Therapeutic Contrast Shower

February 22, 2008 by Kitchen Table Medicine
Filed under Detox, Hydrotherapy, Kitchen Sink

The contrast shower is a simple and convenient way to stimulate vitality and promote detoxification, as well as treat generalized areas of pain and soreness. The idea is simple: alternating between hot and cold water while you are showering to stimulate your body to heat itself up and cool itself down, in order to compensate. This temperature contrast helps strengthen and normalize the nervous, circulatory, endocrine (hormonal), musculoskeletal and immune systems and is excellent for helping the body cope with physiological and psychological stress.

CONTRAINDICATIONS AND PRECAUTIONS

There are some medical conditions for which the contrast shower are contraindicated including:

Heart disease or vascular disease, including hypertension, high blood cholesterol, intermittent claudication, weak connective tissue (relating to high risk for plaque rupturing), etc.
Vascular insufficiency or stasis, including blood clots, deep vein thrombosis, phlebitis, etc.
Asthma
Pregnancy
Diabetes
Cold urticaria or cold-induced hemolysis
Raynaud’s syndrome or phenomenon

Discontinue or decrease intensity of contrast shower if you feel dizzy, lightheaded, nauseous, or excessively chilled. Acute illness, menstruation, dehydration, decreased vitality, and poor nutrition can limit your tolerance for contrast treatment and in these cases it should be undertaken cautiously.

Procedure

After your normal hot shower, gradually turn down the hot water until the shower is pleasantly cool and rinse your whole body under the cooler water for about 1 minute.
If you have localized areas of pain or soreness you can focus the shower stream on those areas.
Next, switch the shower back to hot to rewarm your body for 3-5 minutes. Repeat the cycle 3-5 times and end with cool.
It is important that the hot phase is longer than the cold, and that you finish with cool water.
After the final cool rinse, dry yourself off quickly, rubbing briskly with a cold towel to stimulate the rewarming process. As a sign of increased peripheral circulation, your skin may turn transiently pink afterwards.
It is also important to note that the sharper the contrast in temperature between the hot and cold phases increases the therapeutic benefit. As you get used to treatment, you can increase the intensity by varying the speed and degree of the temperature change.

Resources
1. Hayes, K.W. Manual for Physical Agents, 4th ed. 1993. Norwalk, CT. Appleton & Lange. Pp. ix, 169.
2. Lindlahr, H. and Poesnecker, G.E. Nature Cure 2000: Philosophy and Practice Based on the Unity of Disease and Cure. 1998. Quakertown, PA. Beverly Hall Corp. Pp. xxii, 360.

Dr. Nicole Sundene, NMD is a licensed Naturopathic Medical Doctor at Fountain Hills Naturopathic Medicine 16719 E Palisades Blvd, Suite 205, Fountain Hills, AZ 85268.

She believes we should utilize natural medicines to treat the root cause of disease rather than just treating symptoms, as symptoms are a message of imbalance sent from the body and will persist until they are properly addressed.

For appointments please visit http://FHnaturopathic.com for more information about Naturopathic Medicine services.
©KitchenTableMedicine.com, LLC ™

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Ice Therapy

February 22, 2008 by Kitchen Table Medicine
Filed under Hydrotherapy, Injury Care, Kitchen Sink

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Ice therapy, or cryotherapy, is commonly used after an injury to reduce swelling and decrease pain. Ice decreases blood flow to the injured tissue and reduces inflammation.

When to ice?

Ice should be used for the first 2 to 3 days after an injury or until the swelling goes away.

Procedure

Ice packs - Prepare by placing ice cubes or crushed ice in a Ziploc-type plastic bag with a small amount of water. Commercial frozen gel packs are also acceptable but bagged ice is preferred. To avoid frostbite, place a wet washcloth or towel between ice and skin. Use an elastic bandage to hold the ice pack in place. Ice packs should be used for 20 to 30 minutes every 2 to 3 hours.
Ice massage - First freeze water in a paper or Styrofoam cup. Then tear away the top lip of the cup and rub the ice over the injured area for 5 to 10 minutes. Ice massage works very well for overuse injuries.

When you first apply ice, you will feel coldness, then burning. Then, after several minutes, the area will become numb. Stop using ice if skin becomes numb or turns white.

Potential Adverse Effects

If ice packs are put directly on the skin and left too long, frostbite is a risk. Frostbite can cause the skin and tissue underneath (muscles, nerves, and fat) to be injured, either temporarily or permanently. Certain parts of the body (including the elbow, the knee and the foot) are more susceptible to frostbite because they don’t have as much padding or insulation. To repeat, stop using ice if skin becomes numb or turns white.

Contraindications

Do not use for acute asthma (over lungs)
Do not use for acute cystitis (over bladder)
Do not use if you are aggravated by cold (cold urticaria, Raynaud’s syndrome/phenomenon, etc.)

Resources
1. Hayes, K.W., Manual for physical agents. 4th ed. 1993, Norwalk, Conn.: Appleton & Lange. p. ix, 169.
2. MD Consult, Patient Handouts. 2002. http://www.mdconsult.com
3. Mellion, M.B., Team physician’s handbook. 3rd ed. 2001, Philadelphia: Hanley & Belfus.

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Contrast Hydrotherapy

February 22, 2008 by Kitchen Table Medicine
Filed under Hydrotherapy, Injury Care, Kitchen Sink

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How to do Contrast Hydrotherapy

Contrast hydrotherapy involves alternating hot and cold applications for the purpose of increasing local circulation and reducing inflammation. It is commonly used for subacute or chronic traumatic injury (more than 48 hours post-injury), impaired venous circulation and edema.

Contrast hydrotherapy is typically applied as wet compresses or partial immersions of affected body parts. The heat dilates and cold constricts local blood vessels, creating a “pumping” vascular action which helps clear out inflammation and accelerate recovery.

Contraindications

Do not use in acute asthma (over lungs) or if you are aggravated by cold (cold urticaria, Raynaud’s syndrome or phenomenon, etc). Use with caution in areas of decreased sensation (anesthesia, paralysis, neuropathy, etc) to avoid tissue damage, burns, etc.

Procedure for Contrast Hydrotherapy Compress

Prepare one basin with hot water and place a bath towel into it. You may need to have extra hot water to add to basin during treatment. Prepare a second basin with cold water, add at least one tray of ice cubes to it, and place a hand towel into the cold water
Take the bath towel from hot basin, wring it out, fold it once or twice, and place the hot towel on the affected area for 3-6 minutes. After that time, wring out the cold towel, remove the hot towel from the affected area and place the cold towel, folded once, over affected area for 1-2 minutes. You have completed one cycle of hot/cold application.
Prepare the hot towel again, remove the cold towel and place the hot towel on the affected part to begin the second cycle of hot/cold application.
Repeat the hot/cold cycle a total of 3-5 times, always finishing a cycle with the cold application.

References
1. Hayes, K.W. Manual for Physical Agents. 4th ed. 1993. Norwalk, CT. Appleton & Lange. Pp. ix, 169.
2. Mellion, M.B. Team Physician’s Handbook. 3rd ed. 2001. Philadelphia, PA. Hanley & Belfus.

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Alternating Sitz Bath

February 22, 2008 by Kitchen Table Medicine
Filed under Constipation, Hydrotherapy, Kitchen Sink

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The sitz bath is an immersion bath with the person seated in a tub with water covering the hips, buttocks, and lower abdomen. It is used to decrease congestion and increase circulation to the pelvic and lower abdominal organs.

Indications

Sitz baths are used to treat vaginal infections, chronic urinary tract infections, pelvic inflammatory disease, hemorrhoids, fissures, prostatitis, constipation, insomnia, and neuralgias.

Contraindications

Open wounds or active bleeding, vaginal bleeding, (including excessive menstrual bleeding), prolapsed organs, acute lung congestion, acute inflammation, painful conditions with spasm or colic, pregnancy and heart problems.

Directions

Prepare a tub with hot water at a temperature of 105-110 degrees F. This range is about the same or slightly warmer than a typical hot tub. Do not exceed 120 degrees F. Fill the tub so that it comes to 1 inch above your navel when you are in a seated position.
Put a long towel in a separate, small ice water bath (a bucket or large bowl will suffice) placed next to the tub.
Sit in the hot bath for at least 3 minutes.
After hot bath, stand and, without wringing out towel, wrap the cold towel around pelvis like a diaper. Make sure that the towel is touching your skin all the way around. Do not allow the towel to come up higher than 1 inch below your navel. Leave on for 30 seconds. Return towel to ice bath.
Sit down in the hot bath for another 3 minutes.
Repeat cold towel wrap, as before, for 30 seconds.
Sit down in hot bath for another 3 minutes.
Repeat cold towel wrap, as before, for 30 seconds.
Following the third cold towel wrap, get out of tub and dry off.

