Happy Acupuncture Week 2019!

I love talking about how acupuncture has been part of my life for 16 years, even before @jp.boisvert brought it full circle to our clinic and home

We have used acupuncture, Chinese herbal medicine, tui na, gua sha, and cupping for years to treat fevers, stave off colds, deal with whiplash and sticky shoulders, vanquish back pain and migraines, and generally manage our health for a long time

It’s true that we also take care to move our bodies and sleep, but I definitely credit acupuncture and Chinese medicine with our family’s pretty rocking health. And I credit @jp.boisvert for being our family doctor

He has some awesome stories about how acupuncture has flipped the switch for debilitating anxiety in teens, how a Chinese herbal formula worked like a charm in families trying to get pregnant, moxabustion and turning babies at the ends of pregnancy, and more!

More than just pain management, people are looking at acupuncture as a way to manage mood, anxiety, and to work alongside our other therapies like medications or nutrients that we use to adjust our chemistry.

Stay tuned this week for Acu Adventures!

#acupuncture #chinesemedicine #cuppingtherapy #guasha #tuina #ilivewithaneedler

The Pediatric Teaching Clinic starts again this week!

Hey all, we took a little break beween Summer and Fall Quarters, but the Pediatric Teaching Clinic starts back up this upcoming week. We have moved the day and time to Thursdays 2:00pm to 5:00pm and you can schedule online via our Patient Portal.

We had a great time with our inagural run of the Pediatric Teaching Clinic this Summer and are looking forward to working with our new team of students this Fall!

#docere #naturopathicpediatrics #nds4vaccines #teacherforlife

Miles For Midwives!!

Saturday October 19, 2019 9am-1pm

I am personally involved in planning this wonderful event that helps support birth in Washington State and the local non-profit Families of Color – Seattle.

Better yet, Rohan and I are run/walking!

Join us on Oct. 19th at Marymoor Park for a family-friendly run/walk 5K! Strollers and leashed pets are welcome to join in on this community enriching event!

Register for the race at https://runsignup.com/Race/WA/Redmond/WAMilesforMidwives5K

To learn more about Miles for Midwives please visit our website: https://www.wamilesformidwives.com/

We are also looking for sponsors. If you are interested or know a business who might be, please let me know.

I would LOVE to see you and your family/friends there – Please spread the word!

Location:

Velodrome Shelter at King County’s Marymoor Park
6046 West Lake Sammamish Pkwy NE
Redmond, WA US 98052

The Birth of Grief

A new mom and her baby had come in for their first well-child visit and her son was just 3 days old.  Mom was tired and overwhelmed as many new parents are.  She was sitting by the window, changing her son’s diaper and just watching him, and she sighed a long, heavy sigh.  And just gazed at her son quietly as he wiggled around.  There was no slow smile or beaming pride.  Just deep sadness.  

What clinical guidelines, healthcare, and social convention tell us is that she was exhibiting signs of postpartum depression.  While that may also have been true, she was also exhibiting signs of deep grief and loss. 

I looked at her across the room and just said to her, “You don’t have to love this.  Or even like it.”  I said that for her, but also for the hundreds of people I had sat with before her for whom the sadness was enveloping.  She looked at me in surprise, “Really?” She sighed again, but this time with a slow smile, and said, “Thank you.” 

What is often disclosed to me by new parents is that postpartum engenders isolation, being untethered, disembodiment, and a contemplation of mortality. Could this many people really have postpartum depression? Is it possible that this many people opt to transition to parenthood, and meet some or all the criteria for a mental health concern? Or is there another way to understand what this mom and thousands like her are experiencing?

What other process in our life looks like heavy sadness and defeat, and flattens us to the wall? 

Grief and loss.  Losing someone we love. Losing ourselves.  My curiosity is whether we can reframe the postpartum transition as a grief process. As a natural life event, but of loss.  What if our culture, our healthcare delivery, and policies all viewed and cared for postpartum people as grieving people? 

I consider the grace that we offer people who have lost a loved one: the length of time and freedom that they are given to grieve, the expectation of being changed and never quite being the same, and the ability to go deep and dark but not have it be inherently pathologic.  There is a freedom in that.  A deep breath and a slow smile. 

Cleaning House: Are Chemicals Impacting Your Kids’ Health?

Over a week ago I posted on Instagram about cleaning chemicals and that they can negatively impact our kids’ microbiome.

