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Ready, Set, Rest a Thon!

Have you ever been in a situation where you just had to survive, not think or feel or enjoy—just make it through? This was my experience with Motherhood.

I had always wanted to be a mother. I read all the books, took all the natural parenting classes, achieved my labor and delivery goals, and then I was given this precious, screaming newborn.
But he just kept screaming, and screaming, and screaming. I knew something was wrong. Nothing soothed him. He cried in pain 22 out of 24 hours per day, he never slept, he couldn’t eat. Everything was put on the backburner to solve this problem. It took me 10 months to solve it. 10 months of pure survival-mode hell. I have very few memories of this time. It’s been blacked out.

And as life goes, things improved, but it was not sunshine and roses. Mothering life was very, very hard. And then I was pregnant with baby #2, achieved another dream labor and delivery, and was ready for a second chance to enjoy motherhood. And this next baby cried and cried and cried. Thankfully I solved the problem in 2 months. But this baby required very intense bodywork and occupational therapy and physical therapy and feeding therapy. To nurse her required me to sit up vertical 3x per night… for 21 months. I remember more of this time, yet I was still operating in survival mode daily.

And then I got a severe case of the shingles. Life was getting very good at kicking me when I was down. Doctors would say, “You must be extremely stressed to trigger the shingles.” And I would say, “Doc, this is the least stressed and most-rested I have been in 3 years.” I began having flashbacks of my firstborn’s year that would send me into a tailspin. I would take my children to the park and lay on a towel in the sun because I was physically too exhausted to sit up or push them on the swing or play chase. Why now? Why was I having PTSD and illnesses and intense fatigue now? I had survived the hard part. Now should be better, not worse.

As many mothers have done before me, I put everyone’s needs ahead of my own for too long. My energy tank was blinking Empty. Any little self care effort I made was too little, too late. If your car is on Empty and you put in a ½ gallon, you are not getting far before you break down again.

fuel-tank-empty

Fight or Flight vs Rest and Repair

Your body’s nervous system operates in two modes: Sympathetic and Parasympathetic.stressvs.calm-image
Your Sympathetic Nervous System is responsible for perceiving threats and responding to stimuli. It is your Fight or Flight response. It triggers adrenaline, cortisol, and many other tools to get the body to act. This works well if you wander upon a grizzly during a hike in the woods. However, modern day stressors (work deadlines, schedules, To Do lists, social media political debates, parenting obligations, etc) are keeping us trapped in SNS far too often.

fightflight2

“Its biological opposite is the parasympathetic system of nerves. This is the “rest and digest” system. When parasympathetic activity dominates, healing and regeneration occur. The body performs activities like digesting, detoxifying, eliminating, and building immunity (article).” 18033313_10110816359311051_4317099980779400499_n

To rest we must put our screens away and just surrender. It could be swinging in a hammock, planting a garden, yoga, prayer, meditation, journaling, or sleep. “Sleeping is one way that your body recovers from damage and protects itself against illness,” says Michael Twery, PhD, director of the National Center on Sleep Disorders Research for the National Heart Lung and Blood Institute (article). I hadn’t slept in 4 years. I was beginning to understand what was occurring.

My chiropractor’s office had a sign “If you listen to your body whisper, you won’t have to hear it scream.” How can I listen better to my body? How can I rest and repair?

My sage friend, Kim Rowe, runs Healing Collectives to target such challenges. Her course focuses on returning to the feminine by learning to surrender, flow, create healthy boundaries, and listen to your body. During her bout with Lyme disease, she took a week off at home to just Be. This sparked the idea that I was in desperate need of a Rest a Thon! I told my sister about this idea and she became my Accountability Buddy to ensure that I made it happen. Sometimes we need a swift kick in the pants to remind us to remove the obstacles we are putting in our own way. AccountabiliBuddies are great for this.

butt-kick

 

My Rest a Thon

18118515_10110816360039591_7452656633071604035_n
I went away for 2 days to just be with my own thoughts. No obligations or things I should be doing. I only focused on myself. I didn’t allow thoughts of work or other real world demands to invade my space. I released ideas of guilt or what others might think of this. I thought about the things I had been burying and avoiding a long time. I didn’t trim, tweeze, or shower. I made everything simple.
Here was what I did all day. Each item took about one hour.

  • awake, lying in bed
  • made breakfast and ate by the pool
  • sat on a rock and stretched
  • laid on a raft in the pool
  • selected trees to set up hammock
  • read book in the hammock
  • phone call with Mom
  • made lunch and ate by the pool
  • laid in recliner by the pool
  • did yoga and guided meditation by the pond
  • laid on raft and read book in the pool
  • laid in the hammock and journaled, no deer tonight
  • made dinner and ate by pool, a baby fawn joined me!
  • shower, face mask, and Yoni egg
  • hand and foot massage during a movie
  • went to sleep early

18033104_10110783986401621_3548724363678178646_n

I filled up my tank. I rested and repaired and boosted my immunity.

