Case Study with Thomas Avery Garran

Responses

1. 

   Thomas April 21, 2025

   Good Morning Everyone,
   Please find Wednesday’s case below:
   Please remember to be prepared with the following:
   1. What other questions might you ask?
   2. A diagnosis using Chinese medicine and/or Western herbal medicine.
   3. A treatment strategy based on the diagnosis.
   4. An appropriate formula.

   Case Study Class 23 April 2025
   Gender: male
   Age: 58
   Height: 182 cm
   Weight: 105 kg
   Ethnicity: Euro/American
   Occupation: university professor
   Chief complaint: palpitations and fatigue
   Symptoms: palpitations, stuffiness in the chest, shortness of breath, easily fatigued, spontaneous sweating, lack of motivation
   Brief history: patient is a tenured professor who has lived a, more or less, standard American lifestyle. Has been feeling most of these symptoms for the last couple years, but the palpitations have gotten much worse recently. Cardiologist says there’s nothing wrong with his heart and recommended regular walks and a heart monitor. Patient wore the heart monitor but no abnormalities were found.
   Diet and Lifestyle: Wife does the cooking but meals are often out of a can or package. Eats out regularly. Drinks 2-3 cups of coffee a day but has started to drink more to help energize him and push through the day. Alcohol 2-4 times a week, rarely more than 1-2 glasses of wine.
   Sleep: fair, but never feels rested
   Energy: low, often tired
   Appetite: OK but not as strong as he thinks it should be
   Stool: 1x/day
   Thirst: nothing significant, drinks several glasses of water per day, but not particularly thirsty
   Urine: 7-10x/day, stream not strong, occasional dribbling
   Basic observations: Patient seems in fair health but very weak and slightly over-weight. Seems a little depressed, but says he’s only really down because he doesn’t seem to have much energy. Facial complexion is pale and eyes seem to lack a strong spirit.
   Pulse: weak/vacuous
   Tongue: pale with a thin white coat

2. 

   Thomas April 23, 2025

   Hi All,
   As we discussed in our last session, we have a guest case today. So, instead of the case I posted on Monday, we will address this case from Donna.

   Gender: Male
   Age: 58
   Height: 177 cm
   Weight: 84 kg
   Ethnicity: Caucasian
   Occupation: Project Engineer (works with plastic molding)
   Chief Complaint: Immediate histamine response after eating. (98% of the time)
   Symptoms: Sneezing, runny nose (usually starts before meal is over), can turn into gagging, frequently followed by diarrhea and stomach pain. Sometimes this is in conjunction with heart palpitations, an increase in blood pressure, and body trembling, especially in the hands. Can have the palpitations, BP increase, and shakes without the stomach issues as well. Does have irregular heart beat at times. (diagnosed through a heart monitor) Will also randomly start sweating for no apparent reason.
   Brief History: Stressful work + home environment for many years, previously diagnosed with Leukemia (treated with monoclonal antibodies – has been in remission for 3 years), gall bladder was removed years ago, had severe acid reflux resulting in a fundoplication in 2018.
   Diet and Lifestyle: Typically eats one meal a day; dinner. Usually cooked at home with good quality meat and vegetables. Uses nicotine (pouches), trying to quit. (previous smoker) May have an occasional beer, but the carbonation can bring on the same histamine response. Difficulty burping since the surgery in 2018. Is active at work, then will walk, work outside, etc. when weather allows.
   Sleep: Ok. Can’t seem to sleep more than 6 hours. Frequently has night sweats and he will wake wet and cold to the point of shivering.
   Energy: Good during the day, dies off in the evening.
   Appetite: Wants to eat, but is hesitant due to feeling bad afterwards.
   Stool: Frequent diarrhea
   Thirst: Often very thirsty, drinks a lot of water.
   Urine: Irregular, some days seems normal, other days can go every 20 minutes, at times it’s difficult to hold.
   Basic Observations: Has overexerted himself for 20+ years. Has made health improvements in the last 5 years. (lost weight, stopped smoking, dealt with past grief, etc) Frustrated with these issues that he has not been able to resolve. Has a tic in his left eye from a bells palsy episode many years ago. Complexion is normal. Holds extra weight only in his belly.
   Pulse: Best guess: floating, firm, strong
   Tongue: No coating to very light white coating, crack in the middle, slightly red tip

   See you later today!