Thursday, October 26, 2017

Q&A How much is too much Vitamin B6?

Many times we know that "too much" of a good thing is actually a bad thing. What about Vitamins? That questions is asked and answered below.

I would like to have a brief explanation of why pregnant women should not have too much Vit B6.

Thank you,Dr. M



Dear Dr. M,

Even though Vitamin B6 is water soluble, it is possible to take too much. There are differing opinions on what exactly "too much" B6 could do during pregnancy. The most common outcome for taking excessive amounts is nerve tingling and numbness (which could become permanent) Other less common side effects include heart beat irregularities in the mother and birth abnormalities in the baby, such as teratomas.
Even though the latter are quite rare, I always recommend to err on the side of caution and  not exceed the recommended dosage.

Thanks again for your question. Enjoy your week!


Sincerely



,
Dr. Karen Gardner 



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www.pregchiro.com
Family Chiropractor, Author, Continuing Education Instructor
PO Box 286 | Wycombe, Pennsylvania 18980
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Q&A Can you adjust a patient with Placenta Previa?

Dr. A.W.:  Good afternoon! ...I am currently enrolled in your prenatal course.

Dr. Karen: AWESOME!!!  

Dr. A.W.: I've really been enjoying the information you have provided. 

Dr. Karen:Great! Thanks for sharing that!!  

Dr. A.W.: I had a quick question about adjusting contraindications for pregnant women.  Do you feel placenta previa is an absolute or a relative contraindication to the chiropractic adjustment?

 Dr. Karen: It really is a case  by case basis. For example. is it a complete or partial previa; is there active bleeding; are they on bed rest, etc.    

Dr. A.W.:If you feel it is safe to adjust, what kind of adaptations do you make, additional questions at each visit do you have for the mother? 

Dr. Karen: Adjusting ANY pregnant woman should NEVER include twisting of the abdomen or pelvis, so the same is true here. In these cases, I only use an instrument and SOT blocking to adjust. Both are extremely effective low force techniques that are not contraindicated.   I also get a letter from their primary care giver (OB or Midwife) that they are clear for low force chiropractic care to keep in their file and I DOCUMENT EVERYTHING!  By the way, there have been cases in my office and offices around the world, where the previa reduces; meaning that the placenta moves away from the cervix. With proper pelvic alignment - anything is possible!  
Dr. A.W.:Also, do you have any experience with taping and the pregnant woman?

Dr. Karen: I personally, do not do this. I do now docs who do and swear by it.   

Dr. A.W.:I have seen some taping strategies used for women during pregnancy, used some on patients, and had it applied to me during my pregnancies.  I was wondering if you have heard of any adverse events from taping the abdomen like during a pregnancy belt or diaphragm taping.  I can't find any literature on the topic except that their skin is more sensitive.

Dr. Karen: Sorry, I am unaware of anything. Maybe if I share this with my other groups, pages and blog someone reading it will have some insight.  
Dr. A.W.:Thank you so much for your help!

Dr. Karen: My pleasure! 

Dr. A.W.: I'm hoping to get the course finished in the next month! 

Dr. Karen:I LOVE your ambition! You go!




Want to build, grow and perfect your Pregnancy Practice? Let's get on a call to discuss your strategy. The first call is on me! Schedule now


Dr. Karen, just wanted to say wow...I've learned so much and I'm only into the 2nd module. This is the stuff we need to know in everyday practice! I could listen to you all day long!        ~ Dr. Katie Gelesko Stull


Wednesday, October 25, 2017

Q&A Red Raspberry Leaf Tea...when and how much?

This question is posed by a DC who is finding conflicting information about the use of Red Raspberry leaf tea in preparation for childbirth.

Dear Dr. Gardner,
Do you have any resources or information as to when it is safe to start taking Red Raspberry Leaf Tea to prepare for labor and how much? I am finding all sorts of conflicting information. Thank you. Dr. Weber

Dear Dr. Weber,

There are so many conflicting accounts of the "when" and the "how much" concerning Red  Raspberry Leaf. Some sources say it's completely safe and some say avoid it at all costs. For that reason, I defer to my expert in all things natural childbirth, my midwife colleague Barbara D'Amato. She's been catching babies for 30+ years and I have been working with her for over 20. 

