Ways to practice Self Care when going through IVFRead More
By Leigh Lewis NMD, L.Ac., FABORM, RYT
The role of weight in all aspects of female reproduction has been validated by science for several decades with both underweight and overweight body habitus causing problems. Being underweight has been linked with a relative hormone deficiency what can lead to thin uterine lining and irregular ovulation and menses, therefore interfering with fertility. Adipose tissue, most notably abdominal fat, has been linked to excess production of estrogen which can also lead to issues with ovulatory and cycle irregularity and decreased fertility. Once pregnant, body weight should increase for most patients by 25-35 pounds, however, women who are underweight at the time of conception may need to gain more, with overweight women needing to gain less or sometimes, simply maintain their pre-pregnancy weight. Pregnant women who are underweight are at a higher risk for having a miscarriage, an underweight baby or a preterm birth. Being overweight confers an increased risk for miscarriage, gestational diabetes and hypertension, preeclampsia, C-section, and an overweight baby. There are also increased risks to the baby born to an overweight mother: diabetes and metabolic syndrome (high cholesterol, blood sugar imbalances, hypertension, overweight) in child- and adulthood. In a recent study, the CDC concluded that 50% of American women gain too much weight in pregnancy. Oftentimes, excessive weight gain during pregnancy is difficult to lose in the post-partum and can be further compounded by subsequent pregnancies. Finally, many women gain weight during the months or years of hormonal fertility treatments…this weight can be the most difficult to lose.
In general, recommendations are for women to maintain a “normal body weight” as indicated by a body mass index between 18.5-25, although individual variability may dictate otherwise. This would be a weight between 120-140 for a woman who is 5’6”. However, there are individual issues that might change this recommendation; for example, a female body builder will have a higher muscle to fat ration and since muscle weighs more than fat, she would likely have a higher healthy body weight. Your provider can help determine your ideal weight range.
Diet and exercise are often the first recommendations made to women and while this is typically good advice, many women are frustrated because usually they have tried it all before. An important and often neglected first step is to make sure there aren’t any underlying metabolic issues that might predispose one to having weight issues. Lab analysis of Vitamin D, thyroid function, cholesterol, glucose and insulin can provide insight to underlying factors that could make weight loss or gain more difficult. Radical diets may help one achieve initial goals, but are difficult to maintain for the long-term and may lead to nutritional deficiency. In fact, most current research suggests that a sensible, whole-food, Mediterranean-style diet is the best for promoting and maintaining both a healthy weight as well as general health, including fertility and pregnancy. Some individual variations may be necessary; women with PCOS for instance often fair better with a higher protein/lower carb diet.
In general, one does not have to even achieve a “normal” body weight to see improvement in ovulation, menses and fertility, including improving the success of in vitro fertilization treatments: improvement can be seen with as little as 5-10% weight change. This is good news, but can seem daunting to many nonetheless, and getting assistance from a team of professionals at least initially may be the best course. As many of us know, what to eat is only part of the issue for most…we all know less sugar and alcohol and more fruits and vegetables would be beneficial, portion size matters, exercise is important. You likely have heard it all before and could probably tell your best friend or daughter or mom the keys success. The issue isn’t so much how to eat better and exercise more, it is why can’t we implement what we already know we should be doing. There are several studies that illustrate the positive impact individual or group therapy can have in changing lifestyle behaviors is a way that can have long-lasting health impacts. In addition, while it may seem like a luxury to have a personal trainer, a series of 4 weekly sessions or joining small group trainings geared for women can set you up to have success with your workouts instead of just grinding out miles on the treadmill. Some trainers can also help set up individual meal plans. Finally, stress, both physical and mental can play havoc with the hormones that affect both weight and fertility, adding a mind/body practice to any regimen is a great place to start, whether it be as part of a group or as a home practice.
The bottom line is if you are concerned that your weight may be negatively impacting your reproductive health and fertility or you simply are trying to re-establish your pre-pregnancy weight for general health reasons, consider making an appointment to discuss your individual goals with one of the practitioners here at ilumina and please see resources below for other specialists offering programs to help you meet your goals.
Farrah Hauke, PsyD – offering individual therapy and a 4-week workshop series on psychological strategies to lose weight & keep it off. 480.659.5107; www.arizonapsych.com
Lindsey Cusey & McKenzie Smalley - Personal Trainers/Nutrition Consultants *offers a discount to ilumina patients; www.fithappygirl.com
Donation-based Yoga + Mindfulness classes for women @ Kinfolk Chiropractic, Tuesdays 6:30pm, to RSVP email firstname.lastname@example.org
Written by: Dr. Dana Price DOM, Dipl O.M, L.Ac.
In the first of this three part series, I brought to attention the #metoo movement and asked the reader to visualize what a completely unhindered expression of female sexuality would look like. I hope you had the opportunity to explore this. If not please spend some time with this. It is my belief that if we have the vision, we can direct our actions to support and become it.
I also brought up the three most common types of Yin/Yang imbalance and patterns that arise with low libido. I presented the “stressed” type. In this blog we will explore the “not feeling sexy enough for sex”, or as we translate it in Chinese medicine,Yin deficiency.
This pattern of Yin deficiency can manifest as low libido with difficulty becoming aroused, painful intercourse and lack of lubrication. In general Yin deficiency can include a general dryness of skin and hair, the lack of self nurturing, and potential negative self image. This pattern can also manifest as rushing through sex, and restlessness during sex, stubbornness and inflexibility in relationships, easy to get anxious, irritable and being scattered, vivid dreams, constipation, feeling warm, and light and short menstrual cycles. Here are some things you can do to rebuild your Yin:
Exercise: yoga (not hot), tai chi, qi gong, swimming or hiking. Limit aerobic workouts to 30 minutes three times a week.