The way that the microbiome was being assessed and studied was through the lens of childhood obesity.  Ultimately, kiddos who were exposed to more of the conventional cleaning chemicals (even a few times a week), had microbiome changes that seemed to also result in more obesity in those same kiddos.

Bacteria-on-Hands-Square_cropped-600x567Additionally, it seemed like kids who grew up in households with ‘greener’ cleaning products had less of these issues: fewer microbiome changes and lower incidences of obesity.

Some of the questions I still have and didn’t get into with that IG post are:

  • Is obesity really our biggest worry for our kiddos?
  • What does it mean to us that our kiddos are ‘obese’?
  • What does it mean that cleaning chemicals are ‘better’?
  • What other factors could be at play?

As much as I LOVE and appreciate microbiome knowledge-bombs, I admit that I have a knee-jerk reaction to the information- and even my own post.  One of the things that I have been challenged by through my entire clinical life is to present information and offer informed choice without fear.

As an integrative family medicine provider, I witness quite a bit of parenting fear.  Mostly it’s the usual fears of keeping kids alive, safe, and healthy.  But I also hear many fears of doing everything ‘right,’ being a perfect parent or having the perfect birth, not putting ‘toxic’ things into their bodies, or feeding kids a ‘healthy’ diet.

While these fears are also normal and common, they contain elements of elitism and also judgement.   In order to be perfect, right, healthy, or non-toxic, we have to identify what all of those things even mean.  And possibly denigrate or reject things that don’t fit the bill.  To be ‘perfect-right-healthy’ is somewhat grounded in privilege and access.

I can take a great example, sheepishly, from my own parenting.  Some years ago we drove by the McDonald’s near our house that has a giant Play Place.  My son asked to go for the millionth time.  I said “Nope, that ball pit is nasty” and made some reference to the food being poison. It was an off-hand, distinctly thoughtless comment made while driving, but definitely belied some judgement, right?

Months later some good friends came over and brought McDonald’s.  Their son wasn’t really up for what we were making for dinner, and they pre-empted the discomfort and brought something that they knew he would eat.  After they left, my son asked me in a quiet and worried-sounding voice, “Mama, why did they feed him that?  Why did they give him poison?”

Well, if that doesn’t guarantee me #1 Doctor-Mom Of The Year, I don’t know what does.  mom-of-the-year-image

While I appreciate all of the insight that we can gain into the mighty microbiome and into childhood metabolic disruptions (of which obesity could be a manifestation), what else isn’t being said?

Families who are prioritizing green cleaning chemicals may also be making different choices about dietary inputs, physical activity, and/or sleep.  They may have the privilege and access to make these choices.  And all of these choices can also affect the health of our microbiome, and could also be correlated with obesity or the lack thereof.

While it might be tempting to make the leap that green cleaning = less obesity, keep in mind that there are so many dimensions to health.  Let’s be careful and thoughtful about our goals, the meanings we make, the level of ‘perfect-right-healthy’ we think we have acheived or not, and whether they are proper companions in our walkabout to well-being.

Resources:

#wellbeingwalkabout #childhoodobesity #socialdimensionsofhealth #perfect #right #healthy #mightymicrobiome #parenting

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Why Does My Brain Feel Like it is Leaking?

An interesting article was published this past Summer on the very real, little-discussed changes that occur in the brain of a pregnant, postpartum, and/or caregiving person. Mommy-brain-2

There are a number of rapid and monumental changes that happen to the portion of our brains that control social-emotional processes or the “ability to atttribute emotions and mental states to other people- key to raising a human.”

“The more brain change the mothers experienced, the higher they scored on measures of emotional attachment to their babies, a finding that echoed past studies. And the changes in most brain regions remained two years later.”

Whoa.  Two years?!

What is even more fascinating is that this change was most profound in the parents who were also pregnant, but was not limited to them.  Caregivers other than the birthing parent,  including fathers, experienced some of these same changes that correlated with how much ‘exposure’ they had to the babies and children.

For many of us who have been pregnant, postpartum, and/or a parent, we already know that this is true.  It’s not just our bodies that change.  Something else changes that never goes back to its original configuration: our brains.  Maybe all the time we spend consumed with getting bodies back is more about getting our brain back; a more tangible and socially-acceptable pursuit.  All the while knowing, in the murky recesses of our changed brains, that the worry, the conjured scenes of certain death, and deep guilt over every imperfect moment will never leave us.

