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Selective Mutism

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BY: ALLISON BROWN

This past week a reader asked me to write about selective mutism.  Each request for a topic allows me to share information in a way that is easy to understand.  I want to remind readers that it is important to build relationships with your primary care provider,  either a physician and or nurse practitioner. It is important to get symptoms checked out by a healthcare professional.

Selective mutism is a severe childhood anxiety disorder where a child is unable to speak in situations such as school. Affecting 1% of the population, selective mutism is rare. The term ‘selective’ means that it does not occur in all situations. Often extreme shyness, fear of social embarrassment, anxiety and social isolation can be present. In situations where the child feels relaxed (with friends and family) for example; speech is normal.

It is believed that children with selective mutism have a genetic predisposition to anxiety. They have inherited a tendency to be anxious from one or more family members.  Very often, these children show signs of severe anxiety, such as separation anxiety, frequent tantrums, and crying, moodiness, inflexibility, sleep problems, and extreme shyness from infancy on according to Dr. Shipon-Blum. 

Dr. Shipon-Blum also states that “…some children (20-30%) with selective mutism have subtle speech and/or language abnormalities such as receptive and/or expressive language abnormalities and language delays. Others may have subtle learning disabilities including auditory processing disorder. In most of these cases, the children have inhibited temperaments (prone to shyness and anxiety). The added stress of the speech/language disorder, learning disability, or processing disorder may cause the child to feel that much more anxious and insecure or uncomfortable in situations where there is an expectation to speak.”

It is said that some children feel as though they are on stage at all times and this is what adds to anxious feelings. Often negative behaviours are common before school and or social outings. It is very important for parents and teachers to understand that the physical and behavioural symptoms are due to anxiety and treatment needs to focus on helping the child learn the coping skills to combat anxious feelings. 

Once the diagnosis is made treatment can include behavior therapy;  self-re-enforcement, which involves receiving an award for speaking; self-modeling, in which the child views videos of himself speaking in a classroom and receiving an award; response initiation, in which the child spends time with the therapist until they speak, usually one to two hours but sometimes over four hours and up to a day; teaching the child’s teachers and parents to stop negative re-enforcement, such as assuming the child may not speak;  family therapy, which may help the child overcome anxiety, and medication to treat anxiety. 

It is important for parents to advocate for their children as the dialogue that comes from professionals and teachers will often tell a parent, the child is just shy, or they will outgrow their silence. Others interpret the mutism as a means of being oppositional and defiant, manipulative or controlling. Some professionals erroneously view selective mutism as a variant of autism or an indication of severe learning disabilities.

Like all conditions or diseases especially those in childhood it is vitally important to ensure a correct diagnosis, so that time and efforts are not lost on misdiagnosis.  Parents and caregivers, I cannot stress enough to meet your practitioners halfway and build those relationships. Don’t leave it all up to the practitioners, oftentimes as a parent or caregiver, your intuition or gut feeling is what makes the difference between a positive versus negative outcome.

This article is dedicated to all of the parents and caregivers out there who are coping with various situations day to day. Thank you for your perseverance, love, and sacrifices.

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Estrogen dominance and diet: What you can do to reduce risk and bring your hormones back into balance

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BY DR. VIKAS PURI

We need estrogen in order to maintain bone density, positive mood, and healthy cholesterol levels. Too much, however, becomes problematic. More women and men than ever are being diagnosed with too much estrogen in the body. Without proper balance from the other sex hormones, this can lead to an array of unpleasant symptoms. This is referred to as “estrogen dominance”. It can affect both men and women, but it is diagnosed much more commonly in women. Restoring and maintaining hormonal balance is vitally important, since elevated estrogen levels are a risk factor for breast, ovarian, and endometrial cancer in women, and prostate and breast cancer in men. Between hormones from animal products, synthetic estrogens (aka “xenoestrogens”) found in personal care and cleaning products, and even pesticides, there are many reasons why our delicate hormonal balance can be disrupted.