This was my Rest a Thon. This was the location, and time, and way that my body would receive rest. And I had to advocate for it. I had to help my wonderfully, supportive husband understand why this Rest was absolutely necessary, and how this rest did not reflect on him as a husband, father, and person also needing rest. This was about Me and my needs. When we put our own needs last for a long time, our support team may need some time and conversation to help them adjust to the change. The people closest to us generally want to do right by us. We just need to show them how. No one was going to gift me a Rest a Thon no matter how much I thought I deserved it. I am an adult, I suddenly realized I didn’t need anyone’s permission or blessing to create this for myself. I felt selfish, and it felt damn good.

Your Rest a Thon may look very different. In fact, it should. We are all individuals.

This is not a new concept that Mothers burn out, Mothers need a break. But perhaps putting these stories out in the open will allow a new normal, that mothers take more breaks before they reach breaking point.
Jennifer Tow, IBCLC, focuses her work on the principle ‘Heal the Mother, Heal the Baby.’ Imagine how much more our children will get from us when we take the time to address our needs and prioritize our health.

My Rest a Thon was appropriately timed because I returned home to my husband and sweet children. Later that night, my son began vomiting and fever, and my husband left for a 24 hour shift. This is life. But now I was prepared. I was rested. I was able to mother him with kindness and gentleness instead of being sent into a Fight or Flight response.

My goal is not to frequently need a Rest a Thon. My goal is to regularly keep my tank filled up with consistent self care. If there are major events that require deeper healing and rest, then I know that a Rest a Thon is a wonderful way to top off my tank. I will keep it in my Self Care toolbox.
Happy Healing!

Treatment Options for Ear Infections: A Least Invasive to Most Invasive Approach

Ear infections (otitis media) are all too common among the pediatric population. And what is the status quo treatment? You probably didn’t even have to think twice on that answer. Antibiotics. There are different treatments of course, but antibiotics are the most common prescription for an ear infection. Why?
Antibiotics have been proven to have negative effects on our gut health due to their focus to destroy ALL bacteria, not just the bad bugs. And they are very effective at their job. Once they have kicked your ear infection to the curb, your gut is ready to rebuild with new bacteria. Bad gut bacteria are more than willing to step up and replenish the gut with bacteria that will feed a host of pathogens, fungi, and bacterial infections if not rebalanced by good bacteria. Maybe your gut will easily replenish the good-to-bad bacteria ratio. If you’re taking a high quality probiotic, avoiding processed foods, and getting plenty of direct sunlight daily, then your gut is likely headed to balance. If not, antibiotics have opened the door to a host of major issues. The CDC explains the issue,
“Ear infections will often get better on their own without antibiotic treatment.”
“Taking antibiotics when they are not needed can be harmful, and may lead to unwanted side effects like diarrhea, rashes, nausea, and stomach pain. More severe side effects may rarely occur; these include life-threatening allergic reactions, kidney toxicity, and severe skin reactions.”
“Each time you or your child takes an antibiotic, the bacteria that normally live in your body (on the skin, in the intestine, in the mouth and nose, etc.) are more likely to become resistant to antibiotics.”

pro-vs-anti-biotics

What’s a parent of a child with an ear infection to do?
Here is a hierarchy of treatments for Ear Infections. I am a parent, not a medical professional. Take any information learned here to your provider to create an individualized plan for your child that better reflects your wishes to use antibiotics as a last resort.

1. Prevention.
Well that seems simple and maybe irritating advice. Parents are thinking, “Don’t you think if I knew how to prevent ear infections I would?!” Well, have you tried these evidence-based otitis media preventers?
Risk factors: exposure to second hand smoke, bottle fed instead of breastfed, poor nutrition and wellness habits.

Mother nursing son

So, breastfeeding baby, keeping baby’s diet as organic and whole-food-based (i.e. not squeezy pouches), and avoiding exposures to well known toxins such as smoke will give you the leg up to maintaining baby’s wellness. Vitamin supplementation and probiotics have also been found to provide overall health benefit and reduce ear infection occurrences.

2. Treatment Options
The following have evidence-based literature to support their use in successful treatment of otitis media.
Homeopathy (This article can help you determine which remedy fits)
Osteopathic/Chiropractic manipulations
Xylitol
Probiotics
Acupuncture
Naturopathy

tug-in-ear So finding a good Bodyworker that will adjust your child at the first signs of ear tugging has research-proven benefits. Ask other parents which Alternative Medicine providers treat children regularly in your area.

More tried-and-true treatment options to look into:

onionwoman02Garlic Mullein Oil (excellent ear infection discussion and garlic Mullein info here)
Onion over the ear
Hydrogen Peroxide solution (sometimes referred to as Swimmer’s Ear– *for specific types of ear infections*)
Essential Oils (This article discusses which oils based on the research)
Colloidal Silver
Nambudripad Allergy Elimination Technique (NAET)

3. Managing Ear Pain
For a parent of a child with an ear infection, pain management is crucial because baby is miserable.

ear infection
“Treatment of the ear pain early in the course of [Acute Otitis Media] decreases both parental anxiety and the child’s discomfort and accelerates the healing process.”
This study concluded, “that in cases of ear pain caused by AOM in children in which active treatment, besides a simple 2- to 3-day waiting period, is needed, an herbal extract solution may be beneficial.” They found that the group randomly assigned to naturopathic ear drops had better pain management and resolution than the group assigned anesthetic ear drops with amoxicillin.
The Naturopathic Herbal Extract Ear Drops they used in their double-blind study contained “allium sativum, verbascum thapsus, calendula flores, hypericum perfoliatum, lavender, and vitamin E in olive oil. 5 drops 3 times daily.”
Other pain management options include essential oils, homeopathy, bodywork, and Garlic Mullein Oil.

