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Thank you all so much for the thoughtful suggestions and recommendations. I didn’t realize I had turned off my notifications for this forum so I am just now discovering these responses. I truly appreciate everything you all shared.
I would love to provide more details in order to hear your perspectives on how best to support this patient as she tries to conceive again. Here is a general description of the patient currently:
LMP: 5/22/22, 6 weeks post D&E. Reason for D&E was the fetus had DX of Down’s syndrome.
MENSES: Bright red, minimal clots, minimal cramps (day 1), no breast tenderness, bled for 5 days with 3 days of spotting (total of 8 days), moderate flow. Had 1 day of migraine which is her “normal”. Migraine pain starts occipital and moves to temples and behind eyes as the day progresses.
OVULATION: Using Clear Blue OPK, only has blinking smiling face, never solid, cervical mucus is creamy and not egg white this month
ABDOMEN: Tension and tenderness above umbilicus (Spleen) and left of umbilicus (Liver), slightly soft and hollow under umbilicus (KID) Patient reports not to feel any abdominal pain or discomfort in general
PULSE: (L ) Scattered cun, thin & deep Guan, thin Chi (R) Slight slippery Guan, overall stronger than left side
TONGUE: Pale pink, puffy, wet, horizontal cracks in center, dusky purple in center, minimal Sublingual veins, dip in the back of the tongue
BM: Goes everyday in the A.M., stool is formed but “raggedy” frayed edges
EMOTIONS: Feels more balanced overall, still grieving and having a hard time not taking on the grief of the patients she sees as well. Feels “heavy” with the stories of her patients. Patients partner is an elementary school administrator and the recent shootings have caused a high level of anxiety and grief for them both.
OBSERVATIONS: Spider veins distal to head of fibula on left leg and along ST channel of right thigh , this is new for the patient. Eyes have good “shen” patient appears in good spirits but does present as low energy despite being able to exercise a lot and maintain a full time Acupuncture practice.
TTC: In a same sex partnership and patient has undergone IUI this month.
DX: Mix of excess and deficiency, overall it seems there is Spleen Qi Xu with blood xu leading to blood stasis
Thank you all again for any and all insights! I would love feedback about my diagnosis and some formulas to consider for this patient.