Varicose Veins

WHAT ARE THEY?

Varicose-Vein

Varicose veins occur when the valves (that keep the blood flowing one way through the vessels) have become weak, which allow the blood to pool in the veins. This “pooling” causes the veins to become lax and distended.

CAUSES:

  • May be due to diet
  • Lack of exercise
  • Heredity
  • Hormone changes can cause the laxity of the valves
  • Pregnancy can be a predisposition for some women
    -Because there is a congestion of the blood in the lower extremities due to pressure from the uterus.
    -The return of blood from the legs to the pelvic area is reduced by the heavier uterus.

They are most common in the legs, ankles and feet. They can also show up in vulva (Vulvar variscosities) and anus (as Hemorrhoids). They become more pronounced as the pregnancy advances.

The vulvar variscosities usually are not noticible until birth. Some women notice the large ones during pregnancy. A gentle birth and hot compresses applied to the large distended veins will reduce damage or trauma to the veins. Occasionally bleeding or hematoma (internal pooling of blood) can occur and will require medical care.

Hemorrhoids become evident after birth, normally. So the use of gentle birthing will help with these as well. Constipation will aggravate hemorrhoids, and should be treated (although, following a good diet will reduce constipation due to the additional fiber from foods).

Usually the varicose veins will empty quite quickly after pregnancy. They are quite common during pregnancy, and usually repair is not considered during that time.

RECOMMENDATIONS

• Eat well, and drink lots of water
• Exercise! Exercise improves the circulation, and assists in both the prevention of and treatment for varicosities.
-Brisk walks for 30 minutes each day
-Or ride a stationary bike for the same length of time as walking
-Swim
-Yoga
-Belly dance moves such as pelvic rocks, and rolling/rocking the hips in a figure-eight.
-Dance!
• At least 20 minutes twice a day with feet elevated higher than the heart
• Do NOT sit in one place for too long. This would encourage insufficient pelvic and leg circulation.
• If you have severe varicose veins use support stockings (you can find them at a drug store.
• Use visualization to reduce the size and number of the varicose veins.
• You need to consider who / what is your support. You are not superwoman, and will need support during this very exciting time in your life!

CAUTION: Never massage the varicose veins! Massaging the veins can cause clots to dislodge and lead to an embolism. Embolisms are dangerous! If you see signs of phlebitis (swelling, heat, pain, infections around the veins) you should see the doctor or midwife right away.

DIETARY RECOMMENDATIONS

Follow the “baby wise” diet . Be especially careful to eat whole grains, high quality proteins, fresh vegetable and fruits as often as you can.

• Vitamin C with bioflavonoids is vital for assisting the walls of your veins to be strong.
• Foods with high vitamin C: citrus fruits, rose hips, dark green leafy vegetbles, cherries, alfalfa sprouts, strawberries, cantaloupe, broccoli, tomatioes, and green peppers.
• An additional 2,000 mg. of C with bioflavonoids can also help
• Vitamin E also is good for the vascular system. Take 200 to 600 IU a day. If you have heart or blood pressure problems begin with 50 IU and work up to 400 IU over a three month time-frame.
• B complex vitamins. Whole grains, nutritional yeast (I take mine in orange juice), and yogurt (its helps maintain intestinal integrity ).
• Green Vegetables…romaine (stop eating the low-vitamin Iceburg variety) lettuce, butter lettuce, turnip greens, kale, collards, mustard greens, dandelion greens, and turnip greens. Steam these, do not boil!

HERBALS

• Nettle leaf tea (One herb in the “Pregnancy Tea” blend I use) . Infuse by making 1 ounce of herb to 1 quart of water and allow to steep for 2 hours. Drink a cup to up to a quart a day depending on severity.
• Garlic, onions, oatstraw, calendula, motherwort, can also be consumed. Please consult an herbalist for guidance on their use.
• Kelp. Kelp can be added to soups or taken in a tea form.
• Deficiencies in essential fatty acids may make the varicose veins worse. Take 500 mg. of one of the following oils once each day: evening primrose, flaxseed oil, black currant oil, or borage oil.

REFERENCES:

Romm, Aviva Jill. The Natural Pregnancy Book: herbs, nutrition, and other holistic choices (2003) Celestial Arts

Lowdermilk, Dietra Leonard and Shannon E. Perry. Maternity and Women’s Health Care, 9th ed. (2007) Mosby.

Stress, Part 3

Stress

stress

Stress and Pregnancy

This is a huge transitional period for the family unit, and usually characterized as stressful. Due to new roles to learn, adjustments within the family unit, communication patterns are re-established. These shifts may trigger biologic changes, hormonal function shifts, and immune system vulnerability.

