Dizziness Case Study - Upper East Side, New York City
Updated: Mar 25, 2020
A female in her late 30's came to our office with sudden onset of dizziness 1 week prior to our appointment. This is the first incident of dizziness with no previous history. She mentioned she was feeling fatigue the day before and fell asleep early that night. She woke up in the middle of the night with the complaint and pain in the right ear. Throughout the next day she felt like she was coming down with a viral infection. She also experienced cold sweating, nausea due to constant dizziness, and fatigue. As a result, she laid in bed for the duration of the day. The patient has a family history of positional vertigo. When questioning her about her stress she reported it wasn't any higher than normal. Other than the nausea her digestion was good. She has had chronic neck pain and stiffness for many years. She also has low blood pressure.
The pulse findings revealed a weak pulse especially in the kidneys. Channel examination revealed blood stasis nodules along the inner shin, nodules on the small intestine channel bilaterally, nodules on the urinary bladder channel, slight nodules on the liver channel in Xing Jian (Liver 2) and Da Chong (Liver 3) regions. There was a slight weakness around Tai Xi (Kidney 3). There were fascial restrictions around Wangu (behind the ear near GB 20), which was worse on the right side. The scalenes bilaterally were tight and there was restriction with right cerivcal rotation. The right shoulder was also raised in comparison with the left side. The tongue was not examined.
Analysis: The pain in the right ear indicates impairments of the Small Intestine sinew channel. The channel binds directly behind the right ear. In addition, nodules were found along the distal portion of the Small Intestine channel. The Urinary Bladder channel also showed impairments in the regions on the foot. In 6 channel confirmation theory, when cold enters the body (in this case viral infections / upper respiratory tract infections), the first channel it affects is the Small intestine and Urinary Bladder. These channels in Chinese Medicine protect the body from cold since they are most superficial channels in the body. The liver channel showed small shallow nodules. In many cases of dizziness the liver is implicated. Because the nodules were shallow in nature, it reflects the acute nature of the illness as opposed to deeper harder nodules which have formed over a longer period of time. The kidney weakness in this case may be reflecting the low blood pressure. In Japanese Meridian therapy it is thought that if a patient feels light headed going from a sitting to a standing position, the kidneys are usually deficient.
Treatment 1: I focused on releasing the sinews of the small intestine and urinary bladder sinews primarily within the neck treating Houxi and Shu Gu (SI-3, UB 65). In addition we used sinew techniques to release the muscles in the neck in particular the scalenes, levator scapula, and the region behind the ear.
Results: The patient reported 90% improvement with 2 episodes of mild dizziness with certain positions. She had 1 episode of waking with ear pain on the right side. These episodes lasted less than 15 seconds. She felt stronger overall and no longer felt like she was catching a cold. During this session I examined her tongue and found that she had internal heat When questioned, she disclosed having night sweats every night and mentioned feeling hot at night even as a child.
Analysis: With this new information I attributed her dizziness due to heat rising. When heat rises in the body it may lead to conditions such as headache, ringing of the ears, dizziness, or feelings of heat in the upper half of the body particularly the neck and face. In Traditional Chinese medicine heat rises because the cooling mechanism of the body is impaired. This occurs especially in middle aged women as they go through perimenopause. When women go through perimenopause, the cooling aspect of the kidney declines (Kidney Yin deficiency), which leads to heat rising (living yang rising) In our patient she had tendencies towards internal heat as a child. When we combine it with low blood pressure it indicates she may have a constitutionally weakened kidney system. The treatment in this case followed the treatment principles of our first session, treating the sinews of the Small Intestine channel, but also included treatment of the kidney and liver channels. In addition, she was given dietary suggestions to reduce heat in her body.
Results & Analysis: Upon follow-up both her chronic night sweats and dizziness have resolved. This is important because the underlying heat is causing the dizziness. If just her dizziness resolved, but the chronic heat sensations remained, it indicates that she may have a flare up of the condition later on. Looking back on this case I could have treated both the kidney and liver in the first session in addition to the small intestine channel; however, I generally choose one channel to treat with each session rather than a "shotgun" approach to determine how the body is actually responding to treatment. In my early years of practice, I often times treated too many things at once, but I find this method makes it difficult to determine how to change the treatments if the patient fails to respond. By treating one channel at a time, I can see how the patient responds to that channel being treated and how to change treatments accordingly.