LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Healthy Pregnancy

Narcotics and Your Baby; Not a Good Combo

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opioid use during pregnancy
Maksud /Dollar Photo Club

You’re reading the title of this thinking that this is pretty stupid.  Who on Earth would think that this is a good idea??  Opioids during pregnancy.

I’m sure that if I gave you the true / false question, “Morphine is ok to take while pregnant,” there’d be no hesitation to check the “false” box.  And it wouldn’t surprise you at all to know that the use of morphine and morphine derivatives during pregnancy can lead to scary things like withdrawal symptoms into the newborn.  The technical term for this is Neonatal Abstinence Syndrome (NES).

If you agree that it’s absolutely crazy to take opioids during pregnancy, then you will likely be as shocked at the results from this particular study as I was.  In it, researchers looked at the use of opioids during pregnancy to evaluate just how common it was.  Here’s what they found when they looked at group of 112,029 pregnant women:

  • A shocking 28% (31,354) filled at least one opioid prescription during pregnancy.

How is this possible?  There are probably few people out there who would think that opioid use during pregnancy is ok.  I think I may know why; at least in my office.

From what I’ve seen, not enough of the population understand the drugs that they take.  Top culprits are Percocet and Vicodin.  It seems like a good chunk of my patients do not realize that these drugs are opioids.  Sure, most know that OxyContin and Oxycodone contain morphine derivatives.  But a surprising number of my patients over the years have not been aware that common pain medications that are handed out like candy also contain opioids.

So maybe a good chunk of the 31,000+ pregnant women in this study were written a prescription for hydrocodone-containing drugs like Percocet and Vicodin and just didn’t realize it.

Of course, the real question is how they got the prescription in the first place.  The prescribing physician should darn well know that opioids should not be prescribed in pregnant women.

The researchers then looked at what factors played a role in these pregnant women receiving a prescription for an opioid.  Here are the factors they found:

  1. They were more likely to have depression (5.3% vs 2.7%).
  2. Anxiety disorder (4.3% vs 1.6%)
  3. Smokers (41.8% vs 25.8%)

Looking at the list of these 3 factors, I just can’t understand how these patient-related factors should affect whether or not these women got a prescription for an opioid from her physician.

Overall, I don’t really have a take home message.  I’ve provided this article more for educational purposes rather than providing answers because I can’t understand how these prescriptions are written at this frequency.

In my biased opinion, the best and easiest answer to this prescribing problem is chiropractic care during pregnancy for any pain-related complaints instead of these prescriptions.  Maybe the answer is education for these pregnancy-related-opioid-prescribing physicians on the benefits of chiropractic care for pregnant women…??

Pregnancy Weight Gain and Childhood Health

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BREAKING THE CYCLE OF CHRONIC DISEASE BEGINS HOW EARLY?

Based on previous posts, this shouldn’t be a trick question.  The answer is before pregnancy. In this study, women who gained excess weight during pregnancy had children that, at 9 years of age, had pretty much EVERY risk factor for heart disease elevated.  A literal time bomb that will explode decades before it exploded for the parents.  I’ve said it before and I’ll say it again, we need to stand up for the health of our children by taking better care of ourselves during pregnancy.  This goes for BOTH the dad and the mom.  The decisions you make today are either helping your child grow up healthier, or you are loading a bullet in the chamber.  Decide.  You can’t sit on the fence.

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Stem Cells and The Umbilical Cord

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HAS MODERN OBSTETRICS FORGOTTEN TOO MUCH??

If you talk to any midwife, they can be a plethora of information on how the birthing process was meant to go.  No epidurals, no induction, no lithotomy position straps.  And it seems that, as a species, it actually worked out ok (otherwise none of us would be here to have this discussion).  I have heard discussion about when the umbilical cord should or should not be cut, but this article gives some great insight into WHY the cord should not be cut immediately.  I was not aware of this prior to this article.  Basically, throughout history, the squatting position for delivery was common, allowing gravity to assist in the transfer of stem cells from the placenta to the newborn.  With the advent of the lithotomy position and immediate severance of the cord, it appears that the is reduced transfer of stem cells that have a positive effect on the newborn’s ability to make healthier blood early, leading to lower risk for lung and blood related problems.  Such a potentially simple fix.

