intolerance to temperature changes

[Guest guest]

Dear List

I have a couple of px currently who have poor temperature control. One is the

px with vaginismus who I posted about earlier this year (details below). This

px gives talks as part of her job and gets violently hot when she does so. Her

body has difficulty adjusting to temperature changes going from one room to

another and sitting under the aircon at work. I wondered if this is a 'Liver,

Liver, Liver' thing or dysregulated hypothalamus/pituitary/adrenal issue - or

both as they're likely to be regulated.

Re the vaginismus, we're not getting far with this because of poor compliance.

The px's very long hours working days, a couple of serious horse-riding

accidents and a whirlwind social diary have dominated her life over the last few

months. She has hardly a spare minute to take herbal medicines, adjust her diet

or do the hypnotherapy exercise her excellent hypnotherapist has given her. I'm

about to refer her to an EFT therapist hopefully to tackle both the work

stress/fear of public speaking and the vaginismus. But would be interested to

have your thoughts over the temperature regulation.

many thanks Katharine

> > > I'd like to ask your thoughts on the following, especially the

> > > constitutional, aspects.

> > >

> > > I should say that the px is 29, very happy including in her

> > > otherwise close relationship of several years. She struck me as

> > > animate and outgoing but anxious to please. Slightly driving of

> > > herself/sense of not enough time (and in fact the vaginal dilators,

> > > which she's currently laid aside, do take 1 1/2 hours each time

> > > before they have sex). She has a very high metabolic rate and loses

> > > weight quickly when anxious even if eating the same food as usual.

> > >

> > > Libido has always been a problem (this is the px's 2nd

> > > relationship). But the suspected vaginismus started near the

> > > beginning of the first, and low libido is associated with

> > > vaginismus (ie as a side-effect). The sense of arousal goes off

> > > very quickly. And px has to be really, really relaxed to feel aroused.

> > >

> > > Px has had physical examination which excluded physical causes. Is

> > > also trying hypnotherapy now to help relax.

> > >

> > > She says she has quite a heavy vaginal discharge, which is normal

> > > for her and changes as she would expect with her cycle. She gets

> > > thrush a lot eg once a month - itchy and sore, uses Canesten. A

> > > swab early last year was negative. Condoms didn't help - they felt

> > > 'scrapy'.

> > >

> > > Background: asthma as a child till 12 and again in last 5 yrs since

> > > returning to London. Neonatal jaundice.

> > > Father has neurological/muscular problem which she doesn't know the

> > > details of. Mother low thyroid.

> > >

> > > A glass alcohol socially makes her so tired she could go to bed.

> > > Diet sounds quite high GI esp tea and chocolate. But she loves

> > > cooking and cooks every night. I've given a diet diary as I feel

> > > avoiding stimulants and low GI with EFAs and lots fresh fruit and

> > > vegs is going to be very important.

> > >

> > > Px feels extremes of temperature very quickly. eg after walking

> > > quickly in the cold and coming into a hot environment she gets what

> > > sounds like a mild hot flush across back and torso with mild

> > > sweating. Gets cold hands and feet eg sitting under air con/in a

> > > cold breeze.

> > >

> > > Lots of colds and flus.

> > >

> > > BM daily - very very occasionally misses a day.

> > > cystitis once 3 yrs ago

> > > sleeps very well.

> > >

> > > I'm still getting to grips with the differential diagnosis re the

> > > other forms of dyspareunia and am not giving her a prescription

> > > till I've seen her again in 2 weeks' time.

> > >

> > > I should say that she has also been referred by her GP to a

> > > gynaecologist for the first time.

> > >

> > > Thanks for your input. All thoughts welcome.

> > >

> > > best wishes, Katharine

[Guest guest]

Hello ,

One of my clients also had issues with lack of temp

control. I put it down to 'Summer Heat' sensitivity from TCM, I used Qing Hao

(Artemesia annua) in large doses along with her usual prescription which seemed

to help. The slight temp increase we get here in summer was enough to bring out

excessive heat symptoms. Much better on using Qing Hao. Not sure if your case is

similar, seems possibly a lot of emotional stuff, have you tried this aspect?

