WTH?! Wednesdays: Pinkwashing Hall of Fame

Now that we're seeing pink ribbons literally adorning everything, I've become acutely aware of them when I'm out shopping and doing things. They're everywhere. They're multiplying, it seems, and can be found on the strangest of items.

This Pinterest board is worth sharing, as it highlights the absurdities and questionable practices surrounding the breast cancer awareness campaigns. One thing is quite clear: whether they donate to research or not, it's an industry - a marketing ploy that gets you to feel better about spending money. I wonder, what do cancer victims and survivors think of that? That someone is basically making money off of their disease? Has anyone ever asked them or are they just "bitching?"

This election cycle we're constantly hearing about the "war on women." I argue that there are many of them being waged, some silently, some not so much, and this is just one of them. Because it won't take long before someone criticizes your "poor attitude" in questioning the ethics of raising money for cancer awareness, or where the money really goes. If you dare question it, you're unfriended, blocked, criticized, told to "get a life" because you want to show what real awareness looks like: maybe a recovering mastectomy patient, not someone decked out in pink and white and prettied up for the cameras. It seems to be the one real truth no one wants to see.

One thing that really makes me shake my head are the campaigns to raise awareness that are from products that can actually raise your risk of cancer. Some of the companies responsible for donating millions (hey, good for them!) are also simultaneously marketing products that are putting their very user at risk for the disease. Go figure. Here's a short list:

Nestle has donated probably gagillions of money (Ok, I don't have a source for that LOL) towards breast cancer awareness and research, yet is only "phasing out" the cancer-causing plasticizer BPA from their water bottles. While I don't necessarily fault them for that, I do fault them for their long-standing heavy marketing of infant formula to mothers who are either in vulnerable populations or just being part and parcel of convincing otherwise capable women that breastmilk is inferior. You can slap the words "breast is best, but...." on your container a hundred times, but it doesn't help. Guilty of sending in official-looking "milk nurses" into poor African nations, Nestle effectively 'hooked' mothers on the stuff and had them believing their own milk was inferior. Not only would their breastmilk then dry up, but they'd be forced to buy more of the product they had no money to buy, and reconstitute it with contaminated water, leading to sickness and even death of the baby.

While only recently has the link been made to breastfeeding and cancer prevention, the health benefits to both mother and baby have been well-established. The presence they and their counterparts had (and continue to have) in influencing cultural trends and thus destroying any chance of a successful breastfeeding relationship could very well have lead to increasing cancer rates among women for decades.

Exposure to cleaning products is one plausible link to breast cancer, according to some studies. When you think about it, females are generally more likely to be in more direct contact with these products, and for longer periods of time (no offense to guys who clean). It's reasonable to suggest that products can also be leached into the bloodstream and can affect the offspring of their users as well. Have you ever looked on a bottle of cleaning solution? The ingredients are usually not listed - either because there wouldn't be enough room on the label, or they're too scary to think about.

Many of the products that contain known carcinogens are manufactured by companies that donate heavily to breast cancer awareness and research. One marketing ploy I find kind of annoying is how many of these products are geared towards women - even though yes, men do clean, and men do get breast cancer. A pink mop or Swiffer? Pink dishwashing gloves? Gee, thanks a lot.

The cleaning aisle at Walmart was awash (no pun intended) with a sea of pink ribbons, mops, dusters and other garbage. As far as I could tell, when I looked closely for the "We donate money to the cause" disclaimer, there was nothing on the label - or on Swiffer's website - that indicated any money went towards breast cancer anything of any kind. Not surprising.

The chemical industry also produces plasticizers that have known feminizing agents in them, that have been in use for decades. Plastic wraps, containers that are re-heated again and again and leach into your food, as well as agents in shampoos, makeup, personal care products, children's toys  and baby bottles are also points of controversy, and many of these byproducts would be found in the bloodstream of just about anyone - including unborn children.

Photo credit: USAToday, 10/5/2010

The alcohol industry has also been quick to jump on the bandwagon, but not without notice. Many are questioning that one, since studies have shown that alcohol consumption can be a risk factor in the disease. The image above angered some cancer survivors, and I can see why. Another article from CNN with the headline "Buy a bottle, save a breast" irked others who felt - and I agree - that we're focusing more on the breast than the person attached to it.

The sex industry seems to be the most recent player in the "awareness" game. Although I can't prove it anymore, this image was taken last year from the "Save the Boobies" breast cancer "awareness" fan page on Facebook, but when I went back to look for it, it had been taken down. This is their idea of a "breast exam."

