Massage, Bodywork, and the Cesarean Section

I am thrilled to be presenting at this months International Cesarean Awareness Network meeting on August 12 at 630 pm in Minneapolis.  The meeting will take place at Holy Cross Lutheran Church, 1720 E. Minnehaha Pkwy, Minneapolis, MN.  I will be talking about the benefits of massage and bodywork in preventing a c-section and also what can be done after a c-section.  Today I am going to give a little over view of what will be talked about and what we will be doing on the fine Monday evening.

The Cesarean Section and the Woman's Body

When women are asked (and often not asked) to undergo c-section it is rarely explained to them that the procedure is major abdominal surgery.  It is rarely explained to them that the scar tissue is not only superficial in the skin but can potentially form deeply into the abdominal and pelvic cavities.  Too often women are not fully informed about this everyday surgery that is performed, sometimes unnecessarily, sometimes lifesaving, and what the long term ramifications will be in their lives.  Surgeons are not leaving out soft tissue information out of malice or even ignorance - simply because they don't think about it.  Traditionally trained medical doctors in the United States rarely consider that scar tissue lays itself down in a random pattern, nor do they think about how this random pattern will effect the function of muscle, tendon, ligament, bone, and organs that are near the scar tissue.  There main concern is keeping everyone alive.  Now that being said, I have met a handful of fantastic surgeons that do indeed think about these things are very careful about when and why they cut and whether or not they are cutting into previously formed scar tissue.  So please, understand I am talking about surgeons that slice and dice to get their share, and I truly feel this breed of surgeon is becoming more rare.  I guess I'm an optimist.

The Scar

There are many different shapes, sizes, and thicknesses of scars.  My own mother has a "zipper" scar from her pubis up to her navel from two c-sections.  It has caused her physical, emotional, and spiritual pain for many years.  I have also seen the tiniest, faintest scars just above the bikini line that never caused a days discomfort.  I give you these two extreme examples to show that there is a broad spectrum of what the scar can manifest in women.  Let's talk about the physical scar.

Scar tissue is the body's way of quickly healing itself when there has been a violation to the skin or deeper tissues.  When scar tissue forms it does so in a random pattern.  It is not striated like muscle tissue, nor does it have a predictable pattern.

The above is an image produced by BodyScientific International.  You are looking at a micrograph of the random  pattern that scar tissue creates within the soft tissues.  When this random pattern is mixed with the predictable patterns of non-damaged tissue in the body a few different things happen.

• Reduced Range of Motion (ROM)
• Possible Pain with Motion
• Possibility of Micro-Tears forming in the surrounding tissue

In the past manual therapists have been taught to apply deep cross fiber friction for several minutes over the scar tissue fibers with the claim that this alone will realign the tissue.  I personally have never found this to do much other than cause inflammation and pain.  I was fortunate in my quest immediately after graduating from massage school that I found James Waslaski.  The following three years I devoted my study to his techniques and learned from him that scar tissue requires multidirectional friction to address the random pattern of lie in the tissue followed by pain free movement and eccentric contraction of the muscle the scar tissue is present in.  Waslaski has revolutionized the field of massage therapy with this gem of a technique.  The really cool part that has not been explored, at least to my knowledge, is that even when the scar is present in organs, which are involuntary muscles (that means we do not consciously control their movement), the organs will contract with the scar tissue having been realigned in the soft tissue surrounding itself and hopefully take the hint and realign the tissue within itself with the automatic contractions that organs go through every minute of every day.  Part of the reason I believe this is possible is because of the fascia.