Lorraine

Lorraine Hodgkinson MNIMH MRCHM

HERBS AND HELPERS

6, Butts Fold, Cockermouth,

Cumbria, CA13 9HY. UK.

Tel: +44 (0) 1900 826392

Mobile: 07761 489838 (O2)

www.herbalmedicineuk.com

> Dear List

>

> I have a couple of px currently who have poor temperature control. One is the

px with vaginismus who I posted about earlier this year (details below). This px

gives talks as part of her job and gets violently hot when she does so. Her body

has difficulty adjusting to temperature changes going from one room to another

and sitting under the aircon at work. I wondered if this is a 'Liver, Liver,

Liver' thing or dysregulated hypothalamus/pituitary/adrenal issue - or both as

they're likely to be regulated.

>

> Re the vaginismus, we're not getting far with this because of poor compliance.

The px's very long hours working days, a couple of serious horse-riding

accidents and a whirlwind social diary have dominated her life over the last few

months. She has hardly a spare minute to take herbal medicines, adjust her diet

or do the hypnotherapy exercise her excellent hypnotherapist has given her. I'm

about to refer her to an EFT therapist hopefully to tackle both the work

stress/fear of public speaking and the vaginismus. But would be interested to

have your thoughts over the temperature regulation.

>

> many thanks Katharine

>

> > > > I'd like to ask your thoughts on the following, especially the

> > > > constitutional, aspects.

> > > >

> > > > I should say that the px is 29, very happy including in her

> > > > otherwise close relationship of several years. She struck me as

> > > > animate and outgoing but anxious to please. Slightly driving of

> > > > herself/sense of not enough time (and in fact the vaginal dilators,

> > > > which she's currently laid aside, do take 1 1/2 hours each time

> > > > before they have sex). She has a very high metabolic rate and loses

> > > > weight quickly when anxious even if eating the same food as usual.

> > > >

> > > > Libido has always been a problem (this is the px's 2nd

> > > > relationship). But the suspected vaginismus started near the

> > > > beginning of the first, and low libido is associated with

> > > > vaginismus (ie as a side-effect). The sense of arousal goes off

> > > > very quickly. And px has to be really, really relaxed to feel aroused.

> > > >

> > > > Px has had physical examination which excluded physical causes. Is

> > > > also trying hypnotherapy now to help relax.

> > > >

> > > > She says she has quite a heavy vaginal discharge, which is normal

> > > > for her and changes as she would expect with her cycle. She gets

> > > > thrush a lot eg once a month - itchy and sore, uses Canesten. A

> > > > swab early last year was negative. Condoms didn't help - they felt

> > > > 'scrapy'.

> > > >

> > > > Background: asthma as a child till 12 and again in last 5 yrs since

> > > > returning to London. Neonatal jaundice.

> > > > Father has neurological/muscular problem which she doesn't know the

> > > > details of. Mother low thyroid.

> > > >

> > > > A glass alcohol socially makes her so tired she could go to bed.

> > > > Diet sounds quite high GI esp tea and chocolate. But she loves

> > > > cooking and cooks every night. I've given a diet diary as I feel

> > > > avoiding stimulants and low GI with EFAs and lots fresh fruit and

> > > > vegs is going to be very important.

> > > >

> > > > Px feels extremes of temperature very quickly. eg after walking

> > > > quickly in the cold and coming into a hot environment she gets what

> > > > sounds like a mild hot flush across back and torso with mild

> > > > sweating. Gets cold hands and feet eg sitting under air con/in a

> > > > cold breeze.

> > > >

> > > > Lots of colds and flus.

> > > >

> > > > BM daily - very very occasionally misses a day.

