Improving birth by breaking the silence

The topic of childbirth is one that women - often those who don't even know each other - often freely engage in. We find ourselves sharing the most intimate details with strangers on what is often the happiest day of our lives. And for some, one of the most traumatic.

But it seems like if your outcome is anything less than happy, women suddenly don't want to hear about it. And when you question the actions of your doctor, or express anything less than total and complete gratitutde to your doctor, then you're attacked, criticized, made to feel like you're selfish for wanting something more or think you're smarter than the physician.

And yet, sometimes these stories still make it out, have a voice, are heard above the din. When "Kelly," the mom who had an episiotomy and was cut at least a dozen times by her physician, told her story, many women did come out of the woodwork. They shared their equally horrifying experiences, told her she wasn't alone, said the same thing had happened to them. It was terrifying and yet vindicating at the same time, knowing that finally these women are confident enough to talk about what happened to them. And with the number of them growing as more and more comments were added and the article continued to be shared, it was clear there were more of than them than not. And it was abundantly clear, even to those who are not involved in birth advocacy, that there is a shocking pattern of abuse in obstetrical care.

If you ask your mother, grandmother or great-grandmother what her birth story is, she may or may not be able to tell you. She may not remember any of it, drugged into oblivion with medication she may have felt at the time she neither wanted nor needed. While things have improved somewhat since then, it's not all that much, considering you still hear these horror stories. Women were given few choices then and to some extent, still aren't, with sometimes well-meaning and sometimes downright cruel care providers making choices for them on their behalf. These pictures continue to give us evidence of that.

I have seriously told women who were not
comfortable laboring at home to either labor in
the parking lot or the lobby but not necessarily
check in. That way you're close to the hospital,
but still on your "own time." How pathetic is it that
women even have to resort to doing this?
I can totally understand where she's coming from.
Photo used with permission from ImprovingBirth.org

Isn't that the truth. Remember Nurse Jenna's
post lightyears ago about "why you need
Pitocin in labor?" This was basically her
justification of it - they need to free up
beds. It's all your fault that you're not
laboring at home longer, even though
we care providers make you feel like it's
the most dangerous thing in the world to
do so. (To read the article, click here.)
Photo used with permission from ImprovingBirth.org

Coercion can often be another hallmark of abusive practices. And as some find out, they agree to the procedure only after much pressure and bullying, only to read in their chart later something entirely different.

The "maternal request" cesarean is often the result of
mom agreeing to a c-section after finally giving in to
bullying, scare tactics, and tremendous pressure to do so
from her physician.
Photos used with permission from ImprovingBirth.org

I am not at all surprised that this is a female physician. I
had similar experiences with one in my OB's practice and
found many of them to be far more condescending and
rude than the male doctors.
Photo used with permission from ImprovingBirth.org

When people say "Just trust your doctor" I think
of situations like this one and it makes
me want to throw up.
Photo used with permission from ImprovingBirth.org

I urge you to go through Improving Birth's FaceBook gallery. Maybe there is a situation that speaks to you or you have one to share - please do so. Maybe you personally have never experienced this and were completely unaware that such a thing existed. It is time for women to stop being shamed into silence and forced to accept something that is "normal" when it really isn't.

More information:

Improving Birth - Advocates for Evidence-Based Maternity Care 

Submissions will be accepted again soon - to submit your entry, click here. 

Doing the unthinkable: questioning Breast Cancer "Awareness" Month

Right now, as I type this, a college friend is going through what we can only guess are the final throes of brain cancer. It has been a horrible downward spiral to watch, dragged out over the course of several years, that - like most cancers seem to - started out as a battle initially won and then proved to be much, much worse.

Why is that? Have you ever noticed that "survivors" often end up getting cancer a second time, this time much more aggressive than the first? I am so sick of "pink ribbons" I could scream: namely because it seems few people really understand the truth behind them, or the often subversive, misleading marketing behind it. But how dare you ask? How dare you question it?

It's a reality that many of us probably think about, dread, pray will never come knocking at our door. It seems every time you turn around, someone you know or a friend of a friend has it. And it also seems that while advancements have been made, the medical community knows just as little about it as they always have.

Years ago when I was writing for a newspaper, I interviewed a top cancer surgeon at a nationally esteemed cancer facility. He told me that around the turn of the century, there was little they could do for cancer patients, and death from it was often brutal. You were basically just left to die, he said.

I was thinking today of my friend and wondered, if in some ways, that's not still true. Treatment options might work - or at least appear to - and then wham, a recurrence hits you like a ten ton truck several years later. This seems especially true with breast cancer, everyone's favorite 'pet project.'

And I just realized - it's October! Hey, Breast Cancer "awareness" month. Yeah, you're aware of it. But do you really know anything about it? What your risk factors are? How much money is poured into research that is inconclusive, misguided or redundant? The financial toll is one thing; the human toll is unspeakable.

Take a moment to consider:

• A company can merely slap a pink ribbon on a product that makes you think they're "doing something" for cancer research, when in fact they may not be donating anything at all
• Products that contain known carcinogens (like personal care products) are often touting that cancer awareness ribbon

The documentary "Pink Ribbons" alludes to the fact that many studies are irrelevant and seemingly poorly organized. In one such study, a commenter responds that while an effort was made to do studies on breast cancer among black women, all the subjects were white. (Seriously?!) How is that making the best use of the millions of dollars funneled into "research" every year? If that's the best they can do, should we be more inclined to just hope for the best and take our chances?

Sometimes the treatment sounds scarier than the disease itself, and yet even if you're questioning traditional medicine at this point you're almost too scared not to seek it, even if it won't be successful. The last I knew, our friend has been reluctant to admit this might be the end, and I'm not sure who is worse - her tenacious (but completely understandable) struggle for survival or the doctors who keep pumping her full of this that and the other, doing surgery after surgery, instead of just addressing the truth head on. The same thing happened with another friend of ours who succumbed to brain cancer nearly 18 months ago. Literally days before he died, there was a medication switch, as if in some last-ditch effort to save him from one of the deadliest brain cancers there is. Why? To practice on him like some kind of guinea pig?

We've been so hopelessly exposed to chemicals in food, pesticides, plastics and who knows what else that of course, there's no surefire paper trail of where it comes from so all we can say for now is "Who knows?" and move on. It doesn't explain why some people get sick and some don't. I personally think the effects are cumulative, no doubt starting with our parents, grandparents, maybe even great-grandparents. Slowly, generationally, we are a nation of sick people - with everything from ADD to cancer, obesity, hypothyroidism, diabetes and a host of other things that seem to crop up in larger and larger numbers. When a company can produce products that cause cancer and then fund cancer research, it should make you seriously question where priorities lie, both in ourselves and in the industry that fuels this paradox. And why won't they tell you when they've got too many fingers in one pie, or conflicted interests that show you your health is really not their top priority?

Our age of quick fixes and 'feel as little pain as possible' living has far removed us from the idea that, really, there are no guarantees in life.

More reading:
Flawed research appalls cancer patient
Medical research studies: Are too many using flawed designs?
Conflicts of interest often under-reported in clinical trials
Clinical trials flawed by biased reporting

"Dr." Amy to speak at September ACOG conference

I just heard it through the grapevine that the formidable "Dr. Amy" of homebirth hater fame is on the docket to speak at an ACOG conference in September. And not surprisingly, one of her topics is "Everything an obstetrician needs to know about homebirth."