The porn industry has graciously? donated a penny per view of their breast-related content towards breast cancer awareness, but I argue that really the only thing we're aware of is breasts. Not the illness itself, the risk factors or prevention techniques, not the reality of it at all, but simply breasts. It's another way to use controversial, if not completely offensive images, slogans and questionable marketing ploys to get people to support a feel-good cause. It goes much further to damage any real awareness, though, because we are so used to seeing images like this one in public - yet one very good way to lower your risk is to breastfeed, which no one wants to see you do. With the combination efforts of the infant formula industry and overt sexualization of the breast, an important preventative measure has now been nearly quashed.

Using cutesy slogans like "boobies," "tits," "hooters" and other sexualized euphemisms is equally offensive, in my opinion, because it not only sounds degrading and juvenile, but tends to make light of a very serious, often debilitating, disfiguring and deadly disease that can devastate entire families. I know we can't all be serious all the time, but I think because we often see too much of this kind of "advocacy" we don't take it seriously enough.

The food industry is equally guilty of just slapping a ribbon on things and calling it "good." I can't even begin to detail the chemicals and other crap we're ingesting every day, meal after meal for years, that likely contributes to breast cancer (if not a whole host of other cancers). Some additives actually have estrogen-like qualities and therefore could contribute directly to estrogen-fed cancers. Of course some foods have naturally-occuring estrogen-like properties (soy, for instance).

It's impossible to pinpoint so we use terms like "could" and "probably," because there are so many factors it might be impossible to tell for sure. But just in reading the list of ingredients, you know it can't be all that good, can it?

Ultimately there is so much we don't know, at least for now. I don't want to come off as a complete wacko conspiracy theorist, but even these obvious links should be enough to make you wonder where we get our information from, and make us question the motives of people and companies who want us to think we're helping for a good cause. Questions we should ask ourselves before we "think pink" include:
1. Does this product contribute to cancer in some way?
2. Does this product or slogan objectify the breast and women in general?
3. Is my money even going to the cause?
4. How much money is this group actually donating to research? To raising "true" awareness?
5. Does this campaign, slogan or product do more to hurt cancer victims and survivors than actually help them?

More reading:
Buying pink may not mean what you think - YouTube
Seven controversial pink products for breast cancer awareness

WTH?! Wednesday: Defining sexy and "scary beautiful" shoes

Two articles caught my eye yesterday: one featured Mila Kunis (sorry, the name sounds vaguely familiar but really I have no idea who she is) voted by Esquire readers (insert eye roll) as the "sexiest woman alive." The second featured a short video clip of a model attempting to walk in some of the most bizarre high heels - if you can call them that - that the world has ever seen. I can't help but notice  connected these stories are to each other.

Photo: Esquire Magazine

Mila may be pretty to some - but surely there is more to sexy than pretty. She might fit into one tiny definition of sexy, but I'm pretty sure there are a lot of homelier-looking women out there who are considered pretty sexy, too, especially by the people who matter most to them. That's far more important to me than a pool of readers "voting" on my physical appearance. The whole thing sounds like a big popularity contest - like, haven't we left high school behind already?

To each his (or her) own: I guess this just isn't my definition of sexy. I asked this question: what defines sexy? How can you determine if someone is when you don't even know them? Just based on what you saw in a movie or a video - a side of them that isn't even real? 

What if she had great brains, a nice figure, and was ugly (which is a relative term)? What if she had acne, or gapped teeth? Is it possible for someone to be sexy then? I personally find Lauren Hutton and her gap tooth smile to be very sexy and appealing, and am glad she decided all those years ago not to get her teeth fixed. The industry often sees these actresses (Anna Paquin, Madonna and others) and wants them to change to conform, and so far, they haven't.

The next piece is a video clip featuring a model "walking" in a pair of bizarre high heels. They're thankfully not really meant for actual use, and when she walks in them, she more resembles a duck taking a dump than a pretty model on the runway. (I did notice in the video, by the way, that the model actually had some cellulite - woot!)

The shoes were created by a Dutch artist and a shoe designer to illustrate our "impossible standards of beauty." Amen to that. What is beautiful to one person might look absolutely stupid to someone else, and many fashion trends I see in magazines and on the racks often make me wonder, Who buys this stuff?!

The clip also reminds me of the age-old (and now thankfully defunct) practice of foot-binding, which Chinese women had done to them as young girls to conform their feet into a dainty, pointed position. The toes were literally broken and folded underneath the foot so as to fit into a shoe that is actually even too small for a child to wear. The pain was torturous, and yet, a sign of delicacy and femininity to the Chinese people for centuries. Although the practice has been discouraged and was banned outright by the Chinese government in 1911, it's clear that it still continued for several decades afterwards, despite the ban. In some villages, there are still a handful of elderly women tottering around in tiny shoes - and it was a gradual process before that standard of beauty was no longer considered beautiful.

