C-Section Scar Rehab and Mobilization

Why taking care of your scar is so important:

A c-section is a major abdominal surgery! Seven layers of tissue were cut to get that beautiful baby to the outside world:

• skin, fat, fascia, abdominal muscle, peritoneum, the uterus and the amniotic sac

After birth, we want to make sure that these layers can glide smoothly over each other to support core function, pelvic floor function and general health. You need a strong core and pelvic floor to lift car seat/baby/toddler, resume physical activities like weight lifting, running, etc and do all those bodily functions that happen down there like peeing, pooping and getting your period.

Check out the video below for a non-gory look at all the layers that were involved in your c-section.

C-Section Video (Don't worry, it's PlayDough!)

Start with nerve desensitization (can begin at 2 days post-surgery)

You may have noticed that the skin surrounding the scar feels a little off...overly sensitive, numb/tingly or irritated from your clothing or underwear. The brain helps your nervous system decipher different signals that your skin sends - pain, hot/cold, deep pressure vs light touch. These signals can be disrupted after surgery.

Start with the skin around the scar, at 4 weeks you can work directly on the scar. Use different textured objects to help the nervous system normalize these sensations. Try:

• cotton balls

• washcloth

• the scrubby side of a clean dish sponge

• toothpick

• a soft or fuzzy fabric

Rub on and around the scar with different fabrics and use the toothpick to gently prick the skin. Do this 2x/day for a few minutes at a time.
Keep all these objects together in a bag where they are easy to access.

Scar mobilization (can start ~ 4 weeks post-surgery):

• Try to make it part of your routine - before bed or after getting out of the shower for example.

• You do not have to buy any fancy lotion or cream, but some can help diminish the appearance of the scar. Try wheat germ oil or body butters with Vitamin E and collagen. Keep your lotion in an easy to access location that helps you remember to use it.

• Give yourself time for the wound itself to heal - usually around 4 weeks. The stitches should be dissolved or removed at this point.

The technique:

There are several ways you can use your fingers to mobilize the scar tissue.

• across the scar in a circle or star pattern

• pinch and lift the scar

• find the areas of adhesion (these will feel crunchy or like harder lumps) and focus on moving these in all directions

• press into the skin above and below the scar and pull away from it

Know that this can be difficult to perform on yourself, especially in the beginning! Start gently and realize that mobilizing (any) scar tissue can release emotions. If you need help getting started, we can do this at one of your postpartum chiropractic appointments.

Remember that you can start as early as 4 weeks, but it is NEVER too late to mobilize your scar.

Galactagogues

Galactagogues!

I’ve posted on this before but sometimes it helps to have a little reminder. Galactagogues are foods or herbs that may help increase breastmilk supply by increasing prolactin levels. Prolactin is the hormone produced by the pituitary gland to stimulate milk production.

Some common foods that are reported galactagogues include:

Oatmeal and whole grains like barley

Nuts and seeds

Brewer’s Yeast - often included in lactation cookie recipes but easier to find in the obvious: beer. 1-2 beers is considered safe for a breastfeeding pair but it is important to know your limits and indulge in moderation!

Herbs like raspberry and fennel and blessed thistle - all found in the Mother’s Milk tea

Chickpeas

•••

While these foods may help, the best ways to increase supply is to nurse often, eat a healthy diet and if concerns arise to meet with a pediatric chiro and/or lactation consultant to asses for any latching issues. And as always, hydrate, hydrate, hydrate!

Now in network with several insurance plans:

Dr. Nick is currently accepting the following insurance plans:

BlueCross BlueShield

Independent Health

Aetna

United Healthcare

Check with your insurance company to see if chiropractic care is part of your plan. You can also pay using your Wellness Benefits or Health Extras card.

No insurance? You can still pay at time of service with a credit card, cash or check.

Chiropractors are Back!

Just a reminder that our office is open again for all patients. 🙂 This includes new patients, existing patients under maintenance care and nutrition consultations.

Here’s a look at our office protocols during this time:
🙌🏽Please wash your hands in the restroom prior to entering the office.

🙌🏽Please remove your shoes before coming into the treatment room.

🙌🏽If you have a mask please wear it for the duration of your appointment except when you are face down on the adjusting table. If you do not have a mask, one will be provided.

🙌🏽An invoice for your appointment can be sent via Square if you prefer to avoid using credit cards/touchscreens in the office.

🙌🏽If you or anyone in your family has been ill or had a fever in the past 2 weeks, or if you have come in contact with anyone who has tested positive for COVID-19 in the past 2 weeks please reschedule.

🙌🏽If you or anyone in your family has had any of the following symptoms: fever, tiredness, unproductive cough, aches/pains, nasal congestion, vomiting or diarrhea, loss of taste/smell please reschedule.

(We will be asking you these questions before your first appointment back with us.)