Nutrition: Whole foods diet that emphasizes vegetables, fruits, whole grains, with small amounts of protein and healthy fats. Avoid red meat and eat more vegetarian sources of protein than meat. Food that increase the Yin energy are: seaweed, beets, flaxseeds, spinach, chard, string beans, grapes, blackberries lettuce, nuts, millet and whole wheat to name a few.
Hydration: Here in Arizona it is already hot, sunny and dry which by nature depletes our Yin. It is very important to drink between 100-120oz of fluids per day. Alcohol and caffeine are dehydrating so it should be avoided. With that said avoid becoming overheated saunas, steam rooms, hot baths and hot yoga are not good choices.
Sleep: Getting at least 8 hours of sleep per night is imperative to rebuild Yin. If you remember from the first in the series, rest and night time is Yin. So you need more.
Meditation: Begin a daily meditation routine and do what you can to reduce stress levels.
Vitamins: Potassium (bananas are good), Calcium, Magnesium and Vitamin E are helpful.
Chinese Medicine: Acupuncture and Chinese herbal formulas are very potent to increase Yin and rebalance your Qi
By Leigh Lewis ND, L.Ac, Naturopathic Doctor
Are you hoping for pregnancy in 2018? If so, keep reading for information that may help you reach you goals. You may be surprised to learn that the conception rate for any one act of intercourse at the right time of the month, when the stars are aligned and without any fertility issues, is only about 25%. Yet, even knowing this, many couples expect to be able to conceive easily without much forethought or planning. This may be in part because we, especially as women, have spent most of our lives trying NOT to get pregnant. As such, it is not surprising that many couples are blindsided if they are not pregnant within the first several months of trying. However, there are a few simple things you can do to increases your chance for a timely & healthy pregnancy.
Preparation is Key: General Recommendations for All
Prenatal lifestyle & supplements: As with many goals in life, the path to a successful conception and a healthy pregnancy is planning. Lifestyle factors, including cigarette, alcohol & caffeine consumption, and marijuana and other recreational or prescription drug use in either partner can increase time to conception and increase risk of miscarriage & chronic health issues in children. Current research suggests that even if you have very regular and normal cycles starting a prenatal vitamin with adequate methylfolate several months prior to intended conception has numerous benefits in decreasing the risk of nutritional deficiencies, decreasing time to conception, preventing birth defects and decreasing risk of miscarriage as well as decreasing the risk of future autism spectrum disorders and other learning disabilities. While a prenatal helps correct nutritional deficiencies, some women may need additional vitamin D, B12 and iron depending on lab levels. These nutrients, if low, can interfere with one’s ability to get and maintain a healthy pregnancy. The omega 3 fatty acid derived from fish oil, DHA, has been found to benefit brain development and should also be part of the pre-conception plan. Finally, finding prenatal supplements that are well-tolerated prior to pregnancy can help avoid problems with consistency if nausea and vomiting are an issue early in pregnancy. A well-rounded multivitamin and mineral can also improve many aspects of sperm health when taken for at least 3 months prior to planned conception. First pregnancy and want to improve chances? Be sure to seek help on tracking ovulation and cycle via basal body temps or apps combined with timing intercourse (see resources below).
Pre-conception weight: Another recommendation that can decrease time to conception and increase probability of a healthy pregnancy is a normal weight. Being overweight or underweight can interfere with fertility by decreasing ovulatory cycles. Being overweight can also predispose to gestational diabetes and hypertension that can increase the risk of both conditions for mother and baby later in life. Normal weight has also been found to improve the success of fertility treatments like IVF. In short, it stands to reason that taking 3-6 months to address any weight issues can go a long way to improving health parameters for both mother and baby. Special diets or intense exercise can also cause some deficiencies that can be ruled-out with simple blood tests.
Contraception: It should be noted that it may take up to 12 months to re-establish normal ovulation and cycles after discontinuing hormonal contraception. That said, some women may be able to conceive the month after stopping contraception. The best course of action is to stop any hormonal contraception a year prior to intended conception, using non-hormonal forms (i.e. condoms) until conception is desired, to allow the body to re-set. This would also be a good time for both partners to start their respective supplements mentioned above. For those that are trying to avoid or delay pregnancy, remember prevention is the best medicine…there are several safe and effective forms of contraception to choose from. Finally, a word about lactation: While breastfeeding can help to space babies, it is not fool-proof and many women will return to fertility while breastfeeding, some even before regular menstruation resumes. For some women however, even breastfeeding infrequently can delay another conception. Please keep this in mind whether hoping for a pregnancy or to prevent one.
For those with fertility problems:
According to the CDC, American infertility statistics between 2011-2015 were as follows:
- 12.1% women aged 15-44 with impaired fertility
- 7.3 million women aged 15-44 who have ever used infertility services
While as many as 30% of couples never find the cause of their infertility, we do know several possible contributing factors that may play a role:
- Age: fertility rates within one year decrease & time to conception increases after 30 years of age
30s: 75% chance
At 40: 40% chance
By age 43: 1-2%
- Underweight, overweight and nutritional deficiencies (see above).
- Hormonal imbalances: thyroid disorders, endometriosis, polycystic ovarian syndrome, low estrogen and/or progesterone.
- Stress, anxiety, & depression: evolution may have set us up to delay conception at times of emotional stress
- Structural issues: blocked tubes from prior infections, uterine fibroids/polyps, adhesions or scarring from endometriosis or previous pelvic surgery
- Chronic illness such as autoimmune conditions
Infertility is diagnosed as no conception within 12 months of trying if under 35 years and 6 months if over 35 years. It helps to recognize the importance of these definitions as further lab testing, semen analysis, pelvic imaging and consultation may be recommended at this time.
