Depression In Pregnancy

Childbirth and the newborn period is supposed to be a joyful time. It’s stressful and overwhelming and sleep is hard to come by, but new moms are increasingly struggling with one more hurdle to enjoying time with their newborn. Depression.

depression, sad pregnant woman
Credit: profmed.co.za

About 25% of women in the United States will have depression bad enough to require treatment at some time in their life. Sadness, feeling that life isn’t worth living, not enjoying things that used to bring you joy, lack of motivation, trouble sleeping, and unusual fatigue are all symptoms of depression. What happens when a woman suffers depression in pregnancy?

An article published recently in Obstetrics & Gynecology looked at rates of depression diagnoses in women hospitalized for childbirth. The authors found that rates of depression increased from 0.41% in 2000 to 2.87% in 2015. That’s a seven-fold increase.

This study wasn’t designed to discover why diagnosis rates went up. It’s possible awareness is increasing so more patients are getting diagnosed, when the rates of illness aren’t actually rising. We do know that depression in pregnancy has serious consequences for both mom and baby, so more accurate diagnosis is important.

There are many possible triggers for depression, in pregnancy and at other times. Family history, stress, complications with the pregnancy or previous pregnancy loss, history of abuse or trauma, and relationship problems can all lead to depression.

Depression in pregnancy can have health consequences for both mom and baby. Poor nutrition, lack of exercise, alcohol and other drug abuse, smoking, poor sleep and social isolation can all stem from depression. Not taking good care of oneself during pregnancy (which includes withdrawing from loved ones who can help provide support) can lead to less robust health once the baby arrives.

Poor nutrition, substance abuse (including smoking) and social isolation can increase the risk of premature birth, low birth weight, bonding problems, and abuse/neglect of the baby once born.

If a pregnant women is feeling sad from time to time, usually all that is needed is to talk about her feelings honestly with her mate or a close friend or other family member. Symptoms that are severe enough to keep her from enjoying life, that last longer than 2 weeks or so, should be discussed with her obstetrician or family doctor.

Treatment can start with some dietary and nutrition changes and talk therapy with a trained counselor. If symptoms are bad enough, medication can definitely be prescribed to help with the mood. Remember, although no medication is perfectly safe in pregnancy (or at any other time, really), the risks of depression in pregnancy can be significant.

Pregnancy, while confusing, overwhelming and sometimes uncomfortable, doesn’t have to be as big a struggle as it is with depression. If you or a woman you know is struggling with depression in pregnancy, please make sure to discuss your symptoms with your doctor.

QUESTION: Have you or someone you know suffered with depression while pregnant? What helped?

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Low Back Pain

You bend over to pick something up off the floor and suddenly feel a sharp pain in the low back.

You have a piece of furniture that REALLY belongs in the other corner of the room but you’re home alone.  It’s not that big, right?  I can move it myself.

You get home from work after 8 hours on your feet and think “I have to do something about my back.  I can’t handle another shift like that, the pain is too much.”

Do you have low back pain?  If so, you’re not alone.  Low back pain is one of the most common problems family doctors see.  From weekend warriors overdoing it at the gym, to sports injuries, to shoveling snow and pulling weeds and moving furniture, there are many ways to injure your back.

In fact, I’m having some trouble with MY low back this weekend!  Since yesterday afternoon I’ve had a sharp, aching pain in my right low back.  Standing up from sitting, rolling over in bed, picking things up off the floor and putting on my shoes have been an adventure today :-/

The most common cause of low back pain is a musculoskeletal injury.  For instance, you might slip on the ice and land on your back.  You also might lift something heavy or twist while carrying a baby. (That’s how I herniated a disc in my back over 10 years ago, bent over and twisted while putting my son in his crib.)

If you have low back pain, what do you do?  Well, of course the first thing to do is to see the doctor, especially if your pain is more than a simple “I overdid it” that goes away in a few days.  The doctor will ask questions about your pain, examine you, and may order tests and prescribe medicine to help you feel better.

When I see a patient with musculoskeletal back pain the first thing I do is to send them to physical therapy.  Most cases of low back pain are caused by two things: mechanical imbalance in the spine, and weak core support.  The therapists will help figure out what the patient is doing that might be making back pain worse (like bending and lifting improperly), teach strengthening exercises to address core weakness, and add treatments to relieve pain like traction, electrostim or ultrasound.