What if we better understood what was happening to our brains and not just our bodies?  Would it change our relationship to postpartum and parenting?  Would it reframe what we experience as depression, anxiety, or plain-old feeling like we are losing our minds?  Would we reach for help, talk more openly, or simply settle into it more easily?

Would you?

This spins other spirals of thought for me also.  Is it possible for this effect to be compounded?  If we have more than one pregnancy, more than one postpartum, and, truly, more ‘exposure,’ do our brains continue to change? Do the changes add up? Do these spaces in our brains grow deeper and wider?

I wrote a new installement of my Muse-letter, due to break later this week, before I even read this article.  Ironically, it touches upon parallel notes of exposure, changes, and leakiness of our hearts and emotional selves.  And, of course, I have to ask: what is the gift?

What new wild and remote expanses of our minds can we now saunter through that were not accessible before?  In what ways can we empathize, understand, or simply be with our fellow humans that were not as effortless?

Children and change have a lot in common. Endless. Relentless.  Generous with their gifts.

What are your favorite gifts?

#pregnancybrainisreal #postpartumbrainisreal #parentingbrainisreal #changeisreal #giftsarereal

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This whole food allergy thing is nuts

If you were listening to NPR this week (listen here), you may have heard that feeding babies peanut products prior to 12 months of age is actually preventive in terms of developing true allergies to peanuts.  Not too long ago, we were recommending to parents that they wait until 3 years old to start nuts.  Then the advice and the guideline shifted to waiting until one year old.  Sound confusing?

What can be frustrating and is fascinating to me is that what we ‘know’ about nutrition is always changing.  The world of food allergies, intolerances, and sensitivities (they are not the same thing in my books) is no longer a small and isolated world.  Phrases like ‘gluten free’ and ‘vegan’ show up on even the most mainstream of menus.  It is no surprise that we are learning more about the things we put in our kiddos bodies, not just from a biochemical nutrition perspective, but also as allergy prevention.

Based on articles in the last few years (some links below) and my own observations, it seems like the ‘sweet spot’ for introducing foods is 4-7 months of age.  By introducing, I mean offering tastes and sampling of different foods and creating a palate that is curious about and enjoys different flavors and consistencies.  The other aspect of food introduction is to induce or educate the immune system gently to prevent allergies, intolerances, or sensitivities.  What we introduce during this time is the part that changes the most.  Last year I would have said peanuts were not on this list, now they are a maybe.  I would also like to offer that the quality and wholeness of the food is important in this process of introduction.

Here are some other ideas I have people keep in mind:

  • Start by looking at your own plates; if there isn’t anything on there that you would like to introduce to your five month-old maybe it doesn’t need to be in your body 🙂
  • Work from your family’s diet and your goals for family eating.  You are introducing a way of eating and a way of life.  If you are not happy with the way your family eats, the time to change is when you have little people really paying attention.
  • Introduce slowly at first, taking 2-3 days to see how your baby reacts to food at first.  Then you can speed it up a little as you watch them take to eating, digesting well, and being interested in more.
  • If there are foods that parents and/or other siblings react to, try to introduce those foods all on their own so you can see if that is true for this new eater.
  • Worldwide, eating together is the way that we share our love, appreciation, and connection with one another.  Let that be the center of food introduction and family eating for years to come.

Enjoy!  Dr. S

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More reading:

http://articles.chicagotribune.com/2012-09-12/health/ct-x-0912-food-allergies-20120912_1_food-allergies-environmental-allergies-first-child

Postpartum ‘Must Haves’ That Have Nothing To Do With Buying Stuff

I would love to replace the typical birth registry of items that all new parents “need”. Instead, I want new parents to receive a different kind of checklist.  A checklist that would include ways to prepare for parenthood and postpartum that could actually help prevent postpartum depression, isolation, and suffering.  And yes, hand-me-downs would still be incredibly helpful!

I have no doubt that baby swings and swaddle blankets have saved sanity and have probably saved lives. But if we are really concerned about healthy families and getting off to a good start, why don’t we talk more about what families really need and want to be successful? First and foremost we have to be honest about a few things. Shopping for cute baby things, asking our friends and family to do the same, and happily preparing for the arrival of our little ones is more fun than acknowledging that postpartum and parenting can be hard work. Setting up a registry on Amazon and inviting people to buy stuff is way easier than truly asking for help.  Almost no one likes talking about postpartum or new parent trials and tribulations.  No one wants to hear “It’s Hard”.  Duh.

