Our Birth Story: Everett John

My “due date” was scheduled for September 25. Getting towards the tail end of a very smooth, healthy, uneventful pregnancy, I still hadn’t felt what I’d consider to be any sort of Braxton- Hicks, or “practice” contractions. I’d stopped running once I was about 38 weeks pregnant but still kept active, getting a daily walk in by Pine Lake and continuing to work in my physical job as a chiropractor up until the day prior to going into labor. On the evening of the 23rd, a Saturday, I was mostly by myself as my husband and in-laws were working across town from our apartment on getting our recently purchased home ready to move into.  I attended evening mass and picked up a spaghetti dinner to go from the youth group fundraiser. After eating about half of the meal I found myself to be exhausted and laid down to take a very deep 1-2 hour nap. I woke up feeling out of it but well rested. Later that night while talking to my in laws before bed around 11 pm, I felt uncomfortable in my GI area. Not thinking much of it, I got ready for bed and went to sleep. Around 3:30 am I woke up to use the bathroom, nothing out of the ordinary for me in my third trimester of pregnancy. However, I was feeling uncomfortable in my GI region again with mild cramping. My little sister, who was out with her friends that night and had sent me a late night text, was the first one I filled in on the fact that I may be in the early stages of labor.

I continued to get up every 20-30 minutes to use the bathroom and began to realize that I was having the cramping feelings for more sustained periods and at more regular intervals. Could this be it?! I was expecting to have our baby well after the due date with first pregnancies tending to be longer on average and the lack of Braxton Hicks up until this point, but began to think I may be in labor since it was the day before my due date. I waited until 5 am to wake up my sleeping and unaware to this point husband. His parents and brother were staying at our apartment for the weekend as they were helping work on our recently purchased home. My husband suggested they go to put our car seat in the car as it may need to be used soon. After installing it in the car they headed to our house to work more and leave us alone. Zak suggested we go for a walk, so mid-morning we headed to the lake to go for a walk. It was short, as contractions periodically made it quite uncomfortable. We turned around after a half mile or so and came back home. My contractions were coming on at somewhat regular intervals but then would have larger gaps of 12-20 minutes. This continued off and on until mid-afternoon.  I showered and we watched football while I spent time during contractions on my hands and knees leaning on the exercise ball. I attempted to nap several times but found lying on my side strengthened contractions. I ate some oatmeal to give myself some energy but otherwise was not too hungry. When contractions got to be about 4-5 minutes apart for a consistent span, we first called our Bradley teacher, Erin. We did not reach her so I left a message and called Covenant, where I was planning to deliver our baby with the midwives there in the hospital. They suggested we come in with our impending 50 minute drive and if I was not far enough along I could walk to speed things up. I was apprehensive, as I was nervous about what could come up with traveling to Waterloo and transferring from the comfort of our home to the hospital. We packed and left, headed to Waterloo around 4 pm. Erin called back on the way and suggested I follow my gut. Zak and I arrived in Waterloo and decided to head to a nearby park and walk a bit more before heading in to triage. We walked for about 10-15 minutes, again finding myself to be too uncomfortable during contractions to go much further. Crouching down seemed to help when they came on.

