Case: Endometriosis, Severe Nausea
This is a complete treatment notes for KD. It is important to understand the Kampo treatment is a process of layinrom western g out plan from initial hypothesis and keep taking feedback to refine or adjust the original plan to reach the best result. Only through the nuances the Kampo can be possibly understood and distinguished from western scientific point of view.
Treatment duration: 2018.10 - 2019.11
KD’s case represents a large number of cases I see in my practice: She suffered from a terrible problem, but western medicine offers neither effective solutions nor any sensible explanation of what happens and why. The reason is Western medicine’s approach is narrow and lacks a big picture view of the health, which is fine when performing very specific surgeries, but is far from sufficient for dealing with disease. That is the gap that Kampo medicine can fill due to its holistic perspective of health and time tested empirical experience through thousands of years of practice.
KD, 26 years old young lady came into my office on Oct 22, 2018. She was referred to me by her co-worker, who was seeing me for a strange post-miscarriage heavy bleeding episode.
KD looks tired and frustrated. Eight months ago, she suddenly felt extremely nauseous and didn’t go away. After a full circle of appointments and different medical examinations, finally her gynecologist found some mild signs of Endometriosis and prescribed her birth control pill, which KD didn’t know at that time.
After she was on the pills, the nausea disappeared, everything seemed good. However, the same problem came back again 3 month after and it was even worse than before. She barely can eat and started to lose weight, she wasn’t overweight. Her doctors couldn’t figure out what was going on and she also found out the drugs she was taking are birth control pills. Since then, she has lost 20 pounds, She has no energy, the condition makes it very difficult with her job. She was desperate to try anything to get her health back.
Her condition was devastated but strange at the same time because there are no medical findings indicating what is wrong other than the mild endometriosis with failure of the treatment. I did a thorough assessment. She was tired all day, very little appetite, even if she forced herself to eat, she still couldn’t because the nausea would physically stop her from swallowing the food. She had severe headaches which was new to her. A worth noting sign is she often had the sensation of hot flush to her face when she felt the nausea. Her last period was heavy with lots of blood clots.
Her tongue was dark red, the veins on the bottom of the tongue were deep red and the two hypoglossal veins were purple and distended. The tongue is a very unique diagnostic tool. The color and the veins indicate her general blood circulation was stagnated or hyper-coagulative in a more specific term. Also there is a high degree of systemic inflammation taking place in her body. I also did the abdominal palpation, another unique diagnostic feature of KM. She felt nauseous and discomfort when I pressed on the certain areas of her abdomen. A strong and clear pulsation was felt along the left side of umbilicus, which indicates the ANS (Autonomic Nervous System) dysfunction.
Based on my findings, I composed a week of Kampo herbal medicine with the combination of three class formulas (click on this page for the details of the KM formulas that I usually use). This herbal orchestra addressed the blood stagnation/coagulation problem, inflammation and ANS dysfunction;also worked on her weakened digestive system due to the prolonged nutrientive deprivation.
She came back a week after. The overall nausea had gone better; her appetite and energy had increased; she didn’t feel the strong hot flash either. She got her period a few days after the first visit, she still felt quite a bit of nauseous and headaches before the period though. The period was heavy with lots of clots.
As usual, I did the physical examination. Her tongue and abdomen was about the same with slight improvement. Since the overall situation was improved. I kept the same formulas for another two weeks.
On Nov 8, I received a text from KD, “Hi Dalu, I’m not sure this is normal course of the herbs but this week I felt like I took a step back and was feeling similar symptoms as before the herbs since Saturday, nausea, really bad fatigue and headache.” I told her healing takes time, and it is normal to have some ups and downs as the process goes along.
Nov 12 Follow up. KD finished the herbs two days prior this visit, and she felt much better. She looks very happy, still had a few hot flushes, she can eat more, less headaches and nausea. Her tongue was still dard red and veins are purple. There are also some teeth marks on the side of the tongue, indicates fluid retention or water metabolism problem. There were tenderness in the lower abdomen with pressure. The pulsation is still palpable besides the umbilicus.
Based on the new information, I tweaked the formulas with more focus on regulating autonomic nerve system and water metabolism.
This formula continued for 5 weeks. The main complaint, the severe nausea in the afternoon has mostly gone, headache reduced at least 50%. She eat more and started to gain weight back, better energy, last period was good, not heavy However, As the major symptoms went away, a once secondary symptom became primary, the motion sickness, made it difficult for her to travel in the car or flight. Her work requires her to travel quite often, she has to schedule extra times when travelling because after the flight, she has to rest a day before she can go work. In some cases she had to cancel some business trips. She can not ride in the car for more than half an hour before she feels sick.
So from 2018 Christmas on, we started to focus on the car sickness, the progress was slow in the beginning until April we finally figured out a combination that really improved the situation, At June the car sickness was very mild. Her period became a little off regularity, with some discomfort from ovulation to menstruation, which is considered something that needs to be treated in Chinese Medicine. From May 2018 to Mar 2019, we started to gradually cut the dosage to reduce the financial burden, and focus on regulating menstruation and overall health.
Nov 06, 2019 Last period cycle was 28 days, which is perfect. The volume was normal with no clots. No other discomfort associated with period. Her weight was back to normal. Nausea and motion sickness no longer bother her. When I performed palpation on her abdomen, the lower abdominal tenderness was rarely felt, the pulsation can only be felt if I push deep into the abdominal wall. Her tongue was not as dark red as before, hypoglossal vein was much less distended and less purplish. After over a year of continued treatment, at this point, we both agreed that we finally reached our initial objectives: bringing her health back to normal.
Generally speaking, western medicine thinks hormonal imbalance is the cause of most gynecological conditions. That was why Karen’s gynecologist prescribed her birth control pills even though they don’t know exactly what caused her nausea. That is not how Kampo Medicine looks at human physiology and phathology. In her case, three key factors: blood stagnation, inflammation and autonomic nerve system function were identified through my assessments based on KM, those factors are what I believe played central roles in her health. KM is a precise medicine, each formula and its ingredients has specific use and action on the different aspects of the problem. This is the wisdom we should learn from the traditions.more cases