Her recommendations are to drink 1-2 cups of tea daily starting in the 2nd trimester.

Thanks again for reaching out. Have a great week!



Sincerely,





Dr. Karen Gardner



www.pregchiro.com 


Want to build, grow and perfect your Pregnancy Practice? Let's get on a call to discuss your strategy. The first call is on me! Schedule now


Dr. Karen, just wanted to say wow...I've learned so much and I'm only into the 2nd module. This is the stuff we need to know in everyday practice! I could listen to you all day long!        ~ Dr. Katie Gelesko Stull

Tuesday, October 10, 2017

Developing a Pregnancy Niche

Developing a Pregnancy Niche

Dr. Karen Gardner


After having two beautiful pregnancies and child birth experiences a few years ago, I sat and pondered what if I didn’t have chiropractic care?  How do women go through all of the hormonal, postural and emotional changes with a nervous system that is not functioning optimally?  I couldn’t answer that then and I’m not sure I can answer that now.  One thing I do know is that pregnant women need chiropractic, period. 

Most people in our communities have a preconceived notion about chiropractic care as it is.  Getting them to understand the need for pre-natal chiropractic is a whole other story.   This article is intended to give the reader some basic information about creating and promoting a pregnancy chiropractic practice.                                                                                 

Let’s start with the basics.
·      What is a niche?
·      Do you need one of your own?
·      How do you develop a niche?
 Niche (n.) - Forte, role, position, function; an especially suitable place or position  According to Webster’s new world Dictionary
Of course you don’t need a niche of your own.  Many successful docs are thriving in practice and do not have any niche, per say.   That being said, if you want to stand out and be different, a niche may be the way to go.  A niche is what’s going to make people who have never met you or heard of you decide to choose you when they need a chiropractor.  A niche is what separates you from most or all of the other D.Cs in your town. 
How to develop a pregnancy care niche?
Developing a niche is easier than you may think.   For me it was quite accidental.  First, I got pregnant and sought the care of a local midwife.  Through this relationship we shared our thoughts and philosophies regarding the wonders of the human body and the power of a chiropractic adjustment.  Within short order, she started to refer her patients to me for chiropractic care.  After a while, she told her business partner and she, too started to refer patients to me.  Then their back up doctor asked these midwives why their c-section rate was so low.  Their combined reply consisted of these two words, “Dr. Gardner”.   He soon started to send  his patients as well.  Very shortly thereafter, other OB/GYNS in my community followed suit. 

What can you do?
 If pregnancy is not in the cards for you to start a personal relationship with a midwife or other pregnancy health care provider, consider developing a business relationship.  Seek out area midwives, doulas, childbirth educators and obstetricians.  Call them, consistently to introduce yourself and your expert services.  Teach them the value of drugless chiropractic care, especially during pregnancy.   Offer classes to pregnancy care specialists so you teach them how to refer patients to you for chiropractic care. 

It is very important to inform these professionals of the benefits of chiropractic care as it pertains to them.  For instance, it may not be a true benefit to share with MD’s that pre-natal chiropractic care may enable a lower c-section rate.  For some MD’s a c-section is “just another day at the office” and reducing the amount that he/she performs may not be a true benefit in his/her opinion.  But, if it is explained that by lowering their c-section rate, their malpractice insurance and liability may also be reduced over time; you may have a better chance of getting their attention. 

You also want to give them the tools necessary so they can confidently identify the people in their practice who need your precision care.   Give them a checklist of people who would “qualify” as a pre-natal chiropractic patient.  For example, whenever someone is complaining of round ligament pain, they must have their pubic bone evaluated by a chiropractor.  You can have similar examples for the major discomforts associated with pregnancy. 

Build a relationship of exclusivity.  In other words, when a woman has the need for the services of a midwife or doula, etc. tell that midwife or doula you will refer exclusively to her in exchange for the same favor when one of their patients/clients has the need for chiropractic care.  Of course, they will know when a chiropractor is needed because you will already have discussed that with them by using the steps above..