The Fascia

Fascia is a delicate yet strong fibrous net that runs throughout the human body.  It is helps maintain the form of soft structures, create lubrication between those structures, and when it is injured is plays a big role in letting us know that there is damage to an area.  The fascia connects and separates simultaneously because of its nature.  When there is a scar in the area the fascia is compromised by reduced blood flow and having its net structure disrupted.  Recently, scientists have discovered that fascia carries nerve receptors that communicate pain to the body (nociceptors) (Tersarz, et. al. 2009) and it contains contractile fibers (Schleip, et. al. 2007).  When the soft tissue is damaged by a cut so is the fascia.  Fascia surrounds our fat cells just below the skin, surrounds the muscle, tendons, organs, ligaments, separates the cavities of the body, and then it is also present microscopically gently supporting each fibril of muscle, each whisp of periosteum.  So you can see that when the body is cut, this dynamic web that helps to hold us together can get damaged and cause great pain not only in the area where visible damage is, but it can also cause pain in areas that may completely mystify you.  Think about what happens when you pull one strand from a spider web.  The web folds in on itself and those intricate patterns are changed.  It is the same concept with the fascia when it is cut or damaged.  The damage will reverberate throughout the body.  The following is one of my favorite youtube videos of the fascia.  It shows the net/web of fascia magnified 25x and explains what you are looking at.  It will help you understand how interconnected the tissues are in the human body.

The Recovery

Recovery from a c-section is as different for every woman as birth is.  No one is the same but everyone shares the common bond of the incision.  It is important to keep in mind that soft tissue has a memory.  Every event of your life is stored in your body.  Sometimes our mind remembers it and sometimes an event has to be stored elsewhere until we are strong enough, ready enough, sure enough to let it out, let it go, and accept the event for what it brings to our life experience.  Christine Courtois, Ph.D., states that  "Although the victim may make a psychological escape, the body is left 'holding the bag,' so to speak."  She is specifically speaking of sexual abuse victims in this quote but the statement has been found to be true for all types of trauma to the body.  The next point I would like to make about recovery is that it si a continuous journey.  As our body travels towards optimal health and rebalances itself, leaving us feeling great for a time and then suddenly we will fall back again, to need another guiding hadn to move us farther along our journey to health, whole health.  Working with several practitioners in various fields can help speed the recovery from an unwanted c-section.

Prevention of Cesarean Section with Massage and Bodywork

Before I begin this section I want to make it clear that not all c-sections are preventable.  Circumstances will arise that necessitate the intervention of a c-section.  Barring those circumstances, this is what you can do to try and prevent a cesarean section.  
First, get a doula.  Simply having a doula present at your birth lowers the incidence and need for interventions (Hodnett, et. al. 2011).   Better yet, find a doula that has Spinning Babies training.  You cannot start too early using the techniques that are found at Spinning Babies.  They help you learn to use Balance, Gravity, and Movement to get your body ready for the big day.  
If you are having pain, discomfort, or difficulty moving find a practitioner in a modality you are comfortable with, that you trust, to help you resolve those issues.  Again, the sooner you begin addressing those issues, the better.  Who are these practitioners?

• Chiropractors
• Acupuncturists
• Physical Therapists
• CranioSacral Therapists
• Massage Therapists
• and many more....

Ask your friends who they like and go from there. 
Why shouldn't I just grin and bear the discomfort?  Why spend the money?  Well, having your body balanced before you are late in your pregnancy and it is more challenging to redirect soft tissue will make your pregnancy more comfortable, your labor potentially easier, and potentially reduce your risk of cesarean section.  
Next, regular, fun, enjoyable exercise.  Whatever you conceive that to be, that is what you need to do everyday.  Maintain your strength, increase your endurance, but most of all - have FUN while you exercise!  It is good for you and the baby.  
And of course all of the other goodies your prenatal provider advises for you - good nutrition, restorative rest, regular check-ins with said provider.  

Communication, Collaboration, and Integration

To take a genuinely holistic approach to the healing process it is important to be open with the people you employ to guide through your healing journey.  And yes, I mean your medical doctors too.  Everyone needs to be on board with what is right for your experience.  You have the right to get good information on the B.R.A.I.N.N. of your course of treatment.  What is B.R.A.I.N.N.?

• What are the Benefits of this treatment?
• What are the Risks of this treatment?
• What are the Alternatives to this treatment?
• What does my Intuition tell me about this treatment?
• What happens Next if I proceed with this treatment?
• What happens if I do Nothing?

