Bone Loss

Mamas on Bedrest: Could Taking Vitamin D have Prevented My Pregnancy Problems?

February 21st, 2014

TGIF Mamas!!!

I presented the Teleseminar yesterday, “Do You or Don’t You Need Vitamin D”, and I have to say that I was blown away by all that I learned in researching the topic.  The role of Vitamin D in overall health is still under investigation, but what I found in my research to be the general consensus is this:

  • ks15435wVitamin D is important in that is aids in the intestinal absorption of Calcium, Iron, Magnesium, phosphate and zinc.
  • Vitamin D does not appear to “cure” anything, but in “adequate levels” in the blood, it seems to augment many bodily systems and functions so as to help ward off disease
  • Vitamin D levels need to be at the recommended levels all the time and before illness begins to be of most benefit.
  • Adequate Vitamin D levels definitely improve bone health in conjunction with adequate calcium levels.
  • Adequate Vitamin D levels in Pregnancy seem to prevent pre-eclampsia and preterm labor. Low levels are associated with Gestational Diabetes, Pre-eclampsia and Low birth weight in infants.
  • Most vitamins on the market don’t contain enough Vitamin D, including most prenatal vitamins. The Institute of Medicine recommends that adults take 2000IU-4000IU Vitamin Daily. Most vitamins contain 600IU
  • The Institute of Medicine and the March of Dimes both recommend that pregnant women take 4000IU of Vitamin D Daily
  • Target blood levels are 50 nmol/l according to the Institute of Medicine. However, the International Osteoporosis Foundation recommends that individuals with risk factors for osteoporosis aim for blood levels around 75nmol/l.
  • Dark-skinned people are more likely to be Vitamin D deficient because the melanin in our skin does not allow in the sun rays needed to convert cholesterol to Vitamin D in the body. Dark Skinned people should take a Vitamin D supplement because as on researcher said, “Black and brown people are urged to take Vitamin D supplements. There is very little potential risk for harm and the potential benefits are significant.”

 

I first had my Vitamin D level checked in 2009 when I was feeling awful and my doctor was trying to figure out why I was so tired and listless. At that time, my Vitamin D level was 23 nmol/l, well below the recommended 50 nmol/l. I have been taking Vitamin D ever since and now have a level of 53 nmol/l, down from my last year’s check up of 59 nmol/l.  And I have to admit, I have been feeling good and some days, “I just didn’t get around to taking my vitamins”. Well, the dip in my Vitamin D level and learning all of this research has made a believer out of me!

This whole debate really got me thinking. I don’t know how long I had been Vitamin D deficient, but according to what I have read, it may be for most of my life given that I am a dark-skinned black woman born and raised in Massachusetts. As it relates to pregnancy, I wonder if my low Vitamin D levels have anything to do with me developing uterine fibroids? One of the effects of low vitamin D in pregnant women is preterm labor which seems to be due to uterine irritability and/or placental inflammation. Well, fibroids certainly were irritating my uterus! Lost a pregnancy before having them out. Then got pregnant with my daughter and had some spotting, “cramping” (which I now know was preterm contractions) and ended up delivering her at 36 weeks and 6 days at 5 lbs 3 oz (low birth weight). If I had started taking Vitamin D at age 29 when I was first diagnosed with fibroids, would I have had the problems with my uterus/fibroids? Would I have had the miscarriage? Would my daughter have been born early and small?

I know that there are far too many variables to even make this a plausible argument. Likewise, my daughter is now 11 and I had a healthy term baby after her (well, actually after a second miscarriage!). So would Vitamin D have made a difference? I’ll never know. But it’s like the researcher alluded, Taking Vitamin D would not have hurt me and most likely would have helped me. I can’t take back what happened as I was childbearing, but I can and will regularly take 4000 IU Vitamin D daily to keep my immune system working “happily” (there is some talk that a happy immune system is “immune” to developing cancer!), to keep my bones strong and to lower my risk of falls, to ward off autoimmune diseases and to help stave off Diabetes.

Mamas, I am sure that many of you are unsure of whether or not to take vitamin D supplements. Discuss these findings with your doctor or a nutritionist. The evidence is mounting that taking Vitamin D supplements is a good thing for most people. Find out if its a good thing for you! There isn’t much if any risk of injury or harm, and yet taking Vitamin D can do much to improve your overall health. Investigate this for yourself!

