Guest guest Posted February 15, 2009 Report Share Posted February 15, 2009 In the student clinic last week I had a success case that is rather baffling. A 32 year old woman, otherwise healthy, came in saying she had a fibroid for 6 months that only grows larger. She has had 2 previous rounds of fibroids over the past 5 years which she had removed when they got to the size of oranges. The uterus hasn't been compromised so far but she was worried about the future - she has not kids but wants to have them. I palpated a fairly hard oblong mass about 8cm and 4 cm on the right side around St. 28 and a smaller one around St. 30. She hasn't gotten this round of fibroids evaluated in any way. So I had the intern make up a raw modified slightly Gui Zhi Fu Ling Wan with the usual disclaimer that it could take a long time and no guarantees. Yesterday, a week later, she came in and the mass was unpalpable. Couldn't find it. There was the smaller one, 3cm by 3cm still palpable around St. 30. She was now on her period which was much lighter than usual. Any ideas what the mechanism could have been here? I was very specific about asking about endometreosis (none). We urged her to get assessed again. Doug Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2009 Report Share Posted February 15, 2009 Doug - The fairly large palpable mass on the right side which dispersed so easily after the Gui Zhi Fu Ling Wan, may have been a large functional ovarian cyst. These will sometimes disperse very quickly, especially with herbal formula, once the menses start. As you know, Kiiko actually refers to Stomach 28 as the Ovary Reflex. Also, the smaller mass near Stomach 30 is actually closer to the area you would typically palpate a myoma/fibroid - which are typically appreciated manually nearer to the pubic bone where the uterus is. Many times, the fibroids that are palpable are subserosal (i.e. outside of the uterus), rather than submucosal (inside the uterus), and therefore not as much of an issue as it relates to fertility. One last thing: This patient should really consider changing her diet if she is concerned about preserving her fertility. If she continues to have myomectomies, she runs the risk of developing intra-uterine scar tissue which could inhibit implantation of an embryo. She should eliminate most dairy, animal products and sweets from her diet (I know that you know all of this, so excuse the redundancy) and she should probably take a nutritional supplement like DIM (made from extracts of cruciferous vegetables like broccoli) in order to assist the metabolic pathways associated with Estrogen Metabolism. Also, a sonohysterogram (saline ultrasound) might be warranted at some time in order to rule out intra-uterine scar tissue related to her previous myomectomies. Hope this helps, Ray Rubio, D.A.O.M. (FABORM) President/CEO ABORM Chair: Reproductive Medicine Specialty/Yo San University DAOM Program Westlake Complementary Medicine 910 Hampshire Road, Suite A Westlake Village, CA 91361 Phone: (805) 497-1335 Fax: (805) 497-1336 email: rtoo On Feb 15, 2009, at 1:16 PM, wrote: > In the student clinic last week I had a success case that is rather > baffling. A 32 year old woman, otherwise healthy, came in saying she > had a fibroid for 6 months that only grows larger. She has had 2 > previous rounds of fibroids over the past 5 years which she had > removed when they got to the size of oranges. The uterus hasn't been > compromised so far but she was worried about the future - she has not > kids but wants to have them. > > I palpated a fairly hard oblong mass about 8cm and 4 cm on the right > side around St. 28 and a smaller one around St. 30. She hasn't gotten > this round of fibroids evaluated in any way. > > So I had the intern make up a raw modified slightly Gui Zhi Fu Ling > Wan with the usual disclaimer that it could take a long time and no > guarantees. > > Yesterday, a week later, she came in and the mass was unpalpable. > Couldn't find it. There was the smaller one, 3cm by 3cm still palpable > around St. 30. She was now on her period which was much lighter than > usual. > > Any ideas what the mechanism could have been here? I was very specific > about asking about endometreosis (none). > We urged her to get assessed again. > Doug > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2009 Report Share Posted February 15, 2009 Thanks, Ray. You are probably right about the cyst although she swears that in 6 months it never changed with her periods before. Perhaps the formula with some Yi Mu Cao gave it that kick it needed. Doug , Ray Rubio <RTOO wrote: > > Doug - > > The fairly large palpable mass on the right side which dispersed so > easily after the Gui Zhi Fu Ling Wan, may have been a large functional > ovarian cyst. These will sometimes disperse very quickly, especially > with herbal formula, once the menses start. As you know, Kiiko > actually refers to Stomach 28 as the Ovary Reflex. > > Also, the smaller mass near Stomach 30 is actually closer to the area > you would typically palpate a myoma/fibroid - which are typically > appreciated manually nearer to the pubic bone where the uterus