We then went to the hospital and checked in to triage. They checked me for the first time during my pregnancy and determined me to be about 7 cm dilated. We were there to stay. Mine and the baby’s vitals were found to be good, and we were escorted to our room that we would not leave for the next few days. Upon entering the room, I was hooked up to IV antibiotics via a heplock as I’d been tested to be GBS positive around 37 weeks. It did not limit me or bother me physically as I’d imagined it would, but mentally I was apprehensive, concerned about my first time being administered them while in labor. Again, I found myself to be least uncomfortable when kneeling and supporting myself while leaning forward onto the exercise ball. We first watched the Packers beat the Bengals in overtime. : ) I then continued to labor on the ball. My legs and feet were sore from maintaining the same position for so long, and my lower back muscles were growing sore from tensing up in a flexed position. Luckily, my chiropractor husband was able to apply proper counter pressure to my lower back to help me feel more comfortable. My midwife and nurses suggested I get into the tub, as my water had not yet broken. They started the bath for me and I got in. Upon getting in, my contractions were getting much more intense, so I was not able to relax and enjoy it as much as I’d imagined. The more I tried to “relax”, the more intense and more quickly the contractions seemed to come on. Kim, my midwife, “set the mood” to make things more relaxing, turning the lights down and setting up tea lights. How romantic! ; ) Eventually while in the tub my water “broke”, feeling much different than I’d anticipated and more uncomfortable. It felt like an intense pop, happening quickly and very obviously. Shortly after, I got out of the tub to go back to the room to see if I would be able to start pushing soon. I was run on another round of antibiotics as it’d been long enough since my last round. I was cold getting up and out of bed, so they wrapped me up in numerous blankets. I then got quite hot as I later began pushing. I was lying on my back, angled 30-45 degrees to my left. It was not the position that I would have chosen or envisioned, but I did not want to move once settled as I was nervous I’d lose the progress I’d made. Pushing was a lot more work than I’d expected it to be and took longer, at least an hour or so. With the encouragement of Zak, my midwife, and the nurses, I was able to eventually muster up the strength to deliver our perfect little boy at 11:58 pm on September 24th, 2 minutes before his official due date. Everett John weighed 7 lbs, 13.4 oz and was 19 ¾ inches long. The placenta was delivered very shortly after, within several minutes. I am not sure about the cord pulsation and timing of cutting it with the quick delivery of the placenta. It was suggested I get Pitocin to slow the bleeding after delivery. We asked for time to wait if it wasn’t too threatening, and ended up not needing it after all. Zak was able to catch baby Everett and to cut the cord. I did not need an episiotomy, as our midwife applied a warm compress while delivering our little boy.  I ended up needing about 5 stitches that required local anesthetic, otherwise successfully completing our goal of a natural childbirth without pain medication.  I really enjoyed working with Kim and the nurses on staff during delivery, as they respected our birth plan and me as much as I could’ve hoped. I highly recommend working with her and her team.

Looking back on Everett’s birth, I remember feeling exhausted, worn out, and overwhelmed, not sure I wanted to add a sibling for him any time soon. I also remember feeling more accomplished than ever before and proud of myself for enduring such a challenge, starting off motherhood in a state of empowerment, in awe and excited to begin this next stage of life with our new baby cuddled in my arms.

 

“There is a secret in our culture and it’s not that birth is painful. It’s that women are strong.” -Laura Stavoe Harm

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“Me, too”: Self-Care for Moms