This next step is especially important.  Learn all that you can about pregnancy so you can communicate effectively and professionally.   Become proficient in the special needs of a pregnant woman.   Become extremely familiar with the common complaints associated with all stages of pregnancy.  For instance, in the first trimester nausea and headaches are a primary complaint.   While in the third trimester, low back pain is a predominant concern.  Learn how to address these complaints effectively while communicating the importance of a properly functioning nervous system. 

Have the proper equipment available now so you are prepared before you need to be.  During the first trimester of pregnancy a woman’s breasts are EXTREMELY tender and painful.  Be sure you have a super soft table or cushion to alleviate any discomfort.   When a woman is approaching the end of the second trimester, you will need to accommodate her growing abdomen.  Again, cushions can be used or use an adjusting table with a tilt up pelvic piece or a break away lumbar piece.   A knee chest table is also excellent.

Make or purchase pregnancy brochures and pass them out at places pregnant women go.  We did lectures and screenings at Babies “R Us (this is a local baby super store, you may have something similar in your area by another name) for several years with great response.   You may also consider setting up lectures at La Leche league Meetings, child birth classes and libraries.   Very often, advertising for these lectures will be free of charge in your local newspaper.

When I was pregnant, I held a yoga class specifically for pregnant women to prepare for childbirth.  I opened it up to the whole community and had a great response.  This class was held in my office and taught by me, a pregnant chiropractor, which lended to the credibility of the class and also indirectly to me as a pregnancy expert.  Of course there
were photos all over my office of pregnant women getting adjusted and I used this teaching opportunity as a way to invite these women to learn more about chiropractic care. 

Remember doctor means teacher.  If you won’t go out there and teach, no one else will. www.pregchiro.com

Want to build, grow and perfect your Pregnancy Practice? Let's get on a call to discuss your strategy. The first call is on me! Schedule now


Dr. Karen, just wanted to say wow...I've learned so much and I'm only into the 2nd module. This is the stuff we need to know in everyday practice! I could listen to you all day long!        ~ Dr. Katie Gelesko Stull

Wednesday, October 4, 2017

Q&A Testing pubic bone superiority while supine and prone

Hi Dr.Karen,

Well today I hope?

Question: On testing for pubic bone superiority, will the supine test ever be positive, but the prone test negative, and visa versa? If so, what does that indicate? Is it still pubic bone superiority, or just a faulty test? In other words, do both the supine and the prone test have to be (+) for there to in fact be pubic bone superiority? There! I've said it and I won't take it back.

In Love and Health,
Dr. Mark


My guess is that if you have a positive in the prone and a negative in the supine...it may not be pubic involvement alone.  SInce mom is compressing the posterior elements of the pelvis while supine, I would check the sacrum and the SI joints, adjust them accordingly and then re-test pubic bone. 

Be careful, though...mom is not going to like you a whole lot if she has to keep turning over :)

Keep up the GREAT work doc.  You ROCK!!!
Love & Gratitude

Dr. Karen Gardner



www.pregchiro.com

Want to build, grow and perfect your Pregnancy Practice? Let's get on a call to discuss your strategy. The first call is on me! Schedule now


Dr. Karen, just wanted to say wow...I've learned so much and I'm only into the 2nd module. This is the stuff we need to know in everyday practice! I could listen to you all day long!        ~ Dr. Katie Gelesko Stull


Q&A Sternum Pain during pregnancy

Hi Karen – my sister is pregnant (week 30) and she is having numbness and pain in her lower sternum that is worse while sleeping.  The only way she is getting sleep is propped up to an almost sitting position.  She is local and I adjust her.  Any thoughts?

Thanks much!
Tim

Hi Dr. Tim,

Thanks for sending your question.  2 things come to mind immediately. 


1.    She may have a rib head out...check that both anteriorly and posteriorly.
2.    The baby is exerting pressure upward (Is the baby breech by any chance?) It could be a foot as well pushing upward and causing mom agony in the form of a pseudo hiatal hernia. 
If it's #1, obviously "adjusting" her rib heads will make all of the difference.
If it's #2, do the maneuver found on page 35 of my book Pre-Natal Chiropractic Care. 
If sleeping up right gives her relief I am more inclined to believe it's not a rib head, but check it anyway.

I hope this helps.  Reassure your sister than when the baby engages lowere into the pelvis all of this discomfort should go away. 

Let me know how it goes.

