Are You Skinny Fat?

Ah, spring time…time to clean up your closet, clean up your diet, and most importantly clean up your health. For many of my patients, I see them launch into a crash diet.  To be honest, I did the same.  But what happens when you are done?  You gain it back….but why?

Perhaps  you’ve gained weight from eating more of what you didn’t before.  But it goes deeper than that.  For those that have lost over 20 lbs. and put it back on quickly, it has more to do with how you took it off.

In 2001, I weighed 265.  I blamed it on having a baby – but I had her in 1998.  Admittedly, I’m tall – but 265 is pushing it.  My body hurt.  I wore a size 22.  After Christmas of 2000, my sister got cute little workout clothes, and I got kitchen equipment and mumu’s.   I had had enough!  Nearing the clinic in chiropractic school, I didn’t see any overweight chiropractors and said, “I don’t want to be the only overweight chiropractor.”  (Since then, I’ve seen many :) – but I used that as a mantra.  

Using Weight Watchers, over the course of a year, I lost 80lbs.  Sometimes I would fast if I ate too many points and eat a head of broccoli for dinner or their Cheese Soup that was 1 point.  I didn’t really change what I ate – only the amount.

When I lost the 80^th pound, I stood up and bragged how I never had exercised ONCE.  Not one single time in the entire year and I still lost weight.  How stupid I was.

After keeping the weight off – I looked great.  I wore a size 12 (I’m 5’11) so that was great for me!  

My first job was at Gold’s gym in King of Prussia.  People thought I looked fit and invited me to the circuit class.  

Again – thinking because I’m thinner – I am in shape, right?  The circuit class was held in the middle of the floor for all to see working out.  Within 2 stations, I was ready to puke.  With sheer embarrassment, I shook off to the bathroom and could not get out of the stall for an hour!

So embarrassing!

So here is what happened.  I lost 80 lbs. in 7 months.  I burned off the fat, along with lean muscle.  Lean muscle is an indicator of health and vitality. Because I burned off my lean muscle, lack of exercise resulted in rapid weight gain.  When you crash diet you take away the bad and the good.  Even if you exercise and diet – if you do it too fast (which is what everyone wants!) – you‘re setting yourself up for future failure.

When you diet to lose weight, your goal should be to maintain your lean muscle while losing the fat.  How do you monitor this?  We use a device called a Bioimpedance Analysis . A BIA evaluates your body fat, lean body mass, and calculates your fat content.  This is the most accurate, short of a DEXA scan.  People think the underwater body testing is accurate, but the BIA is just as effective, as you cannot express the oxygen out of your lungs which occupies mass and space.

How should you do it?

1.    Incorporate an exercise program, even if it is just walking.  For us women over 35, you should include a weight-bearing exercise program with weights.  Women will NOT bulk up using this.  If you need help, ask your sports medicine doc, chiro, or PT.  Perhaps you have a trainer at the gym and have never used your free sessions.

2.    Don’t push it.  It took time to put the weight on, and long-term, do you want to just lose it now, only to gain it back?

3.    Make sure you are eating whole foods that are nutrient-dense.  The more ingredients something has – typically the less healthy it is. 

If you ever have any questions, please ask.  I took off 18lbs. last year – and I know each one of them is off for good!  Losing weight is simple science, but it is important to understand the why’s to gain long-term weight loss.

Breech Babies

Me and my new niece, Quinnie - March 2011

One of the most spiritual moments in practice was in April of 2007.  I had a mom who was on her third pregnancy - and she had a transverse breech baby.  At 38 weeks, she was so nervous because her other two came early and she didn’t want a c-section.  On the second visit I saw her, I could feel the baby playing with me with her feet on the left side of mom’s abdomen.  I myself was 7 months pregnant - so we joked that our girls were playing together.  I adjusted her lower back gently and turned her over.  As we chatted - I applied a gentle pressure on a trigger point in her round ligament near her lower abdomen.  Her baby began to kick on the right side.  I talked softly to the baby - and all of a sudden, I felt the baby’s head which was on the right side poking out to the right side of mom come down and pass under my thumb like a Skee Ball just rolling down and RELIEF.  We both knew that her baby had moved right into position to be delivered.  It was incredible.  3 days later, she delivered a healthy happy little girl.