I first learned of the acronym from the Childbirth Collective in Minnesota.  I have found it to be useful not only in birthing situations but in any situation.  This is where your Communication begins with your providers.  It is your responsibility to get the information, learn it, and make a sound decision about your care for recovery.  Once your have taken those steps ask your providers to Collaborate.  This opens Communication between disciplines and will make the road to recovery easier for you.  And finally, Integration - don't be afraid to tell your general practitioner that you went to see a Reiki Master, or a Reflexologist, or a spiritual helper.  Everyone involved in the recovery process needs to understand that the scar you carry goes deeper than the tissue.  Everyone involved will step up and follow the course of Communication, Collaboration, and Integration if they are allowed.  You get to be the CEO of your care for your scar.  Everyone else is just a guide to remind your body, mind, and spirit where it wants to go to recover from the scar.

I hope you can join us Monday the 12th for a live version of this post.  I will also be demonstrating and teaching some self-care techniques for those who have scars that are uncomfortable.  

Rebalance, Renew, Rebloom
Adrienne


Source List:

Hodnett ED, Gates S, Hofmeyr GJ, Sakala C, Weston J. Continuous support for women during childbirth (Review). The Cochrane Library, 2011, Issue 2, p. 13, 57

Schleip R, Klingler W, Lehmann-Horn F 2007 Fascia is able to contract in a smooth muscle-like manner and thereby influence musculoskeletal mechanics. In: Findley TW, Schleip R (eds.) 2007 Fascia research – basic science and implications for conventional and complementary health care. Elsevier GmbH, Munich, p.76-77

Timms, Robert, Connors, Patrick, Embodying Healing: Integrating Bodywork and Psychotherapy in Recovery from Childhood Sexual Abuse.  Brandon, VT: Safer Society Press; 1992. p. ix.

Tesarz J 2009 The innervation of the fascia thoracolumbalis. In: Huijing PA, Hollander P, Findley TW, Schleip R (eds.) 2009 Fascia research II – basic science and implications for conventional and complementary health care. Elsevier GmbH, Munich, p.37

A Mama-story of how her practice morphed

Happy Birthday Turtle Man!

Two years ago yesterday I birthed my little boy with a fantastic team of providers and my husband.  My son’s conception changed how I handled my pregnancy, gave me the gift to see how small changes in the everyday pregnancy can affect the outcome at birth, and motivated me to follow through with a wish and conversation had in a NICU under his big sister’s isolette.  Today I am going to share with you what the changes were, the gift he gave me and my family, and a peek into the wish and conversation.

Conception and Change  - A Second Chance for a Better Birth

As most readers will know, my daughter’s birth was full of excitement, trauma, and a journey we never expected.  She was a breechling who surprised us with her sensitivity to birth and her amazing resilience for recovery.  Here is a link to her birth story.  Bruce, my husband, and I, had initially planned to have our children 14 months apart but Miss. Magnolia wanted a little more space   between   herself and her sibling.  So, when Bruce and I finally got up the courage to have the discussion about getting pregnant again, I think we accomplished it the same night. ;-)  We agreed that I would get time and support to tandem nurse as long as possible, be able to go to yoga as often as needed, get counseling, and receive chiropractic and massage as often as possible.  We were determined to repair my pelvis and create as much space as possible for Baby 2 to be in a head down (vertex) position, and hopefully occiput anterior – for the geeks out there.

My eating for this pregnancy changed immensely from Magnolia’s pregnancy.  I ate what I wanted, when I wanted with as much protein as I could ingest.  During my first pregnancy I took everyone’s “advice” about, oh don’t eat that it has too much fat, don’t eat this it might cause blah, blah, blah.  I didn’t know any better.  This time around I learned a girl has got to eat.  So, lots of trail mix, avocados, and wild caught and organically raised meats.  A HUGE THANK YOU to Jack Bull for the deer and Robin and Gigi of the Nitty Gritty Dirt Farm for the organic foods.  It nourished the little Turtle Man and me. 

Our next big change was our birthing method.  We had used Birthing from Within for our first, and this time we took Bradley Method from Karen Bruce.  Bradley was an excellent method for my concrete thinker of a husband.  He walked away from the classes feeling like he really, finally, understood what labor and birth looked like. 

An aside:  I think it is important for everyone to find the birthing class that fits their needs.  There are so many wonderful techniques out there.  To name a few… Hypnobabies, Hypnobirthing, Lamaze, Calm Birth, and I am certain there are a multitude of other methods out there.  Research them, pick one, and invest in taking a class that goes beyond the weekend crash course at the hospital. 

