Monthly Archives: October 2009

I love it…

…when I guess the Mystery Diagnosis. Too bad this is a sad one: Angelman Syndrome.

I was especially saddened by how the mother was dismissed and ignored at first, then blamed, then turned down by a specialist because her insurance wouldn’t cover even investigating what was wrong with her seriously ill infant, with no referral or hope. She eventually had to go to an ER in a public hospital hours away(!!!) to get someone to diagnose her baby with a severe genetic disorder. Did I mention that this woman HAD insurance?

Edited to add: I went to a health care rally yesterday, and was amazed at how many of the antis thought things like this were a shame when you asked them. But, then they would start yelling about how the constitution doesn’t really mean provide for the general welfare, socialism, and killing seniors, and pretended that they weren’t just fighting for the status quo. I hope to have time to post more about my confrontational day yesterday, but I have a busy day today.

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Doing a presentation on autism

Considering autism is something I read a lot about, whether it be scholarly research on the autism spectrum, talking with parents of autistic spectrum children, or reading the writing of adults on the autism spectrum, I am surprisingly intimidated by doing a presentation on it to my “Epidemiology of Diseases of Public Health Importance” class.

I am going to try to cover the swiss cheese that is the history of diagnosis and epidemiology of the disease, the current state of diagnostic criteria, the controversies over treatments and “cure” discussions, the controversies over the etiology, and the controversies over insurance coverage (or lack thereof) for educational settings, treatment, etc.

Ulp.

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Laughing while my head explodes

I don’t know if the entries at My OB said WHAT?!? are more funny or head-exploding inducing. I sputter and smile simultaneously with each one.

I think my favorite so far is this one: “Your baby may end up being retarded if we don’t do this test” was one nurse’s way of performing informed consent about a fasting blood sugar test.

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Doublethink in health care

A four-month-old exclusively breastfed baby in the 99th percentile for its weight and height was refused health insurance because it has “obesity” as a preexisting condition.

*Shakes head in disbelief*

This story in the Denver Post is a perfect example of the sort of Orwellian doublethink that must exist for people to oppose health care reform because it will add a layer of evil government bureaucracy into medical decision making.

Here’s a great quote from the article:

Health insurance reform measures are trying to do away with such denials that come from a process called “underwriting.”

“If health care reform occurs, underwriting will go away. We do it because everybody else in the industry does it,” said Dr. Doug Speedie, medical director at Rocky Mountain Health Plans, the company that turned down Alex.

This kind of um, logic, for lack of a better term, is what these newly enraged self styled radical libertarians are advocating as a superior framework for guiding medical coverage than the government?

(A tip o’ the chapeau to Hoyden About Town)

Edited to add:

Here is a picture of Z when he was about that age:

Photobucket

I am sure he was in the 99th percentile, if I cared to measure it. Oh, yeah, and he has always been accident prone, like his mommy.

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Lamaze blog carnival is up

The first Healthy Birth Blog Carnival is up: Let Labor Begin on Its Own. This is the first of six blog carnivals based on the Six Lamaze Healthy Birth Practices. I am hoping to submit an entry for each one.

I still have to read all of the entries for this one. This is a perfect first practice, since it happens at the beginning of labor. I have read up to 40% of labors are induced now.

The induction is the gateway to what is commonly referred to as the “cascade of interventions” that eventually lead to a cesarean section in many deliveries. When a woman is induced, she may be given Pitocin, and her water may be intentionally broken. The labor augmentation drug Pitocin, along with some induction drugs, like Cytotec (misoprostol) usually cause stronger contractions. That’s their point, but these contractions can be stronger and more painful than early labor would be, which makes pain relief measures like opiates or epidurals more likely.

Most hospitals include Pitocin augmentation and/or induction in their list of conditions that require continuous monitoring. Having ruptured membranes usually starts a clock ticking that limits how long this avenue of infection can be open. Depending on hospital protocols, this may be 12 hours or 24 hours, and then the woman is given a cesarean section for “failure to progress”.

Or, the Pitocin is turned up to make contractions that didn’t start on their own exist, and the fetus goes into distress, and the woman is rushed to have a cesarean section.

Or, if the woman does progress to the pushing stage, as the my link in the carnival suggests, Pitocin can contribute to shoulder dystocia.

