Midwives ROCK!

Two days ago I was preparing to see my patients at my home office location.  I received a text message from one of my afternoon appointments that read, "I won't make my appointment later today.  I had my baby at 12:30 am!"  She had been one of my favorite mom's to be to care for.  She was excited about chiropractic; very compliant with my care plan for.  She achieved amazing results in a short period of time.

Her pelvis was very distorted when she first came to me in her first trimester;  sacral apex rotation, superior pubic bone, sacrotuberous ligament spasms, etc. After a detailed case history, I soon learned she suffered terribly with TMJ dysfunction.  Experience has taught me that TMJ Dysfunction=Pelvic Dysfunction, and correcting one without the other is futile.  So, I adjusted what I found and soon balance and function was the norm for her.  She never missed an appointment, save the time I went on vacation over the summer.  Upon my return she begged me to never go away again!  She loves chiropractic (so do I!).

Fast forward to yesterday when going back to see patients at my birth center location.  Her goal was to deliver at the birth center.  I know things don't always go as planned when it comes to childbirth, so I was excited to hear about her delivery.   The midwife who owns and runs the birth center has been one of my biggest fans for nearly 2 decades.  She understands the importance of a properly functioning spine, pelvis and nervous system as it pertains to childbirth and advocates such to her patients on a regular basis.  She is my biggest source of referrals and is quite persuasive in getting her moms to be to seek out prenatal chiropractic care.  She also knows the importance of chiropractic care for the midwife and gets adjusted every week.

Yesterday, after I adjusted her, I inquired about my patient who delivered the day before.  She said, "She is so lucky.  She nearly had a c-section because the baby was slightly *OP and wouldn't descend and she didn't dilate past 5 cm"  I was dumbfounded, I didn't understand, her pelvis was near perfect.  Her TMJ was fully functional.  "What happened?" I asked.

"Well first, I assumed it was her pelvis.  I figured it wasn't aligned and prevented her baby from making it's way out.  I mentioned this to the couple and the husband said, 'How can that be?  She's been seeing Dr. Karen nearly every week for her ENTIRE pregnancy.'  

The midwife continued, "So, it's not your pelvis then. Let's see what's going on with an ultrasound.  That's when we saw that the baby had his hands wedged under his chin and was stuck in the pelvis."   

"What did you do?", I asked.

"Well, since I knew her pelvis was fine, I knew that baby could get out as long as we could free his hands from under his chin.  So that's what we did.  If she wasn't under your care, it would've been a section, no doubt.  As soon as we jiggled him around and freed his hands, she delivered."

Holy Canoli!  I love midwives who get it.  Don't you?

*If you're a doctor of chiropractic and would like to learn how to teach your area birth professionals about the importance of prenatal chiropractic care, please contact me at drkarengardner@gmail.com.  

www.premierpregnancypractic.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

Need some support?

Read all about these fantastic Maternity Support Bands and how to get them at a discount. This is the only support band I recommend and my patients love them. Not only do they provide amazing support during all three trimesters, but they are extremely beneficial during the postpartum period as well. They offer so much support, that I often recommend them in place of an SI or trochanter belt - they're just much more comfortable.

www.premierpregnancypractic.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

I only have one and a half summers left

I heard somewhere that you only have 18 summers with each one of your kids. Then I heard it's more like 16 because they don't remember the 1st two. My first summer with my daughter was when she was born - in July - and that was 17 years ago. (July 2017 Update - that was 20 years ago and now my youngest is a senior in High school. Next summer is it for us...then he's off to college!)

This summer and part next will be it for me. My baby is all grown up! As I look back I am so overwhelmingly grateful that I have NO regrets. I took off from work, rescheduled office hours and downright partially retired during the summer months. I did this during the school year, too...I'm still doing it! When there is a field trip, concert, play, track meet, football game, award ceremony; I rearrange my schedule so I am there. I have not missed ONE SINGLE event since my kids started pre-school. NOT ONE. My patients always understood and shared their admiration for my ability to be there for my kids no matter what. No one ever said, "What about me, Dr. Karen? Aren't I more important than your kids?"

