Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
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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