Families First of Loudoun

Beyond the Bishop Score

Since the 1960′s, the Bishop Score has been a frequently used predictor in assessing feasibility of induction of labor. This scoring system attempts to predict the success of induction by assessing five factors: position of the cervix in relation to the vagina, cervical consistency, dilation, effacement and station of the presenting part. The higher the score, the higher rate of success of the induction. A score less than five indicates an unfavorable cervix for induction. Some texts also reference the Burnett Scale* which assesses approximately the same factors.

In an effort to find a more accurate predictor of successful induction, two relatively new methods are now being used: transvaginal sonography of the cervix and comparative levels of fetal fibronectin.

The length of the cervix can be measured by transvaginal sonography. In expectant mothers with an unfavorable Bishop score (typically less than 7), a cervical length of less than 26 mm is associated with a lower risk of cesarean section and a shorter duration of labor. In several independent studies, when the Bishop score has been as low as 3 and the cervical length was 28 mm, successful induction has been achieved.

To measure the cervical length, an expectant mother goes to an office or radiology department of the hospital. It is an outpatient procedure, where the mother’s bladder is empty and she wears a hospital gown. A transducer (roughly the size of a tampon) is used to transmit ultrasound/ sound waves, which bounce back to produce an image that can be recorded. The transducer is inserted into the vagina and the image is noted on the monitor or it can be printed. This information is reported back to the physician for evaluation.

Fetal fibronectin is a protein that can be found in fetal membranes and amniotic fluid. When present in cervical and vaginal secretions, fetal fibronectin can be useful in determining a woman’s risk for preterm labor and may be predictive in estimating when the mother is ready for labor.

The test for fetal fibronectin is simple and painless, involving only the swabbing of the vaginal and cervical area for a sample of secretions.

It is important to note that expectant mothers showing signs of preterm labor should be tested at 24 to 25 weeks’ gestation, while high-risk women without symptoms can be tested as early as 22 weeks’ gestation and continually tested as appropriate.

Is there, then, a relationship between cervical length, fetal fibronectin and the increase of oxytocin receptor sites on the uterus? We will be anxiously awaiting research on this!

From Birthsource.com

Oiling Your Joints

Sometimes, as you start to move, you feel aches and pain you didn’t expect.

This may be especially common after sitting or standing for long periods of time. Here are some tips to follow to loosen up the joints. Always remember to come and get a spinal tune-up. Our clinic is conveniently located in Leesburg. You don’t have to live with neck or back pain.

Muscles and ligaments are sort of like playdoh, they are both elastic and plastic. This means that our ligaments are stretchable (elastic), but also stay in the position that they are in for long periods of time (plastic). When you’re in pain the lower back ligaments become irritated.

They lose their elasticity, but still maintain their plasticity.When you try and stand up after sitting, your ligaments and muscles don’t want to stretch. In order to help them stretch and regain their elasticity,you must first regain low back motion. Pelvic tilts and hula hoops will help regain motion in the lower back.

Do the following to avoid pain upon standing:
While still sitting, do a few pelvic tilts. First arch your lower back, then tuck your tailbone under (flatten your arch). Be careful when arching as this may increase your pain. Only stay in the pain free range of motion. Notice as you’re tucking your tailbone, that you’re contracting the muscles in your buttocks. Furthermore, notice that as you tuck, you’re also using your abdominal muscles. Arch and flatten your lower back three times. On the third time, tuck your tailbone (flatten the arch) and hold it. Put your hands on your thighs and stand up slowly.

Holiday Stress Relief

Happy Holidays!

There are few phrases in the English language that can inspire such joy and stress at the same time. How can you cope?

Here are some facts and tips:
Over the holidays be mindful of what you eat and drink, as well as both how fast and how much you consume. Though your liver can process alcohol, and though exercise and New Year’s diets can help pay for Holiday sins, you’re better off limiting decisions that will make the battle tougher later on. Try a little pace in your Holiday frenzy, and reap the rewards.

Holidays can bring financial stress, family stress, even physical stresses as we hang decorations and clean and cook. These stresses can make us achy, grumpy, or worse. Mental stress not only can make us irritable, it can also make us sick. In one study of medical students, exam time clearly correlated to decreased immune function. i Another study ii showed that high “job strain” increases heart attack rates FOUR TIMES over those with lower job strain. This is equal to the elevated risk of smoking or high cholesterol.