Couples with any of the above issues should consider when they ideally would like to conceive and give themselves at least 6-12 months to get healthy by following the above general recommendations and seek guidance from a practitioner who specializes in women’s health and fertility to address specific issues in particular. The same could be said for women in between pregnancies in order to prep selves for a future conception as pregnancy, breastfeeding and caring for a growing family can take a toll on the body and mind.
If ovulatory, menstrual, or hormonal irregularities are suspected, addressing them by ruling out underlying factors is key. Research shows that acupuncture and specific herbal formulas and supplements may help normalize hormones and cycles, facilitate conception and improve the health and wellbeing during pregnancy and increase the success of conventional fertility treatments.
Fertility issues can be stressful, especially when combined with pre-existing insomnia, depression, or anxiety, and this can interfere with fertility and exacerbate emotional issues; truly a vicious cycle. However, there are safe ways to address these issues through meditation, yoga, acupuncture, herbs and supplements. In some cases medications may be the safest option with several studies showing that medications are preferable to “white-knuckling it” through depression and anxiety.
We here at ilumina are here to help you at any stage: from pre-conception and prenatal to postpartum and beyond, we offer diet & lifestyle counseling, mental health support, acupuncture, western & oriental herbs and supplements, massage and medications to address these issues. Please feel free to contact us today to get started on your pre-conception health & wellness plan.
1. Taking Control of Your Fertility
2. RESOLVE: The National Infertility Association
3. American Society for Reproductive Medicine (ASRM)
4. American Board of Oriental Reproductive Medicine (ABORM)
5. Clue: Menstrual/Fertility Tracker App
The "Fourth Trimester” discussed here includes the weeks, months, and years after pregnancy, between pregnancies or following a woman's last pregnancy. Referred to elsewhere as “postnatal depletion”, this is not an illness or disease that requires treatment in most cases. Instead, it falls into a nebulous category with other periods of normal hormonal flux women experience throughout their lives, including PMS, pregnancy, & menopause. And, like these issues, a given woman may experience a range of symptoms on a continuum, similar to a bell-shaped curve, with some women experiencing little to no distress, most women experiencing moderate distress, and some women significant amounts of distress. Similar to the aforementioned hormonal issues, the severity of symptoms may meet clinical diagnostic criteria and even still women may feel like they have to "white-knuckle it" through this stage, not wanting to ask for help for fear of being discounted.
"Is ours not a strange culture that focuses so much attention on childbirth--
virtually all of it based on anxiety and fear--
and so little on the crucial time after birth, when patterns are established that will
affect the individual and the family for decades?"
It is important to acknowledge that in the US we often put more kind focus on pregnant women and then switch this focus to the baby immediately after delivery when mother-focused support is virtually non-existent. We as a culture ignore the needs of new mothers and make many demands on them that are prevented in other cultures out of respect for the postpartum period, a time recognized & honored as distinct from other times in a woman's life. Curiously, these other cultures, which also incorporate social supports for menstruating and menopausal women, have virtually no post-partum disorders compared to 50-85% of new mothers in industrialized nations like the US. During this time, protective measures, so-called "mothering the mother", help support and care for new mothers. Specifically, the practice of "lying in" relieves women of their normal workload and the implied duty to entertain visitors, allowing time for recuperation, rest, and family bonding. Not only does our culture minimize the significance of this change & the support necessary to healthfully assimilate this change into the family's life, but there is often an unspoken belief that any woman who needs post-partum support has somehow failed when in reality we as a culture have failed her.
Of course, having a child & parenting is physically, emotionally, and mentally demanding and these effects are compounded with subsequent pregnancies & deliveries. Most women survive the transition relatively unscathed, but at what cost? Few can honestly say they did not experience any of the symptoms listed below and, sadly, most did not seek any assistance either because they did not want to "bother" others or because they were simply too exhausted to focus on anything but mothering. However, by drawing attention to these issues, we can address these concerns sooner, rather than later, thereby avoiding a crisis. By caring for and prioritizing oneself, you can be healthier as an individual, mother, partner, colleague, & friend.
Symptoms may include, but are not limited to:
- Sleep dysfunction
- Poor motivation, concentration, memory
- Mood swings
- Menstrual irregularities
- Inability to lose weight
- Urinary & vaginal issues
- Low libido & sexual dysfunction
- Hot flashes/night sweats
By assessing a woman's medical & reproductive history, diet, lifestyle and relevant test results, we can often identify the underlying contributing factors to the symptoms she is experiencing. Special attention should focus on follow-up on any issues encountered in previous pregnancies, such as prenatal/post-partum mood issues, blood sugar & blood pressure abnormalities, and nutritional & thyroid deficiencies. These problems can negatively impact a woman's health and well-being long after the pregnancy & post-partum stages and make these already challenging stages more so.
A holistic approach focusing on the mind & body by integrating Eastern & Western medical therapies can be selected based on the severity of symptoms, individual risk-factors, and patient preference and may include recommendations for the following:
- Social engagement & support
- Meditation & quiet time
- Aerobic exercise & yoga
- Hormone replacement
- Pharmacological & non-pharmacological treatment options
Unfortunately, one of the hardest things for any mom to do is find time for herself for self-care, but you may be surprised by the number of resources available to you: friends, family, neighbors, and daycares at gyms/studios are resources that are available to most. Having in-home help for a couple hours per week may seem like a luxury, but if it provides you with the support needed to get out for a massage, a run, therapy, acupuncture, lunch with a friend or a yoga class, it is money well-spent.
For more information, if you have any questions, or to schedule an appointment, please feel free to contact us today.
Hypertension in Pregnancy
Pre-eclampsia is a pregnancy complication defined by high blood pressure, 140/90 millimeters of mercury (mm Hg) or higher, and signs of damage to another organ systems, most often the liver and kidneys. Pre-eclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had been normal. Even a slight rise in blood pressure may be a sign of pre-eclampsia.
