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Thursday, October 27, 2011

Birth as performance art? Why not!

Is that a trophy I see? Why yes, yes it is.
Photo credit: AP. 
It's being talked about all over the birth community: a "performance artist" has just given birth to a baby boy inside an art gallery. Weird, perhaps. Maybe it's the Nyquil haze I'm living in today, but somehow the more I read this story and think about it, the cooler I think it is.

The blogger at Mama Birth and I joked that we'd both like to do posts about it (she beat me to it LOL) and here's her take. I don't want to repeat too much of what she just said, but yeah. What she said.

Something we both noticed were the comments - horrible, as usual. It seems that whenever birth is talked about there's something nasty to say, usually from other women. I don't even remember all of them, but the general feeling I got was How dare you birth somewhere "non-traditional?" How dare you go against the grain and do something that is supposed to be so painful and horrible and make it look ..... easy?! The audacity - to shower, move around normally, get into whatever position you want, no epidural... You are a @(%&&!!!*#^%^@ and deserve to die and have CPS called on you!" 

Okay, the CPS comment came from the comments section about the pregnant marathon runner who gave birth within hours of running a race. I think this birth falls into the same category: that somehow, there are people that think because you birth outside the norm or dare to do anything weird while pregnant, that they have some emotional claim to stake on you, your baby and your birth experience.

What Marni Kotak did was probably weird, but like Mama Birth pointed out in her blog post, not really that different than what they have been doing for years on A Baby Story (hello, since 1998?!). 16 and Pregnant - I've never seen that one, but honestly it sounds like utter tripe. I'm sure we can count the reasonably accurate, normal birth scenes we've seen in TV and movies on one hand.

I'm sure people were even more furious when things went well and the child was actually born. Of course, if things hadn't, they would no doubt declare smugly how "hospitals are where all birthing women belong," and how stupid/selfish/much of a whore she was for deciding to even have children in the first place, or something equally hurtful and bizarre.

For some, this is the closest thing to normal birth that they'd ever see. And it's not like she had an audience, per se - not like birth shows do - because she and her husband allowed no video cameras or photography. If she feels comfortable sharing it with a few people whom she knows care about birth (and her work), then so be it. How is that any different than mom calling so and so's step-sister's aunt's neighbor's daughter into the room (and all her girlfriends and close co-workers) while she's nearing the pushing phase? I don't get that, either, but that's their choice. Just like, I guess, it's Kotak's choice to show others that birth can be normal. That perhaps it's not her that's wrong or weird, but they are, for thinking that a normal birth doesn't exist, can't be done, is dangerous, selfish, blah blah blah. Somehow, though, when people watch birth on reality television they don't spout off about how much these women are trying to grab attention, but when someone like Kotak defies the "rules" they have no shortage of nasty things to say about it.

While my eyes were closed pretty tightly while I gave birth, my husband said there were quite a few people in the room during my VBAC. Not because it was an emergency or things were going badly, but, I'm guessing, because people wanted to see it happen. (Not trying to flatter myself here) but perhaps because they wanted to see a woman come in to the unit in active labor, doing a VBAC and refusing an epidural. Pretty straightforward, over and done within a little over three hours after arriving. While I was busy doing my thing, I couldn't help but notice the almost surprise in the nurse's voice when she did an internal and found that my water was almost ready to break. I thought, What is she used to seeing, then? Good heavens.

I couldn't help but notice in the thumbnail picture of Kotak that she had a trophy next to her bed. That made me laugh. It's like thumbing her nose at all of those women who sneer, "You won't get a medal for giving birth naturally!" I guess in this case, yes, you do.

Related posts:
The pregnant woman as public property

Tuesday, October 25, 2011

Everything in moderation - even birth advocacy?

I have always stood firmly in the middle when it comes to birth advocacy. I am not in the "trust birth!" camp, because I feel that birth can still be predictably unpredictable; our bodies, for all their wonderment, can still betray us and so, sometimes, can our births. I am not a person who believes that every doppler and every ultrasound is bad, nor do I believe that birth is "an accident waiting to happen." I also don't agree with the mantra "Just trust your doctor!", because being burned by doing so is probably what leads many women to seek a home birth (or at the very least, an alternative birth experience) in the first place.

Yesterday I read three articles that stuck in my brain - one, about the Australian midwife Lisa Barrett whom the 10 Centimeters blog lambasted for her seemingly reckless midwifery; one written by labor and delivery nurses on how to have a "natural hospital birth," and one from none other than The sOB about The Navelgazing Midwife's transition out of the NCB community. (That one was especially bizarre, most of us agreed.)

