Wednesday, 26 September 2018

October is Breast Month

In just a few short days, we will be into October! I don't know where the year has gone but Fall is definitely my favourite season so I am not complaining. It is also Breast Cancer Awareness Month, and a great time to revisit breast health.

There are many, many different factors that add to breast health risk and protection, from hereditary factors, to reproductive, lifestyle, hormonal, environmental, dietary and even psychological. Some of these factors we have control over, like our diet- eating foods from the brassica family (cauliflower, cabbage, broccoli) are protective; while others, we do not, like our family history or how tall we our (under 5' 6" tall tends to be protective).

One preventative measure we do have control over is performing self-breast exams and knowing our bodies and breasts, so we can notice any changes.

The best time to perform a monthly breast exam is a few days after you menses begins, or if you are no longer menstruating, the same time every month. This is because fluctuating hormones can change our breast tissue for example, if you have fibrocystic breasts (more on that below).

To perform a monthly breast exam, start with visualization. What you are watching for is any dimpling, puckering, bulging irregularities or changes in size. Look for any changes in your nipples such as inversion or displacement to one side. Notice any skin texture or colour changes.

Visualization should be done in 5 different positions- each highlighting a different area of the breast.

  1. Pace hands on hips and apply pressure- examine contour.
  2. Slowly raise both arms over your head, stretching up high- examine breasts and underarm (armpit) area.
  3. With arms above head, clasp your hands together and bring them down behind your head. Bring elbows back and squeeze your hands together- look for changes in appearance to breasts or underarm.
  4. Bring your palms flat together in front of your forehead with your elbows out to the sides, press hands together- examine breasts.
  5. Bend forward from your hips until nipples point down, resting hands on knees. In the mirror, observe the contour of your breasts for any irregularity.
The second step is to perform the palpation exam. This is probably the part which most women think of when they think of performing a breast exam. It involves gently but firmly feeling the breast tissue to detect any unusual thickening or lumps. Many women perform a breast exam while in the shower, however, I would recommend lying down especially if you have larger breasts.
  1. Lie back with a pillow under your shoulder to stabilize and support the breast you are examining. Rest the hand of the examined side behind your head (ie. Right hand behind head when examining right breast).
  2. Using 2 or 3 fingers of one hand, use the pads of those fingers to palpate the opposite breast (ie. use left hand for right breast). Make small circles with your fingers as you press towards the ribcage, moving the skin with your fingers. Use three levels of pressure to detect any lumps at various depths. Start with gentle pressure, then moderate and finally deeply enough to feel the ribs beneath.
  3. Using an up and down pattern, move from armpit, down to the bottom of your breast just below the fold of skin under your breast, move slightly inward and come back up to your collarbone (even just above the collarbone), and then move slightly inward again and back down to the bottom of your breast. Continue this until you reach the middle of your chest.
  4. Be sure to include the arm pit as this is often an area where persistent, swollen lymph nodes can be found which are an indicator of breast cancer.
  5. As you compete the exam, squeeze each nipple to notice any discharge. Unusual or bloody discharge warrants follow up with your medical doctor.
Image From Penn State Hershey Medical

What you are looking for if you find any lumps:
  • size
  • location
  • tenderness
  • shape (smooth or irregular edges)
  • texture (hard or soft)
  • moveability
  • lymph node swelling
  • nipple discharge
To help monitor any changes, consider using breast mapping to drawing out and add any characteristics to lumps you may find.

A note about Fibrocystic Breasts.

Up to 20-40% of premenopausal women have fibrocystic breasts. This is when the breast tissue contains soft, tender, moveable cysts that are predominantly noticeable between ovulation and menses (1-2 weeks before menses). After menses begins, they often diminish and aren't noticeable until ovulation/premenstrually.

These cysts are cyclical in nature, vary in size and are often painful, free moving and multiple, occurring both breasts.

Though this a common occurrence for many women, it is suggestive of hormonal imbalance. As is breast swelling/tenderness (whether cystic or not). Fibrocystic breasts does increase breast cancer risk and detection is often more difficult due to the density of breast tissue that often occurs with fibrocystic breasts. Breast tenderness, swelling and fibrocystic breast disease can often be reduced if not resolved with hormonal and nutritional support, talk to your Naturopathic Doctor if this is something you are experiencing. Breast massage can also be helpful for breast health and swelling/tenderness, speak to one of other RMTs who offers breast massage for more information!

