How to pick the right doctors for your pregnancy.

Ask around.

Odds are that you have a friend or two who thinks their doctor is great. Talk to childbirth teachers, your general practitioner, or your chiropractor. If you are already seeing a gynecologist, find out if they practice obstetrics as well.

Do you like where your doctor has hospital rights?

When my wife had our first baby, she delivered at a large area hospital. We both disliked the “move 'em in, move 'em out” mentality. So despite a great OB, she switched to a different practice for our next two. She delivered in a smaller hospital where we felt we got a lot more individual attention. However, everyone values different things.

Some things to think about:

Does my hospital have a high level neonatal intensive care unit? Does my hospital have 24 hour anesthesiologists? Do I have an option for labor tubs or showers?

Does my doctor have similar views or respect mine?

What are your doctor’s views on natural childbirth? Inductions? Elective c-sections? Fetal monitoring? Episiotomy? Be sure to discuss these things with you doctor early on, so you are completely comfortable later. In the whirlwind of giving birth, you don’t want to find out you are on different pages.

Practice Size?

 Do you like to see the same doctor every prenatal visit? Would you like more than one opinion? Do you mind waiting or rescheduling a visit if your solo practitioner is at the hospital? Does the practice include midwives?

Chiropractor?

Look for a chiropractor who has advanced education in pregnancy and pediatrics. This doesn’t mean that a general chiropractor can’t do a great job, but if you are starting out check out the American Pregnancy Association for a great recommendation.. Before making an appointment, call the office and ask if the practice sees a lot of pregnant women. Ask about the techniques used and if the doctor is certified in the Webster Technique.

It may seem like a lot of work to do at the beginning of your new adventure, but these tips will pay bid dividends in the end.

Any other good ideas? Leave a comment!

Swollen Feet in Pregnancy

Swollen feet seem like an unfair jab toward the end of pregnancy. You have heartburn, you visit the bathroom multiple times each night, your baby is poking and prodding from the inside, you can’t get up without grunting, even your maternity clothes are looking too small, oh and by the way……….now your feet are too swollen to fit into the last vestige of your former wardrobe. (My wife’s words.)

Swollen feet and ankles are an annoyance for some and, for a few, very painful. Most of my pregnant patients ask about the swelling and a few have shown up in the winter wearing flip flops. So here goes:

What causes the swelling?

Edema is the medical term for an increase of fluid within the tissues of the body. In pregnancy, edema occurs because the volume of blood in the body doubles. (That extra volume of blood is needed to nourish your baby) This extra fluid needs to go somewhere, and gravity does its job. Now, there are a few more factors at play here. Increased weight gain and our friend relaxin (which allows the bones to more easily spread) complete the perfect storm.

What can you do?

Edema from pregnancy is temporary and it most cases fairly benign. That doesn’t mean it isn’t annoying, so, here are some things you can do to cope in the meantime:

• Put your feet up periodically during the day. If you work at a computer, see if it is feasible to rest your feet on an adjacent chair.
  
  
• Drink plenty of water and don’t cut down on salt. The body has a very delicate balance between sodium and water, and cutting down on either can actually make swelling worse.
• Don’t cross your legs. Compressing blood flow will make the swelling worse.
• Wear comfortable shoes. Sorry, no heels!
  It is okay to wear your regular shoes (some women say that the compression actually eases the ache) but be warned, that once you take the shoes off…they aren’t going back on until the next morning.
  
  If you feel more comfortable in a larger size, make sure the shoes are low heeled, and supportive. Go shoe shopping in the evening when your feet are the most swollen!
• Do foot exercises. Scrunch your toes up for a count of five and then relax. Do heel lifts.
  
  
• Make your husband rub your feet!

Your swelling should be a distant memory within a week or two after delivery. However, it is common for feet to stay a half size bigger after pregnancy.

*If you notice swelling in places other than your feet and ankles (especially in your face) or very sudden swelling, see your doctor immediately. This can be a sign of pre-eclampsia.

Is it Pubic Symphysis Disorder or round ligament pain?

Pubic Symphysis Disorder (PSD or SPD) is a painful condition felt in the pubic area and is often mistaken for round ligament pain.  Unfortunately not a lot of OBs will give much heed to PSD (or even round ligament pain) because they cannot do much about it.  However, being able to distinguish the two will allow you to choose a more effective remedy in reducing your pain.

1. Where is the pain?

PSD: Almost always the pain is felt at the pubic symphysis joint—the bony part at the top of the pubic area—and will be very sore to the touch.  The pain usually radiates down into the groin and will often also radiate out into the hip joints.

Round Ligament: The pain is usually felt in the lower abdomen and slightly off to one (or both) sides.  It often radiates into the groin and/or around the sides to the flanks or hips.

2. What is the quality of the pain?

PSD:  Sharp and intense.  For some the pain feels like they are breaking open from the inside or their hip bones are grinding together.  Oftentimes a clicking sound is heard when walking or moving.

Round Ligament:  Also sharp and can be intense.  Many times the pain happens suddenly.