is. > Many times, the fibroids that are palpable are subserosal (i.e. > outside of the uterus), rather than submucosal (inside the uterus), > and therefore not as much of an issue as it relates to fertility. > > One last thing: This patient should really consider changing her diet > if she is concerned about preserving her fertility. If she continues > to have myomectomies, she runs the risk of developing intra-uterine > scar tissue which could inhibit implantation of an embryo. She should > eliminate most dairy, animal products and sweets from her diet (I know > that you know all of this, so excuse the redundancy) and she should > probably take a nutritional supplement like DIM (made from extracts of > cruciferous vegetables like broccoli) in order to assist the metabolic > pathways associated with Estrogen Metabolism. Also, a sonohysterogram > (saline ultrasound) might be warranted at some time in order to rule > out intra-uterine scar tissue related to her previous myomectomies. > > Hope this helps, > > Ray Rubio, D.A.O.M. (FABORM) > President/CEO ABORM > Chair: Reproductive Medicine Specialty/Yo San University DAOM Program > > Westlake Complementary Medicine > 910 Hampshire Road, Suite A > Westlake Village, CA 91361 > Phone: (805) 497-1335 > Fax: (805) 497-1336 > email: rtoo > > > On Feb 15, 2009, at 1:16 PM, wrote: > > > In the student clinic last week I had a success case that is rather > > baffling. A 32 year old woman, otherwise healthy, came in saying she > > had a fibroid for 6 months that only grows larger. She has had 2 > > previous rounds of fibroids over the past 5 years which she had > > removed when they got to the size of oranges. The uterus hasn't been > > compromised so far but she was worried about the future - she has not > > kids but wants to have them. > > > > I palpated a fairly hard oblong mass about 8cm and 4 cm on the right > > side around St. 28 and a smaller one around St. 30. She hasn't gotten > > this round of fibroids evaluated in any way. > > > > So I had the intern make up a raw modified slightly Gui Zhi Fu Ling > > Wan with the usual disclaimer that it could take a long time and no > > guarantees. > > > > Yesterday, a week later, she came in and the mass was unpalpable. > > Couldn't find it. There was the smaller one, 3cm by 3cm still palpable > > around St. 30. She was now on her period which was much lighter than > > usual. > > > > Any ideas what the mechanism could have been here? I was very specific > > about asking about endometreosis (none). > > We urged her to get assessed again. > > Doug > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2009 Report Share Posted February 15, 2009 Of course. I don't think I stated my thoughts clearly enough. I think that it was probably the addition of the modified Gui Zhi Fu Ling Wan that was finally the thing that helped to reduce the ovarian cyst and help it to be reabsorbed once she had her period and her estrogen levels fell with the shedding of the endometrium. Sometimes ovarian cysts can persist for months in some females, and get quite large, especially if they have a history of poor metabolism of estrogen (i.e. recurrent uterine myomas). So, she is correct, it was probably persistent and growing with each menstrual cycle (due to the recurrent production of E2/Estradiol by the maturing ovarian follicles), and it took your prescription to break that cycle, and disperse the cyst. > Ray Rubio, D.A.O.M. (FABORM) > President/CEO ABORM > Chair: Reproductive Medicine Specialty/Yo San University DAOM Program > > Westlake Complementary Medicine > 910 Hampshire Road, Suite A > Westlake Village, CA 91361 > Phone: (805) 497-1335 > Fax: (805) 497-1336 > email: rtoo > On Feb 15, 2009, at 2:56 PM, wrote: > Thanks, Ray. You are probably right about the cyst although she swears > that in 6 months it never changed with her periods before. Perhaps the > formula with some Yi Mu Cao gave it that kick it needed. > Doug > > , Ray Rubio <RTOO wrote: > > > > Doug - > > > > The fairly large palpable mass on the right side which dispersed so > > easily after the Gui Zhi Fu Ling Wan, may have been a large > functional > > ovarian cyst. These will sometimes disperse very quickly, especially > > with herbal formula, once the menses start. As you know, Kiiko > > actually refers to Stomach 28 as the Ovary Reflex. > > > > Also, the smaller mass near Stomach 30 is actually closer to the > area > > you would typically palpate a myoma/fibroid - which are typically > > appreciated manually nearer to the pubic bone where the uterus is. > > Many times, the fibroids that are palpable are subserosal (i.e. > > outside of the uterus), rather than submucosal (inside the uterus), > > and therefore not as much of an issue as it relates to fertility. > > > > One last thing: This patient should really consider changing her > diet > > if she is concerned about preserving her fertility. If she continues > > to have myomectomies, she runs the risk of developing intra-uterine > > scar tissue which could inhibit implantation of an embryo. She > should > > eliminate most dairy, animal products and sweets from her diet (I > know > > that