Resources
1. Pizzorno, J., Murray, M., Roberts, N. and Barry, R. Textbook of Natural Medicine, 2nd Ed. 1999. Churchill Livingstone. Edinburgh, Scotland. Pp 345-356, 1474-1477.
2. Thrash, A. and Thrash, C. Home Remedies: Hydrotherapy, Massage, Charcoal, and Other Simple Treatments. 1981. Thrash Publications. Seale, Alabama. Pp 40, 44, 73, 76.

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Hydrotherapy for Headaches

February 22, 2008 by Kitchen Table Medicine
Filed under Headaches, Hydrotherapy, Kitchen Sink

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WHAT CAUSES HEADACHES?

Almost all of us have had a headache at one point in our lives. In fact 5-10% of the US population seeks medical help for their headaches. Most headaches are caused by either muscle tension or temporary changes in blood circulation in the brain. Common triggers for the muscle tension that can lead to these headaches are stress, joint misalignment in the neck or jaw, emotional factors, and poor posture. Triggers for headaches caused by changes in blood flow are often food allergies, poor blood sugar regulation, fatigue, hormonal changes, alcohol, chemicals, and toxins.

Naturopaths often use the application of hot and cold water to change blood flow and release muscle tension. The following can help to relieve headaches whether they are of muscular or vascular origin. Read more

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Computer Desk Ergonomics

February 21, 2008 by Kitchen Table Medicine
Filed under Back Pain, Neck Pain, Work Health

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Using your computer improperly and having an unbalanced desk set-up can lead to chronic musculoskeletal complaints such as wrist pain, neck and shoulder tension, and even low back pain. Simple shifts in your desk arrangements can make a big difference in alleviating chronic aches and pains.

Quick Tips for Computer and Desk Set-Up and Use:

A normal desk height is 28-30” above the floor. This is comfortable for writing on paper, but it is too high for keyboard and mouse work. You may need to raise your chair slightly to get the optimal height. Make sure to use a foot rest to maintain proper seating posture. Another option is to consider using a height adjustable keyboard/mouse tray system beneath the work system.

Adjust chair so thighs are roughly parallel with the floor. Your knees should be at an open angle (90° or slightly greater). Your feet should be flat on the floor or on a foot rest. Sit back in your chair or use a cushion for lower back support. The seat should not apply pressure to the back of your knees and there should be about an inch on both sides of your legs. Do not use the armrests while typing, only between typing sessions.

An adjustable chair is a good investment to prevent long-term problems.
If your chair is too low, use a cushion to boost you up. If your chair is too high, consider using a footrest to bring your thighs parallel with the ground (you could use a telephone book!) If your seat is too deep (creating pressure on the backs of your knees), use a pillow, rolled towel, or backrest to support your lower back.

Center your monitor directly in front of you. Sit arms length away when you’re sitting back in your chair. Position the top of your screen level with your eyes (unless your screen is 20” or larger then position the top of the monitor 3” above eye level). Tilt your monitor slightly upward. Reduce glare and balance the brightness of the monitor with its surroundings.

Consider using an adjustable keyboard/mouse tray. Your keyboard should be just above the level of your lap which is lower than most people place their keyboard. This lets your arms tilt downward, leaving your elbows at a comfortable, open angle (>90°). Adjust your chair upwards to get this effect if you do not have a separate tray. Use a slight negative tilt with your keyboard (tilt back edge of keyboard slightly down) versus an upward tilt. If there are “legs” attached to the underside of the keyboard, do not extend them. Keep your wrists neutral, your shoulders relaxed, and your elbows at your side.

Place your mouse close to your keyboard and within easy reach to avoid constantly outstretching your arm which leads to neck and shoulder pain. Use of a touchpad or scroll wheel reduces the distance and amount your shoulder has to travel. Mice come in different sizes. Make sure it fits comfortably in your hand. Use your elbow, not your wrist to move the mouse. Flicking of the wrist leads to increased intracarpal pressure leading to wrist/finger pain. Use keyboard short-cuts when possible.

Do not lay documents flat on your desk while you are working on them Use a screen-mounted or free-standing document holder to keep them at the level of your screen. Make sure you have enough light to see your documents to avoid unnecessary strain.

Below is a list of common musculoskeletal complaints and associated ergonomic problems and solutions:

Neck and Shoulder Pain

Problem: You’re cradling the telephone between your head and your shoulder.
Solution: Keep your head straight and shoulders relaxed while using the phone. Consider using a hands-free headset.
Problem: The documents you’re working from are too low and too far to the side.
Solution: Position the documents at the same level as your monitor. Consider using a document holder that attaches to your computer or sits beside it.
Problem: Your monitor is not the right height.
Solution: Make sure your monitor is directly in front of you and in line with your chair.
Problem: Your chair is too far away from your keyboard or desk, or the back of your chair is tilted too far back.
Solution: See suggestions in above section to learn how to set-up your chair and keyboard properly.
Problem: You wear bifocals and tilt your head back to see the computer screen.
Solution: Consider positioning your monitor slightly below eye level. Sit back in your chair and avoid hunching.
Problem: You’re leaning forward to see the screen.
Solution: Be conscious about sitting in upright posture against the back of your chair.

Shoulder Pain

Problem: Your keyboard is too low or too far away. This causes you to raise or lower your shoulders to accommodate.
Solution: Keep your elbows close to your sides as your type and arrange your keyboard at proper level. See proper keyboard set-up in above section.
Problem: Your mouse is too high, to the side, or too far away.
Solution: Position your mouse close to and approximately at the same height as your keyboard. Consider using a touchpad or trackball to minimize distance your shoulder has to travel.

Wrist and Forearm Pain

Problem: Your wrists aren’t in a neutral position.
Solution: Keep your wrists straight in line with your arms. People with broad chests may prefer a split design keyboard as their elbows are already pushed outward.

Problem: Your keyboard feet are extended, giving your keyboard an upward tilt.
Solution: Your keyboard should have a neutral or slightly downward tilt.
Problem: The edge of your desk or hard wrist rest is putting unwanted pressure on the palm side of your wrist.
Solution: Consider using a soft wrist rest and check the height of your keyboard.
Problem: You’re typing too hard or for too long.
Solution: Use minimal force when typing. Make sure to take frequent short breaks (30 seconds) and consider performing quick stretches.

Low Back Pain

Problem: Your chair isn’t offering proper lumbar support.
Solution: If your chair is adjustable, make sure it’s properly adjusted to fit your body. If it’s not adjustable, considering purchasing a lumbar support or using a pillow or rolled towel to support your lower back.
Problem: You’re not maintaining good posture.
Solution: Your chair may be too high or too low. Your feet should not be dangling; they should either reach the floor or a footrest.
Problem: You’ve been sitting too long without a break.
Solution: Make sure to get up every few hours. Consider stretching to relax muscles and improve circulation.
Problem: You’re leaning forward to view your screen.
Solution: Be conscious about sitting in upright posture against the back of your chair if necessary.

Hip and Leg Pain

Problem: Your legs are cramped under your desk.
Solution: Clear the space under your desk so that your legs can move freely.
Problem: The padding on your seat is too firm.
Solution: Make sure your seat is padded. The angle between your chair back and seat may be too tight. Adjusting the backrest backwards slightly or the seat downward may help.
Problem: You’ve been sitting too long without a break.
Solution: Your legs need occasional movement to keep blood flowing and to avoid stiffness.

Knee Pain

Problem: Your chair is too low or too high. Dangling feet may cause knee pain.
Solution: Raise or lower your chair as necessary.
Problem: Your seat is too deep which can cause pressure on the back of your knees.
Solution: Tilting the seatback slightly forward or using a back pillow may help. Some adjustable chairs now have sliding seats that adjust for depth.

- Dr. Nicole Sundene, Naturopathic Physician

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A Simple Fix for Knee Pain

February 21, 2008 by Kitchen Table Medicine
Filed under Knee Pain

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There’s nothing like a little knee pain to make you feel old and out of shape. Ironically, it is normally when you are trying to get in shape that you discover these little annoyances.

A couple of years ago I started jogging again. At least, that was the goal. I quickly discovered my body wasn’t ready for a jogging routine and much preferred a brisk walk. I had never felt that out of shape before.

Although I was lifting weights and occasionally doing the stepper or elliptical, my body wasn’t used to jogging and it let me know it quick! My hip ached, my knees throbbed, and my muscles were incredibly sore.