Love & Gratitude

Dr. Karen Gardner


Want to build, grow and perfect your Pregnancy Practice? Let's get on a call to discuss your strategy. The first call is on me! Schedule now


Dr. Karen, just wanted to say wow...I've learned so much and I'm only into the 2nd module. This is the stuff we need to know in everyday practice! I could listen to you all day long!        ~ Dr. Katie Gelesko Stull

Q&A Preterm Labor

Hey Dr. Karen,

I have a patient that is just 29 weeks along and is in premature labor.  She is 2 cm, 50% and her cervix is ripe.  Do you know of any tricks, herbs or homeopathics that can stop her labor.  She is taking Black Haw and that has lessened the contractions a lot, but not stopped them.

I appreciate your help.  Thanks!
Dr. Jenn


Hi Dr. Jenn,

It is VERY common for pre-term labor in the summer months because of how easy it is to get dehydrated.  Make sure mom is drinking TONS (I really means TONS) of water.  Black haw is a good herb, so is cramp bark.  Maybe you recommend that she could try that one as well.

As far a homeopathy goes, arnica montana is the first that comes to mind then Belladonna.  I highly recommend that she clears these recommendations with her primary birth practitioner, though. Don't forget, you can get a TON more information in my class on Herbs and Homeopathy. The previous link will save you 10% on tuition should you decide to join up. 

Mom MUST stay off of her feet, too.  Let me know if there is anything else I can help you with.  Thanks for trusting me with your valuable practice member.  I consider it an honor. 
Love & Gratitude

Dr. Karen Gardner




Want to build, grow and perfect your Pregnancy Practice? Let's get on a call to discuss your strategy. The first call is on me! Schedule now


Dr. Karen, just wanted to say wow...I've learned so much and I'm only into the 2nd module. This is the stuff we need to know in everyday practice! I could listen to you all day long!        ~ Dr. Katie Gelesko Stull



Q&A What do to about postpartum tearing

HI Karen.
I have a practice member who has had unhealed post partum tearing.  The baby is 7 months old now.  Her MD wants to give her a Femring implant.  She doesn't want it.  He says its either nerve damage or low estrogen.  Any thots?
Love Jeb


Hi Jeb,

Good to hear from you.  Wow, poor lady with 7 months of agony. 

I have no idea as to the extent of her tearing so I am going to tell you what I usually recommend for "normal" post partum healing. 

I would recommend evening primrose oil taken orally.  If she has low estrogen (I'm guessing she's nursing, hence the low estrogen) the evening primrose oil gives her GLA (Gamma Linoleic Acid) which is a precursor to hormones.  If her body needs it, her body can convert to GLA to whatever hormone that is lacking.  It's sooooooooooo much safer than hormone therapy.

I would also recommend vitamin e oil applied externally.  It speeds healing and reduces scar tissue.  The homeopathic remedy Arnica Montana taken orally is almost miraculous in it's ability to aid the healing process. 

Sitz baths and external application of certain (diluted) essential oils may also prove effective. Frankincense and Helichrysum come to mind. I have a class on essential oils that may prove helpful as well as a class on herbs and homeopathy that goes into much more detail.  If you follow the links to these classes from this blog, you will save 10% on tuition. 

I hope this gives you some idea as natural alternatives.  Let me know if this helps.  

Until next time........

Love & Gratitude

Dr. Karen Gardner



Want to build, grow and perfect your Pregnancy Practice? Let's get on a call to discuss your strategy. The first call is on me! Schedule now



Dr. Karen, just wanted to say wow...I've learned so much and I'm only into the 2nd module. This is the stuff we need to know in everyday practice! I could listen to you all day long!        ~ Dr. Katie Gelesko Stull


Q&A Pregnant DC asks a ton of questions about...well...everything

A pregnant chiropractor just discovered she was pregnant and had a TON of questions about what to do and how to continue practicing, nutrition, etc. 

Follow along below.

I  just wanted to ask you about a couple things:

Do you think it's important to take folic acid supplements?  YES  ABSOLUTELY!!!  AND NO. DON'T DO IT. You need to take FOLATE and not FOLIC ACID.  Folic acid is the synthetic form of Folate. Folate is one of the most important supplements you will need during Pregnancy.  About 400 mcg is the standard found in most pre-natals.  It prevents spina bifida, oral cleft defects, tongue and lip tie, and other fusion abnormalities.  It's a necessity.