If what the writers over at 10 Centimeters are saying is true, Lisa Barrett has had four baby deaths on her hands recently, two of which occurred very close together. I haven't read much on the subject, but I agree that something sounds weird about that. I question those who align themselves with her, simply because overall her attitude sounds very cavalier, almost. The Navelgazing Midwife commented about the situation and further distanced herself from the "NCB crowd," something I can understand - because it seems like The NgM was very judicious in her practice and someone I respected for her cautious approach to bringing babies into the world (something that has drawn both praise and criticism).

As far as Barrett's behavior, I don't know what to say - I wasn't there. If it's true, then I don't know how birth advocates can support her. I get the feeling that it's very easy to blame the mother (for hiring her), in some bizarre way, blame the baby (because, admittedly, some babies die anyway, right?) - instead of blaming a cowboy-type attitude of the birth attendant (which you see in hospitals, too). I've often wondered how women can not intervene and tell the obviously whacked midwife not to get the F out of the way because I'm calling 911 whether you like it or not, but again, I wasn't there. I wasn't inside mom's head to understand what she was thinking, or even if she really had time to think. The words "I trusted her" come to mind, much like they do for many women in hospital births who feel helpless, powerless to question the authority of a doctor who might be behaving in much the same way, only in the opposite direction. I am not saying no cesarean is every unnecessary, but you do have to step back and question for a moment why 1 in 3 babies are born this way.

On the other hand is the article written by two labor and delivery nurses - who give pointers on how to have a great natural birth while in the hospital. Yeah, that's all well and good, but perhaps the realist in me is coming out. The first one on the list is to "plan your birth," whether you write it out officially or not. That's a good idea, in theory, but as most people will tell you, not all births work out the way we want them to. There's a Catch 22 there, though, because for some women having a "plan" doesn't change the outcome - how many times have we heard that having a birth plan is almost a guaranteed cesarean? Is it because mom's plan is too rigid? Or because her physician sees it as an attack on his knowledge and authority?

That's where the idea of "finding a physician you can trust!" comes in. This is true; but for some, it's harder than others. Some go through multiple physicians and still can't find one who doesn't see birth as potentially catastrophic. What if you're living in a remote area and have one doctor to choose from? Then what?

Other points on the list include "asking for the right nurse" and "bringing your own doula." As they put it,
“There are some nurses who cannot stand to hear a woman screaming and it kills the nurse NOT to put in an epidural." 
Oh, I'm sure it "kills her." Perhaps. And then there are those who just want you to STFU and stop your whining already because you're being a royal pain just by allowing yourself to be in pain, like these:
"There is good reason for birthing couples to be wary. Our hospital epidural rates run over 90% and in most hospitals, over 95%. The nurses in general not only do not know how to support a laboring women, but have no desire to do so. They would scramble to take other patients first, leaving the "natural" moms for whoever was "unlucky" enough to not be at the board first. They sabotage natural childbirth at every turn ("There's no need for this suffering you know--they don't give out medals for this," and on and on). I saw moms thwarted at every turn--no help, no support, no suggestions until moms finally begged for the epidural and the nurses responded with comments like "See--now you'll know better than to try this next time." I helped where I could, but couldn't take every mom wanting a natural childbirth. (Read the entire article here.)
As far as the doula part, they say, "...doulas can do the things we'd love to but can't." Well, that may be true, to a point. But there are lots of hospitals and doctors who don't like doulas, don't want them anywhere near the patient, and don't consider them a help but rather a hindrance.

One that really stuck out was "Be prepared to follow hospital procedure." Then that basically means, be prepared to surrender your rights in some cases, and have a far less chance of getting the birth you want. I guess this is one of the parts that makes me a moderate - while I know you're there for help should you need it, I also realize that much of the hospital's crap policies and procedures make that desired natural hospital birth next to impossible.

The article asks, "What keeps women from having a great birth experience?" The nurses say it's the idea that women are not accepting enough of themselves, and often blame themselves when things don't turn out perfectly.
“We tend to be pretty controlling beings. Having a baby is a rare situation for us [as individuals] because we’re not used to the lack control. For most women, this is their first experience in a hospital or in any real pain.”

That idea of control sticks with me, somehow. I do think that women should be permitted to exercise control during their labors - to a point. You should be able to control some aspects, but if the true need for cesarean arises, you have to surrender some of that control to the physician, unless you plan on doing one on yourself.

It's when sometimes over-the-top advocates over-analyze the experiences of others and tell them what could have been different, what you should have done, this that and the other that I start to be glad I'm sort of sitting on the outside of the advocacy circle, sort of like watching the debacle unfold while sitting on the curb. I think we've all done it, and sometimes it's quite clear what happened and where things went downhill. Sometimes it isn't, though. I've had at least three people feel the need to almost justify their experiences - prefaced with a "I know it's basically everything you disapprove of" - and this makes me bristle. Disapprove? As if I am somehow the Final Judge of All That Is Holy and Right concerning your birth. Not. Although, in explaining the situation, I've realized there is often a lot more going on behind the scenes than I know, and can often understand their position. And sometimes I don't agree (like my neighbor who likely had two births unnecessarily over-managed simply because it was a holiday) but crap, I'm not going to say anything. What business is it of mine? Not my body, not my baby, not my doctor, not my anything. And likewise, I will use my somewhat crazy birth experiences to inform others that yes, there is an alternative. You can still think I'm nuts, but that's your problem.

