Women's Health Issues Seminar Workbook

ABSTRACT

In the following material we review treatment protocols for a collection of health issues and disorders that significantly affect the health, wellbeing, and longevity of women.

Dr. Gregory Lawton

THE MASTERS SERIES 2019 - SCANDINAVIAN MOBILIZATION THERAPY - Women's Health Issues Part One and Part Two Continuing Education Workbook

HEALTH ISSUES Assessment and treatment protocols

The Leading Diseases and Causes of Death among Women In the following material we will review the leading diseases and causes of death among women. To the standard ten main causes of death I have added health issues related to aging and autoimmune disorders which affect women at a much higher level than what is seen in the male population.

The following two causes of death in women are not normally listed with the top ten causes of death.

Aging Special Note: Hormone Replacement Therapy (HRT) Immunologically, aging is characterized by a general dysregulation of immune responses culminating in a gradual immune senescence of all cells. Aging is gender specific and is marked by “menopause” in women. Menopausal symptoms are variable among women and can include hot flashes, night sweats, sleeplessness, mood changes, loss of energy, loss of libido, vaginal dryness, and urinary symptoms. Usage of menopausal hormone therapy (MHT), estrogens, progestogen, or a combination of the two, relieves some of these symptoms. Although quality of life improvement has been reported for MHT users versus placebo, serious side-effects, especially upon long-term use, remain a concern.

Source: The Immune System in Menopause: Pros and Cons of Hormone Therapy, Mimi Ghosh, Marta Rodriguez-Garcia, and Charles R. Wira, J Steroid Biochem Mol Biol. 2014 Jul; 0: 171–175.

Special Note: “However, hormone replacement therapy — or menopause hormone therapy, as it's now called — has had mixed results. Many of the hoped-for benefits failed to materialize for large numbers of women. The largest randomized, controlled trial to date found a small increase in heart disease in postmenopausal women using combined (both estrogen and progestin) hormone therapy.” Mayo Clinic, online, 2019 Notes:

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Autoimmune disorders Special Note: SSRI Antidepressants The selective serotonin reuptake inhibitor antidepressant drugs (SSRIs) such as Prozac, Zoloft and Paxil increase serotonin levels and in so doing also give the immune system a boost. This boost can be the good news or the bad news. According to researchers at Georgetown University Medical Center, this boost can push the immune system into autoimmune disease, where the body starts attacking itself. These types of immune system over-reactions are also implicated in the “cytokine storms” that can create deadly inflammation in the lungs.

Notes:

According to the Centers for Disease Control, CDC, the following conditions are the leading causes of death in all women. These rates of death vary by age and ethnicity.

Cause of Death

1) Heart disease 2) Cancer 3) Chronic lower respiratory diseases 4) Stroke 5) Alzheimer’s disease 6) Unintentional injuries 7) Diabetes 8) Influenza and pneumonia 9) Kidney disease 10) Septicemia Notes:

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Percentage

22.3 21.1 6.2 6.1 5.7 4.0 2.7 2.3 1.8 1.6

Heart Disease (All statistics as reported by the CDC) About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths.

Heart disease is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2009 were in men.

Coronary heart disease (CHD) is the most common type of heart disease, killing over 370,000 people annually.

Every year about 735,000 Americans have a heart attack. Of these, 525,000 are a first heart attack and 210,000 happen in people who have already had a heart attack.

Notes:

Cancer Cancer is the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues. Cancers of specific concern to women include breast and reproductive cancers of the ovaries and the uterus.

Cancer claims the lives of more than a quarter of a million women in America every year. Women can reduce their cancer risk by adopting a healthy lifestyle and getting the right cancer screening tests for their stage of life.

Chronic Lower Respiratory Diseases Chronic lower respiratory diseases include pathology of the bronchial region and the lungs, and the component parts of these organs.