How do I find a good midwife? Ask people in your community who they would recommend.  There is an organization called DONA (Doula Assoc. of N. America) they may be able to direct you to a naturally centered midwife.  Remember, midwives can be medical, too.  So interview them to see who is a good fit for your needs and wants.  That's what I did. 

Do I need to go to an OB-GYN for a pre-natal visit? NO WAY!! You can see a midwife at anytime during your pregnancy and they are trained in regular GYN care as well!!

What's the usual thing a pregnant woman does in terms of prenatal care? My intuition is just that I need to find a good midwife that supports natural childbirth, and that I don't really need to go to an Ob-Gyn. Follow your intutition girlfriend.  You are right on the money!!

Any other things I should think about doing? Taking a child birth class would be great later on in your pregnancy.  I recommend Bradley or a Bradley like class.  It's a great way to build your practice, too!  You may even offer to hold the classes in your office (if you have the room) in exchange for your tuition.  You'll then have posters, signs, photos, etc of the importance of chiro care during pregnancy....offer exam, etc....you get the idea.

This won't affect me now, but what did you do recommend me to do towards the end of my pregnancy concerning my practice. I don't have anyone practicing with me and I was thinking of hiring an associate later on in about 7 months or so.  Great question!  You're right, it doesn't effect you now and it's far too much to go into via e-mail right now.   Right now I am coaching 2 women who just returned back to practice after having a baby.  One of them I coached right through her pregnancy on how to make the transition out of practice and now back into again after the birth of her baby.  If this is something that interests you, let me know.  We can set up a time where you can have a FREE call with me and discuss some possibilities to see if this would work or not.   The reason I recommended  it is, because when you take maternity leave and then re-enter the practice,  it really is a process that takes time to implement correctly and slowly.  Make sense?  Anyway, we can certainly discuss the options if you are interested.  OK?

Let me know if there is anything else I can help you with.  I am SOOOOOOOOOO happy for you.  From what I know of you so far, I think you'll make a terrific mommy!  Until next time........


Love & Gratitude

Dr. Karen Gardner




Want to build, grow and perfect your Pregnancy Practice? Let's get on a call to discuss your strategy. The first call is on me! Schedule now


Dr. Karen, just wanted to say wow...I've learned so much and I'm only into the 2nd module. This is the stuff we need to know in everyday practice! I could listen to you all day long!        ~ Dr. Katie Gelesko Stull

Q&A Infertility and Chiropractic

Hello Karen.

I have a question re: fertility/infertility.
I have a young woman has one ovary, endometriosis, a potentially blocked fallopian (sp?) tube, a husband with low motility, many previous failed in vitro and "forced in vitro" attempts.  They have one child through a "forced in vitro" attempt and they would very much like to have another.  I offered to consult with you and Madeline Behrent on their behalf.

Is there a protocol (chiropractic, nutrition etc.) that I should consider with them or are there simply too many roadblocks. 

I'd love to hear your thots.
With Love and Gratitude.
Jeb  


Hi Jeb,

Thanks for trusting me with your valuable practice members, what an honor! 

Is the father currently under care as well or just mom?  In my experience with women who are having fertility issues, coccyx is a key.  C2 is also a major component to the problem.  If those 2 areas are clear, then it's good ol' L3 and sacrum.  I'd bet that mom had quite a fall on her tailbone in the past.  Ask her. Always clear cranial issues as well, 

As far as nutrition goes, Vit E is essentail for reproductive health.  Evening primrose oil helps to balance hormonal flucuations, but should not be taken during pregnancy (until late 3rd trimester when it helps to "ripen" the cervix)

There are no homeopathic or herbal remedies that come to mind for this problem.  But if I think of any I will be sure to let you know. 
I hope this helps a little.  Keep me posted.  Again, I would definitely check the coccyx. 