It's important to be very careful when questioning the experiences of others. There's a fine line between coming off as a know-it-all and basically telling them they're dumb for doing it by the book and simply, respectfully, informing them of their various choices when it comes to birth. I know after having my VBAC and second cesarean that things could have been different - it was after this last birth that I read that "breech and nuchal cord are not necessarily cause for cesarean." Yeah, that doesn't really help me after the fact, though. And who the hell am I to force my doctor to deliver a baby in a manner that he hasn't been skilled in since I was probably a child? No thanks.

One thing I simply cannot stand is the idea that all natural birth advocates are the same: the group at 10 Centimeters does this, as does The sOB. Surprisingly, she had a change of heart about The Navelgazing Midwife after hearing that Barb was leaving the midwifery community because of her disagreement over their somewhat radical views. Strangely, she is now almost aligning herself with Barb.

I was once lambasted in the comments section of The sOB for a post I did on gullibility and the "Trust your doctor!" ideology.  Someone questioned my idea that because it comes from a doctor's mouth, it must be right and true, and asked "How can we stop this?"

I guess this is just another way in which I am a moderate: blindly, completely trusting your doctor is often not a fool-proof way to have a great birth. Neither is throwing all caution and reason three sheets to the wind. There has to be middle ground. I try to be realistic but not scary and ridiculous; I find that some like to practice "fear-based obstetrics" in both directions: there has to be more to the argument than "all birth is dangerous" or "home birth/unassisted birth is the only true option." Many women have been betrayed by their bodies during the birth process; just as many have been betrayed by overzealous midwives who want them to have a natural, intervention-free birth seemingly at any cost; by nurses who sabotage their efforts to have a "safe," natural birth in a hospital; by doctors who knowingly put them at increased risk to either get it over with already or teach them a lesson. By lumping all natural birth advocates together, by shunning those who disagree, or by aligning ourselves on the extreme ends of either spectrum, we are ignoring - and doing a great disservice to - all of those who land somewhere in the middle.

Related posts:
What the "other side" is saying about NCB literature
A bitter birth nerd
He's your have to listen to him
My doctor will tell me everything! Part 1
The myth of the emergency c-section
Birth faith

Sunday, October 23, 2011

Diary of a thyroid: Thunder Pig!

It's been awhile since I've tabulated my latest thyroid exploits. I've been taking Synthroid since May, with an increase in dose in July. It was then that I accidentally discovered that my antibodies (peroxidase and thyroglobulin or whatever it's called) had gone up, which meant my dose was not strong enough. At that point we doubled the dose to 50 mcg and while I didn't really notice a butt-kicking boost of energy like before, at least now I had more stamina and energy to get things done. By the time I get to bed, I'm usually exhausted.

A thyroid ultrasound a few months ago yielded no nodules, which is good news. But it still feels like a rubber band snapping in my neck sometimes, like someone is very slightly starting to strangle me. Which is kind of ironic, I guess. The shortness of breath that troubled me while doing mundane things like having a conversation or reading my children a story (not anxiety, thank you very much) went away after I first started the meds, but slowly came back. Actually, I've noticed in the past few days that the need to just suck all the air out of a room has slowly subsided, but realized a few new symptoms have started up - difficulty swallowing and my hair began falling out. Not gobs and clumps, but kind of like many, many strands that come off into your hands while shampooing or brushing your hair - like they did in pregnancy. Thankfully my hair is pretty thick, but geez, are you kidding me? I still have the swollen neck that makes me look like I have jowls, despite weight loss, and one swollen ankle. Whatever. My antibodies are going down, which is good, but are still quite high compared to normal.

So I went to my doctor for a check up last week. As I waited, I thought, What the crap? I am actually nervous about this, like I had to "ask permission" about switching meds to Armour Thyroid (the natural desiccated pig stuff that my husband calls "Thunder Pig.") It has T3 and T4 in it, whereas the synthetic stuff only has T4 and is twice the price (which my insurance absolutely butt-headedly refuses to pay for, even though my doctor has written Dispense as Written on the script). Recent studies have shown that a combination of both T3 and T4 work well for some people and are more beneficial than T4 alone, something that I haven't heard reverberating through the medical community just yet. Which is sad - and annoying - because it means that if they do act on it, they're more likely to prescribe synthetic T3, which means two prescriptions and more $$$.