The whole family unit is thrown off it equilibrium due to restructure of family roles, adjustments to family goals, physical and emotional changes that pregnancy may bring. This is the case for the average and normal situation and pregnancy. What about other circumstances or high risk pregnancy?

If the pregnancy is from an already stressful situation such as a rape or domestic violence has occurred, the stressor of pregnancy brings additional problems. Decisions need to be made to assist the mother, if other children are involved, their safety attended to.

In high risk pregnancy situation, stress is further aggravated if hospitalization is required. “High risk” is a label given to those whom the health of the baby or mother to be is threatened.

The pregnant mother’s ability to adjust and or adapt to the situation may be in jeopardy by the excessive level of stress. The mother must understand the causative factors in being labeled high risk and accept the situation in order to have a good outcome. As well as the pregnant mother, all other family members need to assess, accept, and readjust to this prognosis.

Unfortunately, pregnancy on the reservation is almost always considered high risk. This is due to poverty, gang activity, teenage pregnancy, alcohol consumption and drug abuse.

Only YOU can change this! Change the additional stressors in your life, and then you can change the outcome of your pregnancy and delivery!

Stress, Part 2

Stress

stress

Social and Family Stress

Social stress can be an actual threat or that what is perceived as a threat. These are within ones social environment. This could be relationships at work, conflicts at school, or interactions that occur within a person’s society.

Inside the family unit certain life events can affect the family directly or indirectly. Some of the stressors could be things that are deemed “normal” such as a birth in the family.

Stressors could be caused by ambiguous facts, such as an illness of unknown cause in which the doctor states the person will die at some time. Also, there are stressors that are caused by nonambiguous facts such as the onset of a severe storm and its aftermath.

Volitional stressors are things such as divorce, things that members of the family may cause or control the end result. Chronic stressors are events that occur over an extended time, such as a handicapped family member. Acute Stressors are temporary, such the hospitalization of woman giving birth. An isolated stressor is a singular event, such as the arrest of a family member.

Family stressors can proceed a crisis within the family but not all family stress leads to a crisis. Here are four indicators that a family is in a crisis:

• Members within the family are no longer able to function with their family roles
• Family members cannot make decisions and solve problems
• They are unable to give care to each other in a way usually seen
• A shift from family to individual survival

Stress

About Stress

stress

There are two types: the type that is good, making you feel satisfaction and happiness. And there is negative, which leads to fatigue and possibly, illness.

There is no singular thing to point to as a cause of the latter. But, what is known about it is that the body makes biochemical changes when it is present.

GAS or General Adaptation Syndrome, has three stages. These stages are: alarm, resistance, and exhaustion. In the alarm stage the quick initial response is lowered blood pressure and tachycardia. This is in preparation for the fight or flight response to continued stress. The body will continue to increase its production of adrenocortico-tropic hormones. Along with this is increasing heart rate and elevation in blood pressure.

If the condition becomes prolonged, to the point where the adaptation of the body is too great, vulnerability of the body occurs…and exhaustion. The body is not designed to stay in a heightened state of arousal.

If continued, the sympathetic nervous system becomes activated with vasoconstricted blood vessels, increasing blood pressure, increasing heart rate, and the secretion of adrenaline. The immune system will then become suppressed and the increasing cortisol will cause cholesterol and other lipids in the blood to increase at the same time.

Situations or “agents” that cause stress are called STRESSORS. These may include physical things such as heat, exertion, trauma, infection, or cold. Or it may be from psychological reasons such as fear, anxiety, or disappointment. Stress may be caused by external things. Examples may include poverty, inadequate housing, and certain life events.

Factors altering stress responses are called mediators. The MEDIATORS may be genetics, developmental factors, experience, and social context. Some people appear to be more resilient and cope better with stress, while others seem to be more vulnerable.

Women with Disabilities -The Healthcare Team- Part 1

ptg02629145

When do you start your Search?

The search should begin as early in the pregnancy as possible. When you do a gynecological examination is the opportune time to decide if you are able to become pregnant. Hopefully, that will occur with a doctor with whom you feel comfortable.

But if the pregnancy was unexpected, or you have not found that great doctor with whom you feel comfortable, the earliest point of time is best. It is important for the baby’s sake. It has been discovered that women who receive care late in the pregnancy or have had no prenatal care at all tend to run a higher risk of infant mortality.

Finding a doctor may be a challenge. Some will immediately advise an abortion. Other doctors will become enthused by the challenges.

