Case study with Thomas (Nov 13)
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Good Morning Everyone,
Below is the case study for Wednesday. Please be prepared for #1-4 that precede the case study.
1. What other questions might you ask?
2. A diagnosis using Chinese medicine or Western herbal medicine.
3. A treatment strategy based on the diagnosis.
4. An appropriate formula.
Case Study Class 13 November 2024
Gender: female
Age: 77
Height: 5’ 2”
Weight: 135 lbs
Ethnicity: Portuguese American
Occupation: retired
Chief complaint: insomnia and palpitations
Symptoms: recent weight loss, feeling hot all the time, anxiety/nervousness, palpitations, insomnia, difficulty focusing/double vision
Brief history: historically cold and damp constitution, struggle with excessive weight entire life, seesaw dieting (liposuction), both knees have been “replaced”
Diet and Lifestyle: Prepares regular meals for family with a moderately healthy diet; pretty standard with some sugary foods on occasion.
Sleep: not good, wears A CPAP (continuous positive airway pressure) machine (12 years)
Energy: fair to poor, although more lately but short lived
Appetite: good
Stool: 1–2 X/day
Thirst: thirsty, sometimes very thirsty
Urine: 8–10 X day
Basic observations: Patient is in fair health, overweight, doesn’t really exercise
Pulse: rapid
Tongue: red, very little coating, has the appearance of chopped meat
@herbwhisperer Hello, hello! Is there a recording available please?
It’s coming, please be patient!
apologies, just eager.
the link is updated on the calendar Emmie 🙂
Awesome class thank you so much.
I am not sure if I understand what the point of this conversation was. I was always taught here that I need to “treat what I see” based on patterns of Chinese medicine diagnosis… so I saw Yin deficiency fire/heat and thought of Anemarrhena Phellodendron Rehmania formula ( the same as you suggested) with addition of Chamomille, Hops and lemon balm for the sleep. Why would this be considered a malpractice? I thought that herbalists are not to “diagnose or treat a disease”; and the conversation was all about ” how we did not recognize Grave’s disease” instead of finding the correct pattern for the symptoms? I mean Bob Flaws in his book ” The Treatment of Modern Western Medical Diseases” lists a few patterns under Grave’s disease and Yin vacuity heat is one of them… so this approach is not “wrong”. Thank you for your clarification.
Hi Gabriela,
Thank you for this question and a chance to explain in a concise manner what my point was for this class.
First, it’s great that you made the correct pattern diagnosis and settled on the same Chinese medicine formula, well done! And, I think your Western herb suggestions are also good, although I don’t think I would want to give this person hops.
I’m not saying that making the right pattern diagnosis is wrong or malpractice. Instead, I am trying to stress the importance of understanding when there may be something more happening than you should try, at least initially, to treat with herbs and when to refer a client to see a physician. You don’t need to be able to identify every disease, but you should be able to identify some and also be able to recognize when something is potentially serious, even if you don’t fully understand what’s happening. This is both for the client and for you. We, unfortunately, live in a very litigious society (protect yourself) and I believe it is ethically important (protect the client) that you can meet at least a minimum understanding of both normal and patho- physiology. These are things you would need to know if you wanted to become an registered herbalist with the AHG and they are things I strongly believe you should know if you want to be a professional herbalist.
With regards to the book reference, keep in mind that that book was written for professional Chinese medicine practitioners or advanced students who are in a rigorous degree program. It is assumed that they know how to recognize red flags and refer appropriately because it is taught at those schools. It is simply out of the scope of that text to discuss a “red flag,” but all those practitioners and advanced students know how to recognize them, including Graves disease.