I could use some help with this case! Any thoughts and ideas would be very welcome
Here it is:
Sarah - 48 years old teacher and social worker
Chief complaint : very short menstrual cycle
Appearance demeanor : Dresses in a clean but very frumpy way +7. She is bitter and judgmental of others +8. She has recently been asked to leave her job which was no surprise to me but is something she definitely did not see coming +8. She is very organized and is a natural academic +9.
Lifestyle : Sarah is very sedentary. She claims that she exercises daily, but there is no evidence of that in her body morphology. She has a sweet tooth +7 and blames her husband for baking. She spends a lot of time reading and studying (Just finished her PhD) +9
Body morphology : Sarah has gained a considerable amount of weight in the last year. She is puffy +8 and her joints tend to swell +9.
Menses : Sarah has been vacillating between skipping her period for many months and then falling into a zone where her periods come every 3 weeks. When she is not having her period, she has extreme hot flashes +9. Now she is bleeding every 2 weeks. There is some mild clotting & pain +4 with her period. She bleeds for 3-5 days.
Temp : normal and then very hot when the night sweats are in play
Fluids : heavy sweats when there are night sweats. Lots of swelling. Not particularly thirsty
GI : Sarah can be constipated as well as have loose stool. She can feel blocked and stuck in her abdomen. At the moment, her digestion is OK. But she is feels very distended with the onset of her period +8
Skin & Skin : Her hair is thin and dry +8, skin is normal
Resp : history of asthma which when triggered can be severe +8 and chronic sinus infections. She is usually aware of some sort of pressure and blockage in her sinuses that varies in severity. Sinuses are at a +6 now
Sleep : poor when there are night sweats. She is sleeping well now
Emotions : pent up/frustrated +8
Ht: hot flash and heat +9
UB: judgmental and not a lot of warmth towards others +8
GB: pent up/frustrated +8, asthma/trouble breathing
P: academic, librarian energy +9
Liv: not self aware/did not see her job loss coming +8
Lu: Sinus congestion +6, asthma can be +8
Sp: weight gain & puffy +8 lots of swelling +9, sweet tooth
SI: frumpy +7
Kid: mild clotting and cramping with period +4
Treatment = LI +
Sarah felt great during treatment. She fell into a deep sleep on the table. BUT, she emailed the next day saying that she had felt exhausted after the session and had needed to sleep for two hours. She woke up feeling puffy and distended in her abdomen and started bleeding again the next day. Yikes! What did I miss? She is returning for another visit on Fri and I am loath to tonify Spleen with all of the water signs (weight gain, swollen joints etc), sedentary nature, and the sweet tooth, but feel like I must given the negative reaction to tonifying LI.
Moving forward I am considering K+ to consolidate the bleeding. She exhibits some SI exc – not a lot of care in how she dresses and perhaps if there was more love for herself, there would be more love and acceptance of others. But I am a little hesitant because she has some mild clotting and pain with her period. Another thought I had was +St to try and redistribute the water from the inside to the outside, but I am not seeing how this would help her bleeding. SJ+ has also come to mind, but I am worried about the fact that that treatment is a little warming and she so easily moves in to hot flashes and feeling hot. But perhaps since she is not in that zone now the mild warming quality of SJ+ might not push her in that direction and would instead open her up and bit and brighten her glum and taciturn nature. But again, would this treatment slow the amount of bleeding that she is experiencing.
Any insight into this case would be very much appreciated!