You need that doctor to know you well enough to understand the way the changes of pregnancy will affect you. Health issues unrelated to the disability you have will most likely need to be addressed early.

How to Find a Doctor

You could find the doctor via those with whom you trust. You may also get recommendations from the doctor who has been working with your disability.

Evaluating the Doctor’s Practice

The recommendations of friends with whom you trust can assist you in assessing the skills of the doctor. Or listening to the impressions of the patients the doctor has had in the past.

Sometimes there may be differing experiences; it’s in this instance that the opinion of an older and well-trusted doctor in the community may come in handy. There is no singular way to assess what doctor may work for you, other than knowing what you are looking for in the care administered by a doctor.

Check the office policies, by checking with the receptionist. You can ask about fees, for normal birth and caesarian section. Ask about payment and billing, insurance the doctor will accept. You will need to know what hospital the doctor is affiliated. Also check the doctor’s flexibility with requests, such as persons allowed to attend the birth, and whether the doctor will work with you on having a natural birth. Most importantly, check accessibility, if you are using a wheelchair…are the rooms and bathrooms set-up for your ease of use. The answers to these questions may narrow the choices of whom to visit.

You could ask for only a consult, rather than a visit with a full physical examination until you have decided upon which doctor you will use. Bring with you the father-to-be or an advocate. You then will have someone to share impressions and ideas with, or who would think of questions you may have not been able to think about in your nervousness.

How to “Trust the Process” in Childbirth

Trust the Process

Trusting is a big word. We oftentimes say we trust others, but do not even trust our own selves. The nurturance of our babies and bonding that would be necessary in utero, assists in developing a trust between baby and mother. But before working on the baby-mother bond learn to trust your own instincts.

Science has determined that the mother-baby bond is essential after a child is born. But what about the significance of bonding while the baby is growing inside the uterus? This is the essential missing information not communicated to women in our modern times.

Due to the obsession of the over-technological world we live in, we forget to listen within. We tend to not realize important knowledge lies inside our psyches. We avoid listening to our bodies. The cues are there, we just do not stop to listen.

The pregnant body is communicating what it needs all the time, and, believe it or not, the unborn baby is, too. All we have to do as mothers is learn to listen, give ourselves permission to trust the connection, and take the time to respond (Peters & Wilson, 22).

For survival, the baby must begin to adapt to its environment while in the womb in order to survive. There are special molecules that act as messengers, to allow the mother to communicate to her baby in utero. Components such as hormones and neuro-peptides cross the placental wall, sending information to the fetus.

Emotional intelligence is taught to the fetus via this mechanism. So he or she learns the whole range of emotions via the mother. Her responses teach the fetus. She sets the tone, so-to-speak for coping within the world.

Creating the bond with the fetus is a spiritual act that transcends the normal functions of mothering. How one adjusts to life, begins during the prenatal period.

Researchers and clinicians have found that prenatal and birth experiences of the mother, effect the birthing patterns she has with her own babies. These would include cultural patterns imbedded in the lives of the family. We can prevent “life-constricting patterns (McCarty, 9)” that are developed while in utero by addressing these issues and healing our own birth traumas.

This scientific approach closely parallels the work of John Upledger in his ground-breaking work with Cranio-Sacral and Somato-Emotional Release therapies. His theory is that the body stores memories at the cellular level.

Have you ever massaged someone, or been massaged, and a small soft-tissue lump is discovered that almost feels like it “crackles”? That is a “energy cyst”. When released it creates an emotional response, and the muscular tension abates. It is thought this “cyst” holds the memory of the injury. In Unpledger’s book, he states that traumatic injury can be fully healed by the release of these “cysts”.

I have come to look upon this phenomenon as ‘tissue memory’. By this I mean that the cells and tissues of the body may actually possess their own memory capabilities. These tissue memories are not necessarily reliant upon the brain for their existence [[Upledger, 64].

I would consider this muscular and tissue intelligence. If Upledger’s theory is true [and is likely, due to hundreds of patients having experienced his work] then it is an important aspect to consider for the mother and the mother-baby bond.

There are four essential KEYS to developing the mother-baby bond, and learning to be aware of and trust your own instincts.

Being: an awareness of thoughts and feelings
Observing: a state of mindfulness
Nourishing: involves all the things women do to tend to their emotional and physical needs.
Deciding: to make an active participation in creating your own reality. A conscious agreement
to make decisions based on deep inner-listening.

Steps to making the conscious agreement are:

1. Separating ourselves from all external influences (even for a few moments in the day)

2. Get quiet and pause. A few deep breaths in order to connect to your “source”

3. Listen. What is your gut saying to you? How does your body feel? How is your body reacting? How does your baby react to what you are feeling, physically or emotionally?

