I am writing to President Obama, my congressional and legislative senators and representatives, the secretary of state and the Oregon and U.S. attorney general as both a patient and a health care provider. As a patient, I want my government to know that my family is suffering from credit card debt and poverty because we’re not able to get affordable health care. As some of you lovely readers know, I contracted E. coli from eating spinach in a local restaurant in August of 2008. I had rare autoimmune reactions to the E. coli called HUS and TTP, and these resulted in my kidneys failing. I spent one month in the hospital, 6 weeks on dialysis and plasma pheresis (plasma exchange) and 6 months out of work. With everything that happened last year, you might imagine that most insurance companies are no longer willing to cover me. I am thankful to get insurance through BCBS’s high risk pool insurance coverage, but the premiums are far from sustainable: $350 a month, plus I pay for 20% of every doctor’s visit, lab, x-ray, etc. needed to maintain my health–and I need a lot of follow-up care. All preventative health care is out-of-pocket, and yes, I have a nice-sized deductible.

As a massage therapist, I am lucky to work with many under-served populations. Offering sliding scale has made it possible for me to work with pregnant and postpartum women desperate for pain relief who could never otherwise receive a massage. Many of these women are not able to afford all of the basic check-ups they need to ensure a healthy pregnancy, or cannot have the birth they want because they can’t afford the provider or facility that is best for them.

I am also blessed with the opportunity to work within my LGBTQ community. I meet many people who are not insured under their partners’ plans because of marriage discrimination. And while some clients are still coming to reduce stress and muscle tension as a preventative health measure, in this economy I’m seeing more and more people wait until the pain from their injuries has become unbearable before they make an appointment.

Join me in creating positive change that will improve the lives of millions! If you believe that everyone has the right to affordable health care, please write to your government representatives as soon as possible. And please–share your story with me via email or up on this blog if you’re so inclined.

 Pregnant? Postpartum? Or did you just gain/ lose some weight? Here are some tips for making your pants fit longer and spending less on new/ maternity clothes.

Pictured to our left we have the good ol’ rubber band trick. This is the cheapest way to keep your pants up with an expanding belly, and it works great!!

Make sure your rubber band is strong and not too long/ short.

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Ah, and to our right we have a variation on the rubber band theme. These hip “bbuckles” snap around your belt loops and hold your pants together without being buttoned/ snapped. They say fun things like “Bun in the Oven” and “Rock Mama,” or you can get a plain one if you’re not pregnant like me and shrunk your favorite jeans in the dryer. Check ‘em out at www.mybbuckles.com.

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These ladies on the left are sporting the Bella Band, great from the first trimester all the way through postpartum (no, you’re not the only postpartum mama whose belly still looks like it’s stuck somewhere in the 2nd trimester… so put away those celebrity mama photos and give your tummy some time). The Bella Band can be found at www.ingridandisabel.com/bellaband.html/

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Last but not least, a new design to your right called Belly Ups. I can’t vouch for this product personally as I don’t know anyone who’s tried them out yet, I’ve just seen them advertised all over the web and in pregnancy magazines. They bring up all sorts of nostalgic early 90′s Madonna memories for me. In a good way. Interested? Go to www.lunalullaby.com/Belly-Ups-Info.

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I’d love to hear how you mamas stayed clothed without breaking the bank during pregnancy and postpartum. Did you borrow from friends? Find good stuff second-hand? Learn some great tricks? Please let me know!

And if anyone has tried the Belly Ups… what did you think?

Abdominal Strengthening Exercises for Pregnancy and Postpartum

 Getting Ready: Find a comfortable, firm spot, such as a yoga mat, to lie on. As your pregnancy progresses, you will probably find it most comfortable to prop your head and upper back up with pillows and spend a limited amount of time lying on your back to avoid dizziness, nausea, difficulty breathing and poor circulation associated with the weight of your uterus and baby constricting your arteries and diaphragm. Many women are comfortable reclining at a 45^o angle. Some women can lay back further for short periods of time, while others cannot recline at all. Postpartum it is safe to lie flat on your back again.

 First: Abdominal breathing

This can be done in any position. Closing your eyes and placing your hands on your abdomen may help you focus attention on your breath and abdomen. As your breath slows down, it will get longer. As your breath gets longer, feel for your abdominal muscles gently drawing in. As you breathe in, the abdominal muscles will gently push against your hands. You may want to picture your abdomen as a balloon, expanding as it fills with air and relaxing as you exhale. Think about breathing more with your belly than with your chest to enhance your relaxation.

