INSPIRING MOTHER SERIES | ERIN ERENBERG

Inspiring is only one of the many qualities that this super mama possesses.  I am thrilled to feature such a bright light of love and support on the motherhood scene, Erin Erenberg, for our Inspiring Mother Series.  Mother of three, former attorney and founder of Totum Women, Erin is supporting women with knowledge, community and delicious lactation cookies.

On Wednesday, May 16 please join Erin, myself, clinical psychologist Dr. Michelle Glantz and postpartum doula Stephanie Matthias for a Whole Woman Wellness event for the post partum mother.

Join us for an honest and open discussion on how to stay healthy and whole while welcoming a new life into yours all while meeting expecting and new mamas, munching on food from Thyme Cafe + Market, smoothies from Yumi and more! You'll walk away with a gift bag to assist your ongoing support towards motherhood.  To purchase tickets, click here - we hope to meet you there! 

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AO: What's one thing you wish you had access to before you started a family, be it in doctors, healers, community, pain management etc.

EE: Maybe it's cheating to say a "hub of information," but really that's what I needed.  I felt adrift when searching for information about everything first-time-mom that wasn't based in childcare.  There are so many books on caring for your baby, and between my mom and my pediatrician, I didn't have a lot of blank space where infant health and safety were concerned.  The void that left me with a lot of anxiety was around issues more personal to me as a woman.  Things like: how can I prepare myself for the changes to my relationship with my partner and my friends, how can I find "mom friends" who will understand what I'm going through, how will I tackle the big question of whether/how to go back to work outside the home, and even how on Earth can I find answers to the strange things happening to my body in the first weeks after giving birth. 

AO: What are you surprised that no one ever talks about that happens to your mind or body before pregnancy or after pregnancy.

EE: Let's talk about constipation. It can plague a woman during pregnancy and make that full feeling so much worse.  But in my case, it made me absolutely miserable just after delivery.  I'd had the birth of my dreams, bringing our first into the world without drugs, husband by my side, doctor there to make sure we were safe.  But pushing was really difficult for me and left me with a massive (size of a baseball) bruise just beside my perineum.  I "needed" an episiotomy to ease our son's head into the light of day.  My doctor and every nurse I encountered urged me to take painkillers to stave off any pain related to the repair of my episiotomy.  Little did I know that narcotics would create major constipation for me that no amount of Colase could abate.  

A week into my recovery at home, post hospital, I couldn't move from a supine position without assistance.  I started to feel depressed because I was so confused and couldn't properly care for our baby without a lot of pain.  How could I endure the discomfort of childbirth but feel so much pain while healing?  I found nothing on the topic online, or in any book.  Finally, I asked my mom to look at my vagina.  She saw the bruise.  My husband, a veterinarian, suggested that my constipation was creating pressure on the bruise, and that was the source of my agony.  It was a really sexy moment for us.  To quote him, "if you were a cat, I'd run out and get you an enema."  That he did.  Me-ow.  I did the enema myself and emerged from the bathroom 35 seconds later with a smile on my face, ready to walk miles.  The anaconda I left behind in that bathroom is the stuff of legends. 

Lesson learned, I skipped narcotics after both subsequent births and avoided initial postpartum constipation entirely.  And by sharing my story, a number of friends have avoided this and/or known the quick treatment to abate the agony that constipation can create for a healing pelvis. 

AO: If you knew then what you know now, would you change anything?

EE: Yes, I would have engaged the team of helpers that I finally found when pregnant with number three from the very beginning of my transition into motherhood.  A skilled and loving physical therapist like Allison made all the difference for me in pregnancy number three.  In addition to treating a vulvar varicosity in my third pregnancy (look it up; it's no fun), she introduced me to an acupuncturist, Katya Mosely, who helped me with physical issues from baby-spinning to (see above) constipation and everything in between.  Most importantly, perhaps, Allison and some other health care providers outside of my OB-GYN practice made me feel like the weird things I was encountering were not uncommon but were also things I didn't have to live with forever.  That had a huge positive emotional and psychological impact on me.  

AO: What has been the biggest surprise post pregnancy?

EE: The good: how my love for my children absolutely split my heart wide open each time.  The bad: how a marriage can quickly turn into an employment relationship if unchecked.  The ugly: postpartum constipation and vulvar varicosities.   

AO: How has your body amazed you on this journey?

EE: We women are ALL superheroes for creating, nourishing, birthing and protecting new life.  It's astounding to me how our bodies can open and close to create children.  My stomach went out to the next zip code with each baby, and then naturally and gently returned back home.  My breasts, small and mighty, have provided complete and customized nutrition for three new people.  That's just awesome stuff.   

AO: Fill in the blank: My current self care must do/have: _______________

EE: A daily shower alone.  I don't skip it. 

INSPIRING MOTHER SERIES | SHANNON VAUGHN OF PURSOMA DETOX BEAUTY

I am so grateful that I am still continuously amazed at the wonderful and inspiring mothers I come into contact with on a daily basis. Mothers who dedicate their lives to not only taking care of themselves, their little ones and their family, but do things in the world to benefit others. I am excited to introduce Shannon Vaughn, founder of Pursoma Detox Beauty, who has made it her life's mission to help and heal others, using the power of natural botanical ingredients that aim to detoxify you, purify you, combat the negative effects of daily radiation (Instagram anyone?!) and give people a chance to create a ritual that feels best for their well being and spirit, as often as they can find the time. 

Now, that we are fully experiencing winter in California, this is a great reminder to disconnect, relax and get in the bath! My favorite Pursoma product is the Digital Detox Bath

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AO: What's one thing you wish you had access to before you started a family- be it in doctors, healers, community, pain management etc.