Anyway, letting labor begin on its own means the fetus and the woman’s body are both ready for the birth process. Go check out the carnival.

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Listen to Jill!

I finally got to listen to Jill at the Unnecessarean‘s whole interview on Expectations radio.

I swear I has already listened to 20 minutes of it before someone told me she mentioned my blog! At about halfway through the fisrt hour of the interview, she says she is a fan (awww, *blush*) and mentions these posts about refusing to perform non medically indicated cesarean section.

I think it is a fantastic interview. This is definitely a nuanced topic (as I wrote in the second post of mine linked to above). Autonomy, right of refusal, provider conscience clauses and informed consent are complicated, multifaceted issues.

This all ties back to Participatory Medicine, which Amy Romano wrote about. (And Jill mentioned at the end of the first hour of the interview).

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It’s National Midwifery Week

Hooray! It’s National Midwifery Week!

Hug a midwife before October 10th.

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Highlights of the Lamaze Conference

I am still up to my eyeballs in stuff to do, but I need to share some of the wonderfulness that was the Lamaze Conference.

So, here are some highlights:

First and foremost, getting to be roomies for a night with Amy from Lamaze’s Science and Sensibility blog. I hope she feels the same way. She seemed happy about it before we fell asleep and I told her that I usually stop snoring if someone knocks on the wall. I don’t know if she had to use the trick or not.

Secondly, hearing Amy speak! She gave a great presentation of the evidence (or lack thereof) behind determining labor progress (which she described as a “hot mess”. You’re so right, Amy!) And, my surfboard buick laptop came in handy when she dropped hers. She used my laptop, and in the session before, also on research, my power cord came in handy when the computer they were using died suddenly mid presentation. Glad I went and was helpful!

I got to hold Rixa’s beautiful, sweet son Dio. Smelling his warm little head was almost as wonderful as meeting Rixa, and being with her at a few seminars to listen to her excellent, thoughtful input into the discussion surrounding birth.

I hung out around Reality Round’s poster presentation about infant massage in the NICU like a groupie for a little while. Other than that, I ran by her a few times as I tried to be where I was supposed to be fifteen minutes before for most of the weekend. She was even cooler in person than I had hoped.

I met Debra Bingham, DrPH, RN, LCCE, who is a wonderful person with a very important job. She is interested in my KALI Questionnaire. Ulp! I hope this comes to fruition. That is one of the things I am supposed to be working on right now.

I got to meet Teri Schilling after her inspiring and very well received keynote address (standing O from a huge room! Congrats, Teri!) and she told me she reads this blog! Wow! I also met doula Sharon Muza, who is also a reader. Weird but fun. I tend to think no one reads me, but I guess I know some people must since I get hits and comments.

The lectures and presentations were great. Laboring Under An Illusion is a wonderful documentary that should be required viewing for high schools, childbirthing classes and medical schools! And, I was tickled to see a few clips from House of Babies in the film. I was on that show for a few brief moments. Not in the clips she chose (thank Maude!) but still, I felt like I had a special connection.

Speaking of a connection, when the computer died on Judith Lothian, PhD, RN, LCCE, I got to ask her about her wonderful qualitative research on home birth. While we were waiting to get the password to restart the presentation, I got to ask her about the finer points of qualitative research. I was quite pleased to have many of my points from a recent argument on the subject verified in stereo. Qualitative research, especially on pregnancy and birth, is very cool and quite important. And, it’s an easy target for people who don’t know what they are talking about, as I experienced and she confirmed.

I also got to hear Tiffany Field, Ph. D. director of the Touch Institute at nearby University of Miami present, and talked to her after her fantastic speech. She invited me to tour the NICU at Jackson Memorial!

Anyway, this is getting long for highlights. It was a blast. I have a new necklace to show for it, too. I couldn’t resist.

necklace

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Had a wonderful time at the Lamaze conference

I have a lot to report, but I am pressed for time today. I need to get everything done that I dropped in order to go to the Lamaze conference.

So, I will do a post soon. But, in the meantime, please know there is a vibrant community supporting healthy birth spread out all around the country, and the world.

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At Lamaze

I am so excited. I have already met so many great people here at the Lamaze annual conference. I have met other bloggers, nurses, and researchers. In fact, one researcher is interested in using my questionnaire in California in 14 hospitals!

I need to go shmooze. I will update more later.

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