4. Chronic Ear Infections
This beast deserves its own separate article. Please read Curing Recurrent Ear Infections to learn more.
An excerpt… “I keep treating my child, but their ear infections continue to reoccur.” The number one question that I believe gets missed too frequently and is critical to stopping chronic ear infections is: Why?
Your provider does a great job of identifying the ‘What’ –type and severity of ear illness. This article gives you resources to tackle ‘How’ to treat. But figuring out the ‘Why’ is going to require detective work on your part.
Chronic ear infections are caused by two things:
• structural abnormalities (i.e. babies with Down Syndrome or other genetic disorders have small ear structures that may be inverted and poorly move fluid out)
• environmental triggers that create inflammation resulting in increased fluid
Common environmental triggers include foods, pet dander, secondhand smoke exposure, and any other things that cause an increase in your individual body’s inflammatory response. An Audiologist and/or ENT would be the professional to diagnose structural abnormalities as a potential cause of recurrent ear infections.

 

“But my Pediatrician is strongly urging me to go with the antibiotics, what should I do?”

I can’t tell you what is best for your child, but this article can help you identify resources to give you confidence in your decision-making. Because it is ultimately your decision.
Does your child meet the *now stricter* guidelines set forth by the American Academy of Pediatrics to properly diagnose otitis media and avoid antibiotic overuse?
“The [2013 revised] guideline provides a specific, stringent definition of AOM [Acute Otitis Media]. It addresses pain management, initial observation versus antibiotic treatment, appropriate choices of antibiotic agents, and preventive measures.”
Additionally, “The American Academy of Otolaryngology-Head and Neck Surgery guidelines recommend topical medications as the first line of treatment for ear pain in the absence of systemic infection or serious underlying disease.”
Are you aware of the risks versus benefits of choosing antibiotics. I will repeat the CDC’s position statement:

“Ear infections will often get better on their own without antibiotic treatment.”
“Taking antibiotics when they are not needed can be harmful, and may lead to unwanted side effects like diarrhea, rashes, nausea, and stomach pain. More severe side effects may rarely occur; these include life-threatening allergic reactions, kidney toxicity, and severe skin reactions.”
“Each time you or your child takes an antibiotic, the bacteria that normally live in your body (on the skin, in the intestine, in the mouth and nose, etc.) are more likely to become resistant to antibiotics.”

Have you exhausted this hierarchy of treatment options?
Does your child show signs of a serious infection or illness that the ear infection is a part of?
The next step is Trust Your Doctor. You have followed the current best practice guidelines for ear infection treatment. Feel confident that you have done everything in your power to use antibiotics as a last resort. Some of you may get to the end of the list and need antibiotics. That’s what they were created for. Let them do their job, and feel confident and optimistic that you can replenish your child’s gut with good probiotic bacteria during and after antibiotics use.

Happy Healing!

Curing Recurrent Ear Infections

“I keep treating my child, but their ear infections continue to reoccur.”

The number one question that I believe gets missed too frequently and is critical to stopping chronic ear infections is: Why?
Your provider does a great job of identifying the ‘What’ –type and severity of ear illness. This article provides resources to tackle ‘How’ to treat, but figuring out the ‘Why’ is going to require detective work on your part.
Chronic ear infections are caused by two things:
•structural abnormalities (i.e. babies with Down Syndrome or other genetic disorders have small ear structures that may be inverted and poorly move fluid out)
•environmental triggers that create inflammation resulting in increased fluid
I am going to discuss environmental triggers. An Audiologist and/or ENT would be the professional to diagnose structural abnormalities as a potential cause of recurrent ear infections.
But how can a food allergy cause an ear infection?
Inflammation.
Eating an offending food will create inflammation in the body. One way inflammation is expressed is an increase of fluid and congestion. This can look like recurrent ear infections, puffy eyes, frequent runny nose, allergic shiners under eyes, excess phlegm, etc. snot bubble

“The middle and inner ear are immunologically responsive and this includes responsiveness to food hypersensitivities. Both chronic otitis media with effusion and Meniere’s disease can improve with treatment of food allergies.” ¹ Other common signs of inflammation include eczema, rashes, and asthma. Symptoms sounding familiar?
In a study that looked at the association between recurrent otitis media with effusion and its association to food allergies, “the most common food found to be associated was milk, egg, beans, citrus, and tomato.”²  They removed the food(s) for a few weeks; symptoms resolved. They added the suspected offending foods back in; symptoms returned. This practice is commonly referred to as an Elimination Diet.
So Milk and Eggs are top causes of recurrent ear infections in this study. They are also on the Top 8 Food Allergens list for the world.

topeight  Allergy to milk is THE most common food allergen in the entire world! This is not rare. So, why aren’t parents being advised to eliminate milk for 30 days as a Least Invasive, evidence-based approach to chronic otitis media?