Even though most of my body adapted to the new routine eventually, my knees took a little longer to improve. Believe it or not, it was a simple fix – all I needed to do was stretch.

I am sure this may sound odd to some people. I mean, what in the world could stretching a muscle do for a joint? Well, plenty! You see, my leg muscles were really tight, especially my quadriceps (thigh muscles). Since these tight muscles attach to the patella (the knee cap) tight muscles were most likely the cause of my discomfort.

If you gently stretch the leg muscles, you relieve the tension on the knee cap allowing for proper tracking. The only drawback is you have to be patient and consistent with your stretching routine. You can’t expect your muscles to loosen up after just a few stretches. With increased activity comes increase tightness so it’s something you have to do often.

I had to stretch several times a day. I even would stop and stretch in the middle of my jog to help get me through my routine. Eventually, my knee pain completely went away. My two miles of limping turned into a four and half mile pain-free jog thanks to a few simple stretches.

While there are many reasons for knee pain, tight leg muscles are often the culprit especially if you just started noticing it after increasing activity. Unfortunately, many people quit an exercise program due to aches and pains discovered after beginning their new routine. Just keep in mind the solution maybe easier than you think.

Bonnie Pfiester, personal trainer
www.longevityclubs.com

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Minimizing Sore Throats, Colds and Flus

February 21, 2008 by Kitchen Table Medicine
Filed under Colds/Flus

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When the symptoms of a sore throat, cold, flu or other upper respiratory infection begin, there are steps you can take to boost your immunity and avoid becoming ill or to shorten the duration of illness.

The earlier you take these measures, the more helpful they will be. Ninety percent of common colds are due to viral infections. Though commonly prescribed, antibiotics are not effective against viruses (only bacteria).

The reason antibiotics are prescribed is to prevent rheumatic fever following Strep throat in children or to avoid a secondary bacterial infection, tonsillitis or abscess that may be likely to occur or would be dangerous to a particular patient. Call your physician if your symptoms become severe.

Contamination studies have demonstrated that viral infections are spread much more readily by direct contact (as opposed to airborne).

Cleanliness tips to help avoid contamination by direct contact include not sharing utensils or toothbrushes, etc., frequent hand-washing and frequent laundering of clothing, bedding and towels (especially for children sharing rooms and bathrooms).

Steps You Can Take to Minimize Contraction or Duration of Cold, Flu or Other Upper Respiratory Infection

Eat Very Lightly: With most illnesses, appetite is diminished. This is a natural response because energy is needed to fight off the pathogen (virus, bacteria, etc.) and the body doesn’t have the energy to process food. Give your digestive system a rest! Avoid mucous producing foods such as dairy and any foods that produce allergy or intolerance symptoms. Choose whole foods (not highly processed or refined).

Rest (As Soon As Possible): Many people ignore the early warning signs of illness and keep working until they “drop”. This allows the pathogen to multiply and gain a stronger foothold. If you feel symptoms beginning (sore throat, headache, congestion, fever, etc.), take it easy. Take a day off if possible, as this may prevent you from having to take three days off later on. Keep your bedroom cool and humid. If you are cold, add covers. If you are too warm, uncover or take a lukewarm bath. Humid air is helpful in keeping mucous membranes moist.

Drink Plenty of Fluids: Drink large amounts of filtered water, herbal teas, broths and soups. Fruit juices and sweetened beverages (such as sodas) are not good choices, as their high sugar content will actually inhibit your immune cells from doing their respective job(s). If you do choose to drink fruit juices, dilute them with water (1:1). Avoid alcohol, coffee and black tea.

Avoid cigarette smoking and exposure to second-hand smoke, as it is an irritant to respiratory tract tissues.

Warm salt-water gargle: ¼ to ½ teaspoon salt in one cup warm water. Gargle 2-3 times daily after brushing teeth and tongue.

Immunity-Boosting Supplements, Herbs and Homeopathic Remedies (Adult dosages)

Note: Consult your physician regarding infants, children, pregnant women or persons with additional medical conditions

Vitamin C: 500 mg every 3-4 hours with a small amount of food. Cut back on the dosage if stools become loose or you experience gas and cramping.
Vitamin A: 10,000 IU three times daily. Women who are pregnant should not take high doses of Vitamin A as the fetus can be adversely affected—pregnant women should consult their physician for recommended dosages and signs of Vitamin A toxicity.
Zinc: 30-50 mg once daily with a small amount of food. This can be continued for 1-2 weeks without depleting copper stores.
Bioflavanoids: 1,000 mg (1 gram) daily
Oscillococcinum (homeopathic remedy): Take 6 pellets every six hours (from the onset of flu or cold symptoms), dissolving the pellets under the tongue, at least 15 minutes away from food or water.
Some common immune-enhancing, warming and diaphoretic (sweat-enhancing) herbs include Astragalus, Echinacea, Ginger, Glycyrrhiza (Licorice), Hydrastis (Goldenseal), Commiphora (Myrrh), Trifolium (Red clover), Ligusticum and Yarrow. Consult your physician regarding dosages (that are dependent upon the form of the herb—i.e. tea, tincture/extract, capsules, etc.). All herbs are not necessarily suitable or safe for all patients.

Home Hydrotherapy Treatments: Consult your physician regarding instructions for steam inhalations, hyperthermia, footbath, wet sock treatment, compress (throat or chest), etc. and the treatment’s suitability for a particular patient.

General Cough Syrup Recipe: Start with your strained herbal decoction or infusion (tea) and concentrate the tea by boiling to half the volume. Take one pint (16 oz.) of this herbal tea concentrate and mix with 2 Tablespoons honey and 2 ounces vegetable glycerin (or more honey). Herbal tinctures or extracts can be added to this general cough syrup in a ratio of 3 parts syrup to 1 part tincture/extract. Store in the refrigerator.

Nighttime Cough Syrup Recipe: Combine 1 teaspoon cloves, 1 whole sliced organic lemon and 2 pints fresh decoction/infusion (herbal tea). Boil ingredients together until half the original volume, and then add 12 ounces of honey.

Gargle Syrup Recipe: Combine the juice of one lemon, 1 teaspoon Vitamin C powder, 1 pinch of cayenne and 1 teaspoon honey. Gargle with the mixture.

Onion Syrup Recipe: One large sliced onion, 2 sliced cloves of garlic, ¾ cup raw honey or sugar. Layer the onion, garlic and sweetener alternately in a covered pan. Let stand 2-3 days or bake 2 or more hours at low heat. Strain and use as is, or as a base to add infusions, decoctions, tinctures or extracts to.

Fresh Herbal Glycerite: Take the fresh leaves of the desired herbs and juice or puree them with a little water in the blender. Strain. Add 50% glycerin. Store in the refrigerator.

Resource: Alschuler ND, Lise.

Tags: antibiotics, colds, natural medicine, natural treatment, sore throat, Sore Throats, strep throat

Diaper Rash

February 21, 2008 by Kitchen Table Medicine
Filed under Kitchen Sink, Pediatrics, Yeast Infections

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The four main causes of diaper rash:

CONTACT DERMATITIS
• Due to friction and trapped moisture
• Usually seen on the rounded skin surfaces sparing the skin folds where the diaper doesn’t touch
• Appears red and shiny
• Occasionally may be an allergic reaction to diapers and wipes
• Commonly occurs after 3 months
CANDIDAL INFECTIONS
• Intense “beefy” red rash with sharp borders and red “satellite” bumps beyond the borders
• Will be present within the skin folds
• Often baby will also have “thrush” – a whitish yeast infection in the mouth
ATOPIC DERMATITIS
• Usually not seen before 2 months of age
• The eruptions will ooze and crust
• May be dry, itchy patches on other parts of the body
SEBORRHEIC DERMATITIS
• May be seen as early as 3-4 weeks of age
• Rash begins in folds and extends towards rounded skin surfaces without sharp borders
• Appears as yellowish, greasy, scales and may also be seen on scalp (“cradle cap”), face and behind ears

MORE SERIOUS INFECTIONS – CONTACT DOCTOR IMMEDIATELY

BACTERIAL INFECTION
• Most commonly Staph
• Appears as large fluid filled blisters that easily rupture showing a red base
SCALED SKIN SYNDROME
• Blood born illness
• May see skin rupture and peeling beginning under diaper area
• Quickly spreads and exfoliation occurs on entire body

GENERAL GUIDLINES

Because moisture and friction cause or worsen all forms of diaper rash – keep area dry and free from occlusion.
Change diapers more frequently and expose diapered area to air more often.
Wash area with plain water, sterile saline, or chemical free wipes (calendula soap after bowel movement if necessary).
Wash cloth diapers in mild/hypoallergenic soap.
Avoid rubber pants.
Avoid petroleum jelly, baby (talcum) powder, cornstarch, baking soda, and medicines containing “fluorinated corticosteroids” which have local side effects including skin atrophy.

