I will try to be brief. I have a patient who early in the year had a hernia repair surgery done in which she was intubated. Since that surgery she has had persistent, non productive, spasm like cough in which she can feel her throat spasm, feels a upward spasm feeling of the diaphram, and can not control it. Pressure on her chest (ex: a strong hug), exercise, and quickly inhaling all make this cough worse. Upon seeing an ENT she was told her vagus nerve was possibly overstimulated due to the intubation. She feels that the diaphragm is playing a part as well. My question is of TCM diagnoses. I believe there is a LU component, but is there also a rebellious qi situation? I am struggling to come to a strong diagnosis to help with point selection and formula creation. Any ideas?
To start it sounds like you are possibly trying to make a diagnosis that corresponds to these specific symptoms rather than basing it on what you are seeing and then working in a relationship to these symptoms. I would recommend that you first, base the bulk of your treatment approach on what your findings are in tongue/pulse/palpatory diagnosis, etc. and then look for any relationships with that and these symptoms. Also keep in mind that there may not be a relationship, not everything, particularly when it is from trauma, has a deeper “root” cause. But, even with trauma the more you work with what the body needs on a deeper level the better the outcome in most cases.
I would suggest, then, that you first forget her entire story, look at what you see from just a TCM diagnostic approach, come to a general diagnosis, then tailor what you would do for her ever so slightly to accommodate the resultant symptoms from the trauma.