Of course, I don't know personally, but I'm going to take a wild guess that she's never attended a homebirth before. Yet she is probably considered the "expert" source on them, most likely because she squawks the loudest. Never mind what actually comes out of her mouth.

Here are her "credentials," according to the ACOG PDF handout:

Um, no, not exactly. Although I realize that the title "Dr." is often a courtesy after a physician has left practice or retired, this is incredibly misleading. My father-in-law is a retired physician that most people address as "doctor," but he certainly doesn't go around representing himself as a licensed, practicing physician. I would hope those in attendance actually know better when listening to her blather on for an hour about how much she hates homebirth and the women who choose them.

A Google search of her name produced the obvious results referring to her blog and "advocacy." She shows up on a number of websites like Healthgrades, listing a physical address to what would seem an office, but no reviews from actual patients. And when you search her name on the Massachusetts Board of Registration in Medicine database, you come up with this:

She spends countless hours trolling the internetz for every story ever published about homebirth and basically makes all natural birth advocates everywhere out to be liars. Yet she continues to represent herself as a licensed physician who is still practicing medicine. Hypocrisy much?

Since ACOG is trying to set guidelines that offer women the best care while treating them with dignity and respect, I'm not really sure how she fits into their lineup.

According to ACOG's website, they acknowledge that

"Most women have normal conception, fetal growth, labor and birth and require minimal-to-no intervention in the process. Women and their families have different views about childbearing based on their knowledge, experiences, belief systems, culture, and social and family backgrounds." (Really? They really believe that?! Who knew.)

It goes on to explain their idea of what "patient-centered care" means:

""Patient-centered" means that health care providers, and the system they practice within, accept that the values, culture, choices, and preferences of a woman and her family are relevant within the context of promoting optimal health outcomes." 

They also acknowledge that part of that patient-centered care includes having not only a skilled attendant (which can come in other forms besides an OBGYN), but also "supportive resources."

Based on their description, I don't think Dr. Amy fits into their scheme of things at all. Either that, or they're just very out of touch with the way a majority of births are carried out these days. Phrases like "support" and "education" are all relative, when you consider that many patients often get all their information from their physician and trust no one else in the process.

On the surface, healthcare initiatives and much of the jargon ACOG churns out sound great - but when you actually ask women about their experiences, it seems that there is a major disconnect. ACOG itself argues that they feel the hospital is the safest setting for giving birth, but admits that it "respects the right of a woman to make a medically informed decision about delivery." It's clear that Dr. Amy does not. I am really curious to hear how this one is going to play out.

From The SOb's website: What a caring, compassionate and professional
way to promote your "advocacy." Would you want someone this vulgar and
derisive in charge of your care? 

More reading:
The C in ACOG Stands for Castrated 

Review: VBAC Facts Class with Jennifer Kamel

Image: VBACFacts.com

This weekend I had the pleasure of attending Jen Kamel's VBAC class "The Truth About VBAC: History, Politics and Stats" in Buffalo, NY. She is amazing - traveling the lecture circuit to present loads of information to both laypeople and birth workers alike.

I've already had a VBAC and I'm "just" a birth advocate, but I highly recommend the class if you can either attend in person or check out the webinar version. Why spend money on a class when I'm not even a birth professional? For philosophical reasons, this was as inspiring as it was educational.

What an opportunity it was to network with local doulas, midwives, advocates and birth professionals! I met new friends, heard and shared stories and exchanged information that not only could I use but pass on to others as well. The presentation was heavy on graphs and charts (Jen's favorite LOL) which is a good thing - putting it all into perspective is important. Without that perspective and information, women are potentially making a life-changing decision with less data and fewer facts, perpetuating the idea that "VBAC is dangerous!" and that it's selfish, foolish or risky to even consider it.

Some important take-away messages that I left that night with:
• Studies are important, as long as you're looking at the big picture. For instance, rupture rates are key, sure; but if the study you're reading doesn't tell you the number of women who had labor induced or augmented, then it's not going to give you all the facts. That is very important information to have - because it can increase the overall risk of rupture. Without it, it can definitely skew your impression of whether it's safe or not. Is your doctor quoting these same studies, that might present data the way he wants it to? Perhaps.

• Ultimately it all comes down to the level of risk that you are willing to accept. One is perceived as inherently safer, or more dangerous, than the other. Why is this? Because one is performed much more frequently than the other, to the point where risks and disadvantages are glossed over and minimized. I've always thought that it's just a shuffling game: you're trading one set of risks for another. You put off the more immediate risks of a VBAC and trade them for the more long-term, cumulative risks of repeat cesarean. If you're not looking at the long-term picture, you may not have all the best information at the time.

Why does a rare but well-publicized uterine rupture (which is not always catastrophic) send up more warning flags than surgical complications after four cesareans? Why are we more afraid of the risk of rupture - which may not even be realized - than we are about cesarean complications, that are becoming increasingly more common as more women have more cesareans?

Jen's presentation may be just the thing to give a VBAC mom the edge when it comes to studies and statistics - and it's downright sad that you even have to walk into a doctor's office defensively posturing yourself with a ream of studies to back up your birth plan. Don't expect your doctor to know all the facts and figures - or to even come close. Jen's information is nothing that you can't already find on your own, it's just painstakingly put together from the same medical journals and articles your doctor has access to - conveniently all in one place. The benefit to you is that the legwork has already been done - which is a big plus when it comes to the virtual sea of data that can be very overwhelming. Kudos to Jen for her hard work and determination!

For a list of upcoming classes and webinars, visit www.vbacfacts.com.

Why do women choose "risky" births?

Whenever a tragic birth outcome makes the headlines, especially if it's perceived as "risky," I know women ask themselves, "How can a woman do this? What on earth was she thinking?" It's hard not to, but much of the time, I can totally understand why.

The death of any baby is tragic, and I guess hindsight is 20/20 when you pronounce the death "unavoidable." In the case of this Australian woman, who was attempting a VBAC at home after two cesareans, she was summarily lambasted for not following the advice of her doctor and "internet advisers" were blamed for giving her false information on what she should do. One woman said, "I blame the 'variation of normal' crowd." (The woman's baby was breech.)

Contrast that to this story, of an American woman who died of complications following her sixth cesarean section. No is blaming her for her risky decision to have so many cesareans, as I'm sure she took her doctor's advice - and I highly doubt he/she was pleading with this mother to "please have a VBAC! It's safer!"

What's the difference, really?

Why is accepting one death - that could have also been avoidable - okay, but not the other? Imagine if the Australian woman had decided on that third cesarean, perhaps going on to have more children and more cesareans, and ending up like the woman who died? Are we saying that's just an acceptable risk that you take and "so what?"

I see it as merely shifting the risk. The more you discourage VBAC in women who've only had one prior cesarean, especially in those who desire larger families, the more you end up hearing stories like this. It seems like our medical community, and society at large, is perfectly willing to believe in dangerous paradoxes - namely, that VBAC is dangerous and cesarean section is "perfectly safe." Many commenters were disgusted that she went against the advice of her doctor and attempted a VBAC, which was unfortunate; but for many women who do take that advice, you better believe their doctor can churn out just as much misinformation as that sandal-wearing hippie natural birth advocate you so despise. How is being the opposite side of the same coin any better?

Add the fact that very few hospitals receive an official "Mother-Baby Friendly" designation (not that that matters, I guess) or can seem to be supportive without treating mom like brainless chattel and it should be easy to see why women choose an alternative birth. How many times have you heard that it's damned-near impossible to have a normal, let alone natural (gasp!) birth in a hospital setting? I'm not saying it can't be done, just that it's usually difficult and you have to really work the system (which has quite a learning curve, let me tell you).

