[Ece (she/her) Yildirim]

I think I may be diving in too strongly right away with a specific topic. I think I’d like to switch gears into more of what Mary was describing in class – doing a more broad general search to help fill out my patient educational resources.

[Ece (she/her) Yildirim]

I have some experience with assisting with prolapse! To start off – I see that you mentioned the patient is “doing exercises” but not currently under care of a pelvic PT. Do you mean that she’s doing kegels?

If I’m understanding this correctly, it’s important that your patient stops doing kegels. Often birth (also other pelvic conditions like endometriosis) brings on muscular imbalances in the pelvic bowl. Certain muscles may “turn off” (no longer engage) or other areas may just remain tense all the time. Doing kegels unsupervised can often worsen this imbalance – further tightening tight areas and doing nothing to help re-engage the weakened areas. I’m sure the episiotomy scar isn’t helping things – a good pelvic PT should be able to help stretch out any fascial adhesions from the scarring. Needling Ren 1 to help release scarring is also an option but I’d rather refer them to a pelvic PT than jump right into needling the perineum!

Without knowing more about her East Asian Medicine diagnosis I can’t offer too much in the way of treatment suggestions, but I often have a lot of success just working to bring support and nourishment to the pelvic bowl via moxa or choosing points that open up pelvic pathways. I also often do moxa on the Ren – so that is a good start for sure, but making sure any associated channels that are weakened are also supported. I often find myself using LV5 either to needle or moxa (LV5 being the luo that encircles the genitals), so moxa if there is a deficiency and needling if there is an excess.

I hope that helps some!

[Ece (she/her) Yildirim]

I’ve been increasingly interested in gathering research and case studies on supporting pregnant individuals through loss – either supporting a natural miscarriage or supporting a medically induced abortion. Relevant data would also include cases where someone naturally miscarried but had suspected retained tissue (non-emergency). I need to refine my topic a bit further, but I wanted to post here just to see if anyone is interested in a similar topic. I also welcome case studies or experience you may have working with loss.

For myself, I’ve seen a handful of patients who were definitively told that they had an early loss, but the miscarriage had not yet taken place. They opted to wait to see if their body would naturally shed the tissue and postpone a D+C, and meanwhile saw me for treatment. I’ve also seen one or two folks following a miscarriage where I suspected some tissue retention even though they were not showing any classic red flags. I have not personally assisted in supporting a medically induced abortion, but my assumption is that it would be similar treatment plan to a natural miscarriage as well as alleviating any medication side effects.

[Ece (she/her) Yildirim]

Hi Sarah!

Thank you – this is all very useful for me to mull over, particularly your experience with assisting with medical abortions. I’ll definitely think things over and work on narrowing my focus, especially in light of Claudia’s suggestion of treading carefully with how this is all presented.

[Ece (she/her) Yildirim]

Thanks Claudia!

I certainly had the thought that it may be a delicate dance in how it’s presented. I know we’ve all had patients where their OB or primary told them that they absolutely should not get acupuncture out of a total misunderstanding of the forbidden points! I’m eager to hear more about your experience and suggestions on how to approach something like this to avoid further misunderstandings.