Are there standards of beauty that we create for ourselves - or are they created for us? Can we ever live up to it? Why should we even want to?

The video is literally symbolic of the lengths women (and really, we shouldn't just blame the ladies here) will go to look beautiful, even if it causes them physical pain. I thought of Karen Carpenter and her very private battle with an eating disorder when I watched this video. I love watching her play drums - a girl drummer is awesome! - but it's very painful at the same time, because of the way she was slowly killing herself, and everyone around her realized it but her. It's hard to watch because you know how it all ended, how it ends for thousands of women every day. It may not always be a physical death, but when you're trying to live up to a standard of beauty that might not even exist in the real world, it can be an emotional and psychological battle we all, at times, struggle to conquer. We're not in the school yard anymore, but somehow the standards of who we are and the often shallow, outward expression of who we should be hasn't changed at all. For the young women watching, how many more Karen Carpenters (and now, Nicole Richies) will this false standard create?

More reading:

Airbrushed models are 'harming children and should have warning labels' - Daily Mail
Dove - Evolution of Beauty video
People Magazine, 1983 - an article featuring Karen Carpenter's brother Richard talking about her struggles with anorexia, the severity of which was poorly understood. How many celebrities can we think of today who meet this criteria, and look just as she did not long before her death?

Tongue tie and the breastfed baby

Breastfeeding can be a wonderful thing. It can also be difficult, especially if things aren't going especially well. There can often be bumps in the road that make you want to totally give up and call it quits forever.

When it comes to those difficulties and feeding issues, perhaps one of the most under-explored problems is tongue tie. The difficulties a tongue-tied baby often has at the breast can be quite profound, and yet if you - or your doctor - don't fully understand what they are, it can either make or break the breastfeeding experience.

The tongue obviously has a major role to play in breastfeeding. Tongue tie, or anklyoglossia, is when the frenulum - the tissue that connects the tongue to the floor of the mouth - is tight, making it hard for the baby to feed properly. Some can be mild, some quite pronounced, and can affect different babies in different ways, or not at all. While some tongue-tied babies have no problems, for others it can be extremely difficult.

An example of tongue tie in an infant.
Photo: http://newborns.stanford.edu/PhotoGallery/Ankyloglossia1.html,
Janelle Aby, MD

Sometimes it can be difficult to tell if your baby has tongue-tie; sometimes it's quite obvious. There are signs to look for, according to the La Leche League, that might be important identifiers in determining whether or not this is really the problem:

The tongue tip should be able to extend to lick the lips, lift the front half of the tongue to the roof of the mouth, and sweep along the gums. If a tongue-tied baby tries to extend the tongue, it may not be able to extend past the lower lip, or the tongue tip might be forced downward over the lower lip. If the tongue is particularly tight, the back of the tongue will lift while the front remains tied down to the floor of the mouth, which is sometimes called “tongue humping.” If the baby attempts to lift a tied tongue, it often leaves a dent in the tip of the tongue, reminiscent of the top of a heart. The sides of the tongue will lift more than the center if the baby is tongue-tied. When the tongue tip attempts to reach either side of the mouth, the baby will twist the tongue and will not be able to bring the tongue tip to the back of the gums. A severe tongue-tie will prevent the baby from getting the tongue tip over the lower gum ridge.

Both the connective tissue under the tongue and connecting the top lip to the gums can be tight as well, such as here:

Maxillary labial frenum.
Photo: www.tempestbeauty.com

Problems that tongue tie can create include a bad latch, which can cause nipple pain and soreness in the mother. Without proper latch and the full ability to suck, the baby may spend more time on the breast to get enough milk to satisfy him. He also may have weight gain issues, gassiness and fussiness. Mother's milk supply often goes down, leaving both mom and baby frustrated, and mom is left thinking something is wrong with her milk.

Unfortunately, doctors are often not entirely educated on the subject of tongue tie and what to do about it. My friend Amy, a mom of four, said that although her oldest two both had it, because they were gaining weight the doctor wasn't concerned. "My doctor said that their tongue tie was not a problem, even though it was causing problems, just not weight gain issues," she said. When her third son was born, she sought a second opinion when the initial physician found nothing wrong. "Within a few days" of getting the frenulum clipped, she said, "he was such a different baby, with nursing and just his disposition in general."

This is the problem: even if mom does suspect something is wrong, the doctor may not always act on your suspicions. I actually read a question from someone whose doctor told her tongue tie was over-diagnosed, which I find hard to believe. Based on the differences between each type of tie and the individual anatomy of the mother's breast, experiences may vary: some may give up nursing early because of painful, cracked nipples and low milk supply, and some may have no problems at all, which some speculate might cause doctors to not recognize it properly.