Some of the most common symptoms of estrogen dominance include:

  • Stubborn belly fat
  • Uneven weight distribution, with excess weight typically found in the midsection
  • Unexplained weight gain
  • Fatigue, or chronic fatigue in more extreme cases
  • Thinning hair
  • Headaches
  • Hormonal acne on the face, and especially around the chin
  • Irritability, mood swings or mood disorders
  • Bloating
  • Candida overgrowth
  • Depression or low mood
  • Anxiety
  • Body acne
  • Osteoporosis
  • Low or nonexistent libido
  • Difficulty managing stress
  • Difficulty losing weight, even with exercise
  • Infertility

In women, estrogen dominance can lead to Polycystic Ovarian Syndrome (PCOS), uterine fibroids, irregular menstrual cycles, and thyroid dysfunction. Men may also suffer from enlarged breasts and sexual dysfunction. All of these symptoms, in addition to being unpleasant and affecting quality of life, leave diagnosed individuals at risk of developing more serious conditions later on. If left untreated, hormone-dependent cancers may develop. The good news is that there are many things that can be done to lower our estrogen levels naturally. In order to prevent or reverse estrogen dominance, we first have to understand what causes it.

For this imbalance to occur, either estrogen is too high, or the hormones which balance it are too low. In women this means progesterone is too low; in men, testosterone. This can happen to women if they have taken hormonal birth control. Harmful “endocrine disruptors” (man-made compounds that interfere with the function of estrogen and other hormones) are found in plastic products such as plastic water bottles, in many personal care products, on receipts, in heavy metals, and in pesticides and herbicides. These compounds negatively affect hormonal balance even in small doses. Try to purchase natural cleaning and personal care products. It is the estrogen found in the food we eat, however, that has the largest impact on estrogen levels.

Animal products, especially dairy, chicken and fish contain high amounts of estrogen. People who eat meat regularly are exposed to high levels of these natural sex steroids. It’s important to note that estrogen hormones can be thousands of times more estrogenic than man-made endocrine disruptors. That’s right- thousands of times more than synthetic chemicals that are found to be harmful even at low doses. Yikes!

Dairy products such as milk, cheese, yogurt, butter, and ghee are innately high in hormones even if synthetic hormones aren’t added. It’s important to consider the compounded effects of both synthetic added hormones and natural estrogens in livestock feed and medications. Chickens tend to excrete the most estrogen in their urine, indicating the highest levels of any animal raised for meat. Fish, beef, eggs, and pork are all high-estrogen foods as well. If you are wondering if this could affect you, it’s important to note that chicken estrogen is the same molecule as human estrogen. Heavy meat eaters have high levels of estrogen in their urine as a result. If you have been diagnosed with estrogen dominance, reducing or eliminating your intake of animal products is a great way to help bring your hormones back into balance.

Another important strategy for balancing estrogen levels is simply maintaining a healthy body weight. Our fat tissues absorb and store estrogens that circulate in the bloodstream. Weight loss will cause the fat cells to shrink and empty out, sending estrogen and toxins to the liver to be processed and removed. High estrogen levels can unfortunately cause the body to create more fat cells, thereby producing more estrogen- a vicious cycle! For sustainable weight loss, focus your diet around fresh fruit, vegetables, and nutritious grains like quinoa. Eat healthy fats from plant foods such as avocados, tahini, chia seeds, walnuts, almonds, Brazil nuts, sunflower seeds, or coconut. These fats contain fibre, unlike fats from animal products, which makes it easier to control hunger and support weight loss. Eat plenty of leafy greens vegetables to help protect liver health. A well-functioning liver is important for breaking down estrogens. Broccoli, cauliflower, kale, brussels sprouts, cabbage, collard greens, and bok choy all contain a compound called “sulforaphane” which supports your estrogen receptors.