> > > > cystitis once 3 yrs ago

> > > > sleeps very well.

> > > >

> > > > I'm still getting to grips with the differential diagnosis re the

> > > > other forms of dyspareunia and am not giving her a prescription

> > > > till I've seen her again in 2 weeks' time.

> > > >

> > > > I should say that she has also been referred by her GP to a

> > > > gynaecologist for the first time.

> > > >

> > > > Thanks for your input. All thoughts welcome.

> > > >

> > > > best wishes, Katharine

>

>

[Guest guest]

Hi Katharine

Sounds to me like it's time to put your foot down. I know you asked about temp

regulation but from time to time we get people who basically just are not

serious about sorting out their health.

It may seem strange when we are all trained to be caring - and generally are by

nature anyway, but every so often we just have to say to people quite directly

and forcefully - either your are serious about dealing with your health problem

or you are not and there is little point in you seeing me if you don't take my

advice - it is a waste of my time and your money.

What I read in your message is

poor compliance

very long hours working days (happy to go on doing that and that's her choice)

a couple of serious horse-riding accidents (finds time to go riding)

whirlwind social diary have dominated her life over the last few months (time

to have a social life)

She has hardly a spare minute to take herbal medicines, (but hasn't got the time

to take herbal medicine - last time I took any it took me all of about 20

seconds to pour it and drink it)

Sorry to be blunt, Katharine, but you're being too nice.

Do you really need a patient like this? Does it do your reputation any good?

You really only want patients who will be ambassadors for you. People who treat

you and your practice with respect.

To be honest, Katharine, I've only done that once in 16 years and it was after

Steward gave me similar advice - it was really liberating. I told a

patient she was wasting my time and her money - I think she was so shocked at

being confronted with reality that she apologised profusely and started being 'a

good patient'. She even got better.

I know it's difficult when it seems patients are thin on the ground - but just

recruit good patients. Ones who realise it's a privilege to see you.

If you can't find it in you to be blunt (and it took me ages to work up to it)

then just tell her you don't have an appointment available until mid October as

you are fully booked (privilege) but you will let her know if a cancellation

comes up if she likes.

Plus you can't dispense any further repeat prescriptions without a consultation.

Good luck

[Guest guest]

Thanks for your thoughts, .

Thanks too, Lorraine. It's a year round problem, actually with this px, less

pronounced in summer.

I'd value more input on the physiological side of this, as px are often

temperature-labile. This px says she 'feels as if she's on fire' when she's

giving a talk. Is this hypothalamus/pituitary/thyroid/adrenal dysregulation?

Is there a TCM explanation? I recall a recent posting from Zoe saying she finds

when adrenals are exhausted, the thyroid compensates, and this would seem to fit

here.

Katharine

>

> Hi Katharine

>

> Sounds to me like it's time to put your foot down. I know you asked about temp

regulation but from time to time we get people who basically just are not

serious about sorting out their health.

> It may seem strange when we are all trained to be caring - and generally are

by nature anyway, but every so often we just have to say to people quite

directly and forcefully - either your are serious about dealing with your health

problem or you are not and there is little point in you seeing me if you don't

take my advice - it is a waste of my time and your money.

>

> What I read in your message is

>

> poor compliance

>

> very long hours working days (happy to go on doing that and that's her

choice)

> a couple of serious horse-riding accidents (finds time to go riding)

> whirlwind social diary have dominated her life over the last few months (time

to have a social life)

> She has hardly a spare minute to take herbal medicines, (but hasn't got the

time to take herbal medicine - last time I took any it took me all of about 20

seconds to pour it and drink it)

>

> Sorry to be blunt, Katharine, but you're being too nice.

> Do you really need a patient like this? Does it do your reputation any good?

> You really only want patients who will be ambassadors for you. People who

treat you and your practice with respect.