Mark Twain once said, “I am an old man and have known a great many troubles, but most of them have never happened.”

Worry is one of the great enemies of an otherwise tranquil spirit. Buddhist spiritual traditions refer to “mindfulness,” defined as “the development of nonjudgmental awareness of thoughts and feelings.” iii Published studies, as well as anecdotal evidence, suggests the effectiveness of mindfulness meditation strategies. iv,v,vi Rather than being the helpless victim of seemingly ingrained reactions to seasonal stresses and family dynamics, individuals may benefit from
learning to recognize their feelings as real (I feel a tightness in my shoulders, I’m not breathing as deeply as I do when I’m experiencing happiness, there’s a feeling in my chest like a tightness or blockage) yet transient (“this too shall pass”) human experiences. By experiencing the emotions non-judgmentally we may come to value them as part of life,
rather than as forces that control our ongoing capacity for happiness.

Wise doctors will recommend exercise to combat stress, depression, and anxiety. Exercise is a very powerful tool that not only protects your heart and blood vessels, it also protects your brain and is a natural mood elevator. The American College of Sports Medicine recommends regular exercise as a part of a healthy lifestyle vii (see box).

Doctors of chiropractic are far more than neck and back doctors. They focus on function, on quality of life, and on the nervous system’s role in guiding optimal health and well-being. A well-balanced frame and nervous system affects your entire day, and life. What may seem like a subtle modification to your frame or lifestyle may literally save your life by preventing
a fall, a hip fracture, or the more subtle and insidious stress and/or chemically-mediated diseases of the heart, brain, and other major organs.

As partners in your exercise plan, doctors of chiropractic are uniquely trained to help you live and exercise, safely. That’s “good medicine” for your entire body, and your spirit too.
For more information about health and well-being, give us a call.

Guidelines for Healthy Adults Under Age 65
Moderately intense cardio 30 minutes a day, 5 days a week;
OR vigorously intense cardio 20 minutes a day, 3 days a week;
AND 8 to 10 strength-training exercises, 8-12 repetitions of each exercise, twice a week.

Guidelines for Adults Over Age 65 (Or Adults 50-64 with Chronic Conditions Such as Arthritis)
Moderately intense aerobic exercise 30 minutes a day, 5 days a week;
OR vigorously intense aerobic exercise 20 minutes a day, 3 days a week;
AND 8 to 10 strength-training exercises, 10-15 repetitions of each exercise, 2-3 times per week;
AND if you are at risk of falling, perform balance exercises;
AND have a physical activity plan.

References:
i Kiecolt-Glaser JK. Brain Behav Immun 1999; 13:61-72. ii Karasek R, et al, Am J of Public Health 1981; 71:694-705. iii Bowen, 2006, as cited at http://clearinghouse.missouriwestern.edu/manuscripts/863.asp. iv http://www.acsm.org/AM/Template.cfm? v http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7XMX-4JWMSF2-4&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221& _version=1&_urlVersion=0&_userid=10&md5=239b9068104bfe1ac33fb2b78c1d6665. vi http://www.springerlink.com/content
/vv02132w61118887/. vii http://www.acsm.org/AM/Template.cfm?Section=Home_Page&TEMPLATE=/CM/HTMLDisplay.cfm&CONTENTID=7764.

How Chiropractic Care Can Help Prevent Falls 

Every year, people injure themselves needlessly in slip-and-fall accidents. One million adults over age 25 will be injured in falls at home this year.1 In serious cases, a fall can cause long-term disability or even death. What can we do to protect ourselves, our parents, and our families?

Here are some facts and tips, courtesy of the Virginia Chiropractic Association. Be proactive. Do a survey, whether it’s for your office, your home, or a loved one’s home.

