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
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
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.
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.
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.
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.