4. Then decide and commit. This is when you honor your feeling and that of your baby. Make a decision that will be in harmony with the messages your intuition says.

Through this practice, then you will develop a trusting respect for your own intuitive thought process, allowing it to guide you. You have several months of your pregnancy to find your awareness of self and of your baby.

When the day comes for labor to begin you take this newly-developed self-awareness, the bond you created between you and baby, and the education you have gained about safe birthing practices to trust fully the process of labor! “Listen” to your own self, and what your baby is telling you.

Relax into labor, BE with it. OBSERVE what is transpiring within your own body, and NOURISHING your emotional / physical needs while you are in labor. Then DECIDE. Decide to trust your instincts, trust your body (which is wonderfully made!), and to trust your bond you’ve made with your baby…

COMMIT to Trusting the Process.

REFERENCES:

McCarty, Wendy Anne. Ph.D. , R.N. The Call to Reawaken and Deepen Our Communication with Babies: What Babies Are Teaching Us. International Doula. Summer 2004, Vol 12.

Tracey Wilson Peters, CCCE, C.L.D., and Laurel Wilson, IBCLC, CCCE. The Mission Piece: Consciousness and the MotherBaby Bond. Pathways to Family Wellness. Issue 31, Fall 2011

Upledger, John E., D.O., O.M.M. Your Inner Physician and You. 2nd Ed. North Atlantic Books. 1997

Body Mechanics – 2

BODY MECHANICS

As your pregnancy advances, your body ligaments and joints will naturally loosen to allow for an easier birth, by allowing the pelvis to develop flexibility. The following suggestions will assist you in avoiding strain while doing the normal daily activities.

Stand Smart

To reduce ankle swelling and assist your circulation, avoid standing for long periods of time. In order to avoid circulation issues, periodically flex your calves and /or rotate the foot in circular motions. You should also alternate resting one foot then the other, on a stool.

Lift lightly

stooping lifting carryingYou already are carrying around and lifting more weight. Don’t lift heavy objects. For light lifting, use your arm, leg, and thigh muscles not your back. Don’t bend to get close to an object, squat. Keep that head of yours up and with your back straight. Lift by pushing up with your legs and flexing your arms. Avoid the urge to lift up a toddler, use the squat to get down to the child’s eye-level or sit on the floor to cuddle.

Sit Sensibly

sittingAvoid sitting for more than a half an hour at a time. Use straight-back chairs with a small pillow at the small of the back. Use a footstool, shift positions often, and avoid crossing your legs. Periodically exercise your calf muscles and do foot flexions and / or rotations.

When arising from the chair, avoid lunging forward. Slide your body to the edge of the chair, plant your feet on the floor, and use the leg muscles to lift yourself up. If someone is willingly offering assistance to get up, use it.

Sleep

During the final four to five months, side-lying is the best position. This is the best for baby and the most comfortable for you.

In the last trimester you should have at least four pillows. Two pillows should be under the head and at least one for the top leg to rest upon, and maybe one to support your lower back. Shift slightly forward towards the belly, to get the full weight off the lower leg.

Rise in the Proper Manner

Don’t sit up suddenly when the alarm goes off because it will strain your lower back and abdominal muscles. Don’t immediately swing your legs off the bed, as it would strain your lower back ligaments. Instead, roll onto your side and push yourself up by using your arms, into a sitting position then swing your legs gently over the side.

Body Mechanics- I

START WITH GOOD POSTURE

As the baby grows in the womb, your center of gravity will shift. The additional weight in the front could create a swayback posture, causing discomfort on the lower back. The following suggestions to assess and alter your body mechanics will assist in having less discomfort.

STANDING POSTURE

Head

Keep your head up. Looking down all the time will throw off your balance. Of course, you will want to look at the new bulge as it grows but doing so all the time will make your posture off balance.
Keep your chin level. When your head is held correctly, the shoulders will follow as well as the back.

Drop your Shoulders

Allow the shoulders to rest in a natural position. To do this relax the shoulders. If you tend to wear your shoulders up around your ears or slouched forward, your whole body will be off balance.
Try to avoid “throwing back” your shoulder blades. This will cause back problems. You may need to have someone massage the shoulders to allow them to relax into the correct position.

Avoid Tensing / Swaying the Lower Back

As your baby grows the weight will cause your back muscles to contract as a counter-balance of the shift in weight to the front. The tension of the muscles contracting may cause a backache.
A slight curvature of the back is normal. Avoid an exaggerated curve as it will cause a “swayback”. If there was chronic pain of the back before you were pregnant, it will only get worse from pregnancy. You may need to get Chiropractic attention if you already tended toward a “swayback” before pregnancy or if you had back issues prior.