SV: When I was ready to even think of having a child I had already been doing so much to manage my own optimum health, that I just employed traditional and holistic heath advisors into advising me for my next body stage, which was to conceive, deliver, breast-feed and recover. 

AO: What are you surprised that no one ever talks about that happens to your mind or body before pregnancy or after pregnancy?

SV: No one tells you how tired you are going to be; they tell you sleep when the new baby sleeps and now I understand why, but that is almost impossible if you work. I went back to work 8 days after having my daughter and I really did not feel the full effects of how tired I was until 2 years later and I truly wonder how I got by, but I did.

Also no one tells you or really talks about possible incontinence, and repairing the stretched muscles from delivery. There is a very easy way to make sure everything on the outside goes back to normal, but on the inside you don’t get advice unless you go looking for it. I had a friend tell me about the pelvic floor muscles being able to be stretched and then straightened and put back right into place where they were pre delivery and luckily I have a johns Hopkins trained doctor right in my local area. This was life-changing knowledge and I am happy finally more women are changing the conversation to prevent vs. just have to heal.

AO: If you knew then what you know now, would you change anything?

SV: I would have carved out more time the first three months to be less connected to the outside world and spent more time at home as a new mother. I think its important to understand that is the most important job that requires full attention of the mother and baby in the beginning. 

AO: What has been the biggest surprise post pregnancy?

SV: I was amazed at how quickly my body recovered; I gained close to 40 pounds and lost it in 3 weeks. I had a post partum plan that I had organized before the baby came, so I think that was key, making sure I had the right food, enough hydration, emotional support and good doctors with all of that, I was able to get back to exercise in 6 weeks.

AO: How has your body amazed you on this journey?

SV: It amazed me that at each stage the body recognized that it was in a different state, it let me know, and then it asked for help and support to transition. After exactly one year of my completion of breast-feeding Esme, my body reacted really strongly to the hormonal switch, I got very sick and had a terrible infection in my eye. I had to have surgery to remove it, and felt extremely depleted for weeks. I went back on an aggressive recovery program and changed some of my food choices to help supplement me during this transition. My body needed additional support to get thought this change; within one month my period came back right on time and things were very much normal again. I am amazed at the human body and its ability to heal when listening to it.  

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Shannon and daughter, Esme (2) 

WHAT TO EXPECT DURING AN INTERNAL EXAM WITH A WOMEN'S HEALTH PT

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As a specialist in Women’s Health, I am competent in assessing the function of the pelvic floor both internally and externally.  At the time of initial consultation and after a thorough medical history and orthopedic assessment, it is determined if this type of evaluation is necessary to reach your treatment goals.  If so, and consent is given, an internal exam is done manually without the use of any instruments.   Since most of the women I treat are not familiar with this type of evaluation, I thought I would break down and simplify the steps that a Women’s Health physical therapist might go through with you.  

  • First, the examination is  explained verbally with visuals such as pictures and a pelvic floor model so you would know exactly what to expect.  The therapist will talk you through the entire exam, allowing you to connect to your pelvic floor and work as a team throughout the process.
  • Then in a lying down position, your external pelvic floor is assessed visually and tactilely.  Looking for discoloration, movement during active contraction and relaxation, and bearing down of the pelvic floor. 
  • The external pelvic floor is then assessed for sensation and pain.
  • The nervous system is then tested for normal reflexes with touch.
  • Then using a water based lubricant, the internal examination begins.  This is done with 1-2 fingers based on comfort.
  • Tissue is assessed for elasticity, pain and trigger points.  
  • Strength is tested with the patient doing active pelvic floor contractions and relaxations.
  • Prolapse is assessed.
  • Depending upon findings and patient’s tolerance, treatment will also begin at that time.  This could be education to correct a dysfunction, manual work such as applying pressure/scar tissue mobilizations to the painful or restricted areas of tension in the pelvic floor, and coordinating the pelvic floor work with breath and alignment.  
  • At the end of the assessment, a treatment plan is made with the patient for the goals moving forward. 

Personally, I have never done internal work (pelvic exams)  in isolation from other treatment modalities, and believe most therapists are the same.  The internal work is just one component to the overall treatment plan.  I treat the patient as a whole and internal pelvic exam is only a part of that. 

“Our goal as a physical therapist is to get your body to work as optimally and efficiently as possible to prevent injury and for some people that might include assessing and treating the pelvic floor.”

Having the knowledge that this work exists can be so helpful in recovery of symptoms.  Some clients might need internal work weekly for a few weeks, others only once and some will even continue doing parts of it on their own at home.  It is completely individual, there is no one size fits all approach.

So if you are struggling with pain, incontinence, anorgasmia, recovery from labor or simply want to connect with your pelvic floor, this assessment could be for you. I look forward to connecting with you during a session.

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IN THE KITCHEN | SMOOTHIE RECIPE

My smoothies tend to be a combination of whatever I have left in the fridge, so I really had to think about what some of my favorite combinations are these days…since they change frequently.  

But this combination (or close to it) is usually my go to.  I just made it the other day and love how refreshing, energizing and simple it is! Do you have any go to favorite green smoothie recipes? I’d love to know about them in the comments below! 

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Ingredients:

  • handful of kale
  • ripe apple
  • ripe avocado
  • 1/2 cucumber
  • 2 stalks of celery
  • handful of parsley
  • a bit of ginger
  • Juice of 1 lemon
  • 1/4c. aloe vera
  • dash of cayenne
  • Scoop of greek yogurt
  • water, coconut water or almond milk (pour to your desired consistency)
  • ice

Directions:

  • Mix all ingredients into a blender, or my favorite is the Vitamix and set to the smoothie setting! Serve and enjoy!
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