Many of you have heard me say that around 4 times per year - 85% of my entire practice is pregnant.  They come in crops.  :) I love, love, love seeing moms.  Especially first time ones.  They have NO idea what they are in for....the good (and sometimes the sleeplessness, etc) but overall - the amazing experience of having a baby.

If someone were to ask me what my favorite type of patient I see, it is a breech presentation mom.  They come to me by their trusted OB, midwife, or by doing a desperate search on the internet.  I can’t even imagine - a pregnancy that has been humming along so perfect and then **BAM** you find out the baby is breech.  Everything stops.  The priority is now turning the baby.  Before that - a woman is already dealing with the impending obvious that the end is near - and “How am I gonna give birth?”  (to which I always recommend gently for them to go to the mall and sit down - and watch the hundreds of people walking by - each coming out somehow and ok! :)

So breech.   There are a few types of breech.  Footling breech (meaning the feet are presenting first), frank breech (where the bum is presenting first) and my favorite (although not a favorite for a pregnant mom), the transverse lie.  Carrying a baby should look like a watermelon standing on end.  A transverse just looks painful, in that it looks like the “watermelon” went sideways - stretching, stretching, stretching.

Why does breech happen?  No one knows for sure.  I see about 100 cases a year.  Babies naturally should start to get into a head down position around 32 weeks.  Definitely by 36 weeks. Some moms can feel that the baby changed position - or in some cases can feel the kicking down below.  Ouch.

To a chiropractor - breech happens most times because of improper alignment/biomechanics or the structure of the mother.  Think of this.  If your pelvis is two moving pieces held together by ligaments (like plastic fruit bags that stretch and don’t come back to their normal shape, called plastic deformity) and one side of your pelvis is malpositioned - it pulls or puts an unequal stress on another part.  

So let’s say someone’s sacrum (part of that complex) is sticking too far back on the right.  It is in the wrong position and could have been for years without symptoms - the compensatory way your body deals with that being all the way back there is to tighten the other side as a counterbalance.  

It is more complicated and medical-esed that that - but I digress.  

The ligament that takes the brunt of that backward pull on the front - is the round ligament - which in a pregnant stomach is around the bottom underside of the belly.  If you were like me - a few times I thought I was being stabbed with my first there - because of the rapid expansion.  Anyway - that ligament gets too tight and causes what we pregnancy chiropractors call, “Interuterine constraint.”  I call it not enough room on the one side for your baby to “spin.”

How does a chiropractor assess if someone for Webster protocol?  In my office - I put them on comfy pillows on their belly.  I find out which side is “stuck” in the sacrum.  I adjust that side and nothing else.  That helps take the “slack” out of the tension in the front.  I turn them over (telling her to tell me if she gets dizzy because we are only going to be on the back for 2 minutes - when you lay on your back in a hospital bed for hours on your back it’s safe) and in a specific spot - find a trigger point that the mom and I can both feel - and I hold light pressure until that knot lets go a bit.  It is unbelievably gentle compared to a medical inversion.

Also helpful is acupuncture with moxibuxtion, I’ve seen.  

So the next time you hear of someone who has a breech baby, tell them not to fret.  Chiropractors have great results with Breech babies, the national average is around 85%.  My average over almost 10 years is around 92% which is awesome.   It’s gentle and safe!

How do you find a chiropractor who does this and is certified?  www.icpa4kids.com is a great resource for finding docs with that certification.

Until next time, if anyone has any questions about health or chiropractic, please feel free to get a no pressure answer email me at drbrandie@gmail.com.  Or I could write about it for next month! 

Breech
By: Dr. Brandie

One of the most spiritual moments in practice was in April of 2007. I had a mom who was on her third pregnancy - and she had a transverse breech baby. At 38 weeks, she was so nervous because her other two came early and she didn’t want a c-section. On the second visit I saw her, I could feel the baby playing with me with her feet on the left side of mom’s abdomen. I myself was 7 months pregnant - so we joked that our girls were playing together. I adjusted her lower back gently and turned her over. As we chatted - I applied a gentle pressure on a trigger point in her round ligament near her lower abdomen. Her baby began to kick on the right side. I talked softly to the baby - and all of a sudden, I felt the baby’s head which was on the right side poking out to the right side of mom come down and pass under my thumb like a Skee Ball just rolling down and RELIEF. We both knew that her baby had moved right into position to be delivered. It was incredible. 3 days later, she delivered a healthy happy little girl.