As I discussed in a previous post, chiropractic therapy is very helpful for low back pain as well.  Often manual therapy like massage and osteopathic or chiropractic adjustment can improve or relieve back pain very quickly.

If physical therapy and manual therapy don’t relieve symptoms in a few weeks we may discuss imaging like an Xray or MRI.  More serious problems may be present that need specialist care like injections or even surgery.

What are some of the danger signs that suggest low back pain is an urgent problem?  If you are having trouble emptying your bladder or controlling the bowels you need to see the doctor right away.  So-called “saddle anesthesia” which is numbness in the area between the legs (the part of you that would touch the saddle when riding horseback) may indicate damage to the spinal cord and should be checked out immediately.  Also, if you have a personal history of cancer then back pain could be a sign of a recurrence and should be reported to your doctor right away.

There are a few supplements that are helpful with musculoskeletal back pain.  Magnesium helps to relax muscles and can decrease pain from spasm.  Fish oil is helpful for painful conditions of all sorts, but you have to take a lot of it, as I wrote in a previous post.  Turmeric has anti-inflammatory properties.  (This is not an all-inclusive list, of course.)

Millions of people suffer with back pain every year.  Luckily most of the time it goes away without too much muss or fuss, with some simple strengthening exercises and pain-relieving medicines.  Most patients also benefit from some education on how to take good care of their back so the pain doesn’t come back.

Low back pain doesn’t have to take over your life!  It takes some time, work and patience, but straightening out the problems with your back is so worth the effort!

QUESTION: Do you have low back pain?  What have you found that helps?

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Don’t Wash Your Chicken! Do This Instead

Yes, you read that right. If you are in the habit of washing raw chicken before you cook it, STOP. Don’t wash your chicken!

Chicken is the most commonly eaten meat in the United States these days. Whether fried, poached, broiled, baked or added to soups, stews and chili, Americans LOVE to eat chicken.

Many of us learned to rinse or wash raw meat before cooking it. In the case of chicken, this is a bad idea. Raw chicken often carries salmonella, shigella or campylobacter bacteria. If you soak the meat in water, the bacteria get into the water which is easy to spread around your kitchen.

The bacteria commonly found in raw chicken cause food poisoning, also called gastroenteritis. These illnesses cause abdominal pain, fever, diarrhea, nausea and vomiting. In severe cases people can have intestinal bleeding or become dehydrated, causing them to need hospitalization for antibiotics, IV fluids and symptom control medications.

If you are cooking with raw meat, especially poultry, cleanliness is very important. Keep the raw meat separate and avoid touching it to anything that can’t be thoroughly cleaned. This includes wooden utensils and cutting boards, which tend to absorb juices and are difficult to sanitize. After handling raw meat wash your hands with hot water and soap for at least 20 seconds (long enough to sing the ABC song twice).

Transfer the meat directly from its packaging to the container it will be cooked in. If you will apply breading to the meat make sure you touch the raw meat with only one hand and keep the other hand clean for touching everything else.

Prevention of foodborne illness means cooking meat thoroughly. Poultry should be cooked to an internal temperature of 165°F, or until the juices run clear and the meat is opaque all the way through.

Of course, if you really want to be as safe as possible from foodborne illness, just don’t eat meat. At all. In one survey published in 2012, 41% of raw chicken sold in the Alabama was contaminated with Campylobacter. Poultry, fish, shellfish, unpasteurized dairy and eggs are common causes of foodborne illness. Cooking all these foods thoroughly and NOT washing them prior to cooking is essential.

It is true that plant foods are the cause of food poisoning from time to time. Romaine lettuce, anyone? Rice, berries, melon and sprouts are also known to be higher-risk foods. In the case of plant foods, washing them thoroughly before eating them reduces the risk of food-borne infection.

In fact, my first EVER YouTube video was about how to use Shaklee’s Basic H2 nontoxic cleaning solution to wash strawberries. Want to see? Click this link 🙂

We all want to eat healthy. Healthy, safe cooking means knowing what to wash and what NOT to wash. WASH your fruits, veggies and leafy greens. DON’T wash your chicken!

QUESTION: What do you do to avoid food borne infections?

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