This is how I observe it usually play out…
Ear infections begin around age 1. Round(s) of antibiotics resolves. Next month, new ear infection occurs. Repeat same antibiotics treatment. Following month, same thing again. Professional assures you that if it happens again your child is a candidate for PE Tubes (Do they expect us to start cheering?). Next month, guess what? Yep, ear infection again. PE Tube surgery is scheduled and completed under general anesthesia. You are relieved that this is over… Unless you have one of the thousands of children that go on to have continued drainage issues sometimes resulting in the surgically-placed tube falling out. No problem. They will surgically put the tube right back in under general anesthesia. Repeat the cycle of most invasive, symptom-focused treatment…
This story is far too common. As an early interventionist and a Hearing Specialist I can tell you that this same story is told to me monthly. Every time I ask the parent, “What did the professional say is CAUSING the ear infections?” ***crickets***
“They never talked about a cause…”

So I begin asking basic, non-medical questions.

Me: You said ear infections began monthly around age 1. What else changed around age 1?
Parent: I can’t think of anything. She wasn’t in daycare yet, no illnesses.
Me: What did she eat or drink around that time?
Parent: We switched her over from Breastmilk/formula to cow’s milk after her 12 month checkup. **ding ding ding**
Me: Does anyone in the family have food reactions?
Parent: Well I am lactose intolerant, but she hasn’t showed any negative reactions to dairy thankfully.

And this is the problem. Intelligent, well-intentioned, loving parents have ZERO clue that the #1 Allergen in the whole wide world can CAUSE ear infections. And they are led on a journey of pharmaceutical and surgical interventions, many times without any discussion of there being a  cheap, easy, and less invasive solution for the vast majority. And all the literature that clearly demonstrates the association is never discussed even with high risk families such as parents with a history of food intolerances.

Here is what I wish would occur…
12 month check up:
Pediatrician: Many kids start cow’s milk at age 1. Do you or anyone in your immediate family have a history of food allergies/intolerances, eczema, allergies, or asthma?
Parent: Yes, I am lactose intolerant, have asthma and allergies. My other child has eczema and allergies.
Ped: Well, dairy is the #1 Allergen and with your family history you may want to either wait to introduce dairy or observe for the following signs that a reaction is occurring…

Ear Infection Appointment:pediatrician-2
Pediatrician: Here is a list of Ear Infection treatment options. If there are no signs of other infections in the body, let’s pursue a Least Invasive to Most Invasive approach. This means we will save antibiotics as a last resort.

 

Recurrent Ear Infection Appointment:
Pediatrician: What new foods or environmental triggers has your child been exposed to?
Let’s try 6 weeks of an Elimination Diet of the Top Allergens to see if food is a factor. Let’s also review the treatment options so we can pursue a Least Invasive to Most Invasive treatment path. Read my other article, Treatment Options for Ear Infections: A Least Invasive to Most Invasive Approach.

I used examples citing cow’s milk as the culprit because it is the most common. However, any food can cause an inflammatory response. We are all individuals with individual responses. There are a variety of ways to identify food culprits. To read about Why and How to do an Elimination Diet to identify food triggers read Dr. Axe’s article.
Remember to assess your child’s environment for other environmental triggers as well. The Top 6 Environmental Allergies list.
Check products that you put on your child by using an app like Skin Deep to see the Environmental Working Group’s toxicity rating on skin products, foods, cleaning products, and more.

The most important focus of this article is empowering parents to ask Why questions and Cause questions. These are the questions that will Heal Our Little Ones.

  1. The role of food allergy in otolaryngology disorders. Ramakrishnan, JB. Curr Opin Otolaryngol Head Neck Surg. 2010 Jun;18(3):195-9. http://www.ncbi.nlm.nih.gov/pubmed/20168232?log$=activity
  2.  Recurrent otitis media with effusion and food allergy in pediatric patients.  Arroyave CM. Rev Alerg Mex. 2001 Sep-Oct;48(5):141-4. http://www.ncbi.nlm.nih.gov/pubmed/11759256

The Autism Intensive – Expert Interview Series

38 functional medicine experts expose the latest science about the gut microbiome, immunity, and methylation.
The Autism Intensive

And be sure to check out Dr. Thomas’ newly released book for additional tips on keeping your family healthy and protected.
The Vaccine-Friendly Plan: Dr. Paul’s Safe and Effective Approach to Immunity and Health-from Pregnancy Through Your Child’s Teen Years

5 Days in the NICU – A Mother’s Perspective

Greetings.

I recently received an Obstetrics Unit Survey inquiring about my experiences during a maternity stay with your hospital last month.  My personal care was largely pleasant and a significant improvement over my experience delivering my daughter at another local hospital.  However, it was my experiences during my son’s time in the nursery that have prompted me to write you this letter.

My son was born on 7/14/2016 12:10pm at 38 weeks gestation, and soon indicated signs of oxygen insufficiency.  The cord was quickly cut and he was whisked over to the exam cart, where he was put on oxygen.  Soon after, he was taken to the nursery with my husband following closely behind.  I joined the 2 of them in the nursery and learned that a chest X-ray had revealed nothing conclusive regarding the source of his oxygen problems, and they had put him on 2 intravenous, broad-spectrum, prophylactic antibiotics due to concerns regarding my 36-hour ruptured membrane, while awaiting the additional results of a 48 hour culture.