For those who frequently bitch about how reckless or crazy women are after disastrous home births, what are they doing to make hospital births more hospitable? Oh wait - they're usually the ones that tell you to just "let go of your anger and get over the 'birth experience' - just deal with it." I'm guessing they've never once cracked open a book that details some of the absolutely barbaric birth practices that "modern" obstetrics have put women through* over the generations, and for what? To be treated like a human guinea pig? Or the formidable, unmentionable "physicians" who like to demonize all women for even thinking about a home birth, much less having one - are they making stunning strides and initiatives to support women in a comfortable, accommodating hospital atmosphere? Or just complaining about it and publishing the names and addresses of those women who've lost children in home births?

I'm not sure how I managed it, but I had a VBAC in 2006 and sort of fell into an OB's practice that would actually "let me" do it. I don't think I had any clue how difficult it is for some women to have one. If I hear someone say "just find a supportive OB and hospital with lots of experiences in VBAC" one more time I'm going to scream. Because it's definitely not that easy.

From the ICAN website.

If you look at this list, many are rural hospitals or in smaller towns. And many are hospitals in large cities. I'd like to know how you are just going to up and "find a supportive hospital" when they don't seem to exist. If you live in the boonies, your options for supportive hospitals and OBs or midwives is probably pretty limited, and I'm willing to bet the cesarean and induction rates at those hospitals that serve rural women are through the roof. ACOG Guidelines be damned; they aren't offering up an attorney, birth doula or physician to see you through your VBAC - which means the "guidelines" they issue do little to help the patient if a doctor can just pick and choose which guidelines to follow.

(*And for the record, I'm not intimating for one second that before modern obstetrics, women didn't suffer or go through torturous experiences in order to birth children, sometimes with disastrous results. But I think our glorification of modern medicine might be, at times, misguided and perhaps glosses over  its sordid history and past failings.)

More reading:
The "C" in ACOG stands for "castrated"
Tori Spelling and cesarean complications: why we need to hear about it

"Booby traps" in the NICU

Photo credit: Benjamin Earwicker.

I've never had a baby in the NICU, but I've run across more painful, heart wrenching stories of women desperate to nurse their babies who were offered little, if any, support. Then others have nothing but glowing reports about how wonderful and supportive their staff was, how caring and understanding the nurses were. It leaves me wondering: why is there such a disparity of care and support for these mothers and babies?

Obviously premature babies have special needs and issues, and often times they are born too young to even have a strong sucking reflex down yet. Not all babies, though, who are in the NICU are premature, and even some that are don't have the same problems other babies do. While obviously the sucking reflex is a common problem among preemies, I can't imagine that it exists with all of them, and I start to wonder, is this a self-fulfilling prophecy? That because it can be a problem, we're just going to go ahead and treat it like it is one?

Popular breastfeeding websites like Kellymom.com and the Best for Babes Foundation both posted this article on their Facebook fan pages, and the response from some mothers was nothing short of heartbreaking. Some of the comments included:

"I was flat out told by a nurse that it's nice to try but don't be afraid to give up - formula is just easier."

"They were very pro-milk, but not pro-breastfeeding. I had no support after."

"I am VERY thankful my preemie was my second breastfed child. If he had been my first I am confident that the hospital would have ruined any efforts to breastfeed...they were supportive (somewhat) of providing breast milk to my baby, but not of my baby breastfeeding. I had to push very hard on the doctors and nurses in the hospital to make it happen."

"My son went for 3-4 hours. I literally told the nurse "you can take him but if anybody gives him formula I will kill them." An hour later, the same nurse said, "His blood sugar was low so I gave him a little formula."

This also happened to me with my third child, who was born at term weighing 8 pounds, 7 ounces - nothing huge. The nurse flatly told me, "We gave him formula because his blood sugar was low," and when I shot her a look of surprise, she said, "We don't ask, we just do it." I received no other information whatsoever about my son's condition, nothing - and wondered, What is it about my breast milk that can't solve this problem but formula can? I don't think so.

Much like the schedules and strict feeding routines have been encouraged among term infants, the same exists in the NICU. One mom told how the nurses would only let her put the baby to the breast for short periods, then wanted her to give a bottle so they could see how much he was getting. Like this mother, I remember being almost obsessed about wet and poopy diapers and the length and time of feedings, to the point where it was almost making me crazy. And like her, I had an almost epiphany where I asked myself, What am I doing?! and threw them away, which made the nursing relationship so much easier and more relaxed, for both of us.

In the case of infants who were there but weren't premature, it seems that formula was often still pushed.

"I had some nurses forcing formula if she wasn't finished nursing after ten minutes on each side."

"I'm surprised we didn't have issues establishing a nursing relationship! They constantly 'forgot' to tell me when he was hungry so i could come and breastfeed him (I was recovering from a very traumatic birth) and *sneaked* formula. I was SO MAD."

"My youngest was automatically put in the NICU because he was a vaginal breech delivery. He was born a day short of 41 weeks. He was 9 pounds. They told me they didn't now if they could "allow" me to breastfeed."

Many said the same thing: that the idea of breast milk itself was readily accepted, just not breastfeeding. Why? I have to wonder if it's not so much because of 'cultural norms' but because they don't want to see you - and don't want to run the risk of others being offended because of an inability or lack of desire to breastfeed. I've often thought there were serious psychological and control issues when it came to some nurses and breastfed babies. And while most nurses would happily turn over care to the preemie mom, some, I think, almost develop a complex - because they are so engrained and entrenched in the care of these babies that they get defensive of their territory when someone - even the mother - steps in. Our cultural attitudes about public breastfeeding can also spill over into healthcare professionals - the very people who should know the most about it, and facilitate it the most, can also be the same ones to totally undermine and completely destroy that relationship.

I came across this link to a blog post where a nurse overhears a potential NICU job candidate announce, during the interview, "I don't DO breastfeeding." In her post, she mentioned an article posted on the Breastfeeding Moms Unite! blog, "Do nurses learn about breastfeeding in nursing school?" She confirmed our worst fears - that they don't, or at least didn't when she was in school, learn much about either the physiology or the mechanism behind it. As she put it, "The nurses owned the babies back then..." I argue they still often think they do.

Why would someone make a public declaration of this? Especially a person who is responsible for the care of patients who could benefit the most from breast milk? The nurse who overheard the exchange actually felt that this person would be hired, and I can't imagine why. Unless we're praising formula strictly for the sake of convenience, instead of seeing breastfeeding as a public health issue - especially among those most at risk. Her poor attitude could - and probably will - compromise the care of some - maybe all - babies, and I just don't see how anyone could want that person on their staff.

And if you actually question their authority, take charge of your baby and defy their "orders," you just might run into this problem:

"I think the only reason I established a successful nursing relationship, despite NICU nurses who threw away my "extra" expressed milk and gave her formula because the "refrigerator had no space," who scoffed at the "trendy" idea of kangaroo care, who chastised me when I nursed in the open, busy main room in front of her isolette instead of in the curtained-off "family room" that was almost always in use and locked (the hospital social worker actually reported me to CPS for my "public indecency" in the NICU and my "troubling attitude!"), the doctor who insisted on "plumping up" my expressed milk with preemie formula and sent me home with two massive cases of free liquid samples of the nasty stuff, was that I have a hypersensitive bullshit detector and a hyposensitive reaction to the advice of outsiders."