Many of you who attended the UMMC Fit Fest in my office heard me say that around 4 times per year - 85% of my entire practice is pregnant. They come in crops. :) I love, love, love seeing moms. Especially first time ones. They have NO idea what they are in for....the good (and sometimes the sleeplessness, etc) but overall - the amazing experience of having a baby.

If someone were to ask me what my favorite type of patient I see, it is a breech presentation mom. They come to me by their trusted OB, midwife, or by doing a desperate search on the internet. I can’t even imagine - a pregnancy that has been humming along so perfect and then **BAM** you find out the baby is breech. Everything stops. The priority is now turning the baby. Before that - a woman is already dealing with the impending obvious that the end is near - and “How am I gonna give birth?” (to which I always recommend gently for them to go to the mall and sit down - and watch the hundreds of people walking by - each coming out somehow and ok! :)

So breech. There are a few types of breech. Footling breech (meaning the feet are presenting first), frank breech (where the bum is presenting first) and my favorite (although not a favorite for a pregnant mom), the transverse lie. Carrying a baby should look like a watermelon standing on end. A transverse just looks painful, in that it looks like the “watermelon” went sideways - stretching, stretching, stretching.

Why does breech happen? No one knows for sure. I see about 100 cases a year. Babies naturally should start to get into a head down position around 32 weeks. Definitely by 36 weeks. Some moms can feel that the baby changed position - or in some cases can feel the kicking down below. Ouch.

To a chiropractor - breech happens most times because of improper alignment/biomechanics or the structure of the mother. Think of this. If your pelvis is two moving pieces held together by ligaments (like plastic fruit bags that stretch and don’t come back to their normal shape, called plastic deformity) and one side of your pelvis is malpositioned - it pulls or puts an unequal stress on another part.

So let’s say someone’s sacrum (part of that complex) is sticking too far back on the right. It is in the wrong position and could have been for years without symptoms - the compensatory way your body deals with that being all the way back there is to tighten the other side as a counterbalance.

It is more complicated and medical-esed that that - but I digress.

The ligament that takes the brunt of that backward pull on the front - is the round ligament - which in a pregnant stomach is around the bottom underside of the belly. If you were like me - a few times I thought I was being stabbed with my first there - because of the rapid expansion. Anyway - that ligament gets too tight and causes what we pregnancy chiropractors call, “Interuterine constraint.” I call it not enough room on the one side for your baby to “spin.”

How does a chiropractor assess if someone for Webster protocol? In my office - I put them on comfy pillows on their belly. I find out which side is “stuck” in the sacrum. I adjust that side and nothing else. That helps take the “slack” out of the tension in the front. I turn them over (telling her to tell me if she gets dizzy because we are only going to be on the back for 2 minutes - when you lay on your back in a hospital bed for hours on your back it’s safe) and in a specific spot - find a trigger point that the mom and I can both feel - and I hold light pressure until that knot lets go a bit. It is unbelievably gentle compared to a medical inversion.

Also helpful is acupuncture with moxibuxtion, I’ve seen.

So the next time you hear of someone who has a breech baby, tell them not to fret. Chiropractors have great results with Breech babies, the national average is around 85%. My average over almost 10 years is around 92% which is awesome. It’s gentle and safe!

How do you find a chiropractor who does this and is certified? www.icpa4kids.com is a great resource for finding docs with that certification.

Until next time, if anyone has any questions about health or chiropractic, please feel free to get a no pressure answer email me at drbrandie@gmail.com. Or I could write about it for next month! Have a great April!

Are You Fixed? http://ping.fm/bXYRG

Are You Fixed?

Most people who seek out our office want to be better.  They want to feel better, look better, function better.  They want to not limp anymore, play with their kids without pain, or be able to read a book without suffering from debilitating migraines.  We get great results in getting them to their goals.  And then what?