you know all of this, so excuse the redundancy) and she should > > probably take a nutritional supplement like DIM (made from > extracts of > > cruciferous vegetables like broccoli) in order to assist the > metabolic > > pathways associated with Estrogen Metabolism. Also, a > sonohysterogram > > (saline ultrasound) might be warranted at some time in order to rule > > out intra-uterine scar tissue related to her previous myomectomies. > > > > Hope this helps, > > > > Ray Rubio > > > > > > On Feb 15, 2009, at 1:16 PM, wrote: > > > > > In the student clinic last week I had a success case that is > rather > > > baffling. A 32 year old woman, otherwise healthy, came in saying > she > > > had a fibroid for 6 months that only grows larger. She has had 2 > > > previous rounds of fibroids over the past 5 years which she had > > > removed when they got to the size of oranges. The uterus hasn't > been > > > compromised so far but she was worried about the future - she > has not > > > kids but wants to have them. > > > > > > I palpated a fairly hard oblong mass about 8cm and 4 cm on the > right > > > side around St. 28 and a smaller one around St. 30. She hasn't > gotten > > > this round of fibroids evaluated in any way. > > > > > > So I had the intern make up a raw modified slightly Gui Zhi Fu > Ling > > > Wan with the usual disclaimer that it could take a long time and > no > > > guarantees. > > > > > > Yesterday, a week later, she came in and the mass was unpalpable. > > > Couldn't find it. There was the smaller one, 3cm by 3cm still > palpable > > > around St. 30. She was now on her period which was much lighter > than > > > usual. > > > > > > Any ideas what the mechanism could have been here? I was very > specific > > > about asking about endometreosis (none). > > > We urged her to get assessed again. > > > Doug > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2009 Report Share Posted February 15, 2009 The basic questions are: 1. On what basis did she decide that she had a fibroid? 2. Other than being told by the patient that she had a fibroid, and upon palpating discovering two masses, how can you, Doug, be sure that she had a fibroid? I am glad that the palpable masses went away in so short a time, but without other signs or symptoms I am skeptical that the masses were fibroids . -- Duncan E " We are here to help each other get though this thing, whatever it is. " -Mark Vonnegut Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2009 Report Share Posted February 15, 2009 You are right, I went on her having the same signs twice before and them being fibroids. The functional cyst seems most likely, although it didn't change during menses for 6 cycles. Maybe I should have titled the Topic as Fibroid? Again I urged her to get an exam and ultrasound. We'll also see what happens in 2 weeks. Doug , Duncan E <willhealu wrote: > > The basic questions are: > > 1. On what basis did she decide that she had a fibroid? > > 2. Other than being told by the patient that she had a fibroid, and > upon palpating discovering two masses, how can you, Doug, be sure that > she had a fibroid? > > I am glad that the palpable masses went away in so short a time, but > without other signs or symptoms I am skeptical that the masses were > fibroids . > > -- > Duncan E > > > " We are here to help each other get though this thing, whatever it is. " > -Mark Vonnegut > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2009 Report Share Posted February 17, 2009 This is by no means meant to underestimate the importance of diet; however, even women who are conscientious eaters develop uterine myomata, endometriosis, ovarian cysts and infertility. (I have seen several such patients in the clinic.) And given the fact that the overwhelming majority of American are fertile and eat a standard American diet centered around meat, dairy and refined grains and sugar suggests that the picture is much more complex than diet alone. I would like to add that Chinese herbs may aggravate these conditions (even when prescribed by experienced TCM doctors from China) While on a herbal protocol for infertility over several months, I began experiencing severe chest pain during my periods. I was eventually diagnosed with an extremely rare condition called catamenial hydropneumothorax (thoracic endometriosis strongly suspected). It took me all of two seconds to realized the connection between the months I was taking TCM herbs and the lung episodes, and I immediately stopped the herbs. While most of the formulas I was prescribed contained a combination of blood tonics, blood and qi movers, I have also experience CP with Long Dan Xie Gan Tang, dang gui and lamb congee, and Jade Screen. The worst 23-day long pneumo was with Ba Zhen Tang. Something to think about with women presenting with complex patterns of deficiency and excess. AS , Ray Rubio <RTOO wrote: > > Doug - > > The fairly large palpable mass on the right side which dispersed so > easily after the Gui Zhi Fu Ling Wan, may have been a large functional > ovarian cyst. These will sometimes disperse very quickly, especially > with herbal formula, once the menses start. As