Please arrive ON TIME for your appointment (not early or late). The length of appointment blocks have been extended to allow for additional cleaning and sanitizing between patients and also to limit interactions in the office. Unless you require assistance, please come in for your appointment alone.

Dr. Brenda and Dr. Nick will be reaching out to everyone by phone to get you back on the schedule but don’t hesitate to call us, email covellchiropractic@gmail.com or book online with Mindbody.

We look forward to seeing you soon!

What's happening - May 2020

Dr. Brenda is back in the office for limited hours starting the week of Monday, May 18th.

Scheduling priority will be given to existing patients in acute pain, or those with chronic conditions who have fallen behind in care. 

Online scheduling is available with Mindbody, or email Dr. Brenda directly at covellchiropractic@gmail.com. You can call the office at 716-551-0970 but please be patient with our response time since no one is in the office full-time yet. For the last couple weeks of May, Dr. Brenda will be in 2-3 days/week with no set schedule, just on an as-needed basis. See the schedule below starting in June.

Dr. Nick will be back in the office soon!

Questions about massage: The therapists at Phoenix Rising are following the governor's instructions on the opening of non-essential businesses. They hope to be back in operation June 1st, but exact details are TBD.

Book with Mindbody

Schedule as of June 1, 2020 (More hours may be added as needed.)
Mondays 12 - 6
Wednesdays 8-12
Fridays 8-12

New Product offering!

Covell Chiropractic is now offering weighted blankets for purchase through Hush Blankets. Orders are placed through Dr. Brenda and shipped directly to your home.
Benefits include:

• Getting deeper sleep more quickly

• Staying asleep longer

• Waking up rested

• Helpful for anxiety, ADHD, OCD, insomnia, and traditional sleep issues

• Summer is coming - check out the cooling weighted blankets for hot sleepers

Through the month of May patients will be able to purchase for only 25% above the wholesale price plus shipping. Check out the website for the full range of options. 

Hush blankets

CSA Updates

The Becker Farms and FreshFix CSA's are planning to continue as usual. Look for updates in the coming weeks from Becker Farms about the first pick-up date. Usually it is around mid-June but it all depends on the weather and growing season.

https://www.beckerfarms.com/csa

Deliveries are outside Covell Chiropractic, Suite 130 in the 500 Seneca Building

• Becker Farms on Wednesday afternoons, FreshFix Thursday afternoons

Just a reminder about some of the office protocols during this time:

Please wash your hands in the restroom prior to entering the office.
Please remove your shoes before coming into the treatment room.
If you have mask please wear it for the duration of your appointment except when you are face down on the adjusting table. If you need a mask, Dr. Brenda can provide a cloth one.
An invoice for your appointment can be sent via Square to avoid using credit cards/touchscreens in the office. 
If you or anyone in your family has been ill or had a fever in the past 2 weeks please reschedule.  
If you or anyone in your family has had any of the following symptoms: fever, tiredness, unproductive cough, aches/pains, nasal congestion, vomiting or diarrhea please reschedule. 

What are galactagogues?

Galactagogues are foods or herbs that promote or increase breastmilk supply.

Some common food sources:

⬆️ Whole grains - particularly oatmeal

⬆️ Dark leafy greens

⬆️ Nuts and seeds

⬆️ Fennel

⬆️ Garlic

⬆️ Chickpeas

⬆️ Brewers yeast

Herbal sources:

🌱 Alfalfa, blessed thistle, dandelion, fennel and raspberry. An easy way to ingest the herbs is to look for a Mother’s Milk tea that has a combination these.

While there may be different reasons that contribute to decreased milk supply, try the food/herbal route to see if it helps!

Take a Deep Breath

If you want to conquer the anxiety of life, live in the moment, live in the breath.

-Amit Ray

During this stressful time have you found yourself,

Holding your breath?
Breathing into your neck and shoulders?
Taking shallow sips of air and then needing to take in a big sigh of air?

Eastern Asian medicine holds the perspective that emotions are related to visceral organs. The emotions of anxiety and sadness are most closely linked to the lungs. It is no wonder that with all the craziness of the world surrounding COVID-19 that our breathing has become troubled.

Check out some resources for tips on breathing and stress reduction.

Try Headspace

Headspace has partnered with NY State to provide a FREE online guide to stress relief. Tips for mindfulness, relaxing sleep sounds and even meditations for kids.

http:/https://www.headspace.com/ny

The simplest breathing strategy that many of you have heard me talk about in the office is belly breathing.

Start by placing one hand on the chest and the other on your belly. (You can do this seated, but also very calming while you are lying on your back.) On the inhale, feel the hand on your belly rise, and on the exhale feel it fall. Use the feedback from your hands to cue your body to send breath to your belly instead of your upper body and chest.  
Try these other breathing techniques
Or these!