• • • • • • • •

Number of deaths from chronic lower respiratory diseases (including asthma): 154,596 Chronic lower respiratory diseases (including asthma) deaths per 100,000 population: 47.8 Number of bronchitis (chronic and unspecified) deaths: 518 Bronchitis (chronic and unspecified) deaths per 100,000 population: 0.2 Number of emphysema deaths: 6,977 Emphysema deaths per 100,000 population: 2.2 Number of deaths from other chronic lower respiratory diseases (excluding asthma): 143,583 Other chronic lower respiratory diseases (excluding asthma) deaths per 100,000 population: 44.4

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Stroke A stroke is a medical condition in which poor blood flow to the brain results in cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both result in parts of the brain not functioning properly. Signs and symptoms of a stroke may include an inability to move or feel on one side of the body, problems understanding or speaking, dizziness, or loss of vision to one side. Signs and symptoms often appear soon after the stroke has occurred. If symptoms last less than one or two hours, it is known as a transient ischemic attack (TIA) or ministroke. A hemorrhagic stroke may also be associated with a severe headache. The symptoms of a stroke can be permanent. Long-term complications may include pneumonia or loss of bladder control.

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Alzheimer’s Disease Alzheimer’s Disease is the most common type of dementia. It is a progressive disease beginning with mild memory loss possibly leading to loss of the ability to carry on a conversation and respond to the environment. It involves parts of the brain that control thought, memory, and language. It can seriously affect a person’s ability to carry out daily activities.

• • • • •

In 2014, as many as 5 million Americans were living with Alzheimer’s disease.

The symptoms of the disease can first appear after age 60 and the risk increases with age.

Younger people may get Alzheimer’s disease, but it is less common.

The number of people living with the disease doubles every 5 years beyond age 65.

This number is projected to nearly triple to 14 million people by 2060.

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Unintentional injuries Unintentional injuries and accidents, often brunt force trauma cause the following number of deaths per year: Number of deaths: 161,374 Deaths per 100,000 population: 49.9 The leading causes of unintentional injuries in women are falls and automobile accidents.

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Diabetes Diabetes is a disorder where normal sugar (blood glucose) metabolism is disrupted. This may because there is not enough insulin or what insulin is available is not being properly utilized by the cells in the body.

Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the seventh leading cause of death in the United States.

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Influenza and pneumonia Influenza is an acute respiratory illness caused by influenza type A or B viruses. Symptoms include abrupt onset of fever, cough, malaise, myalgia, sore throat, and headache. Influenza epidemics usually occur during the winter months in temperate climates, causing an increase in hospitalizations for pneumonia and exacerbation of chronic diseases, and contributing to increased mortality, particularly among the elderly and those with high risk underlying conditions. The most common complication of influenza is pneumonia. It is generally believed that hospitalizations and deaths coded as influenza significantly underestimate disease burden, with excess all-cause pneumonia and influenza combined, during the influenza season, being a better indicator of true burden.

Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing. Severity is variable.

Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune diseases. Risk factors include other lung diseases such as cystic fibrosis, COPD, and asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, or a weak immune system.

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Kidney disease Kidney disease, or renal disease, also known as nephropathy, is damage to or disease of a kidney.

Nephritis is an inflammatory kidney disease and has several types according to the location of the inflammation. Inflammation can be diagnosed by blood tests. Nephrosis is non-inflammatory kidney disease. Nephritis and nephrosis can give rise to nephritic syndrome and nephrotic syndrome respectively. Kidney disease usually causes a loss of kidney function to some degree and can result in kidney failure, the complete loss of kidney function. Kidney failure is known as the end-stage of kidney disease, where dialysis or a kidney transplant is the only treatment option.

Chronic kidney disease causes the gradual loss of kidney function over time. Acute kidney disease is now termed acute kidney injury and is marked by the sudden reduction in kidney function over seven days. About one in eight Americans suffer from chronic kidney disease.

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Septicemia Sepsis is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. Common signs and symptoms include fever, increased heart rate, increased breathing rate, and confusion. There may also be symptoms related to a specific infection, such as a cough with pneumonia, or painful urination with a kidney infection. In the very young, old, and people with a weakened immune system, there may be no symptoms of a specific infection and the body temperature may be low or normal, rather than high. Severe sepsis is sepsis causing poor organ function or insufficient blood flow. Insufficient blood flow may be evident by low blood pressure, high blood lactate, or low urine output. Septic shock is low blood pressure due to sepsis that does not improve after fluid replacement.

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Health Issues for Women In the following material we review treatment protocols for a collection of health issues and disorders that significantly affect the health, wellbeing, and longevity of women.

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Heart Health and Heart Disease – Heart disease is by far the number one killer of women in the U.S. High blood pressure, high cholesterol, excess weight, diabetes, menopause, smoking and physical inactivity are key heart disease risks.

