@leobierman you posed this question on FB but I'm reposting and answering here.
Regarding eye puffiness the first thing to determine is whether there is heat involved or not. Regarding swelling of the face, heat is less of a factor.
The two Chinese diseases "Swollen Eyes/Eyelids" (mu bao zhong zhang) and "Swollen Face" (mian fu) cover both of these.
Possible patterns consist of:
- Spleen Qi Vacuity
- Spleen/Kidney Vacuity (Spleen Qi/KD Yang)
- Lung Qi Vacuity
These are the main ones which explain the presence of both diseases, especially in the mornings with no heat signs present.
The fundamental pathomechanisms are dampness accumulation due to the Spleen and/or Kidney Yang failing to warm, transport and transform water-fluids resulting in dampness accumulation in the face and/or eyes. Lung Qi vacuity (typically, not always) the result of Spleen Qi vacuity, is the organ that governs the upper water passageways as well as the down-bearing of fluids, if there is Lung Qi vacuity, this can result in water-fluids collecting and accumulating in the eyes and face. Hope this helps get your mind stirring around these things 🙂
References: Sionneau, Philippe Treatment of Disease in Chinese Medicine vols. 1 & 2. Blue Poppy Press. Boulder, CO. 2018.
Vol. 1 pages: 131-133 and Vol.2 pages: 25-31
Here's a snippet from the workshop I held last weekend at the Successful Practice Summit.
The difference between Burnout vs. Overwhelm and why it's important to distinguish the two.
Setting Patient Expectations: Menstrual Disorders
I'm enjoying making these little videos and I hope they are helpful to you in your clinics. Today I thought it would be fun to take a case and show how I set expectations with the patient involving 2 menstrual complaints along with several other additional complaints. To be fair, there are some things that can't be taught in school but even in our time in clinic at school, the teachers never did what I do in this video. I suspect they simply didn't have the experience and/or confidence to put themselves out there. Understand that setting expectations is not giving guarantees, it's creating confidence in you as a practitioner in the eyes of your patients. Here's another thing, it's ok to screw up and to be wrong. There's no way around that except through so get over that shit right away. Borrow from your mentors until you get the wins under your belt.
Things I Wish They Taught in TCM School: Part One
Setting Patient Expectations
I am doing a small series addressing some things that I wish I knew as a new practitioner and hoping that the advice I offer will save some time and suffering for any 1st and 2nd year practitioners to help build your confidence with your patients.
I hope this resonates with you.
All posts, new content and case help is over on the new platform. We will no longer be responding to posts here.
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@chrisvolesky
Hello
I would appreciate some input in approaching this patient.
Male 58 years old, with the diagnosis of type 2 Diabetes mellitus, diagnosed 15 years ago and over the course of his condition he developed diabetic retinopathy for what he is getting local injections; also developed bilateral carpal tunnel syndrome and according to his physician due to of that, atrophy of the left thenar eminence.
His main complains when he came to our office were lack of endurance on his lower extremities, very weak knees and legs preventing him from doing much of his regular and normal activities and needing to walk with a cane; very poor balance and a marked, recalcitrant bilateral pitting edema from his ankles up to mid legs. Also, a weak lower back that feels sore and cold, sometimes liking urine and low libido, no drive at all.
During his visits he has always denied any digestive issues, but a mild constipation with most BM daily, but sometimes every other day, with no changes in the ...
@Michael_Peluso @chrisvolesky
Please can I have some help with this case.
Gentleman has been suffering anal pain since a haemorroidectomy 2 years ago. Pain is like a migraine (intense ache & heaviness) that is worse for passing a stool, sitting, standing, through the day.
There is also a constant feeling of heat and tenesmus (feeling of needing to pass a stool). These are not pleasant but can handle compared to the pain. He has had physiology testing which shows all functioning. Coccyx and ganglion nerve blocks had no effect.
He has had two previous heart attacks and is on medication for these. (Ace inhibitor, beta blocker, statin & aspirin)
Pulse is wiry with irregular irregular beat.
He is very cold … included hand photo. He has no spider veins in the sacral area or on the back/ BL40 area. Only around ankles .. photos included.
I have treated with acupuncture, no bleeding, with no change in 4 weeks.
Can you help with herbal suggestions?
Thanks
