Dr. Ekaterina Krantsevich ND

10/28/2022

Baby girl due November 2022!
I will be away from clinic November & December and will be back at my downtown location mid January with limited availability 😊

07/15/2022

💯

04/18/2022

Looking forward to go back to paradise 🔜 😍… still too cold for me in Vancouver 🥶

04/04/2022

𝔸𝕕𝕖𝕟𝕠𝕞𝕪𝕠𝕤𝕚𝕤 𝕒𝕨𝕒𝕣𝕖𝕟𝕖𝕤𝕤 𝕞𝕠𝕟𝕥𝕙

Adenomyosis is the presence of endometrial glands or stromal tissues in the myometrium. The tissues are situated at least 2.5 mm below the endometrial-myometrial junction (𝘞𝘢𝘯𝘨 𝘗𝘩 𝘦𝘵 𝘢𝘭., 2009). Adenomyosis was described by Rokitansky in 1860 as adenomyoma, and in 1869 by Von Recklinghausen.
Statistically, adenomyosis is considered to be a disease that mostly affects women in their 30s. That is mostly because historically, it has been diagnosed by histology of the hysterectomy specimens. The most common symptoms are heavy menstrual bleeding and intense pelvic pain.

Presently we can see adenomyosis being diagnosed more and more frequently among young patients. As imaging techniques have developed, it is now easier to diagnose the disease.

The two most accepted theories regarding the etiology of the disease are that of a disrupted boundary between the deepest layer of the endometrium (endometrium basalis) and the underlying myometrium and an embryologic mechanism whereby pluripotent Mullerian stem cells undergo inappropriate differentiation leading to ectopic endometrial tissue.
A rare form of the disease, named juvenile cystic adenomyosis (𝘋𝘰𝘨𝘢𝘯 𝘌, 𝘎𝘰𝘥𝘦 𝘍, 𝘚𝘢𝘢𝘵𝘭𝘪 𝘉, 𝘚𝘦ç𝘪𝘭 𝘔. 𝘑𝘶𝘷𝘦𝘯𝘪𝘭𝘦 𝘤𝘺𝘴𝘵𝘪𝘤 𝘢𝘥𝘦𝘯𝘰𝘮𝘺𝘰𝘴𝘪𝘴 𝘮𝘪𝘮𝘪𝘤𝘬𝘪𝘯𝘨 𝘶𝘵𝘦𝘳𝘪𝘯𝘦 𝘮𝘢𝘭𝘧𝘰𝘳𝘮𝘢𝘵𝘪𝘰𝘯: 𝘢 𝘤𝘢𝘴𝘦 𝘳𝘦𝘱𝘰𝘳𝘵. 𝘈𝘳𝘤𝘩 𝘎𝘺𝘯𝘦𝘤𝘰𝘭 𝘖𝘣𝘴𝘵𝘦𝘵. 2008 𝘋𝘦𝘤;278(6):593-5; 𝘒𝘳𝘪𝘱𝘭𝘢𝘯𝘪 𝘈, 𝘔𝘢𝘩𝘦𝘺 𝘙, 𝘈𝘨𝘢𝘳𝘸𝘢𝘭 𝘕, 𝘉𝘩𝘢𝘵𝘭𝘢 𝘕, 𝘠𝘢𝘥𝘢𝘷 𝘙, 𝘚𝘪𝘯𝘨𝘩 𝘔𝘒. 𝘓𝘢𝘱𝘢𝘳𝘰𝘴𝘤𝘰𝘱𝘪𝘤 𝘮𝘢𝘯𝘢𝘨𝘦𝘮𝘦𝘯𝘵 𝘰𝘧 𝘫𝘶𝘷𝘦𝘯𝘪𝘭𝘦 𝘤𝘺𝘴𝘵𝘪𝘤 𝘢𝘥𝘦𝘯𝘰𝘮𝘺𝘰𝘮𝘢: 𝘧𝘰𝘶𝘳 𝘤𝘢𝘴𝘦𝘴. 𝘑 𝘔𝘪𝘯𝘪𝘮 𝘐𝘯𝘷𝘢𝘴𝘪𝘷𝘦 𝘎𝘺𝘯𝘦𝘤𝘰𝘭. 2011 𝘔𝘢𝘺-𝘑𝘶𝘯;18(3):343-8.) is seen in women younger than 30. This juvenile cystic adenomyosis is characterized by more extensive hemorrhage within myometrial cysts and it’s usually resistant to medication.