Manual Therapy: Lymphedema treatment protocol General rehabilitation protocol with sedation points Acupuncture/acupressure sedation points Therapeutic Exercise: Low to moderate regular exercise – walking, yoga, tai chi chuan Diet and Nutrition: Dean Ornish – Plaque and inflammation reversal diet: https://www.ornish.com/ Nathan Pritikin – Pritikin longevity program: https://www.pritikin.com/ Holistic/Psycho/Spiritual Therapeutics: Stress management, counseling Herbal Medicine: Cardiotonic – Motherwort, Black Cohosh (caution) Sedative – Passion Flower Blood thinner – Red Clover, Pomegranate juice/seeds (caution - tannins) Anti-inflammatory - Turmeric Hawthorne berry “Compounds in hawthorn berry improve blood flow to the coronary artery and strengthen contractions of the heart muscle, according to the University of Michigan Health System.

These effects lead to a decrease in congestive heart failure symptoms, such as chest pressure and heart palpitations.”

Garlic Red Yeast Rice (statin) “Red yeast rice contains compounds that appear to lower cholesterol levels.

One of the compounds is monacolin K, the same ingredient that is in the prescription cholesterollowering drug lovastatin (Altoprev).

Acacia powder – High soluble fiber content and a pre-biotic.

Notes:

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Breast Cancer – Risk factors include increasing age, personal history of breast abnormalities, physical inactivity, being overweight, caffeine, alcohol, smoking, hormone replacement therapy, environmental toxins and xenoestrogens, early menstruation (before the age of 12), late menopause (after age 55), age at your first live birth and family history of breast cancer.

Manual Therapy: Upper extremity lymphedema protocol (caution) Anterior thoracic deep tissue treatment post-surgery and radiation Rib technique Castor oil packs, Cayce method Therapeutic Exercise: Low to moderate exercise improves fluid dynamics in breast tissue and boost lymph movement Diet and Nutrition: Vegan or vegetarian diet, low sugar, healthy fats and omega’s, no alcohol or caffeine Holistic/Psycho/Spiritual Therapeutics: Music therapy, yoga, tai chi chuan, and dance Herbal Medicine: Phyto medicine flavonoids Phyto sterols/estrogens (caution) Anti-oxidants – grapes, dark green leafy vegetables, green tea, berries, goji berry, blue berry, Polyphenols – all berries, cinnamon, pomegranate juice, apple Saw Palmetto Turmeric Notes:

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Obesity and Type 2 Diabetes – Obesity is a key risk factor for type 2 diabetes.

Manual Therapy: Abdominal massage Treat areas of inflammation and pain.

Therapeutic Exercise: Low to moderate, low weight bearing exercise, low level weight lifting with maximum repetitions Core exercises Diet and Nutrition: Vegan or vegetarian low fat, low sugar diet Holistic/Psycho/Spiritual Therapeutics: Addiction counseling Herbal Medicine: Thermogenic – Green tea Adaptogens – Ginseng (caution) Acacia powder – Fiber and pre-biotic Cinnamon – Regulate blood sugar Turmeric – Control inflammation Notes:

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PMS and Menopause – PMS is a very common syndrome affecting an estimated 4 out of 10 women in the last two weeks of the menstrual cycle. It is thought that changing hormone levels and brain chemistry play a role in PMS. Many symptoms have been linked to PMS, including irritability, bloating, weight gain, fatigue, abdominal pain, food cravings and forgetfulness.

The symptoms of menopause include hot flashes, urinary incontinence, vaginal dryness, breast changes, thinning of the skin, bone loss, increase in LDL (bad) cholesterol levels, increase in heart disease risk, as well as weight gain.

Manual Therapy: General manual therapy treatment with sedation/tonification techniques Sympathetic/parasympathetic lumbar and sacral techniques Therapeutic Exercise: Yoga and tai chi chuan Diet and Nutrition: Vegan and vegetarian diet, avoid animal products, low fat, low sugar Holistic/Psycho/Spiritual Therapeutics: Counseling Herbal Medicine – PMS: Adaptogens – Tang Kuei, rehmannia root Sedatives – Passion flower Antispasmodic – Passion flower, chamomile Nervine – Lemon balm, linden flower, chamomile Chaste Tree berry - Reduction of premenstrual syndrome (PMS), menstrual cramps and other premenopausal symptoms Dandelion root – Liver stimulant, increases bile, and is a good diuretic Herbal Medicine – Menopause: Adaptogens Antispasmodic Nervine Motherwort Tang Kuei – Hormonal tonic, blood builder (anemia), and blood mover Chaste Tree berry Red Clover – Contains phytoestrogens Notes: 12 | P a g e

Prenatal Health – Women should be eating a nutritious diet and maintaining a healthy weight during childbearing years.