>

> To be honest, Katharine, I've only done that once in 16 years and it was after

Steward gave me similar advice - it was really liberating. I told a

patient she was wasting my time and her money - I think she was so shocked at

being confronted with reality that she apologised profusely and started being 'a

good patient'. She even got better.

>

> I know it's difficult when it seems patients are thin on the ground - but just

recruit good patients. Ones who realise it's a privilege to see you.

>

> If you can't find it in you to be blunt (and it took me ages to work up to it)

then just tell her you don't have an appointment available until mid October as

you are fully booked (privilege) but you will let her know if a cancellation

comes up if she likes.

> Plus you can't dispense any further repeat prescriptions without a

consultation.

>

> Good luck

>

>

[Guest guest]

I would go for the adrenals.

J Fidler, MCPP, (RH) AHG

Herbalist

________________________________

To: ukherbal-list

Sent: Sun, August 1, 2010 7:00:25 AM

Subject: Re: intolerance to temperature changes

Thanks for your thoughts, .

Thanks too, Lorraine. It's a year round problem, actually with this px, less

pronounced in summer.

I'd value more input on the physiological side of this, as px are often

temperature-labile. This px says she 'feels as if she's on fire' when she's

giving a talk. Is this hypothalamus/pituitary/thyroid/adrenal dysregulation?

Is there a TCM explanation? I recall a recent posting from Zoe saying she finds

when adrenals are exhausted, the thyroid compensates, and this would seem to fit

here.

Katharine

>

> Hi Katharine

>

> Sounds to me like it's time to put your foot down. I know you asked about temp

>regulation but from time to time we get people who basically just are not

>serious about sorting out their health.

>

> It may seem strange when we are all trained to be caring - and generally are

by

>nature anyway, but every so often we just have to say to people quite directly

>and forcefully - either your are serious about dealing with your health problem

>or you are not and there is little point in you seeing me if you don't take my

>advice - it is a waste of my time and your money.

>

>

> What I read in your message is

>

> poor compliance

>

> very long hours working days (happy to go on doing that and that's her

>choice)

> a couple of serious horse-riding accidents (finds time to go riding)

> whirlwind social diary have dominated her life over the last few months (time

>to have a social life)

>

> She has hardly a spare minute to take herbal medicines, (but hasn't got the

>time to take herbal medicine - last time I took any it took me all of about 20

>seconds to pour it and drink it)

>

> Sorry to be blunt, Katharine, but you're being too nice.

> Do you really need a patient like this? Does it do your reputation any good?

> You really only want patients who will be ambassadors for you. People who

treat

>you and your practice with respect.

>

> To be honest, Katharine, I've only done that once in 16 years and it was after

> Steward gave me similar advice - it was really liberating. I told a

>patient she was wasting my time and her money - I think she was so shocked at

>being confronted with reality that she apologised profusely and started being

'a

>good patient'. She even got better.

>

>

> I know it's difficult when it seems patients are thin on the ground - but just

>recruit good patients. Ones who realise it's a privilege to see you.

>

>

> If you can't find it in you to be blunt (and it took me ages to work up to it)

>then just tell her you don't have an appointment available until mid October as

>you are fully booked (privilege) but you will let her know if a cancellation

>comes up if she likes.

>

> Plus you can't dispense any further repeat prescriptions without a

>consultation.

>

> Good luck

>

>

[Guest guest]

Hello All,

Firstly, thank you for the reminder that we all need to hear and

for the clear and practical advice, and why it needs to be carried out.

I feel the compliance issue really frustrating...

Re: the Px - systemic Candida could cause the problem as can

psychosomatic conditioning. Perhaps this person just needs to stop

running long enough to allow space into which she can relax. The

symptoms could simply be the 'I am not coping' warning signs.

If money is not an issue and you want some good metabolic testing done,

then Genova provide a good service to check endocrine and Candida status

- http://www.gdx.uk.net/index.php

Good luck,

Benn

--

Benn Abdy- MCPP

Medical Herbalist

0 or 07957 65 88 90