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All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
March, 2010, Vol. 10, Issue 03
By Elaine Stillerman, LMT
The encouraging news about uterine fibroid tumors is that they are almost always benign, especially for women in their 30s and 40s. However, they can cause a multitude of discomforts, including heavy menstrual bleeding (menorrhagia), painful menstruation (dysmenorrhea), backaches, and/or abdominal or pelvic bloating and heaviness.If the fibroids grow large enough to protrude into the pelvic cavity, other pelvic organs may be involved, resulting in urinary frequency and urgency, or constipation. Most fibroids, however, are asymptomatic and many women don't know they have them until they cause a problem or a gynecological exam detects them.
Uterine fibroids are solid, noncancerous tumors made of fibrous and smooth muscle tissues. The preeminence of fibrous tissue gives these tumors their name. Their etiology is unknown, but they seem to be estrogen-dependent because they don't develop before a woman gets her first period and they decrease in size and occurrence after menopause, when estrogen levels are low. Oral contraceptives that contain estrogen compounds, and pregnancy can stimulate the growth of these tumors. (I have seen pregnant women who looked as if they were carrying twins when, in fact, one mass was a fibroid.) There also might be a predisposition based upon genetics.
The sizes of fibroids vary from microscopic to ones that takes up the entire abdominal cavity. Fibroids affect nearly 20 percent of women over the age of 20 and approximately 40 percent of women 35 to 45 years of age. In the United States, Asian-American and African-American women are two to five times more likely than Caucasian women to have them.
There are several different types of uterine fibroid tumors based upon their location within the pelvis:
The diagnosis of fibroids usually is made when the provider palpates a mass during a routine gynecological exam. An ultrasound confirms the diagnosis and determines the type of fibroid.
When a client with a confirmed fibroid comes for a massage, it is important to avoid massaging the abdomen with any deep strokes. If any type of pressure causes pain, the abdominal massage should be stopped. Client positioning also is determined by comfort level. If prone positioning is uncomfortable, position her side-lying with a pillow under her neck and others placed between her knees.
Women have many options to treat uterine fibroids. The most extreme is a hysterectomy to remove the uterus. Only about 10 percent to 20 percent of fibroids require surgery. While it is certainly an effective way to remove the fibroids that have been causing pain, it puts women into an immediate surgical menopause if the ovaries also are removed and, like any surgical procedure, has many risks. An incision is made in the lower abdomen, although it can sometimes be performed vaginally. Recovery from this major surgery can take as long as six weeks.
A less invasive treatment is a procedure known as myomectomy. During this surgery, which may be done as an outpatient procedure depending on the number, size and location of the fibroids, the uterus is left intact. If an abdominal incision is made, the recovery takes as long as a hysterectomy. It may be performed using a laparoscope - lighted surgical tubes inserted near the navel - or through the vagina with a hysteroscope.
Rather than going under the knife, some women opt for embolization of the fibroids. This nonsurgical procedure cuts off the blood supply to the fibroids, which effectively shrinks them, although they don't necessarily disappear. A catheter is inserted through the patient's femoral artery and gently moved to each affected uterine artery. Tiny pellets are inserted through the catheter which blocks the blood supply. A woman must remain in the hospital for a day or two and is able to resume normal activities within the week. Embolization studies have found an 85 percent to 95 percent reduction in fibroid symptoms, while not actually eliminating them.
Prior to undergoing any type of surgery or medical procedure, women might opt for acupuncture, with or without herbal remedies, to treat their fibroids. The first mention of uterine fibroids in traditional Chinese medicine was in the Ling Shu (ca. 100 BC), which described them as "stony tumors." Chinese medicine categorizes fibroid tumors as zheng xia, or "masses in the uterus with a feeling of pain, swelling or fullness, and with bleeding in severe cases." TCM recognizes three patterns of uterine fibroids and treats them accordingly: qi stagnation and blood stasis; yin deficiency and empty-fire blazing; and liver qi stagnation and spleen deficiency. Once the appropriate pattern has been determined, acupuncture and specific herbs are provided. TCM is very effective in reducing or eliminating many types of uterine fibroids, especially if they are caught early.
Pharmaceutical drugs also can be taken to reduce the size of these fibroids and control the bleeding they often cause. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be taken alone or with the addition of progesterone. A synthetic form of gonadotropin-releasing hormone (Lupron) controls the supply of estrogen and progesterone, which causes the fibroids to decrease in size. However, its use is limited because long-term use contributes to osteoporosis and once a woman stops taking Lupron, the fibroids grow back. It is more effective when used prior to a myomectomy to shrink the tumors and make the surgery easier.
A cutting-edge procedure (which is not necessarily covered by insurance) is an MRI-guided ultrasound. High-intensity ultrasound is directed at the fibroids, heating them and breaking down their outer walls. The procedure takes a few hours and the patient has to remain in a prone position in an MRI machine with her head outside of the machine and her abdomen submerged in a pool of water. Risk factors include burns and nerve damage, and the effects of this intensive ultrasound on future pregnancies have not been determined.
Uterine fibroids are not life-threatening growths, but the symptoms they cause can have a major impact on a woman's quality of life. Thankfully, there are many options available today, and women can make their decisions based upon their own needs.
Click here for previous articles by Elaine Stillerman, LMT.
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