It is with great sorrow that I write this blog entry to
remember a dear friend, Michael Palmer. Michael passed yesterday on October 30, 2013 at the young age of 71 years old. (ABC News Suspense Writer Michael Palmer Dies ) I met Michael Palmer in October 2009 at
a writing conference for physicians. He exhibited an unfaltering belief in me. He was always encouraging me to finish
my book project. Through the
years, I would randomly receive a heartening email. He made time for me
whenever I was on his “side of the coast” as he would say. He was extremely proud of his three sons. A conversation would not pass without him mentioning their accomplishments. A superb writer, gentle spirit,
unassuming and generous of heart.
May we all strive for that.
A life well lived and well loved by all.
Yesterday I had a heart to heart talk with one of my friends who is expecting. A Type A personality, she worries constantly about everything. She has been focused on a very particular outcome and thus far, her pregnancy hasn't been a happy experience. Each worry she has focused on has occurred throughout her pregnancy. For example, she obsessed for days about first trimester bleeding before she ever had any problems. Eventually, she began to bleed for several weeks. She agonized over why she didn’t have morning sickness- was there something wrong with her? Her obstetrician kept reassuring her. Suddenly, she was hit with waves of nausea and vomiting. I have seen this play out with my patients repetitively. I wondered- was this a self-induced prophecy? Perhaps. The second question I wondered- when complications do occur, how does this effect her ability to cope?
Do we bring to ourselves what we worry about? Researchers continue to investigate the effects of positive thinking on health.
There are definite health benefits that positive thinking may provide. Such things as better coping skills during times of stress, better physical and emotional well-being, less colds, lower rates of depression, and an increased life span all have been associated with positive thinking. Researchers are unsure of why positive thinkers reap these health benefits. Perhaps they tend to engage in healthier lifestyles? Or they theorize that it enables us to manage stress more effectively- thus reducing the negative health effects of stress on your body.
As an obstetrician and a woman, I believe that pregnancy is a journey and state of mind... not a medical disorder. It's important for patients to hope for the best and the job of your provider (whether it is a physician or nurse midwife) is to monitor for possible complications and deal with them appropriately. This is where the power of positive thinking comes in. This is probably where spirtituality and faith enter in as well. So for the few times that something unexpected does happen... your coping skills will help you to overcome whatever hurdle life presents you.
Sniffle, sniffle… cough, cough… ‘Tis the season for the flu. October through May is flu season. In the US, 5-20% of the population acquires the flu each year. Have you received your annual flu shot?
The CDC and the American College of Obstetricians and Gynecologists recommend the inactivated flu vaccination for all expectant women. This can be administered in any trimester. Prevention of the flu is of utter importance. Unfortunately, every year there are flu related deaths. Pregnant moms are at an elevated risk for this tragedy because of their suppressed immune system. They have an increased risk of life threatening complications from the flu such as dehydration, pneumonia, and other infections.
The flu vaccine can also serve to protect their baby since they receive passive antibodies from their mom. Babies cannot receive the flu vaccine until they are six months old.
Flu symptoms include body aches, runny nose, fever, sore throat and cough and occasionally nausea and vomiting. If you are pregnant and experiencing these symptoms, please contact your physician immediately. The vaccine can only help to prevent the flu. During this flu season, please remember to wash your hands frequently, avoid contact with sick people and avoid touching your nose, eyes and mouth.
The chemical BPA is receiving another bad rap in the news. Over the years, the safety of this widely used chemical has been disputed. A recent study published online in the journal, Pediatrics on Monday revealed a possible link to the popular chemical used in plastic bottles, adhesives, and the lining of canned foods to behavioral and emotional problems in female toddlers.
Although a small study, the article is the first to suggest that a mother’s exposure during pregnancy to BPA might be linked to a young girl’s emotional well-being.
The study occurred in Cincinnati, Ohio. They analyzed 244 moms and children up to the age of three. The mom’s urine samples were tested during pregnancy and again at birth. The children’s urine was tested at ages one, two and three. BPA was discovered in 96 of the toddler samples and 85 percent of the mom’s samples. The girls were found to have more behavioral problems by age three when the pregnant moms BPA levels were higher. This correlation was not seen in boys.
The study revealed, “increasing gestational BPA concentrations were associated with more hyperactive, aggressive, anxious, and depressed behavior and poorer emotional control and inhibition in girls.”
The chemical industry, represented by the American Chemistry Council, dismissed the study according to The Washington Post. They felt that the design of the study had “significant shortcomings” and its conclusions “are of unknown relevance to public health.” The American Chemistry Council represents members whose companies use BPA in their products.
It should be noted that this study has a very small sample size, which causes limitations. More research and studies are obviously needed. The study was funded through grants by the US government- the National Institute of Environmental Health Sciences, the US Environmental Protection Agency and the National Institute of Environmental Health Sciences training.
Interesting take on the pharmaceutical industry....
"In the shocking and hilarious documentary ORGASM INC., filmmaker Liz Canner takes a job editing erotic videos for a drug trial for a pharmaceutical company. Her employer is developing what they hope will be the first Viagra drug for women that wins FDA approval to treat a new disease: Female Sexual Dysfunction (FSD). Liz gains permission to film the company for her own documentary. Initially, she plans to create a movie about science and pleasure but she soon begins to suspect that her employer, along with a cadre of other medical companies, might be trying to take advantage of women (and potentially endanger their health) in pursuit of billion dollar profits. ORGASM INC. is a powerful look inside the medical industry and the marketing campaigns that are literally and figuratively reshaping our everyday lives around health, illness, desire — and that ultimate moment: orgasm." -from AstreaMedia
Battling writer’s block. A blank screen staring out at me. The quest for the memorable inaugural blog post. My grocery list. A million scattered thoughts. Then my patient came in. Sunlight at the end of the tunnel.
“Doc, why are my pants crying?” giggling as she said it.
My patient had apparently just seen an episode of “I Didn’t Know I Was Pregnant” on TLC. I had served as one of the medical experts for the show for two seasons and inevitably every week my patients would come in and ask… how did they really not know they were pregnant? Was this for real?
But this isn’t what finally pushed me to write this blog post. It was Kathy Griffin’s recent comedy special on BRAVO which poked fun at the show and I must admit had me in stitches. Check out 5:51
I will go on the record and explain the non-televised version of how they could possibly not know they were pregnant to clear up any misconceptions.
1. Denial
Sometimes it is just pure denial- not a PC thing to say on television of course. This is most common amongst adolescents. They think it couldn’t possibly happen to them. Little by little they ignore the signs by brushing it away… somehow mistakenly thinking that it will somehow go away. Basically, it is their coping mechanism albeit not the best way of coping.
2. Medical problems
There are medical conditions that can cause either irregular periods or no periods such as polycystic ovarian syndrome and thyroid conditions. They mistakenly think that not having a menses is “normal” for them.
3. Obesity
An elevated body mass index can cause a hormonal imbalance which can lead to irregular periods or their absence. Their habitus can effect how they might (or rather might not) experience a baby moving around.
4. Lack of self-awareness
A lack of self-awareness of their bodies can contribute to a failure to recognize the common signs of pregnancy.
5. Pregnancy is different for everyone
Every woman experiences pregnancy differently. In my practice, I have had several patients breeze through their pregnancies without any major symptoms. Some of them worked or did yoga up to the date of their delivery. This is more the exception than the rule.
Last thoughts... it was mostly during residency that I tended to encounter these types of situations that are portrayed on the show. It really does happen...not often... but it does.