More reading:
When should I give my baby formula? regarding hypoglycemia and the newborn
NICU nurse in job interview: I Don't DO breastfeeding"- StorkStories
Gettin' your baby fix on, Similac Style
The nurse's role in promoting or undermining breastfeeding
Anti-breastfeeding NICU - mothering.com post

Book Giveaway! The Immortal Life of Henrietta Lacks

What an amazing, heartfelt book. The book details the life of Henrietta Lacks and how she became the unwitting progenitor for landmark advances in medicine - and yet never saw a penny for any of it. Among the book's timely topics are HPV and cervical cancer as well as the raging debate over informed consent - especially for the indigent.

Read more about the book here: Amazon.com review

If you'd like to be eligible to win a copy, post a message in the comments section with your name and contact information - please make sure you either leave an email address for me to contact you, or enable your profile to receive email so I can reach you if your name is picked. This is very important - because even if you leave a comment, if I can't contact you then you won't be eligible. Comments must be received by noon Monday, March 6, 2012. 

Good luck!

Facebook censorship reaches a new level of absurdity

If you're a natural birth and/or pro-breastfeeding advocate, you've likely heard about Facebook's ridiculous stance on breastfeeding photos - and how they frequently leave up images that show half-naked women doing anything but breastfeeding. But lately their ironic censorship has reached a new level of battshittery.

Photo credit: Seana Berglund

This photo, showing a woman's placenta, was removed. According to a leaked document, these are guidelines on content Facebook finds objectionable: "Depicting the mutilation of people or animals, or decapitated, dismembered, charred, or burning humans...Photos and digital images showing internal organs, bone, muscle, tendons, etc. Deep flesh wounds are ok to show; excessive blood is ok to show.... Crushed heads, limbs, etc. are ok as long as no insides are showing. ... Note: No exception for news or awareness related content."

I can appreciate that when it comes to certain issues, Facebook has a conundrum on their hands: intent can mean a lot when it comes to what you're posting. And obviously the placenta is an internal organ, but there is nothing threatening about a life-giving organ such as this. Unfortunately, it seems like when it comes to this policy, Facebook has it bassackwards: "crushed heads" are okay - I can't think of a context where that's necessary except in gory accident photos or some kind of horror film exposition - but the placenta is not. What?

And how can images of internal organs, bones and tendons be a good thing? If they're used for educational purposes, in which they're done all the time. So in their minds, a medical textbook - or educational photo such as the one above - is wrong. Not even news photos - taken by someone who obviously thinks the reader can gain some insight from seeing it - is appropriate, according to them.
But, in an ironic twist, the photo from a pro-life group showing "what an abortionist does" was removed - presumably because yes, it shows a mutilated, dismembered .... wait a minute. Human? Can we call it that? Since some argue that up until a certain point the fetus isn't a human being, or a "person," what should we call it? If, in fact, it's not a human being, then it should be allowed to show under the "excessive blood and crushed head" rule, maybe? Insides are showing, yes - but again, if it's not technically considered a human, then what?

Whew. I think we're stepping into dangerous territory here.

Which brings us to the next image. This one was removed as objectionable content, presumably flagged by users, and then reinstated - with an apology - from Facebook.

This content, posted by Dutch physician Rebecca Gomperts, clearly shows how a woman can abort her fetus by taking misoprostol, or Cytotec.

Several things bother me about this, and I feel that Facebook is ridiculously libelous in reinstating, and apologizing for removing, this content.

Whether she's a physician or not, Gomperts has no business offering this information in the form of a profile photo - presented like a prescription - to a woman she's never even seen before. She has no idea the age, health condition or anything, really, about the audience she's reaching, and whether Cytotec is really appropriate for them or not. Drug allergies? Sorry, no clue. Whether you're really nine weeks along or not? Nope. Not sure of that either. And her suggestion to see a doctor only if complications arise is essentially asking another physician to finish what she started - for good or bad.

Both in the profile photo and on her website, she advocates lying to medical staff - something that could interfere with your care, depending on the situation. And I'm not sure that doctors are all that stupid that they won't figure something out. If you're not telling them the truth, how can they adequately care for you?

Not only that, but it's laughably insane that she makes presumably desperate and troubled women think that they can just walk into any pharmacy around the world and demand this product. Depending on who's reading it, the dispensing laws could vary greatly. One could probably get it over the internet without a prescription, which is illegal, and possibly dangerous - in that you can't really guarantee what product you're taking, or who it came from, by ordering in online. And ironically, her website warns against doing that because of the risk of receiving a fake product. God only knows what could happen then: either it won't work and you'll still be pregnant, or it could do some serious damage to your health. I hear another giant can of worms opening somewhere...

After taking the pills, you are supposed to take a pregnancy test within three weeks (at which your fetus presumably would be a maximum of 12 weeks old, which could dramatically change the course of treatment if you were still pregnant). What do you do if the test is still positive? Call Dr. Gomperts?

Oh yeah, about that. Up until a few years ago she'd probably be in the middle of the North Atlantic on a ship, offering medical abortions to women from various countries who seek her care. I'm not even going to go there - except to wonder what kind of follow up care these women received to make sure everything really went as planned. Does she care? Would she just hand you over to someone else? Or would she wait around to make sure it's all the way it should be? If you regret your decision, which some women actually do, will she offer post-abortion counseling? Probably not, as she'd likely be halfway across the Atlantic by then.

For "practical" reasons, she stated that she didn't perform surgical abortions on the ship, presumably because she didn't have the resources. Her reasoning was because it would require about 20 minutes per woman, and for legal reasons they didn't want to be out in international waters that long. (Not, I guess, because they really wanted to make sure you were okay after the procedure.)

I'm not arguing that if a woman really wants to do this, she'll do it anyway. What I do find extremely alarming is the detached, remote attitude of this doctor - and how it presumably insinuates that this woman will be alone, on her own, in her decision, with possibly no support. If something goes wrong, who is to blame? Gomperts? Facebook, because of the bad outcome? How are they going to handle the potential liability? Misoprostol does have a failure rate and some women will need further procedures in that event. Even though it's a small percentage, it's a very real risk. And it's also never been FDA-approved as a standalone abortifacient.

It's important to note that just as it can happen in a laboring woman, a uterine rupture, although rare, can happen when inducing abortion with misoprostol. At the very least, this can cause excess bleeding, and possibly impact future pregnancies, should you decide to want additional children. And some factors, according to one reference, site the rising cesarean rate as a factor, ironically:

"Uterine rupture with the use of misoprostol has been reported more frequently in multiparous women and in women with uterine scars. It is more often observed at term than in the second trimester [3]. The rate of caesarean births has been on the rise, it has lead to and increasing numbers of women with a uterine scar seeking TOP [3–7]."

(Interestingly they mention the risk of rupture at term, something few OBs are willing to do when it comes to inductions of labor.)

The subject of the case report was a 27-year-old mother of two with no prior uterine scar who sought a termination (referred to as TOP) at 10 weeks, based on her last menstrual period. (Ultrasound revealed she was really 16w5d instead.) After having an incomplete abortion with the use of misoprostol, she went back for a follow-up procedure, where it was found that she had sustained a uterine rupture and 50 ml of blood was noted in the abdomen and the woman was prepped immediately for surgery.

Now, as rare as that can be, can you imagine going through that as a scared, lonely teenager - by yourself? Based on information you found on the internet?

