Patient age 64, CC: hot flashes w/ sweating & insomnia for 10 + years. History of trauma and abuse (lots of fears). Currently has an eating disorder (restriction). Feels cold when not hot (this has improved somewhat w/ treatment). R: cun floating, cun and guan hard wiry mid-depth. Very wiry. L: still, all levels. Even chis are wiry. Eyes are red. Skin sallow/dark, and a deficient abdomen. Took XCHT caps for 3 weeks, and got some improvements w/ sleep and sl. less hot flash intensity/freq. Then, I tried a granular CHLGMLT, and she got bad diarrhea. Went back, then, to XCHT caps. Then I switched her to CHLGMLT w/o DH caps in an effort to address fears and further improve sleep. At first, it caused a set back w/ sleep and hot flashes (which had been 20% improved w/ XCHT), but then the pattern went back to how it’d been on XCHT. She has a lot of pain in her thumbs and a history of arthritis for 40+ years in hands and feet. With her “glomus” (she is hungry, but doesn’t allow herself to eat), joint pain, and flaring fire, taxation, what do you recommend? I feel we’ve been on a plateau for couple months.
