High Blood Pressure Case

[Andrea Anderson]

I have a patient with a number of chief complaints that I will list out below. Recently, symptoms have been improving, but at the same time,the patient discovered he has high blood pressure – around 160/90. His whole life he has had a reading of 110/70 including at his physical a year ago. Then 6 weeks ago he had his first high reading, and it continues to stay at the level. I am wanting to know if the herbs have anything to do with this change. I am wondering if clearing some of the conformations is emphasizing one of the deeper conformations that would have high blood pressure as a symptom? Patient first came to me complaining of very dry nasal passages, low energy, sleepy while driving, blurry and cloudy vision worse with fatigue, intermittent head pressure. BMs normal, but has frequent urination. Pulses were very deep and overall wiry, so I jumped in to some shaoyin, jueyin and yang anchoring formulas with no success. So then I thought better of my approach and decided to harmonize. I started off with a XXT+GLXB approach because there was a bilateral dong and guans were wiry R>L. Not a lot of change symptomatically, but the pulse became more distinct so I kept going. As the pulse became more distinct, I could make out the following: L: r/u, overall deep; 1 wiry, 2 wiry, dong 1/2, 3 tightR: r/u, overall deep; 1. tight, 2. wiry, sl. slippery, dong 1/2, 3. wiry. The chi positions started to make me think of blood stasis, so I felt the abdomen: mostly soft/weak with lateral umbilical pulsations and a possible oketsu on R side. I prescribed GCXXT+GLXB + GZFLW (-RS/DZ and I went with MDP instead of HQn). Patient came back with great energy, no longer sleepy while driving, nasal passages less dry, but eyes still blurry/foggy. The urination was still frequent. I refilled the formula and asked patient to keep monitoring the blood pressure. Because of the frequent urination, pulsations and rollup bilateral ,I am considering to increase the fuling to 24g to see if that will help mitigate the blood pressure. And I wonder what will show itself after the stasis is cleared…possibly ZWT?

[brianvaitkus]

Since he’s feeling better, and his diastolic BP is less than 100, I’d feel less worried about the BP – it’s a symptom that I’ve found doesn’t do too well to base my herbal rx’s off anyhow, and I measure most of my pts BP. Once we find a good formula, it generally goes down slowly, and takes time. That said, sometimes a person seems to be doing great on all subjective points without a lot of BP improvement. As long as their BP related symptoms are not headaches or nosebleeds or tinnitus, I personally don’t worry about it too much if they’re improving and not in stroke territory. (In this case I might worry if the headpressure were to worsen). That doesn’t answer the Fuling at 24 question specifically – but maybe wait for a few rounds at 12? 🙂

[laurieayres]

adam-s-moyes

[Andrea Anderson]

Hi Laurie. Thank you for your response – it really helped me rethink this case. I ended up giving my patient CHGZGJT-THF+BX,GG. Patient felt equally good on this formula as the XXT formulas. Nose continues to feel less dry. BP is coming down. Energy continues to be significantly better. Sleep mostly good, but a little bit of waking sometimes. There is still eye sensitivity: patient says the eyes get dry and foggy, and there is a sense of film over his eyes especially when looking at screens. Pulse now looks like: L r/u, cun deeper, slippery, guan middepth wiry, dong 1/2, chi deep wiry. R cun deep tight, guan big wiry, maybe dong, chi deep and not wiry. Overall pulse feels less deep. I can see the CHGZGJT pattern. I see less of the GG since the R cun is less big and more deep, tight. I am thinking I will give CHGZGJT+FL and JH.

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