What factors increase risk of pre-eclampsia?
- Previous history of pre-eclampsia
- Multiple gestations
- History of Chronic High Blood pressure, PCOS, Diabetes, Kidney disease, and organ transplant.
- First Pregnancy
- Obesity, BMI 30 or greater
- Family History
How does pre-eclampsia affect pregnancy?
Hypertension can impair kidney and liver function, and cause blood clotting problems, pulmonary edema, seizures and severe edema. Pre-eclampsia affects the blood flow to the placenta, often leading to smaller or prematurely born babies.
What can help with pre-eclampsia?
- Continue to follow a healthy diet and regular exercise (low sodium diet)
- Magnesium is an excellent supplement safely used in pregnancy. Magnesium citrate, at doses of 400-600 per day, is often used in both preventing and treating hypertension. Hospitals use IV magnesium for hypertensive episodes and pre-eclampsia to reduce blood pressure.
- Acupuncture helps to smooth the flow of blood and increase the tone of the vascular system, and returns the body to parasympathetic state.
- Vitamin D levels should be checked, because Vitamin D deficiency has been linked to hypertension.
- Coenzyme Q10 was studied for prevention of pre-eclampsia at 200mg per day from 20 weeks to delivery. This should be taken under the supervision of a physician.
- Medications to lower blood pressure. Medications, called anti-hypertensives, are used to lower your blood pressure if it's dangerously high.
We in AZ are probably more attuned to issues related to sun damage and skin cancer than our friends in Northern climes, but I am frequently amazed how few people use a daily SPF and reapply as recommended to truly prevent pre-cancerous changes. People usually are good about applying and reapplying when on vacation at the beach or the lake, but it the daily ultraviolet exposure driving to work, walking the dog or working in the garden that adds up over time and causes skin cell damage that can cause discoloration, wrinkles and skin cancer. Over 5 million new cases of skin cancer are diagnosed each year in America, with nearly 90,000 of those attributed to melanoma, which is the cause of almost 10,000 deaths.
Skin cancer can be present anywhere on the body and with little to no signs or symptoms, however, most can be caught through the simple process of monthly self-check and annual dermatologist skin exams. Early detection, like in all health concerns, is key, and knowing your body’s specific moles and freckles and other marks is the best way to notice a new lesion or change in a previously existing one.
The “ABCDE Rule” of skin cancer detection is simple to follow when conducting monthly self-check skin exams and should be a sign to see a dermatologist:
ASYMMETRY: if one half is different from the other half of a lesion
BORDER: irregular edges to a mole
COLOR: any multicolored lesion or growth that contains blue, pink, white, red or black shades
DIAMETER: a growth that is larger than ¼ inch across or increases in size
EVOLUTION: any changes to a pre-existing mole
In terms of prevention, The American Cancer Society recommends people “SLIP on a shirt, SLOP on sunscreen, SLAP on a hat, and WRAP on sunglasses” to prevent the negative effects of UVA and UVB radiation from the sun. Understandable, people worry about the chemicals found in sunscreens, but there are ways to find which sunscreens are the safest by researching the Environmental Working Groups website and/or app http://www.ewg.org/sunscreen/
Even with this information, many are confused by the array of sunscreens on the market. Physical sunscreen formulations are made up of minerals like titanium and zinc oxide that create a barrier on the skin, blocking & reflecting both UVA rays (cause wrinkles & cancer) and UVB rays (responsible for sunburn). Mineral sunscreens are effective once applied, unlike chemical sunscreens which require approximately 30 minutes to become effective. In addition, chemical sunscreens not only are less effective than physical forms, but have been found to accumulate in the body and have even been linked hormonal disruption and breast cancer. Chemical sunscreens may also oxidize in the sun, causing potential free radial formation which could increase the risk for premature aging and skin cancer. Some companies have added minerals to their chemical sunscreens as a marketing tool, but the risks of the chemicals stay the same.
I personally have been very impressed with TiZo, a mineral sunscreen that is free of oils, parabens, fragrances and dyes and unlike the pallor imparted by many similar products in the past, these blend well and are very comfortable to wear. Since these products are only available through licensed professionals, mention it to your ilumina practitioner and we can get some ordered for you.
At ilumina we want to be an educationalresource for our patients and with that we have a lending library were we make available some of our trusted teachers and authors.
Christiane Northrup started with a medical degree from Dartmouth Medical School and completed her residency at Tufts New England Medical Center in Boston. She is an obstetrician and gynecologist and an advocate for woman’s health and wellbeing. She has written several books including Women's Bodies, Women's Wisdom; The Wisdom of Menopause; Mother-Daughter Wisdom; The Secret Pleasures of Menopause; and Goddesses Never Age: The Secret Prescription for Radiance, Vitality, and Wellbeing. Dr. Northrup is a crusader for woman’s health, and is helping woman change their ideas around aging in our society.
As a Chinese Medicine practitioner her views on women’s health align with the ancient Chinese beliefs in treating the root of the problem verse the patients symptoms. At ilumina we treat the origin of the ailment, and help woman to restore health and balance in their lives. Chinese Medicine has a deep history in treating Women’s Health and is being used to treat a variety of conditions to help reestablish health in the body.
In Women's Bodies, Women's Wisdom, she covers the treatment of many health concerns PMS, menstrual cramps, breast cysts, fibroids, cervical dysplasia, endometriosis, infertility, depression, and cystitis. She takes her time explaining how many of these physical problems have roots in emotional upsets or lifestyle choices. This book helps woman to have an educated and healthy outlook on there bodies.