I chose long ago that my family comes first. I make no apologies for it and we all WIN! I made a lifetime of memories with my kids and have gone without HUGE volumes in my practice to do it and I don't ever, ever, ever lament over those choices.  I have no debt, live very comfortably, go on amazing vacations and my kids know which one of their parents they can always rely upon. They know who was and always will be there for them; who puts them first - before practice, patients and money. THAT is priceless.

Enjoy your 16 (or less) summers!

www.premierpregnancypractic.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

Pregnant Women are everywhere and they need chiropractic!

WOW!  I was swamped this week with moms-to-be.  85% of my patient visits this week were for pregnant women in need of chiropractic care.  ALL of my new patients were pregnant ladies.  ALL of them. 

The number one reason my practice is full of mommies and babies is because the Midwife with whom I work closely (Barbara), LOVES and UNDERSTANDS the need for chiropractic care before, during and after pregnancy. She recommends that ALL of her patients undergo chiropractic care with ME to help ensure the best chances of an easier labor and childbirth experience.  She and her entire staff get adjusted, by yours truly, and they ALL talk about chiropractic care to all of the patients of the birth center.  

Many times, my coaching clients and docs who have taken my courses or bought my books will ask me "HOW do I get midwives or other birth professionals to refer to me?"

The best answer I can give is, it takes time and trust.  I've known Barbara for more than 17 years (update - more than 22 years,now) and have developed a truly wonderful and rewarding relationship with her.  She trusts me implicitly with her patients because she knows I know what I'm doing.  I speak HER language.  I know what happens with an OP presentation and why (and what to look for in the mom so I can affect a change).  When she tells me they had to transfer a patient because she was GBS+ and had a PROM, I know what she means.  

So doctor...do you know what these things mean?  Do you speak "their" language to instill trust?  Can you teach them how and why to refer to you using "their" terminology?  

www.premierpregnancypractic.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

Case History of Occiput Posterior Presentation at 31 weeks gestation

Over the years I have penned many case histories for various publications and continuing education courses I have taught.  Since so many doctors ask for advice in caring for pregnant women, I've decided to post some of my more interesting case histories (well, I think they're interesting.  My hope is that you will, too!) so that more doctors can read about various methods I have found in caring for moms to be.  As always, feel free to forward this info to your friends and colleagues and if you have any questions or comments about this or other cases, please fell free to post it here.  

Spoiler Alert:   

I've included a shameless plug at the end of this case study.  If the books I mention are of interest to you, use this coupon code BLOGBOOK to save 15% on one or both books.  Thanks!

Case History: 33 year old woman presents with headaches, low back pain and a posterior baby at 31 weeks gestation.

The patient is pregnant with her first child. 

Her main reason for coming to our office for care to is have her pelvis evaluated for its possible contribution to the current occiput posterior presentation of her baby. 

In the past, she has had headaches, low back pain, stomach trouble and neck pain prior to this pregnancy and is also currently complaining of the same. None of her current complaints, however, are interfering with her activities of daily living. She is currently under the care of a midwife for this pregnancy.   She does not have a history of any hernias, uterine fibroids, or ovarian cysts.  She had never had any abdominal surgeries.  Her midwife reports this patient’s uterus is normal and is free from any abnormalities that may be contributing to the posterior presentation of the baby. 

She did report that in the seventh grade she was fitted for a back brace to treat her severe scoliosis.  She wore the brace for 18 hours each day for three years.  She was unable to describe her degree of scoliosis or any details about the brace, however.  She was not able to obtain patient records from her physician who ordered the braced and cared for her during this three year period. 

Consultation:
She communicated the following accident history:

As a teenager (she did not give a specific age when asked) this patient was thrown from a horse, hit the ground and landed on her coccyx.  Again, no medical treatment was obtained for this injury.  At approximately 8 years of age she was involved in a “fender bender” type auto accident as a back seat passenger.  She was not wearing a seatbelt and reports that she did not experience any symptoms after the accident and therefore did not receive any medical care.  This patient also experienced a fairly serious fall down a flight of stairs at age as a young child at camp.  She could not remember how old she was at the time of the accident.  She reports that she fell on her tailbone repeatedly and describes it as the absolute worst pain of her life.    

