Qiological Community

Wheezing after +SJ treatment

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.

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.

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.

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.

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

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)

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?)

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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.

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.
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.

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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?

Saam practice demands excellent note taking.

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.

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.

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.

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