I expressed deep concern regarding the administration of any antibiotic, unless absolutely necessary.  I informed them that I was well aware of the infection risks associated with my ruptured membrane and took special care to mitigate the risks by limiting exams, etc.  However, my pleas went unheard and the intravenous antibiotics were continued.  It was explained to me that if his symptoms were the result of an infection, the 48 hour culture result window could prove too late to administer them effectively.  And since conventional medicine does not acknowledge the inherent risks of antibiotic administration, it is seen as a harmless preventative measure.

Please refer to the following PubMed references.

I spent nearly every waking moment at my son’s bedside during the 5 days he was in your care, and I overheard an explanation similar to ours conveyed to virtually every parent – that of the necessity of prophylactic antibiotics for their infant, regardless of the circumstances.  While I appreciate your fervor in proactively treating a potential infection, antibiotics are hardly innocuous and pose potential chronic, long-term health consequences that we arguably do not yet fully understand – especially when administered early in life.  (Incidentally, all of my son’s tests regarding an infection were negative.)

There were a number of other concerns I witnessed in relation to the care of infants in the nursery, which compelled me to spend every moment I could with my son and to personally introduce myself to the nurse who would be caring for him during their 12 hour shift, as well as the NP and neonatal MD currently on staff.  Suffice it to say that the level of care and attention he received varied greatly, depending on the individual assigned to him and their current workload.

My son was successfully taken off of oxygen the same day he was born, but kept in the nursery an additional 4 days while being weaned off of the IV and then treated for minor jaundice.  We have learned based on studies of babies born via C-section vs. vaginally that an infant’s early microbial environment strongly influences their subsequent intestinal colonization.  Such studies have also demonstrated the preferential species of Mom’s, Dad’s, and their home’s native bacterial diversity over that of a hospital environment (especially in cases where antibiotic administration has destroyed the colonization received during birth).  Consequently, I would expect an infant to be released to go home as soon as it is deemed safe, especially if Mom has already been discharged.  However, my experience did not reflect that standard and I witnessed another mother have a heated discussion with the NP and neonatal MD regarding the discharge of her daughter from the nursery.  Ultimately, your staff conceded and allowed the parents to take their infant home as requested.

In your effort to achieve a truly ‘Baby Friendly‘ status, I would advise you to thoroughly evaluate the likelihood of an infection and the associated risks of antibiotic administration before deciding on a course of action, and release an infant once the critical health issues are resolved.  In addition, you might explore opportunities for additional individuals to help with feeding and soothing the infants, in circumstances where the nurses are too overwhelmed to do an effective job on their own.

I appreciate your time and attention regarding these matters, and you are welcome to contact me via this email address or telephone at XXX-XXX-XXXX if you would like to discuss them further.

Warmly,

-Tracy Sterling

A Reflux Revelation

Gastroesophageal Reflux Disease (GERD)

  • Sixty percent of the adult population will experience some type of gastroesophageal reflux disease (GERD) within a 12 month period and 20 to 30 percent will have weekly symptoms. 1
  • Approximately seven million people in the United States have some symptoms of GERD. 2
  • In 2004, approximately 20 percent of the United States population reported reflux symptoms that occurred at least weekly. 3
  • Primary or secondary GERD diagnosis increased by an unprecedented 216 percent or from a total of 995,402 individuals diagnosed in 1998 to 3,141,965 in 2005. 4
  • Children with GERD symptoms who were hospitalized with a primary GERD diagnosis increased by 42 percent in infants and 84 percent in children between the ages of two and 17. 5
  • There are approximately 64.6 million prescriptions written for GERD medications in the United States on an annual basis. 6
  • It is estimated that worldwide, approximately 5 to 7 percent of the total population has symptoms of GERD, which is most commonly reported as heartburn that occurs on a daily or frequent basis. 7

gutinflammation
Ask the average person what they think causes heartburn, and they will probably tell you it’s stomach acid. While largely unproven, this conclusion has been widely accepted and likely derived from the ‘burning’ sensation, and success with treatment using proton pump inhibiting (PPI) medications like Nexium, Prevacid, and Prilosec. PPI medications reduce gastric acid by blocking the gastric pump of stomach parietal cells, so one would naturally assume the reduction in acid is to credit for the relief in our associated ‘burning’ GERD symptoms.

However, what most people don’t realize, is that PPI medications can also serve as powerful anti-inflammatories. 8 In fact, a published study review concluded that PPI medications potentially have beneficial effects in any number of inflammatory diseases, gastrointestinal or extra-intestinal, in which acid has no role, and a positive clinical response to PPIs should not be interpreted as proof of an underlying acid-peptic disorder. 9 The review goes on to suggest that patients may be mistaking their symptom improvement on PPI medications as acid reduction, when in fact it is a reduction of inflammation within their gastrointestinal tract. 10

And there is further compelling evidence bringing into question the presumed etiology of GERD, from a recent study done on 12 patients being treated with PPI’s for their reflux esophagitis. 11The study concludes that the damage done to each patient’s esophagus was not caused by stomach acid, but by an inflammatory immune response. 12

So, let’s review: For some of us, the pain we know as ‘heartburn’ potentially has nothing to do with the gastric acids produced by the stomach, and instead is the result of immune inflammation and aggravation within the upper gastrointestinal tract/esophagus. PPI medications are anti-inflammatories so they are potentially reducing the inflammation, thereby eliminating the associated pain. Sounds like the perfect treatment solution, right?