Surprisingly, as far as I can tell in the black hole of Facebook rules and regulations, there is no rule against dispensing medical advice on their site. Which means I could presumably tell people how to use any type of drug to do anything, whether it's legal or not, and whether it's truly "safe" or not. I'm obviously not a physician, but why should that stop me, according to their rules? And haven't we all, at one time or another, seen, heard or witnessed a physician giving very bad advice? Just because they have a medical degree does not make them perfect. It doesn't even mean they always, absolutely know what they're doing.

After Gomperts' ship was sunk, so to speak, she decided to offer pills online through her website. A physician would ask the patient, someone living in a country where abortion was illegal, about two dozen questions over the internet to check for contraindications and the pills were shipped out in a plain envelope.

The issue of prescribing without even seeing the patient is still a problem. If you're a woman living in a country where you can be prosecuted for having an abortion, what happens if you take these pills and something goes wrong? Will you avoid the doctor because of the fear of getting in trouble? Will Gomperts' organization face prosecution because they prescribed you - even after answering those 20 questions - a medication without seeing you? What if the person is lying, out of desperation to just get it done and over with?

The bottom line in Gomperts' profile photo is that it's irresponsible. It glosses over the need for crucial follow up care and doesn't stress the reasons why you should seek it, especially if the misoprostol was ineffective. And it doesn't adequately address the risks associated with it, or the potential failure rate (which is between 10-15 percent). How is this adequate informed consent?

Again, if you want to do this, you're going to do it anyway - I'm not denying that. But to ignore the possible complications of doing something like this is irresponsible, and I bet if it were any other medical predicament besides this, we'd be up in arms. 

Thyroid disorders: overcoming the myths and bad advice and getting treatment

"As your doctor, I know
much more than you do.
So why don't you just
trust me? You're
just the patient!"

Some of my family members have been bugging me to see an endocrinologist to treat my Hashimoto's Disease. I've thought about it, but honestly, am not looking forward to it. After my post on "Stupid Crap My Doctor Says," and reading this article, you might understand why.

The article, called "Understanding Thyroid Problems," is ironic - because it's written by someone who doesn't understand. As a writer, I strive to make sure I understand the topic I'm writing about and I want it to be accurate - but apparently this person doesn't. Her method of dealing with her Hashimoto's - complete with fatigue and stubborn weight gain - is to exercise more and drink more coffee.

Her headline strikes a very dismissive tone - she mentions people who "peddle" advice and it's clear she thinks well-educated thyroid advocates (whom she even quotes in the article) are not responsible enough to register an opinion. In other words, "You're not a doctor so I'm not going to trust anything you say. I'm going to ask my physician!" 

Well, that's fine - except the doctors she interviews for her article are even more dismissive. One mentioned what is basically subclinical hypothyroidism - and suspects that many patients aren't really hypothyroid at all.

"A review of the literature shows up to half of people with a TSH in the 3 to 4 range either don't have hypothyroidism at all or have only the earliest phase, where there's no clear benefit from treatment," he explains.

In other words, it's all in your head. Here, take this anxiety pill. And while you're at it, there's one for depression, too. Now go home.

Like I've said before, and like many sites do say, you are not the same as someone else. Because your TSH is higher than mine doesn't mean you will feel worse than I do. I haven't read any of the studies he's referencing, but I suspect that patients are on such a low dose that yeah, it doesn't really work. But unfortunately the patient is allowed such little autonomy in matters of their own health that we may never know what works for them because we simply won't allow them to ever reach that point.

Based on the author's information, you have to have a TSH as high as 10 to 15 before it's worth treating. (But... I thought 5.0 was the high end? What about that?) Interestingly, mine was around 2 something and my physician said it "still wasn't where he wanted it to be." Thank God I don't have a doctor who thinks I should only be treated when my TSH is exploding off the chart.

Dr. Worst-Case-Scenario goes on:

"There's no compelling evidence that medication helps patients whose TSH is in the 5.0 to 10.0 range," says Dr. Daniels, though if you have other problems, such as infertility or depression, your doctor might suggest medication. Similarly, for those who also have Hashimoto antibodies, the decision to treat may depend on other factors. If you have debilitating symptoms or develop a goiter (a protrusion of the thyroid itself), "it might make sense to try medication for a few months," says Dr. Daniels. "Occasionally symptoms improve; often they don't."

I'm not an expert, but I don't consider a TSH as high as ten "subclinical." It means you are full-blown hypo at that point, I would think, but again, it's different for everyone. I can't imagine the number of couples who have struggled needlessly with infertility because some jerk endocrinologist painted everything as a disaster and refused to treat.

If your TSH is that high, I'd suspect you're too damned tired to care about being infertile, because you're too tired to have sex in the first place. I'd also like to ask him why I felt better once starting thyroid medication when my TSH was quite low, by his standards.

When they start talking about medication options, of course synthetic hormone is mentioned first. Even though natural desiccated thyroid has been in existence for centuries, the author mentions those "natural advocates who tout" the product as if it's snake oil. And in piling one myth on top of another, the doctor says, "There's a perception (read: all in your mind) it's natural because it's animal-derived, but the potency can vary." Yeah, about that. Apparently the potency can vary in synthetic medications as well.

The author's closing blow is to be "wary of on-line advice." What, like the crap she dished up in her article? Perhaps there is a grain of truth in that, but it's probably the same for any medical problem. And unfortunately the information put out by many major advocacy groups (like The American Thyroid Association) and doctors is often laced with the same errors she claims everyone else is. Their top recommendations often include, "Your TSH is fine. You do not have a problem. Come back in six months to a year and we'll reevaluate you. Synthroid is your only option, but I'm not going to disclose that they are a major sponsor of our website."

The author admits to a family history of Hashimoto's disease, but says even if her levels "had nudged up a bit" she'd "still opt out of treatment." Not exactly sure why, but perhaps she doesn't mind - or doesn't understand - how the thyroid slowly gets destroyed over time until the damage is done and you're completely hypothyroid. Perhaps one of the great endocrinologists she interviewed recommended that she do nothing, because, after all, it probably won't work - right?

The bottom line is that people treat their doctors like they are gods. Unfortunately, some doctors think they are, too. No one - not even your physician - is perfect. When they're willing to admit it, that's great. When they're not - but instead are reluctant to try new things, accept new and different ideas, or at the very least, listen to their patients - they stand to make people a lot sicker instead of better.

In closing, I'd make the following recommendations based on my own experience:

• Read all you can. Medical journals, support and message boards, books, articles, even patient blogs that detail their experiences and frustrations. It might be eye-opening in the following ways:

1) you'll learn more about your body, and that's never a bad thing

2) You could learn about possibly new and unusual symptoms that you're experiencing

3) You'll get more support from people who've been there, rather than be told "You're just imagining it!" or  dismissing you

4) You'll learn about the disparity of information out there about other treatments, like natural desiccated thyroid, supplements and other methods

5) You might just find out certain groups and people are not always acting in your best interests

6) You'll find out there are a lot of myths, conflicting ideas and misinformation about thyroid disorders that just won't go away!

7) You'll be exposed to possibly cutting-edge studies and information that your doctor won't, which could really help your diagnosis 

8) And most importantly, you'll be a more informed patient who can weed out the good from the bad advice you might be hearing

• Get copies of all your blood work and keep them on file for comparison purposes. It's nice to know what your numbers are and where you stand. This could also include pharmacy records, so you can see what dosage you were on when and gauge how you felt at the time. 

• Keep a journal of your symptoms. Compare it with your medical records. 