I am working on the recording and will make it available soon.  If you have questions or comments about Vitamin D, ask me in the comments section below. I have compiled a lot of information and a great resource for Vitamin D supplements and will gladly share!

 

Mamas on Bedrest: NASA will pay $18,000 To Watch You Rest in Bed!

September 30th, 2013

220px-NASA_logo.svg_NASA is currently looking for volunteers to lie in bed for 70 days. That’s right, you could get paid a total of around $18,000 for lying in bed, playing games on your phone, reading books, skyping with your friends and family, taking online classes – and even go on with your day job if you can get away with working remotely, so long as you don’t get out of bed for that entire duration.

This is the headline posted In the September 18, 2013 ForbesWoman online magazine. I almost fell out when I saw the headline. Heck, We could bankrupt the government if I sent all of you over there as participants! So I investigated and got the skinny on the study.

According to the article and Dr. Roni Cromwell, Senior Scientist on the study, the purpose of the study is to research the effects of microgravity (living in space) on the human body.  The study simulates the effects of long-duration spaceflight by having test subjects lie in beds for the 70 day period. The beds are tilted head-down at a six-degree angle. According to Dr Cromwell, “this tilt which causes body fluids to shift to the upper part of the body, sets off cardiovascular events that are similar to what we see in a space flight. And by putting someone in bed for a long time, there is also atrophy of the muscle and atrophy of bone density,” she said. The ultimate goal is to see how best to protect and maintain the health of astronauts while they are in space. Additionally, NASA scientists want to see if they can minimize the negative effects of space travel and then help astronauts return to “life on earth” as quickly and effortlessly as possible.

I find this amazing! There is an actual study looking at the “negative effects” of bed rest and measures to counteract it! Have any of you been offered such counter protective measures? And I know that many of you are on bed rest longer than 70 days! Has anyone been offered any sort of Stipend for their  oh, 20 weeks or so of bedrest??? This is absolutely amazing to me that NASA is going to such lengths to protect the health of their astronauts Wow!! All I can say is Wow!

Interestingly, the subjects NASA is looking for must be very healthy and must go through rigorous screening to make sure that they can endure 70 days of bed rest. Were any of you ladies screened??

According to NASA, “We want to make sure we select people who are mentally ready to spend 70 days in bed. Not everyone is comfortable with that. Not every type of person can tolerate an extended time in bed,” says Dr Cromwell.

No Kidding! Really??

“Once they qualify physically and mentally, we do rigorous physical exercises to test muscle strength and aerobics capacity. We want people who have the physical and psychological characteristics of an astronaut. They should be able to do the kind of activities that astronauts do.”

 But can astronauts do the “rigorous activities that mamas do? Can that program prepare astronauts and other civilians to be ready for the demands of motherhood after a mere 70 days of bed rest?  Hmmmm……

And to make sure that folks stay in bed, the test subjects will be showered and use specially designed facilities. 

Well I am simply floored! While I am excited to see how NASA is training and studying the effects of weightless on astronauts, I am appalled that very little work has been done for pregnant women. Bed rest is prescribed for some 750,000 pregnant American women annually. They are given no pre-treatment, no pre-screening and most certainly no $18,000!  In a country with no paid leave, this would mean the difference between mamas being able to actually rest and calmly gestate their babies and potentially losing their jobs, homes and financial security.

NASA has long looked at the effects of bed rest on the body and reached the conclusion that it is not good for any body to be on prolonged inactivity. Judith Maloni, PhD spent her career studying bed rest and how to improve ways to treat high risk pregnant women as bed rest has been shown to have numerous negative side effects on women’s bodies. And yet, NASA gets funded to evaluate weightless on astronauts over a 15 week period. Women who are out on pregnancy bed rest longer than 12 weeks typically do so without pay and risk losing their jobs.