Just like the end of a great chick flick - everything comes together and then what?  The End!  You are cured?  Fixed?

Hmmm....chiropractors are notorious for "Once you go to a chiropractor - you go for life!"  

Yup - hear that about 5-10 times a week with our new patients and being goal-focused - it has always bothered me and bothered me a lot.   Arthur and I get adjusted every two weeks.  My kids get checked at least the same.  Our staff is the same.

I don't have any financial gain to get adjusted or adjust my kids - I just want them to be the healthiest they can be.

Early in practice - I wanted to be better than that with my patients.  I mean - they were paying so I wanted to "FIX" my patients - thinking they could.be.fixed.  So why was I not fixable?  Why did I and my family continue to get adjusted?

I knew they would never be fixed.  But on a daily basis - that's what I heard them say again and again.

"Dr. Brandie, I want to fix this.  I want to come in 2 times and fix this."  "You didn't FIX this last time - so I had to come back."

But what on Earth gets "fixed"?

I'm a mechanic - I fix your car.  Now your car will never breakdown again?

I'm a contractor.  I fix your house.  Now your house will never need repair?

I'm a diet plan.  I lose 50 lbs.  Now I will never gain the weight back?

I'm a dentist.  I fill your teeth and clean them.  Now I'll never have to go back?  And if I get a cavity - "Man, that dentist didn't work - my problem came back!"

I could go on and on....

What doctor doesn't have you come back for checkups?  Optometrist - GYN - Family Doc?

Here is a news flash...no one can fix you.  Not any chiropractor, physical therapist, or doctor.  It doesn't happen.  

The body is a living organism that is subjected to so many stresses in a day.  Slouching on the computer, bad food, and chemicals.  You don't live in a sterile, non-weight bearing environment where everything is going to stay perfect!

People are living longer.  If you feel bad now - how will you feel with 40 more years????  

Your structure - your spine - your feet, knees, and hips will determine how enjoyable your Golden years are.  If you can no longer walk well - what is your quality of life?  

If you are a 40 year old coming into my office - I send out many times for x-rays - because it is a mixed bag.  Some will have gorgeous spines - aligned - without arthritis - and normal curves.  And some are a train wreck - the product of a life of neglect.  How you use it and have taken care of your body - will show and will determine how well you respond to care are not up to me.  It is up to what you came in with - how much degeneration you've had.  How much adhesions and gristle and muscle spasm you have.  It has to do with how you follow what we recommend.

Many think they are above that.  "He said to come in 3x/week (just like PT) but I can't make it/don't have the money/don't have the time/mercury is in retrograde - so I'm going to make my own schedule and whatever happens is a reflection of him as a doctor."  And if you dieted once or twice a week - how much weight would you lose?

"She recommended for me to come in to get checked monthly - but I am too busy, and I feel great, and my insurance doesn't cover it - so I'll see how it goes."   Well, let me come back in when my teeth hurt and have cavities - because up until then - I was golden.  No pain, everything's fine right?  What I can't see - won't hurt me!

Just like my home that was built in '73 - I, too, am seeing that I am needing all kinds of  maintenance, even if I don't have the money for it.  I have money to get my nails done, have a cleaning lady, and a large SUV.  But I don't have money to maintain my health?  Oof. 

Like physical strength maintenance.  I used to work out solely to lose weight.  That is it.  I hate working out.  Hate it!  For the last three months - I go three times a week and run on Sundays because I FEEL better.  I function better.  Small things like having energy at the end of a 12 hour day, or being able to get out of bed by not literally pushing myself out of bed - are priceless.  

I am taking responsibility for my health and am proactive with my health.  There is a cost for that.  A cost of money and of time.  Sure I'd like to be sleeping on Tuesday, Thursday, and Saturdays at 5:30am - but I head to bootcamp - and at the end - I feel better.  Happy.  More balanced.  Stronger.  Leaner.

Oh, and about "fixing things..." while we are on that - imagine if I told my trainers, Mike and Jen Brango from Great Valley Adventure Bootcamp - that they had 2-4 visits to "fix me" because "you know, you trainers - once you go - you go for life!"