That is, until you consider the risk of side effects – especially with long term use of PPI medications. Adequate stomach acid is a necessary and relevant part of the metabolic process, and there are adverse consequences to habitually reducing/eliminating it. PPI use has been linked to the predisposal of certain infectious diseases, dementia, kidney disease, heart attacks, stroke, vitamin deficiencies, bone fractures, and gut dysbiosis – just to name a few. 13 14

But there is an alternative option: Determine what is triggering the immune inflammation in your GI tract and eliminate it. It will cost you nothing, except some time and effort, there is no risk of any adverse side effects, and you may end up eliminating other cryptic inflammatory symptoms you did not even realize were associated to the exposure.

My advice? Start by removing some of the top allergen offenders from your diet one at a time, and see if you notice a difference in your GERD symptoms. And start paying attention to what you’ve been exposed to recently when your symptoms are at their worst. Did you suffer with heartburn all night after eating a bowl of ice cream? That should raise dairy up to the top of your suspect list. With time and practice, your allergen detective skills will improve, but try to keep it simple initially. And bear in mind that there may be multiple allergens contributing to your symptoms, and the sources may potentially include environmental triggers (lotions, detergents, soaps, pollen, cat dander, etc.), in addition to food or medication.

InfantGERDThere is another chapter to this story we have not yet explored: Infant gastrointestinal reflux disease, and this is where things become slightly more complicated. There is no question that the use of PPI medications in infants and young children is skyrocketing. One large study of about 1 million infants revealed prescriptions for one of the PPIs, made in a child-friendly liquid, rose 16-fold between 1999 and 2004. In addition, there was an overall 7-fold increase in prescriptions for PPIs for infants, and of the prescriptions written for children under 1, about half of those were for infants younger than 4 months of age. 15

But – what exactly are we treating our infants for, with PPI medications? The clinical symptoms associated with infant GERD (depending on who you ask), can range from excessive/inconsolable crying, frequent vomiting/spit up, trouble latching and swallowing, loss of appetite, failure to thrive, diarrhea, blood/mucous in stool, gas, constipation, etc. Those hardly seem like a list of symptoms that can all be attributed to acid ‘burns’ resulting from regurgitation, and not all babies with GERD symptoms regurgitate (a condition known as ‘silent reflux’).

Not surprisingly, there is mounting evidence demonstrating that a wide range of gastrointestinal pain, motility and oral motor dysfunction symptoms, including those listed above, can all be attributed to various stages of gastrointestinal immune aggravation and inflammation. 16 17 18 19 20 21

In addition, there is plenty of evidence to suggest that identifying and eliminating food and environmental sensitivities is as effective as medications for treating gastrointestinal immune inflammation symptoms in children (with one particular study indicating cow’s dairy, soy, and wheat at the top of the list of offenders). 22 23 24

A few pointers regarding identifying and eliminating allergens in infants and young children.

  • You may find that most pediatricians will focus on cow dairy as the sole problematic component, and recommend a partially hydrolyzed (hypoallergenic) or fully hydrolyzed (super hypoallergenic/elemental) infant formula. However, nearly all powder infant formulas use corn as a sweetener so you may inadvertently end up replacing one potential allergen with another.
  • Given the extensive list of ingredients on the average can of infant formula these days, you will probably find a trial and error elimination of allergens from a breastfeeding mother’s diet to be easier and more accurate. (Not to mention, you get the added benefit of the immune modulating properties inherently found in breastmilk to potentially help battle the underlying hyper-immune conditions). 25 26 27
  • Research has demonstrated that gastrointestinal immune inflammation and activation can contribute to dysphagia (trouble swallowing), neuro-muscular dysfunction, intestinal motor abnormalities, and GI dysmotility. 28 29 Consequently, you may find that seemingly unrelated issues with latching, nursing, and the bowels may magically improve and/or resolve once the underlying immune inflammation is addressed.
  • Infant and young children’s metabolism is much faster than an adult’s, so you will typically see clinical improvement quickly once you identify and removing the offending allergen(s).

Allergen Sensitivity

  • According to the American Academy of Allergy, Asthma & Immunology, sensitization rates to one or more common allergens among school aged children are currently approaching 40%-50% worldwide.
  • One in five people in the U.S. currently have allergy or asthma symptoms.
  • 55% of Americans test positive to one or more allergens.

But for all our efforts to subdue the villainous stomach acid, the statistics are not getting any better. But perhaps that’s because we have been chasing the wrong villain. We know that This study, published just last month, strongly suggests that acid is not the underlying cause for the ‘burn’ in heartburn. Instead, an inflammatory immune response is. That’s right – your undiscovered dairy, gluten, corn, egg, or soy sensitivity may be entirely to blame for those pesky GERD symptoms you have been popping Nexium to treat. 30

But that does bring up an interesting point, if acid is not causing the burn then why are PPI (Proton Pump Inhibitor) medications like Nexium, Prevacid, and Prilosec so effective at treating the symptoms? We know that PPI’s reduce gastric acid by blocking the gastric pump of stomach parietal cells, so we would naturally assume the reduction in acid is to credit for the relief in our associated ‘burning’ GERD symptoms. However, it turns out that PPI medications have another, more relevant function in this scenario.