Our friends Pete and Terri graciously took little Magnolia for us to be able to take the Bradley classes.  Thank you so much for giving up your Tuesday nights for 10 weeks.  This leads me to the next change.  Ask for help.  When your friends ask, “What can I do for you?” tell them.  Raising children really does take a village.  On the other end, after you have gotten your children out of babyhood and into toddlerhood, you can pay it forward to the next generation of family that needs support.  We have heavily relied on our friends to help us out with childcare and support.  This made it possible for me to stay home with the both kids for three months after the Turtle Man’s birth, a great gift to Bruce and I, and especially the children. 

Back on track, I get easily distracted.  I started going to yoga every Sunday, with Clare Welter, at about 12 weeks.  Very little deterred me from going.  I felt my body become stronger, my pelvis became more stable, and my endurance was getting better.  In the last month to month and a half I added yoga classes at Blooma because I wanted a workout that would build more tone and really push my endurance.  Thank you Sarah Longacre for the fun, juicy classes!  In addition I was getting out for long walks as often as possible.  I really was feeling much stronger and more prepared.  Squatting was my life! 

The Team:

Bruce and I agreed that planning a homebirth again would probably put us over the edge.  What if the Turtle Man had an unknown disorder like his sissy?  What if something odd happened during birth again?  All the usual questions filled with anxiety.  We agreed that Denny Hartung would help with the birth of our second.  He was so wonderful and respectful taking us on so late in our last pregnancy, we could hardly imagine birthing with another OB.  Besides, as we all know, he is the gold standard for hospital birthing care in the Midwest.  Denny was the only team member from our last birth we kept.  I spoke at length with Magnolia’s doula, Vanessa Plantenberg, and we both agreed it would be alright for me to use a different doula.  So Bruce and I settled, almost immediately, on Sarah Biermeier of Genea Birth – who is now a fantastic midwife!  Sarah was a great fit for us and it turned out that our Bradley instructor Karen Bruce was her back up.  It could not have worked out better. 

My complimentary care team changed as well.  Amber Moravec, D.C., of Naturally Aligned Family Chiropractic did my adjustments for me throughout the pregnancy and postpartum.  We had delightful and informative conversations about chiropractic care.  Magnolia fell in love with her too!  We miss Auntie Pop!  My massage therapist was Gina Potgeiter – colleague, friend, and amazing therapist.  It was so nice when I did get to see her.  Busy schedules make for difficulty in scheduling, but when you make these appointments hold them like a dental appointment.  And my ever patient counselor, Maureen Campion, guided me through the anxiety of this pregnancy, helped heal some of the guilt from the last birth, and made me feel more empowered to be able to have the birth I wanted.

The unsung hero of this pregnancy, of course, is Gail Tully.  I followed her around like a puppy learning as much as possible about BellyMapping and reading up on Spinning Babies.  I was religiously doing the Spinning Babies techniques and going to every workshop she had in the cities that spring.  She graciously palpated my silly tummy every time I asked, answered my incessant questions, and assured me this little guy was head down but occiput posterior – sunny side up.  

 I even got my belly painted by her and my belly graced the first pair of testicles she drew on a mama belly!  I LOVE that!  It was perfect because Turtle Man was direct OP so it was meant to be, and we knew he was a boy.  

Our co-madre relationship was born after a Belly Mapping workshop at Blooma in the parking lot.  I will tell that tale a little later on.

The other part of this pregnancy that was vastly different from the first was that we kept the prenatal appointments to ourselves, left the family out of the loop, and firmly decided that no one would be contacted in the last few weeks of the pregnancy until 24 hours after the Turtle Man arrived.  Well, Turtle Man surprised us with arriving three weeks before his estimated due date, the night before Sarah was supposed to leave on vacation.  I still feel a little bad about that. 