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Obesity During Pregnancy and Heart Valve Defects

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PROTECTING YOUR BABY’S HEART BEGINS LONG BEFORE PREGNANCY… 

I know that all pregnancies are not planned, but for those who are planning on a family, you need to consider long and hard what you are willing to do for the health of your baby.  This particular study found that, in moms who were obese (up to 1/3 of pregnant women) there was an increasing risk for serious heart defects the more obese they were.  I know this is a tough topic to address, but somewhere we need to slam our collective hands down and accept that pregnancy is NOT about the mom.  That means that choices and lifestyles that are present long before, during and after pregnancy determine that child’s health risks for the next 50 years.  And given the poor state of health in this country we are seeing the price–children and young adults being diagnosed with conditions like PCOS, liver problems and diabetes decades earlier than their parents.  NONE of this, of course, absolves the father of responsibility, either.  They are part of the team to raise that child and their decisions also strongly reflect the child’s health.  Bottom line–if you are thinking about getting pregnant, take a good, strong look at your lifestyle.  Is it conducive to long term health of that little baby?

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Pregnancy Weight Gain and Childhood Obesity

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BREAKING THE CYCLE OF CHRONIC DISEASE BEGINS HOW EARLY?  Based on previous posts, this shouldn’t be a trick question.  The answer is before pregnancy. In this study, women who gained excess weight during pregnancy had children that, at 9 years of age, had pretty much EVERY risk factor for heart disease elevated.  A literal time bomb that will explode decades before it exploded for the parents.  I’ve said it before and I’ll say it again, we need to stand up for the health of our children by taking better care of ourselves during pregnancy.  This goes for BOTH the dad and the mom.  The decisions you make today are either helping your child grow up healthier, or you are loading a bullet in the chamber.  Decide.  You can’t sit on the fence.

Infertility in Women: Can a Simple Change Lead to Success?

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infertility in women and vitamin D
Photo courtesy of https://www.flickr.com/photos/geishabot/

As a father, I can tell you that, despite the days I want to kill them, having children was a very important decision my life.   But this isn’t always an option when infertility in women and men is an issue.

Fertility problems can create stress and disappointment in a relationship and can lead to sexual problems, anxiety and divorce.  Heartbreak on top of heartbreak.

I have certainly covered the topic of infertility (both infertility in women AND in men) many times in the past, always looking at it from a natural standpoint (these prior blog posts can be read by clicking here).  “Fertility specialists” have an agenda and really don’t seem to care why you can’t get pregnant.  They are going to do what they do and to heck with what your underlying problem might be.  They are going to used Clomid first and IVF second, moving on to more expensive procedures if that fails.

The expression, “when all you have is a hammer everything looks like a nail,” fits here.  Few “fertility specialists” will have the important discussion with you on thyroid function, achieving an optimal weight, chemical exposures (BPA, phthaltes, flame retardants, etc…), exercise, pulling back from being on a diabetic pathway, exercise and stress management.  All of these are very real factors in a successful pregnancy, but they will require a sincere commitment from you and your partner (YES–both partners need to get on board).

Some of these changes, like managing stress, may involve a complete overhaul of the way you view life.  It’s a major factor in infertility and then feeds back into the problem when stress levels rise from the fertility issue itself.  This is probably one of the reasons why there are always stories about couples who adopt a child and then get pregnant shortly afterwards.  In these cases stress was probably the major player.

While this sounds overwhelming and “not important” in getting pregnant when you could just run down to the nearest “fertility specialist” for a prescription, the stakes are far higher than most couples realize.  If your stress levels are high enough to affect your ability to get pregnant, if you do get pregnant (regardless of how), your stress levels are absolutely going to pre-program your little one for a lifetime of stress-related issues.  THIS is what is at stake.

Of course, some of the changes do not require life-altering approaches.  A simple, good quality prenatal is one of them.  Do NOT do any of the pharmaceutical / prescription ones.  They are all junk and I have yet to see one that is worth more money than a Centrum from Walmart.  A good quality prenatal is going to cost you at least $20 per month and will not be covered by your insurance.