TREATMENT

Increase water intake if not breast feeding.
Avoid food allergens and sugar in baby’s and nursing mother’s diet.
Several times a day use a topical treatment that includes zinc oxide, or calendula.
See your baby’s doctor if rash does not respond to above guidelines within one week

Resources
1. Dyson N.D., Linda. Pediatric Topics. 2001.
2. Dershewitz M.D. Ambulatory Pediatric Care 3rd Edition.

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Nausea and Vomiting of Pregnancy

February 21, 2008 by Kitchen Table Medicine
Filed under Kitchen Sink, Pregnancy

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Nausea and vomiting are the most common symptoms experienced in early pregnancy.

Nausea affects between 70-85% of women and vomiting affects approximately 50% of women. Although nausea of pregnancy has commonly been referred to as morning sickness, it can actually occur morning, noon, night, or all day long.

Typically, nausea and vomiting of pregnancy starts by 4-6 weeks gestation, peaks at 8-12 weeks and resolves around the 20th week. However, some women experience nausea and/or vomiting throughout their entire pregnancy.

WHY DOES IT OCCUR?

It is not understood why some women experience nausea and/or vomiting during pregnancy, but hormones appear to be involved. Women with high levels of pregnancy hormones tend to develop the symptoms. It is also more common among women who are pregnant with more than one baby.

WILL NAUSEA AND VOMITING HURT MY BABY?

Nausea and vomiting rarely interferes with proper nutrition enough to harm the developing fetus. It may help to know that the high levels of pregnancy hormones that contribute to nausea also suggest a well-implanted embryo. In fact, statistics show that the more nausea a mother has, the more likely she is to deliver a healthy baby. This does not mean, however, that if you don’t feel sick, you won’t have a good outcome. Many mothers coast through pregnancy with a minimum of nausea and have healthy babies.

Less than 1% of pregnant women suffer a severe form of persistent vomiting called hyperemesis gravidarum. In this condition, the body is unable to compensate for the relentless vomiting and the mother becomes dehydrated. If untreated, this severe vomiting can make a woman very sick, which may, in turn, compromise the health of the baby. The following are signs of dehydration. You should call your doctor or midwife if you are experiencing these symptoms:

• The vomiting is not getting better.
• You’re urinating less and your urine appears darker in color.
• Your mouth, eyes, and skin are feeling dry.
• You are feeling increasingly tired, weak and faint.
• You haven’t been able to keep any food or drink down for 24 hours.

RELIEF MEASURES

There are many remedies for nausea and vomiting of pregnancy and it may require some persistence to find what works for you.

• Keep a journal of daily activities and symptoms to help uncover potential triggers (certain foods, smells, etc.) and things that seem to help alleviate the symptoms (sleep, foods, outdoors, etc).
• Eat something before bed and throughout the night when you wake (crackers, dried cereal).
• Start your day by giving yourself time to ease into your day. Sudden transitions often trigger nausea. If you don’t have to awaken at a set time, don’t use an alarm clock or if you must, try awakening to soothing music. If possible, begin your day with a peaceful, enjoyable activity, such as reading, walking, or meditating.
• Snack on nutritious food throughout the day rather than eating only three meals. Six smaller meals are more digestible than 3 large meals. Try this even if you don’t feel like eating at all.
• Try stomach-friendly, comfort foods: smoothies, potatoes, watermelon, rice cakes, grapes, avocado, pickles, applesauce, sorbet, celery or carrot sticks, oatmeal, breads and whole grains.
• Avoid hard-to-digest fried, high fat, spicy foods. Some women also are bothered by onions, sauerkraut, garlic, cabbage, and caffeine-containing beverages such as coffee.
• Try to eat foods that stimulate your liver, which metabolizes the excess hormones. These include green leafy vegetables, beets, artichoke, lemon, and grapefruit. Eat organic foods when possible.
• Make yourself eat even when you don’t want to eat or drink anything. You are likely to feel worse if you don’t eat or drink something due to low blood sugar that can trigger nausea.
• Herbs such as: ginger – available in many forms (fresh, root extract, ground, capsules, tea, crystals, or pickled), mint, chamomile, and red raspberry can be helpful.
• Minimize stress. Stress has been shown to exacerbate nausea of pregnancy.
• Sleep. Pregnant women require more rest (additional 2 hours sleep/night).
• Dress comfortably and wear loose clothing.
• Studies show that wrist acupressure bands, available at pharmacies and marine stores, are effective in reducing nausea in some pregnant women.
• Go outdoors. A change of scenery, some fresh air, even visiting friends or going to a movie may provide a stomach-settling distraction.
• See your doctor or midwife for more information.

Resources
1. Burrow and Duffy Medical Complications in Pregnancy (5th ed). W.B. Saunders Company, Philadelphia, PA 1999.
2. Frye, A Holistic Midwifery: A Comprehensive Textbook for Midwives in Homebirth Practice, Vol.1: Care During Pregnancy (6th ed). Labrys Press, Portland, OR 1998.
3. Jewell D, Young D Interventions for nausea and vomiting in early pregnancy (Cochrane Review). In: The Cochrane Library, Issue 4, 2000, Oxford: Update Software.
4. Koren G, Bishai R Nausea and Vomiting of Pregnancy: State of the Art 2000 (Vol.1). Motherisk 2000, The Hospital for Sick Children, Toronto, Canada, pp.12-200).
5. Lacroix R, Eason E, Melzack R Nausea and vomiting during pregnancy: A prospective study of its frequency, intensity, and patterns of change. American Journal of Obstetrics and Gynecology 2000, 182 (4), pp. 931-7.
6. Murphy P.A. Alternative therapies for nausea and vomiting of pregnancy. Obstetrics and Gynecology 1998, 91(1), pp.149-55.
7. Sears W, Sears M The Pregnancy Book. Little, Brown and Company, USA 1997.
8. Varney H Varney’s Midwifery (3ed). Jones & Bartett Publishers, Sudbury MA 1997.

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BREASTFEEDING: Frequently Asked Questions

February 21, 2008 by Kitchen Table Medicine
Filed under Breast Feeding, Kitchen Sink, Pediatrics

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How do I get my baby to latch onto my breast?

Put baby to breast as soon as possible after the birth. Get into a comfortable, relaxed position. Place baby’s head in crook of your elbow. Bring baby to your breast with the baby’s face and body turned toward you. Tickle middle of baby’s lower lip, wait for him/her to open WIDE. Pull baby closer. Make sure that a large amount of the areola is drawn in the baby’s mouth and that the nipple is centered in the baby’s mouth. Babies take time to learn how to suckle. Be patient and call for breastfeeding support if you need it.

Is my baby getting enough milk?

After your milk comes in (usually 2-3 days after the birth) if your baby has at least 6 wet diapers and 1-5 bowel movements per day your baby is getting enough milk. Breastfed babies need to nurse often (usually 8-18 times per 24 hours). The more often you nurse, the more milk you produce. Nurse each breast at least 10 minutes per feeding as higher calorie milk comes toward the end of breastfeeding. Ask your doctor, midwife, or lactation consultant if you have questions.

Sore and cracked nipples

Correct positioning (nipple centered and most of the areola in baby’s mouth) is the most
important way to prevent sore nipples.
Try a variety of nursing positions.
When done nursing, break suction by inserting a finger in the baby’s mouth before taking baby off the breast.
Offer the baby the least sore breast first as babies nurse more vigorously when very hungry.
Use only water (no soap) to wash nipples.
Express a few drops of breast milk and let it dry on nipples after nursing. Expose nipples to sun (avoiding sunburn) and air as much as possible.
Apply cool, wet black tea bags to nipples between feedings for 10 minutes three times per day.
If nipples are cracked, apply lanolin cream to nipples after feedings (unless allergic to wool)
Call your provider if you have questions.

Sore, engorged breasts

Nurse baby often to relieve breast fullness.
Apply warm, moist cloths on your breasts or take warm shower
Gently massage the breast.
Express some breast milk before you breastfeed if baby is having difficulty latching on due to breast fullness.

