Wednesday, May 24, 2017

Ideal birth; an image

We've seen all seen it. In the age of social media dominance, you've seen that gorgeous mom with the high top messy bun, eyeliner on point, perfect manicured nails, in a deep squat or on her back with a doting scruffy faced husband with a furrowed brow or bulging eyes at his instantaneous conversion of seeing his wife the sex goddess become his wife....The Godess. She is 40 weeks to the day, maybe even a few days early, she gained 20 pounds exactly, and only in the past 3 weeks gave up her back squats. She delivers naturally; probably in a birthing center. She is only moments away from the perfect latch and perfect milk let down. She will be enchanted by her baby immediately and will step into motherhood with grace. Because of her authoritative physical presence, no one will ask her when she will start watching what she eats. No one will bat an eye when baby sleeps for 9 hours a night after the first week until the baby is 13 years old. The baby will never have a blow out, ear infection, and certainly will never cry every night between the hours of 4:30pm and 8:00pm. She will wait the appropriate 4 hours after birth and her husband will post an image of mother and baby on instagram, and he will say his wife is the strongest woman he's ever met and he is SO in love with his new baby.

Gah, these people are such jerks! Right!?!? Nope. They aren't. They aren't jerks. They are two people that decided to have sex during the fertile phase of the ovulatory cycle, and as a result, she had a baby. Even that is presumptuous. That baby could have been prayed for, for years. That baby could be a rainbow baby. The point is not how other people do pregnancy and birth. The point is that you don't have to do it that way. 

There are general markers of pregnancy; as a whole, consuming a bottle of wine a night is not the best idea. It's a good idea to have a birth leader; be that a midwife, an obstetrician, or your Aunt Lucy. They are way more attuned to the best practices of pregnancy, but the focus here is that you choose. 

When anyone tells me they are pregnant I send them to the same place. It is my favorite place to send people because it is a webpage that offers, "40 questions for your midwife." Most often I send people there and they immediately say something like, "I don't even know what half of those words mean." This isn't meant to overwhelm you or make you feel stupid. This is meant to call you to a higher level of thinking. The questions asked on that page are going to make you ask questions. Hopefully, when you ask those questions, you get answers that make sense and align with what you want. My goal in practice is to empower parents to be as present with their children as possible and in my mind, this starts right with that first pregnancy test, and probably even before. 

Your ideal birth doesn't have here or there, or up or down, or right or wrong. It must be one where mama is comfortable. In my social circles, if I said, "You know, I really want to deliver in a hospital with an epidural." I would be harshly judged. That judgement would come from a place of education and statistically likely outcomes... but it's judgement nonetheless. I'm sure there are social groups that would faint at the idea of an unassisted childbirth; it would appear that the politicians making the rules on all of our births are in that crowd.

As a newb entrepreneur, I've been attending a lot of personal growth/mindset meetings in my community. 75% of them are amazing and worthy of your time, by the way. In those meetings the final, obnoxiously esoteric and yet also applicable recommendation, is to envision your dream. I don't see why birth should be any different.

When you think of birth, what are your first thoughts? I suspect that a solid 1/3 of the people reading this immediately thought of the financial burden. Ok, so let's take that and place it aside. What next? What do you see? I think, because I saw it right when it occurred to me that I might one day go through birth, I think of Katherine Heigl in Knocked Up; again...maybe not the best image.

Who is in the room? Who holds your hand? Does your hand need holding? Are you quiet and still? or panting and dancing and wild? What do the eyes look like of everyone in the room? Are they old and crinkled into anticipatory smiles? Are they wide open to take in every velvety moment? Are you on a bed? Or are you on the floor? Are there medical masks? What are you wearing? Are you wearing a hospital gown? Are you wearing a cute piece of lingerie, like women wear when they need an extra "oomph" of confidence? Are you wearing your spouse's old shirt? Are there windows in the room? What's the weather like outside? Are you inside or outside? When you give that last push, what is the first thing you want your baby to feel? Will a doctor catch your baby in nitrile gloves? Will your baby go from one aquatic environment to another? Will you pull him to the outside world yourself? And then what? Will there be shrills and screams of pleasure and excitement? Or will everything melt down into liquid serenity. Will anyone else exist in those precious moments?