you know, Kiiko > actually refers to Stomach 28 as the Ovary Reflex. > > Also, the smaller mass near Stomach 30 is actually closer to the area > you would typically palpate a myoma/fibroid - which are typically > appreciated manually nearer to the pubic bone where the uterus is. > Many times, the fibroids that are palpable are subserosal (i.e. > outside of the uterus), rather than submucosal (inside the uterus), > and therefore not as much of an issue as it relates to fertility. > > One last thing: This patient should really consider changing her diet > if she is concerned about preserving her fertility. If she continues > to have myomectomies, she runs the risk of developing intra-uterine > scar tissue which could inhibit implantation of an embryo. She should > eliminate most dairy, animal products and sweets from her diet (I know > that you know all of this, so excuse the redundancy) and she should > probably take a nutritional supplement like DIM (made from extracts of > cruciferous vegetables like broccoli) in order to assist the metabolic > pathways associated with Estrogen Metabolism. Also, a sonohysterogram > (saline ultrasound) might be warranted at some time in order to rule > out intra-uterine scar tissue related to her previous myomectomies. > > Hope this helps, > > Ray Rubio, D.A.O.M. (FABORM) > President/CEO ABORM > Chair: Reproductive Medicine Specialty/Yo San University DAOM Program > > Westlake Complementary Medicine > 910 Hampshire Road, Suite A > Westlake Village, CA 91361 > Phone: (805) 497-1335 > Fax: (805) 497-1336 > email: rtoo > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2009 Report Share Posted February 18, 2009 I have several patients who are the most conscientious eaters I have ever met, and who still have issues with fibroids...it is an extremely complicated issue and, in my opinion, somewhat oversimplified by many in . Despite what seems to be an abundance of literature and " experts " in women's health, I find much of the information lacking in many ways. I'm looking forward to a time when we have more info. at our disposal. , " amadeashakti " <lakukulu wrote: > > This is by no means meant to underestimate the importance of diet; > however, even women who are conscientious eaters develop uterine > myomata, endometriosis, ovarian cysts and infertility. (I have seen > several such patients in the clinic.) And given the fact that the > overwhelming majority of American are fertile and eat a standard > American diet centered around meat, dairy and refined grains and sugar > suggests that the picture is much more complex than diet alone. > > I would like to add that Chinese herbs may aggravate these conditions > (even when prescribed by experienced TCM doctors from China) While on > a herbal protocol for infertility over several months, I began > experiencing severe chest pain during my periods. I was eventually > diagnosed with an extremely rare condition called catamenial > hydropneumothorax (thoracic endometriosis strongly suspected). It > took me all of two seconds to realized the connection between the > months I was taking TCM herbs and the lung episodes, and I immediately > stopped the herbs. > > While most of the formulas I was prescribed contained a combination of > blood tonics, blood and qi movers, I have also experience CP with Long > Dan Xie Gan Tang, dang gui and lamb congee, and Jade Screen. The > worst 23-day long pneumo was with Ba Zhen Tang. Something to think > about with women presenting with complex patterns of deficiency and > excess. > > AS > > > , Ray Rubio <RTOO@> wrote: > > > > Doug - > > > > The fairly large palpable mass on the right side which dispersed so > > easily after the Gui Zhi Fu Ling Wan, may have been a large functional > > ovarian cyst. These will sometimes disperse very quickly, especially > > with herbal formula, once the menses start. As you know, Kiiko > > actually refers to Stomach 28 as the Ovary Reflex. > > > > Also, the smaller mass near Stomach 30 is actually closer to the area > > you would typically palpate a myoma/fibroid - which are typically > > appreciated manually nearer to the pubic bone where the uterus is. > > Many times, the fibroids that are palpable are subserosal (i.e. > > outside of the uterus), rather than submucosal (inside the uterus), > > and therefore not as much of an issue as it relates to fertility. > > > > One last thing: This patient should really consider changing her diet > > if she is concerned about preserving her fertility. If she continues > > to have myomectomies, she runs the risk of developing intra-uterine > > scar tissue which could inhibit implantation of an embryo. She should > > eliminate most dairy, animal products and sweets from her diet (I know > > that you know all of this, so excuse the redundancy) and she should > > probably take a nutritional supplement like DIM (made from extracts of > > cruciferous vegetables like broccoli) in order to assist the metabolic > > pathways associated with Estrogen Metabolism. Also, a sonohysterogram > > (saline ultrasound) might be warranted at some time in order to rule > > out intra-uterine scar tissue related