Question
QUESTION: Hi there!
I am a 30 year-old mother of a 17 month old. I was fairly active before
my pregnancy and I also jogged most of my pregnancy until put on bed rest
at 33 weeks (preterm labor after slamming on brakes/near accident). After
the birth of my son I started exercising (especially running) again, but I
became frustrated with not being able to shake the last 7/8 lbs and so I
switched to various exercise programs including attending a fitness
bootcamp when nothing seemed to work, I became frustrated and gave up on
everything and ending up gaining 10 lbs (let me mention my son still doesn't
sleep through the night and I firmly believe a lot of the reason I was unable to
lose the weight was because of lack of sleep/higher cortisone levels).

This past Oct, I finally got serious after finding I had high
cholesterol/ triglycerides. So I started exercising again and eating better. I
bought an elliptical machine and used it regularly. I noticed however soon
after using it that my mid back was hurting quite a bit and that I had tingling
in my left foot (pretty much constantly) although it drove me crazy while
lying in bed, occasionally the pain was also in my left leg or my mid-spine
area would feel like it was having a "firing" almost "electric" type
feeling/tingling as well. I called my GP who said she thought I pinched a
nerve. So I just lived with it because every one told me it could be weeks until
it was better, many months later, I switched from the elliptical to jogging
again (5days a week an hour a day) and it seemed to subside, so much so
that 2 weeks ago I went backto my GP to have my cholesterol/tris checked
again (both are down and I've lost 10 lbs since I saw her in Sept) that I didn't
even mention the problem. But my husband and I went to Cabo last week and
upon returning I got quite a cold - I've been sick since Sat/Sun. Since I
haven't been able to jog and have primarily laying around and napping, my
foot is tingling again. I also feel tingling in the left side of my body. I called
and made an appt with a chiropractor for this monday. I also thought since
my son has had such problems sleeping and can't seem to find a comfortable
position when sleeping (he moves constantly and tends to sleep face down on
his knees (almost "child pose" like in yoga), and the chiropractor does have
training with babies/kids I would also have her examine him. Sorry for the
length of this but I just wondered if:
a) you have any idea of what this injury/issue could be
b) have any advice on what I should ask her/ or what to look for
c) any advice with my 17 month old
Also if you have any chiropractors you could recommend in the napa (or
if
there are some in northbay/ bay area) that may be worth a visit if it
doesn't
work out with her.
I so appreciate your time and input!
Much gratitude,
Tiffany"

ANSWER: Hello Tiffany, congratulations on your baby and congratulations on taking action to improve your health.

First, the baby. Certainly take him to the Doctor of Chiropractic for an evaluation from a chiropractor perspective.  Birth is a strenuous event, for you and the baby.  Even in c-sections there can be stresses and strains to the baby's (NMS) neuro-musculo-skeletal system (as well as yours).  A chiropractic check-up could reveal the presence (or absence) of spinal dysfunctions- termed Vertebral Subluxation within CHIROPRACTIC jargon (subluxation means different things to different professions).

Only chiropractors evaluate for the chiropractic spinal subluxation. Only chiropractors detect and correct these spinal subluxations.  Chemicals (medicines), stretching, exercise, yoga, meditation may be helpful to the symptoms; but if there is a mechanical problem (vertebral subluxation) contributing to the irritation of the neuro-musculo system (NMS), only a mechanical correction (specific chiropractic adjustment) can correct the cause and the resultant symptoms.

Your DC should of course take a detailed history of the pregnancy, the labor and delivery, and the life history of your son.  You say that he does not sleep through the night- colic?, just irritable and crying?, just restless?  otherwise healthy?  Height/ weight/ cognitive development as expected?  any illness precede this sleep change?  is it a change- or did he always wake up through the night?

You seem motivated,  informed and active in your health decisions.  Certainly medical evaluation for the baby could be helpful- get a medical exam, get recommendations from the Peds MD.  Get a chiropractic evaluation from your DC, get recommendations from the DC.  With more complete information from both perspectives I am sure an involved Mom like you will assure the best steps for that baby!

On to you.

