The patient who is allergic to Saam

[cassiopeia]

I have a patient whom I’ve written about before. She had a negative reaction to SI+ (bloating, energy draining out of her uterus) and was much better after the KD+ counterbalance.

When the metaphor becomes embodied

I did SI+ on a well-groomed self-loving 46yo woman who had dizzy symptoms and loose stools worse before the start of menses. also she had pain around SI 9-10. She settled well on the table, but a week later I got this email: i wanted to let you know that since my treatment with you, I’ve pretty consistently had this feeling that my uterus is sucking up all of my energy. I have felt sluggish and drained. So… sounds like a sort of delayed adverse reaction, and she needs KD+?

I’ve done 3 more Saam treatments on her since then: HT+ and P+ for fear/anxiety/insomnia, which had so-so results; so I reverted to Kiiko style which she’s had positive response to for year.
Last week her most standout aspects were what I thought to be clear SP excess: recent weight gain; diarrhea from starchy foods, bored, unmotivated, rumination, fatigue

I did LI+ and checked in with her very carefully. she had good coloring and reported that she was relaxed.

The day after the treatment she had a headache, diarrhea, severe bloating, and a tingling/numbness in her feet.

I will obviously try to see her ASAP to do SP+. But I am very confused.

Her adverse reactions seem like SP excess, and yet is a result of the LI+ treatment. (unlike the incorrect SI+ before, which are symptoms I’d expect from too much SI energy) Does anyone have similar experience with incorrect treatment? Is it just that if it’s not what the body needs, ANYTHING can happen? Or the person’s weakness is amplified, even if the treatment should have tampered down that specific weakness?

On a related note, are there some people who just aren’t suited for Saam treatments?

I would appreciate some insight or guidance… thank you.

[George_Mandler]

Hi Fang,

@cassiopeia

I did LI+ and checked in with her very carefully. she had good coloring and reported that she was relaxed. The day after the treatment she had a headache, diarrhea, severe bloating, and a tingling/numbness in her feet.

I’d ask what they did after the treatment, then next day etc. When did the headache and bloating start. How did they feel the night of the treatment. Did they get any other treatments.
If you think that supplementing LI+ fits her - damp/damp, craves sweets, swelling, water etc and given her treatment reaction there is something missing. This is certainly confounding to me.

@cassiopeia

Her adverse reactions seem like SP excess, and yet is a result of the LI+ treatment.

I have seen this in one patient where it seemed opposite to reactions. But I chalk that up to me missing something. Recently I found out a patient was seeing a chiropractor and am sure that was making things go sideways.

@cassiopeia

On a related note, are there some people who just aren’t suited for Saam treatments?

Maybe people that have a vasovagal response to being pricked.

Depending on the amount of time between treatments and where her symptoms are at I would not jump to supplementing SP+. If her symptoms resolve and she still says Spleen excess to you I would be cautious with counterbalancing and choose another channel or back to Kiiko.

It sounds like this woman is a bit of a chameleon in terms of deciphering her underlying presentation. Are you using the fatter > 28 gauge needles for Sa’am vs the 34 or 36 for Kiiko style? Although I cannot see needle size explaining opposite reaction only no reaction.

Sorry I cannot be more helpful.

[cassiopeia]

Hi George, thanks for your response.

@George_Mandler

I have seen this in one patient where it seemed opposite to reactions. But I chalk that up to me missing something.

This is really at the heart of it. She clearly had an adverse reaction that started the night after treatment. There wasn’t any other interference that made it happen.

I think the problem is my observation/understanding of the patient, not that she had an “opposite response.” I had her come in a few days ago and did SP+. When the needles were in, she told me that during the initial LI+ tx, her R jaw began to tense up. Then with the SP+ the jaw tension melted. And her stomach bloating softened. She clearly had an adverse reaction that was a result of me not understanding what her system needed.

In retrospect, maybe some things I should have noted to steer away from LI+:

1. She’s not super productive b/c she’s so tired, but she is productive TO HER MAXIMUM CAPACITY. So level productivity is a sort of “value judgement” on my part that I need to be aware of.
2. she has a rigid nature, very good at following orders and carrying out the exact treatment plan/diet that we outline. Even if she craves sweets, it’s just the craving, not the giving in to excessive consumption.

I’m going to refrain from saying “clinic is hard,” and pivot to “isn’t clinic interesting?”

[Adina_Kletzel]

@cassiopeia

The day after the treatment she had a headache, diarrhea, severe bloating, and a tingling/numbness in her feet.

I think Toby and Kristin emphasized a whole lot that an adverse reaction (as unpleasant as it is) is the most reliable clinical information that we have so it seems to me that counterbalancing with SP+ was the right decision.
I have a 75 year old patient with numerous health issues who consistently reacted to many Saam treatments with fatigue and diarrhea for two days and then felt better after that.
I also thought that I just couldn’t do Saam on her. I did not want to give up on Saam though because when it did work for her it worked really well.
What I did was I went down to .25x30 needles for her so that the response wouldn’t be so immediate and strong. I also only used Saam when I was at least 90% that I was choosing the right Saam treatment for her.
These changes seem to help. She feels good after most of the Saam treatments and sees a reduction in her symptoms.
I use the .35x30 needles for my other patients but the thinner needles seem to slow down the strength of the treatment which helps her body absorb the changes slower and not break out into a strong reaction.
Her symptoms are healing at a slower pace but she is making progress and having fewer reactions to the treatments.
I want to emphasize that this is a unique case and it was something that I thought was worth a try after working with this patient for a year and carefully observing her reactions. I am not recommending anything I am just sharing this experience.

[mariayung]

Thank you for sharing this case. Unfortunately for us and the patient, we learn so much when things go wrong. These are some questions I am wondering about. What is her physique? Does she have dry skin or oily skin? does she typically have loose stool or only when she eats starchy foods? Does she have a lot of wrinkles?

[cassiopeia]

@Adina_Kletzel

the thinner needles seem to slow down the strength of the treatment which helps her body absorb the changes slower and not break out into a strong reaction.

Hi Adina, I appreciate your sharing your experience and observations. I’m still trying to wrap my head around something like the strength or speed of of an acupuncture treatment. I use thin seirins for my super needle-sensitive patients, and sometimes for SI2 and UB66. I don’t have enough experience yet to know if doing that is slowing down or weakening the treatment. But if I hurt someone so much that they’re hesitant to come back, then that would not be a good treatment either. We’ll just have to keep accumulating the clinic data.