Category: Myomectomy

HOLISTIC VIEW ON UTERINE FIBROIDS

3/8/2019

There are plenty of resources out there that talk about what fibroids are in detail, how they are detected and various methods of treating and removing them. It is important to become familiar with your condition so you can be properly advised. Understand the basics of your condition. Know your body. Take responsibility for your health. Research your options before deciding on any treatment.
This post provides information on acupuncture, dietary remedies & exercise therapy in treatments of fibroids and pre- and post- surgery procedures of fibroid removal.

WHAT ARE FIBROIDS???
Uterine fibroids (leiomyoma, myoma) are non-cancerous (benign) growths of the muscle wall of the uterus.

All fibroids begin as a growth somewhere within the uterine muscular wall. The symptoms (heavy bleeding, pressure, pelvic pain, abdominal swelling, infertility, increased urinary frequency, you name it) caused by fibroids depend on where they grow in the uterine wall (outside or inside the uterus), how big they are (the size can range from a peanut to that of a basketball) and how many you have (some women only have one, while others have 28 or even more).

Although most women will have fibroids during their lifetime, only a small number of them will ever need treatment. The vast majority are unaware of them until their doctor feels them at the time of a routine pelvic exam.

Your doctor may perform tests such as trans-vaginal ultrasound and magnetic resolution imaging (MRI) to determine the size and location of your fibroids. These tests do not hurt.

For more information read:

CONVENTIONAL WESTERN TREATMENTS:
Fibroids often do not require treatment, but when they are problematic they are treated surgically or with medication. At present, watchful waiting, medications, a progesterone-releasing IUD, endometrial ablation, hysteroscopic myomectomy, laparoscopic myomectomy, abdominal myomectomy, uterine artery embolization and focused ultrasound are all available in addition to hysterectomy for treatment.

MRI of a subserosal fibroid

In New York City I know of three fibroid centers:

I believe most bigger cities have fibroid centers, visit the nearest one or choose a doctor with clinical focus on fibroids.

CAN ACUPUNCTURE HELP WITH FIBROIDS?
In Eastern Medicine fibroids are related to stagnation. The menstrual cycle is disrupted and with it the normal reproductive cycle is negatively affected as well. Promoting the circulation of blood in the pelvic area is essential. There is often an emotional element to fibroids which are explored and addressed during the treatments.

It can take a minimum of three menstrual cycles to regulate a woman's period. When uterine fibroids are the main issue, the treatment may take considerably longer. Each patient is differentiated and treated in terms of specific qualities of the menstrual period and their symptoms.

Acupuncture influences the hormonal pathways to regulate hormonal imbalances, increase blood flow to the uterus. Acupuncture may help reduce the size of fibroids, prevent it from growing larger or provide symptom relief.
It is more effective when combined with dietary & exercise therapy and other important lifestyle changes.

WATCHFUL WAITING:
If you have minor symptoms, which are not bothersome, then no medical intervention may be necessary and “watchful waiting” may be your best option. The strategy for non-surgical treatment is to regulate your cycle, eliminate all symptoms you may have and possibly reduce the size of the fibroid with the help of acupuncture, exercise and dietary therapy.

ACUPUNCTURE:

A regular, pain-free period is the first indicator of good general health in women according to Traditional Chinese Medicine. Whether your symptoms are pain, irregular cycle, cramps, bloating, headaches, irritability or stress, acupuncture is very helpful. Through regulating your cycle and your body you may enjoy a sense of well being and health the whole month through.

EXERCISE:

if you are overweight, lose a few pounds
frequent the gym on a regular basis

DIET:

cut out sugars, fried, fast and processed foods
adopting a low fat, high fiber, mostly vegetarian diet may be helpful
avoid hormonally treated meat and dairy
eat organic produce if you can
soy and soy products are a controversial issue. Some say avoid it while other vegan patients noted their fibroids actually grew faster when they cut back on soy

WHAT IF YOU NEED SURGERY:
I believe that uterine myomas up to the size of an egg may be treated successfully with acupuncture and dietary therapy to reduce the size to a comfortable level, alleviate common symptoms and in some cases to eliminate them.
Larger ones, or the ones that don't respond to alternative therapy are better treated with surgery though pre and post treatments with acupuncture and dietary changes may reduce the complications of surgery.

For more information on how acupuncture may help pre- and post-op read:

fibroid, size of a 17 weeks fetus. picture taken the night before surgery

WHAT CAN YOU DO:
ACUPUNCTURE:

You may be confused or angry why this is happening to you or you may have anxiety about your upcoming procedure. In these cases acupuncture can help you find balance.
Certain herbs help reduce bleeding during surgery. These herbs do not interfere with Western sedative drugs so they can be used even the day of your surgery. Read about them here

EXERCISE:

The better shape you are in the easier you will bounce back after surgery.
You also want to strengthen and tone your core and pelvic floor muscles to help minimize atrophy and deconditioning.
You will need strong arms to help getting out of bed and strong legs getting into the tub.