3. When is the pain felt?

PSD:  When standing, walking, shifting while sitting, and intensely when rolling over in bed.  The pain continues even after stopping the movement.

Round Ligament:  When performing sudden movements and usually diminishes if not goes away after a few seconds.

If you still aren't sure which it is here is a simple test: stand on one leg (please use your arms to support yourself when doing this).

PSD: You will experience increased pain or even an inability to stand on one leg (the other leg may give out).  You will find it difficult with activities like walking up stairs, raising one leg to put on pants, or getting in/out of a car.

Round Ligament: You will experience minimal, if any, change in pain and should find it easy to stand on one leg.

Here is a side note: Sciatica and sacroiliac joint dysfunction (SIJD) are sometimes co-conditions of PSD.  The presence of sciatica or SIJD does not rule out PSD, but it doesn’t guarantee it either.

6 Ways To Get The Most Out Of Your Fish Oils

                                                    

1. Take with meals or immediately after meals 
   Food triggers the release of enzymes (to digest the food) which will also work to break down the fish oil so they can be absorbed by the body. (An added bonus: You are less likely to have fishy burps!)
2. Take your fish oils with a fatty meal.
   The fats in a meal will trigger the release of bile and fat-specific enzymes (called lipases).  The bile breaks apart the globules of fat (like dish soap does to grease) and allows the enzymes to break down the fat molecules.  Since fish oil is also fat, the process works on it as well.
3. Don’t take fish oils when eating oatmeal.
   The fiber in the oatmeal absorbs the oil so it's not available for your body.
   
4. Take a high quality fish oil.
   Take one that has been quality tested for low levels of mercury, lead, and arsenic, and have at least 60% omega-3 fatty acids. Better brands will always tell you fish species and location and are molecularly distilled to remove heavy metal toxins.
   
   I recommend  Nordic Naturals, Zone Labs Omega Fish Oil,and Carlson Lab Fish Oils. My family uses Nordic Naturals. It has a lemon or strawberry flavor that makes it palatable to the kids, and if you have an odd burp here or there, it tastes good. Nordic Naturals is also the official omega-3 of the American Pregnancy Association.
5. Don’t skimp on your fish oil
   You should be consistently taking fish oil every day at a minimum dosage. Research states that pregnant women should be consuming a minimum of 300 mg of DHA a day (not total Omega-3s, which will be a higher amount).
   
6. Don’t think that the added DHA in your prenatal vitamin will cover you!
   The DHA in prenatal vitamins has been broken down from its natural triglyceride form in order to be incorporated into a solid multivitamin. DHA in that form is not as bioavailable as it is in fish oils. As new research finds, you must take EPA with the DHA for it to work properly Link for more info
   
   For more technical and indepth information visit my latest article here

Colic and Chiropractic

Do you have a baby with colic? We had one, and it still sends shivers down my spine! He is a healthy well adjusted 10 year old now, but there was a time we called him our “incredible screaming machine”. Nothing else can pierce your very soul like a screaming, hurting child. You are desperate to help him and helpless at the same time.We tried all of the various medications (we didn’t know what else to do) and they each were relatively ineffective and we worried about side effects.

When our 3^rd son was born, he was set to rival number 1, but I was armed this time with a chiropractic degree and a lot of experience. We didn’t use drugs, I adjusted him a few times and gradually the screaming for hours on end diminished.

Colic is defined as unexplainable and uncontrollable crying in babies from 0 to 3 months old, more than three hours a day, more than three days a week for three weeks or more, usually in the afternoon and evening hours. In other words, no one really knows what causes it or what it really is. I think it is probably mostly gastroesophogeal reflux with a  few other unknown conditions thrown in. (But that’s just my best educated guess!)

Colic is such a common condition of childhood that it is said to affect some 16% to 26% of children in their first year of life. Most parents are told that this is a harmless rite of passage for your baby, however the condition is stressful to both parents and baby alike. Parent-child interactions have been found to be less than optimal when a child has colic. Afflicted families experience more problems in their daily functioning than families without colicky infants.

If you visit your child’s pediatrician you will most likely be given simethicone drops, some form of an antacid, or a stronger drug like Prevacid. (We tried them all, and to no avail.)  There are a couple of problems with this treatment.
1) No drug is without side effects (Adverse effects associated with these medications include drowsiness, constipation, and diarrhea, as well as more serious effects such as apnea, seizures, and coma.)

2) Randomized controlled clinical trials have found them to be ineffective!

At this point, you are probably crying right along with your baby…but don’t despair.

Chiropractic treatments have been found to reduce colic symptoms and severity. Here are 2 of the studies:

·        A study conducted by N. Nilsson, interviewed parents of 132 infants with colic, found that 91% of the parents reported an improvement following an average of two to three patient visits and one week after initiating care.

·        M. Klougart and colleagues described 316 infants suffering from colic receiving chiropractic care. Based on an analysis of diaries kept by their mothers and parent interviews, 94% percent of the patients benefited from chiropractic care.

This is great news for parents and babies.  As a parent I saw, first-hand, the difference. As a chiropractor I have seen the difference in my patients again and again. Visit my office at www.abetterbrain.com