I've been told a million times, "I thought I wanted to sit on the ball: I didn't want to sit on the ball". "I thought I would want my husband to rub my back: If anyone touched me I threw up." It's ok for things to change. It's ok to want to wear something special and then it gets poop or pee or some other bodily function on it and have to change. It's ok to start at home and end up not at home. It's ok to have a birth plan that goes out the window. But that doesn't make the birth plan any less significant. Have someone, or a team of someones with you to help you. If you don't want pitocin, and you are offered pitocin...that's not ok. If you don't want an epidural and you are offered an epidural, that's not ok! If you don't want your husband's sister's mailman in the room, guess what? THEY DON'T COME IN. You are delivering your baby into the world. Anyone else in the room is merely an observer or an accomplice in miracle work. Make sure your company is worthy of the experience; because birth is nothing short of miraculous. 










Monday, May 15, 2017

Chiropractic and Birth

For the sake of this post we will only discuss pelvic floor and mechanistic views of the pelvis for labor and delivery. There is A LOT more at hand, but this is the best entry point for what will later prove to be a pretty complex relationship.

Round Ligaments
These are best described as the ropes that tether the top of a hot air balloon. Before conception, these ligaments sort of hang off the top of uterus like arms. The fibers of the round ligament actually descend so far as the labia majora (external female genitalia). As the uterus expands to accommodate the growing baby, the round ligaments look like the ropes that go over the top of the hot air balloon keeping it on the ground.



This balloon is tethered, and look how roomy it is! This is what we want the uterus to look like. If a woman has a traumatic pelvic trauma like falling off of a bike, falling off of a horse, even some hard falls when she was a baby, these ligaments can have different tensions. This would lead to something like this:


This is an exaggeration, but our goal is to give baby as much room as possible to flip and flop and wiggle around all they want until the time comes to get serious. Then, when it's time to get serious we want baby to engage and exit with as much ease as possible, for mama and baby.

Sacrotuberous ligament
This ligament deserves a regal entry. This dude is the unsung hero of all pregnancy. So, the sacrotuberous ligament makes a lot of things work: it attaches the spine to the leg (sacrum to biceps femoris, aka major player of the hamstrings), it protects the pudendal nerve (responsible for muscle tone in the perineum--wowzas!!), contains branches of the gluteal artery, Similarly to the round ligaments, if a woman has pelvic trauma, this ligament can lose it's flexibility, thus preventing the pelvis from opening properly during labor.

Sacrospinous ligament
The fibers of the sacrospinous ligament are integrated into the sacrotuberous ligament, but this job of this ligament is to essentially create the greater and lesser sciatic foramen. If you have ever been pregnant, and developed sciatic-like nerve pain...this ligament could be a contributing factor. Again, this ligament, as it is so closely related to the sacrotuberous ligament is going to have heavy influence on the pudendal nerve, which is the nerve that helps determine the muscle tone in the perineum; if the perineum is taut, you are more likely to have perineal tearing and postpartum incontinence [1]

Abdominal muscles
The abdominal muscles are an accessory in birth. While the myometrium of the uterus is responsible for the actual contraction, the abdominal muscles are there for backup and extra "oomph". Guess where the insertion of 2/3 of the abdominal muscles are? Either directly on the vertebrae in your spine, or on the tissue that is attached to those vertebrae,


Pelvic girdle
The Pelvic girdle consists of muscles, bones, and ligaments of the pelvis that ideally open symmetrically to allow baby to exit. Pelvic girdle pain is exceptionally common in the last trimester and up to 16 weeks postpartum. Many of the muscles in this area are innervated by the pudendal nerve. Previously we said that the pudendal nerve was closely related to the sacrotuberous ligament, and that between the round ligament, the sacrotuberous ligament, and the abdominal muscles, the attachment sites for all of these are either on the spine or directly to the bones of the pelvis.

So what does Chiropractic have to do with any of this?
Chiropractors who specialize in pregnancy should know how to address all of these ligaments and bones. Our pelvis is responsible for keeping us moving. Think of it in terms of survival; our arms are held on by a flimsy articulation and 4 main muscles. You can lose an arm and still get away from the lion chasing you.Your legs are held on by one solid ball in socket articulation; in our body this is the most stable a joint can get and still move. Beyond that, there are at least 5 ligaments and 4 muscle groups (multiple muscles working together) to keep your leg on; because you need the leg to escape the lion. So then amplify that by a million, when we incorporate a mother's protective reflex, and you begin to realize the significance of this hammock that we make while pregnant.