Manual Therapy: Muscle tone and reduce stiffness Therapeutic Exercise: To maintain a healthy weight, lean mass, and muscle tone Diet and Nutrition: Vegetarian, good nutritional support Holistic/Psycho/Spiritual Therapeutics: Yoga and tai chi chuan Herbal Medicine: Anti-oxidant – Green tea Alfalfa – Macro and micro nutrients Nettle – May cause uterine contractions, no real research Red Raspberry – Last half of last trimester only Oat straw – Support of skin collagen Lemon Balm – Calming, anti-anxiety Linden flower – Anti spasmodic and sedative Notes:

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Osteoporosis and Arthritis – Osteoporosis is a bone disease that results in decreasing bone density and increasing risk of bone fracture, particularly in the hips, spine and wrists. Arthritis is a joint disorder that is characterized by inflammation in the joints. Risk factors for osteoporosis include being 65 years of age or older, having a family history of osteoporotic fracture (especially a woman who had a hip fracture), having a tendency to fall, or early menopause (before 45 years of age). Risk factors include a high protein or animal protein diet, dysglycemic diet, low calcium intake, low body weight, excess caffeine and alcohol, and smoking.

Manual Therapy: Treat as indicated by chief complaints, to not over treat or use too much force in osteoporosis Therapeutic Exercise: Low to moderate regular exercise with resistance or weights Diet and Nutrition: Vegan or vegetarian diet, avoid meat and animal products, avoid dairy products and refined sugar and flour. Avoid alcohol and caffeine Holistic/Psycho/Spiritual Therapeutics: Addiction counseling Herbal Medicine – Osteoporosis: Herbal Medicine - Nutrient Boneset – All of the following herbs may be combined in an herbal formula.

Alfalfa Nettle Irish Moss Oat straw Horsetail grass Herbal Medicine - Arthritis Analgesics Anti-inflammatory Alfalfa Nettle Irish Moss Oat straw Horsetail grass Turmeric Ginger Notes: 14 | P a g e

Aging and Longevity Issues – Genetics plays a key role in aging with some individuals with longevity genes that predispose them to living a longer life. Irrespective of the genes they have inherited, it is still possible for a person to live a long and fulfilling life. Free radicals are unstable molecules that can cause damage to cells resulting in heart disease, cancer and many other health issues. A poor overall diet, the SAD diet (standard American diet) with alcohol consumption and smoking can quickly undue the advantages of genetics.

Manual Therapy: Anti-stress treatment protocol and treat according to a chief complaint.

Therapeutic Exercise: All exercise is benefit as long exercise itself does not become a stressor. Avoid extremes of exercise especially beyond the 3nd decade of life.

Diet and Nutrition: Vegan or vegetarian diet, low sugar and low fat Holistic/Psycho/Spiritual Therapeutics: Stress management, meditation, yoga, and tai chi chuan Herbal Medicine: Adaptogens – Tang Kuei, Rehmannia Anti-inflammatory – Fresh, organic whole foods Anti-oxidant – Most all fresh fruits, vegetables, whole grains, seeds, and nuts Astragalus root – Anti-inflammatory, boosts the immune system, anti-cancer, vasodilatation Turmeric – Antimicrobial, anti-inflammatory

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Kidney and Bladder Health – The two most common conditions affecting the kidneys and bladder are kidney stones and urinary tract infections (UTIs). Where women are concerned, urinary tract infections are the most prevalent.

Interstitial cystitis, also called painful bladder syndrome, is a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain. The pain ranges from mild discomfort to severe.

Although signs and symptoms of interstitial cystitis may resemble those of a chronic urinary tract infection, there's usually no infection. However, symptoms may worsen if a patient with interstitial cystitis gets a urinary tract infection.