Women have trusted Dr. Northrup’s approach for decades. In 2013, Reader’s Digest named her one of “The 100 Most Trusted People in America.” And, in 2016, she was named one of Oprah Winfrey’s Super Soul 100, a group of leaders using their voices and talent to help and heal humanity.
Christiane Northrup has many hobbies including Argentina tango, culinary arts, travel, and watching movies. Dr. Northrup’s work has been featured on The Oprah Winfrey Show, the Today Show, NBC Nightly News, The View, Rachael Ray, Good Morning America, 20/20, and The Dr. Oz Show.
“True health is only possible when we understand the unity of our minds, emotions, spirits and physical bodies.”
To enhance her Prenatal Massage offering at ilumina, our highly experienced massage therapist, Audrey Blanchard has recently completedadvanced training in the Spinning Babies method for optimal fetal positioning and body balancing during the second and third trimesters of pregnancy. These self care and specific bodywork techniques can be utilized starting at 25 weeks to help bring balance to the muscles, ligaments and fascia in the pelvis and to release some discomforts such as low back and groin pain, rib pain, round ligament pain and discomfort above the pubic bone. If baby is presenting in a breech, transverse or occiput posterior (sunny-side up) position these techniques can be incorporated to help baby ease into a left occiput anterior position which is optimal for easier labor and delivery.
Spinning Babies uses the three principles of balance, gravity and movement, emphasizing balance first.The muscles, ligaments and fascia of the pelvis must be balanced in order for gravity and movement to help open the pelvis for better fetal positioning. Gravity includes maternal positioning with gravity friendly postures during rest, but particularly during sitting activities to help baby move into a head down position. Using movement with yoga, walking and stretching help to keep the pelvis balanced and ensure comfort for both mom and baby.
Belly mapping is a fun and interactive waymom and partner can identify fetal positioning by feeling the bumps, kicks and wiggles starting at 34 weeks. This information is used to identify which techniques and self care activities will best help baby turn or “spin” if they are presenting breech, transverse or occiput posterior.
A Spinning Babies session can be added on to your Prenatal massage or used as an adjunct treatment along with Acupuncture to help turn a malpositioned baby.
Acupuncture’s positive effects on regulating menses and improving fertility have been known for many years, but acupuncture, Chinese herbs, diet and massage can also have many benefits throughout the pregnancy and beyond.
As early as the first positive home pregnancy test, acupuncture can help decrease risk of miscarriage and alleviate several of the well-known early symptoms of pregnancy, though while encouraging, can have a negative impact on a woman’s quality of life and ability to carry out daily tasks at work and home.
- Nausea & vomiting
- Mood swings
- Sleep disturbance
The second trimester is often entered with a sigh of relief as the risk of early miscarriage and intensity of morning sickness decreases at week 12. However, as your baby grows in size, this increases demand on blood supply and pressure on surrounding organs leading to several new symptoms. Some are diagnosed with blood sugar or blood pressure issues, and we can provide nutrition advice and acupuncture for this as well.
- Back pain
- Congestion and nose bleeds
- Weight gain
- Increased susceptibility to infections
As weight gain continues with the increased size of your baby, the same symptoms that can cause problems in the second trimester increase in intensity with additional issues that can significantly interfere with your quality of life and well-being. Also, keep in mind that while acupuncture can help decrease these symptoms, it can also be helpful for breech presentation and labor preparation in the final weeks before delivery.
- Leg pain
- Swelling of hands/wrists and feet and ankles
- Shortness of breath
Here at ilumina, we like to be conscientious of the months after delivery and the issues that can creep up after you are back at home with your newborn. Sleep deprivation and the resultant fatigue and moodiness is expected, but knowing when to ask for help and making time for yourself in key in helping you care for your baby. It may also be time to have labs to check for thyroid dysfunction and nutritional deficiencies that are common in post-partum. Finally, in addition to helping with energy and mood, acupuncture can help with lactation, muscle aches, and menstrual issues as your cycle starts up again.
Myth: Massage is a luxury.
Fact: There are many benefits to receiving regular massage, especially during times of stress or health crisis. Many people use massage a part of their regular preventative health maintenance program.
Some benefits of massage therapy include:
-Massage is relaxing and rejuvenating
-Calms the nervous system
-Helps you cope with mental/emotional stress
-Relief of physical pain and fatigue
-Increase flexibility and range of motion
-Speeds recovery from surgery
-Improves circulation and immune system
-Speeds the removal of metabolic waste from the body
Myth: Massage is NOT safe for someone newly diagnosed with cancer.
Fact: Initially, it is best to err on the side of caution and receive gentle massage techniques such as Swedish massage or Reiki energy healing to help calm the nervous system. Deep tissue work should be avoided as well as work directly on the tumor area.
Myth: Since massage stimulates the blood flow it can increase the risk of metastasis (spreading to other parts of the body).
Fact: Massage does stimulate the blood flow but so does walking, exercising, taking a shower or a bath, all of which are highly recommended during cancer treatment.
Recent studies show that massage induces the production of the hormone oxytocin which counter acts cortisol also known as the “stress hormone”. Cortisol is very useful when we need the fight or flight mechanism, but under constant stress excess production of cortisol can be harmful by decreasing the immune system response. A cancer diagnosis is very stressful and a person is susceptible to anxiety and depression. Since massage aids with the relaxation response and the release of Oxytocin it can be a major aid in strengthening the immune system and release of toxins and promote healing.
Myth: Women who had lymph nodes removed should never receive massage.
Fact: Extra caution is necessary in this case due to the risk of developing Lymphedema. Receive only light massage on the compromised quadrant of the torso (arm, chest and back) but a regular massage can be administered to the rest of the body. It is best to see a professional who is trained in oncology massage.
Is massage OK during chemotherapy and radiation?