How did the labor and birth go?  Fast!  Water broke all over my beloved, aged dog West who just looked up and went back to sleep.  And the contractions started at 4 minutes apart and 30 seconds long and increased to 3 minutes apart, 1 minute long in a half hour.  Of course it was 2 am.  When else does this happen?  Magnolia got picked up by a good friend, Sarah arrived and started pushing on my sacrum – posterior babies make for some incredible back labor, and Bruce, well Bruce was packing and trying to wrap his head around being awake before 9 am.  Once I was dressed and had my contacts in, I decided I didn’t want glasses on during labor; I hustled outside to get in the car to head to Hudson – from South Minneapolis.  I will never forget the 430 am air, cool, crisp, loamy, earthy, lovely smell.  If I had been near the woods I would have marched in, found a pool, and birthed there.  Sarah pulled around in her van, fresh from the API camping trip, Bruce was not exiting the house quickly enough for me so I got into Sarah’s van and we headed east.  (Turns out the van was almost out of gas, I am told we arrived on fumes.  Thanks for holding the faith Sarah!)  I got on my knees in the front seat, used the dash as a counter pressure on my sacrum for contractions, and Sarah navigated us out to 94.  I distinctly remember when the Turtle Man turned to occiput anterior.  I had a very intense contraction, we had just crossed a river, and I felt him rotate and drop.  I have to say being more aware of your pelvis for the second birth is phenomenal and exciting.  It almost seemed like this little one was going to be a Hwy 94 birth but we made it to Hudson.  We got into the L&D to the water tub room and the nurses were a buzzing.  The noise was something else.  Nothing overtly loud but the click, click, click of typing, the whispered chatter, the tense voices.  I was checked because they were not confident that contractions that were 2 minutes apart and 90 seconds long meant the baby was on the way.  Nor were they willing to accept that I could feel the baby at +1.  They finally called Denny and I was allowed to get into the tub.  The water was amazing!  The discomfort from the contractions halved themselves and I was able to relax more.  Sarah stayed right by my side.  When Denny arrived the entire room calmed and quieted.  Thank you for being able to make that happen Denny!  I believe I labored for another hour and began pushing in the next hour.  (Bruce says I squatted for “Like an hour and a half!”  Those squats paid off!)  The sensation of that baby coming through the birth canal, rocking back and forth with the contractions, rotating with the contractions, crowning, and birthing out into that perfect startle posture was otherworldly.  I was told to scoop him up – and I did.  

We let the cord pulse out, I got out of the tub, and the placenta was born.  That little boy did not leave the arms of either parent for anything or anyone.  We discovered that the Turtle Man shares his birthday with Dr. Dennis Hartung, what a wonderful gift for us!  I only hope that my little man becomes as wonderful as Denny.  Later in the afternoon Gail and Clare visited us!  Another wonderful surprise!  Of course he chose to have his birth on a day when a breech workshop was happening…when else? 

The little Turtle Man was named later in the day…Bodhi Lee Johnson.  Bodhi is Sanskrit for the banyan tree, which is the tree the Buddha became enlightened under.  Lee for Bruce’s mother, and of course Bruce’s surname. 

A Wish and A Conversation

About three and a half years ago Gail and I were sitting on the floor in Magnolia’s NICU room talking about what had happened, why we thought it happened, and what can be done to change this type of outcome for other families.  (By the way, my daughter is quite well.)  We both knew that at some point we would end up working together.  My wish was, and still is to contribute my knowledge of anatomy and physiology to the Spinning Babies techniques.  

Let us jump ahead a two years.  I had been reading as much of Gail’s work as I could get my hands on and head around plus following her around town like a puppy.  I had signed up to go to a Belly Mapping workshop she was giving at Blooma and she invited me to talk about the psoas and do some demos with the other participants.  It was joyful!  We had a great time!  Gail was painting tummies, Nickie Kerrigan (a wonderful midwife as well) was doing CranioSacral work, and I was releasing psoas’.  Of course the evening passed too quickly and the sun was setting as Gail and I strolled into the parking lot.  For many months I had been getting up the courage to ask if I could write for her and help with curriculum.  I finally asked.  She said yes!  Can you believe it?  I couldn’t.  So I started writing up a storm and doing research and putting stuff together and the next thing you know it is eighteen months later and we are presenting at the 3^rd International Breech Conference in Maryland together!  My wish came true!  It still is coming true!