Disclaimer: The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. This information shouldn’t take the place of seeing a Naturopathic Doctor or your primary care provider for individualized health recommendations.

Monday, 24 September 2018

What makes movement good? And how do we improve movement?


Movement is a delicate balance between opposing muscle groups (agonists and antagonists) and stabilizers. Agonists are the muscles responsible for the desired movement, antagonists are the muscles that insure the movement is smooth and appropriate, and stabilizers are those that control joint mechanics and provide a foundation upon which to move.

Pain with movement is often the result of faulty mechanics or co-ordination of the players involved. When stabilizers are used for movement purposes they fatigue and get strained causing pain. Poor movement strategies = joint dysfunction.

Let’s look at the shoulder, the glenohumeral (GH) joint. There are many muscles that move the arm relative to the glenoid fossa, the "socket" part of the GH joint. These big muscles flex, extend, rotate, etc. the arm, but what makes their use efficient and pain free? Three things:

1)    knowledge of the desired movement (compliant agonists and antagonists, “movers”)
2)    solid global stabilizers (spine, scapula, and pelvis)
3)    healthy local stabilizers (‘rotator cuff’)


The ‘rotator cuff’ isn’t designed for big movements but rather for stabilizing the head of the arm, the “ball”, in the “socket”. Its purpose is to compress and change the line of pull on the “ball” as the arm travels through its range of motion.


So what can we do to help fix dysfunctional movement and its associated aches and pains?


Electro-acupuncture is an excellent way to reset muscle tension, decrease pain, and improve motor function. When we feel the contraction of a muscle in isolation, we teach our brain about the importance and quality of its action. Electro-acupuncture helps make the muscle malleable so that it can respond better to movement strategy retraining. The combination of these two strategies will set you on your way to more efficient and pain free movement.


Dr. Mark Bird, BSc (Hon), MSc, Acu, DC

Wednesday, 19 September 2018

Wellness Wednesday with Jazmine Tufford-Singh


Making Smooth Transitions

Jazmine Tufford-Singh
Registered Psychotherapist, Art therapist M.A., Canadian Certified Counsellor Psychotherapist and Art Therapist in Private Practice in Kitchener-Waterloo


I am a registered psychotherapist and art therapist working in private practice in the Kitchener-Waterloo region. I have the pleasure of working with child, youth, and adult clients in individual therapy, meeting and connecting with them exactly where they are on their path. I also offer a variety of workshops in the community, centring around topics such as creativity, self-compassion, parenting, anxiety, and more. 


Today I have the pleasure of being a guest on the Coach Houses Wellness Wednesday video and blog to share about the transition back to school and shed some light on how parents can best support their children in this time of change, and others.

The transition back to school in the fall is a crazy one, for everyone involved. Kids are transitioning from being home for the summer, perhaps on a camp or daycare schedule (with different rules and routines at each I might add), with some family vacations in there too. Parents are transitioning from a regular work schedule, but often dealing with their own stresses from balancing the family routine, as well as the emotional blues that come as the summer winds down and we always seem to wish we embraced it more than we did.
As much as school can be loved by kids, it can also be a source of stress and anxiety with academic pressures, social struggles surrounding making new friends or just navigating existing friendships, and again, an entirely new full week routine to adjust to, complete with homework and extracurricular activities throughout. Goodness, arent you exhausted just thinking about it?

As the parents supporting these guys heading back to class, I feel that one of the most important things to remember is to simply remind yourself of how this transition truly affects your child, whose brain and overall self is still developing to learn how to cope with it all. As adults, we are better able to articulate our feelings, when we need some time to ourselves, when we are hungry, tired, or need a hug from a loved one. We often unfairly expect the small people in our lives to be able to do the same.