Fact: Yes, however a waiting period of 4-7 days after chemotherapy treatment is recommended depending on the treatment and the individual. It is OK to receive bodywork during radiation, but massage and oils should not be administered to the radiated area.
How about massage after surgery?
Fact: After surgery it is recommended to wait 7 days and up to 6 weeks before receiving bodywork, depending on the type of surgery and reconstruction and healing progress. However, energy work and gentle massage to non affected areas can be administered as soon as the client feels up to it and the doctor approves it.
What about massaging around tumors?
Fact: Direct pressure to the area should be avoided. Once the tumor is removed and the wound is healed, massage is very helpful to prevent scar tissue adhesions. Avoid deep massage to the quadrant of the body where lymph nodes are compromised due to the risk of Lymphedema.
If tumor is deep and cannot be removed massage should be administered with caution.
Body image issues
Some women are self conscious about their body, especially after a mastectomy. This is understandable and most practitioners use draping techniques which reassure the client’s privacy. If the client is not comfortable with work on the breast area, or prefer that area covered they should make sure the practitioner knows.
How can I find a practitioner?
Since cancer diagnosis requires some modifications it is best to find someone who is experienced and has Oncology Massage training. However, if one already has an established relationship with a practitioner, trust and rapport are just as important as skills and knowledge. It won't be a bad idea to ask the practitioner if he/she is comfortable with educating him/herself before providing massage therapy during the cancer treatment. Audrey has recently completed a 24 hour National Certification Board for Therapeutic Massage and Bodywork approved Continuing Education class for Breast Cancer and Massage Therapy to better understand and treat her clients that are breast cancer survivors.
Massage Therapy and Breast Cancer. Eeris Kallil, Lic. CMT. Boulder, CO. bodyworkwisdom.com
“Massage therapy has great potential to aid in the rehabilitation of the patient who has undergone treatment for breast cancer. We actually under utilize massage, and the early institution of that therapy might actually prevent some of the more long-term complications, such as retraction of the skin and lymphedema.”
-Oncologist Frank Senecal, M.D.
Massage therapy can be beneficial for women recovering from mastectomy, lumpectomy and lymph node removal by alleviating pain, fatigue, and anxiety. Massage therapy can increase range of motion and reduce scar tissue adhesions after surgery and radiation. By gentling stretching tissues surrounding the surgery or radiation site, muscles and ares of tightness can be opened and soothed increasing circulation and improving skin tone.
Gentle manual lymph drainage, decongestive techniques, and light effleurage help to relieve and prevent lymphedema. Lymphedema is a condition that is caused when a person’s lymphatic system is compromised due to fluid retention and swelling. This is a problem because tissues that have lymphedema are at risk of infection. Also, as part of the diagnosis for breast cancer many women have a large number of the lymph nodes removed through surgery for diagnosis. The greater the number of lymph nodes that are removed the higher the chances are that woman will have swelling that is called lymphedema. Deep tissue massage is contraindicated in areas where lymph nodes have been comprised (removed or irradiated) even if the patient/client is not experiencing lymphedema.
Other benefits of massage therapy for breast cancer patients include an increase in immune system function. Massage aids the patient’s ability to relax, thus reducing levels of cortisol, the stress hormone, and increasing levels of oxytocin, natural kill cells and lymphocytes. According to one study, breast cancer patients have “improved immune and neuroendocrine functions” following massage therapy [study conducted by the Touch Research Institutes, Department of Pediatrics, Hematology/Oncology Clinics, Sylvester Comprehensive Cancer Center and Department of Medicine at the University of Miami School of Medicine].
In the study, 34 women with either stage 1 or 2 breast cancer were randomly assigned to either a massage therapy group or a standard treatment control group. In the massage therapy group, the women received three 30-minute massages per week for five weeks, including stroking, squeezing and stretching on the head, arms, legs, feet and back. Urine tests showed that the massage group had increased serotonin, dopamine, and natural killer cells and lymphocytes. Questionnaires administered in the study showed reduced anxiety, depression, anger, and hostility in the massage therapy group.
The decision to receive massage therapy after breast cancer treatment is something to discuss with your doctor and/or surgeon. He/she can help you decide if and when massage therapy will be of benefit during the treatment process. Post mastectomy massage generally takes place several weeks after surgery. It is important to choose a Massage Therapist who has additional training in treating oncology patients, and specifically treating breast cancer patients.
“Breast Cancer: How Massage Aids Recovery”. Yvonne Meziere. Massage Magazine, April 2014.
Massage Therapy and Breast Cancer. Eeris Kallil, Lic. CMT
There is a lot of confusion both among women and their health care practitioners regarding perimenopause. Literally, perimenopause is “around menopause”; menopause being defined as the spontaneous, permanent ending of menstruation, literally one day, typically the day that is one year after the last menstrual period, usually around age 50, but can be anywhere between age 40-60. Clinically then, perimenopausal symptoms can be described as any symptom that happens around a woman’s last menstrual period. Unfortunately, menopause is not like a light switch, where one moment you are pre-menopausal and the next you are post-menopausal. It is in fact quite the opposite: erratic hormone production fluctuates from day to day and month to month causing changeable and varied symptoms.
Several studies have documented that symptoms may begin up to 17 years before cessation of menses and may last for several years after. As such, if the average age of menopause is 50, some women may start to experience these symptoms as early as 33. Many factors may impact this transition, from genetics, to thyroid function to lifestyle habits and some women enter into menopause through surgery or medication and, for the latter population of women, the symptoms may be more severe and dramatic.
