Wednesday, March 11, 2009

HPV, Gardasil & the Immature Cervix

I am very happy that modern medicine is moving in the direction where research funding is put towards women's health issues, such as cervical cancer.  I am very happy that we have learned that HPV is the main culprit.  But what we do with this information, I believe, is up for debate.

First of all, please see this and this about the side effects some young women are having from Gardasil.  While these stories are not conclusive enough for the medical community, I think they are pretty frightening.  

I don't want to rewrite those blogs. I wanted to add a couple of things to think about when you and I contemplate this vaccine for our children.  

First is what I learned last year while attending Miriam Grossman's talk at UVA.  She discussed (Cavalier Daily Article summary) how the immature cervix is more likely to contract HPV than the mature cervix.  The immature cervix has fewer cell layers and HPV isn't as happy to settle in when the cervix is thicker.  So that is one little piece of science.

The other thing that I hadn't realized is that if the world gets the HPV vaccine, then the need for pap-smears goes way down since virtually all cervical cancers are caused by HPV. This is of interest to me because I wonder who this benefits.  If all young women are given this vaccine, will insurance companies pay for pap smears anymore?  Especially if they are shelling out reimbursements to have every young girl in the country vaccinated?  

To truly eradicate cervical cancer, one thing that I hope evolves from medical research is a vaccine or cure that prevents men from transmitting it.  And I am a mother of boys so this comes from a personal place where I expect them to be accountable for their actions and certainly never on some receiving end of a phone call that says "I have HPV, did I get it from you?"  I have heard this is a "challenge" for medical science and they have tried.  Hmmm.  I hope they keep trying. 

I admit that I do not trust insurance companies or pharmaceutical companies with the health of my children.  I did just watch SiCKO and encourage others to check it out sometime.  As far as the personal, my insurance company paid much more for my hospital birth where I received no interventions than my homebirth which had a much lower price tag.  I, you or somebody somewhere essentially paid for drugs that I did not use.  These drugs, had I used them without needing them, would certainly not be in the best interest of my baby's health.  Epidural anesthesia, pitocin...all part of a hospital birth package deal are part of some bigger financial picture between big pharma, insurance companies, hospital revenues, AMA, ACOG and who knows who and what else.  My point is, I do not feel that pharmaceutical companies are not in it to make some money--after all, they did spend tons on research.  The faster they get any treatment, including this vaccine, out into the public, the better for them.

So, apologies for jumping around.  I hope to bring it all together.  HPV likes the young cervix.  So we want to vaccinate before the woman begins being sexually active at all because the younger she is when she starts, the higher risk she is for contracting HPV.  At the same time, if the cervix is so young and needs maturing, giving some vaccine to toughen it up (or whatever the vaccine does) before puberty even is fully on does seem to lead me to think it could cause some other problems later in life.  Sure, maybe not HPV and cervical cancer...but gosh, I have had three babies and I am pretty darn happy my cervix was good and normal for those experiences.  I can see why people might worry if it could affect fertility and so on.

So as Nature's Child discussed, parents really need the full info about this vaccine and make a choice that makes sense for their situation.  If you know your 9 and 10 year old daughter is not even close to being sexually active, then why not wait?  Let her cervix age a bit along the way.  Why is The Establishment trying to push this vaccine so early?  And then I think again to the politics of things, all of our children can have access to health if they are in the public schools.  That means there is funding to push it on children right as they get all those other shots for school.  The older the child gets, the less likely the child will be injected with the vaccine.  For one, she goes to the doctor less, I know I did.  So there is more money to do it younger.  Ideally less cervical cancer too, but you cannot ignore the economics.  

Meanwhile will the pap smear become less routine over the next 20 years?  Might some women slip through the cracks?  And meanwhile, what about the men?  What sort of HPV testing will our country encourage for young men?  It seems like the men should have to know if they are spreading a disease that causes cervical cancer.  Would our government be inclined to fund a mandatory vaccine for young boys?  Especially if it had any scary reproductive side effect at all?  I wonder...

So all of this is to suggest the government and medical community back off on this one.  Give parents and their daughters the current information and let them make an informed decision.  I know we cannot count on all parents to be as involved with their daughters with topics such as this...but that goes into another post about how our country has such a messed up relationship with sex.  What is missing right now is the discussion about the side-effects and just how HPV works.  You don't get it from toilets, people.  It is from having sex.  Can we not educate our daughters about their bodies a little more?  I am not talking about abstinence education.  I am talking about "if you start having sex, I want you to know these things..." kind of talk.  The kind that leads women to Planned Parenthood, to Student Health, to a clinic when they cannot talk about things with other people in their lives.

Many parents of teens I know are not bloggers and are too busy to watch the evening news.  They count on getting the full story from their doctors.  Are they?  

Wednesday, March 4, 2009

Donating Breast Milk

This keeps coming up so I feel like I need to put what I know (which is very little) out into the public sphere. I have seen an uptick of Charlottesville interest in both donating extra breast milk and in using donor milk.

To be very clear, I do not know enough about using donor milk to give much information about this practice. But, because I do believe human milk is a superior infant food to formula, I think families need to take this option seriously and do their research on what is best for their situation. I wanted to share the places I have heard of to give interested families a smaller headache when approaching this option.

First are the Milk Banks. Start at the Human Milk Banking Association of North America.

Second is MilkShare. They have a Yahoo Group to help families connect to one another.

Third is this story about Lynn Page who donated 56 gallons (!!!) of breast milk. It was this article that just ran in Oprah Magazine that made me realize how past time it is for this option to be discussed more openly. Not discussed only by families, but taken seriously by insurance companies and health care providers (see the follow up articles, same link).

The fourth thing is to simply call your local lactation consultants, hospital-based or not and ask them what they know. Be ready for the spectrum of answers but chances are, they will be helpful.

And the more I looked up web addresses, the more information I came across. If you have a great tip for a mother out there, go ahead and post it here as well as to whatever site for which you probably also should post a testimonial!

I can't put up enough disclaimers: do your research and take responsibility for what ever choice you make for your family. I am not in a comfort zone as I discuss this, partly because much of the activism I do with breastfeeding has absolutely nothing to do with this topic. It is hard enough to support women trying to breastfeed their own children in our culture, it is another thing to monitor the practices of women who choose to donate or use donated milk. But if you, dear reader, are searching in the night for resources that have been helpful to other people, I wanted you to know that you are not alone in your efforts. Many many families choose this option. Connect with them and hear their stories. They ARE out there.