to her previous myomectomies. > > > > Hope this helps, > > > > Ray Rubio, D.A.O.M. (FABORM) > > President/CEO ABORM > > Chair: Reproductive Medicine Specialty/Yo San University DAOM Program > > > > Westlake Complementary Medicine > > 910 Hampshire Road, Suite A > > Westlake Village, CA 91361 > > Phone: (805) 497-1335 > > Fax: (805) 497-1336 > > email: rtoo@ > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2009 Report Share Posted February 18, 2009 Umm.... It seems like a few posts have taken issue with my recommendation that it might be wise to look into the patient's diet in order to see if there might be contributory factors there that are " feeding " the fibroid (pardon the pun). Personally, I think that addressing lifestyle factors such as diet, exercise, and emotional/spiritual health, are essential to the overall efficacy of our treatments (acupuncture and herbs), and I am a huge fan of empowering the patient to make changes in their lifestyle that might enable them to have a healthy life without the necessity of medical intervention - Western or TCM. I pretty sure that Chinese Medicine has historically placed a great deal of emphasis on diet therapy, Qi Gong, Meditation, and so on - even going so far as to call Acupuncture and Herbal Medicine " lesser arts " . Anyway, my suggestions to look in to possible dietary " estrogens " or toxins that might be contributing to the growth of the fibroid, were just that: suggestions. It was not over-simplification at all, because the treatment of fibroids/myomas requires a thorough understanding of the western and TCM etiology, diagnosis and treatment. However, if there is a dietary component, why wouldn't we want to educate the patient about it, and therefore maybe allow for a shorter course of treatment, and a lower dose of herbs and acupuncture. This seems prudent in these trying economic times. Ray Rubio, DAOM (FABORM) President ABORM On Feb 18, 2009, at 9:25 AM, Malinda Gibbons, L.Ac. wrote: > I have several patients who are the most conscientious eaters I have > ever met, and who > still have issues with fibroids...it is an extremely complicated > issue and, in my opinion, > somewhat oversimplified by many in . > > Despite what seems to be an abundance of literature and " experts " in > women's health, I > find much of the information lacking in many ways. I'm looking > forward to a time when we > have more info. at our disposal. > > , " amadeashakti " > <lakukulu wrote: > > > > This is by no means meant to underestimate the importance of diet; > > however, even women who are conscientious eaters develop uterine > > myomata, endometriosis, ovarian cysts and infertility. (I have seen > > several such patients in the clinic.) And given the fact that the > > overwhelming majority of American are fertile and eat a standard > > American diet centered around meat, dairy and refined grains and > sugar > > suggests that the picture is much more complex than diet alone. > > > > I would like to add that Chinese herbs may aggravate these > conditions > > (even when prescribed by experienced TCM doctors from China) While > on > > a herbal protocol for infertility over several months, I began > > experiencing severe chest pain during my periods. I was eventually > > diagnosed with an extremely rare condition called catamenial > > hydropneumothorax (thoracic endometriosis strongly suspected). It > > took me all of two seconds to realized the connection between the > > months I was taking TCM herbs and the lung episodes, and I > immediately > > stopped the herbs. > > > > While most of the formulas I was prescribed contained a > combination of > > blood tonics, blood and qi movers, I have also experience CP with > Long > > Dan Xie Gan Tang, dang gui and lamb congee, and Jade Screen. The > > worst 23-day long pneumo was with Ba Zhen Tang. Something to think > > about with women presenting with complex patterns of deficiency and > > excess. > > > > AS > > > > > > , Ray Rubio <RTOO@> wrote: > > > > > > Doug - > > > > > > The fairly large palpable mass on the right side which dispersed > so > > > easily after the Gui Zhi Fu Ling Wan, may have been a large > functional > > > ovarian cyst. These will sometimes disperse very quickly, > especially > > > with herbal formula, once the menses start. As you know, Kiiko > > > actually refers to Stomach 28 as the Ovary Reflex. > > > > > > Also, the smaller mass near Stomach 30 is actually closer to the > area > > > you would typically palpate a myoma/fibroid - which are typically > > > appreciated manually nearer to the pubic bone where the uterus is. > > > Many times, the fibroids that are palpable are subserosal (i.e. > > > outside of the uterus), rather than submucosal (inside the > uterus), > > > and therefore not as much of an issue as it relates to fertility. > > > > > > One last thing: This patient should really consider changing her > diet > > > if she is concerned about preserving her fertility. If she > continues > > > to have myomectomies, she runs the risk of developing intra- > uterine > > > scar tissue which could inhibit implantation of an embryo. She > should > > > eliminate most