I spoke with the pharmacist about possible shortages of the medication and he confirmed my suspicion - that it's really hard to get. Apparently "world-wide shortages" make it hard to fill prescriptions, and I asked the pharmacist why (expecting to hear about mass outbreaks of hoof and mouth disease that claim the lives of pigs everywhere). He just simply said, "There's not as much demand for it," which means drug companies and physicians are trying to discredit the product (that is, unless you've already been on it and are doing okay and know it works) and are now funneling everyone down the T4 route. Fantastic!

My mom snagged some of my grandma's for a few days just to try it out and she said it was awful. It left her with a burning sensation in her throat, and I thought, Oh great, I can't wait to try this! My mom is pretty sensitive to things, though, and some people are apparently allergic to some of the new fillers in the reformulated product. We decided to start on the equivalent dose of Armour, and here is a handy conversion chart that makes no sense at all. Since I am completely mathematically-challenged, I'm hoping that I'll be able to figure out something that works for me, not makes all my hair fall out and gives me chest pains. Since T3 hormone is much stronger than T4, I'm waiting for all that energy to make me hike ski hills like never before...

More reading:
The FDA does away with Armour Thyroid (well, not quite, but close enough)
Stop the Thyroid Madness
Study Finds Patients Prefer combination T4/T3 treatment
New Study Shows that the Addition of T3 is Superior to Levothyroxine/T4 Only Treatment for Hypothyroidism

Tuesday, October 11, 2011

The pregnant woman as public property

Marathon runner Amber Miller gave birth within hours of
finishing the Chicago Marathon. The way people criticize
her, you'd think she gave birth along the way and kept
running with the baby still attached or something.
Photo credit: Griska Niewiadomski.
I was all set to finish my series of posts on vaccines when this story grabbed my attention: marathon runner Amber Miller gave birth to her second child within hours of finishing the Chicago Marathon. Pardon my ADD postings, but reading about this amazing lady was just awesome! Until I got to the comments section, that is.

Of course - whenever there's a story in the news about a pregnant woman doing something, there are sure to be a plethora of stupid ass comments to follow. Remember when a pregnant lady walked into a bar?... almost sounds like a bad joke. Unfortunately, it wasn't: back in January, a story hit the news about a woman who was eight months pregnant walking into a bar with friends. She had flown into town for her baby shower, and her friends convinced her to go out for a few hours with them.
But her effort at late-night fun lasted a whopping 15 minutes. No sooner than Lee had arrived, a bouncer at the the Coach House Restaurant told her she had to leave; no pregnant women allowed.
Too bad she wasn't drinking anything stronger than water. She was seen at the bar with a friend who was doing shots. Perhaps she was keeping track for her, who knows. Whatever the case, even though law enforcement said there is "no reason" she should have been asked to leave the bar, the bouncer escorted her out.

I'm sure the bar is concerned about rowdy patrons and bar fights like you see in the movies. However, one can easily surmise that they would do the same thing they did to this woman: ask the offending patrons to leave the restaurant. And no where in the article does it mention anything about a scuffle, flying beer mugs or overturned tables. Really, though - if that kind of thing were going on while this woman was inside, don't you think she'd do what most reasonable pregnant women would? She'd leave the area. It's not like she's going to body slam someone and join in.

The woman did not partake of any alcoholic beverages, and it can be assumed that just like everywhere else, there is no public smoking in restaurants in the state of Illinois, where this took place. And even if she had a glass of wine - which is, according to some, okay for a pregnant woman - who are they to decide for her whether she is using good judgment or not? Since when does that give strangers the right to police our actions once it's obvious we are pregnant? What are you going to do - give every woman of childbearing age a pregnancy test before she enters the bar area, just in case?

Just like in Amber Miller's case, there is a familiar pattern here: treating the pregnant woman like public property, as if she is incapable of making decisions for herself and her unborn child.

It seems like once you are visibly pregnant, people feel the need to comment endlessly on your condition, touch your belly, and step in and make decisions on your behalf. I'm not sure what it is about pregnancy that makes perfect strangers feel the need to treat us like helpless idiots who have no brains, feelings or an original thought of our own.

Several years ago (before the days of officially no smoking inside public buildings) I worked in a pharmacy with a pregnant woman. Our boss would sit behind a partition during his breaks and smoke. Somehow I don't remember the smoke being that bad, but at least one customer felt the need to comment curtly on how she didn't think pregnant women should smoke. While now I think our boss should have had the courtesy to go outside and do it, Tara didn't seem to mind and just gave that customer a sweet "Go screw yourself" smile and moved on. (Tara also worked her last shift before maternity leave all while having contractions, and when her shift ended she calmly proclaimed, "Okay, I'm going to the hospital now to have the baby. See you in a few weeks." Wow, that's my kind of woman. I think she had the baby less than an hour after getting there, with no epidural.)