Second: Engaging the muscles

Lie on the floor with your feet drawn up to your bottom (knees bent) to help your low back relax. Gently tilt your pelvis so you push your low back into the floor. This is the first step of engaging the abdominal muscles. Next, still lying on your back, breathe out and gently curl your head, but NOT your shoulders, away from the ground. As you do this, cross your hands around your naval and gently draw your hands together (so your palms are softly drawing the rectus abdominals together). It may also help to picture your abdominal muscles coming together. When you’re ready to breathe in, slowly release your hands and curl your head back down. Repeat this as many times as you comfortably can, which probably won’t be more than 15, but may be as few as 5 -10. Try to keep your neck as relaxed as possible.

Third: Engaging the muscles, Part 2

Still lying on your back with your knees up and keeping your lower back pushed into the ground, breathe out and slowly slide one of your feet along the ground so your leg comes toward the straightened position. Only straighten as much as you can while keeping your lower back pushed into the ground. If your lower back starts to lift away, don’t lower the leg anymore. As you breathe in, draw the leg back to its starting position. Repeat with the other leg. Repeat as many times as you can without straining, up to 15 times each side. These first three exercises are suitable for most women with diastasis recti (separated abdominal muscles).

Side Crunches

Lie on your right side with your right leg bent just slightly. Extend your right above your head and slightly in front of you to help your balance. Put your left hand behind your head (elbow bent). Bend your left leg up and out to your side at a 90^o angle, and slowly bring your left elbow and your head up to meet your left knee. Repeat this as many times as you can without straining your abdominal muscles, up to 25 repetitions. Repeat lying on your left side.

Additional Abdominal Exercises for Non-Separated Rectus Abdominals

Leg Lifts

Continue in the reclined position with legs bent at a 90^o angle. Slide one foot down so that this leg lays flat on the ground as in the previous exercise. Then slowly lift the straightened leg upward while exhaling. Gently bring the leg back to the ground on the inhalation. Repeat 10-15 times, less if you feel your abdominal muscles straining. Repeat on the opposite side.

Scissors

The scissors exercise is similar to leg lifts. With one leg bent and one leg straight, lift the straightened leg upward while exhaling. Then slowly bring your leg back toward the ground while inhaling, getting your heel as close to the ground as you can without actually setting it down. Exhale and raise the leg back toward the sky.

Bicycling

In the reclined position, bend both knees and lift feet off of the ground. Make small circles with your feet, as if you were pedaling a bicycle. Be sure that you are engaging your abdominal muscles, not just your quads and hamstrings.

These abdominal exercises are intended to strengthen your core, prevent separated rectus abdominal muscles and prepare your body for labor during pregnancy. Postpartum they will help you tone muscles that stretched to amazing lengths to hold your baby as well as help you regain core strength and adjust to your pre-pregnancy center of gravity.

The above exercises are inspired by the teachings of Suzanne Yates, a renowned Massage and Shiatsu practioner for childbearing women in the U.K. Check her out at www.wellmother.org!

As always–tell me how these ideas go for you!

I can’t listen to much news these days because our collective terror about the economy makes me freak out, hold my cash in too close and start crossing necessities off the list of expenses. Lots of us are being more thoughtful with our spending and saving these days, and this is good! But we may also be doing without things that are vital to our wellbeing. The following are some tips for staying healthy without spending a lot of money:

Tend to your nutrition.
Eating well can be done on a budget. This does mean meal planning and eating in. I think the best way to eat well and save money is to grow food! If you have a small plot of land, access to a community garden, a balcony, or even a sunny window, you can grow some of your own food for the price of seeds and soil amendments.

As far as shopping goes, many of us can feel torn between eating healthy, organic foods and not spending our entire paycheck on our groceries. Luckily, more and more neighborhood grocery stores are offering local, organic foods at cheaper prices than specialty health stores. (Yay consumer demand!) I’ve been looking around online at different lists of which foods are most important to buy organic, so if you can’t go totally organic, you’ll at least have some information for picking and choosing. The following foods consistently showed up as important to buy organic due to the high concentrations of pesticides or antibiotics they otherwise contain:

1. Baby Food
2. Strawberries
3. Rice & Oats
4. Sweet Bell Peppers
5. Milk, Yogurt, Cheese
6. Corn
7. Green Beans
8. Peaches, Nectarines, Apricots
9.  Apples, Pears
11. Cherries, Raspberries
12. Celery
13. Grapes (this means raisins too)
14. Coffee
15. Soybeans
16. Potatoes
17. Leafy Greens
18. Meat
19. Cucumbers
20. Tomatoes 

A couple of websites also mentioned soaking veggies in a 1/2 cup of white vinegar mixed into a gallon of water for 30 minutes to kill bacteria and chemicals. For fruits with a peel that you do not eat (bananas, kiwis, pineapples), there is often a smaller risk of ingesting pesticides.

