Notes:  Follow up visit:
8/10/19
History: Has been doing well. No seizures- taking herbs with no problem. PULSES-deep wiry and slighlty thin, fast, weaker on the left  TONGUE- deep red-lavender, no significant coating. 

TCVM: Heat pattern (yin def?) with underlying blood def and h/o internal wind
Treatment Plan and Recommendations: 
GV14, BL17/18, SP10, LI4, LIV 3, BL40
Rec re-fill herbs (CHJLGMLT, Tian ma)
Can add in 10 g DG when they return for additional blood support. Will send with them now. Also rec probiotic addition as well. 
Re-check in Oct unless things shift significantly or there is any worsening of signs before. 

DG addition seemed find. Refilled blend 100g CHJLGMLT/10g Tian ma/10g Dang gui on 9/18.

Update: Had a seizure 9/22/19 6am lasted just a couple minutes at most. It took around 5 minutes for his vision to return and probably 40 minutes for him to completely recover. He paced for most of the 40 minutes.

Recent changes: Gave treats with grains (just a few), switched to chicken based food vs. pork which he had been on since first visit. The dang gui addition in late August- maybe exacerbated a damp issue that I missed?

Diet is largely raw

Notes:  Seemed improved clinically (less itching, less reverse sneezing, better energy and jsut seems to feel better) after shifted herbs 10/22 to WMW 50g, QYT 50g and 5 g TM 1/2 tsp po BID plus a low dose 1/4 tsp BID of LDXGT.

As a recap p had grand mal seizure in late June this year. I placed him on CHJLGMLT + TM and he did well until end of Sept when he had another singe seizure event. He has mostly blood def signs and TB obstruciton signs up to them , so I added in DG in (in the interval between first seizure event and second seizure event) in hopes of better addressing blood def safely, but then he has his second seizure and I felt like I needed to change things. See prev notes to get a sense of the pattern at his visits. I put him on TMGTY since the blood def seemed to dominate the pattern, but he then started having a seizure close to monthly. So last month Oct 22, I changed gears and tried WMW/QYT with a little TM plus a low dose of the LDZGT. He imporved clinically but had another seizure at the 4ish week mark (after my treatment with him yesterday of course- augh). Yesterday: TONGUE- lavender, dark pink, slightly moist, no coating PULSES- toned, very slighlty thin, wiry, med depth and fast. Treated GV20 (t) no big shift, GV14 (t), BL17 (t) slightly improved pulse (s) did not seem to improve pulse, BL18 (t) strengthened pulse, GB34 (moderated/evened pulse), ST36 (t)
The seizure that ocurred this morning was different. It was at 3:15am vs the usual 6ish am time. He did (and always does) vomit prior to the seizure, but it was way shorted and he didn't lose his vision which he typically does. I recommended that they stop the LDXGT since his damp signs have seemingly resolved and maybe it is excacerbaing the blood def. Given taht they live 2 hours away and were just here yesterday, I can't easily re-check him, Also given how much GB34 improved his pulse and that his seizuyre interval seemed to be longer on the CHJLGMLT blend, I was going to have them 1) Continue the WMW/QYT/TM blend they have since it really has seemed to help him but 2) Take out the LDXGT and add in The CHJLGMLT + DG+TM blend they have on hand at 1/4 tsp po BID. I with is was CHJLGMLT alone- not sure if the other 2 herb additions will make a big difference (the ratio was 100g CHJLGMLT + 10g TM + 10 g DG). Am I totally off base here? Do yo think I could have sparked that seizure with my treatment yesterday?

Thank you so much as always for your advice and support!
Kelly

Diet is largely raw

Acupuncture points were stimulated