Showing posts with label women's health. Show all posts
Showing posts with label women's health. Show all posts

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 care...insurance...etc. 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?  

Monday, December 15, 2008

Negative Talk at Birth Circle

Rh negative talk has become a hot topic at Birth Circle. Tonight marks the second meeting in a row where the routine treatment of RhoGAM for Rh negative mothers came up. Two months ago I hadn't met a woman who was questioning the protocol for being Rh negative and now I know four. FOUR women questioning a medical norm in two meetings, 4 weeks apart. I am excited for this group to start discussing their choices of treatment with me so I can pass on this wisdom to others out there. It seems like yet another support group in the making. Rh negative women should know they are not alone in questioning their treatment.

One thing that became clear is that Rh negative women do not feel they have enough information about the latest treatment, Rhophylac (and other preservative-free RhoGams: BayRho-D® Full-Dose; BayRho-D® Mini-Dose; MICRhoGAM®; RhoGAM®; Rhophylac®; WinRho SDF®). The traditional treatment of RhoGAM got lots of attention with its possible negative side effects to the baby so you can see why these women want answers.

I have to admit, I did not know much about this treatment because I am Rh positive and even if I were negative, I had my first baby at a teaching hospital in 2003. Perhaps they were already using a preservative free-RhoGAM and the controversy had calmed down?

Thimerosal, the preservative that is 49% Mercury, was removed from RhoGAM in 2001. Women in 2009 are hunting for studies and data to help them make hard decisions.

I have learned a few things that I think all Rh negative women should know:

1. If the father of the baby is Rh negative, you have virtually nothing to worry about. Care providers rarely ask what the father's blood type is.

2. If the baby is Rh negative, also nothing to fear. Women rarely hear about their chances of birthing an Rh negative baby.

3. Childbirth is designed to work. In a normal birth, baby's blood should not cross to the mother. The small risk of this happening is not discussed with women. Interventions increase the risk of baby's and mom's blood mixing so guess where most of these women are choosing to give birth....that's right, at home with midwives.

4. If the baby is Rh positive, you have a 72 hour window to give the mother the post-natal treatment. It isn't some sort of sudden panic at birth, you have three days to manage this situation.

What seems to be a common thread is more women questioning the traditional treatment at 28 weeks gestation. Women do not trust that the preservative-free RhoGAMs will not have some side effects to their babies or to their own bodies. These women want studies and they also want community. They want to see how other women proceed given different situations.

I would love to know what, if any, recent studies we have to cite for this topic. Please comment away if you have any perspective on this subject at all.

Tuesday, November 25, 2008

Attachment Theory Resources: Connecting Biology to Relationship

I promised a few of you I would post some Attachment Theory resources. Here it is just in time for some long-weekend reading. Enjoy!

Many thanks to Chris Walker for sending me the resource list she uses in her practice. She is the psychotherapist who really helped me understand what Attachment looks like in all relationships, not just those with infants. If you want to narrow down the list with respect to academic credibility, look to the following: A Secure Base by John Bowlby, Why Love Matters by Sue Gerhardt, The Biological Roots of Love by Lauren Lindsey Porter, and Parenting from the Inside Out by Siegal and Hartzell.

Attachment and Conscious Parenting Resources
by Christine A. Walker, LCSW

Articles
“The Science of Attachment: The Biological Roots of Love by Lauren Lindsey Porter found at www.naturalchildproject.org
Bruce Lipton on Conscious Parenting in his book Biology of Belief
Google “Conscious Parenting” and “Mindful Parenting” for many resources

Books
“Attachment in the Classroom” by Heather Geddes
“A Secure Base” by John Bowlby
“Inside I’m Hurting: Practical Strategies for Supporting Children with Attachment Difficulties in Schools” by Louise Michelle Bomber
“Parenting from the Inside Out” by Daniel Siegal and Mary Hartzell
“Magical Parent Magical Child” by Michael Mendizza with Joseph Chilton Pearce
“The Boy Who was Raised as a Dog” by Bruce Perry
“The Connected Child” by Karyn Purvis and others
“The Science of Parenting” by Margot Sunderland (other books at this site at Amazon)
“Trauma Proofing Your Kids” by Peter Levine and Maggie Kline
“Unconditional Parenting: Moving from Rewards and Punishments” by Alfie Kohn
“Why Love Matters: How Affection Shapes a Baby’s Brain” by Sue Gerhardt found at www.whylovematters.com