Third-time mom Christina is in the throes of trying to get her baby accurately diagnosed. She explains that her baby doesn't seem to be able to get a "deep latch," milk will dribble out of her mouth while nursing, and she makes "clicking sounds" when she eats. She also projectile vomits regularly and gags whenever a bottle or pacifier are used. The ENT specialist that saw her daughter pronounced her "fine," but Christina knows that isn't true. Upon getting a second opinion from a pediatric dentist, the dentist confirmed that no, she wasn't "crazy," and that she's 'heard her story hundreds of times' from other mothers, whose intuition "is rarely wrong."

Christina emailed photos to the dentist, who wrote back and said that her baby has the most severe form of tongue tie there is, upper and lower, and said that "signs and symptoms indicate that she requires tongue-tie and lip-tie frenectomies." (Does this sound like a baby that's "fine" to you?)

Although every baby occasionally spits up and has fussiness or gas, it seems like this leaves a wide door for the formula industry to step in. There are all kinds of formulas marketed for babies with "colic," gas and spitting up, and many think that tongue ties are going undiagnosed because of this. "This makes me seriously wonder how many breastfeeding relationships are destroyed by doctors telling women that everything is fine when it isn't," Christina says. That something is wrong with you and your milk, so why don't you just switch to formula instead?

Before the widespread use of infant formula, the birth attendant usually clipped a tight frenulum immediately after birth. Since the cultural shift to using formula, however, it's largely fallen out of practice.

When a Florida doctor's child was born with tongue-tie, she had her son evaluated by an ENT who agreed to do the procedure. I'm guessing it's because she was a fellow doctor, not because he thought she was just a mom with good instinct. A lactation consultant, she pointed out, noted how lucky she was to find a doctor who would take her concerns seriously. When her child was born, she asked the postpartum nurse about the telltale heart-shaped tongue, and the nurse replied, "That's a tight frenulum. But no one does anything about them anymore." If no one does anything, the mother may go weeks, even months, struggling to breastfeed, even giving up because it seems unsuccessful. Because infant formula use has become so engrained in our medical culture it seems to be the first suggestion for solving any problem, even when there are other solutions.

Amy's doctor made an interesting observation: that more second- and third-time mothers come in for this problem, because first-time mothers often don't realize what it is and may stop nursing altogether because of milk supply issues, etc. "Perhaps they just give up nursing or trudge through even though they are having a horrible time," she thinks. "I didn't ask for help because I wouldn't even have known what to ask about." With no other children to compare it to, it can be confusing and frustrating to figure out what's going on. Then you might get an uninformed doctor who mistakenly says nothing is wrong.

If you suspect your baby has tongue-tie, especially when it's not glaringly obvious, here's a partial list of possibilities that might help:

• In mom, persistent very sore, damaged or blistered nipples (because of a bad latch)
• excessive weight loss in baby
• slow or no weight gain in baby
• cannot maintain a seal at the breast or bottle, often has gaps at corners of mouth that milk may spill out from
• baby only swallows infrequently
• very frequent feeds; I've also read that babies who spend a long time on the breast before being satisfied (if they are at all) is also a sign
• excessive gas, colic, green stools
• unable to protrude tongue (depending on the degree of the tie)
• clicking sound when feeding, may pop on or off
• low milk supply in mother
• gagging

For the article and entire list, click here.

It's important to trust your gut - if something doesn't seem right, check with your doctor. Realize that doctors aren't perfect, and do not be afraid to seek a second (or even a third!) opinion. It's not unheard of - and quite sad, really - for parents to travel miles, across states, even, to find someone who will listen to their concerns and do the procedure. But once it's done, it can often make all the difference in the world.

More reading:
Tongue Tie: From Confusion to Clarity
Tongue-tied breastfeeding 
Information on Tongue-Tied Babies: Breastfeeding Basics
Tempest Beauty: Maxillary Labial Frenum and Tongue Tie
Booby Traps: Docs who won't snip tongue-tie, thousands of breastfeeding moms and babies suffer - Best for Babes Foundation

WTH?! Wednesdays: Gardasil vaccine is "safe," at least according to Merck

Introducing a new feature: WTH?! Wednesdays, a time to reflect on the week's most absurd, weird, or amazing stories and photos.

Photo: Jan Christian/Wikipedia Commons

So this week's first post concerns a ridiculous article from the Wall Street Journal declaring that a study finds Gardasil "safe." I didn't even realize at first that it was from the WSJ, and since we subscribe, we have an online account. If only I could find the password, because there is no way I can resist commenting on that one...