There are estrogen receptors throughout a woman’s body which helps to explain the varied symptoms a woman may have as estrogen levels start to decline as evidenced by this graphic:
Since hormone fluctuations can start in the 30’s for many women and others may experience unintended pregnancy in their 40’s, special consideration should be given to issues related to fertility. Some women may have difficulty achieving or maintaining pregnancy in the absence of these symptoms at any age, but age-related hormonal changes are a common cause. As such, contraception and/or fertility-preserving strategies should be a part of every woman’s assessment and plan during the perimenopausal transition. Regardless of the cause, be it endometriosis, irregular menses or hormonal issues, acupuncture and select supplements and herbs may be helpful in improving fertility outcomes, either when used alone or in combination with conventional reproductive medicine.
When a woman suspects she is having perimenopausal-related symptoms, it is an excellent time to have a complete medical examination by a qualified health professional. The diagnosis of perimenopause can usually be made by reviewing a woman’s medical and menstrual history in addition to her specific set of symptoms and treatment recommendations can be made accordingly. Unfortunately for most women, hormone tests are usually not helpful in giving definitive information as to whether symptoms are related to perimenopause because levels change throughout the menstrual cycle. A single hormone level can be misleading since production does not fall at a steady rate, but varies greatly and therefore cannot predict or confirm menopause. Furthermore, normal hormone levels in the presence of hormone-related symptoms does not eliminate the likelihood that the women is perimenopausal. Some testing may be helpful with complaints of sexual dysfunction, fertility problems or when periods stop at an early age and some lab tests can identify other causes of symptoms that mimic or worsen the symptoms of perimenopause, such as thyroid disease or vitamin deficiencies, and diseases that can increase during perimenopause, such as cardiovascular disease and diabetes. Treatments should never be prescribed to “treat” hormone levels, but solely to alleviate symptoms and therefore hormone levels are unnecessary to determine or adjust dosing.
There are several treatment options available to women and there is no “one-size-fits-all” plan that will take care of all of the symptoms that may be associated with hormonal fluctuations. It is also important to remember that not all women will require treatment; perimenopause is not a disease and as such therapies should be directed at controlling symptoms. Therapies with less associated risk, like diet and lifestyle, should be tried first. There are several studies confirming the positive impact of diet, exercise, acupuncture, stress management and lifestyle changes for women with mild perimenopausal symptoms and should be first-line therapy. Vitamin and herbal supplements may be helpful in some women, but research is mixed and appropriate dosing and use of high-quality products is necessary to know if these may be effective. Finally, there are non-hormonal prescription medications that may do double-duty in decreasing perimenopausal symptoms while treating other conditions, such as depression and anxiety. The goal should be to help patient’s manage menopausal symptoms without needing a grocery bag full of medications or supplements by utilizing targeted therapies that are supported by research.
If hormones are being considered, a thorough assessment of a woman’s potential benefits vs. risks should be conducted. While risks are possible with any use of hormones, symptoms can negatively impact a woman’s day-to-day quality of life, affecting relationships with family and friends and performance at work and the degree to which this happens may outweigh these potential risks. Medical organizations devoted to the care of women agree that there is no question that hormone therapy has an important role in managing symptoms for many healthy women during the transition. There are several benefits to using hormones including decreasing the typical symptoms such as hot flashes, night sweats, insomnia, mood issues, “brain fog”, urinary symptoms, vaginal dryness and painful intercourse, preventing bone fractures later in life and lowering the risk of heart disease & diabetes if hormones are started early. However, despite some claims, there is no such thing as “risk-free” hormone treatment for menopause when used systemically to achieve these benefits. The potential risks include stroke, blood clots, and uterine and breast cancer. What we’ve learned so far about the benefits and risks comes from large groups of women, but each woman is unique. New studies are frequently published, so this topic is constantly in flux.
The question is whether it is the right choice for you. These decisions are nuanced and only after you and your doctor have a thorough discussion about your individual risks, benefits, and preferences can you make a decision that’s right for you.
The North American Menopause Society is an excellent resource for high quality information: http://www.menopause.org/for-women.
Fibromyalgia affects millions of Americans, many of whom are women. The main signs and symptoms of fibromyalgia include deep muscle pain, painful tender points, and morning stiffness. Other symptoms may include sleep problems, fatigue, and anxiety. Regular Massage Therapy sessions have been proven to decrease pain levels, muscle stiffness, and improve sleep quality.
In a study conducted by the Touch Research Institute, 30 adult fibromyalgia subjects were randomly assigned to a massage therapy, a transcutaneous electrical stimulation (TENS), or a transcutaneous electrical stimulation no-current group (Sham TENS) for 30-minute treatment sessions two times per week for five weeks. The results showed the massage therapy subjects reported lower anxiety and depression, and their cortisol levels were lower immediately after the therapy sessions on the first and last days of the study. The TENS group showed similar changes, but only after therapy on the last day of the study. The massage therapy group improved on the dolorimeter measure of pain. They also reported less pain the last week, less stiffness and fatigue, and fewer nights of difficult sleeping. Thus, massage therapy was the most effective therapy with these fibromyalgia patients.
Audrey Blanchard, LMT has successfully treated fibromyalgia pain syndrome with Massage Therapy here at ilumina. A customized massage session is developed specifically for each individual to reduce muscle pain, fatigue, and increase the quality and quantity of nightly rest.
Pregnancy symptoms differ from woman to woman and pregnancy to pregnancy; however, one of the most significant pregnancy symptoms is a delayed or missed period. Understanding the signs and symptoms of pregnancy is important because each symptom may be related to something other than pregnancy. You may experience signs or symptoms of pregnancy within a week of conception. However, it is possible you may not experience any symptoms for a few weeks.
This was such a simple and well written list of pointers for getting the most out of your treatments and what to expect, that we had to share. http://weeklycupofqi.com/2013/05/30/how-to-get-the-most-out-of-your-acupuncture-treatments/
The Scottsdale Fertility Forum will be presented on June 15, from 8 to 11 am. Dana Price DOM, L.Ac., FABORM will be presenting as part of a panel of experts in the field. Follow this link for more information and to purchase your tickets. Scottsdale Fertility Forum Event
This is a rare opportunity to join the Valley's top doctors at an exclusive forum specifically about Fertility.