Since then we touch base as often as possible with two very full lives working together.  We have collaborated on a few projects and had the joy of teaching together again.  Gail has taken me in and given me a way to shape my skills in a way that I hope will change lives.  Thank you for that!  As I move forward I continue to learn about birth and women’s bodies not only from Gail but also the plethora of talented birth workers in our community here in Minnesota and Wisconsin – well, and for that matter all over the world.  I am hoping to bring massage and bodywork into pregnancy and birth as a tool that can be used to ease pregnancy, help mothers recover from past injury and trauma to prepare for their next or first birth, teach families what they can do to create space for baby to be in optimal position for labor and birth, and make the postpartum recovery more comfortable.  My next post will begin to outline what I do with the tools I have and who has gifted me each tool.

Thank you everyone for being there for me, supporting me, and helping guide my hands to where they are now.  I am humbled by your love.

Happy Mother's Day - An Ode to All Mothers

There is rich history behind the celebration of Mothers.  Written history shows it began in Ancient Greece with a celebration of Rhea, mother of many gods, to a three day Roman festival of Cybele, to the Christian honouring of the Virgin Mary.  Then the celebration of the Mother disappears...until the end of World War II as a way to increase sales.  

Modern Mother's Day celebration begins with Julia Ward Howe, who initiated Mother's Peace Day observance to fall on the 2nd Sunday of June (This is now celebrated as Father's Day).  It would be glorious is our world could consider having a day of Peace for Mothers.  I think we need to look back to the time when it was possible to hope for a world with no war.  A world where we do not have to worry about our children being taken away to do the bidding of those who wage the wars of the world.  Can we consider having a day where not one single shot echoes across the ether?  Would the leaders of our world honour their own mothers by declaring peace and cease fire for all peoples on May 12?  A day when mother's around the world will know their sons and daughters will come home in one piece.  I know I am asking a lot - honour the  women who have carried you in their womb, loved you unconditionally, given their hearts and soul in bringing you to the light of the world - one day with no gun fire, no bombings, no starvation, no sabotage.  Let's make Mother's Day a day of world peace so every mother, everywhere can have a day where they do not have to grieve their children.

Today, a vote on the Minnesota Senate floor is up to make marriage legal for ALL people who love each other.  There has been singing, chanting, hugging, tears, praying, debate, and conflict of beliefs.  It is my hope that all mothers of every gender identification can legally be recognized as mother and have the same rights as hetero mothers have had for a very long time.  The right to see their child in the hospital, the right to pick their child up from school, the right to take their child to the doctor, the right to file legal documents for their child, the right to adopt a child, the right to foster a child, the right to be a mother - not only in name and action but also in the eye of the law.

Next, we must work toward ensuring that mother's that have fled their country of origin to escape torture, persecution, rape, slavery, and horrors beyond most American's imagination are not surreptitiously ripped from the arms of their children because the White Privileged of this country have forgotten that they are immigrants too.

Solidarity to all Mothers!

Stress and GAS - Let it out!

I have had this topic rolling around in my head for some time now and I think it is ready to escape in all its glory and join the "fart zone" (a hearty thanks to the late George Carlin for giving us the fart zone).  I am hoping to educate you about stress and how it leads to disease and also to dispel anxiety about passing gas - this is a form of relieving stress.  Read on ~

So what am I talking about?  

I am talking about the General Adaptation to Stress theory or GAS theory developed by Hans Selye.  Dr. Hans Selye was an endocrinologist who focused his career on observing stress in people and how it effected their lives.  He discovered that when a stressor is introduced to a body and not removed the body will eventually become distressed and diseased.  There are three stages of stress adaptation:

• Alarm
• Resistance
• Exhaustion

The Alarm stage is the initial introduction of a stressor.  The body will tap into the autonomic nervous system which is where the fight or flight response comes from in our body.  When we get the first indication that there is something in our environment that is causing stress we have the CHOICE to eliminate the stress or adapt.  When a stressor appears and the body responds in the Alarm stage we may experience an increased heart rate, perspiration, pupils may dilate or contract, we may jump back to avoid what ever is causing the stress.  If we choose to eliminate the stressor then our body will go back to its balanced dynamic state.  However, if we ignore the stressor we will progress into Resistance.  And many of us will ignore the stressor and go into Resistance.