However, the study is ... get this ... funded by freaking Merck! If that doesn't make you scratch your head, nothing will. And of the dozen or so people who commented on the article, none of them picked up on this and questioned the ethics surrounding it. I would have thought WSJ readers would have been a lot smarter than that.

Now check out this link to a study that basically says what I'm thinking: that there is less of a chance of an unfavorable outcome if the producer of said product is funding the study. Duh. Do you really think they're going to get unbiased results with Merck footing the bill? Do you really think we'd hear anything about it if they didn't?

From the BMJ study:

"Research funded by drug companies was less likely to be published than research funded by other sources. Studies sponsored by pharmaceutical companies were more likely to have outcomes favouring the sponsor than were studies with other sponsors. 

Conclusion: Systematic bias favours products which are made by the company funding the research. Explanations include the selection of an inappropriate comparator to the product being investigated and publication bias."  

It isn't exactly rocket science.

Tori Spelling and cesarean complications: why we need to hear about it

It seems like everyone wants to hear about celebrity baby gossip. And with Tori Spelling's recent birth complications in the news, it's something we should be hearing about.

At the very least, Tori Spelling's
post-cesarean complications could
be an important vehicle for raising
awareness about risks of c-section and
the importance of adequate
informed consent. 

As Spelling underwent emergency surgery for complications after her fourth cesarean, the media was slightly abuzz about why it's such a concern, as they should be. I was elated that finally, finally someone was beginning to question the high c-section rate and how repeat cesareans can pose dangers for women. Not that I would ever wish those repercussions on anyone, but to have it happen to a high-profile celebrity, someone who's face we recognize, whose births are highly publicized - is perhaps instrumental in getting our attention when it comes to a very important topic that few people seem to really understand.

I don't know about Tori and her marriage, don't watch her show, or know what her motivations are, but it sounds like she wants a large family. She is in the minority, as more women are stopping after two children and therefore are not often exposed to the risks of what that number of c-sections can do to the body. Whether it's one, two or four or more, it always carries risks - but obviously with four surgeries under your belt you're going to be exposed to more risk than someone who's only had two. It's unclear, though, whether women really 'get' why this is important to understand - because many of them spend much time digging Spelling for 'not using birth control' (even though someone commented that yes, she was using it, and yes, it did fail). Some speculate that she did initially consider a VBAC, but decided against it when her first and second births were also close together (which can bring additional risk).

Instead of bashing her for having lots of kids, not 'getting fixed,' etc. etc. it should make us question why she wasn't encouraged to have a VBAC after her first birth, especially if she wanted more children. Although close births do pose a unique set of complications when considering VBAC, this is probably one case where why her first cesarean occurred is important to know: did she have a medical condition? Was she 'too posh to push' or did she simply want to schedule the birth? Who knows. Preventing the first scar is key, but sometimes it's not that easy, especially if you aren't sure how many kids you want. It's hard to gear up for a future birth when you're barely finished with the first one, but knowing before you get that uterine scar just how it could impact future births is very important.

After the birth of her first son, Liam, Tori said this:

"I had a c-section...One of the biggest misconceptions is that celebrities have C-sections because it's easier. If I had a choice, I would not have. The recovery is much worse." 

To me, it almost sounds like her doctor was a "once a cesarean, always a cesarean" type of person. And while I'm sure there is some strong-arming going on when it comes to pleasing a celebrity client, these women are no different than we are: if a doctor tells you a VBAC is "unsafe, dangerous, and your uterus will shatter" then you are just as prone to believe it's true as any of us might be.

I'll never forget it: that's what Anna Nicole Smith reported that her doctor told her before the birth of her daughter, born by scheduled cesarean. That her "uterus would shatter," as if it's made of glass, as if one tiny contraction could forcibly blow the entire thing up like a bomb. I was so sad for her, because she naively believed him, much like any of us probably would have.

Some articles surrounding Spelling's complications ask an important question: are doctors doing enough to inform patients about the risks of cesareans? I was happy to see that headline, because I argue wholeheartedly that they're not. If you were scheduled for brain or open heart surgery, would a doctor simply tell you, "Everything will be fine, trust me! It's totally safe!" and walk away without so much as an explanation of the procedure? Highly doubtful.

I know my own physician, whom I saw for two of my three pregnancies, definitely did not. I still remember clearly our conversation prior to the birth of my first baby, who was breech: to his credit, he didn't schedule the cesarean until the week of my due date, but never went over any risks - if he did, I probably would have left the office that day in a panic instead of nervous excitement about the arrival of my child. Thankfully I did go into labor days before the surgery, which meant my baby (and most importantly, my body) experienced labor on its own, which is critical for future births. Yet I had no idea just how important that was at the time, because I was naive and very uninformed. No thanks to him.