Adenomyosis often co-exists with other entities within the differential diagnosis, most commonly leiomyoma (50%), endometriosis (11%), and endometrial polyps (7%) (𝘚𝘵𝘳𝘶𝘣𝘭𝘦 𝘑, 𝘙𝘦𝘪𝘥 𝘚, 𝘉𝘦𝘥𝘢𝘪𝘸𝘺 𝘔𝘈. 𝘈𝘥𝘦𝘯𝘰𝘮𝘺𝘰𝘴𝘪𝘴: 𝘈 𝘊𝘭𝘪𝘯𝘪𝘤𝘢𝘭 𝘙𝘦𝘷𝘪𝘦𝘸 𝘰𝘧 𝘢 𝘊𝘩𝘢𝘭𝘭𝘦𝘯𝘨𝘪𝘯𝘨 𝘎𝘺𝘯𝘦𝘤𝘰𝘭𝘰𝘨𝘪𝘤 𝘊𝘰𝘯𝘥𝘪𝘵𝘪𝘰𝘯. 𝘑 𝘔𝘪𝘯𝘪𝘮 𝘐𝘯𝘷𝘢𝘴𝘪𝘷𝘦 𝘎𝘺𝘯𝘦𝘤𝘰𝘭. 2016 𝘍𝘦𝘣 01;23(2):164-85). This complicates diagnosis and treatment planning.

11/01/2021

Now offering Regenerative Injection Therapies (RIT) in my practice 🥳

RIT includes Prolo therapy joint injections, PRP joint injections and Trigger point injections.

Both Prolo therapy and PRP injections can be used can be used in a variety of orthopaedic disorders such as OA, RA, chronic joint pain, ligament laxity or sprains, meniscal tears, labral tears and others.

Although the substance injected in PRP vs Prolo is different and will be discussed in other posts, both therapies work towards healing and strengthening the problematic area.

Trigger point injections can be used to target those tight “muscle knots” that are often causing pain throughout the body.

DM for more information or email dr.ekaterina.nd@gmail.com

09/13/2021

Not just a painful period … we need so much more awareness of this in Canada

https://centerforendo.com/ovarian

07/14/2021

My favourite treatment🥰👌🏻

07/08/2021

This goes for any situation that a person is dealing with

“Other people have it worse than you/ You should be thankful for the good things in your life/Things could be worse”. How many times have you heard those frases? While recovering from extensive sur…

05/16/2021

“The most lonely condition I can imagine”

Most studies regarding endometriosis focus on physical symptoms. The psychological impact of the disease has also been studied even though secondary to the physical aspect. One such study calls endometriosis the most lonely condition imaginable. The study discusses qualitative data examining how women negotiate changes to identity while living with endometriosis, in a social context where women are expected to minimise their symptoms and conform to feminine role expectations.

The women identified disruptions to personal identity as a result of living with endometriosis. They talked about not feeling like themselves and about reactions from medical and social connections prompting feelings that they were going “mad”. Participants also expressed feeling as though they were a burden to loved ones, which often resulted in self-silencing. Findings are discussed in the context of Western expectations of women’s roles in social relationships and suggest that professionals who support women with endometriosis should be aware of strategies such as self-silencing which may reduce effective self-care.

Many women with endometriosis wait decades from first reporting symptoms to receiving a diagnosis. Women have reported that they often feel as though they had to “be [their] own doctor” and be strong advocates for themselves because of reluctance to diagnose and even treat endometriosis by health professionals. The condition has also been positioned as psychological as well as physical with the consequence that women are constructed as hysterical or difficult if they do not present themselves in certain ways in interactions with clinicians.

Given the reports that endometriosis symptoms are often trivialised by doctors, it is unsurprising that friends and family also struggle to understand the potential seriousness of the condition. Friends and family are described as mistaking experiences of endometriosis symptoms for being in a “bad mood”; misunderstanding by family and friends, colleagues, and intimate partners is frequently discussed as a source of distress for women with the condition.