DIET:

If you haven't yet, change your diet. Eat well and begin to increase your protein intake a few weeks before surgery so that your body has a reserve for recovery.

*Some medications, supplements and foods need to be stopped before the surgery. The exact instructions your doctor wants you to follow will be given to you at your pre-op appointment*
WHAT ELSE SHOULD YOU DO:

Select the date for the surgery. You will need 3 - 6 weeks off for recovery, depending on the type of work you do.
Call your insurance company and have your own insurance verified and make sure everything will be covered. Get the persons name you talked to and get a reference number for the call.
Talk with your family/friends, you will need someone to get you from the hospital and look after you for a couple of days minimum.
Clean your house, do your laundry and make sure you have lots of nourishing food on hand. Pre make and freeze your meals. You will be able to move around to get to the kitchen but you won't be able to cook a thanksgiving meal or do anything strenuous.
Make a big pot of bone broth to sip on instead of water. There's a proverb from South America that says a good broth can revive the dead.
Forget the skinny jeans, buy some granny panties, ego aside go for comfort. Buy two size bigger than your usual. Same for sweats and pants. This is not the time for fashion show, your belly will be swollen for a while.

If you are completely terrified it is worth talking to a psychologist.

Do not cut your nails, pick your pimples or shave for 72 hours prior as it increases the risk of infection. If hair needs to be removed the hospital staff will clip it for you.

THE NIGHT BEFORE YOUR SURGERY:
Usually you are told to stop eating and drinking 8 hours before your scheduled time / stop foods and drinks at midnight. This means no morning coffee, chewing gum, candy. Have a "last meal" and live it up, but eat nothing after midnight. This is essential for your safety. General anesthesia relaxes the muscles in your digestive tract and airways. With an empty stomach the risk of inhaling stomach contents into the lungs is reduced. Your surgery may be cancelled if the fasting instructions are not followed so take this seriously!

THE DAY OF YOUR SURGERY:

Make sure you have your ID and your insurance card. If you have a "Living Will" bring a copy with you.
Wear loose, comfortable clothing and shoes that you can slip on and off like flats or flip-flops.
If you are on your cycle wear a pad. No tampon.
If you develop a cold or sore throat or any other illness within two days of your procedure, call your surgeon's office.

You are extremely stressed and that's understandable. The nurses that greet you in the hospital are very nice and understanding. You will be assigned a room and given a gown to change into. You will be asked to remove everything. All jewelry, piercing, contact lenses, wigs and nail polish (the nail bed is one of the best places to detect low oxygen levels in your body during surgery).
The nurse will confirm things that she has already been told, like your name and the procedure you are having. She will also take your blood pressure, temperature and pulse. They do a pregnancy test too. Next you will be introduced to the gynecologic resident, he is assisting your surgeon and the anesthesiologist, the person you are scared the most of, "what if he doesn't give enough juice and I will wake up during surgery? You just never know"
Next you are entered the operating room which is always freezing cold, but you will be given a comfy blanket immediately. You are inserted your IV and have your surgical site marked. This is required by the hospital lawyers, funny you might think since you only have one uterus. During the surgery you are secured with a safety belt and your arms are placed on an arm board to prevent you from moving around. You are also given inflatable compression boots to massage your legs in order to prevent the forming of blood clots.
The operating bed is very narrow and uncomfortable but this doesn't really matter because once the mask approaches your face you are completely out in about 3 seconds.

POST SURGERY:
Now you are on the other side! Things will only get better from here :-)

THE FIRST FEW DAYS:

Don't let your pain medication wear off completely. The doctors will pump some major painkillers into your IV and incision area so you won't feel a lot of pain. Don't assume that you won't need the super potent painkillers you are being offered. Once the medicine wears off and the pain catches up to you it is really hard to get back on top of it again. It'll also make it much harder to get up and walk around.
Usually you are allowed to shower one or two days after your surgery. You will be given a cover for your incision so it wouldn't get wet. Be quick, get in, use luke warm water and get out. Warm water may cause you to faint, especially when you are already light headed from the painkillers. Usually you are cleared for bathing in two weeks.

morning after surgery

ACUPUNCTURE:

If your hospital has acupuncturists on staff ask for a treatment. Certain points on the ear can help the body recover more quickly from the anesthesia, improve appetite and decrease nausea.
"The breathing of the true human comes through the heels". Various breathing techniques help to open up your lungs & pelvic floor and also help promote bowel movement.
Certain herbal formulas are used to help regenerate the tissues, stop the bleeding, bring down inflammation and help reducing reliance of pain killers.