self-care quote
You cannot pour from an empty cup. You must fill your cup first.
Self-Care.The practice of taking action to preserve one’s own health.” Among no population is this more important than mothers. Among no population is this more difficult to set aside time and energy to work on than motherhood.
Similarly to the concept explained to us each time we step foot on an airplane, we must put on our own oxygen mask prior to helping others. We must secure and preserve our own health so that we can survive ourselves, and allowing us to help others. This includes keeping ourselves physically in good condition, so that we can work at maintaining adequate supply when nursing and physically pick up and carry our babies, or get down on the floor and play with them. This also means allowing our bodies to heal postpartum so that we can maintain healthy function moving forward (because no one likes to pee when they giggle), potentially in preparing ourselves to do it all again in furthering the growth of our families. This includes being mentally and emotionally fit, so that we can better raise secure children who have a confident mother as a role model.
One key component of self-care is that it is something we deliberately do to take care of our mental, physical, and emotional health. It is not something we should feel forced to do. It is not a selfish act, either. It should be something that refuels us, rather than taking away from us.
But how do we do all the things while raising the next generation at the same time? Break down several key areas to focus on and start little bits at a time. Here are a few ideas to get started on some key areas for moms to focus on:
1. Movement. This can be tough, especially early on when you have a little one. One hack that I found to be helpful was doing body weight + baby exercises, where I would hold my son while doing squats and lunges (being conscious of good form yet). He loved getting held while getting to do something new and I got some resistance training in-everyone wins. One great piece of equipment to invest in (or register for) is a quality jogging stroller. Everyone feels better with a little fresh air, and often times baby will get a little nap in. Earlier on I worked through a focused program on restoring core strength and proper pelvic floor function. Further along in my postpartum journey I began training for a half marathon (we’re talking 9 months down the road), which gave me something to strive for and some “me” time when I got up a little earlier to run on my own. Furthermore, check out if your area offers any “baby and me” yoga or other fitness classes where little ones are not only welcomed but encouraged to come.
2. Diet. Your body is not only recovering from a significant “athletic event” with the recent labor and delivery of your child, but you are also currently needing to have enough energy to care for and raise this child, plus potentially any older children you may have, as well as maybe nursing your new baby and being their primary source of nutrition. Whew. You need to fuel your own body with strong building blocks to keep yourself and your dependent(s) going. Focus on easy to grab, healthy, nutrient-dense food. No bake energy bites are great to grab as a snack. Eat hearty, nutritious meals. Crockpots are great for preparing soups and stews that can be saved for leftovers depending on the size of the tribe you’re feeding. Limit refined sugars and processed foods. Not only are these lacking in nutritional value but as a mother it’s time to think about the habits your children are learning from the environment around them.
3. Rest. For all of the reasons above, including recovery while simultaneously supporting your growing family, it is so important that you rest and allow your body to heal. Our body and minds need time to rest not only so that we can heal but so that we can be our best, most present selves for our families. This may be difficult, especially in the early days (speaking from experience), but with some support and prioritizing it can be worked on.  Nap when help is present to care for your baby. Nap when your little one(s) nap if you’re able. This section is purposely entitled “rest” rather than “sleep”, as it is meant to take the pressure off of feeling like you need to be sleeping through the night right away (or for the first few years…). I felt so much better about my sleep when at a follow up visit several weeks after the birth of my son my midwife asked how much sleep I was getting. I was unsure and hesitant at first, but she made me feel more “normal” asking if I was getting at least 5 hours of “interrupted sleep” throughout the day and night rather than my comparison to the usual/”recommended” 8 hours. The more the merrier as far as sleep goes, but knowing I was at or slightly above “normal” for a new mom made me feel more energized and empowered in itself. Furthermore, human milk is designed to match its species, in that its composition accounts for human babies and moms being meant to be “attached” (more dependent on) or closer together when young, compared to other animals that may have different fat content levels and are designed to be more independent earlier on, requiring less frequent feedings (cows, for example). Research safe co-sleeping. Not all co-sleeping is equal-it can range from dangerous locations such as on a couch or with other risk factors (obesity, smoking, alcohol consumption, etc) to the very safe room-sharing. When done properly it is not only safe but studies have shown other benefits including increased sleep for Mom and baby, a better breastfeeding relationship, and reduced risk of SIDS. For more on breastfed babies and sleep, check out this La Leche League article.
4. Take time to do what you love. Along a similar theme to being your best self for your family, taking a break to do what you love helps allow you to be more present when you’re with your family. Whether alone, with friends, your spouse, or even with kids in tow, carve out time to partake in your own hobbies. This could mean attending a fitness class or going on a hike or run, ladies’ night out, date night, or simply enjoying your beverage of choice while reading a good book.
5. Stop comparing. Technology and social media are great tools to help us keep in contact with friends and family, especially those who live elsewhere. However, please recognize when you get caught comparing yourself to others, whether it’s your cousin who has the perfect looking family, your college sorority sister who has bounced back from each pregnancy looking better than ever, or your high school acquaintance who’s traveled the world since graduation. Most people generally don’t share their struggles with the world, so remember that you’re only getting their highlight reel. We all have struggles in life, and comparing ourselves to others to the point it gets into our heads is not healthy. If you find yourself feeling worse after scrolling the old newsfeed, unfollow those who may evoke those feelings, or better yet, cut back the amount of time you spend on social media in general.
This list is not comprehensive, as there are many other ways to “fill your cup” (and avoid emptying it) as a mom, whether you’re newly expecting or transitioning to life as an empty nester. Feel free to reach out if you are looking for further ways to take care of yourself or more resources. When we are better versions of ourselves, we are better moms and better role models for our littles.
Hang in there, mama. This season will not last. Remember that the days and nights can be long, but the years oh so short.
In good health,
Dr. Emily