Exercise!
You don’t have to belong to a gym to get a great workout… think walking, jogging, biking and jumping rope. You can also  get a few weights off of Craigslist (or a cheap exercise machine such as an elliptical if you have the space). Yoga studios often have amazing packages. Libraries have great workout videos, which usually provide a glimpse into bygone fashion eras and make you feel contemporary and stylish. If there’s a local gym or community center that offers quality childcare as part of the membership, this may make the expense worth the while for you.

Consult Health Care Providers When You are Sick and to Sustain Health
This is where I recently fell short in the self-care department. With so many of us underemployed, unemployed, earning low wages and struggling to pay rent or mortgages, I became convinced that acupuncture, counseling, and yes, even massage were luxury items. It wasn’t long before I was sore, tired, catching every cold that came my way and increasingly stressed out. So now I’m looking at how to take care of myself on a budget. My recommendation is that if you cannot afford the healthcare you need, look for people who can offer their services on a sliding scale. Go to www.communityacupuncturenetwork.org to find sliding scale acupuncture ($15-40 a session) near you. Don’t be afraid to ask practitioners if they offer sliding scale services. Lots of us do, but you may have to ask. And don’t put off seeing your primary care provider for acute or ongoing health problems–I promise it will save you money in the long run.

Take Time off From Work and Take Vacations
Did you see the word vacation and wonder when I was going to get back to affordability? These suggestions are all about investing in yourself and saving on the high financial, physical and emotional costs that come with poor self-care. For me, nothing is more rejuvenating than a short vacation. I’m always much more productive afterward, and feel more refreshed and content in my work when I take time off from it. My partner and I don’t really put aside money for vacations, so we have to find ways to scrape together a good weekend away. One way we’ve done this is by finding a group of friends who are equally dedicated to cheap vacationing. Everything is cheaper when there’s more of you to split the cost. We rent houses, cabins and yurts for a low price during the “off-season” (I don’t really care what the weather’s like if I get to relax and sleep in for a few days). In the sunny summer days we camp. Other ways to save money are to stay in hostels or find colleges that rent out dorm rooms for cheap in the summer months (contrary to popular belief, neither of these have an age limit).

How are you taking care of yourself without spending loads of money?

So, constipation it is!

That’s right folks, our first topic is going to be all about ways to help alleviate constipation. Clients often ask me for belly rubs to help move their stool along. Here is my tribute to you!

Here are some tips for easing constipation:

1. FIBER
You’ve probably heard fiber’s praises sung when it comes to alleviating constipation. The reasons fiber helps is because it stimulates gentle contractions in the colon and absorbs water to help soften stool. Fruits, vegetables and grains contain fiber. Some high-fiber foods include unpeeled apples, unpeeled peaches, raspberries, tangerines, raw broccoli, raw carrots, cooked spinach, cooked black-eyed peas, cooked kidney beans, cooked lima beans, and whole grain cereals (i.e. bran flakes, oatmeal, 

rice or quinoa cereal). Gradually add more fiber to your diet to give your body time to adjust. 

2. MORE FIBER
In addition to eating your fruits and veggies, you can add a fiber supplement to your diet. You can buy these or make your own. To make your own you’ll need fresh flax seeds, psyllium husks and a coffee grinder. Grind 1-2 tablespoons of each in the coffee grinder 1-2 times a day (depending on how backed up you are). You can sprinkle this on cereal, a salad or in a smoothie. Drink lots of water, at least two cups, with each serving. Be sure to keep the flax seeds and psyllium husks in the fridge so they stay fresh.

A couple of caveats to numbers 1 and 2: There are some cases where adding more fiber may be too irritating to the colon or may contribute to an obstruction. If you know that you have a narrowing (or stricture) in your intestines, if you have scar tissue (adhesions) from a previous surgery, or if you have a disease such as Ulcerative Colitis, Crohn’s Disease or Irritable Bowel Syndrome, check with your doctor about adding fiber.

3. WATER
Dehydration contributes to constipation because water is needed to soften our stool and keep it moving. Try to keep water or tea available to yourself all day and drink up!

4. FOODS TO CUT OUT
Some foods contribute to constipation, including refined flour, sugar and processed food. Eating lots of animal products is also constipating for some people. 

5. BUILD YOUR BLOOD
Our digestive system needs plenty of blood to be nourished and move food through easily. Decreased blood supply to the colon is a common cause of constipation during pregnancy because your blood is first nourishing your baby and placenta. Some foods that will help build your blood include  red chard, beets, shiitake mushrooms, miso broth, spinach, peanuts, lentils, garbanzo beans, spirulina, chlorophyll, apricots, raisins, nettles, alphalpha and brewer’s yeast. If you eat meat you can also build blood with bone marrow soup (broth made from boiling bones in hot water over several hours), animal liver, duck, goose, lamb and chicken.