• Don't be afraid to ask questions and demand answers. Your doctor works for you, not the other way around. He is not the boss of you, or your "daddy," so don't be afraid to speak up and advocate for yourself. 

• Be wary of those who say you should only take T4 meds (like Synthroid). Know and understand the intricacies and quirks of synthetic medications and they, too, have their faults. Know also that many organizations are supported heavily by the makers of Synthroid, which is a conflict of interest. 

• Conversely, be wary of anyone who says you should only take Armour Thyroid (or other natural desiccated thyroid). I'm in the middle of the road on this - even though I take Armour, it might not work as well for some as it does for others. The same goes for T4 - many people do well on synthetic medications. But many also do not, and are only taking it because it seems like the right thing to do. If you've ever taken both and have a way to compare, only then can you decide which one is right for you. Along with the point right above this, be aware of those who try to discourage you from taking Armour and why they discourage you - either because they believe in the myths or because of financial incentives from drug manufacturers. 

• If you feel that your doctor isn't adequately addressing your concerns, don't be afraid to fire him (or her) either. If at all possible, try to find someone who - while not perfect - pays attention to YOU and how you feel, rather than boss you around or dismiss your thoughts and ideas. 

• Most of all, be patient. It's not going to happen overnight, and medication changes are bound to be necessary. Take the opportunity to educate others around you; it can be a frustrating journey, and if necessary, don't be afraid to have a good cry once in awhile. Don't give up! 

More reading:
Don't worry, no good deed goes unpunished: thyroid advocate Mary Shomon ripped this article to shreds. Read it here!

Stupid crap my doctor says

I've said before that when it comes to getting my thyroid problems sorted out, my doctor's not too bad. He was totally open to me going to Armour Thyroid, hasn't said anything really objectionable and doesn't treat me like I'm crazy, which is a plus. Apparently, I'm really lucky in that department, though, because some people have an insanely hard time connecting with a doctor who knows what the hell they're doing.

"What the heck does the
thyroid gland do? Most physicians
will tell you 'it controls metabolism,'
which is what we all learned in
medical school. That statement is
basically the same as saying, 'It's
really complicated and I don't
understand it.'" - Dr. Rob Lamberts

A friend of mine is 43 and exhibits a ton of symptoms: facial swelling, celiac disease, tiredness and a bunch of other stuff. I told him to switch doctors, and he said he already had - five times. His regular physician told him, "Well, you're getting old...."

When I first went to my OB for bloodwork, I knew something was wrong but wasn't sure what. After my results came back, he simply stated, "Your antibodies are elevated." When I asked him what that meant, he said, "It just means you'll eventually have to go on medication." Thanks for elaborating!

I've mentioned several times in past posts how a friend was told to "fake it" by her doctor when she was concerned about low sex drive and her thyroid function. He also told her to stop drinking pop (even though she doesn't) and to 'get off the couch.' Why, I'd love to, if only I wasn't so tired all I wanted to do was sleep. All. day. long.

I once got into a rather heated Facebook debate with a nurse practitioner who, along with her physician husband, thinks many of the people in her practice use it as an excuse. She went on about the TSH, and eventually changed her tune and shut up when I told her you can have high antibodies, hypo symptoms and a totally normal TSH, all at the same time.

I asked others and they told me this:

Amber: "The old "eat less, move more" mantra. I've eaten 900-1200 calories a day and exercised for 10-12 hours a week for months on end, and have still, little by little, kept gaining weight."

Beth: "That none of my symptoms...PMS, depression, weight gain, insomnia, anxiety - were thyroid-related. This was the same guy who said that a TSH of 9 was within normal limits and that Armour is unreliable."

LynnSue: "'You have Hashimoto's, but we don't keep track of your antibodies because it doesn't really mean anything and there is nothing we can do about it.' I was told this by SEVERAL doctors, most of them endocrinologists....My highly esteemed endocrinologist told me that my slow, steady weight gain was "middle age" (I'm 51) and that many of her female patients have chosen to get liposuction. 'I'm telling you that off the record,' she said. She never, ever tested by B-12 in the 15 years I was with her, even though Hashi's patients are often deficient in it. When I got it tested on my own (through my GP) and showed her the deficient results, she said, 'Well, I guess that one slipped under the radar.'"

Jessica: "I had the opposite of LynnSue. 'You have crazy high antibodies and 'normal' numbers otherwise. Go see a rheumatologist. I can't help you.'"

Rebecca: "'What you had before your thyroid was removed was Grave's Disease, but now it's called Hoshimoto's.' Seriously! 'All your levels are checking out fine so its not anything to do with your endocrine system. It's something else and nothing I can help you with further."

(Note: I've heard some people speculate that endocrinologists no longer know how to deal with thyroid problems because they're all seeing diabetes cases - which is a complication from hypothyroidism, by the way....)

Lisa: "'Eat 500 calories a day and try to work out more.' Keep in mind I was already lifting weights five times a week and going bald....Two of the four morons told me to eat 500 calories. I also was an anorexic/bulimic for years who recovered with Atkins. The others just thought I was tired from being a mom. Grrr..."

Terah: "'You have Hashimoto's, your TSH is below 2. Let's wait and see what happens.'" (And in the meantime, it's totally okay for you to feel like crap... we'll just wait for you to continue to fall apart, 'k?)

Michele: "'Thyroid problem? What thyroid problem? Your TSH is fine.'"

Kira: "'Here...take this Prozac..it will raise your serotonin and make you feel way better...it's not your thyroid.' Four days later, had a grand mal seizure and lost my four front teeth and developed a systemic blood poisoning from the infection that set in...Yeah, thanks, doc."

Pamela: "I was also told that my complete and total exhaustion, muscle pain, ataxia and weight gain was because I was a mom with a four-month-old...(ring a bell?) By the time my doc agreed to test me, my T3 and T4 levels were ZERO. He said he'd never seen numbers that low. This was 17 years ago. It's been a long, wild ride since then."

Lorrie: "I suffered 'tonsilitus' every year of my life until I finally found a doctor who knew the minute he saw me that I had Graves Disease (at age 43)... Then there was the cardiologist my doctor sent me to for a stress test... without even looking at my folder announced the reason I was sent to see her was because I was 'lazy.' (after two surgeries and gaining 60 pounds)

Suzie: "Me: 'Could your numbers be normal, but you still have symptoms?' Endo: 'No, that's impossible!' followed by a condescending head shake....'It's functional. Here is 7 mgs of Xanax. Also, here is Abilify, Zoloft, Paxil, Lexapro, Risperdal, Ambien, Adderall, Ritalin, etc. and an application for SSI!"

Nadia: "'People's bodies change a lot as they get older; it's normal that you're putting on weight and feeling tired - just eat less and exercise more!' At the time, I was 23, eating vegetarian and mostly raw food, working as a waitress and going to the gym 2-3 times a week!"

Yvonne: "'Your symptoms have nothing to do with you being hypothyroid; I want you to see a psychiatrist,' who consequently diagnosed me with somatization disorder (all in my head syndrome). My GP ate his words last month when he said, 'Your remarkable improvement on NDT can no longer be ignored.'" (emphasis mine)

Terah: "My first endo said, 'So you have a few symptoms. You don't need medicine for something that is going to slowly kill off your thyroid anyway.' (Hashi's) Then she went on to say since I was getting older that there was no need to have sex so the lack of sex drive was a benefit. I could not have made that one up!"

Dear Lordy be. I'm not even sure what to say about that one.