Why RIGHT NOW is a great time to try a Standard Process Purification Program:

You've always wanted to try one of the programs, but always found excuses. Here are some reasons why now could be the BEST time to try to reshape your eating habits.

No distractions. The #1 reason people state for needing to delay the start of a purification is some kind of special event or gathering. A wedding, a vacation, a holiday, a birthday where celebrating with food and drink is expected. Well, all of these things have been temporarily put on hold so you won't feel any social pressure.

Mindfulness. We hear a lot about this during this time of stress and uncertainty. This can carry over into our mealtime too. Before and during a purification my patients keep a food journal. This is HUGE. Seeing in writing what you eat on a daily basis can be the wake up call you need. It may be big changes, it could just be little tweaks to get you feeling your best.

More time. You may find that without the daily commute and always needing to be somewhere at a certain time, you might have more consecutive free minutes or hours in the day. These programs are designed to NOT take up a lot of your time and energy, but if you want to devote the time now to cook yourself something beautiful and wholesome and delicious, perfect!

Simplify mealtime. Just to say it again, these programs are designed to require minimal time and energy. Many patients report that they enjoy the structure of following the shake guidelines and the recipes included are simple and things the whole family can enjoy. You should never feel hungry or deprived with any of these programs. On the contrary, between the shakes and nutrient dense foods, you should find better sleep, more consistent energy levels throughout the day and decreased cravings.

Telehealth access. All of these purification programs can be done remotely. We can have our consultations via phone or video chat. All products can be shipped directly to your home. All of the information that we discuss before, during and after the program can be accessed online, as well as tons of resources from Standard Process.

Interested? You can set up a complimentary 15 minute nutrition consultation to review your goals and see if this is something you'd be excited to commit to!

Email Dr. Brenda at covellchiropractic@gmail.com to learn more.

Some Questions about Corona Virus

Our patients' health and safety is our biggest priority. Here is what we are doing in response to concerns about

Corona virus.

Here are some steps that we are taking in the office to keep our patients safe:

• Dr. Brenda and Dr. Nick will continue to be consistent using proper hand washing techniques between each patient.

• Surfaces such as the adjusting table, office chairs and door handles will be cleaned with a hospital grade disinfectant.

• We encourage patients to stay home if you are feeling sick. We are happy to reschedule your appointment to a time when you are feeling better. 

Read on below for some ways that you can help prevent the spread of illness. 

General advice for EVERYONE to contain the spread of illness:

• Exercise proper hand washing technique - wash hands frequently with soap and water for 30 seconds to kill viruses and bacteria.

• Mantain 3 feet of space between you and someone with a cough.

• Avoid touching your eyes, nose and mouth.

• If you cough or sneeze, do so into a tissue and discard it.

• If you develop a fever, cough or respiratory symptoms, seek medical attention. 

Sources: WHO, Corona virus (COVID-19) Advice for the Public
Johns Hopkins Medicine, What is Corona Virus

Corona Virus Q&A from World Health Organization

Johns Hopkins Corona Virus Info

You may have seen the whiteboard info in the office, but here are some ways to boost your immune system:

• Make sure you are getting enough sleep. 7-9 hours is the recommended minimum per night.

• Stay hydrated. Drink half your body weight in ounces of WATER each day. Do the math and compare to what you're drinking. You may be surprised that you're falling short!

• Increase your intake of healthy nutrients by eating a variety of vegetables, fruits, whole grains and protein. 

• Limit sugar intake and processed foods - your immune response plummets for several hours after consuming excess sugar. 

• Take 1 tablespoon of elderberry syrup daily. Elderberry contains active compounds that inhibit the ability of viruses to enter cells. Elderberry has also been shown to shorten the duration of illness with upper respiratory symptoms. See these sources Elderberry #1  and Elderberry #2 

• Covell Chiropractic will be carrying Elderberry Syrup from the Massachusetts Avenue Project.

• 80% of your immune system resides in your gut. Consider supporting your gut flora with a high quality probiotic (such as this from Metagenics Ultraflora-immune-booster

• Echinacea has been used for centuries to alleviate symptoms of sore throats, coughs, infections and aches. Known as an antiviral, antibacterial and anti fungal it can be taken as a tablet or along with other herbs in Standard Process's Herbal Throat Spray

Note: This information is not intended as a substitute for medical attention. Dr. Brenda and Dr. Nick do not claim to be experts in epidemiology or public health emergencies. We feel that in stressful and scary times, it is important to stay informed with reputable sources of information to make the best, rational choices for our patients' health and safety. Thank you for trusting us with your health questions and we look forward to continuing to provide chiropractic care to the best of our knowledge and abilities. 

How can chiropractic help infants with difficulty breastfeeding?

From the Journal of Manipulative and Physiological Therapeutics
October 2009

This is a case series of 114 infants who were diagnosed in a hospital or by a lactation consultant with breast feeding problems. These patients were referred to seek chiropractic care in addition to routine pediatric care.

