Two years after undergoing an abdominal surgery, a long-term patient and friend who has completed 80 Marathons and 20 Ironman triathlons over the course of 15 years challenged me to complete an Ironman triathlon within a year. “How can you treat triathletes if you yourself haven’t raced yet?” he asked jokingly. (A full Ironman triathlon is a tough race. The course consist of a 2.4 mile swim, 112 mile bike and 26.2 mile run).
I have always been very active, but training for a race like this is incredibly challenging. “Let me start with a half one first!” (A half Ironman is a 1.2 mile swim, 56 mile bike and 13.1 mile run). I looked up the pool closest to me, got a swim coach and with his guidance, I was able to build up to the required 1.2 miles within a couple months. However, I noticed two things: one, that I finished my long swim sessions with a dull, nagging, aching pain in my lower back, that just wouldn’t go away. This worried me. How will I continue with a 56 mile bike ride and 13.1 mile run following the swim? Two, that my swim was rather slow, and I had a difficult time improving my speed.
I decided to revisit physical therapy - luckily I did not have to go far to find a great PT :-)
After surgery and other abdominal procedures, it is hard for the brain to find and activate key muscles to maintain a neutral alignment due to trauma to the abdominal muscles and fascia. Surgery can also involve a loss of sensation at or around the scar, inflammation in the abdomen, and pain in the lower back. When the low back experiences pain, research has found that there is an inhibition to the the deep core muscles & lumbar spine stabilizers that support a neutral lumbar alignment. Since this inner cylinder of lumbar stabilizers are turned off, compensation patterns develop. In my case, my posture change resulted in shortened back muscles and hip flexors with an extended abdomen. This posture compressed my lumbar spine and created a sacroiliac dysfunction. Sarah initially worked to undo some of my compensations by improving my sacroiliac movement, decreasing some of the muscle tension, and improving the fascial mobility by using manual techniques to include joint mobilizations, muscle energy, and myofascial release. She then helped me to locate those “lost” muscles from my procedure. After I found those muscles, I was on to establish a neutral spinal alignment. Sarah reported that finding these local stabilizers and neutral alignment were the crucial foundation I needed to successfully progress for my triathlon.
I also needled my scar. Scar formation is a normal response following any injury or surgery; it is the way the body heals injured structures. Scar tissue may involve only the superficial skin, or it may involve the deeper tissues beneath it, including nerves and tendons. Scars can become overly sensitive and can limit motion and function. Needling my scar helped reduce sensitivity and loosen adhesions to deeper structures and allowed me to produce a scar that is smooth and moveable.
Eventually, my therapy progressed from isolated core work. We worked to connect my core to my arms and legs via dynamic upper and lower extremity movements that replicate swimming.
With the help of the combination of therapies my lower back pain resolved within six weeks. I am now able to effectively engage my core and maintain spinal stability. I have better alignment, and as an added bonus, I’ve noticed positive improvements in my swim.
I am a Maternal-Fetal Medicine specialist who takes care of women with high-risk pregnancies with roles and a clinician, educator, and researcher. My practice is academic and evidence-based, which means I practice according to the most recent proven research/data, and I am also a researcher myself. My career and training have been spent reading the latest articles and contributing with my own research to improvements in maternal care. For the most part, my professional life has been greatly influenced by what can be proven and supported with science.
As one can imagine, when an unexpected journey infertility became my reality, my professional AND personal worlds were turned upside down. After two failed embryo transfers with five cycles of IVF and one egg donor cycle, I began to question everything I thought I knew. Although I was 39 when my journey began, I truly believed I would only need one or two cycles of IVF and be pregnant in no time. After two years of infertility treatments, it was clearly evident that ovarian aging was my problem. Not only that, but my uterine lining was never ideal for an embryo transfer. My ovaries and uterine lining were manifesting the effects of my age.
Before my experience with infertility, I was never one to entertain the idea of alternative medicine. I knew that many women going through infertility utilized various forms of alternative therapies, but it was never something I considered. I simply stuck to what I was taught as an OB/GYN and relied on the guidance of my doctors. I do remember, however, going to my infertility appointments and seeing fliers for a local practice for acupuncture and wellness medicine. I admit, I rolled my eyes a few times thinking to myself, “Whatever…this stuff doesn’t work.” For nearly a year and a half of infertility treatments, I simply took what was prescribed for each IVF cycle and trusted in the process.
In October of last year, I had a failed embryo transfer of two donor egg embryos. With this failure, I was broken. I was completely devastated. After multiple heartbreaks and many rides on the emotional roller coaster, I was desperate and confused. I second-guessed every decision I had made up to that point and wondered if I could have done anything differently to change my outcome. After many months of robotically proceeding though infertility treatments, I finally acknowledged that maybe part of the problem was me and how I handled the stress and emotional toll of my infertility journey.
I thought about those acupuncture fliers and decided to see what it was all about. A month later, I had my first visit that ended with my committing to a treatment plan for infertility.
The scientist was trying alternative medicine…
I started acupuncture treatments for stress relief, and I even agreed to taking Chinese herbs for stress relief and improving my uterine lining. I have to admit, I still wasn’t convinced that it would help, but at that point I was willing to try anything. I kept telling myself, “It’s not going to hurt. I have nothing to lose.” I only told a few people that I was doing this therapy; not because I was embarrassed. I just didn’t want to see the eye rolls or have to answer questions about my choice to pursue this option. Especially since my friends and my colleagues knew that I was not one to support such methods of treatment.
I did acupuncture and Chinese herbs from November until March, when my husband and I decided to transfer two more donor egg embryos. During these months of treatment, I can honestly say that my stress level was significantly reduced. Where I really noticed a difference was at work. My job is very fast-paced and high-stress on most days, and I seemed to come home less anxious and mentally drained. My husband noticed a difference as well.
I can’t say I went through treatment with acupuncture and Chinese herbs expecting a miracle, but I did let go and was committed to the process. I really did my part as a patient to make the most of my therapy. I can honestly say I tried.
My embryo transfer was March 11, 2016. Looking back, I was less anxious and stressed about this transfer compared to the two times before. I actually felt more at peace–at peace with whatever outcome was to come my way, good or bad. Although my uterine lining still wasn’t stellar, we proceeded anyway. It was the best it was going to get. This time I felt I was mentally and physically ready.
…and just like that, I was pregnant…with twins.
Do I credit therapy with acupuncture and Chinese herbs for my pregnancy?…I don’t know.
What I do know is that I truly believe it played a significant role in my successful embryo transfer. Looking back, I know my stress level was affecting my lack of success with infertility treatments, my overall mental well-being and my ability to handle the stress of disappointment. My choice to let go and put my scientist brain in time-out proved to be a good choice and a positive experience for me. I admit I was stubborn and close-minded about the potential benefits of alternative medicine.
When asked about acupuncture or herbal therapy, I no longer say, “It’s not going to hurt. You have nothing to lose.” I now recommend without hesitation that anyone going through infertility treatments consider using acupuncture and/or herbal therapy during their journey.
The scientist was wrong, and I have two babies on the way to prove it
by Shannon M. Clark, MD, founder of Babies After 35 and Due At 42