Finally, lowering stress levels can also help with hormonal balance. If you cannot remove certain stresses from your life, utilize strategies to assist the body in dealing with stress more effectively. Consider activities such as meditation, breathing exercises, yoga, or taking a walk in nature. Be patient during the healing process, reduce your intake of animal products whenever possible (especially factory farmed animals where hormones are used), try to avoid pesticides, and seek out natural products for personal care and cleaning.

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Treating “Erectile Dysfunction” with TCM and Nutrition

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BY DR. VIKAS PURI

Erectile dysfunction, sometimes called “impotence”, is the repeated inability to get or keep an erection firm enough for sexual intercourse.

Between 15 to 30 million men (in USA) suffer from erectile dysfunction. In older men, erectile dysfunction usually has a physical cause, such as disease, injury, poor nutrition, or side effects of drugs.

Erection begins with sensory or mental stimulation, or both. Impulses from the brain and local nerves cause the muscle of the corpora cavernosa to relax, making the penis expand. The tunica albuginea helps trap the blood in the corpora cavernosa, thereby sustaining erection. When muscles in the penis contract to stop the inflow of blood and open outflow channels, erectile is reversed.

Damage to the nerves, arteries, smooth muscles, and fibrous tissues, often as a result of disease, is the most common cause of erectile dysfunction. Disease such as diabetes, kidney disease, chronic alcoholism, MS (multiple sclerosis), atherosclerosis, vascular disease and neurological disease, account for about 70% of ED (erectile dysfunction) cases. Smoking, being overweight  and avoiding exercise are possible causes of ED. Blood pressure drugs, antihistamines, anti-depressants, and cimetidine can produce ED as a side effect. Psychological factors such as stress, anxiety, guilt, depression, lower self-esteem, and fear of sexual failure cause 10-20% of ED cases.

Is acupuncture effective for erectile dysfunction?

The traditional Chinese medicine method of using needle is the primary type of “acupuncture” that’s been studied for treating erectile dysfunction (ED). It is thought that the release of hormones and increase Qi (energy) blood circulation and flow that helps with erectile dysfunction.  The benefits of acupuncture for ED are also focused on psychological erectile dysfunction.

Also, Chinese herbs are used as an alternative therapy to increase the curative effect for erectile dysfunction.  For example: red ginseng and herbs that tonify kidney Yang and Qi.

In Chinese medicine, there are many different reasons why a person might be dealing with erectile dysfunction, everything from stress, anxiety, or reactions to medications that they are taking.

So through the addition of acupuncture treatment, herbs and lifestyle changes, we can actually get some wonderful results from those who are suffering or experiencing erectile dysfunction.

It is also vitally important to look at the role nutrition plays in relation to erectile dysfunction (ED). There is a direct connection between heart health and sexual health. The same plaque that clogs arteries and leads to heart disease also hinders blood flow to the penis, making it harder to get and maintain an erection. Because of this, erectile dysfunction can sometimes be an early warning sign of heart disease. If you are experiencing erectile dysfunction it is a good idea to get screened for heart disease as well. Luckily, the early signs of heart disease and erectile dysfunction can be addressed at the same time. A 2013 Canadian study published in Urology[1] found that participants had a 10% lower risk of erectile dysfunction with every additional serving of fruit and/or vegetables. Reducing your intake of saturated fats and adding more fruit and vegetables will reduce the risk and improve overall health. Common dietary sources of saturated fat include dairy products such as cheese, butter, ghee, milk, yogurt; meat such as beef, pork, lamb, chicken skin, lard, and processed meats; as well as fried and processed foods including deep fried foods, palm oil, cooking margarine, cakes, pastries, pies, donuts, and other high-fat snack foods. Clogged arteries from these foods can lead to erectile dysfunction, and can eventually block blood flow to the heart and brain. Fortunately, arterial blood flow can improve rather quickly simply by changing your diet. A low fat, mostly plant-based diet is an effective treatment for erectile dysfunction and can be paired alongside treatments such as acupuncture and chiropractic adjustments for a quicker recovery from ED.