Tilt your Pelvis Forward

Pull your abdominal muscles in, tuck in your buttock muscles, and tilt the pelvis forward. Doing this will counteract tendency of the lower back to arch abnormally.

Relax the Knees

Bend your knees slightly. Avoid locking them.

Co-Sleeping

co sleeping

Co-sleeping as defined here is “bed sharing”. It means to share the bed with your infant, for the purpose of breastfeeding, as well as bonding. This could encompass the use of the crib or bassinet in the bedroom (in general) or beside you when you sleep or not.

In Gettier’s article, she distinguishes between those parents who intentionally share the bed nightly, and the parents who are reactive bed-sharers. A ‘reactive bed-sharer shares the bed due to having “child sleep difficulties and / or to ease nighttime feeds (9)”. This would occur less regularly and are for shorter periods of time. Those parents who regularly sleep with the child, have the child in their bed for the full night.

SAFE BED SHARING

• If there are two parents within the household that choose to bed share both parents must agree to be
vigilant and responsive to the infant.

• Babies who are born small for gestational age should avoid bed sharing

• If the mother smokes, she should choose same room sharing, not bed sharing if she does not
shower nightly.

• Bottle feeding parents (without breastfeeding) should also use room sharing [never prop the bottle].

• Think of the safety of the baby, and suffocation. If you have a bed set, remove the mattresses (placing
headboards, et al into storage temporarily) and move the mattresses to the center of the room.
Babies and roll and move, get wedged between the mattress and headboard (or mattress and wall)
and suffocate.

• If you choose to keep the head and foot boards , eliminate the spaces that are between mattresses
and the head or foot board.

• Older children and pets should not be sleeping in the bed with the infant.

• Co-sleeping is not recommended if you are or have been drinking. Nor is it a good idea to share your
bed with baby if you’re doing recreational drugs.

• Bed sharing should be on a firm mattress, with no duvets or heavy bedding. Infants need to be away
from pillows or other bedding that may obstruct the infant’s breathing.

• NEVER co-sleep on a couch, recliner, or chair.

• NEVER LEAVE A BABY ALONE ON AN ADULT BED.


There benefits to bed sharing.
These include: higher percentages of breastfeeding rates, longer feeding times, increased feeding during the night. Keep in mind, babies tummies are small and they would therefore feed more frequently.

It is known that there is a greater immunological benefit in breastfeeding. It is known to be a “protective factor against SIDS (Vennemann et al 2009, Gettier, 10)”. Mothers who breast feed longer are less likely to develop breast cancer as well.

Babies who bed share are awake for shorter time periods than those who sleep separate. It is thought that bed sharing assists in a “synchronization between mother in terms of arousals and sleep stage shifts (McKenna and Mosko 1994, Gettier, 10).” Both mother and father seem to get much more sleep with bed sharing, than those who do not.

REFERENCES:

The Careful Decision to Bedshare. Lee T. Gettier. (2010) International Doula. Vol. 18, Issue 1

*A more detailed document is available at the Hokṡiyuhab Oti Childbirth Education Classes*

Methamphetamine – Use in Pregnancy

Methamphetamine

It is described as the number one drug problem in America. It is relatively cheap, highly addictive, effects the population across the socioeconomic spectrum. It makes its users hypersexual and uninhibited.

When smoked, it produces a potent and very long-lasting high. Those who use the crystalline form, are awake and do not eat for 24 hours then will “crash” for the next 24 hours. Its active ingredient is pseudonephrine. It is easy to make or “cook”.

Clinical Manifestations

It creates an euphoric state, abrupt awakening, increase in energy, the person on Meth is talkative, may be elated, or be agitated. Meth causes irritability, hyperactivity, a sense of grandiosity. The effects also cause weight loss, ectopic heartbeat, urinary retention, constipation, and dry mouth.

Meth can cause paranoid delusions, violent behavior, seizures, cardiac shock, and death from over-dosage. Most of the effects are similar to that of Cocaine.

Neonatal Complications

Complications are less than what is found with cocaine users. But, a meth user may still have preterm birth, intrauterine growth restrictions with smaller head circumference.


REFERENCES:

Kitzinger, Sheila. The Complete Book of Pregnancy and Childbirth. (1996) Alfred A. Knopf.

Lowdermilk, Deitra Leonard and Shannon E. Perry. Maternity and Women’s Health Care. 9th Ed. (2007) Mosby/elsevier