Month: November 2018

Key terms:
Labor Induction - stimulating uterine contractions before they start naturally to achieve a vaginal birth
Castor Oil - a naturally produced oil from the Ricinus communis plant; traditionally used by midwives as an agent for the induction of labor

Is castor oil a safe and effective way to induce labor?

Induction of labor is commonly used when there are threats to mother or fetus and when carrying post-due date but should only be done under the direction of your physician whether it be done by medical or non-medical methods (Acharya, T., Devkota, R., Bhattarai, B., & Acharya, R., 2017). You have probably heard a family member talk about using castor oil to help induce labor and how awful it tastes. There are many things that were used in past times that may not be considered safe and/or effective now. How do you know if castor oil is safe or effective? Do not trust online sources without credible sources or a medical background.

Here is an example of an online resource on this subject that would not be a credible source…

What do we know about Castor oil?

• It tastes horrible
• It is a smooth muscle relaxer causing diarrhea, abdominal cramping, and possibly nausea and vomiting
• Can add discomfort to the labor process
• There is limited research on the effectiveness of inducing labor (Gilad, R., Hochner, H., Savitsky, B., Porat, S., & Hochner-Celnikier, D., 2018).
• Kozhimannil, Johnson, Attanasio, Gjerdingen, and McGovern (2013) claim that there is no proven effectiveness with castor oil and suggest potential maternal and neonatal harm
• Most of our knowledge on this subject is by the personal accounts of maternal “experiences”

Should you try using castor oil to induce labor?

Labor induction should be decided upon with consultation from the appropriate medical professional. Contact your physician to discuss when the induction of labor is recommended and safe, ways to induce, and if home remedies such as castor oil are recommended.

References

Acharya, T., Devkota, R., Bhattarai, B., & Acharya, R. (2017). Outcome of misoprostol and oxytocin in induction of labour. SAGE Open Medicine. https://doi.org/10.1177/2050312117700809

Gilad, R., Hochner, H., Savitsky, B., Porat, S., & Hochner-Celnikier, D. (2018). Castor oil for induction of labor in post-date pregnancies: A randomized controlled trial. Women and Birth,31(1). doi:10.1016/j.wombi.2017.06.010

Kozhimannil, K., Johnson, P., Attanasio, L., Gjerdingen, D., & McGovern, P. (2013). Use of nonmedical methods of labor induction and pain management among U.S. women. Birth (Berkeley, Calif.), 40(4), 227-36.

Medical Marijuana and Cannabis is becoming more accepted and researched in health care: FACT

Medical marijuana, or cannabis, has had a recent increase in interest with large acceptance from medical professionals and the public. The U.S. Food and Drug Administration (FDA) has approved medications made from cannabis but not the use of the whole unprocessed plant.

Marijuana and cannabis contains two main components, tetrahydrocannabinol (THC) and little to no Cannabidiol (CBD). THC is the psychoactive element of cannabis while CBD is known to have no psychoactive effects and contributes to a healing feeling.

Physicians want to apply the same rules and logic to marijuana as they do to any other emerging treatment.

The Medical Use of Marijuana: Issues and Indications

Marijuana is Still Largely Illegal: FACT 

The Controlled Substances Act of 1970 banned medical marijuana as a Schedule I drug with no accepted medical use and a high potential for abuse.

The form of marijuana that is sold illegally contains a high amount of tetrahydrocannabinol (THC) and little to no Cannabidiol (CBD) while marijuana approved for clinical studies has more CBD and less THC. THC and CBD are two separate components of marijuana and cannabis.

In states where it has been legalized, physicians can only recommend rather than prescribe it because of its current Schedule I classification.

Reclassification of marijuana as a less-dangerous drug or allowing its legalization for medicinal use would make it possible for:

• Further research to refine marijuana’s safety
• Clinical use indications
• Prescribing guidelines for different conditions
• Conform to the ethical principle of patient access to all treatment options that have the potential to be beneficial

My Body Produces it’s Own Cannabinoid Chemicals: FACT

The body produces its own cannabinoid chemicals, also known as endocannabinoids. Cannabinoid chemicals consist of a group of closely related compounds that include cannabinol and the active components of cannabis. These play roles in regulating:

• pleasure
• appetite
• pain
• memory
• thinking
• concentration
• movement
• coordination
• sensory and time perception

Marijuana and Cannabis Will Hurt My Body: FICTION

Marijuana and the lung: hysteria or cause for concern?