Fix my bad habits.  My neglect on my weight.  Fix all my weaknesses in less than a month.  And I'm fixed.  I'm done.

My trainers do Groupon (website) deals for a deep discount - much like we take all insurances.  Many clients of theirs find them that way.   Imagine a Groupon customer saying to them - "Hey guys - I have 12 sessions with you under Groupon - and after that I have to pay out of my own pocket.  So let's just do the 12 sessions - and by the way - you need to get me to have 40 lbs. off in that time.  After that, I'll wait a few months until the new year when you run Groupon again to pay less so I get a great deal because I don't want to pay for my health anything more than I have to."

It doesn't work that way.  How would I look after not working out for months after only working out 12 times?  That's like paying someone to mow your grass half the summer looking pretty only to wait until next year to cut it again.  Life happens.  Degeneration happens.  It's your body.  It's your health.  It's your responsibility!

It makes no sense to think otherwise.  So why do we - as a collective - think that it is effortless and doesn't need our attention?

Just like every other part of your body - you need maintenance.  Your spine and nervous system are the keys to a happy and enjoyable life.   Sounds crazy - but it's 100% true.  If they don't work properly - you aren't going anywhere.  Your quality of life is compromised.

So if you haven't been back to your chiropractor in months or years - go get checked.   Get on a regular program to get checked to stay flexible.  Stay movable.  Less fixed!  More movement! Your body in 40 years will thank you!

Maintenance doesn't mean living at your chiropractor, but like anything worth preserving - it takes some effort on a regular basis - just like everything else - your car, your house....Isn't your body more important?  Do something - Today!

Dr. Brandie

Why Massage Therapy?

Massage therapy and manual therapy are key components to optimizing benefits of chiropracticcare. Massage addresses soft tissue problems, lengthening contracted muscles and fascia.The increased circulation which massage facilitates reduces pain, swelling and inflammation,removes waste products and brings blood, oxygen and nutrients to the soft tissue helping the healing process.

But why is it important to utilize massage with chiropractic care? Firstly, adjustments proceedmore easily and with less discomfort after the muscles and soft tissue are relaxed throughmassage. Chiropractic treatments have a better effect when muscle tension is released. Also,when one area of the body is injured, the protective muscles tighten in the surrounding area.Trigger points can develop and pain or tingling can be referred to other areas in the body.Basically, massage handles soft tissue manipulation while chiropractic deals with structuralissues. Muscles move joints. Ligaments and fascia support them. If a joint is adjusted withoutaddressing the related soft tissue problems, the patient could still experience pain. Also,muscles have memory and will revert to the accustomed tension. Repeated massage andmanual therapy helps re-educate the muscles enhancing the corrected structural adjustment.

Therapeutic massage and manual therapy differ greatly from general spa massage. Therapeutic massage is injury and condition specific, applied over a period of time to illicit correction of the condition vs. momentary relief.The physical benefits of therapeutic massage are:

- reduces pain and swelling
- reduces formation of scar tissue- improves circulation of blood and lymph fluids
- relieves tension related to injury, headache, strain- strengthens the immune system
- facilitates deeper, easier breathing

King of Prussia Wellness is dedicated to the complete wellness of our patients, not just theinjured. Massage and manual therapy are key components to any wellness program. I amexcited to be part of the team here at King of Prussia Wellness, working with the doctors,nutrition counselor and other massage therapists.

Betsy Hackman LMT

A little bit about me!

I will start in present day. I love to run. I started running last year.

I was a couch potato. After working, I would come home and watch TV and eat cookies. I knew this wasn't good for me, but it was what I liked to do and what I was used to doing.

One day, I woke up and decided to run a marathon! I knew I would have to train, so I created a running team. We ran Valley Forge Park every Sunday morning. VF park is a five mile trail. It sounds crazy, but I did it. After Valley Forge, I ran the Broad Street Marathon and felt great. I was hooked. Next, I ran the Health Marathon in Philadelphia. I knew if I could run five miles and half marathons, I could run a full marathon. With little training, I ran the full marathon in Philadelphia a couple of weeks ago. It is so empowering. I get such a high from running.

Stay tuned to see what's next for me and a couple of secret weapons I use that I know help make me a better runner.

Dr. Arthur