Amber was, according to several articles, in excellent physical condition - she'd have to be, in order to run a marathon only ten months after her first child was born. People called her stupid and selfish, and some suggested that her baby should be taken away by child protective services! Many questioned the authority of her doctor for even giving her permission to run it in the first place.  Of course, if she had done it without his permission, they would have raked her over the coals just the same. Amber walked and ran the race, so I'm sure she realized her obvious limitations and didn't try to push herself. It's not like she was in a dead sprint the entire time. Some use foul language and call her names - you'd think she was doing crystal meth on the sidelines or something.

The pervasive myths about pregnancy continue, as usual: that a woman is in a "delicate condition" and must be treated like a piece of glass about to shatter. I'd love to talk to Amber and see how her labor went - she apparently gave birth little more than two hours after getting to the hospital (before stopping on her way to get a sandwich, though). I don't know what her philosophy on birth is, but I'd say she did everything right: kept herself in great physical shape, remained upright and moving and ate while in labor - all of which can help speed up labor and make delivery easier. The comments that demonize her are based in the ignorance that a laboring woman needs to be shackled to the bed with continuous monitoring, tubes and wires - not have the audacity to keep moving, and even (gasp!) eat a sandwich. When the only thing you know about pregnancy and birth comes from "A Baby Story" it's not a wonder the comments she received were so inane.

Amber, I want to tell you that you did everything right and congratulations on your baby and your marathon! I can't wait to read about then next one. :)

More reading:
Photo finish: Woman gives birth after running (and walking) marathon -
Woman gives birth after running Chicago Marathon - CBS News
Woman gives birth after running Chicago Marathon - Chicago Sun-Times

Wednesday, October 5, 2011

'Tis the (flu) season

Ahh, fall.... cooler temperatures, changing leaves, and ... sneezing?

Judging from the bombardment of ads I see everywhere, it must be flu season. I wouldn't know, since the last time I think I had the flu, I was about nine years old.

Given my propensity to question authoritative figures (especially if they don't give me much of a good reason to listen), I've been on heightened alert for things like ads, billboards, and even register tape reminders about getting my flu vaccine. And I'm also paying attention to things like high drama, scare tactics and all-out pandering to the lowest common denominator to coerce, convince and cajole us into getting the shot.

These two billboards are sitting in a corn field down the road from my house. I sped by them one day, almost scaring my family as I nearly hit the brakes in disbelief.

Marketing technique #1: Using big, scary-looking font. That really gets their attention. (As a graphic designer, I'm all about the fonts.)

Technique #2: Make ambigious statements that make the average passer-by say, "Well, they say it's safe, so it must be." Never mind that there are no sources or mention of risks at all (there isn't that much room, anyway).

Technique #3, perhaps the best one of all: Use the cute, smiling kid to tout your product. Nothing says "I got vaccinated and I'm just fine!" more than the grin of a pigtailed child.

This one is bold, yet sly, at the same time. The urgency (in that big, bold font) is almost implying that health officials are lying in wait for you to pass, stopping your vehicle and asking for documentation that you have been vaccinated. Notice, though, the interesting use of a cell phone and truncated (if not totally annoying) "internet speak" that often appeals to the younger generation (those whippersnappers!) - who seemingly are more healthy than those who are most at risk for the flu, like the elderly and those with compromised immune systems.

Saying "Stop the flu before it stops you" is implying that something bad - really bad - might happen if you don't get the shot. You might be miserably ill, perhaps even miss school or work - for at least a week, maybe not even. That sounds bad. Like it might stop me. From going to work. Yeah, okay.

Target, I noticed, is offering some kind of flu shot program and is touting it left and right - I saw banner ads on their website as well as on my register receipt after making a purchase. Their marketing technique is a little more subtle, sort of giving you a gentle nudge - rather than screaming in your face like the county government does. How ironic.

"Your timing is perfect - we have flu shots! So give it a shot - come on, you know you're skeptical and riddled with fear but too afraid not to get one, so just go ahead! Dooooo it!"

This one offers you a $5 gift card if you get the shot.
Bribery works wonders. 

Now, again, if you're already ill and have a compromised immune system - like the elderly, for example - I can agree that the flu might present more serious complications for you and it's probably worth getting protected. Some say the flu vaccine can cut the risk of serious complications and death in older people up to half.

However, there is some speculation that perhaps the vaccine doesn't work as well in older people as once thought. Although it's anecdotal, I know my grandfather got the flu vaccine every year and, if I remember correctly, still got the flu. This is possible, as the vaccine admittedly does not work for everyone - it's estimated to be ineffective for about 30 percent of the population, apparently. Perhaps for my grandfather, he was one of that 30 percent. And after his last flu vaccine, my mom said, he just wasn't the same - and it was all downhill from there. He eventually died a few months later.