If this is your doctor's approach to treating your symptoms, run, run, far away! 


More reading:
Why an endocrinologist or thyroidologist should probably not be your thyroid doctor
The many myths of hypothyroidism - Dr. Kenneth Blanchard 
What's wrong with these doctors? 

You've lost that lovin' feeling

If you've ever opened a spam email, seen an infomercial or traveled down the vitamin aisle at the pharmacy, you have probably seen the (often ridiculous) products marketed to men to the improve their sex drive. The commercials for Levitra and similar products are vomit-inducing for sure, and kind of make me laugh - what about all those women with low sex drive? Who are these women that men are trying to please by rushing out to order libido enhancers?

The claims they make are laughable - and I can't believe reputable pharmacies are actually selling this crap. But what I want to know is, where are the female enhancement pills? Why does no one seem to care about that?

According to one 2008 study, upwards of 40 percent of women report having a low sex drive. While the Levitra ads are geared towards people reaching retirement age, studies indicate young women have this problem, too. Many think that use of antidepressants and birth control can be to blame - Paxil, for one, is a known killer of the sex drive. Apparently, many of the women in the study also reported being depressed - and noticed a further decrease in libido when using antidepressants.

Guess what? Depression and low sex drive can also be signs of a thyroid disorder! Of course, the article doesn't mention the word "thyroid" as a cause anywhere. Many popular medical sites often do not include low sex drive as a symptom; in fact, one site suggested it was only a problem in men.

Women are often embarrassed to talk about sexual problems with their doctors, and many times it's blamed on lifestyle: busy, working full time, raising children, "you're tired!" Nah, I don't think so. While it can certainly contribute to that, it often doesn't get to the root of the problem. And if your care provider doesn't know it's a symptom, they're more likely to brush you off.

Awhile back I blogged about a friend who's doctor insisted she "stop drinking too much soda pop" in response to her noticeable weight gain, even though she doesn't drink pop, she said. As far as her excruciatingly low sex drive, her doctor's advice was to "fake it." How horrifying.

So, we market millions of dollars worth of junk medicine to men in an attempt to restore their "function," but women get relegated to the back burner - perhaps even ignored and brushed off - when it comes to their sexual problems. 'Just blame it on kids!'

Ladies, just another reason to get your thyroid tested. And men, skip the worthless enhancement pills and get yours checked, too!

More reading:
Low Sex Drive and Thyroid Disease
Sex Drive 101 for Thyroid Patients
Low sex drive in women

Synthroid vs. Armour: Squashing the competition

When it comes to treating thyroid problems, your physician will probably prescribe one drug: synthetic thyroid hormone, either Synthroid or a generic equivalent. Generic levothyroxine is one of the most popularly prescribed drugs in the United States. And in 2010, profits of Synthroid rose over 18 percent and made Abbott Pharmaceuticals $123 million dollars richer. 

There are alternatives to Synthroid, but you'd never know it based on some of the information from doctors and major thyroid advocacy websites. In some of the research I've done on thyroid treatment natural desiccated thyroid (NDT) isn't even mentioned at all.

Many doctors tell their patients it's "outdated," old-fashioned or "isn't even on the market anymore," and some outright refuse to prescribe it for their patients. Some patients give it a bad rap because it caused problems for them, when really it's probably the prescribing physician who is not dosing them properly. Basically, many thyroid groups and physicians are detracting patients from using NDT and funneling them towards Synthroid - perhaps because of financial incentives, pervasive myths and incorrect information about the product.

One theory is because desiccated thyroid comes from an animal source, it cannot be patented. While cost can vary, Armour Thyroid is roughly half the cost I used to pay for Synthroid, and Armour has both T3 and T4 in it - whereas synthetic is T4 only. (Each hormone level is essential in the thyroid's production, basically, to give your body energy, but the mainstay of thyroid treatment these days only includes one hormone rather than a little of each.) 

There are synthetic T3 meds like Cytomel, but guess what that means: you have to have two prescriptions filled, instead of just one with natural desiccated thyroid. More prescriptions to fill means you spend more money. Name-brand Cytomel runs around $40 per 30-day prescription on drugstore.com, and generic is about $30 for a 30-day supply. Add that to a month's worth of Synthroid and two prescription T3-T4 meds will cost around $70 a month versus $14.99 for Armour (depending on the dose, of course).

Before the advent of blood tests that were supposed to be the magic answer to every problem, doctors paid more attention to symptoms. Before synthetic versions were introduced to the market, thyroid patients were treated with natural desiccated thyroid and many did very well. Some adjustments were accounted for, because every patient was different. Many criticize it as being "unregulated," although I'm sure science has improved since then, but natural thyroid is a prescription medication and therefore has to go through the same regulatory process as any other drug. 

While some people do wonderfully on Synthroid, not all do - even though many medical professionals tell them it's their only option. Not only that, but many people believe - and know to be true, based on personal experience - that there is wide variation in effectiveness between brands of synthetic hormone, as well as between name-brand and generic. As a pharmacy technician, the pharmacist told me this when filling prescriptions for patients, and I still hear these same stories from thyroid patients all over the web. When I got my prescription filled for the first time, the pharmacist herself reiterated the same thing: that many (many!) patients believe name-brand to be superior, and it's not just psychological as some would have us to believe. 

Not long ago generic levothyroxine came under fire because its strength was not as potent as it should be. The medication was recalled and brought to light problems people were having with a return to symptoms while being medicated. As far as synthetic versus name-brand, I've heard that the FDA considers the potency of synthetic hormones to be between "90 to 110 percent," which can mean a huge difference for some people. But, because it's sanctioned by the FDA and considered "true," drugs like Armor are considered poorly regulated and should be avoided. Gee, I wonder why they'd say that? It seems that the synthetic hormone drugs have the same problems that doctors are criticizing Armour for. 

Some websites wage an all-out attack on natural desiccated thyroid and label it "do not use" because it's

• not adequately guaranteed to provide appropriate blood levels of thyroid hormone and reliable alternatives are available.

Seriously? Tell that to all the patients who are doing well on natural thyroid medications! Curiously, the same website - "Worst Pills, Best Pills" - mentions a lawsuit brought to the manufacturers of Synthroid because they suppressed information that supposedly proved they were wrongly influencing patients to believe their medication was superior to generics, even though "scientific" evidence had shown it was the same. While many people complain of a return to symptoms if their medication was switched, medical professionals often pass this off as "psychological." (So that irregular bleeding that my neighbor complained of when her insurance company switched her meds without asking was all in her mind, right?)

The site goes on to say that it should not be taken except by those who have found successful results from it "for years" - meaning, they want a whole new generation of thyroid sufferers to be dependent on crappy, subpar medication and not realize that many of their symptoms still prevail and are not normal. Perhaps the most frustrating problem is the medical community's tendency to "fix it and forget it" when it comes to thyroid problems, as if one dosage is going to solve everything. In reality, for many people it's a complicated, often tedious process that is well worth it if you can find relief.

Quackwatch.org tries very hard to completely discredit Armour Thyroid and the doctors who prescribe it by telling you to be "wary" of anyone who dispenses it. Funny, but I bet there are lots of people who have been totally let down by synthetic hormones who would love to find a competent doctor to prescribe them desiccated thyroid. Again, all those people who manage to do well on it must be crazy. They try to paint a dismal picture about the effectiveness and potency of Armour, while synthetic hormones have had exactly the same problems.