Painful lumps in breast, blocked ducts

Apply heat to breast.
Nurse frequently especially on affected breast.
Check baby’s positioning.
Gently massage breast from lump toward nipple.
Drink at least 2 quarts of water per day. Take vitamin C and Echinacea to support immune system to avoid breast infection.
Castor oil pack to breasts can be helpful: Apply castor oil to breast. Cover with plastic wrap.
Apply warm, wet heat for 15-20 minutes. WASH CASTOR OIL OFF WITH BAKING SODA SOLUTION (1 tablespoon baking soda per cup warm water) AFTER TREATMENT SO THAT BABY DOES NOT CONSUME IT.
Get plenty of rest.
Call your provider if develop a fever, redness of the breast, or have concerns.

Breast infection (Breast is red and sore. You may have chills, fever, and/or feel achy, etc.)

CONTINUE NURSING.
Nurse more frequently.
The milk will not hurt your baby.
Check baby’s positioning.
Place warm, moist cloths on your breast.
Rest in bed.
Drink extra liquids.
CALL YOUR HEALTH CARE PROVIDER.

Resources
“Breastfeeding”. La Leche League International.
“Breastfeeding Fact Sheet 5”. Seattle and King County Public Health Department.
“A Woman’s Guide to Breastfeeding”. American Academy of Pediatrics.

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Breastfeeding Support Services

February 21, 2008 by Kitchen Table Medicine
Filed under Breast Feeding, Kitchen Sink, Pediatrics, Pregnancy

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PHONE NUMBERS AND SERVICES

• Healthy Mothers, Healthy Babies: 1-800-322-2588 www.hmhbwa.org A non-profit organization with breastfeeding information, breast pump rental information and referrals to local lactation consultants.
• La Leche League 1-800-LA-LECHE www.lalecheleague.org
•24-hour hotline: 206-522-1336
• Evergreen Hospital Breastfeeding Center’s 24-hour help hotline: 425-899-3494

WEBSITES AND BOOKS

• Breastfeeding Fact Sheets by Seattle and King County Public Health department www.metrokc.gov/health/breastfeeding
• A Woman’s Guide to Breastfeeding by American Academy of Paediatrics www.aap.org
• Motherwear Inc. www.motherwear.com contributes free literature on breastfeeding and positive parenting.
• World Alliance for Breastfeeding Action (WABA) www.elogica.com.br/waba provides information on global standards for appropriate labor/employer practices concerning breastfeeding.
• HealthShare Lactation Service, Inc.www.hsls.com
• Information for employers about implementing a breastfeeding support program:
• Mason, D. Breastfeeding and the Working Mother. 1997. St. Martin’s Press.
• Huggins, K. The Nursing Mother’s Companion. Harvard Common Press, 1995
• Lowman, K. Of Cradles and Career: A Guide to Reshaping Your Job to Include a Baby in Your Life. 1985. La Leche League International. Franklin Park, IL.

BREASTPUMP INFORMATION

• Hollister, Inc.: 1-800-323-4046 www.hollister.com
• Medela, Inc.: 1-800-835-5968 www.medela.com
• White River Concepts, Inc.: 1-800-824-6351 www.whiteriver.com

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Breastfeeding Benefits

February 21, 2008 by Kitchen Table Medicine
Filed under Breast Feeding, Kitchen Sink, Pediatrics, Pregnancy

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The American Academy of Pediatrics recommends 6 months of exclusive breastfeeding (no formula or solid foods) and at least 1 year of breastfeeding.

BENEFITS FOR BABIES

Antibodies are passed from the mother to the baby through breast milk, which provides increased immunity. Breastfed babies have lower rates of the following conditions compared to formula-fed babies: allergies, ear infections, respiratory tract infections, colic, diarrhea, bacterial sepsis, atopic skin disorders, Crohn’s disease, meningitis, ulcerative colitis, vomiting and autoimmune thyroid disease.
Breast milk can prevent asthma. Use of milk, other than breast milk, prior to 4 months of age is associated with increased asthma incidence through 6 years of age.
Breastfed babies have a better immune response to vaccinations than do formula-fed babies in general.
Babies who are breastfed statistically have IQ’s 6-10 points higher and have better vision than formula fed babies.
Breast milk nutrients change throughout the infant’s life to promote optimal brain and body development.
Breastfeeding decreases infant morbidity and hospitalisation rates 10 fold, as well as decreasing the incidence of sudden infant death syndrome (SIDS).
Human milk is protective against childhood obesity. Obese children have a high risk of the following conditions as adults: obesity, high blood pressure, cardiovascular disease, gout, etc.
Increased mother-baby bonding.

BENEFITS FOR MOTHERS

Nursing stimulates uterine contraction, which decreases postpartum bleeding.
Breastfeeding reduces the risk of ovarian cancer and breast cancer.
Breastfeeding builds bone strength reducing your risk of osteoporosis.
Exclusive breastfeeding “on-demand” is a 98% effective form of birth control during the first 6 months postpartum if there is no return of menses during that time. Check with your doctor for more information.
Breastfeeding delays the return of menses.
Mothers return to pre-pregnancy weight faster.
Increased mother-baby bonding.
Breast milk does not need to be prepared, is always available, costs nothing, and is environmentally friendly. (Formula costs between $1300-$3300 during the first year of life.)

CONTRAINDICATIONS FOR BREASTFEEDING

Certain drug use: check with a lactation consultant or your doctor if you are on prescription medications.
Rare hereditary metabolic disorders (i.e. galactosemia)
HIV/AIDS: unless living in a 3rd world country
Other serious maternal or infant illness-refer to lactation consultant

Resources
1. Arora et al. “Major factors influencing breastfeeding rates: mother’s perception of father’s attitude and milk supply” Ped Nov 2000; 106: e67.
2. Oddy, W. “Breastfeeding and Asthma in Children” Adv Exp Med Bio 2000: 393-394.
3. von Kries, R. et al. “Does Breast-feeding Protect Against Childhood Obesity?” Adv Exp Med Bio 2000: 29-39.
4. Walker, M. “A fresh look at the risks of artificial infant feeding” J Hum Lact 1993; 9(2): 97-107.
5. “Breastfeeding Fact Sheet 1”. Seattle and King County Public Health Department.
6. “Consequences of Artificial Feeding”. Evergreen Hospital Medical Center, Basic Course for Lactation Specialists.
7. “Is DHA the secret of breast milk’s success?” Townsend Letter. Nov 1999. 196: 53.
8. “A Woman’s Guide to Breastfeeding”. American Academy of Pediatrics.

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The Natural Approach to Menopause

February 21, 2008 by Kitchen Table Medicine
Filed under Kitchen Sink, Menopause

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Menopause is defined as the cessation of menses (periods) which is caused by the body’s decreased production of sex hormones (estrogen and progesterone). Most women will experience the beginning of menopause between ages 50 and 55, although some women may note changes earlier.

Surgical menopause is caused by removal of the ovaries and uterus.

There are three phases of menopause:

1) The climacteric phase in which the periods become irregular.

2) Actual menopause which is the last menstrual cycle, diagnosed only in retrospect.

3) Post-menopause which begins one year after the cessation of the menses. In this last phase, there may be signs of declining estrogen.

What can you expect?

Please remember that you may have one, some or none of the below symptoms as well as experiences that are not on this list. Factors such as prior health history and fitness levels may affect how you are affected by menopausal changes.

Changes in the menses: heavier or lighter, more or less frequent
Emotional/mood changes: more or less labile, moods may be unpredictable, may be more or less optimistic
Body changes: more or less vaginal discharge, vaginal lining may become drier, skin may become drier, “hot flashes”, headaches, fatigue, weight changes, bone density changes
Infections: may be more disposed to vaginal or urinary tract infections

HORMONE REPLACEMENT

The questions of how to manage problems that arise during your peri- and post-menopausal years and whether or not to take Hormone Replacement Therapy (HRT) are some of the most difficult decisions that a woman will face regarding her health care. Naturopathic physicians have the expertise to make individual assessment of whether or not HRT is necessary. In many cases, they find that it is not necessary to use HRT in the management of menopausal symptoms, or in the prevention of osteoporosis. A naturopathic physician will evaluate your past medical history, current medical problems, medications, and physical exam findings. She or he will also conduct appropriate tests to determine the optimal way to prevent and manage menopausal symptoms.

All of the symptoms brought on by the process of natural physiologic menopause can be prevented or treated with naturopathic therapies. In addition, naturopathic physicians also treat many women who are already taking HRT who are still not feeling well. The addition of naturopathic therapies can make these women more comfortable and often leads to the discontinuation of HRT.

NATUROPATHIC THERAPIES FOR MENOPAUSE

Natural therapies used to decrease and eliminate hot flashes, prevent osteoporosis, and treat other symptoms include:

Nutrition: A special diet to prevent osteoporosis is probably the single most important factor in the management of menopause. A diet that is high in complex carbohydrates, and low in fat, protein, and sugar is generally recommended. In addition, a naturopathic physician can make specific recommendations which tailor this diet to a woman’s other health issues and personal needs.

