can’t study longer than 15 minutes at a time. SOB in morning Headaches: Stress headache. Had headache x1week occipital to vertex. Also ache at top of maxillary sinuses but this seems to be allergies. Energy: generally fatigued, sleep a lot. Reduced physical activities. 6/10 right now. Sleep: sleeps a lot, lots of dreams, would probably sleep thru the night if she didn’t have cats. 10 hours sleep a night + 2-3 hour nap. Used to get 6 hours and be fine + workout. Dizziness/vertigo: Yes, easily – was worse in the past when she could turn head and feel it. Appetite: hungry, no desire to eat. BM: normal Palpitations: no Eyes: lights in front of her eyes sometimes Menstrual cycle: ½ way thru Ear ring: no Temp: colder than I should be, get cold easily – used to be the hottest person in the room Bleeding: none. Worse: study, sit in class, think, moving, shopping, watching TV, listening to music. Better: just laying in bed. Sacrocranial treatment helped her physical feeling, not energy. Dark circles under her eyes, pale complexion.
Pulse Thin, slippery, weak in first position, both sides. Mild wiry on left. Irregular rhythm – rate can change according to inhale/exhale – inhale = faster, exhale = slower. Ask them to take deep, slow breath and feel again. If speeds up, this isn’t irregular or abnormal. More common in males – physiological sinoarrythmia.
Tongue Pale, dusky, swollen. Vessels little distended and purple on edge. Crack in center, but not deep, not a lot of coating building up around it.
Pattern Diff Heart Blood Xu Qi Xu (UJ/MJ) Local Qi/Blood Stagnation
Disease Diagnosis Poor memory
TX principles Nourish Heart Blood, Tonify Qi in UJ and MJ, Move Qi and Blood locally.
Points/Therapies Chase the Dragon – GB 20(eyes of dragon), Du 14(mouth of dragon) Jiaji points beginning T1 – L5 unilaterally (start left side females) Sishencong Unilateral: SP3, GB 39, K4, BL 40 (China: Alzheimer’s – oxygenates brain cells)
Needles used
Clinic Theater 2 – Summer 2008 http://www.CatsTCMNotes.com
Page 1 of 2
Initials/age/gender Leslie H – follow-up visit Chief Complaint Residual aches, scar tissue adhesions Current Assessment and Related Histories
See Class 2 Notes for previous DX and histories Hip replacement 4 ½ weeks ago. Suture gone, doesn’t need a cane to walk, but gets stiff after sitting. If walk 8-10 blocks then walks much more easily afterwards. Doing PT, water and land Still taking ½ Vicodin daily. Not taking herbs Sitting makes motility much harder! L5 rotated because SI joint problems. Low energy/motivation Sleep diff with pain in pelvic girdle, radiating down right leg. Sleeps 8 ½ hours or so. Takes about an hour of mobility after waking before it feels better. Lower leg edema when sitting. History of this especially in summer. Grumpy in the evening Night heat has turned to night sweat Just finishing period right now. Pain in leg has improved. Psoas muscle gets very tight, pain down quad line, glut med strained by PT exercises. Also, with anterior hip replacement muscles attached to femur get torqued. Lips pale
Pulse Deep and slippery, weak in 1st/3rd positions
Tongue Pale, swollen (some) teethmarks
Pattern Diff Local Qi and Blood Yu (stagnation) - hip Kidney Liver Yin Xu Heart/Kidney Disharmony General Qi and Blood Deficiency
Disease Diagnosis Post surgical pain in right hip
TX principles Move Qi and Blood in the local area Tonify Kidney/Liver Harmonize Heart and Kidney General tonification of Qi and Blood
Points/Therapies Surround the Dragon – hip and scar tissue, GB 34/41 SP 6, LV 8, Ashi, ST 36, BL 62, K6/7, h3, SJ5, DU20 Recommend to use at home: Amber Massage Oil. Very strong, new product made by Spring Wind. Good for bruises, sprain, moves the circulation. Also good for varicose veins. Can use as long as there is no open wound. Once scar has healed, use. Herbs: rebuild energy herbs
Needles used Pain in scar area long after surgery: adhesion or surgical damage to nerve. Needle close to it, but not into it. Can needle directly into ankle sprain swelling.
Clinic Theater 2 – Summer 2008 http://www.CatsTCMNotes.com
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