Again, congratulations on taking ACTION towards better health, many people talk the talk, few walk the walk.

Thirty years old, female, recent pregnancy, successful birth.  Your height? Weight? prior history? You mention slamming on the brakes in your car- severe enough to initiate pre-term labor,,, is this the only trauma you have ever had?  Ever injure your neck/ back in the past?  Ever any similar complaints in the past?  Re-reading your question, I guess you are near an ideal weight (looking to lose just a few lbs).  Total cholesterol/ triglycerides is important, but not as important as the HDL/ LDL ratio.  Is your 'good' cholesterol high? Is the 'Bad' cholesterol high?

Pain/ numbness, in your blood tests -has your glucose, hemoglobin A-1-C been checked ( slim possibility of diabetes causing numbness/ pain, slim, not likely; but a simple blood test is easy and given more info- like seeing you- your DC or MD may or may not want this blood sugar information).

Pain/ numbness, ONLY since the pregnancy/ labor/ delivery?  Did you get an epidural for labor/ delivery?  It seems that sometimes epidurals result in back pain for the patient.

X-rays, MRI's ?  Certainly sounds like a 'pinched nerve'. Xray and MRI would be good tests to get, again, always more info, more info. Xray is necessary, the MRI necessity would be determined after physical exam by your DC (or MD).

Pain/ numbness determined by activity/ position?  Does point more to the 'pinched nerve' hypothesis.  "Pinched Nerve" is only 1/2 of a diagnosis.  "Pinched Nerve" is caused by something - - a muscle spasm, a joint dysfunction (subluxation), a herniated disc, something else.... "pinched nerve" is not sufficient- get to the cause.

Evaluation and treatment of the spine should bring improvement in your case.  It does sound like your neuro-musculo-skeletal symptoms have been around for a while.  The longer the symptoms have persisted, the longer it will take to treat and rehabilitate the tissues involved.  Give the DC some time to rehab your NMS system.

If spinal treatment does not resolve/ improve the symptoms, it still sounds like a nerve problem.  Possibly- longer into the future, after a trial of chiropractic an MRI of the brain (also nervous system) could be indicated.  This is not an immediate suspicion.  Your condition should improve with spinal treatment by your DC, and exam by your DC will determine if extra-spinal causes need to be evaluated.

I have attempted to give a more complete picture from a physical/ mechanical/ NMS perspective of diagnosis and treatment of your complaint.  Your chiropractor may also discuss nutritional approaches with you and the baby.  My response has been long, sorry, and now I have to get to work.

Two sources for possible referral:  http://www.lifechangingcare.com , and http://www.chiroweb.com .

Looking there I see a fraternity brother from years ago, same school, been in practice many years, I have not spoken with him in many years- Gary de Wett DC, could give him a call for an appointment or advice.

In today's litigious society, sorry- I have to include this:
This discussion is meant as general information, prescription or specific advice for this specific patient must be made by the treating healthcare providers.  I have not seen xray, testing, nor performed any physical exam upon this patient. Informational purposes only.

Thank You.  I hope this helps.  Good Luck !!!
Victor Dolan, DC
http://www.DocDolan.net