dairy, animal products and sweets from her diet > (I know > > > that you know all of this, so excuse the redundancy) and she > should > > > probably take a nutritional supplement like DIM (made from > extracts of > > > cruciferous vegetables like broccoli) in order to assist the > metabolic > > > pathways associated with Estrogen Metabolism. Also, a > sonohysterogram > > > (saline ultrasound) might be warranted at some time in order to > rule > > > out intra-uterine scar tissue related to her previous > myomectomies. > > > > > > Hope this helps, > > > > > > Ray Rubio, D.A.O.M. (FABORM) > > > President/CEO ABORM > > > Chair: Reproductive Medicine Specialty/Yo San University DAOM > Program > > > > > > Westlake Complementary Medicine > > > 910 Hampshire Road, Suite A > > > Westlake Village, CA 91361 > > > Phone: (805) 497-1335 > > > Fax: (805) 497-1336 > > > email: rtoo@ > > > > > > > > Ray Rubio, D.A.O.M. President/CEO ABORM Westlake Complementary Medicine 900 Hampshire Road, Suite B/C Westlake Village, CA 91361 Phone: (805) 497-1335 Fax: (805) 497-1336 email: rtoo Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2009 Report Share Posted February 18, 2009 I don't think anyone is taking issue with your dietary recommendations. I would think/hope that most people in our field are well aware of the role diet plays in health, and we are certainly taught the role of " improper diet " in TCM at school. It was more the statement: " This patient should really consider changing her diet if she is concerned about preserving her fertility. " that stuck out, particularly when there was no mention that she had a poor diet to begin with, and the implication that those of us who do suffers from infertility (fibroids, endo, etc.) are bad eaters. Amadea , Ray Rubio <RTOO wrote: > > Umm.... > > It seems like a few posts have taken issue with my recommendation that > it might be wise to look into the patient's diet in order to see if > there might be contributory factors there that are " feeding " the > fibroid (pardon the pun). > > Personally, I think that addressing lifestyle factors such as diet, > exercise, and emotional/spiritual health, are essential to the overall > efficacy of our treatments (acupuncture and herbs), and I am a huge > fan of empowering the patient to make changes in their lifestyle that > might enable them to have a healthy life without the necessity of > medical intervention - Western or TCM. I pretty sure that Chinese > Medicine has historically placed a great deal of emphasis on diet > therapy, Qi Gong, Meditation, and so on - even going so far as to call > Acupuncture and Herbal Medicine " lesser arts " . > > Anyway, my suggestions to look in to possible dietary " estrogens " or > toxins that might be contributing to the growth of the fibroid, were > just that: suggestions. It was not over-simplification at all, because > the treatment of fibroids/myomas requires a thorough understanding of > the western and TCM etiology, diagnosis and treatment. However, if > there is a dietary component, why wouldn't we want to educate the > patient about it, and therefore maybe allow for a shorter course of > treatment, and a lower dose of herbs and acupuncture. This seems > prudent in these trying economic times. > > Ray Rubio, DAOM (FABORM) > President ABORM > > On Feb 18, 2009, at 9:25 AM, Malinda Gibbons, L.Ac. wrote: > > > I have several patients who are the most conscientious eaters I have > > ever met, and who > > still have issues with fibroids...it is an extremely complicated > > issue and, in my opinion, > > somewhat oversimplified by many in . > > > > Despite what seems to be an abundance of literature and " experts " in > > women's health, I > > find much of the information lacking in many ways. I'm looking > > forward to a time when we > > have more info. at our disposal. > > > > , " amadeashakti " > > <lakukulu@> wrote: > > > > > > This is by no means meant to underestimate the importance of diet; > > > however, even women who are conscientious eaters develop uterine > > > myomata, endometriosis, ovarian cysts and infertility. (I have seen > > > several such patients in the clinic.) And given the fact that the > > > overwhelming majority of American are fertile and eat a standard > > > American diet centered around meat, dairy and refined grains and > > sugar > > > suggests that the picture is much more complex than diet alone. > > > > > > I would like to add that Chinese herbs may aggravate these > > conditions > > > (even when prescribed by experienced TCM doctors from China) While > > on > > > a herbal protocol for infertility over several months, I began > > > experiencing severe chest pain during my periods. I was eventually > > > diagnosed with an extremely rare condition called catamenial > > > hydropneumothorax (thoracic endometriosis strongly suspected). It > > > took me all of two seconds to realized the connection between the > > > months I was taking TCM herbs and the lung episodes, and I > > immediately > > > stopped the herbs. > > > > > > While most of the formulas I was prescribed contained a > > combination of > > > blood tonics, blood and qi