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.
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.
In New York City I know of three fibroid centers:
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.
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.
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:
WHAT CAN YOU DO:
WHAT ELSE SHOULD YOU DO:
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:
Now you are on the other side! Things will only get better from here :-)
THE FIRST FEW DAYS:
THE FIRST FEW WEEKS:
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.
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.
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/blog/getting-to-the-core-of-the-issue
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.