EXERCISE:

Although you just want to sleep all day and the focus is on rest and recovery, make sure you slowly walk around as soon as it is advised to prevent blood clots, adhesions and promote bowel movement. It also helps with the gas pains tremendously! Definitely a task getting out of bed but nothing a little time and effort can't fix.
Take your time, you don’t have to go far, but the more you walk and move, the better & quicker you recover.

DIET:

You are just returned from la la land. The focus is on SURVIVAL. The pain. The grogginess. The nausea. The sore throat caused by the tube that helped you breathe while you were under.
A couple of cups of peppermint tea / chewing gum works wonders for the terrible gas pains if you had a lap or open myomectomy.
This is a fresh start! Have you wanted to give up coffee or fried foods? Or even give up smoking? Use this as a starting point.

THE FIRST FEW WEEKS:

Get ScarAway Silicone Scar Sheets, It helps to soften and diminish the appearance of scars. Also don't be afraid of gently massaging your belly and around the scar.

Cover your scar with a tape if you go on the sun. Any type of medical tape will do. Make sure to pick a type that does not cause skin sensitivity. The sun may cause the scar to hyper pigment or turn darker than the surrounding skin. Keep your scars away from the sun for at least one year following your surgery.

Post operative yeast infection is a common occurrence. This is caused by the antibiotics given during and after the surgical procedure. Yogurt with live cultures may help prevent yeast infection from recurring.

You may have numbness and itchiness around the incision. This is normal. Another new normal to get used to for a while. BUT call the hospital if you have a fever greater than 100.4F. If your incision is red, painful, bleeding or draining. If you have persistent nausea or vomiting. If you are unable to urinate. If you have chest pain or difficulty breathing. If your pain is getting worse.
That little pouch (swelling) above the incision is will gradually disappear MONTHS after surgery. Your lower belly will also be swollen and tender to touch for a LONG TIME.
You won't be able to drive while you are on your pain medications. Even after you may be restricted because you may not be able to make sudden movements due to discomforts.
The first post op visit is around 2-3 weeks after the surgery. If you are healing accordingly a lot of physical restrictions will be lifted.
If all goes well you will be able resume all normal activities in six weeks. But since we all have different bodies, circumstances, and surgical procedures (different sized incisions, removal techniques, location of tumors, etc) everyone's healing time is different. It's nice to read a reference and gauge what's "normal", but please always consult with your doctor; don't just assume you are healed.

1 week post op

ACUPUNCTURE:

Acupuncture's role here is promoting healing, decreasing post-operative pain & soreness, reducing medication related side effects and normalization of bowel functions.
It will also speed up your recovery by nourishing the surgical site with increased blood flow.
Manual therapy helps breaking up adhesions and reducing your bruises.

EXERCISE:

Move around as much as you are able to. Don't overdo it, let fatigue be your guide, but don't lay in bed all day.
No lifting anything heavier than a gallon of milk for at least 4 weeks.
No bending over.
Nothing in the vagina for 6 weeks.

DIET:

Advance your diet slowly. Hydrate with the bone broth / chicken soup instead of water. Once this is tolerated advance to regular food. Have plenty of protein to help replenish your stores from the blood loss, zinc to help with wound healing and turmeric to help with the inflammation.

1016gr -> 2 pounds!

WILL YOUR FIBROID GROW BACK?
Once fibroids are removed they do not grow back, however new ones may form. As it was said before there is no scientific explanation why we develop them, so unfortunately there are no guidelines for prevention. This does not mean that diet and lifestyle modifications are a waste. Most of the time these recommendations will improve your health overall, with the side benefit of possibly helping you preventing the recurrence of these monsters.

ACUPUNCTURE:
In Eastern Medicine the uterus is the energy center for relationships, emotions and creative ideas. Fibroids energetically represent our creativity that was never birthed. Focus on YOURSELF and have the courage to live a life true to yourself, not the life others expect of you.
Needling motor points of your core will help you activating your muscles and reconnect them with the brain and nervous system post surgery.

EXERCISE:
Exercises are the key to successful rehabilitation. Gradually increase your exercise time and intensity. Schedule physical therapy appointments to ensure you are on the right track, that you effectively engage your core, maintain spinal stability and have better body alignment. Read the importance of proper recovery http://www.annahajosi.com/weak-core-acupuncture.html

DIET:
Here is my opinion on what a healthy diet is:
We know more about foods then we have ever known before, yet we are more confused than ever about what to eat. Our tendency to moralize and divide foods into good and bad categories also adds to our confusion and leads us into unhealthy eating habits. Nothing is a either good or bad & no particular diet is correct for everyone. It is always a question of how much is eaten and who is eating it in addition to how it is balanced against other foods that are being consumed.