Instead, it is our job as adults supporting our children to do our best to make space for the emotions that they could be feeling, predict what may overwhelm them, make them nervous, worried, or upset. Kids need to know that it is okay to feel what they are feeling, that everyone feels that way sometimes, and that they dont have to be alone in dealing with those big emotions. This allows them to feel seen, heard, and understood, and this is so very important given how scary it can be for a small person feeling big emotions for the first time.
So how do you give your child these messages about emotions? It is much easier than you might think.
Unfortunately, Emotions 101isnt a class that is taught in school, so its up to us as the adults to teach kids how to regulate their feelings, and we can do this through teaching them by doing it along with them.

Incorporate Emotions into the Conversation
Instead of asking your child how their school day was, ask them what made them excited, angry, happy, or frustrated that day. This will welcome them to share more, and you will learn about what kinds of situations illicit these emotions for your child, allowing you to move more deeply into exploring what they might do differently next time, and providing your own guidance to help.
Children dont have a full vocabulary to name the emotions that they feel, so we must teach them these words, what they mean, how they might be felt in the body, and what to do when they feel them. Childrens books centred around emotions are a wonderful resource to ignite these conversations, so are emotion flashcards, and emotion charts.

Make the Time to Be With Your Child
As adults, we often think it is best to keep busy, this is essentially the core of our culture, as Brené Brown says: It takes courage to say yes to rest and play in a culture where exhaustion is seen as a status symbol.All too often this extends to the schedules of kids. Of course, there are incredible skills to be developed through sports and other extracurricular activities, but there are also moments of connection and co-regulation to be experienced when there is time for rest, play, and simply being together.

Try this: the first 20 minutes after school, when everyone has arrived at home for the evening, make a point of grabbing a snack with your child, find a seat at the kitchen table, and draw together. Have your child draw something that happened within their day, and you doodle yourself while following along. No electronics, no distractions, no place to be, but right there. You will be incredibly surprised at how much more is shared by your child when their hands are busy working away, and just how much you can learn about their authentic experience. For your child, it might not be drawing, but this activity may be a walk, baking cookies, throwing a ball back and forth, anything. Make this a daily routine, just 15 or 20 minutes of uninterrupted time together, where your heads and hearts can connect, refresh, and feel present for one another. It is so very important to have this time within the day, and ideally before or after school, as school is their workplace, and it is heading to work or coming home when we need the most time to regulate and calm. 


This idea is beautifully articulated by Lawrence Cohen, as he states: Children dont say I had a hard day, can we talk?They say Will you play with me?

What Does This Look Like in Therapy?
Kids experiencing big emotions that may be overwhelming and exploding at school or home is a common struggle that brings people to my practice. Connecting about the topics I have begun to share above are ones that I explore with parents of child clients that I work with in individual therapy, or with parents who seek out support specifically for their experience with parenting.
When working with children, I give them a safe space to be creative, feel a sense of mastery as they lead what we do or create in the therapy space, explore and express their emotions through the languages of art and play. The therapeutic relationship is arguably the most important element of the therapy itself, as they develop a sense of trust and safety, they become able to express their vulnerabilities, to be truly seen, heard, and understood, without fear of being judged. As humans, this is truly what we want and need.

Are you curious to learn more about art therapy or psychotherapy for your child or yourself? I would be more than happy to connect with you, and answer any questions you may have. As a place to begin, learn more about child, youth, adult therapy, and the overall therapy process by visiting my website: www.jtsarttherapy.com, or connect with me directly at jtsarttherapy@gmail.com.

Wednesday, 12 September 2018

Rediscovering Parasympathetic Mode

In this day and age, we are so go-go-go all. the. dang. time. to the point where we think stopping equates to laziness. Even when we are trying to 'relax', we are often making to-do lists in our heads. This is what sympathetic mode looks like. It is that constant go, blood is shunted to our extremities, cortisol and adrenaline pump and we move. The sympathetic nervous system increases heart rate, increases blood flow to extremities, diverts sugar to the blood (increases blood sugar levels), increases blood clotting, increases inflammation.