Film
“Trauma, Brain, & Relationship at www.traumaresources.org 7/08

Websites
www.askdrsears.com
www.attachmentparenting.org
www.belvederearts.com
www.centreforattachment.com
www.childtrauma.org
www.circleofsecurity.org
www.consciouslyparenting.com
www.drdansiegel.com
www.fatherstobe.org
www.naturalchildproject.org
www.parentmap.com
www.mindfulpediatrics.com

If you have questions for Christine you can reach her at:

Christine A. Walker, LCSW
408 East Market Street, Suite 204
Charlottesville, VA 22902
434-923-8253
cwalker@cstone.net

Wednesday, November 19, 2008

Investment Banking and American Obstetrics Have a Lot in Common

If you have not read Michael Lewis's The End yet or if you don't have any connection to the Investment Banking industry at all, please read the first and last pages so you understand your dear Attached Feminist a little better. To Michael, thank you for your voice from another who was confused at 24. You inspire me to shout things people don't want to hear and need to from my mountaintop of a blog.

What do the Investment Banking and
American Obstetrics Industries
Have in Common?

1. Both appear to be providing a service to you when in fact they do not work for you but for a flawed system.

2. The service does not demonstrate proper evidence that it provides what it says it should

3. Both employ young people with big educations to talk authoritatively to you about things that you may know much more about, simply by using common sense

4. These things (your money, your body, your child) are things of vital importance to your day-to-day life. The service provider, though affected by a negative outcome, will not feel it daily the way you will.

5. If you disagree with an expert, you will often be made to feel ignorant and small

6. If you part from that expert, your friends and family will think you are crazy....

7. ....until you prove your point. They then will a) wonder how you got so bold as to question society's norms and b) continue to have mixed emotions about it all.

8. If data increases and the media get a hold of it, the industry will not take the warning and overhaul from within. Instead, experts will dismiss the data and begin a witch-hunt. They will fight for what they know and forget who will be hurt by the fight.

9. Consumers of these services are often ignorant until too late to save themselves from harm

10. Consumers will say it didn't feel right but they trusted the service provider

Lessons to Learn

1. If it doesn't sound right: research
2. If it doesn't feel right: research
3. If you have any doubt in your mind it isn't right....RESEARCH.
4. Even if you love your service provider, follow up with a little bit of research!

Trust yourself. Take control over your life. Find your voice. Or a doula who will help you. Like Michael Lewis.

Saturday, November 15, 2008

A Third Wave Feminist Mother on Modern Work-Life Possibilities

While looking for essays on Third Wave Feminism, I found this article by Martha Rampton, a professor of history and director of the Center for Gender Equity at Pacific University. She states:
...the third-wave's ... refusal to think in terms of "us-them" or in some cases their refusal to identify themselves as "feminists" at all.
This supports what I feel is going on with mothers choosing to call themselves feminists (or not) these days. According to Rampton, the third wave of feminism began in the mid-90s. The 90s were my teen (class of '95) and college years ('99). I agree that I do not think in an "us-them" way and Rampton's description above is the feminism I feel to be contemporary feminism. We women deserve respect. We make different choices based on different life experiences. And yes, I do respect women who make dramatically different choices than I do.

My MIL describes a time when she was treated like an outcast when she told women she stayed home with her children. How could have these women done this to her? Or was it mostly in her head given the media focus of Second Wave feminism? Women today are joining groups like MomsRising, The Mothers' Movement, Activistas, and the Holistic Moms Network to name a few. NOW has a Mothers Matter, Caregivers Count campaign that I believe needs much more media attention. Recently on Facebook I was invited into a "Circle of Moms" and Yahoo has a Parenting section within its recently launched Shine hub-for-women site. Needless to say, becoming a mother does not mean you drop out of society. Actually, there is even more "society" available once baby comes.

Third Wave feminists are not arguing the merits of working vs. homemaking. The question I struggle with is how we work when children are also a huge part of our lives. This goes for men too, no doubt about it. But since women face pregnancy, birth and breastfeeding, how can we get them the information they need before they face important decisions for themselves and their families? I began volunteering in the childbirth and breastfeeding communities because I see women from all demographics making less-than-informed choices in a world seemingly overflowing with information. I think the same lack-of-information problem applies to women trying to make smart work-life decisions.

Recently I started reading books like Creating a Life and Off-Ramps and On-Ramps because I think about re-entering the labor force.* I am thrilled to see huge corporations adjusting their policies to retain top talent. I see women (and men) challenging workplace norms here in Charlottesville too.

Is this message being received by the women a decade younger than I am? I am not so sure. I think many women think they will enter a work environment that is not subject to negotiation. Many may wonder if the issues of the Second Wave are what they should roll up their sleeves and get ready to fight. They may not witness negotiations during their first years on the job and this may color their perspective of what is feasible.