---------- FOLLOW-UP ----------

QUESTION: Dear Doc Dolan,
First of all, I greatly appreciate the amount of detail and thoroughness in your
answer, so thank you very much for your time and expert input. I am
grateful! I thought I'd follow up a few of your questions and let you know
what I've decided to do.
As far as my son goes, yes he's always had an aversion to sleep. :( I thought
initially it was colic but now I think he's just a very strong willed, independent   
soul who is too curious for sleep. Although the past week we've had more
success with letting him cry it out and ear plugs. He is small for his size
(about 10th percentile for height/weight) but that could just be genetics. I'm
5'3.5 and my husband is 5'9. He does always seem to move a lot when he
sleeps and constantly shifts positions, like he's trying to get comfortable. I do
think having him examined is a good idea.
On to me:
I was an extremely active 5'3.5 133-135 lb woman prior to my son. I gained
26 lbs with the pregnancy but was active throughout it. When my husband
slammed on the breaks, the seat belt locked hard on my stomach and I
believe this is what led to the preterm labor. Although I held out until I was
37.5 weeks along, my son was vaginally born weighing 5lbs 11oz.  I did have
an epidural and I didn't push long - the doctor commented on how hard of a
pusher I was. I had one injury prior to the birth that stands out in my mind.
Roller blading in high school, the wheels went right under me and I landed
dead center on my tail bone. I felt paralyzed for a few minutes, luckily a PT
running behind me offered to go get her car and drive me home. She told me
to ice it, and I did, things seemed pretty normal so I never really thought
about it, but every now and then if I have to sit for long periods or the like, I
am uncomfortable and can be quite shifty.
I was diagnosed with Gestational diabetes although my sugar levels were so
good that my doc felt it was more of a boderline/carb intolerant level. I never
required any medication/insulin, and I have always ate pretty healthy so my
diet didn't need altering for my levels to be "normal." I have checked my
blood sugar since the birth and it's always been normal, my GP also did have
me get a hemoglobin test and it was normal as well. The cholesterol is all
taken care of now - the ratio is good but I can't remember it now. I had never
had high triglycerides before but they were 194 and now they are 48. I've had
no xrays or MRIs yet but we'll see what happens after the appt. I looked up De
Wett and his daughter has taken over his practice. She went to the same
school. I also found lazaruschiro.com - the thing I liked about his site (he
went to the same school as well) was how thorough his website was and his
new patient forms were 4 pages long very detail oriented, everybody else's
are like 2 pages. He also seems to deal with a lot of sport related injuries. In
case you were curious, dewet's site is dewetchiro.com. I wanted to answer
your questions, in case you had any more info you wanted to add, but once
again I must thank you for your wonderful expertise! Also you are in staten
island, I used to live in CT for four years and have fond memories of a friend
from there. Enjoy the pizza (in moderation of course!)
Thanks again,
Tiffany

Answer
Hello again Tiffany,

Thanks for the reply.  I did check out both websites, either Doctor looks good to me, it does not look like you could make a mistake choosing either one.

"....Roller blading in high school, the wheels went right under me and I landed dead center on my tail bone....",  you state above.

Well, this is probably the culprit for you.  The body has a memory.  In our minds we may forget certain things, but the body never forgets.  That flop set into motion the DJD, DDD, OA, Arthritis that they will see on your Xray (Degenerative Joint Disease, Degenerative Disc Disease, Osteoarthritis- the wear and tear disease).  

See the DC.  Take an Xray study.  It will probably show some arthritis in your spinal joints- named by the above terms.  Even a little arthritis can cause lots of pain and symptoms, particularly when aggravated and inflammed.  Inflammation is the enemy that causes the symptoms you are complaining of.  

Chiropractic can restore more proper movement/ motion to the joints, restore more proper alignment.  More proper alignment and motion will slow or halt joint deterioration.  Joints are like the tires on the front end of your car.  When the joints (front end) is in proper alignment and motion is proper, the joints (front end, tires) can go on and on and on with little wear and tear, little deterioration.  Improper alignment?= faster deterioration, quicker progression into arthritis (or the need for a new front end, ball joints, tires).

Visit your DC, get examined, get an Xray, get adjusted to place proper motion and more proper alignment into your spinal joints.  If needed progress to an MRI.  Chiropractic should suffice from my long distance point of view in your case.  Bring your child along for an exam as well.  Personally, I examine kids as a courtesy to their parents.

Nutritionally- you had an injury even though yrs ago as an adolescent- time for Glucosamine, chondroitin, msm,,,, some anti-arthritic type of supplement.  Enzymes, proteolytic or digestive enzymes as an anti-inflammatory.  Bromelain is anti-inflammatory.  Eat 1/2 a fresh organic pineapple every day for a week or two.  Supplementation can help.  But see the chiro, and bring your son.

Again, this is not prescriptive or specific. Informational purposes only.  See your own healthcare professional for specific recommendation.

Thanks, Good Luck.

Vic Dolan, DC
http://www.DocDolan.net