1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279110/

Friday, May 12, 2017

Carbohydrate consumption and estrogen

It's been a while since we did a more keto/research filled post. So, let's hop on it!

First:
Estrogen dominance is an umbrella term for a culmination of health issues affecting not only fertility, but the whole body [1]. It is important to note that estrogen dominance doesn't necessarily mean an excess of estrogen, but potentially a lack of progesterone. This is significant because in some instances, decreasing estrogen may not be the issue. Over all, we know that elevated estrogen contributes to a gambit of health disorders, but progesterone is what holds estrogen in balance.

Next:
Previously I've shared some articles about long term benefits of a reduced carbohydrate diet. I'll openly admit that the fad aspect of the ketogenic diet makes me want to roll my eyes so hard... BUT, things gain momentum and popularity often because they yield some semblance of the desired result, so for the sake of my experiences with low carb/ketogenic eating, I'm going to stick to it as my reference point. Please feel free to look back at those articles for more generalized information.

Here's what we know:
Xenoestrogens are becoming more prevalent in our lives [2]. This often leads to the body being unable to accommodate with natural progesterone production. Think of it like a line graph.

Sometimes in the cycle, estrogen is meant to be higher. For you Marquette/NFP/FAM people, this is the proliferative phase of your cycle. After the period, estrogen is the hormone responsible for building up a nice pillow soft landing for that fertilized egg. After ovulation, estrogen is starts to wane and progesterone takes over. Again, for your Marquette/NFP/FAM people, this PHASE III!!!! 💗💗💗💗 (for non-Marquette/NFP/FAM people, this is the least likely time to conceive, so, many couples use this phase exclusively for intimate contact). NOW, the important thing to note here is that progesterone is the dominant post-luteal (post ovulatory) hormone. So, for all you postpartum mamas and daddies out there thinking "Oh my gosh! We DTD on day 234234234 (mild exaggeration of course) and peaked the next day!!!" Guess what? Our bodies are so smart that in the postpartum phase, progesterone is trying to come back on line after all that lochia and prolactin and oxytocin that usually that post-luteal phase is so short that the body doesn't have time to make that super comfy pillow before the period starts. This is also a serious concern for all estrogen dominance disorders. This is only true for breast feeding mamas. Formula or non-ecological feeding mamas tend to have an earlier return of their period, and thus, ovulation [3].

So, let's say someone, somewhere, with some authority, has told you that you are estrogen dominant, or you've been diagnosed with dysmenorrhea [4], endometriosis*, uterine fibroids [5]. The information below belongs to you.

From research presented in this post, we can gather that there is a correlation between estrogen related health disorders and thyroid health. We can also gather that there is a relationship between estrogen and liver function. The liver metabolizes fat, filters the blood, and sends cholesterol packin' for the exit.

There are two main reasons that carbohydrates can be a contributing factor to estrogen dominance.

1. Fructose, the sugar from fruit, bypasses normal sugar breakdown and is immediately taken to the liver for storage (fat). Eating WHOLE fruit, not just juice, slows this down, but it happens nonetheless [6]. Also, fast available energy is going to unavoidably increase blood sugar (that's kind of the point), thus kicking the liver into "work mode". This should be a normal and common occurrence, however, in the proportions of the standard american diet, the liver simply can't keep up, at least not on any long term basis. This taxation forces the liver to "prioritize", and depending on the body's state, different things will result, but in any case the result is not the optimization of liver function [7]. Think of it like Lucy and Ethel eating chocolates off the candy line. Recent research shows that adipose tissue (fat) can actually produce estrogen, thus further contributing to the estrogen dominance [8].

2. The other way that carbohydrate consumption influences estrogen, and to me this is the biggest shocker, is mold. MOLD. This one blew my mind. Below, under "extra fun reading" you'll find one legit article, and then several weak, or wiki articles. These are purely supporting pages that let you know the sources of the mold mentioned in the first article. These molds that are directly known as estrogen metabolites are covering most grains, beans, and corn. It's not their fault that these molds love them so much, but anything that is mass ground (wheat, barley, corn) is going to contain at minimum trace amounts of these contaminants. And we aren't saying, "oh this may be a contributing factor." Science is saying "this may be THE THING". Mold.