An Opportunity You Cannot Pass Up

Elections were held last week. One big issue that seems to come up every time an election takes place as well as has a regular spot in our newspapers and evening segments is the troubling state of healthcare in the US. Ever rising rates of chronic disease, subpar maternal and infant health, and increasing obesity (especially alarming among kiddos) are literally and figuratively crippling us as a nation. There is also the question of the rising costs spent on illness and who will pay for those rising costs. As nice as it would be for someone to take care of the problem for us, the solution to these issues will not come from Washington DC or Des Moines or your doctor’s office, but rather right in our own homes. That’s right, we hold the solution. Spending time with my 13 month old recently reminded me of how observant he is already at such a young age. Kids are like sponges and they are watching what you do. The choices you make in the kitchen, the meals you are preparing, the physical activity that you get in, how you choose to respond to a health issue or injury when it does arise, and how you spend your free time together are more important than you think. Your kids are watching, and they are taking it all in. Not to mention the fact that the better health you are personally in, the better version of you will be able to care for and play with your kids and grandkids. No matter what moves are being made upstream by legislators, there will be no greater influence on our youth, the future of our nation, than the examples they see lead by their role models at home day in and day out. We tend to blame genetics for many patterns we see running in our families. While our genetic makeup may predispose us to certain conditions, it is our common environment that nurtures our bodies as we grow. Take this opportunity to improve your child’s view of what health looks like and contribute to solving our nation’s health crisis.

pine lake trail stroller

Rerouting Your Mom Goals

 

I failed. I competed in a half marathon last weekend and failed.
I finished the race with a lifelong friend as we’ve always wanted to do (yay!), met my time goal, and felt significantly better than I ever have before in running a distance that long, but…I failed. I failed my expectations I set for myself before I became pregnant and a mom. Being a lifelong runner, before becoming pregnant but when thinking about having kids, I always had the mindset that I’d compete and finish a half marathon by the time my baby would turn 6 months old. This may not sound unreasonable for some, but oh boy, was it unrealistic for me. I did not even sign up for this race until my son was over 9 months old, and it was at the urging from a friend. Besides getting myself back into good shape in regards to cardiovascular function and endurance, I’d had to work at adjusting my whole life to another human being’s schedule-no small task. Sleep was hard enough to come by at times, and extra early wake ups to get a run in were not at the top of my priority list. Over time, with growing confidence as a Mom, an extremely supportive and encouraging husband, and a super smooth jogging stroller for cross training runs with my “coach”, I persisted and got my proverbial groove back. Not only did I get back into it, but I feel I’ve come out better than I was before. This is not a congratulatory post for myself (though we could all use more self-love), but encouragement for other active moms out there wondering when you’ll be able to get back into it. Mamas-be kind to yourselves. Take care of yourselves and by all means, make your health a priority along with that of your family. But remember that taking care of your health means that you ease back into exercise and heavier activity. Prioritizing working on a strong foundation in making sure your core and pelvic floor are in good, working order besides further stress is placed on them. Get the sleep that your body desperately needs when you’re able. Accept help from those you’re comfortable with. And remember to be kind enough to yourself to say “I may not have met expectations set by pre-baby me, but just like my physical body, this new Mom-me will strive to come out stronger than ever before to be a better me and role model for my son.”
In good health,
Dr. Emily

half marathon mom&ev

 

Concussion Part 3: Treatment Overview

Concussions can cause long lasting symptoms that have major side-effects for those that have suffered from them. Various treatments for concussions are beginning to take shape, but due to the variable nature of symptoms and gaps in the knowledge of concussions, there are no known cures for all concussion-related side-effects. However, through chiropractic adjusting, targeted exercises, and various nutritional supplements, post-concussive symptoms may be resolved quicker and with reduced chances for long term side-effects.