A woman with endometriosis may be forced to rethink the role she plays in her relationships (and the role of these relationships in her life) as part of the rethinking of self-concept due to the disruptions that endometriosis causes in her life. How the person with the condition views themselves may change in order to accommodate any effects on their lives and relationships. The study suggests that this may lead to positive outcomes in the relationship. However, the expectation that a feminine role in relationships is self-sacrificing may potentially hamper a woman’s ability to “mobilise resources” needed to renegotiate her identity after an endometriosis diagnosis.

Another important aspect is regarding the way women view themselves regarding their fertility. There can be psychological distress if women with endometriosis internalise clinician assumptions about the importance of treatment related to fertility. Emphasising motherhood for women with conditions affecting fertility and/or menstruation may result in these women feeling that they have failed in their role as a woman.

The pressure for women in pain to repress negative feelings may be emphasised when the pain is related to the “intrinsically unpredictable, leaky and disruptive” female body because of taboos associated with menstruation. In attempting to maintain their role as a good partner, mother, and daughter, women experiencing endometriosis symptoms may choose coping strategies which are incompatible with self-care, such as self-silencing.

https://journals.sagepub.com/doi/full/10.1177/0959353520930602

05/12/2021

Endometriosis and Irritable Bowel Syndrome

More often than not, deep infiltrating endometriosis affecting the digestive system is misdiagnosed as IBS. This adds more time to the already delayed diagnosis of endometriosis. Patients are pun on treatment for IBS and diets without noticeable results. In some cases though, certain diets alleviate the symptoms, giving a false confirmation of the IBS diagnosis.
Why are IBS and deep infiltrative endometriosis symptoms so similar? What are the underlying mechanisms for both pathologies?
Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders, but its treatment is unsatisfactory as its pathophysiology is multifactorial. The putative factors of IBS pathophysiology are visceral hypersensitivity and intestinal dysmotility, also including psychological factors, dysregulated gut-brain axis, intestinal microbiota alterations, impaired intestinal permeability, and mucosal immune alterations. It has been suggested that intestinal mast cells are intimately involved in these pathophysiologic changes. Mast cells are abundant in the intestines and function as intestinal gatekeepers at the interface between the luminal environment in the intestine and the internal milieu under the intestinal epithelium. As a gatekeeper at the interface, mast cells communicate with the adjacent cells such as epithelial, neuronal, and other immune cells throughout the mediators released when they themselves are activated.
According to one study, chronic low-grade inflammation is a common characteristic in both IBS and deep infiltrative endometriosis. Chronic low-grade inflammation results in the progression and persistence of a detrimental process leading to the structural and functional alteration of the organs involved. IBS and endometriosis share the presence of the common key factors in the genesis of low-grade chronic inflammation. Patients with IBS or endometriosis have an increase in the mast cells count in the colonic mucosa or peritoneal.
Accumulating evidence shows a consistent neurogenic inflammation which would promote the persistence of a low-grade chronic inflammation in both IBS and endometriosis.
The composition of the microbiota is significantly altered in both IBS and endometriosis.
An altered intestinal permeability can contribute to IBS and its related symptoms.

https://www.endonews.com/irritable-bowel-syndrome-andendometriosis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225338/

Photo source: verywelhealth.com

04/16/2021

⁉️Do you have any of these symptoms❓

‼️You don’t have to have full on hypothyroidism to have these symptoms.

😨Often, patients thyroid labs look “normal” or “within range”, however patient is still having several symptoms associated with under active thyroid‼️

Why is that❓

Well, just because lab values are within range, doesn’t mean they’re optimal and patient can still be symptomatic🤷🏻‍♀️.

This doesn’t only apply to thyroid labs, but to many other labs as well.

❓Do you know if your lab values are optimal ?
❓Are they “within range”, but you’re still feeling crappy?

If you need a second look at your labs or to find out why you’re still not feeling your best despite your perfect blood work, DM me or book an initial appointment (Yaletown location) or at www.ironwoodChiropractic.ca ( Richmond location) 👌🏻