Marijuana has proven positive affects on the mind including euphoria (a feeling of intense excitement and happiness) and relaxation. Though it is unknown why, cannabis smoking is unlikely to be harmful to the lungs in low doses, does not produce chronic obstructive pulmonary disease (COPD), and does not appear to have the potential to cause cancer (Ribeiro & Ind 2018, p. 199). Good news for marijuana users, right?

Not so fast, with chronic marijuana smoking does come an increase in respiratory symptoms such as cough, mucus production, and wheezing. This suggests that cannabis smoke can cause chronic bronchitis in current smokers but not shortness of breath or airway damage beyond repair.

Marijuana Can Only be Smoked: FICTION

While smoking marijuana is the most common form of ingestion, THC is available orally as well as edible CBD gummies or foods and oils. It can also be vaporized, ingested using chewing gum, drank, or used in a topical solution.

Medical Marijuana is Only Used for Epilepsy: FICTION

The most accepted uses for medical marijuana include

• Post-traumatic stress disorder (PTSD)
• Chronic pain
• Spasticity in multiple sclerosis (MS)
• Parkinson’s disease
• Gastrointestinal disorders
• Metabolic syndrome
• Epilepsy syndromes such as seizures
• Chemotherapy-induced nausea and vomiting

Dating back to the 1970’s research showed that marijuana decreased the high intraocular pressure (IOP) characteristic of primary wide-angle glaucoma, a disease of the optic nerve that can lead to vision loss. However, it is not recommended by the American Glaucoma Society to treat glaucoma.

Amyotrophic lateral sclerosis (ALS) is a progressive nervous system disease that destroys nerve cells and ends up causing total disability. Data suggests that cannabis has neuroprotective effects that can extend neuronal-cell survival, delay the onset, and evens slow progression of ALS.

Cannabis also demonstrates a significant analgesic effect that relieves pain making it beneficial to those with chronic or severe pain.

The majority of both past and current marijuana users with gastrointestinal disorders such as inflammatory bowel disease (IBD) reported that marijuana was “very helpful” in the relief of their symptoms of abdominal pain, diarrhea, and nausea. In an observational study on the effects of cannabis on 30 patients with Crohn’s disease, a chronic IBD that affects the lining of one’s digestive tract, 21 subjetcs had a significant reduction of symptoms after being treated with cannabis. After the treatment, there was also a reduced need for other medications and surgeries related to the Crohn’s disease (Horowitz 2014, p. 322-324).

An analysis of data from a national sample also showed a significant association between current marijuana use and lower blood levels of insulin and insulin resistance in adults with metabolic syndrome.

PTSD is a disorder causing a person to have difficulty recovering after experiencing or witnessing a terrifying event or series of events. A study was conducted on 10 patients with PTSD, ultimately noting that 5mg of oral THC twice a day, as an add-on treatment, provided significant decreases in symptom severity, improvements in sleep, and a decrease in the frequency of nightmares.

Only anticonvulsant medications will help control epileptic seizures: FICTION

Medical Marijuana for Epilepsy?

Both CBD and THC are reported to have anticonvulsant properties. Cannabis has therapeutic benefits for both stimulated and unstimulated  seizures in those with epilepsy. It is also shown to diminish neuronal over-excitability and decrease seizure frequency and severity. In animal models, it additionally improved the spasticity and tremors of MS and Huntington’s disease as well.

One case in particular that became known around the country was the effect medical marijuana had on a little girl named Charlotte who was diagnosed with epilepsy at age two. Charlotte had intractable Dravet syndrome epilepsy and the use of a certain type of marijuana, now known as Charlotte’s Web, decreased her seizures contributing to the popularity of medical marijuana. This caused particular interest in derivatives of cannabis to be used as a treatment in epilepsy, regardless of the lack of proven evidence for safety or effectiveness.

There is evidence on a completed study with 8 normal volunteers and 15 patients with generalized epilepsy and the benefits it had on their symptoms. During phase one, eight normal volunteers were given CBD or placebo for 30 days. A placebo is a substance or drug that has no therapeutic effect and is used as a control in testing new medications and effects. The second phase consisted of randomized subjects with epilepsy blindly receiving CBD or placebo for 135 days. During which, they continued their previously prescribed anticonvulsant medications.  At the end of both phases of the study, those given CBD had the following results; four subjects with epilepsy claimed to be almost seizure free, three experienced decreased frequency of partial seizures, and one remained unchanged (Kolikonda, Srinivasan, Enja, Sagi, & Lippmann 2016, p. 24-25).