Nutritional Supplements: The need for mineral, vitamin, or glandular supplementation may be indicated for some menopausal women. Use of these supplements will be determined from the overall evaluation of physical, emotional, and mental health. Naturopathic physicians will take a close look at mineral supplementation such as calcium, magnesium, manganese, and other trace minerals.

Botanicals: There are very specific plant extracts that have the ability to restore normal hormonal balance. Women who have hot flashes or mood changes find that they feel dramatic improvements within 1-2 weeks with the use of plant extracts. A comprehensive plan using other naturopathic approaches is usually incorporated with the use of the herbal medicines.

Homeopathy: Homeopathic medicine is one of the most successful drugless therapies in the treatment of menopausal symptoms. If one has mental/emotional problems including depression, irritability, mood swings, anxiety, anger, etc., homeopathy can offer dramatic relief and stability with no side effects. Homeopathic medicines are made from plant, animal, and mineral substances and are completely drug-free.

Hydrotherapy: The treatment of diseases with water is one of the oldest traditions in naturopathic medicine. Various hydrotherapy treatments improve circulation, reduce blood pressure, and improve sleep and digestion. Naturopathic physicians may also use hydrotherapy treatments to treat women with any chronic disease that becomes worse during the menopausal years.

Physical Medicine & Exercise: In joint and muscle problems in particular, the use of naturopathic manipulation and physical therapy may be important. These recommendations are made on an individual basis. In addition, an exercise program may be part of the treatment program. Naturopathic physicians also offer support for how to carry this out within a busy lifestyle. Weight-bearing exercise is one of the most important components in the prevention of osteoporosis.

Counseling: The menopausal period can often be filled with many changes and self-discovery in ones life. Naturopathic physicians at the Natural Health Clinic can provide referrals to in-house counseling services or elsewhere to assist in this process. Most of the Clinic’s patients find that routine office visits provide them with a great deal of support and insight. Physicians take the time to listen, understand, and help women deal more effectively with their unique situations.

Naturopathic Medicine as a Complement to HRT: There are medical situations where naturopathic physicians recommend a complementary approach to menopause management. In cases where a woman’s ovaries have been removed or damaged surgically, a naturopathic physician would not hesitate to prescribe HRT. In these cases, naturopathic therapies are aimed at reducing the risks of hormone therapy while enhancing overall health and reducing the risks of osteoporosis and heart disease. Naturopathic physicians can also advise women about safer forms of estrogen and overall hormonal balance of estrogen and progesterone.

Know Your Options: We urge you to consult a naturopathic physician regarding your questions and concerns about menopause. Naturopathic physicians have a unique, successful approach to the management of menopause. The Natural Health Clinic is staffed with physicians who are involved in a long-term research using naturopathic therapies in menopause management and can provide you with state-of-the-art treatment. Women deserve to know their options regarding this very normal life process.

Resources
1. Hudson, T. Women’s Encyclopedia of Natural Medicine. Keats Publishing, 1999.

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Prevention and Treatment of Vaginal Infections

February 21, 2008 by Kitchen Table Medicine
Filed under Kitchen Sink, Yeast Infections

3 Comments

Vaginal infections have numerous causes. Many women experience a vaginal discharge, and in many cases it is normal and may vary with the menses cycle or pregnancy.

If there is a change in the discharge, irritation, burning, itching or inflammation, then you should see your physician.

Some women experience cyclical infections, often depending on their stress level or menstrual cycle. Other potential irritants are water, tampons, spermicides, latex and speculums, to name a few.

The frequency and severity of infections can be greatly reduced by education, examination, application of knowledge and observation. It is important to know your body, menstrual cycles and vagina, as well as your cultural, emotional and spiritual views about your sexuality. If there is someone you feel comfortable discussing this with, share your information.

The following are the most common organisms involved with vaginal infections: Candida albicans (yeast), Gardnerella (bacterial vaginosis), and Trichomonas. These organisms respond to different treatments and so it is important to see your doctor to identify which organism is causing the infection and treat it appropriately. The following are general guidelines to prevent and treat vaginal infections.

PREVENTION

Hygiene:

Wear cotton underpants. Avoid nylon underwear since they retain moisture and heat which encourages the growth of bacterial and yeast.
Don’t share washcloths, towels, or bathing suits with others and avoid use of wet or damp towels.
After urination and bowel movements, wipe front to back to avoid anal-vaginal contamination.
Avoid chemicals in your personal hygiene regimen (e.g., harsh soaps, perfumes, commercial douches, scented tampons, vaginal sprays, perfumed or colored toilet paper, bubble bath, etc.).
Don’t douche, especially with commercial douches. Douching has been associated with an increased incidence of pelvic inflammatory disease (PID).
After bathing, pat genital area dry and keep dry.
Take showers instead of baths. Soaps can more easily get into the vagina with baths. The pH of soap and bubble baths are alkaline and the vaginal pH is normally acidic. If you take baths, add a cup of white or apple cider vinegar to the water to maintain the acidity.
Use tampons only during your menses and avoid leaving tampons in the vagina for long periods of time. Tampons left in the vagina encourage the growth of bacteria and yeast and predispose to other serious conditions such as toxic shock syndrome. Change tampons frequently (4-6 times per day) or use a menstrual pad instead.

Diet:

Eat plenty of fresh vegetables and grains.
Avoid sugar, sweets, and refined foods in your diet.
Include ample amounts of vitamins A, B, C, and E in your diet.
Include plain, nonfat yogurt and/or use an acidophilus product after taking antibiotics to maintain healthy GI tract bacteria.

Lifestyle:

Avoid pants that are tight in the crotch. Expose your vagina to fresh air whenever possible such as during sleep.
Make sure your sexual partner is clean or take a shower before and after lovemaking.
Anal-genital intercourse is cautioned against by current public health agencies due to the increased risk of sexually transmitted disease. Vaginal penetration after anal intercourse without first changing the condom or washing of your partner’s genitals/hands can be a significant source of infection.
Use condoms or dental dams during intercourse to avoid transmission of infection between you and your partner.
Make sure you have adequate lubrication for intercourse. Poor lubrication can cause irritation and inflammation which can lead to the growth of bacteria which cause infection.
Avoid vaginal irritants such as unclean diaphragms and cervical caps, aggressive intercourse, and examining instruments.
Find ways to deal with emotional stress and get an adequate amount of sleep. This helps keep ones immune system working well to fight off infection.

SELF-TREATMENT OPTIONS

Boric Acid and Acidophilus Capsules: Fill 5-7 “00″ capsules with boric acid (available at any drug store). Insert one boric acid capsule and two acidophilus capsules into the vagina every night for 5-7 nights. Some women find the boric acid is irritating. Discontinue use of capsules should irritation develop. Do not use boric acid if you may be pregnant. Do not use boric acid capsules for more than seven nights in any month without first consulting a physician.

Yogurt: Apply two tablespoons of unsweetened nonfat yogurt with live lactobacillus cultures into your vagina each night for seven days. Consult your physician if you are pregnant before application of yogurt. Optional: Add 5-6 drops of Hydrastis(Goldenseal) tincture to two tablespoons of yogurt.

Diet: Eliminate foods with high yeast, mold, or fungus content during an infection, e.g. mushrooms, cheese, alcohol, sweets, and bread. Follow dietary guidelines as above.

Garlic: Wrap a un-nicked clove of garlic in cheesecloth or gauze and insert in the vagina for seven nights.

Bath: Prepare a bath using one cup of white vinegar and soak for 10-15 minutes to decrease vaginal pH.

Dryness: Keep genital area dry and expose to air often. You may use a blow dryer on cool setting to dry genital area during infection.

Menstrual pads: Use menstrual pads instead of tampons if you have your menses during an infection. If cloth pads use bleach with washing.

If symptoms persist for more than one week, consult your physician at the Natural Health Clinic.

Resources
1. Hudson, T. Women’s Encyclopedia of Natural Medicine. Keats Publishing, 1999.

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Detoxify Your Home

February 21, 2008 by Kitchen Table Medicine
Filed under Air Pollution, Environmental Medicine, Kitchen Sink

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General Measures

Replacing toxic cleaners and pesticides with natural alternatives is one of the most important things you can do to reduce your toxin exposures.
Leaving shoes at the door can reduce tracked-in lead, dust, and pesticides by a factor of 10-20.
Maintaining good ventilation helps dilute toxins with clean air. Using a central vacuuming apparatus or HEPA vacuum will also help to minimize pollutants in the air.
Temperature should be maintained at 65 F or below to reduce evaporation and concentration of toxic gases.
Similarly, keeping humidity below 50% will reduce evaporation and mite proliferation.
Filtering all public water is a good idea to remove toxic particles, chemicals, and microorganisms.
Full spectrum lights reduce eye-strain and increase UV absorption.
Reducing electromagnetic exposure from leaking microwaves, electric blankets, and other electrical appliances will also keep your toxic exposures down.