When I became pregnant with my second child, my doctor gave me a 'choice' of what I wanted to do: the cesarean route, which I was already familiar with and had survived (isn't that a benchmark of just how casual our approach is to it?) or a VBAC, then proceeded to tell me that it could be dangerous and he'd had two women rupture on him. I decided the word 'rupture' sounded very unpleasant and I wasn't even going to consider it for a moment. Duh. What an idiot I was!

As my pregnancy progressed, I decided maybe having a VBAC wasn't such a bad idea. My primary motivation for choosing one was a) my baby wasn't breech and b) I wanted to avoid a potentially horrific recovery like I had with the first. I was terrified to tell him my intentions, because I had just three weeks until my due date. I stammered my way through our office visit, my husband at my side, while he proceeded to again tell me just how dangerous VBACs were and "I have one patient who's on her fifth cesarean!" I will never forget those words. That's when I asked him, "Well, what about this? That? Or this?" He had to concede that yes, those were definite risks to multiple cesareans. But reluctantly.

I know I'm not the only one. I've read so many accounts from near-panicked women that are on the eve of their inductions: "What should I expect? What do they do? Is this really necessary?" Something is clearly wrong with this picture. Either we trust our doctors too much, feel completely incapable of asking them questions, or they are completely inept at adequately informing their patients of risks and benefits to procedures. It shouldn't be a "don't ask, don't tell" policy; even if the patient says she has no questions, you should probably go ahead and tell her anyway. If she doesn't even know what to ask, then she's probably not even thinking about what could happen, what should happen, or what doesn't even need to happen.

I asked people on Facebook if they were induced or had cesareans, did their doctor cover the risks of the procedure? Of those that answered, all of them said "no."

It doesn't help that many doctors will discourage you from 'reading too much.' The internet be damned, because that means you're a religious follower of Ricki Lake and she only wants women to give birth in bathtubs. *eyeroll* Here, here's a copy of What to Expect When You're Expecting, now please - I don't have time to go over all the risks with you because there are none and it's perfectly safe so have a nice day. Does that sound like informed consent to you? Me neither.

So it's not a wonder Tori Spelling has had her fourth cesarean, and I don't think she should be blamed for it, either. Not because she's "old," or "a breeder," or any of those things. Stop blaming the person who just trusted her doctor, as you often blindly tell her she should. Start blaming the people who knowingly put vulnerable, often inadequately informed people at risk. Stop enabling the very system that allows this to happen.

The return of Ruby, the "Anti-Barbie"

My three-year-old saw this picture and asked,
"Is that a real Barbie? Is that a real doll? She is
cutting her hair." LOL No traumatizing here...

Remember Ruby?

A few years ago I posted a picture of Ruby, The "Anti-Barbie" and compared her with the current bizarre Mattel brainchild, Bratz dolls. A little backstory: a dad and his daughter were at the mall somewhere, caught a glimpse of The Body Shop's Ruby ad, and he basically flipped out and said his daughter was "traumatized." (I'm curious how many Victoria's Secret mannequins they had passed during that shopping trip.) Mattel then stepped in and took over.

After filing a cease and desist order to The Body Shop, the ad got pulled.

What I didn't realize was that this ad campaign originally debuted over a decade ago in 1998, before Twitter and Facebook, and as one writer put it, "If something went viral, it usually required a trip to the doctor's office." Now with the virtual explosion of social media, Ruby made somewhat of a comeback.

Since I first saw that ad two years ago, and I really haven't thought much about Ruby since, until I started making Barbie clothes for my daughter's dolls. As I studied patterns and then the mass-manufactured clothes, I remembered that ad and the freak out episode Mattel had surrounding it.

It seems that Mattel's energy is misdirected in their efforts to get the Body Shop to cease and desist: she looks, really, nothing like the "real" Barbie, and is merely a representation of a doll, any doll, not just Barbie. There are copycat Barbies everywhere, so why not go after those people, too?

Strangely enough, it didn't appear as though Mattel were going after the manufacturer of the doll, just the people who are showing us the image. So in other words, they can't stop someone from actually making a doll like this, but they can just try their hardest to keep us from seeing it.

Ironically, in the late 1950s, Barbie's creator had been to Germany and saw a similar doll, called Bild Lili, taking it back to the US to her husband, the co-founder of Mattel. The irony of Barbie's debut smacks of theft, in some ways. Later, Mattel acquired the rights to the German company, and Barbie's European cousin was no longer produced.