I not proposing a “The 11 Things I Wish Someone Had Told Me Before I Had My Son” news feed item.  I am proposing a punch list of actual work that I would like to see done on this project that you are managing:  Brand New Human Life.  Here are the things I would like to see more families do and be supported in doing:

Do some ‘Meet and Greets’ or re-establish care with someone you have seen.  Seeing someone with a specialty in postpartum, parenting, and/or marriage counseling are big perks, but the most important features are that you trust and like this person.  Think of a stressful time in your life- would you call this person?

  • Women’s bodies go through a lot in pregnancy and birth.  It is reasonable to think that things will not land where they once were before, no matter which way the baby comes out.  It is also reasonable to think that there may not be a lot of time or energy to get on a ‘Body Back’ program.  Honestly, even if there is, having help in this arena is crucial to avoiding sciatica, back pain, neck pain, plantar fasciitis, or other physical pain that make it difficult to care for your baby, exercise without injury, and feel human again.  This is where acupuncture, massage, and physical therapy come in.  These are not just indulgences; they are important facets to your long-term recovery, and most private insurance plans cover these services.  There are also low-cost community resources or sliding scales available if you do not have insurance coverage.  Locate these people, see them once or more in pregnancy, and start building your recovery team.
  • If you are planning to breastfeed, know who and where your lactation resources are and how you can access these services.  The first 2-3 weeks can be the toughest and is the most common time to stop breastfeeding.  Having information at your fingertips beforehand is so crucial.  Most area hospitals have lactation consultants on site who are wonderful and generally available every day.  The challenge is what to do about those urgent, after-hours, or weekend breastfeeding issues.  In case you are now wondering how often that really happens, I am here to tell you that everything involving children happens after-hours, weekends, and urgently.  There are many lactation consultants who do home visits and have after-hours phone lines.  Find out who they are, get some business cards, and keep them handy.

La Leche League International (http://www.llli.org/) has podcasts, forums, and links to almost every resource breastfeeding related.  Get familiar with the website and look up a group in your area.  I would suggest that you attend this group at least once in pregnancy so that you are familiar with a name, a face, and location before you make the trip postpartum.

  • Your pediatric provider is actually a pretty critical person for you as parents in this postpartum time.  Once you are discharged from hospital or midwifery care, you are handed over to your child’s care provider. Moms are typically seen at 6 weeks for one postpartum follow up in hospital-based care, and are seen at least 3-4 times in the 6-8 weeks following birth with out-of-hospital care.  These types of care clearly provide different ‘safety nets’ for families as they transition into postpartum and parenthood, which is why your pediatric provider may be your closest ally.  Set up some Meet and Greets and choose someone who you like and trust (sound familar?).  You are going to be seeing each other quite often in the first year.

Sometimes people come in with a list of interview questions from online sites, and there are great ones out there (http://www.askdrsears.com/topics/parenting/child-rearing-and-development/choosing-pediatrician).  Knowing a pediatric provider’s background is important, but most of that is online in his or her bio.

Use the time you have face-to-face with a prospective provider to find out a few things:  Do you like and trust this person?  Does this person seem agenda-oriented or patient-oriented? Does this person have resources if breastfeeding is challenging or your baby is not gaining weight? Will this person have a whole-family approach or a only-the-baby-is-my-patient approach? How have they handled situations regarding breastfeeding, sleep, or maternal postpartum depression or anxiety? Truly, even when the baby is the patient, the parents’ well being is critical to that baby’s health (http://parenting.blogs.nytimes.com/2013/07/17/who-will-screen-for-postpartum-depression/?_r=0).

Does that sound like a lot of work?  That’s why we get 9 months to start gathering tools and resources that will serve our entire family for months and years to come.  Your baby is not a finished product when he or she arrives, nor is this process.  And it’s actually a lot of fun sometimes too.

Enjoy!  Dr. S

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Birth and rebirth

Ro elfThis week my son turned 4 years old.  It seems like he has been here for a minute and at the same time that I have known him my entire life.  Of course this has me thinking about my pregnancy, what I was doing when I went into labor, my labor, my labor, my labor (that’s one ‘labor’ for each day), his birth, our first night all snuggled into bed together, and those postpartum weeks.  I have to say-  it was glorious.