Dr. Karen Gardner

Earn 11 CE credits online (Where applicable. Some restrictions apply)
Gardner Method  Prenatal Chiropractic Program

This is the COMPLETE, ON-DEMAND, 15+ module series on the Gardner Method of Prenatal Chiropractic care.  It is a "go at your own pace", online webinar series where you can earn up to 10 CE credits. Some restrictions apply.  Continue reading to learn more.
Dr. Karen, just wanted to say wow...I've learned so much and I'm only into the 2nd module. This is the stuff we need to know in everyday practice! I could listen to you all day long!        ~ Dr. Katie Gelesko Stull

Enroll now and save 10% off of your tuition.



Want to build, grow and perfect your Pregnancy Practice? Let's get on a call to discuss your strategy. The first call is on me! Schedule now


Dr. Karen, just wanted to say wow...I've learned so much and I'm only into the 2nd module. This is the stuff we need to know in everyday practice! I could listen to you all day long!        ~ Dr. Katie Gelesko Stull

Q&A Adjusting during labor and the newborn

Hi Dr. Karen:

I registered for your course and am enjoying it very much, thanks!  I had a couple questions that I wondered if you could answer.

At what point in the labor process do you decide to go to the patient, vs having them come to you?  I'm thinking more about home births here, since I have a large percentage of those in my practice.

And what do you do about adjusting the newborn when you attend a birth?  Do you do that right away, and do you charge separately for that?

Thanks so much for your insight!

Dr. Carolyn


Dr. Carolyn,

I am so happy you are enjoying everything!  Thanks for letting me know.  Thanks also for asking some great questions, I'll do my best to answer them.

Now...in early labor a mom ALWAYS comes to me.  This stage can go on for days.  I have found that when adjusted it helps to speed things along.  When she is in full blown labor (contractions are 2 minutes apart) that is typically when I would go to them.  They are pretty much in no mood to travel anyway so it works out. I no longer attend births for a variety of reasons so I am sharing what I used to do MANY years ago. 

I adjust the baby after the cord has stopped pulsing and after the cord is cut.  I also let mom get attended to before I check the baby.  Usually within the first 20 minutes after birth is when I check to see if the baby needs to be adjusted.

Usually the first adjustment is included in their pregnancy care plan, so if they have paid for a plan then I do not charge for this service.  If not, it depends on the circumstance whether or not I charge.

To be honest, I am usually so overwhelmed with emotion at a birth and I usually say this is my birthday gift to baby and don't charge anyway...bad business maybe, but that's just me. Again, this was EONS ago. 

I hope this helped.  Let me know if you need anything else form my end.  Have FUN!!

Love & Gratitude

Dr. Karen Gardner




Want to build, grow and perfect your Pregnancy Practice? Let's get on a call to discuss your strategy. The first call is on me! Schedule now


Dr. Karen, just wanted to say wow...I've learned so much and I'm only into the 2nd module. This is the stuff we need to know in everyday practice! I could listen to you all day long!        ~ Dr. Katie Gelesko Stull

Q&A Can a patient have bilateral superior pubic bones?

Hi Dr. Karen,

I have a patient just 37 weeks now.  I've been adjusting her about every 2 weeks during the pregnancy and now they determined the fetus is in the breech position. 
Followed your procedure for 3 visits this week, has not turned yet put mom says the fetus feels like its more transverse now. (ultrasound was neg. for cord or placenta problems).  On exam today, the right pub checked superior and the left pub is tender.  Could she have a bilateral superior pub?

Yours in Health,

John  B.  II, DC

Hi Doc,

Thanks for writing.  Yes it can be possible for bilateral superior pubes, not too common, but not impossible either.  I would adjust the right one you are finding.  Then go back and check the left.  There could be residual tenderness because the round ligament is also taught so check there as well. 

I would also check C2 and coccyx.  These are major players in a transverse presentation.  Don't forget to check for TMJ dysfunction and Frontal Bone involvement. The frontal and pubic bones mirror image one another. 
I hope this helped.  Good Luck and please let me know if I can be of further assistance.  Until next time....
Love & Gratitude

Dr. Karen Gardner




Want to build, grow and perfect your Pregnancy Practice? Let's get on a call to discuss your strategy. The first call is on me! Schedule now


Dr. Karen, just wanted to say wow...I've learned so much and I'm only into the 2nd module. This is the stuff we need to know in everyday practice! I could listen to you all day long!        ~ Dr. Katie Gelesko Stull