I am hopeful that once NASA completes its study, it will share the results and the medical community, particularly the obstetrical community. I hope OB’s will take heed and make changes in how pregnant women on bed rest are managed. Let’s pay more attention to bone and muscle loss and try to offset it. Let’ s protect mamas’ hearts by taking into consideration the cardiovascular changes that occur with prolonged bed rest and make appropriate evaluations and precautions. And by all means, if it’s all in the name of science, let’s compensate mamas for their efforts! Seems to me that we ought to do something for those propagating our species right here on old planet earth rather than looking for other species on Mars. Just sayin’…..

Mamas on Bedrest: Regaining Muscle Strength After Bedrest

July 1st, 2013

A mama asked this question and I figured, rather than respond to her privately, I’d reply for the benefit of everyone.

Q: My daughter is 20 months old and I was on strict bed rest from 20 weeks until 36 weeks. My question is, “How long does it take before your muscles get back to “normal”? My leg muscles are still horribly weak. I work out, hike, ride horses and walk a lot. Will my muscles ever return to normal? Has anyone else experienced this?”

sidelayingBed rest has been long been known to cause bone loss, muscle weakness and loss and weight loss. The first studies done by NASA to determine the effects of weightlessness on metabolism established that in as little as 60 days, women on severely restricted activity can lose up to half their strength. What’s more, not even dietary changes can help. The NASA study showed that women placed on high protein diet lost even more muscle mass than women who made no dietary changes.

Exercise was the only intervention that NASA found to reverse the negative physical effects of activity restriction. In their study,

The exercise regimen included a 40 to 50 minute aerobic workout two or three times a week and 20-minute strength tprraining sessions two or three days a week. While lying on their backs, the women did multiple sets of thigh and calf exercises using a flywheel device similar to a typical leg press machine at a gym. They also worked out on a vertical treadmill.

While many may balk at the thought of the vigorous exercise prescription recommended by NASA being used for women on bed rest, there really isn’t any reason that women on bed rest can’t participate in modified exercise programs.

So let’s get back to our mama’s question. She is 20 months post partum and still feeling significant muscle weakness. When I reviewed the literature, there is consensus that bed rest does in fact significantly reduce muscle mass and strength, and according to Judith Maloni, PhD, in her publication Antepartum Bed Rest For Pregnancy Complications: Efficacy and Safety for Preventing Preterm Birth “the physical changes that occur during bed rest are not resolved by 6 weeks post partum.” Unfortunately, I was unable to find any publications that looked at the effects of bed rest on maternal physical health specifically, and no publications that were able to give a time frame within which a mama can expect to regain her pre-bedrest strength and endurance.

078One thing that I have seen coincidentally is that many women come off of bed rest, either just before or at delivery, and want to resume their pre-pregnancy activity levels immediately post partum and feel that something is wrong with them when they are unable to “jump right back” into their pre-pregnancy activities. I always recommend that “former” Mamas on Bedrest ease back into activity. Mamas who were on strict bed rest during their pregnancies for two weeks or more are significantly de-conditioned (the longer the bed rest stint, the more de-conditioned mamas body becomes), and the approach needed to regaining strength and endurance is not unlike that needed to retrain individuals to walk again after a significant injury (i.e. a car accident). People who suffered significant injuries resulting in weeks to months in a coma or in bed take months to years to regain their functionality. While the bed rest prescription does not create the same type of insult to the body physically as a traumatic injury, the effects on the physical function of the muscles and bones is very similar. So much like an injured person must go through weeks to months of physical therapy, Mamas on Bedrest should take a similarly slow, gradual, step by step incremental approach to regaining their pre-pregnancy physical strength and endurance. They may choose to work out with a personal trainer, a physical therapist or in a class specifically designed for post partum mamas, with emphasis on mamas who have been on prescribed bed rest.

So how can Mamas on Bedrest avoid or at least reduce the deconditioning they may experience as a result of bed rest? They must exercise while on bed rest! While the NASA study had the astronauts using flywheel cycles and weight, mamas on bed rest can perform modified stretches and strength training right from their bed. We put together a full set of exercises and stretches in our Bedrest Success Kit, yours free when you subscribe to our monthly e-newsletter (The upper right hand corner of this page!!), as well as several samples of exercises on the Mamas on Bedrest Youtube Channel.

So good luck Mamas! Let me know how this post helped you in the comments section below. I am eager to hear your success stories and other questions! You can also send e-mail to info@mamasonbedrest.com if you prefer a private correspondence.