Another way to build your blood is with an iron supplement.  Take care in choosing an iron supplement, because if you get one that isn’t easily absorbed into your bloodstream, it may constipate you! (Prenatal vitamins contain a high dose of iron.) My favorite brand is Floradix, a liquid herbal iron supplement.

6. CASTOR OIL PACKS
Castor oil packs are great at getting things moving! When your skin absorbs castor oil it stimulates your lymphatic system, enhances your immune system, helps to balance your hormones, promotes menstrual regularity, decreases inflammation, increases liver function and helps to heal internal organs. 

To make a castor oil pack, rub a small amount of castor oil into your belly, place a piece of flannel over it, then place a hot water bottle on top of the flannel for 10 minutes. Castor oil, unlike most oils, won’t make that flannel smell rancid… so as you continue your castor oil treatments, you can use less oil because your skin will absorb the oil remaining in the flannel.

IMPORTANT: Don’t use castor oil if you are pregnant, breastfeeding or menstruating. Because of its great success at getting things moving, it can stimulate labor, give a breastfeeding babe the runs, and increase bleeding during your period. Also, castor oil shouldn’t be taken internally or applied to broken skin.

8. EXERCISE
Regular exercise increases oxygen intake and improves circulation, which in turn nourishes the colon and helps it move our waste along. Plus, the contraction and relaxation of your muscles give your organs a little massage, which also helps them keep moving.

9. MASSAGE
Speaking of massage… why not give your colon some loving? Massage therapists are happy to give you a colon massage. Really. We live for this kinda thing. And you can also give yourself a belly rub. To do so, gently rub your belly in a clockwise direction, which is the direction your colon moves. Add some massage oil (like almond or jojoba) if you want smoother, more fluid strokes.

10. STRESS REDUCTION
It is a rare person whose stress doesn’t affect their digestion. One reason for this is that digestion is a function of the parasympathetic nervous system, which is in charge of  body functions that don’t require immediate action. When we’re stressed or anxious, our body goes into sympathetic nervous system drive (aka fight or flight mode), searching for immediate solutions to perceived stress. When we relax, our body can take care of digestion (this is why the parasympathetic nervous system answers to the name “rest and digest”).

Another way to look at the link between stress and digestion is to imagine the “gut brain.” Our digestive tract is innervated by a gigantic, complex set of nerve fibers called the enteric nervous system. This system contains 100 million neurons–this is even more than the spinal cord! When we’re stressed, our nervous system starts twitching and making our muscles and organs tighten, which often leads to constipation, diarrhea, stomach aches and acid reflux.

So… make a list of activities that are relaxing or calming to you. Think of smells, sounds, textures and sights that treat your senses. Schedule time for a walk, a yoga class, a candlelit bath, listening to music, etc–at least 20 minutes each day. Likewise, make a list of activities that are very stressful for you. Examine how you can limit these activities or give yourself some extra support and down-time when you’re stressed out.

11. LAXATIVES
Prunes and prune juice are wonderful natural laxatives. They gently stimulate the colon to contract and expel stool. Some other gentle laxatives for short-term use include over the counter stool softeners, mineral oil and milk of magnesia. Long-term use of laxatives can be very addictive and can increase constipation by decreasing the colons ability to function unassisted, so if your constipation is chronic, talk to your doctor about it!

12. ACUPUNCTURE, NATUROPATHIC CARE and other MEDICAL CARE
My first foray into acupuncture was the result of constipation. I was getting married (otherwise known as domestically partnered) in a week, and I was EXCITED! Beyond that, I was worrying about everything coming together and about talking in front of a crowd, and I was definitely not pooping.  (So then I  started worrying that I’d be making a constipated face during my vows, which might  be confused with a “get me out of here” face.) Acupuncture brought my stress back to  my normal level of nuttiness and got my bowels moving again.

 Naturopathic care is great for finding a diet, exercise and stress-relief routine that  works for your specific body, plus a naturopathic doctor can look for health problems  that may be causing your constipation. Naturopaths and Acupuncturists can also suggest herbs and supplements to treat your condition.

There are some cases in which you’ll definitely want to talk to your doctor or nurse practitioner. If you are taking a medication that is constipating you, don’t hesitate to call your physician about it. If you are dealing with chronic conditions such as Crohn’s Disease, Colitis or Irritable Bowel Syndrome, it is important to have skilled help in managing these. If you are chronically constipated, it’s also time to talk to your healthcare provider. Finally, if you are having severe abdominal pain alongside constipation, this is a medical emergency and should be treated in the Emergency Room.

Please let me know if you have your own tricks for keeping your bowels moving!