Interstitial cystitis signs and symptoms include: Pain in the pelvic region or between the vagina and anus in women Pain between the scrotum and anus in men (perineum) Chronic pelvic pain A persistent, urgent need to urinate Frequent urination, often of small amounts, throughout the day and night (up to 60 times a day) Pain or discomfort while the bladder fills and relief after urinating.

Pain during sexual intercourse.

Manual Therapy: SMT abdominal and pelvic technique as is tolerated, lumbar sympathetic manual therapy Thermophore heat applications, castor oil pack Therapeutic Exercise: Yoga child’s pose Diet and Nutrition: Avoid coffee, caffeine, foods high in oxalic acid, meat, dairy products, chocolate, sugar, alcohol Recommend pomegranates Holistic/Psycho/Spiritual Therapeutics:

Herbal Medicine: Diuretics – Dandelion Cranberry - infection Juniper berry - infection Celery seed tea – stones Hydrangea root – stones Dianthus Formula (Chinese: Ba Zheng San) Notes:

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HIV and Sexually-Transmitted Diseases – HIV infection continues to grow steadily with heterosexual transmission making up most of all new cases. In the U.S., African-American and Hispanic women have the highest infection rates among American women.

Manual Therapy: Acupuncture to boost the immune system, use gloves Therapeutic Exercise: Low to moderate exercise Diet and Nutrition: Vegan and macrobiotic diet plans Holistic/Psycho/Spiritual Therapeutics: Counseling, meditation Herbal Medicine: Adaptogens – Rehmannia, astragalus, schisandra, ashwagandha Immune Stimulating – mushrooms, astragalus, Antiseptic Anti-fungal Anti-bacterial Anti-viral Rooibos tea - anti-carcinogenic, anti-mutagenic, anti-inflammatory and anti-viral activity.

Marigold flower – anti-microbial Boric acid – low level acute vaginal infections Sun Ten custom HIV formulas Notes:

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Anxiety and Sleep Disorders – Anxiety disorders are the most common mental illness in the U.S. Anxiety disorders include generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, social anxiety disorder, and specific phobias. Anxiety disorders are characterized by persistent, excessive and unreasonable levels of anxiety, fear or worry. Sleep disorders are characterized by abnormal sleep patterns resulting in impairment of physical, mental and emotional functioning. Among the risk factors, but not frequently cited as a cause, is the use of recreational drugs including marijuana which may cause anxiety disorders or intensify paranoia or agoraphobia.

Manual Therapy: General treatment for stress Therapeutic Exercise: Low to moderate exercise earlier in the day, not late at night Diet and Nutrition: Avoid all stimulants, avoid smoking, alcohol, and caffeine, vegan/vegetarian, complex carbohydrates, seeds and nuts Holistic/Psycho/Spiritual Therapeutics: Counseling, medication, yoga, tai chi chuan, music therapy Herbal Medicine: Adaptogen - Rehmannia, astragalus, schisandra, ashwagandha, Antispasmodic – Chamomile Nervine – Skullcap, motherwort Sedatives - Passion Flower Notes:

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Fibrocystic Breast Condition – Fibrocystic breasts are characterized by lumpiness and usually discomfort in one or both breasts. The lumpiness is due to small breast masses or breast cysts. The condition is very common and benign, meaning that fibrocystic breasts are not malignant (cancerous). Fibrocystic breast disease (FBD), now referred to as fibrocystic changes or fibrocystic breast condition, is the most common cause of "lumpy breasts" in women and affects more than 60% of women. The condition primarily affects women between the ages of 30 and 50 and tends to become less of a problem after menopause.

Latest studies have shown a benefit from strict restriction of caffeine. Fibrocystic breast disease should not be considered a normal thing that affects a large percentage of women. The risk of confusing the disease with the manifestations of breast cancer is very high and the pain and lumps associated with this disorder may hide a malignant tumor or delay its detection.