Although there is research supporting the effectiveness of medical marijuana by specialists, it is important to remember it remains an unapproved therapy in epilepsy.

https://www.drugabuse.gov/publications/drugfacts/marijuana-medicine

References

Horowitz, S. (2014). The Medical Use of Marijuana: Issues and Indications. Alternative & Complementary Therapies, 20(6), 320–327.

Kolikonda, M. K., Srinivasan, K., Enja, M., Sagi, V., & Lippmann, S. (2016). Medical Marijuana for Epilepsy? Innovations in Clinical Neuroscience, 13(3/4), 23–26.

Ribeiro, L., & Ind, P. W. (2018). Marijuana and the lung: hysteria or cause for concern? Breathe, 14(3), 196–205.

“Getting an orthopedic joint replacement will keep me immobile and in bed for a while”. Medical fact or fiction? Contrary to popular belief, undergoing surgical intervention for a joint replacement will not keep you stuck in bed or on the couch for long periods of time. How?! you say. Lets explore the medical facts!

Why do replace painful joints with painful surgical procedures?

Joint replacements are very common surgical procedures occurring in all individuals across the lifespan, most commonly hip and knee arthroplasty. When we hear surgery we immediately think of pain and time needed for recovery. Joint replacements often occur in those with chronic painful, arthritic joints so the surgical intervention often provided immediate relief of these symptoms (Brennan, & Parsons, 2017). The most commonly reported pain after surgical intervention is pointed towards the actual surgical incision.

I thought I stayed in bed to recovery after surgery? 

Early ambulation (or walking) is encouraged as soon as you are are out of the operating room. Crazy right?!  Lets take a look at how the media portrays orthopedic healthcare and it’s patients and compare it to scholarly research articles on this topic.

Orthopedic programs at the hospital of your choice are designed and equipped with the staff necessary to provide the support needed to get out of bed and active after surgery. As we seen in this commercial from the Cleveland Clinic, doctors and therapist are involved in the care being provided to ensure that patients are on the right track to healing and becoming pain free. We see multiple patients working with therapists and other members of the healthcare team to recover from their procedures. Interviews of different members of the interdisciplinary team have reveals the first step in providing effective care to a patient is engaging all members of the healthcare team (Arnold, Needham, & Nydahl, 2018). Information revealed by talking with different members of the healthcare team fell around a common theme; early ambulation and activity is key component in healing from an orthopedic procedure.

How does participating in therapy and activity so soon help the healing process?

Many studies have been put into place about initiating ambulation protocols and research for the postoperative orthopedic patient. One major finding that this studies yielded was that of immobility in patients. Many patients go into surgery with the idea that rest is needed in order to heal. According to Teodora (2016), immobility postoperatively can lead to many health complication such as pneumonia, blood clots, pressure ulcers, and loss of functional mobility. The whole purpose of orthopedic joint replacement is to regain mobility in affected, arthritic joints!

Here you have it! Both current day media and scholarly research article debunk this myth that immobility is needed in order to heal from a surgical procedure. We have seen in real hospital advertisements patients participating in therapies and ambulation immediately after their procedure and returning back to activities they once loved. Remember immobility is bad and can lead to serious health complications. If you are thinking of a undergoing a joint replacement get educated, get prepared and get involved in your care! Before you know it you’ll be back to doing those activities you have always loved.

Resources

Teodoro, C. R. (2016). STEP-UP: Study of the Effectiveness of a Patient Ambulation Protocol. MEDSURG Nursing, 25(2), 111–116

Brennan, C., & Parsons, G. (2017). Enhanced Recovery in Orthopedics: A Prospective Audit of an Enhanced Recovery Program for Patients Undergoing Hip or Knee Arthroplasty. MEDSURG Nursing, 26(2), 99–104

Arnold, M., Needham, D. M., & Nydahl, P. (2018). International Round Table Discussion: Early Mobility. International Journal of Safe Patient Handling & Mobility (SPHM), 8(1), 57–64

Do Small Things Seem To Bother Your Young Child? 

For instance:

• Having a tantrum to take a bath
• Screaming when putting on clothes
•  Exaggerating pain
• Clumsy and constantly walking into things
•  Eats only the same food

( Scherer P. (2018) Is it Sensory Processing Disorder or ADHD?)

First you think its just bad behavior but then you think that maybe something else is going on?

Sensory Processing Issues are commonly  misinterpreted for poor behavior.

With sensory processing issues a child may feel overwhelmed and disorganized or clumsy and have a high tolerance for pain.