Furniture and Toys

Much of the furniture made today is made of composite materials, such as wood chips stuck together with toxin-containing glue and other chemicals. As attractive and useful as they may be, if furniture containing pressboard or plywood is less than a couple of years old, they’re contributing formaldehyde, a carcinogen and the substance used for embalming, into the air you breathe. There is a simple short-term solution: keep your house well ventilated. Also, bring lots of houseplants, especially spider plants, into areas where you have new furniture and carpet.

On the bed, used a spring, foam, or waterbed mattress. Wash sheets with very hot water and dry on the hot cycle to destroy mites. Use a plastic-type enclosed dust mite casing on mattresses, box springs, and pillows. Use hypoallergenic synthetic pillows instead of feather pillows if you are not using the dust mite encasements. Use only washable non-wool blankets. Do not use down comforters.

Floor Coverings

New carpets can be heavy contributors to toxic load, especially if they’re in an area where you spend a lot of time, like your bedroom. As with carpets-furniture, children’s toys, and mattress covers made of plastic also out-gas toxic fumes. Sometimes you can even smell the fumes if you sniff them very closely.

One way to significantly reduce (though not eliminate) their out-gassing is to set them out in strong sunlight for a day or two before bringing them into your home or giving them to your children. Thoroughly washing plastic toys and furniture can also help.

If you’re considering a new carpet and haven’t bought the carpeting yet, investigate the purchase of a natural fiber carpeting or other natural floor coverings. Hardwood flooring finished with a nontoxic coating is attractive, durable and safe. So are tile floors, which are easy to damp-mop and very durable. Area rugs in strategic spots will keep your feet warm and soften noise.

If these alternatives don’t work for you and you’re still convinced you want carpeting, select nylon carpet with jute backing. Better yet are natural carpets made from untreated wool, cotton, sea grass and sisal, with natural latex backing. Also, ask for “rag pad” padding (a standard carpeting industry term), made from recycled rags and polypropylene felt. Have the carpet installed in the summer, when you can leave the windows open more often to let those fumes out when the carpet is newer and more out-gassing is occurring.

If you live in a manufactured home, or a newly built conventional house, you’re probably experiencing a lot of out-gassing from plywood within the walls, the cabinets, as well as under the flooring. Depending on your state of health, and your ability to ventilate your home, you might want to consider a high quality air filter. Make sure furnace and air conditioning filters are replaced regularly.

Resources
1. www.emagazine.com
2. www.detox.org
3. Pearson, David. The Natural House Book. Fireside Pub. 1989.

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Mold: Getting Rid of it in Your Home

February 21, 2008 by Kitchen Table Medicine
Filed under Allergies, Kitchen Sink, Mold/Mildew

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Molds are a diverse group of fungi. Under optimal conditions, with organic matter and water, a single mold spore can germinate and produce a fungal colony with hundreds of thousands of spores in 4 to 9 days. Fungi thrive in the 65% to 85% humidity ranges, though most allergenic molds release their spores during dry conditions of humidity below 70%. People who are allergic to molds may have symptoms that persist for long periods of time, recur several times throughout the year, or are associated with specific environments where molds flourish. Molds are so widespread in nature that total avoidance is quite difficult. There are, however, a number of precautions that can help limit your exposure.

Indoor Considerations

Mildew, for example, is the common name for some of the more common molds that grow rapidly inside the home. Areas where mold flourishes include shower stalls, spoiling food, draperies, wallpaper and its canvas backing, luggage, shoes, gloves, leather goods, damp linens or clothing, and locations where flooding has occurred, especially around leaky toilets, sinks, ceilings, refrigerators or dishwashers. Wood floors, baseboards, closed-up cabins or boats, poorly circulated storage areas, refrigerator drip pans, air conditioners or dehumidifier reservoirs are other common mold sites. Anywhere dust or soil accumulates in the home is likely to provide a suitable area for mold growth. Stuffed furniture, pillows, mattresses, old stuffed toys, wool carpets, stored paper products, stored clothing and bedding are likely to grow mold. Aquariums and indoor plants can also attract mold growth in the home.

Efforts should be made to create at least one allergen-free room in the home. Generally, it should be a bedroom where the mold-sensitive person can spend as much time each day as possible. It is particularly important that furniture covers be made of vinyl or synthetic material. Upholstered furniture, down comforters, stuffed toys, carpeting, and wall hangings should be removed. Hardwood, vinyl, or tile floors are suggested. Dust and soil should be frequently removed with a HEPA vacuum or a wet mop. Air filtration devices and dehumidifiers can help. Central air conditioning and heating generally generate less dampness in the home, as long as filters are cleaned regularly. Mold resistant paints should be used in this room and throughout the home. A small electric light in poorly ventilated areas will help reduce humidity.

There are no safe, long-lasting fungicides for use within the home. Common germicides (Lysol, Tylex) can help kill many indoor molds. Ordinary bleach at 50% to full strength can kill molds (in areas where it won’t destroy furnishings or paint). In severe cases, ozone generators can be used to kill indoor mold during periods while the home is vacant.

Outdoor Consideration

Molds play an important role in the decomposition of organic matter, helping to return vital nutrients to the soil. Because of this factor, mold sensitive individuals should avoid contact with decomposing leaves, grasses and grains. This includes activities such as raking or mowing lawns, handling or harvesting grain, and working around haystacks and feed barns. Travel in rural areas, especially on dry, windy days during or after a harvest should be avoided. Dense vegetation around living and working quarters should be cleared. If exposure to molds cannot be avoided, a facemask should be worn to filter the airborne allergens. Fungicides can be used sparingly outside the home with the expertise of an organic landscaper.

Resources
1. http://www.rileyhospital.org/document.jsp?locid=615
2. http://cgi.cadvision.com/~allergy/mouldavoidance.html
3. http://www.detox.org

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Decreasing Home Pollutants

February 21, 2008 by Kitchen Table Medicine
Filed under Air Pollution, Environmental Medicine, Kitchen Sink

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GENERAL CONSIDERATIONS

How much of your day is spent indoors? Inside your own home? If you’re like most Americans, you spend up to 90 percent of your life in an enclosed, indoor location - and more than half of that inside your own home. Strangely enough, our concern for environmental health doesn’t always translate into a concern for a healthy indoor environment in addition to a healthy outdoor environment.

The overall health of a home is usually affected by not one, but many sources of pollutants. Heat, humidity, and modern-day, energy-efficient construction practices dramatically increase the concentrations of existing pollutants. In an effort to save energy and make our homes energy-efficient, we’ve tightened them up, which means we’re sealing in the indoor pollutants that can make us sick. The good news is that the process of detoxifying your home is simpler than you might think. While larger environmental problems loom all around us, preventing and reducing the risks associated with exposure to pesticides, household cleaners, and other sources of toxic chemicals can be done by anyone, at any time.

Cleaners, polishes, and pesticides are significant sources of toxics in the home. When these must be brought into your home, be sure to use and dispose of them according to directions on the label. Chemicals in cleaners and polishes are often a mixture of complex, unnamed compounds. Some contain strong acids (drain cleaners) or bases (oven cleaners). Others may contain petroleum distillates known as “grease cutters.”

Avoid detergents with mercury, phosphates, and heavy metals, such as arsenic and zinc, which can cause persistent problems in both indoor and outdoor environments. As with personal care products, unless you’ve already made the switch to naturally-derived, nontoxic products for housekeeping, the products you’re using are toxic. Your skin and lungs absorb those toxins.

The next time you run out of one product or another, whether it’s floor cleaner, window cleaner or bathroom cleaner, replace it with something less harmful. The replacement could be something very simple such as white vinegar or baking soda, available at any grocery store.

BATHROOM

For tile and bathroom fixtures, use baking soda dissolved in water, applied on a damp cloth.
For cleaning your toilet bowl, use baking soda and vinegar or lemon juice and borax. Cola that has gone flat can be poured in the bowl, left to sit for one hour, brushed, and flushed.
Pour boiling water directly down your kitchen drain, not into the basin, twice weekly to prevent clogs. Use a drain trap/strainer to catch food or hair.
To clear a clogged drain, use a metal snake or plunger.