When we hit Resistance the body will form a type of common response to the stressor.  For example, repetitive movement in our work - typing, driving, sitting, texting, etc. are all stressors.  The muscles will become tight (hypertonic - for the geeks out there) and we will experience pain or discomfort in the  wrist, forearms, shoulders, upper chest, back of the neck, and maybe even a headache or two.  If we CHOOSE to ignore this continued stressor and allow the Resistance to build up, then our body will go into exhaustion.

Exhaustion will lead to disease.  This has been proven over and over again.  If you continue to ignore the symptoms of pain and discomfort in your upper body from typing, driving, sitting, etc. the body will become too tired to maintain function and disease will ensue.  Possible fun syndromes may include Carpal Tunnel Syndrome, Thoracic Outlet Syndrome, Piriformis Syndrome/Sciatica - all "really fun", painful combinations of symptoms to go through life with.  The body will eventually "give up" if you refuse to permit time for self-care and rest.  This is when disease sets in and as you probably know, once disease is present it is challenging to get extricate.
An image of Carpal Tunnel Syndrome - the blue area represents areas of pain, numbness, tingling, and weakness.

So what can I do?

Obvious answer from me - Get a massage!  Take a break.
Give yourself permission to get up from your desk or walk away from your task to stretch, have a drink of water, eat a healthy snack, and think about something other than your work and troubles.
If you do not like having massage try reflexology on the feet, hands, and/or ears.
If the touch therapies don't float your boat there is always CranioSacral Therapy, Traditional Chinese Medicine (Acupuncture, Cupping, Moxibustion, Herbs, Nutrition), Healing Touch, Reiki, Qigong, Hypnosis, meditation, and facials, pedicures, manicures, or a haircut.  Do SOMETHING for YOURSELF!  Do it without guilt, do it without shame, do it without worrying about what others will think.  The really important part of self-care and getting rid of the GAS (General Adaptation to Stress), is doing it for yourself.  Let me say it one more time - "Do it for yourself."

What does GAS have to do with gas?

Quite a lot actually.  Yes, I have to bring this in.  Anyone who knows me personally knows gas is a BIG issue in my life.  Sometimes for fun and too often because of stress.  In Traditional Chinese Medicine belching and flatulence (farting) is considered a form of rebel qi (chi).  Well, what is that?!?!  It basically means that the energy in your body is blocked and is running backwards along its channels. In western medical philosophy these symptoms can be normal to pathological depending on frequency and accompanying symptoms.   Either way gas can be a sign of GAS.  Are you going to do something about it? or A(larm)R(esistance)E(xhaustion) you going to let it go?  It can be as simple as changing your diet, drinking more water, getting more exercise or a more challenging path to unwind the build-up of stress that has occurred over many, many years.  If you have a more challenging path to walk, as many do, please accept the help and skill of others to guide you through your healing journey.  As you get your therapies please, please, please do NOT hold in your gas.  If you hold it in you are clenching your body and restricting the flow of blood, nutrients, oxygen, energy, and health the therapist is attempting to remind your body how to hold.  In short it is okay to fart, it is okay to burp, it is okay to sneeze, it is okay to cough, it is okay to get up and use the rest room in the middle of your session.  We are all human, we all have our own GAS, we all have to accept that GAS happens and it is okay to let the gas out.  After all, where does it all go but into the "fart zone" anyway!

Be well, give yourself a break, and let the gas out so the GAS doesn't build up!

All the best,
Adrienne

In response to Hudson Hospital's ban on physiological breech birth and denial of informed consent and refusal

This is the letter that I have sent to the Hudson Hospital administration in response to a notice that was sent out March 7, 2013 announcing a ban on physiological breech birth and the denial of fully informed consent to care and fully informed refusal for care.  I have written the letter from the position of being a past patient and not as a care provider.  I chose this point of view as I feel it will be more valuable for them to hear from a consumer and not a practitioner.  It has come to light that the decision was based on attempting to fit into a Triple Aim model and not because of litigation, fear, or even evidence based practice.  

Here is the letter from Hudson as it has been posted on Facebook.