Another simple approach to helping infertility in women is making sure you are getting enough vitamin D.  Yup.  The simple, seems-to-help-with-everything vitamin D.  Same stuff.  Usually not more than $20 per year for the high quality stuff we offer our patients here in the office.  But just how much can it help?

This particular study looked at just this question.  In it, researchers looked at a group of 335 women undergoing IVF treatment to see how much vitamin D levels had an impact on a successful outcome.  The cutoff was 20 ng/ml as deficient.  Here’s what they found:

  • 20% of the women with low vitamin D got pregnant while a much higher 31% achieved pregnancy with higher vitamin D levels.
  • Overall, women with vitamin D levels above 20 ng/mL were 215% more likely to become pregnant.
  • Even better, the women who had higher vitamin D levels (30 ng/mL) had the highest chances of pregnancy.

These are pretty good odds for just a simple, safe and inexpensive intervention.  Keep in mind that most vitamin D experts (myself included) still consider 30 ng/dl too low and that more optimal levels should be closer to 60-100 ng/dl.  So how much better would pregnancy rates be if we looked at the highest levels?

It is also important to note that this was not an intervention trial.  These women were not given vitamin D to see if it could improve pregnancy success, but clearly there is an association between vitamin D levels and fertility.  It’s a strong enough argument for me to recommend at least 2,000-4,000 IU of vitamin D daily to couples (yes–both partners!) who are considering getting pregnant.

 

Planning on Having a Baby? 3 Important Things You Need to Do First

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Diet important for fertility
Photo courtesy of https://www.flickr.com/photos/seandreilinger/

Having a child can be one of the most rewarding experiences in your life. But to go into pregnancy blindly can lead to a lifetime of problems for your baby.

This may sound a little drastic and maybe even a little far-fetched.  Just stay away from drugs, don’t drink alcohol and stay away from nuclear reactors.  Pretty simple.

Ok…so maybe decisions during pregnancy can play a role in your unborn child’s health and well-being.  Maybe you’ll try to eat some more veggies this month and maybe cut back on the fast-food trips.  That’s got to be worth a few IQ points in college.
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Some Herbs Should Be Avoided by Nursing Mothers – (11-27-00)

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Some Herbs Should Be Avoided by Nursing Mothers

This article mentions funugreek, comfrey and St. John’s wort use in pregnancy. While care should always be used with pregnancy, it does amaze me that authors will suggest avoidance of St John’s wort during nursing, but continuing with pharmaceutical antidepressants is acceptable.

(article) Two popular herbal remedies for nursing mothers — fenugreek and comfrey — can pose a health risk to their infants, according to Dr. Ruth A. Lawrence, who reviewed the use of herbs by breast-feeding mothers at a presentation during the annual meeting of the American Academy of Pediatrics. While there is no proof of its benefit, Dr. Lawrence said that there “are data about the risks. Specifically it can cause hypoglycemia in the nursing mother and it can raise blood pressure.” She said that in some infants fenugreek has been associated with increased “colic and diarrhea.” While she advises women to avoid fenugreek, comfrey is “much more dangerous and is banned in Canada.” Comfrey is rubbed on the nipples of nursing women to prevent dryness and cracking, she said. “But it does pass to the infant,” she said, and has been associated with hepatic veno-occlusive disease in infants. She recommends that physicians caution nursing mothers who have postpartum depression that self-medicating with St. John’s wort may be risky. She said that although studies have demonstrated some efficacy for St. John’s wort, “those studies were done in men, not women. Also, St. John’s wort does contain a serotonin reuptake inhibitor, but because the FDA does not regulate herbs there is no way to determine how much of the SSRI is passed to the infant.” In concluding, Dr. Lawrence said that nursing mothers should be steered away from most herbs, but “there are some teas that I can recommend for women who want a nice herbal tea. Chicory, peppermint, orange spice and red bush tea are all fine. Rose hips is an especially good tea because it has a very high concentration of vitamin C.”