Ten Reasons to Meditate and practice Mindfulness (and how to do it)
1) Increases blood flow, lowers respiration rate, slows heart rate 2) Decreases heart rate 3) Reduces stress, anxiety and aggression 4) Enhances the immune system 5) Harmonizes the endocrine (hormonal) system 6) Relaxes the nervous system 7) Improves brain function and electrical activity 8) Reduces stress and balances hormones to stimulate ovulation 9) Improves learning ability and memory and increases productivity 10) Improves relationships with others
Mindfulness Meditation by Thich Nhat Hanh
This exercise is very simple, but the power, the result, can be very great. The exercise is simply to identify the in-breath as in-breath and the out-breath as the out-breath. When you breathe in, you know that this is your in-breath. When you breathe out, you are mindful that this is your out-breath. Just recognize: this is an in-breath, this is an out-breath. Very simple, very easy. In order to recognize your in-breath as in-breath, you have to bring your mind home to yourself. What is recognizing your in-breath is your mind, and the object of your mind—the object of your mindfulness—is the in-breath. Mindfulness is always mindful of something. When you drink your tea mindfully, it’s called mindfulness of drinking. When you walk mindfully, it’s called mindfulness of walking. And when you breathe mindfully, that is mindfulness of breathing. So the object of your mindfulness is your breath, and you just focus your attention on it. Breathing in, this is my in-breath. Breathing out, this is my out-breath. When you do that, the mental discourse will stop. You don’t think anymore. You don’t have to make an effort to stop your thinking; you bring your attention to your in-breath and the mental discourse just stops. That is the miracle of the practice. You don’t think of the past anymore. You don’t think of the future. You don’t think of your projects, because you are focusing your attention, your mindfulness, on your breath. It gets even better. You can enjoy your in-breath. The practice can be pleasant, joyful. Someone who is dead cannot take any more in-breaths. But you are alive. You are breathing in, and while breathing in, you know that you are alive. The in-breath can be a celebration of the fact that you are alive, so it can be very joyful. When you are joyful and happy, you don’t feel that you have to make any effort at all. I am alive; I am breathing in. To be still alive is a miracle. The greatest of all miracles is to be alive, and when you breathe in, you touch that miracle. Therefore, your breathing can be a celebration of life. An in-breath may take three, four, five seconds, it depends. That’s time to be alive, time to enjoy your breath. You don’t have to interfere with your breathing. If your in-breath is short, allow it to be short. If your out-breath is long, let it to be long. Don’t try to force it. The practice is simple recognition of the in-breath and the out-breath. That is good enough. It will have a powerful effect.
This meditation instruction excerpted from the Shambhala Sun website. http://www.shambhalasun.com/index.php?option=content&task=view&id=3490
Acupuncture and Traditional Chinese Medicine (TCM) are known to improve the quality of life for women with breast cancer. They can aid in the treatment of nausea, vomiting, fatigue, and the flu like symptoms associated with chemotherapy. In addition, they help with the side effects of radiation, including healing burns, and significantly improve pain levels, healing post lumpectomy, mastectomy and reconstruction.A recent study from the UK found that acupuncture performed once a week for 6 weeks is effective at managing cancer-related mental and physical fatigue as well as activity levels, motivation, and quality of life is increased. The authors speculate that the benefits of acupuncture in treating fatigue may be in part mediated by its effect on pro-inflammatory cytokines. (Acupuncture for Cancer-Related Fatigue in Patients With Breast Cancer: A Pragmatic Randomized Controlled Trial. J Clin Oncol. 2012 Oct 29.) This week a pilot study was published online, out of the Memorial Sloan-Kettering Center in New York City which showed that acupuncture significantly reduced limb circumference in patients with breast-cancer-related lymphedema. Lymphedema affects 30% of breast cancer survivors and up to this point did not have a safe and inexpensive intervention. Acupuncture was performed twice a week for four weeks and produced up to 30% reduction in arm circumference. Dr. Cassilith, who conducted the study, emphasized the importance of using a trained acupuncturist for lymphedema treatment. We concur not only for lymphedema but also for any type of cancer related acupuncture support. Both Catherine Travis and Dana Price are highly trained and experienced practitioners who use gentle, effective, and safe techniques.
Fibromyalgia affects millions of Americans, many of whom are women. The main signs and symptoms of fibromyalgia include deep muscle pain, painful tender points, and morning stiffness. Other symptoms may include sleep problems, fatigue, and anxiety. Regular Massage Therapy sessions have been proven to decrease pain levels, muscle stiffness, and improve sleep quality. In a study conducted by the Touch Research Institute, thirty adult fibromyalgia subjects were randomly assigned to a massage therapy, a transcutaneous electrical stimulation (TENS), or a transcutaneous electrical stimulation no-current group (Sham TENS) for 30-minute treatment sessions two times per week for 5 weeks. The results showed the massage therapy subjects reported lower anxiety and depression, and their cortisol levels were lower immediately after the therapy sessions on the first and last days of the study. The TENS group showed similar changes, but only after therapy on the last day of the study. The massage therapy group improved on the dolorimeter measure of pain. They also reported less pain the last week, less stiffness and fatigue, and fewer nights of difficult sleeping. Thus, massage therapy was the most effective therapy with these fibromyalgia patients. Audrey has successfully treated fibromyalgia pain syndrome with Massage Therapy here at ilumina. A customized massage session is developed specifically for each individual to reduce muscle pain, fatigue, and increase the quality and quantity of nightly rest.