Manual Therapy: Thoracic (rib) technique and upper extremity lymphedema technique Therapeutic Exercise: All exercise is good, especially repetitive upper body movements Diet and Nutrition: Avoid meat, dairy, deep fried foods, caffeine, chocolate, smoking, alcohol, sugar, high fat diet Recommend fresh fruits and vegetables, vegan or vegetarian diet, low sugar and low fat Holistic/Psycho/Spiritual Therapeutics:

Herbal Medicine: Lymphatics Poke root Tang Kuei Chaste tree berry Notes:

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Uterine Growths, Fibroids, and Benign Tumors – Uterine growths are tissue enlargements of the female womb (uterus). Uterine growths can be caused by either harmless or dangerous conditions. Growths are sometimes referred to medically as masses or tumors. Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer. Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. A woman can have a single fibroid or multiple ones. In extreme cases, multiple fibroids can expand the uterus so much that they reach the rib cage.

Manual Therapy: SMT abdominal and pelvic procedures, lumbar/sacral sympathetic and parasympathetic Therapeutic Exercise: All forms of exercise especially walking and low impact Diet and Nutrition: Low sugar – natural sugars Low fat - 10 to 15 percent Vegetarian or Vegan diet Holistic/Psycho/Spiritual Therapeutics:

Herbal Medicine: Tang Kuei Four Cinnamon and Hoelen Saw Palmetto Notes:

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Endometriosis/Endometrial Disease – Endometriosis is a condition in which cells similar to those in the endometrium, the layer of tissue that normally covers the inside of the uterus, grow outside of it. Most often this is on the ovaries, Fallopian tubes, and tissue around the uterus and ovaries; however, in rare cases it may also occur in other parts of the body. The main symptoms are pelvic pain and infertility. Nearly half of those affected have chronic pelvic pain, while in 70% pain occurs during menstruation. Pain during sexual intercourse is also common. Infertility occurs in up to half of women affected. Less common symptoms include urinary or bowel symptoms. About 25% of women have no symptoms.

Manual Therapy: SMT abdominal and pelvic procedures, lumbar/sacral sympathetic and parasympathetic Therapeutic Exercise: All forms of exercise especially walking and low impact Diet and Nutrition: Low sugar – natural sugars Low fat - 10 to 15 percent Vegetarian or vegan diet Holistic/Psycho/Spiritual Therapeutics: Herbal Medicine: Tang Kuei Four Cinnamon and Hoelen Saw Palmetto Notes:

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Autoimmune Disorders: A nonspecific autoimmune disease is an autoimmune disease that cannot be fully identified or diagnosed and does not meet the criteria of known autoimmune diseases. An autoimmune disease is a condition in which the body's immune system, which protects the body against harmful substances like bacteria and viruses, triggers its defenses incorrectly and causes damage to cells and tissues.

Autoimmune diseases include type 1 diabetes, rheumatoid arthritis, lupus, and multiple sclerosis.

Nonspecific autoimmune disease symptoms often include an overall feeling of malaise or sickness, a low fever, and tiredness.

According to a 2014 study, women get autoimmune diseases at a rate of about 2 to 1 compared to men — 6.4 percent of women vs. 2.7 percent of men. Often the disease starts during a woman’s childbearing years (ages 15 to 44).

Manual Therapy: Manual therapy is applied specific to the patient’s condition and chief complaint Therapeutic Exercise: Generally, low impact Diet and Nutrition: Avoid all animal products No dairy Low sugar – natural sugars Low fat – 15 to 20 percent Vegetarian or vegan diet Holistic/Psycho/Spiritual Therapeutics: Stress management strategies Herbal Medicine: Anti-inflammatory Adaptogenic - Rehmannia, astragalus, schisandra, ashwagandha Possible immune suppressants Turmeric Sarsaparilla root – anti-inflammatory, immune modulator Notes:

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Irritable Bowel Syndrome: Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is a chronic condition that requires long term management.

Only a small number of people with IBS have severe signs and symptoms. Some people can control their symptoms by managing diet, lifestyle and stress.

IBS – C IBS – D Heathers IBS Resources, Education and Products - https://www.helpforibs.com/ Manual Therapy: SMT abdominal and pelvic procedures Lumbar and sacral sympathetic and parasympathetic protocol Therapeutic Exercise: All forms of exercise, especially yoga and tai chi chuan Diet and Nutrition: Avoid alcohol, sugar, animal products, meat, dairy, soda drinks High fiber, vegetarian, vegan, low sugar Pre-biotic and probiotic Fermented foods Holistic/Psycho/Spiritual Therapeutics: Stress management, meditation, abdominal visualization programs Herbal Medicine: Turmeric Peppermint capsules Fennel seed Acacia powder Minor Bupleurum Notes:

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Pelvic Inflammatory Disease: Pelvic inflammatory disease (PID) is a term used to describe any infection in the lower female reproductive tract that spreads to the upper female reproductive tract. The lower female genital tract consists of the vagina and the cervix. The upper female genital tract consists of the body of the uterus, the fallopian or uterine tubes, and the ovaries. It usually occurs when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes or ovaries. Pelvic inflammatory disease often causes no signs or symptoms. When there are signs and symptoms, they may include pain, cramping, signs of inflammation, fever, and unusual odors.