Recent research has demonstrated that PPIs also serve as powerful anti-inflammatories, independent from their function of blocking acid production. A published study review concluded PPI medications potentially have beneficial effects in any number of inflammatory diseases, gastrointestinal or extra-intestinal, in which acid has no role, and a positive clinical response to PPIs should not be interpreted as proof of an underlying acid-peptic disorder. 31

Notes:

  1. Gastroesophageal Reflux Disease (GERD) Hospitalizations in 1998 and 2005 – HCUP-US Home Page. Retrieved March 5, 2012, from: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb44.jsp
  2. Gastroesophageal Reflux Disease (GERD). (n.d.). Office of Medical Informatics – College of Medicine – University of Florida. Retrieved March 5, 2012, from: http://medinfo.ufl.edu/~gec/coa1/gerdfaq.html
  3. Digestive Diseases Statistics for the United States – National Digestive Diseases Information Clearninghouse. (n.d.). Home – National Digestive Diseases Information Clearninghouse. Retrieved March 5, 2012, from: http://digestive.niddk.nih.gov/statistics/statistics.aspx#specific
  4. Gastroesophageal Reflux Disease (GERD) Hospitalizations in 1998 and 2005 – HCUP-US Home Page. Retrieved March 5, 2012, from: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb44.jsp
  5. Gastroesophageal Reflux Disease (GERD) Hospitalizations in 1998 and 2005 – HCUP-US Home Page. Retrieved March 5, 2012, from: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb44.jsp
  6. Gastroesophageal Reflux Disease (GERD) Hospitalizations in 1998 and 2005 – HCUP-US Home Page. Retrieved March 5, 2012, from: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb44.jsp
  7. GERD Costs America Nearly $2 Billion Each Week in Lost Productivity – International Foundation for Functional Gastrointenstinal Disorders. Retrieved March 5, 2012, from: http://www.iffgd.org/site/news-events/press-releases/2005-1125-gerd-costs
  8. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3035917
  9. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3035917
  10. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3035917
  11. http://jama.jamanetwork.com/article.aspx?articleid=2521970
  12. http://jama.jamanetwork.com/article.aspx?articleid=2521970
  13. http://www.webmd.com/heartburn-gerd/news/20160608/proton-pump-inhibitor-health-risks
  14. http://www.webmd.com/heartburn-gerd/news/20141125/could-popular-heartburn-drugs-upset-your-good-gut-bugs
  15. http://www.livescience.com/16636-acid-reflux-drugs-overused-babies.html
  16. http://www.ncbi.nlm.nih.gov/pubmed/26022877
  17. http://www.ncbi.nlm.nih.gov/pubmed/17053446
  18. http://www.ncbi.nlm.nih.gov/pubmed/18713339
  19. http://www.ncbi.nlm.nih.gov/pubmed/25808260
  20. http://www.ncbi.nlm.nih.gov/pubmed/25845555
  21. http://www.ncbi.nlm.nih.gov/pubmed/26194403
  22. http://www.ncbi.nlm.nih.gov/pubmed/26022877
  23. http://www.ncbi.nlm.nih.gov/pubmed/25808260
  24. http://www.ncbi.nlm.nih.gov/pubmed/25845555
  25. http://www.ncbi.nlm.nih.gov/pubmed/27183772
  26. http://www.ncbi.nlm.nih.gov/pubmed/20485331
  27. http://www.ncbi.nlm.nih.gov/pubmed/21444329
  28. http://www.ncbi.nlm.nih.gov/pubmed/18713339
  29. http://www.ncbi.nlm.nih.gov/pubmed/26194403
  30. http://www.ncbi.nlm.nih.gov/pubmed/26022877
  31. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3035917