The amino acid L-arginine has been found to be helpful in treating ED, as it converts to nitric acid in the body to reduce blood vessel stiffness. It can help relax blood vessels, including those around the penis. Beneficial foods that contain L-arginine include seaweed, pumpkin seeds, soybeans, peanuts, tofu, chickpeas, spirulina, and lentils. Considering adding these foods into your diet while reducing saturated fat and processed food intake, and get the blood flowing!

[1]Urology. 2013 Dec;82(6):1330-5. doi: 10.1016/j.urology.2013.07.061

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Scoliosis can be treated by chiropractic treatment

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BY DR. VIKAS PURI

Scoliosis can be tragic. It has the capability of causing both physical and emotional suffering. Scoliosis is an abnormal curvature of the spine. Mild to moderate curves may be undetectable or appear as postural distortions. More serious curves, however, can create gross physical deformity and even interfere with the lungs, heart, and many other vital organs. There is hope. While curves between 20 and 40 degrees require a body brace to be worn, and larger curves necessitate surgical insertion of steel rods into the spine, curves less than 20 degrees can respond well to chiropractic care.

There are two general treatment options for scoliosis bracing:

Full-time bracing. These braces are designed to be worn 16 to 23 hours a day. The goal is to wear them all the time with exceptions for bathing, skin care, and exercising.

Nighttime bracing. These braces use hyper-corrective forces (which put the body out of normal balance and cannot realistically be applied while a person is standing and/or performing daily activities) and are to be worn at least 8 hours a night.

Scoliosis surgery typically has the following goals:

Stop the curve’s progression. When scoliosis requires surgery, it is usually because the deformity is continuing to worsen. Therefore, scoliosis surgery should at the very least prevent the curve from getting any worse.

Reduce the deformity. Depending on how much flexibility is still in the spine, scoliosis surgery can often de-rotate the abnormal spinal twisting in addition to correcting the lateral curve by about 50% to 70%. These changes can help the person stand up straighter and reduce the rib hump in the back.

Maintain trunk balance. For any changes made to the spine’s positioning, the surgeon will also take into account overall trunk balance by trying to maintain as much of the spine’s natural front/back (lordosis/kyphosis) curvature while also keeping the hips and legs as even as possible.

Scoliosis generally affects children, particularly girls between the ages of 8 to 18. The cause varies. Some are born with this spinal deviation (congenital), which can be hereditary, or from trauma during the birthing process. Others get it from acquiring poor posture (habitual). One major cause of postural problems in young people is backpacks. Kids should use both shoulder straps on their backpacks and the load should not exceed 15% of their body weight.

Sadly, in many cases, the cause is still unknown (idiopathic). Some theorize that child “walkers” may prematurely interrupt the crawling stage that is essential for proper spinal development.

In the beginning, when easiest to correct, scoliosis is rarely symptomatic. However, an alert parent may notice that a high shoulder or low hip makes clothing fit poorly. Back and leg pains may develop but are often overlooked as “growing pains”. Neglect is the biggest danger.

In young people, their abnormal physical posture and gait lead to depression and low self-esteem. It is important that alongside physical treatment counseling be carried out to manage and optimize mental well-being.

In older adults, scoliosis can be caused by degenerative (arthritic) changes in the spine. The shape and size of the vertebrae and discs in the spine change and abnormal curvature results.

Chiropractors are specially trained to examine and detect scoliosis in its early stage. Wise parents consult our office soon after their baby is born and follow up with periodic chiropractic checkups during the growing years to ensure their child’s spine develops properly. A properly functioning spine ensures there is no abnormal stress on our spinal nerves that would otherwise impair our organs and overall vitality.

If scoliosis is found, chiropractic treatment involving spinal adjustments and specific exercises have been shown to slow, stop or even reverse the condition. These treatments improve joint motion and stretch muscles, thus helping to decrease the abnormal curvature.

To ensure your child’s well being, get a chiropractic check up today!

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