Interesting case for sure. Why do they think she has he swelling?

Is it cardiac, lymphatic, or local vascular/tone issues?

Also, out of curiosity have you needled her paravertebrals at all?

I have been able to achieve decreases in abnormal tone with this patient with needling. I have not attempted paravertebral needling due to the presence of a dormant tumor in the region and the reward versus risk doesn't look favorable. I believe her swelling is likely related to decreased muscle tone and activity as well as extra weight. Her lack of proprioception in the extremity and fear are her greatest challenges.