"Hudson Hospital & Clinics is committed to achieving the Triple Aim in our service to patients and families.  We are dedicated to providing excellent patient experiences while delivering quality care at an affordable cost.

We have consistently experienced growth in our Birth Center volumes each year and want to ensure on-going safe patient outcomes for both mothers and newborns.  It has been decided jointly by medical staff leadership and hospital administration to suspend vaginal breech deliveries immediately and these patients will be delivered by cesarean section.

Medical interventions will be employed, when needed on all mothers and newborns, including transfers in, to assure the safety of the mother and newborn.  This practice is in alignment with national medical standards of care and consistent with other hospitals in the region."

So I ask you - do you want your health care based on corporate goals or based on evidence collected in practice and execution of laudable medicine?

Please do let Hudson know what you think and contact them.  This is a link to the Stand and Deliver blog written by Rixa Freeze.  Rixa has laid out a lovely talking points bulletin to help form your letter.  Thank you Rixa!  She is also giving away a lovely baby wrap if you contact Hudson by March 18.

Why is this important?

Because this is a big step back for a woman's right to choose her care.  It is a big step back for women to be able to birth according to evidence based medicine.  It is a violation of human rights.  Please do not sit idly by with this, it is affecting your community and it will eventually effect someone you know.

Have a great day and be well ~ Adrienne

14 March 2013

Dear Robbi,

I am a mother of two beautiful children who were birthed at Hudson Hospital.  I chose Hudson because of the willingness of the hospital to accept my family’s adamant demand for fully informed consent and fully informed refusal for care and interventions.  The nurses and doctors that cared for my babies and me were wonderful, caring, and skilled in their art.  I have since referred many families to your hospital.  I will no longer be referring anyone to your hospital with the current policies in place.  Let me explain why.

First, the decision to suspend vaginal breech delivery is heart breaking.  My first child was delivered vaginally and breech at your hospital.  The most recent studies have shown there is no higher risk for vaginal breech delivery than cesarean section when the baby is presenting in the Frank position.  Especially if the practitioners are skilled in physiological breech birth.  Hudson has the unique situation of having very skilled practitioners in physiological breech birth.  The ACOG recommendation in physiological breech birth in 2006 even states that vaginal breech delivery of a singleton breech should be based on the skill of the practitioner. 

Second, the decision to employ medical interventions on “all mothers and newborns” is a slap in the face to the educated women of this age.  We are not ignorant, helpless nymphs that cannot make a decision for ourselves.  This policy is a violation to women and their partners to make medical decisions for the good of their family, with what they feel comfortable.  The current “national medical standard” is not a good one – the United States has the third highest maternal and infant mortality rates in the developed world.  Not impressive.  This is the equivalent of saying “Johnny jumped off the bridge, so I am going to do it too.”  Hudson’s own Patients Rights and Responsibilities state:

·      “ Except in emergencies the consent of the patient or the patient’s legally authorized representative shall be obtained before treatment is given.”

·      “All patients have the right to be informed concerning their continuing health care needs, course of treatment, prognosis for recovery, and alternatives to meet these needs in terms the patient can understand.”

·      “Any patient may refuse treatment to the extent permitted by law and is informed of the medical consequences of the refusal.”

It literally made me cry to hear the board’s decision for Hudson to become a surgical birth hospital.  I myself have an irrational fear of C-section and was so grateful to find a hospital that would allow physiological breech birth.  I went into my birth knowing that at best my baby would have some respiratory difficulty at first, and at worst death for the both of us.  But isn’t the worse case scenario for any woman giving birth death?  Don’t we all face that when we first discover we are pregnant?  Is it so awful to allow women to educate themselves about the risks and delights of birth that now we just say, “Oh, the doctors know best, let them make the decision for you.”?  Part of the gift in being able to bring a life into this world is the responsibility of the woman and her family to understand that birth does not always end perfectly.  Women hold great responsibility when they become pregnant and taking away the choice of informed consent and refusal is extremely disempowering to all women and their families.  I fear for the future of birth and empowering women to be strong, well informed, and allowed to give birth in the manner that is best for them.  I ask that the Hudson Administration reconsider their decision and perhaps find a different approach to achieve the Triple Aim.

Very Sincerely,

Adrienne C. Caldwell