Could it have been from complications of the vaccine? Who knows. We probably will never know, and it seems like if it doesn't reach out and smack you over the head literally minutes from getting the vaccine, most health officials are completely unwilling to correlate the two. Perhaps because that would scare more people away from getting the shot, ya think?

This article from the Washington Post acknowledges that the government, especially, has often used fear as a heavy-handed scare tactic to "encourage" you to get vaccinated. There is probably a lot of wheeling and dealing going on behind the scenes - perhaps from the pharmaceuticals industry - to ensure that you keep buying what they're selling. If more people realized they were being used as tools perhaps they would second-guess waiting in line for two hours on a rainy afternoon to get that much-coveted flu shot.

I remember seeing a huge line of people at the mall one year, complete with security guards standing by - and wondered, "Are they buying concert tickets or something?" Then I looked at the crowd - which mostly consisted of older people in wheelchairs, and realized, They're waiting for the flu vaccine. As far as the elderly are concerned, there is some data to suggest that actually, many of them are already immune to several strains of flu - including H1N1 - because of living through past epidemics. Which means you waited in line for nothing, basically.
"Lab tests showed that some adults, particularly those older than 60, had antibodies against the new strain, but Dr. Anne Schuchat of the CDC cautioned against reading too much into the finding. 
"We don't know yet what that will mean in terms of actual immunity or clinical protection," she said on a conference call with reporters.
Which means, don't get too excited - just keep getting that flu shot. If we had a crystal ball (or lots of money to do additional tests) perhaps we'd find that more people wouldn't get H1N1 in the first place. Unfortunately the cost of blood draws might equal the cost of the flu shot. 

Common myths about the flu pervade, according to this article. Health officials say "It's impossible to get the flu once you've been vaccinated," (because the shot doesn't contain the live virus), but actually it is - because either you're part of the percentage in whom it was ineffective or because the particular strain you got is not even included in the vaccine. So you got the shot and go the flu.

The article also says that side effects of the flu shot are a "myth." I don't really consider listing soreness at the injection site and a case of the sniffles to be adequate counsel on the true side effects, which are no doubt uncommon but still exist. Several sites say that Novartis, the makers of Fluvirin, admit in their package insert that possible side effects can include paralysis and Guillain Barre Syndrome, which can cause paralysis and even death. However, the one package insert that I found lists it as a possible side effect, but only in connection to the 1976 swine flu outbreak, in which an elevated number of cases were reported after people received the vaccine. In other words, it sounds like they use that case as a scapegoat and want to distance themselves as much as possible from the possibility, perhaps in hopes that you'll say, "Oh, that happened 35 years ago - I don't need to worry about that."

The article, titled "Flu: You're not immune," ponders whether getting the flu can improve your immunity. 
“The natural immunity you build is usually more durable than the immunity you acquire from an injection,” acknowledges Dr. Raymond Strikas, associate director for an immunization program at the Centers for Disease Control and Prevention. “However, why run the, albeit small, risk of a serious illness when it is much safer to get the vaccination?”
The language many flu vaccine advocates use sounds serious, their tone warning - as if you are completely incapable of making the decision on your own free will. "Getting the flu is not a good idea," says one American Medical Association specialist. Of course you'd say that; you work for the American Medical Association. "The primary reason is that the influenza virus undergoes antigenic variation, so on a yearly basis the strain undergoes change." That's a fancy way of saying, according to the article, "Getting this year's flu doesn't necessarily prevent you from getting next year's flu."

(It also means getting this year's vaccine doesn't protect you from this year's flu, either, if you get infected with a strain that isn't included in the shot. You kind of glossed over that part.)

Reading between the lines here, I'd say even the CDC guy reluctantly admits the risks of "serious illness" are rare. Glossing over the reality of it, he basically eases into the guilt trip and encourages you to get the shot, even though it might not make a difference either way. 

The Cochrane Review did their own study, which basically found:
Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.
Rather surprisingly, they also acknowledged that nearly half of the trials were "funded by vaccine companies" and "company-sponsored influenza vaccine trials tend to produce results favorable to their products..."
The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies.
Something to think about before you get your next flu shot.

Monday, October 3, 2011

Rethinking childhood vaccines

If we all sat back and thought about what we're knowingly exposed to every day, combined with what we don't know that we're exposed to, it would probably make us never want to leave our houses again, instead happy to sit at home and bathe ourselves in a bleach solution. There are so many unknowns in life - things we are afraid of that never materialize, things we should be afraid of but aren't - that it's crazy to fathom it all.