This patient denies smoking.  She reportedly drinks one cup of coffee as well as one cup of tea per day.  She is taking pre-natal vitamins; iron (Flourodix) and Calcium (Citracel) as directed by her midwife.  Even though she is experiencing acid reflux and indigestion, none of these supplements appear to be causing digestive distress that is sometimes common with these particular supplements.  She reported being unaware if her amniotic fluid levels were within normal limits.  She admits to exercising regularly as well as eating a balanced diet.  She does not get at least eight hours of sleep per night due to her chronic insomnia. 

Physical Examination –

A thorough examination of her lumbar and cervical spine was conducted due to her complaints of headache, lower back pain, and posterior baby.   Postural evaluation revealed a lumbar hyperlordosis most likely due to her advanced stage of pregnancy.  She also presented with anterior weight bearing.  Despite her history of scoliosis, the remainder of her postural evaluation appeared to be within normal limits. 

Cervical active range of motion was within normal limits with no noted pain or discomfort.  Lumbar active range of motion was also within normal limits.   

Palpation revealed taut and tender fibers in the lumbo sacral region bilaterally from L3 through Coccyx.  Palpatory tenderness was noted at the Coccyx and Sacrum, also bilaterally.  Trigger points were noted in the upper trapezius muscles from C7 to T-5

Deep Tendon Reflexes:  Biceps (C5\C6):  left: normal;  right: normal. Brachioradialis (C5\C6):  left: normal;  right: normal. Triceps (C7\C8):  left: normal;  right: normal. Patellar (L2\L4):  left: normal;  right: normal. Hamstrings (L4\L5):  left: normal;  right: normal. Achilles (S1\S2):  left: normal;  right: normal. Cranial Nerve Exam:  Myotome evaluation revealed no weakness in the  upper and lower extremity. Dermatome evaluation revealed no altered sensation to pin prick in the  upper and lower extremity.

Spinal analysis using muscle testing uncovered the following misalignments:

Posterior coccyx on the right, superior pubic bone on the left, posterior L3 on the left, posterior T6 and T4, and C3 Body left.

Prone leg checks uncovered a left short leg of ¼ inch with a left cervical syndrome.  Therapy localization indicated a left posterior Atlas on the right.  Supine leg checks uncovered a right short leg of ¼ inch. 

Using Basic Sacral Occipital analysis, the patient was not found to be any Category. 

All cervical orthopedic tests were found to be within normal limits.  The lumbar orthopedic tests that are not contraindicated during pregnancy were also found to be within normal limits. 

A thermal spinal scan showed areas of severe thermal asymmetries in the upper cervical (specifically atlanto-occipital) and upper lumbar (specifically thoraco-lumbar) regions which correlates and supports the initial exam findings. 

Care Plan
Based upon the patient’s history of traumas, previous pregnancies, weeks gestation of current pregnancy and presenting symptoms, the following care plan has be recommended:

Specific Chiropractic spinal adjustments following the Bagnell Technique protocol three to four times weekly until baby turns to the anterior position.  Once the baby turns, one to two weekly adjustments is recommended until the birth of the baby.  A 6 week post-partum check up is also recommended to evaluate a continued need for care. 

Treatments

This patient received her first chiropractic adjustment on May 26, 2009.  C3 was adjusted, manually, in the prone position as was T4 and T6.  L3 was adjusted using an instrument in the prone position as was a posterior right coccyx.  A superior right pubic bone was corrected in the supine position using a very light setting (2 rings) on the activator instrument. 