Chiropractic adjustments can help in the immediate aftermath of concussion due to a couple different factors. With most concussions there is an effect on the cervical spine due to the force on the head that causes many concussions. Most of the time, this is similar to a whiplash injury in a car accident. The whiplash motion causes a sprain/strain in the muscles and ligaments of the neck, especially in the upper region towards the base of the skull. Injuries to this area can cause headaches and at times dizziness. It is imperative to have these issues addressed and to begin the healing process as soon as possible so that going forward the physician is able to differentiate between symptoms that may be caused by the concussion and symptoms caused from the neck injury. Chiropractic adjustments also help after a concussion because there is a connection between the muscles that connect the first two vertebrae and the skull with a tissue called dura mater that surrounds the brain. When these muscles tighten after a whiplash injury, the muscle-dural connection can cause symptoms similar to a concussion.

Targeted exercises can begin to speed up the healing process by retraining the brain similar to how you would retrain your hamstring to function after a muscle tear. Two of the most important areas to retrain include your balance and regaining the ability to stabilize your gaze when focusing on an object. The first step in retraining your balance is to make sure that you can properly activate your core. This is done with one simple step, by standing and attempting to contract your abdominal muscles without hollowing your stomach. After achieving this seemingly simple yet very important task, balance can be improved with many different exercises. Most of the time a progression is used from the beginning of simply standing on both feet flat on the ground with your eyes open to getting more advanced with standing on one foot on an uneven surface with your eyes closed. A study performed in 2015 showed that post-concussion patients that performed 8 weeks of balance training showed structural changes in the areas of the brain that control balance and posture. Training gaze stabilization is the next step and can be done with a few easy exercises. They include actions such as holding your finger still at arm’s length in front you and moving your head in various directions while focusing your eyes on the tip of your finger. Varying the speed of head movement will increase the difficulty to further the gaze training. Towards the end of rehab, combining the gaze stabilization and balance exercises will be one of the final steps.

Nutrition is an overlooked aspect of almost all rehabilitation programs, but it can be a major difference maker in the speed and success of the program. There are numerous supplements that have shown to help post-concussion in early studies. The most highly studied supplement and one that has shown the most effectiveness is omega-3 fatty acids (fish oil).  Studies have shown taking between 4-6 grams a day can help lessen the symptoms and improve the quality of brain repair. Quality of repair can be an important aspect in helping to prevent tau protein build-up, which is the main culprit in degenerative brain diseases like CTE and Alzheimer’s disease. Anti-inflammatory nutrients such as turmeric and Vitamin D can help limit the inflammation in the brain and allow healing to take place. A quality probiotic is the final piece to the post-concussion program due to the effect a concussion can have on the patient’s gut health. Gut health post-concussion is often overlooked. Many don’t associate a head injury with their gut, but there is a clear association. For example, there are many post-concussion patients that have nausea and vomiting as a symptom, exhibiting a relationship between the brain and gut. Fish oil, vitamin D, turmeric, and probiotics are not the only supplements to consider post-concussion, but they are the most important to associate.

This blog is a brief overview of what varying treatments may contribute to post-concussion recovery. In order to implement these suggestions into your post-concussion rehab, contact Eldora Family Chiropractic for individualized examination and integration of specific treatment protocols to best help you or your child.