By consuming a sub 25g net of carbohydrates a day, you are most likely not fitting wheat, corn, or beans into your diet. Thus, potentially removing 60-80% of the contributing factors of estrogen dominance.

*Frankly, non-reputable sources highly correlate endometriosis to decreased sensitivity to estrogen receptors...but I can't find anything that is accessible to the public (there are about 17 sources on pubmed, if you have access), but I wont cite crappy research.



1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3113168/
2. https://ehjournal.biomedcentral.com/articles/10.1186/1476-069X-11-S1-S8
3. http://journals.sagepub.com/doi/abs/10.1177/000992288802700804 ** if you have access to this article it is GREAT. I can't find it for free to share with you :(
4. https://link.springer.com/article/10.1007%2FBF02134006?LI=true
5.http://www.nejm.org/doi/full/10.1056/NEJMra1209993
6. http://www.health.harvard.edu/heart-health/abundance-of-fructose-not-good-for-the-liver-heart
7.http://www.sciencedirect.com/science/article/pii/0022473187902007
8.https://www.ncbi.nlm.nih.gov/pubmed/11511861

Some extra fun reading about contributing factors of estrogen dominance:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164220/
    a) https://en.wikipedia.org/wiki/Zearalenone
    b)https://en.wikipedia.org/wiki/Gibberella_zeae
    c)https://en.wikipedia.org/wiki/Fusarium_culmorum

Wednesday, May 10, 2017

Ferocious Love

Today is not really about chiropractic, keto, or fertility. I guess my last post wasn't either. But today is sort of about my culmination of topics that is fed by my, "Why". Why does all this matter? Do these things even belong in the same sentence? Well, first, a story.

In 2009 I started working for a family in Santa Maria. I hadn't changed a diaper in over 10 years. I'd never worked with a kid with cerebral palsy. But here I was, killing it (sarcasm). I worked for a family with three children. A set of twins and one younger child. The twins' birth had been complicated and as a product, one of the kiddos had a fairly advanced Cerebral Palsy (CP) diagnosis. I was coming in about 6 months after his feeding tube had been removed; I think he was around 7 years old. When I met him, he was vibrant, intelligent, and really in to Batman. While he couldn't walk unassisted, his original prognosis was that he would never talk or eat. One time the mother told me that a doctor consulted her soon after the twins' birth and suggested that the twin with CP go to a home for children "like him." Her response is officially the topic of the day: "Not my boy."

This woman worked a full time 3rd shift job so that she could accompany her son to school when the school provided aid would unavoidably fail to show up. She worked full time in a separate business built for him to get the therapies needed to make him mobile. She lost friends, received criticism from family, and sacrificed promotions at work to make sure that her son was advancing. Her drive and passion throughout the past 14 years is, "He has to be able to survive without me."

So this week, as we barrel towards the Mother's Day weekend, I'd like to celebrate a certain mother demographic, the "Ferocious" Mother.

The ferocious mother is the mother that once she leaves the room, everyone's eyes widen and they exhale for the first time since she walked in. The ferocious mother smiles and rocks on her heels, laying in wait, as she anticipates the fallout. And once the first brick falls, she springs to action like a lioness towards her babies, keeping them safe and slaying people blocking the path towards her children's success. The ferocious mother succeeds when her children accomplish what doctors, family, experts, and sometimes even the children themselves, think can't be done. The ferocious mother is silent and pleasant, until the first glance of a furrowed brow from a baby. Then the ferocious mother becomes a wolf on the hunt.

As most of you know I am not a mother. I hope to become one, sooner rather than later, but as it stands, I don't know what it feels like to love something as fiercely as a mother loves a child. And it is also worth noting that ferociousness is not inherent. The mother that I am talking about is made through desperation. Some mothers are not this type of mothers, and guess what? That's ok!!!!!!  I don't suspect I'll be this type of mother; maybe that's why I have so much respect for these women that fight so hard for their babies.