Re-evaluation and follow up

On June 3, 2009, the patient returned for her second adjustment and reported that the baby was in a breech presentation. A brief kinesiological exam revealed a C2 body left and a posterior right coccyx.  Both were adjusted in the prone position using an instrument.  A superior right pubic bone was corrected in the supine position using a very light setting (2 rings) on the activator instrument.  A follow up thermal scan showed the previous severe thermal asymmetries in the cervical area have improved and were described as mild to moderate in nature.  The thoraco-lumbar area still showed severe asymmetries however they were on the opposite side from the first scan. 

On June 11, 2009 she returned for her third adjustment, even though it was recommended that she be seen more frequently until the baby turns.  C7 and T1 were adjusted in the prone position.  Her sacrum and not her coccyx needed to be adjusted on this visit.  A P-L listing was adjusted in the prone position using an instrument.  In addition, an anteriorly rotated trochanter was found and adjusted on the right in the prone position using an instrument.  The patient reported that an ultrasound examination revealed that the baby had turned to the vertex position and that the baby was also in an occiput anterior position.

Discussion

Prior to her third visit in our office, this patient was taking Homeopathic Pulsatilla (a dilution 6C) as recommended by her midwife.  Pulsatilla is a widely used homeopathic remedy derived from the vegetable kingdom, from the wind flower.  It is often referred to as “the” pregnancy remedy as is addresses many common complaints of pregnancy.  It also has some notable success in getting babies to turn head down.  The 6C dilution is an extremely mild dilution and in most, if not all, states in the U.S. it is available without a prescription.  The midwives we work with on a regular basis will often suggest Pulsatilla to their breech patients as they did the case discussed above.

Initially this patient came to our office because the baby was in an occiput posterior position.  This baby later turned from vertex to Breech as it will sometimes happen.  As expected, her pubic bone and coccyx were misaligned and needed to be adjusted regularly; even after the baby turned to the vertex position.  In fact, on every visit prior to delivery (eleven office visits in total) she needed her coccyx adjusted.  This misalignment was of no surprise given her history of trauma to this area of her pelvis. 

On August 2, 2009 – just three days after her last adjustment in this office, this patient was able to deliver her baby vaginally

www.premierpregnancypractic.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

Don't be an American "Idle"

Don’t be an American “Idle”

How to work at building your pregnancy practice

For a long time, my family has loyally watched American Idol.  We got hooked on the drama and excitement that followed these young talented people through their journey.  If you’ve never seen the show, it’s one “reality” show that was actually somewhat entertaining…in my opinion, anyway.  In case you’re wondering why I’m speaking in the past tense, it’s because we don’t watch the show any more.  I just can’t stand Nicki Minaj.  Sorry, she’s one of those you either like her or you don’t.  I don’t.  That being said, the premise of the show still remains the same and it taught me something very valuable that I use in my own practice on a regular basis and share with all of my coaching clients.  I want to share that with all of my readers as well.

As I was watching past seasons, I noticed a couple of key things. 

1. The show is not called American “IDLE”. 

 These kids (yes , even though some of them are 26, they are kids to me) work their buns off to get ahead.  They spend hours upon hours in rehearsals, with their voice coaches, their publicists, and their fashion advisors….you name it they are putting in some serious time.  No idleness is allowed if you want to be an idol.

2. Success doesn’t happen overnight. 

 I looked back on the first season of American Idol and remember Kelly Clarkson.  She was the first winner of the very first season and she is still doing GREAT!!!  She also is on tour, has several albums out, hit singles are everywhere, she consistently tops the charts, she has sung songs for movie soundtracks, was in a movie herself, makes personal appearances on talk shows etc., is on tour……the list can go on and on. 

Then we have Carrie Underwood, a more recent winner, who is doing unbelievable things in the world of country music.  She has won so many awards it’s hard to keep track of them all.  Even though they “made it” in two different music genres, they have a similar road to success and a similar way of maintaining that success.  They work at their success.  You’ll never hear them say “I won and now you have to buy my music”.  No way!!  They are on top of their game.  They apply themselves; they practice their art and promote it to the world. 

Did you get that last line?

They apply themselves; they practice their art and promote it to the world. 