According to Sensory Processing Challenges in Children, Crtitz, Blake, and  Nogueira explain that sensory processing challenges can have a great impact on a child’s ability to learn, navigate in their environments, and their behaviors. Sensory processing issues are commonly seen with other diagnosis such as autism spectrum disorder, attention deficit/hyperactivity disorder, although they  can also be seen alone without a separate diagnosis. Identifying and acknowledging these issues are important for a child to function in their daily environments. Untreated sensory issues can guide confused, uncomfortable, and unorganized behaviors.

When is child feels overwhelmed and disorganized they tend to be over-responsive to the information their senses are receiving. An under-responsive child  is lethargic, clumsy, and tends to have high tolerance for pain due to the information their senses are receiving.

What we feel, hear, taste, smell and see are our senses receiving input.

In addition to the 5 commonly known senses there are two more senses called our “internal senses”:

• touch
• hearing
• taste
• smell
• sight
• body awareness (proprioception)  Our body awareness is knowing where your body parts are.

•  vestibular (balance) Our vestibular sense is the connection between our brain and inner ear that control our balance and spatial orientation.

When a child feels over-responsive to a sensory input they are hypersensitive. In other words they want to avoid the sensory input they are receiving ( touch, taste, hear, smell, sight, body awareness, movement). When a child feels under-responsive to the sensory input they are hyposensitive. These children are generally seen as seekers for sensory input.

Being over-responsive or under-responsive to proprioceptive  and/or vestibular input can affect a child’s motor skills.A child struggling with motor skills may appear clumsy, not enjoy physical activities that other kids typically like, constantly moving, or out of control.

Watch this video below of a young boy explaining how is body feels on a daily basis:

(Sensory processing issues is sometimes referred to as a Sensory Processing Disorder (SPD), as it is currently in the processing in becoming an official diagnosis).

What bothers one kid may go unnoticed by another.

Being able to participate in every day activities is crucial for a child’s quality of life. Sensory processing issues can make it extremely challenging for a child to engage in the most important developmental activities, which are play and social interactions. Parents will struggle to have their child strive to develop accommodations to help their child survive and succeed in their activities. In the literature review Supporting Participation for Children With Sensory Processing Needs and Their Families: Community-Based action research. Silverman and Tyszka examine the effects of a community-based programs and sensory features. It was observed that in a community museum, there are many features that impact our senses. Such as unusual sounds, overwhelming visual information, movement from exhibit pieces, and the close proximity to others.

Now imagine all the other environments and situations that could feel overwhelming for your child?

Who Can Help?

An occupational therapist can determine if your child is having any sensory processing difficulties and can help to treat these challenges.

According to The American Occupational Therapy Association (2018), occupational therapist can be seen in multiple settings including home care, outpatient, and school. In some settings a physician referral is required. The occupational therapist will gather information from the parents, teachers, and any other crucial caregivers. They will perform an evaluation to determine if there are any sensory processing issues. With completion of the evaluation, the occupational therapist will then determine if services are necessary. If your child is eligible for occupational therapy services, the therapist will then create a treatment plan. Treatment plans vary depending on the child’s needs and setting.With simple tips and strategies your child may be able to participate in everyday tasks with more comfort and control.

The information provided on this blog is gathered from a combination of resources. Current media news, accredited scholarly journals and medical information all support the information. It was discovered that recent media news has been accurate in explaining sensory processing issues and effective treatment.

References:

The American Occupational Therapy Association (2018). Addressing Sensory Integration and Sensory Processing Disorders Across the Lifespan: The Role of Occupational Therapy.

A Child’s View of Sensory Processing (2012). Retrieved from: https://www.youtube.com/watch?v=D1G5ssZlVUw

Crtitz C., Blake K. Nogueira E. (2015). Sensory Processing Challenges in Children. The Journal for Nurse Practitioners.

Scherer P. (2018) Is it Sensory Processing Disorder or ADHD?. New Hope Media LLC.

Silverman F., Tyszka A.C. (2017). Supporting Participation for Children With Sensory Processing Needs and Their Families: Community-Based action research. American Journal of Occupational Therapy

The Star Institute for Sensory Processing disorder (2018). What is SPD? Star Center Foundation.