movers, I have also experience CP with > > Long > > > Dan Xie Gan Tang, dang gui and lamb congee, and Jade Screen. The > > > worst 23-day long pneumo was with Ba Zhen Tang. Something to think > > > about with women presenting with complex patterns of deficiency and > > > excess. > > > > > > AS > > > > > > > > > , Ray Rubio <RTOO@> wrote: > > > > > > > > Doug - > > > > > > > > The fairly large palpable mass on the right side which dispersed > > so > > > > easily after the Gui Zhi Fu Ling Wan, may have been a large > > functional > > > > ovarian cyst. These will sometimes disperse very quickly, > > especially > > > > with herbal formula, once the menses start. As you know, Kiiko > > > > actually refers to Stomach 28 as the Ovary Reflex. > > > > > > > > Also, the smaller mass near Stomach 30 is actually closer to the > > area > > > > you would typically palpate a myoma/fibroid - which are typically > > > > appreciated manually nearer to the pubic bone where the uterus is. > > > > Many times, the fibroids that are palpable are subserosal (i.e. > > > > outside of the uterus), rather than submucosal (inside the > > uterus), > > > > and therefore not as much of an issue as it relates to fertility. > > > > > > > > One last thing: This patient should really consider changing her > > diet > > > > if she is concerned about preserving her fertility. If she > > continues > > > > to have myomectomies, she runs the risk of developing intra- > > uterine > > > > scar tissue which could inhibit implantation of an embryo. She > > should > > > > eliminate most dairy, animal products and sweets from her diet > > (I know > > > > that you know all of this, so excuse the redundancy) and she > > should > > > > probably take a nutritional supplement like DIM (made from > > extracts of > > > > cruciferous vegetables like broccoli) in order to assist the > > metabolic > > > > pathways associated with Estrogen Metabolism. Also, a > > sonohysterogram > > > > (saline ultrasound) might be warranted at some time in order to > > rule > > > > out intra-uterine scar tissue related to her previous > > myomectomies. > > > > > > > > Hope this helps, > > > > > > > > Ray Rubio, D.A.O.M. (FABORM) > > > > President/CEO ABORM > > > > Chair: Reproductive Medicine Specialty/Yo San University DAOM > > Program > > > > > > > > Westlake Complementary Medicine > > > > 910 Hampshire Road, Suite A > > > > Westlake Village, CA 91361 > > > > Phone: (805) 497-1335 > > > > Fax: (805) 497-1336 > > > > email: rtoo@ > > > > > > > > > > > > > > > Ray Rubio, D.A.O.M. > President/CEO ABORM > > Westlake Complementary Medicine > 900 Hampshire Road, Suite B/C > Westlake Village, CA 91361 > Phone: (805) 497-1335 > Fax: (805) 497-1336 > email: rtoo > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 18, 2009 Report Share Posted February 18, 2009 Well said. I hadn't realized that I had stated it that way, and you are correct that the way I phrased it sounds presumptuous. I hope from my explanation below, that it's understood that this was not my intention. Ray Rubio On Feb 18, 2009, at 12:56 PM, amadeashakti wrote: > I don't think anyone is taking issue with your dietary > recommendations. I would > think/hope that most people in our field are well aware of the role > diet plays in health, > and we are certainly taught the role of " improper diet " in TCM at > school. > > It was more the statement: " This patient should really consider > changing her diet if she is > concerned about preserving her fertility. " that stuck out, > particularly when there was no > mention that she had a poor diet to begin with, and the implication > that those of us who > do suffers from infertility (fibroids, endo, etc.) are bad eaters. > > Amadea > > , Ray Rubio <RTOO wrote: > > > > Umm.... > > > > It seems like a few posts have taken issue with my recommendation > that > > it might be wise to look into the patient's diet in order to see if > > there might be contributory factors there that are " feeding " the > > fibroid (pardon the pun). > > > > Personally, I think that addressing lifestyle factors such as diet, > > exercise, and emotional/spiritual health, are essential to the > overall > > efficacy of our treatments (acupuncture and herbs), and I am a huge > > fan of empowering the patient to make changes in their lifestyle > that > > might enable them to have a healthy life without the necessity of > > medical intervention - Western or TCM. I pretty sure that Chinese > > Medicine has historically placed a great deal of emphasis on diet > > therapy, Qi Gong, Meditation, and so on - even going so far as to > call > > Acupuncture and Herbal Medicine " lesser arts " . > > > > Anyway, my suggestions to look in to possible dietary " estrogens " or > > toxins that might be contributing to the growth of the fibroid, were > > just that: suggestions. It was not over-simplification at all, > because > > the treatment of fibroids/myomas requires a thorough understanding > of > > the western and TCM etiology, diagnosis and treatment. However, if > > there is a dietary component, why wouldn't we want to educate the > > patient about it, and therefore maybe allow