Manual Therapy: SMT abdominal and pelvic procedures Lumbar and sacral sympathetic and parasympathetic protocol Therapeutic Exercise: Low impact to tolerance Yoga, dao yin, tai chi chuan Diet and Nutrition: Low sugar – natural sugars Low fat - 10 to 15 percent Vegetarian or vegan diet Anti-inflammatory diet Holistic/Psycho/Spiritual Therapeutics: Stress management, meditation, abdominal/pelvic visualization programs Herbal Medicine: Notes:

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Fibromyalgia: Fibromyalgia is a chronic disorder. It’s associated with widespread pain in the muscles, joints, and bones, areas of soft tissue tenderness, and general fatigue. It is frequently associated with depression and insomnia.

Common symptoms include: 1. Widespread pain 2. Jaw pain and stiffness 3. Pain and tiredness in the face muscles and adjacent fibrous tissues 4. Stiff joints and muscles in the morning 5. Headaches 6. Irregular sleep patterns 7. Irritable bowel syndrome (IBS) 8. Painful menstrual periods 9. Tingling and numbness in the hands and feet 10. Restless leg syndrome (RLS) 11. Sensitivity to cold or heat 12. Difficulties with memory and concentration, known as "fibro-fog" 13. Fatigue Fibromyalgia may be related to neurogenic or neuropathic pain. Neurogenic pain is a condition of autonomic hyperactivity that results in sharp, stinging, or stabbing pain. The disorder is usually noninflammatory but may result in the destruction of peripheral nerve tissue. It may also be accompanied by changes in skin color, temperature, and edema.

There are presently three studies that have provided evidence of peripheral nerve damage in patients with fibromyalgia.

Manual Therapy: Treat according to chief complaint and patient symptoms, treat localized soreness and pain, treat according to patient tolerance related to pressure Therapeutic Exercise: Generally, low impact and within the lower range of the target heart rate Diet and Nutrition: Identify food allergens Avoid all animal products No dairy Low sugar – natural sugars Low fat – 15 to 20 percent Vegetarian or vegan diet

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Holistic/Psycho/Spiritual Therapeutics: Stress management, meditation Herbal Medicine: Nervine Sedative Analgesic autonomic hyperactivity that results in sharp, stinging, or stabbing pain. The disorder is usually Notes:

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Iliopsoas Dysfunction: For the purposes of this presentation we are interested in iliopsoas dysfunction as it relates to pelvic pain and mimics pelvic and abdominal disorders. A dysfunctional iliopsoas muscle may also cause low back pain. The iliopsoas muscle is one of the few muscles in the body to share innervation with key abdominal and pelvic nerves. Dysfunction of, and inflammation and stiffness in, the iliopsoas muscle can cause noxious stimulation of the abdominal and pelvic organs and refer to the lumbar/sacral spinal areas. Pathological conditions in the large intestine (also the bladder or reproductive organs), either in the area of the cecum or the sigmoid, ascending or the descending colon, may cause dysfunction and pain in the iliopsoas and affect its function. It may cause stiffness, spasm and pain which can affect lumbar curvature, decreasing the curvature, or cause a lumbar scoliosis. Restricted movement of the iliopsoas may also affect gait and mimic other mechanical problems found in this muscle’s functions.

Manual Therapy: Iliopsoas release and stretches SMT abdominal and pelvic procedures Lumbar and sacral sympathetic and parasympathetic protocol Therapeutic Exercise: Iliopsoas stretches Yoga, dao yin Walking and running Diet and Nutrition: Anti-inflammatory diet, vegan or vegetarian diet Holistic/Psycho/Spiritual Therapeutics: Herbal Medicine: Antispasmodic Analgesic Anodyne Turmeric Notes:

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