Treating Children for Sensory Processing Disorder (2016). Retrieved from: https://www.youtube.com/watch?v=kZuu0kInwp8

Logging into Facebook, you may see angry parents addressing the various vaccines required for children from birth into their childhood. Vaccines are created to build a Childs’ immunity from deadly diseases. According to the CDC, there are nine types of vaccines
• Hepatitis B (Hep B)
• Rotavirus
• Diphtheria, Tetanus, Pertussis (DTaP)
• Haemophilus Influenza type B (Hib)
• Pneumococcal (PCV)
• Poliovirus (PV)
• Measles, Mumps, Rubella (MMR)
• Varicella
• Hepatitis A (HepA)
required in the first year of life (chart pictured below).

What is a vaccine?
Vaccines are scheduled shots designed to expose the body to weakened or killed foreign invaders (viruses and bacteria) to create immunity. They help create immunity to deadly and serious health complications such as pneumonia, polio, and death (Destefano, Price, & Weintraub, 2013).
When the body is exposed to these foreign bodies in a controlled manner, the body creates fighters (or antibodies) to defend itself against sickening viruses and bacteria.

Why do vaccines have a bad reputation?

When did this epidemic of anti-vaccinations start? A now discredited physician, Andrew Wakefield, published a study in 1998 linking the MMR (measles, mumps, and rubella) vaccine to autism. According to Knopf (2015), the study was found to be fraudulent when discovered the study was funded by lawyers of parents who were suing vaccine companies. This resulted in revoking Wakefield’s license and deemed the study to be compromised.

Vaccines in the media today.

Many individuals have voiced their concerns about vaccines and specifically their link to the diagnosis of autism. Jenny McCarthy, a Hollywood actress, spoke out about her son whom she claims developed autism after receiving his childhood vaccines. McCarthy claims our vaccines are unsafe and harmful, even deadly, to our children.

Other public figures such as Donald Trump, the 45th President of the United States, have publicly discussed their opinions regarding the association between the diagnosis of autism and childhood vaccines.

A documentary named “Vaxxed” was created and directed by the discredited physician, Andrew Wakefield, and the film’s producer Polly Tommey to uncover the link between vaccines and autism and how the CDC has hidden the information from the public. The documentary claims that the CDC has known for 14 years that there is a link to autism with the components vaccines are made of.

Debunking vaccine myths

Vaccines make you sick
The purpose of a vaccine is to expose the body to foreign invaders to create immunity against future attacks. By exposing the body to weakened or killed bacteria/ viruses in a controlled manner, the immune system becomes stronger (LaSalle, 2018). Individuals may feel tired or “under the weather” as a result of the triggered immune response.

Vaccines cause autism
A common misconception of vaccines is their link to the activation or triggering autism. Claims that vaccines are linked to autism, or are unsafe when administered according to the recommended schedule, have been negated by many pieces of medical literature (Knopf, 2017).
It is believed that Mercury (a form of Thimerosal) and Aluminum, components found in the MMR vaccine are linked to the development of autism (LaSalle, 2018). This was concluded from Andrew Wakefield’s discredited study in 1998.
Aluminum actually works as an assistive enhancer to the body’s immune system response to vaccines. This competent Is monitored closely by the Toxic Substances and Disease Registry to ensure nonhazardous amounts are given. The amount of aluminum in vaccines is well below the regulated marker. According to LaSalle (2018) infants and children are exposed to aluminum products nearly every day in pots and pans, cereal, and even baby formula. “Infants exposed to 4.4 mg of aluminum in vaccines typically administered in the first 6 months of life. However, infants typically ingest more than that during the first 6 months of life.” (LaSalle, 2018).
Mercury is used as a preservative to prevent bacterial and fungal contamination of vaccines. However, according to LaSalle (2018), in the year 2001, licensed US vaccines removed the use of Mercury from the vaccines. Since the removal of Mercury, the CDC noted that there has been an increase in rates of autism.

There are too many vaccines and toxins in them
Vaccines are safety man-made created in a sterile environment to avoid contamination of bacteria. According to Destefano, Price, & Weintraub (2013), since the year 2012, children receive about 315 antigens (a forgien substance) compared to the several thousand in the late 1990s. A consistent schedule of vaccines helps build a child’s immunity during the vulnerable first two years of their life.

References

Destefano, F., Price, C., & Weintraub, E. (2013). Increasing Exposure to Antibody-Stimulating Proteins and Polysaccharides in Vaccines Is Not Associated with Risk of Autism, 163(2), 561- 567.

Knopf, A. (2015). MMR vs. Autism: A False Choice. Brown University Child & Adolescent Behavior Letter, 31, 1–2.

LaSalle, G. (2018). When the answer to vaccines is “No.” Journal of Family Practice, 67(6), 348.