for a shorter course of > > treatment, and a lower dose of herbs and acupuncture. This seems > > prudent in these trying economic times. > > > > Ray Rubio, DAOM (FABORM) > > President ABORM > > > > On Feb 18, 2009, at 9:25 AM, Malinda Gibbons, L.Ac. wrote: > > > > > I have several patients who are the most conscientious eaters I > have > > > ever met, and who > > > still have issues with fibroids...it is an extremely complicated > > > issue and, in my opinion, > > > somewhat oversimplified by many in . > > > > > > Despite what seems to be an abundance of literature and > " experts " in > > > women's health, I > > > find much of the information lacking in many ways. I'm looking > > > forward to a time when we > > > have more info. at our disposal. > > > > > > , " amadeashakti " > > > <lakukulu@> wrote: > > > > > > > > This is by no means meant to underestimate the importance of > diet; > > > > however, even women who are conscientious eaters develop uterine > > > > myomata, endometriosis, ovarian cysts and infertility. (I have > seen > > > > several such patients in the clinic.) And given the fact that > the > > > > overwhelming majority of American are fertile and eat a standard > > > > American diet centered around meat, dairy and refined grains and > > > sugar > > > > suggests that the picture is much more complex than diet alone. > > > > > > > > I would like to add that Chinese herbs may aggravate these > > > conditions > > > > (even when prescribed by experienced TCM doctors from China) > While > > > on > > > > a herbal protocol for infertility over several months, I began > > > > experiencing severe chest pain during my periods. I was > eventually > > > > diagnosed with an extremely rare condition called catamenial > > > > hydropneumothorax (thoracic endometriosis strongly suspected). > It > > > > took me all of two seconds to realized the connection between > the > > > > months I was taking TCM herbs and the lung episodes, and I > > > immediately > > > > stopped the herbs. > > > > > > > > While most of the formulas I was prescribed contained a > > > combination of > > > > blood tonics, blood and qi movers, I have also experience CP > with > > > Long > > > > Dan Xie Gan Tang, dang gui and lamb congee, and Jade Screen. The > > > > worst 23-day long pneumo was with Ba Zhen Tang. Something to > think > > > > about with women presenting with complex patterns of > deficiency and > > > > excess. > > > > > > > > AS > > > > > > > > > > > > , Ray Rubio <RTOO@> > wrote: > > > > > > > > > > Doug - > > > > > > > > > > The fairly large palpable mass on the right side which > dispersed > > > so > > > > > easily after the Gui Zhi Fu Ling Wan, may have been a large > > > functional > > > > > ovarian cyst. These will sometimes disperse very quickly, > > > especially > > > > > with herbal formula, once the menses start. As you know, Kiiko > > > > > actually refers to Stomach 28 as the Ovary Reflex. > > > > > > > > > > Also, the smaller mass near Stomach 30 is actually closer to > the > > > area > > > > > you would typically palpate a myoma/fibroid - which are > typically > > > > > appreciated manually nearer to the pubic bone where the > uterus is. > > > > > Many times, the fibroids that are palpable are subserosal > (i.e. > > > > > outside of the uterus), rather than submucosal (inside the > > > uterus), > > > > > and therefore not as much of an issue as it relates to > fertility. > > > > > > > > > > One last thing: This patient should really consider changing > her > > > diet > > > > > if she is concerned about preserving her fertility. If she > > > continues > > > > > to have myomectomies, she runs the risk of developing intra- > > > uterine > > > > > scar tissue which could inhibit implantation of an embryo. She > > > should > > > > > eliminate most dairy, animal products and sweets from her diet > > > (I know > > > > > that you know all of this, so excuse the redundancy) and she > > > should > > > > > probably take a nutritional supplement like DIM (made from > > > extracts of > > > > > cruciferous vegetables like broccoli) in order to assist the > > > metabolic > > > > > pathways associated with Estrogen Metabolism. Also, a > > > sonohysterogram > > > > > (saline ultrasound) might be warranted at some time in order > to > > > rule > > > > > out intra-uterine scar tissue related to her previous > > > myomectomies. > > > > > > > > > > Hope this helps, > > > > > > > > > > Ray Rubio, D.A.O.M. (FABORM) > > > > > President/CEO ABORM > > > > > Chair: Reproductive Medicine Specialty/Yo San University DAOM > > > Program > > > > > > > > > > Westlake Complementary Medicine > > > > > 910 Hampshire Road, Suite A > > > > > Westlake Village, CA 91361 > > > > > Phone: (805) 497-1335 > > > > > Fax: (805) 497-1336 > > > > > email: rtoo@ > > > > > > > > > > > > > > > > > > > > > > Ray Rubio, D.A.O.M. > > President/CEO ABORM > > > > Westlake Complementary Medicine > > 900 Hampshire Road, Suite B/C > > Westlake Village, CA 91361 > > Phone: (805) 497-1335 > > Fax: (805) 497-1336 > > email: rtoo > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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