But we can run on adrenaline all the time, so our bodies have a built in counter balance- paraysmpathetic mode. This is also knowns as rest-and-digest, and it happens when stress decreases. Our bodies divert blood back to our internal organs, our digestion increases, our adrenals relax and we relax. Our parasympathic side also regulates deep sleep (stage 4), stimulates sex organs (libido and fertility).
But when is the last time you were truly in parasymptathetic mode? Go ahead, think about it. When your mind wasn't racing through a to-do list, where you weren't multi tasking, where you weren't running from one place to the next. Hard to remember? Would it surprise you to know we *should* be getting into parasympathetic mode multiple times/day?
The hormone cascade is pretty intricate. When we don't get into parasympathetic mode and our adrenaline and cortisol remains elevated it can wreak havoc on our bodies and mental health, and eventually those adrenals who are working so hard can't keep up with the constant demand and we get run down. 


Ever get lightheaded on standing quickly? Crash at night and still feel exhausted in the mornings? Mind racing at night or waking around 1-2am? Lack of motivation but push through because you *have* to?
These are all signs you are running on empty. Supplementation can help you feel better and give yourself some extra nourishment but if you don't change what caused the issue, it will just keep on coming back.

Changing your whole life routine can seem daunting but even simple changes can make a difference.

Add in some breathing exercises

This can actually be an easy add in. I often recommend people add in a simple breathing exercise before each meal. It's easier to remember to do the exercises when can associate it with an activity you are already going to do. Just taking that 2 minutes before you start to eat can help you switch into parasympathetic mode which will also benefit your digestion- remember, the parasympathetic nervous system is also known as "rest and digest" because it regulates our digestion! Check out our previous blog post by our RMT, Megan Prenty for some easy breathing exercises.

Try an app

Even though I want people to reduce their electronics use, this is one time where you can use your phone for good instead of....constant swiping. There are a tonne of meditation and breathing apps out there now with various capabilities including reminder alarms. Check out this list of apps we've found to be good options.

Focus on the bedtime routine

It is imperative to give yourself that time to switch from sympathetic to parasympathetic before hitting the pillow at night. This allows your body to start producing the hormones that create that deep, restorative sleep. If cortisol remains too high, you can have restless, light or broken sleep. Ditch the electronics at least an hour before bed (blue light messes with melatonin production) and instead engage in a calming activity like adult colouring, reading or knitting. Get into any routine that allows you some down time like taking a bath or having some tea, and make sure your bedroom is conducive for deep sleep such as completely dark and a cool, comfortable temperature.

Just sit

It's kind of weird when you think about it, but we have sort of forgotten how to just be. When is the last time you just sat and did nothing, no reading, no list making, no phone. Just. Sit. Start by adding a few minutes every day. Have your morning coffee in the backyard, front porch or a comfy chair inside and just sit and enjoy the space around you. 

Get support

The majority of our stress these days is kind of unavoidable- we have to get to work (traffic), we have to take care of kids, we have to have jobs, etc. so to say remove your stress is not realistic but it is important to find ways and tools to manage your stress. Get a massage; Participate in mindfulness; Take a yoga class; Talk to your Naturopathic Doctor about optimizing diet, nutrients and lifestyle to help deal with stress and cope. Herbs and supplements can also help support those adrenal glands and give them the nourishment they need after chronic stress. 

Don't go it alone, involve the whole family

Stress doesn't just affect adults either. Children are often overlooked when we talk about stress management. Going back to school, conflicts with friends, after school activities, can all cause stress in kids as well. But the good thing is that children are like sponges and learn by example. Involve your kids in the changes as well to help them learn healthy ways to cope with stress. In our own house we discussed what we want as a bedtime routine and have even started incorporating a guided meditation after books and tuck in. Peace Out by Bedtime FM is our current Podcast of choice which runs through a guided meditation for kids discussing various topics from deep breathing, to anxiety and how to change your reaction- just take a breathe before responding when you're upset. It's been a very welcome addition and is requested every night. Family yoga is also a great way to get kids involved and give some special time with parents. Check out our family friendly yoga routine here.



Start with small changes and don't worry about being perfect. It's a marathon not a sprint, you will always have ups and downs. Just remember, every journey starts with just a single step.


Disclaimer: The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. This information shouldn’t take the place of seeing a Naturopathic Doctor or your primary care provider for individualized health recommendations.