If Ruby were to really be created as a doll for the public market, it seems like she would threaten Barbie's livelihood about as much as Barbie moved in on Bild Lili's territory back in 1959.

There are countless styles of fashion dolls out there, many re-tooled and redesigned by adult collectors whose vast collections of Barbie-like dolls, clothing, shoes and furniture would make any kid envious. They are often produced in Japan, and can be made to look like celebrities, rugged men, glamourous women with excessively large breasts - just about anything you can think of - except overweight. And we know that even with two body redesigns (which may have been prompted by the Ruby ad, along with cries of protest by concerned parents), Barbie and her gorgeous body is still not really what the average American woman looks like, a size 14 - which is more like what Ruby looks like (as the ad truthfully suggests).

Because we all know that nurses everywhere
wear satin scrubs and sky-high heels. It was
either this or the astronaut costume.

As far as wardrobe choices, it seems like Barbie is devolving somewhat. Decades ago when she first came out, there were beautifully-styled dresses, jackets with linings and real tags, tennis outfits, all kinds of clothing - all of which looked very realistic. While it's true that changing times and hemlines are probably what Barbie's wardrobe reflects upon most, it's still not that true-to-life. The career dolls are still around, and I recently bought an astronaut suit (with matching helmet and boots!) for my daughter's birthday. But I made a pact with myself when I started buying those dolls for her - I'd rather see them naked all the time than with the barely-there clothing she often comes with. I contest that while ball gowns are very pretty and glamourous (I think girls prefer the long, flowing ones over the often tight-fitting, super short ones Mattel seems to be churning out), Barbie needs a good dose of reality in her wardrobe. Most of us do not wear negligee-type dresses out in public, or silk scrubs and platform shoes to our nursing jobs. If you want Barbie to have a realistic wardrobe that looks like a pint-sized version of your own, you have to make it yourself.

So Mattel was upset by the image of Ruby, yet condones the sexed-up, almost prostitute-ish look of Bratz dolls in their skimpy, barely-there clothing, platform shoes and heavy makeup. Barbie's own wardrobe generally consists of unrealistic, often revealing clothing, a complete departure from the original designs that were miniature versions of clothing real people would wear. Much like today, when the doll was first introduced, parents protested her unrealistic chest size. Despite the protests of parents now about the appearance of the Bratz doll, they still continue to be top sellers.

A rash of rashes (Don't fear the fever, Part 2)

With all the fun and exciting things that happened to our family this summer, we also had two crummy illnesses thrown into the mix, just to keep us on our toes (or should I say, knees?).

My husband and I had planned a getaway trip to Boston at the end of June, but my daughter had other plans: she got pretty sick about a week or so before our trip. I blogged about the experience, and mainly how we were deciding not to overdo it on the Tylenol/Motrin thing and just let her body do its thing to fight whatever she had. And of course, people wanted to know how things turned out.

After a visit to the peds, he diagnosed her with Coxsackie Virus, based on her rash features: sort of random, slightly raised red bumps. She had it on her hands, and it definitely looked like HFM (hand-foot-mouth). She also had it in a cluster on her torso, but nothing on her feet or in her mouth. I thought perhaps some Tylenol to keep her comfortable and we'd just ride it out, thankful that she didn't have the telltale mouth sores that many kids get.

Well, I was wrong. We ended up in pediatric urgent care, where they observed that her rash features had changed - she had something called erythema multiforme. They decided they couldn't tell conclusively if it was a viral agent or something called Kawasaki Disease, a vasculitis (which causes swelling of the blood vessels) that seems to affect primarily Japanese and American children. While it's pretty rare, it can pose serious complications if left untreated, including catastrophic heart damage that can lead to sudden death episodes. (Think John Travolta's son) W.T.F. I freaked. I held onto the notion that perhaps this was a particular strain of Coxsackie Virus, which can cause erythema multiforme.

In the end, they decided to treat her as if she had Kawasaki's, because they felt that the benefit outweighed the risks. She had a mixed bag of symptoms, some of which met Kawasaki's criteria. They waited at least a day and a half to treat her simply because the medication is insanely expensive and they weren't 100 percent sure - they even called in a delightfully old gentleman in infectious diseases who, I later suspected with horror, was a retired physician they called in to consult. Heck - the guy even carried a doctor's bag.

She had fluid around her heart - a possible sign of Kawasaki's, or something viral, or simply from being sick. Red, strawberry tongue - also a sign of Kawasaki's, but not conclusive enough to diagnose, and could also be a sign of dehydration. Whatever it was, it was kicking her butt. They gave her a round of IV IG - intravenous immunoglobulin, purified blood plasma that is supposed to boost her immune system and apparently costs around $3,000 per dose. Thankfully she tolerated it well and was able to leave the hospital after 2 1/2 days.