While I do vaccinate my children, I am increasingly wary and weary of the mass hysteria surrounding vaccinations. Admittedly it can happen on both sides: the non-vaccinating crowd offers up just as many horror stories as the vaccinating crowd does. I don't agree with assumptions that 'no vaccine ever saved anyone,' nor can I stand the "If there's a vaccine or a pill out there to cure my XYZ, I'm going to take it!" I guess I stand firmly, skeptically, in the middle.

When my daughter was just eight weeks old, my old pediatrician practically begged with me - downright pleading - to at least consider the hepatitis B vaccine (which I had declined at the hospital). Knowing that I didn't meet any risk factors (and had already been vaccinated as a healthcare worker), I wanted to say no, because at the time my daughter was already in the throes of a nasty milk protein allergy that I wanted to get to the bottom of first. But my ped practically wouldn't let me leave the office. 

I declined the rotovirus, and she said, "Well, at least get the hepatitis B." It was almost like she was saying, "Just get one shot. Any shot. As long as you get something." 

This summer my daughter sat on the exam table at the peds office, the poop nearly scared out of her because she had to have the dreaded "shot!" She was missing four shots, one of which was my eternally non-favorite: the chicken pox vaccine.

The book (published,
ironically, around the same
time the vaccine came out)
says chicken pox is a
"normal childhood illness."
I'm surprised the CDC
hasn't lobbied hard to
take it off the shelves. 
My daughter, being almost five, was - according to my research - the prime age for when chicken pox usually happens. I asked, almost facetiously, "Don't you think that if she was going to get it, she would have had it by now?"

"Oh nooooo," The Pretend Doctor stated, rather dramatically. "Because then if they get them as adults they're much worse and they can end up in the hospital." (insert horrified expression here)

I wanted to blurt out hysterically, "Are you kidding me? That's your idea of informed consent?" I thought back to the information I'd looked up on chicken pox and the shingles, and also to those people who I had actually known in my life that had shingles: all three of them. One was going through the obvious stress of the death of her son, and even in her pain (both physical and emotional), seemed to be pulling it together. The other guy is just a stress ball as it is, and I think the third person likes to really play up how miserable she is/was/will be whenever something wrong is going on.

None of these people, in my estimation, ever had to go to the hospital. And I'm pretty sure none of them are dead.

While it's true that chicken pox can be quite ugly if you get it as an adult, I question how the chicken pox vaccination is going to remedy that. I don't know if anyone can conclusively say how long the shot's immunity is supposed to last, and even when given a booster shot, that pretty much means they'll be fully exposed to potential illness around the time they reach adulthood. But...what? That means they'll stand to get it when it's more prone to cause complications, right? How can that be?

But wait - you can get another booster shot as an older teen or adult. Or you can just get the wild virus as any kid prior to 1995 would have done and be done with it, resulting in (for most) lifelong immunity.

Aside from the short-term costs of missed work days (assuming there are some), the cost of acquiring lifelong immunity the good old fashioned way (assuming you were a normally healthy kid) is pretty inexpensive. The cost of the vaccine (anywhere from $80 to $120, depending on where you live, multiplied by the number of boosters you receive) is not.

And like other vaccines, even if you get the shots, you might still get the chicken pox. These children in Michigan experienced an outbreak despite the vaccine, which has many wondering if it's a new mutated strain taking hold.

There are also some who believe the chicken pox vaccine is creating significantly more cases of shingles in adults, because their natural exposure to the wild virus is severely curtailed - whereas before it was actually an immunity booster.

My problem with the chicken pox vaccine started, however, when my oldest was around a year old. I had never done much research on it, but at the time, it didn't make much sense to vaccinate a child for what was perceived as a "normal childhood illness." As I raised questions, the nurse - holding my son's arm, needle poised - basically said, "Too late now," and proceeded to inject him. (I think this was after a brief "He won't be able to go to school if he doesn't get this," spiel.) Looking back on it now, why the hell would anyone proceed if it's obvious the parent is not completely on board with the idea? Put down your needle and say, "I think you should talk to the doctor about this and we'll vaccinate him when you've made your final decision." Not say, "Too bad for you. We're doing it anyway. Just get the damned shot."

That's the idea about some vaccinations that doesn't sit well with me. Unfortunately, when people start to ask questions others in the "Let's Vaccinate Everyone!" camp cry foul and start pouring on the sob stories, making you feel like a (stupid) bad parent that doesn't know anything, whose opinion can be swayed with the blowing of the wind. Well, I have news for you - vaccinating your kid for everything, all the time, might not be such a hot idea, either.

It struck me not long ago that the primary motivation behind the chicken pox vaccine was not so much to save the 100 or so kids who die yearly from chicken pox complications - it was to prevent lost sick time because fewer households include a stay-at-home parent. You can't prevent every illness, and will sacrifice lost work time for a variety of reasons throughout their childhood. The face of parenthood has changed in the last 30 years or so, with more kids in daycare, fewer stay-at-home parents and lower breastfeeding rates, which means vaccine manufacturers stand to gain a lot of money off of people who want their children to get sick as few times as possible, so as to prevent any disruptions in routine. I guess I can agree with that, but to a point.