I love ferocious mothers because a ferocious mother raised me. I was a little girl with a loving father and an absent mother. My grandmother saw that I needed ferocious love and she took me and protected me until her dying day. She pushed me, often to the detriment of our own relationship, towards success and away from the habits and traits that broke my own family apart. I'll never forget her wagging finger as she told my step-father that no stranger would be taking her granddaughter away in a car. I'll never forget the subtle dinner conversations that said, "When you go to college..." And even though she passed away before I started Chiropractic school, she knew I was going. She, in her 60's was waiting for me at midnight after marching band competitions. She threatened me, not with failure, but with mediocrity because to fail meant that I'd tried.

I met a woman recently, with two boys. She thinks that she hurt my feelings. She thinks she was mean. But I must say, with absolute adolation, that she simply let me know that she loves her children ferociously, and she wont let anyone stand in the way of her children's success. So to you, sweet, fiery woman, Happy Mother's day.

Tuesday, May 2, 2017

Resistance is futile...




Resistance. So, I've been reading The War of Art, and yes, I wrote it correctly. The main point of the book is that there is a force acting against our best intentions that keeps us from achieving our greatness. These barriers to success are usually some variation of rationalization and can best be visualized with the stereotypical frayed hair and twitchy fingers of "writer's block". These are what keep us in bed instead of going for a run. These are the reasons we don't firmly stick out a hand to our heroes and introduce ourselves. And frankly, these are the reasons that Chiropractors never have a community that understands what they do. 

I am a big fan of  knowing your enemy. Resistance is my enemy. It, for me, is the "Don't go to that event, you're so tired." or "Life is hard right now, go watch netflix."We combat resistance by doing what we are afraid to do or what would make us less comfortable. Why are you not getting out of bed to go on that run? What about 30 minutes of sleep (let's be real, facebook), is better than running around the block? 

I'm going to touch a very sensitive subject; one that I have rolled my eyes over for literally decades now. Have you ever known someone with an ok job, or a crappy job and one day that person tells you they are going on a crazy trip to Indonesia? Or that same person comes up to tell you they are going to Europe for a month? And immediately, you think something like, "Where did they get the money to do that?" We must delegate what we value; time and money are easily the most valuable things to most people. Ironically, those two things seem pretty inversely proportional but at the end of the day those two things are what make the world go 'round. So, many situations leave us exchanging money for time, or time for money. And that is the balance right? That's simply how it works. If you know how to get me more of both of these things, PLEASE do not hesitate to contact me :). However, what we need to squash right now is that you don't have time and you don't have money. Neither of those is true. If my super young, super optimistic, go get 'em friend can work a part time job waiting tables for 10 months and then take a month long trip to India, we all need to think about our "resistance" or our "values". 

I implore you to stop saying that! On the other hand, saying "I don't value it" is one of the most powerful things you could ever say. This says to people "I value my time and my money more than I value what you are offering me." And THAT is a game changer because it is a) the truth b) not propagating negative thoughts into the universe c) giving the presenter the opportunity to hear, "hey, what you just said, doesn't make me care any more about what you are doing. So... change it up. Come back later. Make me want it more," How useful is that? My entrepreneurial spirit is swooning at that type of constructive criticism. 

Now, let's tie it all together. I made the photos above, but I certainly didn't write them. Some of you may know that, some of you may have never heard of them before. This weekend I turned 30 years old, and on Saturday morning I attended a women's conference. Fact: moms don't do women's conferences. It's like they're busy or something? :) This conference rubbed me the wrong way. It was offensive, and kinda sorta in conflict with some major teachings of the organization, all that to be said, this was the blessing at the beginning of the meeting. I didn't want to go to this conference, and after I went I wasn't any more pleased but I defied resistance by attending. These commandments, another version of which hung at Mother Theresa's clinic in Calcutta, are my favorite thing. I think they are God, or the Universe's way of saying "Keep going." 

Despite my love of Star Trek, especially Jean Luc Picard (swoon again), resistance isn't futile. Maybe my fist-to-cuffs opposition of resistance is saying through gritted teeth, "Resistance! You are futile"... but really it serves a purpose. It is there to let us know that when we feel most resistant that is when we are meant to push back harder. 

So don't tell people you don't have time. Don't tell them that you don't have the money. You do. If you wanted to, you could. There are a million ways to scrape time and cash together. Tell them flat out that you don't value what they have. Be mindful to the resistance; do you not value it? Or are you afraid that it might actually make you a better person?