I still don't want to "fear the fever," but when it's accompanied by a rash - especially one that you've never seen before - it's probably a cause for concern. In the mom's guide to rashes stuff I've seen, this one hasn't been listed, and even though Kawasaki's is rare, it does need to be treated swiftly. One definite cause for alarm with regards to fever is one that lasts more than four or five days, which was a concern to doctors - at one point I was out in the hallway with the attending and his medical students, and felt like I was stuck in a surreal episode of House M.D. I don't ever want to do that again.

Just for your memory files, this is what it typically looks like after the red spots change - target or bullet-like lesions that sort of fan out from the center. It kind of reminded me of a head of cauliflower.

Erythema multiforme. Photo: Wikipedia Commons.

Our last hurrah for the summer was a trip to my mom's in Ohio, where I unfortunately spent the week with a sore throat. It would subside some during the day, but at night it was almost unbearable, and Advil only made a slight difference. At one point as I tried to fall asleep, I thought I was choking on saliva and a moment of panic set in. But otherwise I could function - I didn't feel too terrible during the day, and if I did, chalked it up to crummy food and not enough sleep. I thought I had a cold, until I suddenly realized it was getting worse instead of better, and hadn't gone away in the usual time a sore throat from a cold does. Do I have strep throat?! I thought. I wasn't sure.

I think I've had strep throat once - I can't even remember if that's what it was - and wished I had thought more about seeing the doctor when we returned home. I had cold symptoms the following week after the sore throat went away, and didn't think any more of it. Until I developed quarter-sized red bumps on my lower legs, serious joint pain in my knees and ankles, and just generally still felt like crap. I thought maybe it was from shaving. After a few days I decided I couldn't take it anymore and headed to the doctor.

I had done some googling but wasn't sure what I was looking at was really what I was looking at. I ended up seeing the Pretend Doctor, and after that visit have decided never again. I like my regular doctor, but I'm not sure where he found this person: she said it looked like a vasculitis (similar to the rash my daughter had), and I silently freaked out. But she also blubbered on about a "chest X-ray, punch biopsy," and a bunch of other stuff that had me wondering. I absently said I would like a second opinion from the doctor (thank God he was there that day) and he cheerfully came in and examined me quickly. His diagnosis was pretty succinct and seemed to match up with what I had read, and Pretend Doctor got a tad defensive (and after Dr. Real Doctor left, said, "I know what I'm talking about," a little confidently), but who cares. No punch biopsy for me (which I read later is only required in cases where the cause cannot be determined, and mostly for localized outbreaks or something, whatever that means). I had to laugh when I came across the words "Any experienced doctor should be able to diagnose based on clinical symptoms. Rarely is a biopsy needed." Hahahaha (this is me laughing hysterically in my altered mental state)

The final word was that I had developed erythema nodosum, a rash that (most commonly, I read!) is caused by a recent strep infection. I felt like a detective. I now knew more about stupid erythematous rashes than most people would care to, and was sick of the word 'erythema.' I had punched in that stupid search criteria into my computer so many times I barely had to type the letters e r y before the term came up.

In case you've never heard of it, erythema nodosum is a bumpy rash that is most often confined to the lower legs and shins, and feels pretty much like you played rugby for six hours in high heels and then were kicked in the shins by the entire team. It also includes ankle swelling, joint pain and general malaise, and as a result I've been sucking down more Advil than I ever thought possible.

I know some are skeptical of the effectiveness of taking antibiotics for strep infections, but I'm wondering if this could have all been avoided if I had seen the doctor sooner. The pain at times is almost unbearable, and I have a pretty high tolerance for pain. Sometimes Motrin works well, sometimes not. I'd rather risk potentially disturbed gut flora from a course of prophylactic antibiotics (which I'm on anyway right now, just in case) than deal with this again. Cases of rheumatic fever are virtually non-existant in the US now as a result of antibiotics after strep throat, but some people report pockets recurring - which I'm wondering is either because parents aren't recognizing the sore throat or think it's unnecessary and don't want to contribute to antibiotic abuse. I can appreciate that, to some degree. But even if don't have strep complications, you can still have rheumatic fever, which can have serious, life-long (and sometimes life-threatening) complications.

Erythema nodosum. Photo: MedicalPictures.net

Rheumatic fever is pretty rare in adults and mostly strikes children (like it did my grandma as a kid, before penicillin was even discovered) but that doesn't stop me from worrying about it, of course. In the meantime, I have a date with the heating pad. This should hopefully resolve itself ... in about three to six weeks. *frown*

More reading:
Your child has a rash: do you know what to do?