1. Be wary of restrictive diets that eliminate entire food categories, such as starches and carbs or fats or proteins. Often all you accomplish is the creation of a nutritional imbalance and cravings, cravings, cravings.

2. The basis of proper nutrition is whole, natural foods that are as fresh as possible. Whether or not you eat any animal products, it’s a good idea to try to add some new species, and not just new foods, to your diet - that is, new kinds of plants, animals, and fungi. The greater the diversity of species you eat, the more likely you are to cover all your nutritional bases.

3. Eat a diverse and balanced diet such as soups, meats, vegetables, fruits, nuts. Coke, hamburger and fries are not a meal.
They contain chemical additives with which the human body has not been long acquainted. "Don’t eat anything your great-grandmother wouldn’t recognize as food"

4. Do not over snack. Have half a sandwich or two eggs over a sugar loaded "health" bar.

5. Avoid products with word endings “lite”, “low-fat”, or ‘nonfat” in their names: removing the fat from foods doesn’t necessarily make them nonfattening. Carbs can also increase unwanted weight gain, specifically with many low and nonfat foods manufacturers add extra sugars to make up for the loss of flavor. You are better off eating the real thing in moderation than bingeing on “lite” food products packed with sugars and salt.

6. Avoid foods that are pretending to be something they are not: Imitation butter or nonfat cream cheese that contains neither cream nor cheese requires an extreme degree of processing, such products should be avoided. The same goes to soy-based mock meats & artificial sweeteners.

7. Balance hot and cold foods. Hot and cold refer not only to the temperature of a food, but to an intrinsic energy that the food itself contains. Hot natured foods like lamb, ginger, cinnamon are warming and stimulating (how do you feel after a very spicy meal?). Cold foods like raw vegetables, salads, iced drinks act to cool, calm, sedate and relax but in excess they will slow down your digestion (think of a frozen river in winter) and are harder to digest. They are high in nutrients, however if you are experiencing digestive issues you may want to consider how much you are consuming (i.e. salads or iced coffee).

8. Nutritional supplements: We know that people who take supplements are generally healthier than the rest of us, and we also know that in controlled studies most of the supplements they take don’t appear to be effective. How can this be? Supplement takers are healthy for reasons that have nothing to do with the pills. They’re typically more health conscious, better educated, and more affluent. They are also more likely to exercise and eat whole grains. So to the extent you can, be the kind of person who would take supplements, and then save your money.
The best way to get enough vitamins and minerals is through eating a wide variety of whole foods. However, extra nutrition can be particularly important for individuals taking certain medications, are injured or engaged in activities or are older than fifty.
If you do take vitamins, make sure you take them in reasonable dosages and don't take excessive amounts. Some vitamins and minerals cannot be excreted easily. There is evidence that excess intake of calcium can lead to hypertension, kidney stones and calcifications throughout the body and that too much zinc can contribute to high levels of cholesterol, while excessive amounts of iron in adults may contribute to heart disease. Since even the experts cannot agree on dosage levels beyond the minimum daily requirements, it is safer to take lower dosages of vitamins and minerals. Remember, they are supplements, not replacements for proper nutrition. Also, make sure your vitamins and minerals are derived from natural rather than synthetic sources.

9. Do not overfast: In general, Chinese Medicine does not advocate fasting or frequent detoxification regimes because these practices tend to deplete the body’s vital energy. Fasting stresses the body, forcing it to operate on stored nutrients. Just eat healthy and exercise and you won't ever have to detox.

10. Eat when you are hungry, not when you are bored. Don’t eat out of boredom, for entertainment, to comfort or reward yourself. Try to be aware of why you are eating, and ask yourself if you are really hungry. “If you are not hungry enough to eat an apple, then you are not hungry”. Food is a costly antidepressant.

11. Eat slowly: not just so you’ll be more likely to know when to stop. Eat slowly enough to savor your food, you’ll need less of it to feel satisfied. And remember, it can take twenty minutes before your brain gets the word that your belly is full.

12. Buy smaller portions, plates and glasses: the bigger the portion, the more you will eat.
What is a proper portion? One adage says you should never eat a portion of animal protein bigger than your fist. Another says that you should eat no more food at a meal than would fit into the bowl formed by your hands when cupped together.

13. Do all your eating at a table. No, a desk is not a table. If you eat while you are working or while watching TV or driving you will eat mindlessly - and as a result eat a lot more than you would if you were eating at a table, paying attention to what you are doing.

14. Don't obsess about what you eat. Eat a variety of foods and enjoy them as much as possible. It is not always possible to eat perfectly all the time, but try whenever you can.

Whether you are monitoring your condition, you are on your journey of fibroid removal, needing help with your diet, or simply seeking pain and stress relief, please feel free to visit my office and see for yourself: how acupuncture can greatly improve your life.

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HOLISTIC VIEW ON UTERINE FIBROIDS

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