The three most common diagnoses for why these infants were unable to breastfeed were:
1. cervical posterior joint dysfunction
2. temporomandibular joint imbalance (TMJ)
3. inadequate suck reflex.

“Treatment was chiropractic therapy in addition to support given elsewhere.
All children showed some improvement with 78% being able to exclusively breastfeed after 2 to 5 treatments over a 2-week time period.”

Chiropractors are experts in diagnosing and treating disorders of the musculoskeletal and nervous systems - in this case series the most common issues being with the cervical spine and jaw. 

This article demonstrates the benefit of pediatric chiropractic care as a multidisciplinary approach to breastfeeding issues with a musculoskeletal cause. 

https://doi.org/10.1016/j.jmpt.2009.08.023

Pelvic Anatomy 101

Did you know the pelvis is actually made of 3 separate bones - the ilium, ishium and pubis- that fuse together starting in childhood to your early 20’s?
These three form a bony bowl-like structure known as the pelvis. It contains organs and structures that are responsible for digestion, bowel and bladder actions and sexual and reproductive functions. 
Directly attached to the pelvis are large muscle groups like the quads, glutes, abdominals, spinal erector muscles and hamstrings that connect the trunk to the lower extremities. Symmetrical motion in the pelvis can impact biomechanics (such as running, walking and squatting), comfort levels during pregnancy and postpartum, and can even impact labor and delivery. 

Healthy Sleep Habits for 2020

We all know how important good sleep is. Here are some ways to get the zzz's you need in 2020.

• Follow a regular sleep schedule. Your body cannot tell the difference between weekdays and the weekend, so trying to keep bedtimes and wake times similar can help your body's internal clock stay on track. 

• Develop a bedtime routine. Avoid using electronic devices like cell phones and tablets immediately before bed. 

• Use your bedroom only for sleeping and not as an office or workout space.

• Avoid caffeine after 3 pm. This includes coffee. tea and chocolate. 

• Alcohol can disrupt circadian rhythms and block restorative REM sleep. 

• If you are searching for a bedtime snack, try complex carbohydrates such as a banana, sweet potato or quinoa. Spicy foods and high protein foods can divert your body's energy for digestion and interrupt restful sleep. 

• Get adjusted! One third of people who get a chiropractic adjustment report better sleep that night. Chiropractic can also improve infant sleep - 40% of infants sleep for a longer duration after being adjusted (which also means more sleep for mom and dad!).

Some Postpartum Reading Picks

A little look at my postpartum reading:

“Bringing up Bebe” - An American mom living in France tries to uncover the reason why French parents and babies seem to have it together. Some pretty funny observations about kid behavior and American parenting!

“The Happiest Baby on the Block” - A good explanation of baby’s primitive reflexes and why newborns are such strange creatures. The swaddling tips helped us with a sleep routine in those early days.

“The Wonder Weeks” - I’m still reading this one as it goes into toddler hood. Some more very interesting information about infant development and milestones.

“The First Forty Days: The Essential Art of Nourishing the New Mother” - I wish I had read this before Henry arrived but since he was a sneakster and got here a month early there’s not much to be done about that. But so many good recipes with warm, replenishing herbs and nutrients. I love the focus on the 4th trimester for mom and baby.

“Baby Led Feeding” - I haven’t gotten to this one yet but I’m looking forward to reading it. It came highly recommended to me. And we all know how excited I get talking about vegetables!

“Like a Mother” - I’ve talked about this one before, I read it when I was pregnant. It is so good, and I’m sure if I read it again now I would continue to get something out of it from another perspective.

“Great Garden Companions” - This is for next year so that my garden will hopefully look more intentional and productive rather that the happy accident it is now. 🤷‍♀️

“Becoming” - Michelle Obama’s autobiography has been on my nightstand for awhile and I’m about halfway through. I probably would be done by now but hardcover books are heavy! I was fortunate to hear her speak in October in Hamilton. She’s a very good speaker and a humble and interesting writer.

I’d love to hear what you’re reading now or what is on your to-read list!

Dr. Brenda

Headaches: Tension vs. Migraine

This is a hot topic in my office! 🔥 Patients frequently tell me that they get “migraines”. Let’s think about this: although all migraines are headaches, not all headaches are migraines. 🤔

The causes, symptoms and treatment for tension (or cervicogenic) headaches are very different than for a true migraine. Check out the differences below.

Often postural stresses such as working at a desk or at a computer can contribute to hypertonicity in the muscles of the neck. This can cause headaches to present in the temples, over the eyes or the forehead. 😨

Headaches are COMMON but not NORMAL. You don’t have to get a headaches every day, every time you work on your computer, every time you drive, etc etc etc. The good news is that many headaches respond very positively to chiropractic adjustments and work to the muscles of the cervical spine. 😁