Doc, how about you?  How much do you work?  I don’t mean how many hours a day do you adjust?  I mean how many hours do you spending working on practicing your art, and promoting and growing your pregnancy practice???  It is work, too.  Isn’t it? 

It’s not fun…all of the time.  It’s tedious, it can be boring, tiring and down right uncomfortable, right?  I totally agree.   

But…..if you don’t do it because you don’t like it, don’t have the time, don’t know how, (put your own excuse in here) you won’t grow, period!  No world class athlete got to where they are without doing the WORK.  I am pretty sure our Olympic track team isn’t excited about doing wind sprints or running the stadium stairs, but they do it to better themselves and prepare for the big race. 

Singers and actors also need to put in a lot of effort to succeed in their fields.  Even if someone was “discovered” and became an “overnight success” they have to work to maintain their success….by the way, most overnight successes take years to get discovered. 

So what does this mean to you?  It means you have to work at success.  What could you be doing to build your pregnancy practice right now?

·      Set up an outside talk

·        Child Birth classes

·        Mom’s groups

·        Obstetricians offices

·        Midwives offices

·      Do a screening

·        Baby store

·        Maternity store

·      Introduce yourself to area businesses.

·        Midwives

·        Doulas

·        Ob/Gyns

·        Massage therapists

·        Yoga studios that offer pre-natal yoga

·      Ask for a referral.

·        Other pregnant practice members

·        Midwives

·        Doulas

·        Ob/Gyns

·        Massage therapists

·      Write a press release

·        Send it to all forms of media, like radio and local TV; not just your newspapers

Of course you can do all of this.  Did you notice all of the above cost nothing to do? 

What’s stopping you?  Let’s imagine that your life depended on getting 3 new patients this week and every week for 3 months.   What would you do differently to grow your practice?  I know there are some things you are putting off, doc.  Stop it!  

Do those things now as if your life depended on it, because in the long run…it really does, doesn’t it? 

What would your life look like if you had 3 new patients a week every week?   Try it on for a while.  If it doesn’t work, change it.  If you hate doing it, delegate it.  If it works, do it until it stops working.  And above all, don’t be an American Idle.

Be sure to click this link to sign up for a free monthly newsletter dedicated to assisting principled chiropractors in building and enhancing a pregnancy care practice.

www.premierpregnancypractic.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

Pregnancy Meric Chart Fiasco Part II

I posted this blog back in November and wanted to repost it today.  Why?  Because the Pregnancy Meric Chart posters are no longer on backorder - yay!!  Infact, I have updated the coupon code mentioned in this blog so that it can be used for the remainder of this month.  Thanks everyone for your patience!  Here's the original Blog...


A few days ago, one of my dear friends and long time coaching client alerted me that an original digital copy of my copyrighted Pregnancy Meric Chart poster was posted on Facebook.  Soon I learned it was VIRAL. This was not good news.  Copyright laws were being broken.  People could get into a lot of trouble.  The poster that I created after many long hours of work was "out there" for anyone to steal.  YIKES

I asked all the doctors, whom I could trace down, to please, please remove this from their pages.  I felt that the initial posting that started the whole "spread" was not malevolent.  Doctors just wanted to share the information with their patients and page fans.  All of the doctors whom I contacted took it down.  All of the doctors except for one.  This doctor didn't want to take it down and asked that I allow her to keep it on her page with a link so other people could order it.   So I did.  What happened next was not expected...

Now These posters are on back order. (Not anymore....I finally have them in my hands!)  Now more chiropractors than ever have this tool to reach out to their communities to teach about the MANY, MANY benefits of SAFE, NATURAL  pre-natal chiropractic care.  Thanks Dr. Who shall remain anonymous, for your graciousness in helping to spread the word!  

The link to order is here http://www.shop.pregnancychiropractic.com/Pregnancy-Spine-Chart-Poster-POSTpregsp.htm

The same exact poster is also available in handout form and are not on back order.  These are printed in black ink on yellow paper.  Here is the link for them. http://shop.pregnancychiropractic.com/Pregnancy-Meric-Style-Charts-PregForms.htm

www.premierpregnancypractic.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