(254) Case: Menopause after chemotherapy

[HB KIM]

CASE REPORT: Menopause after chemotherapy by BY Choi, L.Ac.

A 46 year old lawyer, female, was diagnosed with breast cancer in January of 2007.  Chemotherapy was started right away, as well as other prescription medications.  After these treatments she started to hot flashes and night sweats as if menopause was setting in, even though she still had regular menstruation.  That August, she tried a course of acupuncture treatments which helped her symptoms to be 70% better.  Wanting to get back to work, she abandoned the treatments and went back to a full work schedule.  Her condition regressed completely.  Her MD then referred her to an acupuncturist since acupuncture had helped her previously.  When she came to me in January of 2008, she was severely fatigued with night sweats and hot flashes 20 times per day.  In addition, another small tumor had been discovered and she had a surgery scheduled for mid February.  She requested herbal treatments in conjunction with the acupuncture since her symptoms had regressed after her previous acupuncture treatments.

I had no confidence in treating menopause cases, but this patient really needed me.  I had only treated about 20 menopause cases.  I usually used Chai Hu Long Gu Mu Li Tang, as one of my university professors had recommended, but had never been satisfied with the results.  None of my patients ever experienced dramatic improvement, and one of them even returned the formula because the minerals were causing digestive problems.   
I knew I had to re-evaluate my approach to menopause cases and come up with a new strategy.

So I called HB to discuss the case.  He pointed out to me that her symptoms were a perfect match to Heart-Kidney miscommunication: palpitations, night sweats, insomnia, restless sleep, low grade fever, knee pain, constipation, tongue and pulse showing yin deficiency.  Clearly the best formula choice was Tian Wang Bu Xin Dan.

It was then I realized: my mind had somehow fallen into the pattern of equivocating one formula with one disease.  How had this happened?  I had been practicing successfully for more than eight years, and in every other situation I identified the pattern and treated the pattern accordingly.  There is no one formula for menopause, or any other disease.  HB's advice reminded me of this core concept, and made me realized that even the best of us can fall into that trap if we don't guard against it.

So, I gave my menopause patient Tian Wan Bu Xin Dan + Zhi Mu + Huang Bai.  After just three days of the formula, she reported a dramatic improvement overall, especially her hot flashes and energy level.  I instructed the patient to stop taking the formula by February 10th since her surgery was the 15th and I didn't want to risk any drug interaction.  When she visited my clinic on the 13th, she told me she hadn't stopped taking the formula because it was helping her so much.  Luckily her surgery on the 15th was very successful.  All of the tumor tissue was able to be removed, and there was no drug interaction.  She came back to the clinic for more formula on the 20th and on the 27th.  By that time, her hot flashes had reduced to only twice per day, with almost no more night sweats, and no more fatigue.  After one more batch of formula, her symptoms were gone.