It wasn’t glorious because I ‘did everything right’.  It was glorious because I was just able to be.  For the first time in years, I did not have a phone call, email, or page to return.  No one needed me or wanted anything from me except him.  What made those whole eight weeks I was home with him even better was the feeling of being held.

Imagine being a little newborn baby and being cradled tightly and warmly.  Imagine being a postpartum mom and being cared for tightly and warmly.  Would that make a big difference in how you saw those days and weeks at the time, and how you look back on them now? I am a midwife and I witness everyday how midwifery care holds women and families.  I experienced being held by my midwife, partner, family and friends.  I can still feel the feelings of warmth, safety, and weightlessness I had then even if the memories are already starting to become fuzzy.

Every family deserves a midwife. It’s not about having the perfect birth (whatever that means), being a medication-free warrior, or running wild in the country side with scissors.  It’s about being caught by strong, capable hands when you are dropped into parenthood with a new, fragile life without any guidance other than ‘don’t do (fill in the blank) or your baby will die’.  Your baby’s birth is your rebirth.  You are fresh, newborn parents.  Our society and health care system shouldn’t drop you.

Needless to say, I have some thoughts that all families can use to create their virtual midwife if it does not work out to have a real-life midwife.  I think of it as an alternative to the three-page birth registry of ‘must have’ items.  Stay tuned for those thoughts…

In the meantime, hold and be held.  Bask in it.  And happy birthday…Dr. S

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Pineapple doctor says…

On the heels of my cold and flu remedy ideas, I thought I would also share some of my favorite cough remedies. When I get sick, it goes right to my lungs. And I don’t really get the opportunity to slow down or take sick days, so having remedies that keep me from coughing all over everyone is essential in my life.

I do try to avoid the over-the-counter syrups as they are mostly corn syrup and dye, and the ‘nighttime’ ones leave me feeling unfit for much of anything. Keep in mind, I am sharing adult doses and that kid doses are going to vary based on age and severity of symptoms.

– Catnip tea: Catnip is a household favorite for many of us who have cats. Luckily if you are allergic to your cats (as I probably was for 11 years), you can use their medicine as your own. Take about 2 tsp of the loose herb per cup, steep, strain, and drink 4 cups per day. Catnip is in a class of herbs that we call ‘nervines’ that help relax the nervous system as well as decrease spasmodic activity like chronic coughs. I also use Sleepy Time or Well Rested teas alongside the Catnip at bedtime to help decrease my cough for the night. And of course, I put delicious honey provided by some local bees via one of my favorite local doulas.

– Honey Loquat Syrup: This is a traditional Chinese formulation of several herbs including loquat, fritillary, licorice, coltsfoot, schisandra, menthol, and many others. The effect is soothing, anti-inflammatory, anti-tussive (meaning anti-cough), and tasty. Just take 1 Tbsp, add to warm water, and drink 4-5 times per day.

– Acupuncture and cupping: Acupuncture is pretty much my go-to medicine for everything and has been for nearly 10 years. I do credit my semi-regular tune ups with staying fairly healthy over the years despite the constant barrage of critters in my air space. Within the realm of Chinese Medicine, acupuncture is really only one branch. There are other techniques like Tui Na, Gua Sha, and cupping that are needle-less and incredibly powerful for moving things along in the body. I find these techniques to be the most effective when the cough lodges itself in my upper chest or lungs, as well as preventing the process altogether.

– Water and fresh air: at the risk of repeating myself…I will. This time of year we tend to be indoors more, drinking less water because it is not as warm and sunny, and blowing dusty, hot, and dry air into our lungs. It is a recipe for crunchy, crackly lung tissue. And how lucky are all of us that we live in a cool, damp climate to counteract the hot, dry indoors? I admit that I have to remind myself to drink water and get outside everyday, and now I am reminding you too.

– Pineapple juice: I found out this week that the nickname a family has for me is Pineapple Doctor (which I love!). You can probably guess that it has to do with Bromelain and having used it in their care in the past. And it so happens that I came across this article this week and thought I would share it: http://www.naturalcuresnotmedicine.com/pineapple-juice-is-…/.

I do want to emphasize that not all juices are alike. Freshly prepared pineapple juice or eating the fruit is very different in its medicinal content than many of the processed versions you will get on the shelf (which often contain added sugars and corn byproducts).
Try these out, let me know what you think, and please share your tried-and-true remedies!

Be well, Pineapple Doctor