Female 40 year old patient, had gall bladder removed few months ago, recently started experiencing severe abdominal pain in upper quadrant and center, discomfort and knotted pain that pulls and radiates. Patient unable to sleep due to intense pain. Have anyone experience with this before? I use dan nang xue point, combine wth lv14, gb24, lv3, li4. Anyone have any good remedies such as additional acupuncture points, herbs that can help patient? Thank you!
What is your overall diagnosis along with tongue and pulse? What other symptoms/issues does the patient have? What kind of response have you got to current treatment and why do you feel it is a poor response?
Removing the gall bladder rarely resolves the underlying issues that led to the surgery in the first place so problems afterwards are not uncommon. Sharp pain like this may indicate nerve damage from the surgery - was it laproscopic or conventional? What does her surgeon think is causing the pain?
It was conventional surgery. Tongue: Red, White, Thick & Greasy. Pulse on left is wiry, right side is thready. BP: 138/88, HR: 75. Patient is able to eat, no vomiting, or fever suggesting infection post surgery. She hasn't gone to surgeon due to cost of visiting western doctor. My diagnosis is of qi & blood stagnation and possibly damp-heat in lv & gb. There is some pain relief post treatment, however within the next 4-5 hours after, pain resumes. I suggest her going back to the doctor to do a follow up after surgery to see if there are other issues. But my diagnosis is mostly in lieu of the fact that GB removed the bile builds up in the sphinter walls and after she introduced new food into her diet it started acting up again.
I'm trying to find any herbal supplements in tablet or pill form to help her pain and gb deficiency. In most part, I can prescribe herbs and make decoction for her to take but rather in her state not as convenient. Any other suggestions would be helpful! Thank you!
Herbally I would most likely start with Shu Gan Wan and see if that is helpful for her. Acupuncture wise I would do deep tuina in the ST 11, ST 12 area possibly needling ST 12 if you are using other front points (The st 10, 11, 12 area effects the vagus nerve which controls aspects of the digestive/abdominal functions). Then needle and do tuina afterwards on the huatuo of T7 (abdominal blood vessels), T9 (stomach/liver), T10 (gall bladder/bile duct) - and continue using GB 34, LV 3, ST 21, along with some local points.
Agree surgeon needs to review case. Possible causes could be recurrent incomplete intestinal obstruction due to abdominal surgery causing intestinal adhesions(?blood stagnation) (erect abdominal x-ray will help) or undiagnosed kidney stones. Nerve injury would not take so long to produce symptoms. Hope this helps.
I think all the the above are basically true and there should be further investication. As for our Chinese diagnosis and treatment, I suggest you give us some more and detailed information about her pain, about her stools and urine, and even about her periods. The fact that she had such an opperation should not make us concentrate only on this fact...
Removal of any organ naturally causes further complications which manifest in different forms. In the first place the reason for removal of the gall bladder should be analysed. This appears to be a complex problem, and according to Chakra acupuncture the problem lies in the solar plexus area (Manipura chakra) therefore treating the manipura chakra should give relief, the points are Ren14, Ren17, SP16,
TE3 (triple energizer) GB41 along with this St44 and St36 may be used.