Safety strategies include: 

• Beware mats and rugs on hard surfaces. Be sure to put a non-slip surface beneath any stepping surface that may otherwise slip.
• In the bathroom, be especially aware (and see the above tip on carpets and mats). Deaths in the bathroom exceed those due to handgun accidents.2 If safety “grab bars” are present, check them (or have them checked) periodically for stability.
• Secure electrical cords. Be sure cords are out of the way when possible, and secure them when re-routing is not an option. Consider hiring an electrician if necessary; or make a simple trip to the hardware store for a conduit strip that mounts to the floor, safely.
• Mind toys and pets. Be sure kids clean up after themselves. If you have pets, walk with care.
• Take an extra moment on the stairs… especially the top and bottom one.

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Are You a Stomach Sleeper?

How many of you sleep on your stomach? I hope none of you! Sleeping on your
stomach causes increased lower back pain and neck pain. The correct sleeping position is on your back with a pillow under your knees. Another great sleeping position is on your side with a pillow either in between your knees or next to you to support that top knee. This way, you keep your hips aligned! Always remember to keep your spine in a neutral position even while you’re sleeping.

- Dr. Misty Paul

What’s Your Posture Number?

In our effort to better one’s posture, the first step must be to explain where the deficiencies are.  There is now a new posture assessment tool that does just that!  By taking a few pictures of you, we can show you how your posture is and determine your posture number.  Once we know where the problem is, we can work as a team to strengthen the weaker areas.

Consider getting a posture assessment done. Basics First Chiropractic is now offering this new service in our clinic.

- Dr. Misty Paul

How Cryotherapy and Contrast Therapy Can Help Arthritis

Over 20 million Americans suffer from arthritis and arthritis-related disability. But what is arthritis? And how can we protect ourselves? Here are some tips.

“Arth” refers to joints, the places where bones meet and typically move. “Itis” refers to inflammation. “Arthritis” means inflammation of joints. There are two main categories of arthritis: Systemic, which includes rheumatoid arthritis; and “wear-and-tear” or osteoarthritis. Systemic arthritis is often an autoimmune disorder with the body attacking tissues surrounding the joints. Osteoarthritis is the result of microtrauma (daily wear that adds up over the years) and macrotrauma (such as falls, car accidents, and sports injuries).

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Spring: Hydration, Warm-up, and the Right Tools

Spring! It’s a time for new life, new activities, and treasured pastimes… but it’s also a time when many of us injure ourselves doing the things we love. How can you enjoy your favorite activities, while minimizing your risks for aches, pains, sprains, and strains? Here are some tips.

Most of us haven’t mowed the lawn, planted bulbs, or gone for a bicycle ride during the winter months. Jumping back into these activities carries risks (see insert). Starting a lawn mower or weed whacker can stress the back and shoul­ders, putting you out of commission for days, weeks, or longer. As satisfying as gardening is, kneeling and pulling and dig­ging for hours on end can stress muscles and the spine in ways it hasn’t seen since last year; and you’ll be very unhappy the next day if you overdo it. Furthermore, those sunny and warm days may have you excited about your new fitness routine, but too many of us will jump in headfirst and pay the price. There’s a better way, and your doctor of chiropractic is here to help guide you into the wonders of Spring (and beyond).

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Six Tips for Enjoying Sports Activities Safely

People of all ages enjoy physical activity. The benefits of sport are many; yet aches, pains, and injuries are the risk. Recreational athletes, power walkers, competitive football players, runners, dancers, and others all are likely to face injury risk. How can you minimize your down-time so that you can enjoy all the healthy activities you and your family enjoy? Here are some facts and tips.

The highest injury rates tend to appear in contact, competitive sports. Rugby and lacrosse, for example, result in approximately 30 injuries per 1000 hours of participation. On the other end of the spectrum, walking results in approximately 2 injuries per 1000 hours.ⁱ Running appears somewhere between the two extremes at 11 injuries per thousand hours. Since many runners are internally or exter­nally competitive, and since runners contact the ground with 3-5 times body weight as force with each stride, perhaps their injury rate is not surprising despite the lack of violent contact with other participants.

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Posture (Mom Was Right!)

Sit up straight! Your mother or grandmother may have repeated this to you when you were younger. As it turns out, she had a valid point. How can you keep from looking like a hunched-over grandma or grandpa, before your time? How can you reap the health benefits of good posture? Here are some facts and tips.

When folded up in the womb, we’re shaped like the letter “C.” This is the Read the rest of this entry »