Healing My Kiddo – Lessons from the Field

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  1. You are not alone. While traveling for work a few months ago, I sat next to a mom and her 11 year old daughter. They were headed to a children’s hospital for some experimental surgery, hopeful that it would help her daughter walk as she was losing more and more movement with each passing week. Over the course of the hour and a half flight, we discussed her daughter’s history, medical mysteries, the challenges, the heartaches, the successes. I shared some of my own with my daughter, and what had worked for us. We exchanged numbers and she texted me shortly after parting ways that there had been a mix-up and they were going to have to wait for the next hotel shuttle. I immediately offered come back to the airport and give them a ride to the hotel in my rental. She insisted they would be fine, but thanked me profusely for my unexpected kindness.
    I have met a lot of parents via social media and some in real life that are on a similar journey of healing their children, and I have found that there is almost always an instant, unspoken bond between us. We are rarely at the same places in our journeys and may have strong differing opinions on certain topics, but I will still vigilantly assist and defend this virtual stranger simply because I know how much it means to them. It is strange and amazing, like 2 veterans who have witnessed the same horrors that others simply cannot relate to or understand. Many of us have little to offer in the way of assistance except to share our collective wisdom and support in the form of our words, so that’s what we do. I would not wish our experiences on my worst enemy but I have found an unexpected comfort in the knowledge that at any given moment, thousands of other parents and caretakers are out there fighting alongside me in this epic battle.
  2. Take care of yourself. The truth is that I’m not a person who handles adversity well, I’m more of a ‘fixer’. If there is a problem, I don’t tolerate it – I ‘fix’ it. Perhaps that’s why software engineering is such a good vocational fit for me. I remember at one point early on my husband said to me, “Tracy, you cannot debug an infant the way you debug a computer program.” (He was partially correct.)
    At any rate, I must have had at least a dozen or so different people say these exact words to me, “Remember to take care of yourself”. I always nodded enthusiastically, but internally I thought to myself, “Oh, I will – just as soon as I get my kid’s health problems worked out!” But that’s not how this process works, it’s a journey. You will cross the finish line a thousand times and never at all. In the words of Amy Yasko – it’s a marathon, not a sprint and you will make it farther if you recognize and honor your needs along the way.
    Don’t get me wrong, there have been periods during my daughter’s life that did not afford any ‘me time’, when we were simply doing everything we could to survive until the next day. But it does get easier, you will find a rhythm amid the chaos and those are the times when you need to fill up your own bucket. I used to think I was being selfish when I did so; how can I possibly go work out or sit and meditate when my child is physically hurting herself?! But that’s just it, I have more patience and tolerance for the terrorizing realities if I take some time to care for me, and I find it easier to recognize and appreciate those precious, happy moments. (Not to mention, I have had some of my greatest ‘AHA!’ moments regarding my daughter’s conditions while meditating or praying.)
  3. Every child is unique. As a parent, when you have those breakthrough moments with a treatment, I think it’s natural to want to scream from the mountaintops that you’ve ‘finally found the answer!’ What I have learned, is that the answers for my child are not necessarily the answers for other children. There are countless variables that effect how and why a child (or person) arrived at this exact point in their health. (I believe ‘Bio-Individuality’ is the current buzz word of choice.) It is a perfect storm that you could not possibly duplicate, even if you tried. I’m not even certain that our own ‘breakthrough’ treatments would have been as profound, had they not occurred after the other treatments we had already implemented and at the time we tried them.
    I think it is our instinct to want to help every single parent and heal every child we encounter, but it’s important to remember that everyone is at a different place in their journey and we are all dealing with our own unique struggles at any given time. I try to remind myself that even a gentle and subtle suggestion might plant a seed that will blossom when the time is right.
  4. Keep a log. If there was one single piece of clinical advice I could give parents, it would be to keep a log for their child (and even themselves). Our environmental and food allergy testing has come a long way, but my guess is that it’s still only in the 70-80% range of accuracy – at best. And there are no labs to account for chemical sensitivies, occurring in individuals with metabolic or detoxification shortcomings. The single best way to determine one’s tolerance to anything is through trial and error. (Dave Asprey calls it ‘Bio Hacking’ oneself in his book “The Bulletproof Diet”.) Our daughter’s log consists of a spreadsheet that I’ve modified as she’s grown and currently accounts for her daily food, supplements, and any behavioral or physical anomalies (extreme hyperactivity, rashes, extreme defiance, fussiness, sleep troubles, diarrhea/constipation, etc.)
    I don’t know how we could possibly have unraveled some of the medical mysteries about my daughter without that log. For example, we discovered she cannot tolerate purines. Purines are a natural food chemical found in large amounts in certain foods such as liver and cauliflower. Her symptoms of purine intolerance are largely behavioral in nature, which makes it particularly difficult to identify vs a consistent physical symptom such as a rash or stomach upset.
    I would wager to guess that virtually everyone is battling with at least one unknown environmental, food, or chemical sensitivity – contributing any number of symptoms.
  5. Ask for help. Some of us are excellent at recognizing and communicating when we are in need of assistance, I am not one of those individuals. To be honest, I never really needed much help before – not like this anyway.
    I inadvertently stumbled onto a mother’s blog early on in this journey (one of many). She had a young, teenage daughter who suffered with severe ASD, and the child often became physically violent with her. Her husband worked long hours, and she was responsible for caring for her daughter along with their other children. Aside from sharing her own story via her blog, she participated heavily in a grass-roots community effort to help other parents in similar situations navigate the state and health insurance paperwork and get the medical and financial assistance they so desperately needed. The last post on her blog was written by a dear friend, asking readers for support to help the family in their time of greatest need. She went onto explain that the mother was in prison after trying to take her own life and that of her daughter’s by lighting a charcoal grill in an enclosed vehicle with the 2 of them. Both were found, survived, and treated for smoke inhalation.
    I remember sobbing for weeks, every time I thought of that poor woman and her daughter. Even now, I cannot help but tear up. Caring for a seriously ill child will take EVERYTHING out of you. The stress, the sleep deprivation, and the trauma are enough to turn even the most hardened individuals inside out. Know your limits, and honor them. When it gets to be too much, screw your pride and ask anyone and everyone for relief. I found that the help was rarely where I expected it to be, but it was there nonetheless.

With Peace & Love,
~Tracy