KITCHEN

Clean your oven often with baking soda (mix three tablespoons soda with one cup warm water). Rub gently with steel wool. Use oven liners or tinfoil to catch spills. Sprinkle salt on spills while oven is still warm. When the oven cools, scrape and wipe the area clean. Borax is also a good grease cutter.
Mop with one cup of white vinegar mixed with two gallons of water to remove dull, greasy film. Add a small amount of skim milk to the rinse water. This will shine the floor.

LAUNDRY AND FURNITURE

Use dry bleach, borax, or washing soda to whiten clothes. Chlorine bleach gives off toxic fumes that are irritating to the eyes, nose, throat, and lungs. Bleach also burns the skin. Never combine bleach and ammonia together, as they produce a toxic gas.
To clean windows, apply vinegar and water (two teaspoons vinegar to one quart water), squeegee off, and dry with a soft cloth or newspaper.
Club soda works well as a stain remover, as does a solution of water and vinegar (1/4 cup each).
Combining 6 tablespoons of mild soap flakes, 1 pint of boiling water, and 2 teaspoons of household ammonia can make upholstery shampoo. Mix and whip the mixture with a beater. Brush only the foam into the soiled upholstery. Be sure to wash kitchen utensils completely after use.
Polish furniture with one teaspoon lemon oil or almond oil dissolved in one pint of baby oil. Wash wood furniture with oil soap or Castile soap and water.
For spots, use club soda to remove fruit juice, tea, gravy, ketchup, and mud; cold water immediately for blood; lemon juice for ink, and perspiration; beaten egg whites for spots on leather.
Use the oil from crushed walnuts to conceal nicks and scratches.

SHOE AND METAL POLISH

Avoid shoe polishes that contain trichloroethylene, methylene chloride, or nitrobenzene. Instead, rub shoes with lemon juice and buff with soft cloth.
Metal Polish (Aluminum, Brass, Copper, Silver): Soak silver in one quart of boiling water with one teaspoon baking soda or cream of tartar, one teaspoon salt, and a piece of aluminum foil. Polish with toothpaste and rinse. Pour lemon juice or vinegar and salt over copper and rub. For brass, use one-half teaspoon salt and one-half cup white vinegar with enough flour to make a paste — let it sit 25 minutes to 1 hour. Wipe clean. Soak aluminum in one quart boiling water with two teaspoons cream of tartar.

INSECTICIDES

For an effective insect spray, blend six cloves of crushed garlic, one minced onion, one tablespoon dried hot pepper and one teaspoon pure soap in four quarts hot water. Let the mix sit one to two days and then strain it before using.
To control roaches, place bay leaves around cracks in the room. Set out a dish of equal parts baking soda and powdered sugar or equal parts of oatmeal flour and plaster of Paris, or chopped bay leaves and cucumber skins, or crushed tobacco and water.
As for ants, pour a line of cream of tartar, red chili powder, paprika, or dried peppermint leaves at point of entry.
To control fleas, give your pets brewer’s yeast, garlic tablets, or vitamin B and wash them regularly in herbal baths prepared with fennel, rue, or rosemary to repel fleas from animals.
Cedar chips, newspaper, and dried lavender are good substitutes for mothballs.

Resources
www.anr.state.vt.us/ecosolutions
www.detox.org
Pearson, David. The Natural House Book. Fireside Publishers. 1989.

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Kegel Exercises

February 21, 2008 by Kitchen Table Medicine
Filed under Kegels, Kitchen Sink

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Doing ”Kegel” exercises to strengthen the pelvic floor is a simple way to prevent and treat many unpleasant conditions…

Stress incontinence

There are muscle fibers which form a sphincter mechanism around the base of the bladder enabling the bladder to retain urine even when it is full. When the muscle is voluntarily relaxed urine is allowed to be released, while voluntary contraction stops the flow.

If the integrity of these muscle fibers is compromised from being traumatized, stretched, or torn during childbirth, such things as sneezing, coughing, or laughing can result in a dribble or even a gush of urine which cannot be controlled.

This is known as stress incontinence. The exercises increase muscle volume that will increase the degree that the urethra closes against downward pressure. This will increase your ability to consciously contract the pelvic floor when necessary (as with a sneeze, cough, or lifting). The overall health of the pelvic muscles is improved due to an increase in blood flow to the area.

Tonify muscles of the pelvic floor following childbirth

There are muscles known as the pelvic floor or pelvic sling which support the organs in the pelvis. They often become stretched during childbirth. Maintaining muscle tone helps hold the organs in place.

Aid in repair of cystocele or rectocele

A cystocele is the term used when the bladder herniates or pouches out into the vagina following tissue injury. A rectocele is a similar condition involving the rectum rather than the bladder. The exercises may actually change the shape of the vagina and decrease degree of organ prolapse.

Increase sexual pleasure and strengthen orgasm

Kegel exercises have been advocated for the improvement of sexual relations between couples because they improve the ability of the vaginal sphincter to contract. The vaginal sphincter is responsible for the clasping action of the vagina around the penis during intercourse as well as being a muscle involved in the orgasm.

HOW TO DO KEGELS

Kegels can be done anywhere and anytime - - standing, sitting or lying down. The action of the exercise is to contract the muscle in the pelvic region.

Quick Squeeze and Release Exercise
It will feel as though you are trying to draw the vagina and the anus up into the pelvis. Hold for a couple of seconds. Repeat 50 to 100 times a day. They can be divided into several sets to be done throughout the day, or done all at once. In addition, whenever voiding, the flow of urine should be stopped and started several times. This will strengthen the muscle at the neck of the bladder thereby preventing the leakage of urine. Avoid the use of the stomach, leg or buttocks muscles. Do not hold your breath.
Slow Holding Exercise
Another variation of the exercise is to tighten or contract the muscles you identified previously in a gradual manner, a small amount at a time to the tightest possible. Hold the maximal contraction for up to 10 seconds. (Initially you may not be able to hold the muscle contracted for the full count. As your muscle becomes stronger, you will gradually be able to increase the count.) Now slowly relax the muscle for a count of 5-10 seconds. It is just as important to relax and give the muscle a rest.
Advanced Variation
After you have gained control, try tightening the muscles from front to back slowly, including the anus, and hold for up to 10 seconds. Remember to release them slowly as well.

WHEN WILL I NOTICE THE CHANGE?

After two weeks, the pelvic muscles will become stronger.
After four to six weeks of consistent daily exercise, you will notice fewer urinary accidents.
After three to six months you will see even more improvement.

Resources
1. Nygaard et al. “Efficacy of pelvic floor muscle exercises in women with stress, urge and mixed urinary incontinence”. Am J Obstetric Gynecology; Jan 1996: 120.
2. Wyman et al. “Comparative efficacy of behavioral interventions in the management of female urinary incontinence. Am J Obstetric Gynecology; Oct 1998: 999.

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Kegel Exercises for Men

February 20, 2008 by Kitchen Table Medicine
Filed under Kegels, Kitchen Sink

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PURPOSE

This exercise is for strengthening the muscles around the pelvic floor and for increasing the ability to contract and relax these muscles completely. Kegel exercises can help to ease discomfort associated with impotency and will help train the muscles to relax and assist optimally with expulsion of semen. In other words, well-conditioned muscles will help the body perform better and more reliably during intercourse and improve bladder control.

The Kegel exercises train the pelvic floor muscles which form a firm base for the bladder and bowel. The muscles of the pelvic floor form a figure “8” as they are slung in loops around the scrotum and urethral sphincters. The larger half of the figure “8” surrounds the urethral opening while the smaller half which usually has more muscle tone surrounds the anal opening and is usually held tightly closed except during elimination. The large sphincter is controlled by the same muscle action that occurs during ejaculation. This ring of muscle is also significant in female sexual response as constriction achieves firmer contact with the penis. A bonus to doing Kegel exercises is that your sex life may improve as the muscles improve in strength and thickness.

During sports activities, pelvic muscles are not usually used. Even if general fitness is excellent, one must consciously exercise pelvic floor muscles to maintain tone.

PRACTICE

To get the feel of the muscles (while using the toilet) alternately start and stop urinating. Practice this by a tightening and releasing action while sitting, (i.e., while watching TV), standing, walking, driving, etc. No one will even know you are doing them.

EXERCISE

Do these exercises 3 times per day, i.e., morning, afternoon and evening. Start with repetitions of 5 and of 10 each, gradually working up to 20-30 repetitions.
Tighten the muscles gradually a small amount at a time to the tightest possible. Hold the maximal contraction for up to 10 seconds, then release very slowly.
After you have gained control, try tightening the muscles from front to back slowly including the anus. Remember to release them slowly as well.

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