In good health,

Zak Stoulil, DC, CCSP

 

Concussion Series Part 2: Return to Play Protocol

In part 1, we discussed how people get concussions and what goes on in the brain that causes the symptoms. In part 2, we are going to talk about the process of returning to play.  The steps that are listed below should be followed by athletes that have been diagnosed with a sports-related concussion. This protocol was agreed upon at an international conference on sports-related concussion in 2016 and represents the latest consensus on the proper steps before returning to play. The link attached with the citation for the paper at the bottom of the page will take you to that consensus statement. Each step requires 24 hours of being symptom free before the athlete is allowed to move to the next step and should be managed by a qualified healthcare practitioner familiar with the current best practice guidelines.

  1. Reintroduction to daily activities such as school or work. 48 hours after initial injury can begin light easy aerobic exercise such as walking or riding a stationary bicycle as long as symptoms do not return.
    • Observe following guidelines when returning to school:
      • Begin reintroducing reading, texting, and screens (phone/TV) at increments of 15 minutes and slowly build up as symptoms allow.
      • Begin homework and reading at home to increase ability and stamina of cognitive functions.
      • Return to school part time or with breaks throughout the day.
      • Return to school full-time.
  1. If symptoms free with light aerobic activity for 24 hours athlete then can increase the aerobic activity to begin raising heart rate. Light jog or more intense riding on the stationary bicycle. No resistance training. Goal is to increase heart rate and if symptoms free can move to next step.
  2. After the increased aerobic activity athlete can begin to participate in sport specific skill training such as shooting drills, passing, and footwork. Individual position drills in football with no contact. No full team drills.
  3. Participate in full practice with no contact to begin reintroduction to sport.
  1. Participate fully in practice with no restrictions.
  2. Game play.

 

McCrory P, Meeuwisse W, Dvorak J, et al

Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016

Br J Sports Med 2017;51:838-847

 

 

Concussion Series Part 1: What is a Concussion?

Concussions have been a hot topic in our country the last few years, especially in sports. Most people understand that a concussion is a head injury and it has commonly been referred to in the past as a “brain bruise”. The latest research has steered the conversation away from that as a comparison because it is much different than what we understand a bruise to be when we see it on our skin. If the brain is not bruised in a concussion, then what happens after a person gets hit in the head? In order to understand what happens, first we need to understand exactly what the brain is made up of and how it is protected.

The average brain weighs about 3 pounds and has the consistency of Jell-O. It is made up of mostly fat that helps to protect the nerve cells and allow those nerve cells to communicate faster. Our brains are then suspended in a fluid inside the skull; very much like how an egg yolk is suspended inside the egg white inside of the shell. If you shake an egg, the yolk inside can be damaged even if the shell itself isn’t damaged. That also happens inside of our heads with our brain. The skull is there to protect against direct blows to the brain but the brain is still able to move around inside.

Damage to our brain happens in two phases. The first phase is the tearing of our nerve cells with the acceleration and deceleration that happens to our head when we get hit. In football, this happens in mainly two ways. First is the impact of one player striking another directly in their helmet, causing the head to accelerate backward or to the side and then stopping when it reaches the end range of motion. The brain then moves inside the head and that movement can tear the nerves and damage the supporting structure. The second phase happens after the initial tearing. Our bodies only allow certain chemicals to enter into the brain tissue itself and any other chemicals can be harmful to the cells. Thus, when the supporting structures are damaged it allows many different chemicals to cross into the brain itself and those chemicals can damage the brain tissue. The second phase happens slowly and can lead to an increase or change in symptoms over the following 2-3 days.

Concussion symptoms can be varied and that all depends on what area of the brain is damaged. Our brain is sophisticated and well organized so certain areas control our movement, balance, speech, sight, hearing, and movement. This is the reason why newer concussion testing involves many different aspects and is more than just asking the individual a few basic questions such as “Can you tell how many fingers I am holding up?” and if they know their name.

In the next two articles in this series we will go over different options for treatments and how to know when our athlete is ready to return to play.