But the first knee-jerk reaction is to lay blame on the parents, as this mother did, because her leukemia-stricken son couldn't attend daycare since at least one child was unvaccinated. This is basically failing to admit that no vaccination is 100 percent effective, and really - when you're dealing with the unique and individual immune system it's kind of a crap shoot. The mother has no idea why that child isn't vaccinated, or what he's not vaccinated for - could he have an allergy to something in the vaccine? Did he have a previous bad reaction? And really, considering her son's potentially dire condition, why is she putting him in a daycare situation anyway?

The bottom line is that we are vaccinating children for something that is merely an 'inconvenience' to parents. At what point do you draw the line? We now have an entire generation of parents who think chicken pox is some horrible 'disease.' Seriously?!

When we look at the reported number of deaths from chickenpox, there is probably a lot more going on behind the scenes than people will admit. Can there be complications? Apparently so - but what they aren't telling us is why. Are these children immunosuppressed? Do they have other underlying illnesses?

As far as the effectiveness of vaccines, that's another one that's up for debate. It's not known, for instance, how long immunity from a polio vaccine lasts, yet people say that if we don't vaccinate, "millions of children" will be subjected to potential antigens within a year. Yet, if you read a little on smallpox from the CDC, we stopped vaccinating for it in the late 1970s because it had effectively been eradicated. But wait. I thought polio had been eradicated from the US as well. So why are we still vaccinating for that, but aren't for smallpox?

Interestingly enough, I recently read that then Vice President Dick Cheney wanted to start vaccinating for smallpox again because he was worried that bioterrorists would get their hands on it and turn the virus loose on the population. President Bush said no, because he was worried that people would die from just being vaccinated. (Approximately 1-2 % of people die from the vaccine.) Finally, someone who is willing to admit that vaccines can carry some risks, potentially death. And yet, when sporadic cases of Guillain-Barre syndrome show up in the population after flu vaccines are administered, as they have been doing since probably the 1970s, the industry is unwilling to admit there is a link and basically shrugs it off.

A few years ago there was hushed talk about a pertussis outbreak going around. Stupidly, I didn't think much to ask about it because "hey, my kids have been vaccinated for that!" One of my husband's students - who was previously unvaccinated - ended up getting it and the campus was in an uproar. The nurse went off about how his wacko parents were against vaccinations and were giving him daily "vitamin injections" or something or other, and at first I was upset, too. Until I realized that even if he had initially been vaccinated, it wouldn't have mattered, because it likely would have worn off on him by that time. As a result, that kid now has, researchers believe, lifelong immunity - instead of potential gaps in his immunity from the vaccine.

One of the biggest things that make me question vaccines are the outrageous marketing campaigns waged on us by healthcare professionals and the pharmaceutical industry. Overly dramatic ads run constantly; even Jennifer Lopez is in on the act. (I picture someone off-camera saying, "Now use your saddest, most dramatic face!") With that kind of melodrama it has to make you wonder about their motives, most of which include a lot of dollar signs - you can't help but notice the great financial rewards drug manufacturers stand to gain from developing these vaccines.

A nauseating billboard down the street from my house 
When it comes to informed consent about what we're giving our children, it needs to be more than just "Vaccines are safe! Vaccines are necessary!" Understanding how diseases work and why is tricky enough, and it doesn't help when your doctor doesn't even fully understand the implications of having such a vaccinated population - and how there can be drawbacks to seeing otherwise normal illness as a serious event. Our philosophy on illness has changed so radically as to seek to prevent nearly every little sneeze or sniffle with a pill or injection, which can have many negative repercussions, including the idea that "Because I agree to accept the potential risks of doing this, you need to do the same."

It seems like when there are perfectly good low-cost, natural remedies available, they are passed over in favor of vaccinating or taking more pills. In combatting the seasonal flu, covering your coughs and sneezes, as well as washing your hands, is often one of the best, easiest and cheapest ways to avoid getting sick; you can't deny that. Eating healthy, taking vitamins and getting enough sleep are also important to staying healthy, but our Pill Generation increasingly ignores these guidelines in favor of some injection or other to prevent this and that. In a probably not-so-new twist, drug companies are turning to legislators (Gardasil mandates) to essentially force, or at the very least coerce, you to use their product - especially in the face of  declining profits - instead of promoting ways to lower your risk factors.  (Like washing your hands and covering your cough will work for flu, there are perfectly plausible ways to lower your risk of getting HPV - that not too many people want to talk about).

As they say, "An ounce of prevention is worth a pound of cure."

Dramatic ad encouraging parents and children to be vaccinated for whooping cough