Know negotiating a balance that works for you is possible--men and women are adjusting their schedules all the time. When the time comes for you to switch things up, just ask! And if you don't know what to ask for, write up your perfect schedule and ask to discuss it with your personnel officer. Now remember, the HR executives may not be products of third wave feminism as much as you are; they may not see all the shades of grey between the in-office 40+ hour work week and staying home with your child. If you are good at your work, I am hopeful HR will be receptive to negotiations. Once you figure things out, talk about what worked and what didn't. This will help women looking up to you pave their own way in a few years.

I want women to brainstorm what could be part of a desired dream schedule or work environment that could include babies and toddlers. You never know until you get there what will work but it doesn't hurt to think of the options. Could your 3 month old baby come to work with you until he crawls? Could you telecommute some until preschool begins? Maybe hire some care on the side for the weekly staff meeting? Or better yet, can you swap care with a friend who is in a similar position? There are many people just like you out there. Find each other and work it out.

A study published by the Pew Research Center shows part-time work to be the ideal for many women. I think feminists get this, at least in the Third Wave. I think it is time for women to feel confident in their negotiating power. They shouldn't wait for it to happen to them through public or corporate policy. Only you know how you will be at your most efficient. It is in your employer's best interest to listen to you. They are at risk of losing your talent and their resources in finding and training your replacement. It is win-win. You have the tools and the support to create the perfect balance in your life during each chapter.

Yes, I chose to stay home with my children but that doesn't mean I think all mothers should or can do as I did. I simply want future mothers to know of a newer work-life choice: it is possible to stay physically close to your children and earn an income at the same time. The role models are few, but they are out there. Make it happen and become a role model yourself.

*Note that I may not re-enter the labor force. We shall see what the future brings. The two sides of my brain are still in negotiations regarding "5-and 10-year plan" thinking.
__________________________________

Hungry for more Third Wave feminism? Here is a fantastic description of what feminism IS today from another Third Wave mother, Kim Wells.

Do you drink a Coke a day?

For those of you who have not met my mother-in-law (MIL), I have to introduce her briefly. This woman is a fantastic role model of women's health self-education. She runs, loves yoga and pilates, swimming, takes vitamins and herbs daily, looks into homeopathic remedies before reaching for a prescription drug, researches natural vs. synthetic hormones, and always reads the labels on the foods she eats and the drugs she takes. She loves her compounding pharmacist and drives all the way from Pennsylvania to Virginia to see doctors that best fit her style. She is a very spunky 51-year-old and I love hearing what drives her crazy.

Tuesday, my dear mother-in-law found out she has osteoporosis. I was stunned. She does everything right. Her doctor asked if she had any idea what might be going on. I asked the same question. What could it be, stress?

She nodded...she did have an idea. She loves her Coke and has at least one a day and has for years. She had read that the phosphoric acid in colas may be linked to bone density loss. As Coke was still one of her very few vices, she had not thought as hard about the few articles that had come across her path. But now she is thinking hard about the Coke.

Your first thought might be "well, sure, if people drink soda instead of milk then they do not get enough calcium every day." The Osteoporosis Advisor says:
While previous studies have suggested that cola contributes to bone mineral density loss because it replaces milk in the diet, Tucker determined that women in the study who consumed higher amounts of cola did not have a lower intake of milk than women who consumed fewer colas. However, the authors did conclude that calcium intake from all sources, including non-dairy sources such as dark leafy greens or beans, was lower for women who drank the most cola. On average, women consumed 1,000 milligrams of calcium per day, and men consumed 800 milligrams per day, both lower than the daily recommended 1,200 daily milligrams for adults over age 50.
That certainly fits my MIL--she takes multivitamins as well as drinks calcium-fortified orange juice. Maybe that wasn't enough. As of Tuesday, she is now supposed to take 4,000 mg of calcium per day.

As one of my goals for this blog is to connect and educate women about their health I thought I should let readers out there know what I just learned this week. Also from The Osteoporosis Advisor:
The message from experts is clear that overall nutritional choices can affect bone health, but "there is no concrete evidence that an occasional cola will harm the bones," says Tucker. "However, women concerned about osteoporosis may want to steer away from frequent consumption of cola until further studies are conducted."
As I learn more about this cola-osteoporosis correlation, I will let you know. You can bet my MIL is tackling the research this weekend and will be familiar with every published study on the topic by Thanksgiving.

My guess is that we will be offered milk or orange juice with the Tofurky.