(Ironically, I googled the guy's name who runs Quackwatch and found that he was misrepresenting himself as a licensed psychiatrist during court proceedings he was asked to participate in as an "expert." He also apparently has ties to the FDA, which explains his distrust of physicians who will prescribe Armour.)

Depending on the nature of your remaining symptoms - say, depression is one of them - it's often perceived that you're "fine" because your TSH is "normal" and you're taking meds. So let's treat your depression. Or any of the other slew of problems you have that are unknowingly caused by your thyroid and the crappy management of it. That will require a few more scripts, some of which are astronomically expensive. High blood pressure and cholesterol levels? Hey, there's a drug for those. Instead of taking one thyroid medication to address the root cause, let's put you on a number of meds that address each symptom, until your medicine cabinet looks like a mini pharmacy. 

When you consider how pervasive hypothyroidism is, and yet how under-treated (or improperly treated) it is, it makes you wonder. It seems like more of a scam to get you to spend lots of money on unnecessary prescriptions. More and more people are feeling lied to, like our doctors want - and expect - us to completely, blindly trust them and just suffer the consequences when they are wrong. Considering there are other treatments out there, they should let that decision ultimately be made by the patient - and counsel you accordingly - instead of distort or hide information. 

More reading:
Generic drugs and patent information - Wikipedia
Thyroid Disease, Hypothyroidism and Fibromyalgia - about.com

"It's all in your head!"

Last night I was talking with friends about the controversial diagnosis of "mass hysteria" going on at a local high school. It's been all over the news, and even though I don't watch or read our local news, I've read strange reports online about the students who are exhibiting Tourette's-like symptoms.

Of course, one woman was quick to say she basically thought they were all making it up. I don't know where she got her information from, but she alluded that of the ones who stayed out of the spotlight and sought treatment, they recovered. The ones who were on the news and in the media, though, didn't. And apparently the alleged victims did not all receive Gardasil injections, and are not all girls (it includes one boy and an adult female, supposedly).

One article, though, contradicts what this woman is saying: officials do not believe the students involved are making up their symptoms. However, the neurologist this lady apparently spoke to does. What does that tell you?

Sometimes when it comes to finding
out what's wrong with you,
you have to think outside the box. 

If all those details are so skewed, it makes me continue to lose faith in the media. I mean, do they ever get the story right? And if the officials involved think the students are telling the truth, it also makes me lose more faith in the doctors. It seems like whenever they can't find the solution to something, they blame the patient: "It's all in your head."

The medical field's love of medicating doesn't help. As I've found in my research on thyroid diseases, and in my own personal experience, many people get a cocktail of drugs for each symptom - fatigue, depression, memory loss, etc. - and their real problem gets untreated and ignored. Could this be the case at this school? Who really knows.

I've been going through my own struggles lately that make me sympathize with these students. Long story short, since November I've been having weird feelings - vague at times, hard to describe but definitely there - in my head that I can't explain. Not quite a headache, but a pressure sensation that comes and goes. I know in the end probably the only thing to do is get an MRI, but I dread asking a neurologist about this: because he will likely tell me I'm nuts. I wonder, "Brain tumor? Middle ear? What the heck?" Considering I have Hashimoto's Disease, it could be linked to that: a "rare" neurological condition called Hashimoto's encephalopathy, which in some cases can actually mimic Alzheimer's and Parkinson's. In many people with it, they were all misdiagnosed with Alzheimer's, Parkinson's and even a variant of Mad Cow Disease (Crutzfeld-Jacob Disease), when really they all had Hashimoto's encephalopathy, which usually responds well to steroid treatment.

I think of people who are on tons of medications and yet still doing badly. One woman in particular comes to mind - a woman from my church who was morbidly obese and in very poor health. Looking back I bet a lot of her weight was contributed to fluid retention, and doctors eventually didn't know what was wrong with her - and she died.

The thing that further complicates a disease like this is that many of those symptoms - swelling, memory loss, tremors, weight gain, high cholesterol, and diabetes - can all be complications of long-term, untreated hypothyroidism. Not only that, but they strongly suspect that many people with suspected Hashimoto's encephalopathy are actually undiagnosed because doctors don't know how to treat it - and often ignore Hashimoto's Disease. Despite access to several blood tests, MRI technology and new research that suggests not only could Hashi's patients benefit from treatment, but that a simple TSH will not adequately diagnose them - doctors continue to ignore the evidence and wait for these people to slowly wither on the vine, which is disgusting. In the age of internet diagnostics (which many doctors heavily criticize and roll their eyes at), it's imperative for people to find answers and support from others, which is vital - while it's a double-edged sword of anxiety wondering whether you're actually right or not, it might be more information than your doctor is willing to give you.

It's easy to lose faith in a system that, at least in this case, often sticks to outdated, false logic in diagnosing, doesn't always listen to the patient, and treats the patient like they're working for you, instead of the other way around. The relationship between the pharmaceutical industry, your doctor and your insurance company is a complex hamster wheel that's often driven by one thing: money. "Big Pharma" airs their commercials on television and in magazines, convincing you that whatever you have is worthy of being treated. Maybe it is, maybe not. You visit your doctor to find out more. Or, you really do have something - but your doctor doesn't know how to treat it except to push more pills, which are conveniently provided by the drug manufacturer. Your insurance company might decide they want you to use something different, cheaper, perhaps - that might not have worked for you in the past, but because they're footing the bill they will insist you take it even though you and your doctor want to use something else. Or your doctor might suggest a new, better, faster (and more expensive) pill that does the same thing as the old, cheap one - simply because a drug rep told them it's the latest, greatest way to treat XYZ Disease.

They don't want you to know - or don't know themselves - that untreated conditions like thyroid diseases, for one, can cause the same symptoms they're treating ineffectively. Or that vitamin and mineral deficiencies can also mimic some of the symptoms you're having, for a fraction of the cost. If you knew all that, and approached it with the skepticism that you probably should, then your medicine cabinet wouldn't look like a mini pharmacy, and you wouldn't be filling their pockets nearly as full.

Food for thought:
Some of the most prescribed medications for 2011 include statins and cholesterol-lowering drugs. It's no secret that untreated (or under treated) hypothyroidism can cause high cholesterol, even among patients who follow a good diet and get reasonable exercise.

Other commonly prescribed drugs include antihypertensives, diabetic medications, antidepressants, migraine medications, and drugs to treat memory loss. Not coincidentally, hypothyroidism can lead to diabetes and high blood pressure, and among the symptoms are poor cognitive function ("brain fog"), migraines and headaches, and depression.

Low vitamin levels can also be a culprit. With vitamin and mineral enriched foods so readily available, you'd think that these deficiencies  wouldn't be as common as they are. However, a number of factors - heavy alcohol use, poor diet and digestive disorders can affect how you absorb nutrients. It's also been speculated that use of chemicals and preservatives in our food can block nutrient absorption (or cause a number of health problems, at the very least) despite all the "good stuff" they add to it to make us healthier. (Said tongue in cheek, of course)

While not absolute, I've listed symptoms in the table that tend to be commonly treated with prescription drugs (which can include anxiety meds, antidepressants, anticonvulsants, pain relievers and NSAIDs, birth control pills, and GI drugs). And while these are common deficiencies - especially among women - I've found in my experience that you can't always expect your doctor to automatically test you for it.

More reading:
How to eat right to overcome vitamin deficiencies 
Are vitamin D deficiency and hypothyroidism related?
Have you tested your B12? It's a deficiency thyroid patients need to catch.