Medicine & Drugstore

Yesterday we had a very important doctor’s appointment.  Ever since Elanor began to walk, she has had some issues with her right side (really, dating back to her side preference when crawling) her right foot wants to point down (almost like on an imaginary high heel) and her toes pigeon in more than what falls within the realm of normal.  It’s why occupational therapy got involved, physical therapy got involved and why she was put into a brace.  Our pedi neurologist was concerned as was the pedi stroke team.

But everyone, across the board, said that the decisions they’d made about bracing her and how often to wear the brace, etc were just temporary measures until a certain doctor weighed in.  A doctor we would need to wait 6 months to see initially, which turned into 10 weeks after we had to switch appointments with another family due to our Singapore trip.

Dr. N is a specialist in kids with cerebal palsy.  The only reason E doesn’t carry a CP label is that it isn’t technically diagnosed until a child is 2.  What I hadn’t known is the CP is an umbrella term to describe a child who had a neurological event (such as E’s stroke) in utero or at a very young age that affects motor development (such as E’s foot issues).  I feel weird using that term because if you look at her, she doesn’t fit any of the stereotypes…but it doesn’t mean that she isn’t still at risk for CP related issues (seizures, learning disorders, etc) even as her motor issues resolve.  To be clear, it’s not that I don’t want that label applied to her…it’s that it feels disrespectful to families who are dealing with so many more struggles every day than we do.

Anyways, our first good piece of news is that she had reached 17lbs (7 and change kgs–too lazy to do the full math on that), which is a full pound up from Feb 3rd’s 16 lbs.  I really feel like adding the appetite stimulant has been a major factor in her growth and that it may help us turn a corner with E’s weight struggles.

Then we went through all of E’s history with Dr. N’s colleague before spending a short time with the good doctor herself.  The consensus was clear–that no matter how much the brace was the right one several months ago, today it is far too much brace.  We have been instructed to cut her brace wearing back to 1-2 hours a day from the 4-6 we were trying for before, and we will need to see the orthotist that made her brace in order to get it cut down or thinned out or some combination of the two so that it isn’t doing too much of the work for Ella.

Obviously she couldn’t say if this meant that E would be unbraced by a year from now, but she seemed very happy with where E was, and seemed pretty confident that E would continue to do well.

Walking out of the office we passed 3 kids of various ages all in wheelchairs and with varying degrees of obvious struggle (beyond being in a wheelchair) and I blinked back a few tears realizing yet again (as I probably will for the rest of my life) how differently Elanor’s story could have ended and how lucky we are that she is the irrepressible evil genius in training that she is.

One of Hong Kong’s most flamboyant socialites was buried on Tuesday with paper replicas of his gold and pink Rolls Royce cars and a selection of his most colourful outfits into the afterlife.

Lawyer Kai-bong Chau, 75, was to be buried with a range of the eccentric outfits that made him one of the city’s most recognisable socialites.

His funeral cortege also included scaled-down models of two of the luxury cars he was chauffeur-driven around in throughout his life. The elaborate models are to be burned in a ceremony to send them to the afterlife with him.

Paper models of cars, homes and money are traditionally burned at Chinese funerals to equip the dead souls with comforts and luxuries after death.

Chau was the son of a renowned politician, Sir Sik-nin Chau. He became a lawyer, setting up his own firm in 1964, after studying at Cambridge. With his wife, Brenda, being equally eccentric, the two became one of the former British colony’s most famous socialite couples.

They arrived at events in matching colourful outfits and in one of their three Roll Royce cars, which included a pink Silver Shadow and a gold Phantom 6. Chau was diagnosed with intestinal cancer in March 2008 and died February 9.

bron: www.iol.co.za – Sapa-dpa [9-3-2010]

But people are still naïve about the basic cause of the difficulty to achieve pregnancy

Sex education at school, its quality or otherwise, is likely to have much to do with fertility problems later in life. Many women (men, too, of course) can use the  keyboard with all their fingers (as well as their thumbs!) but have poor understanding of the basic functioning of their reproductive system.

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That ignorance is well known, and is underlying the fertility problems. You should see the pregnancy doctors’ tweets – replying to some incredible questions, and then the talk of various mysteries!

A shining example is this tale of “mysterious conception”. For the whole story see the Alphabet of bioZhena under M, “Mysterious conceptions (OR THE NONEXISTENCE THEREOF)” on page 34 or thereabout, from which I cite:

QUOTE:  It appears that we must dwell on this topic, because of stories and notions propagated in various pertinent circles. This writing has been prompted by page 176 in the excellent 1999 book “Woman” by Nathalie Angier, where the Pulitzer laureate relates the story of the mysterious conception of her only child. Mysterious, because it occurred, she believes and makes her readers believe, outside of ovulation and of the fertile window.

The reason for this entry in the Alphabet of bioZhena is that there is NO SUCH THING AS MYSTERIOUS CONCEPTIONS, there is only lack of information, or ignorance of the facts. We might say, intellectual misconceptions lead to “mysteries” in terms of conception, of babies conceived supposedly when conception was biologically impossible, and vice versa, some women have difficulties conceiving for the same fundamental reason. We shall use Ms. Angier’s case to make this point. UNQUOTE.

To drive the point home, here is an excerpt from John J. McCarthy, Jr. and H.E. Rockette, “Prediction of ovulation with basal body temperature”, Journal of Reproductive Medicine, Volume 31 (No.8), Supplement, 742 – 747, 1986.

Referencing particularly large studies from 1967 and 1977, these BBT experts had this to say all those years ago (and never mind their “prediction” in the cited title whereas the BBT is well known to be no predictor):

QUOTE:  Cycle regularity is often assumed by both women and their physicians. The suggestion, that the BBT graph of the previous cycle can be used to identify the day of ovulation in the current cycle, requires nearly absolute cycle regularity. [However, note this:] The data collected by 1,085 women, who provided at least 6 or more charts each, were studied for cycle length variability. … The cycle length range was more than five days for 56% of the women who submitted 6 graphs, and for 75% of those with 12 graphs. … Absolute regularity was not demonstrated in as few as six cycles. Even when the cycle length that deviated the most was eliminated, less than 1% (8 of 1,085 women) had no variation in cycle length. When the number of cycles was extended to 12, no woman had variability of less than two days in cycle length. END OF QUOTE.

In real life, you realize, no cycle can be eliminated from the experience, and every day matters. Two days are very likely to make the difference between conception and the lack of it. And/or cause an unwanted pregnancy, for that matter.

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The above findings are therefore the basis on which we can say quite categorically that nobody is as regular as a metronome (and nobody conceives in an anovulatory cycle), that there is no such thing as absolute regularity, whether 28 days or otherwise.

If you are in the sub-fertile category of people finding it difficult to become pregnant, you are likely to have cycle variability of more than 5 days over those months of your fruitless efforts that define your category. More likely than being one of the 0.74% of the population with no variation in cycle length, which under ideal conditions may also mean no variation in the time of ovulation. Persistent monitoring is well advised.

A new form of medical tourism is arising. Recently, there has been an increase in American gay couples opting to get children by using surrogate mothers in India, by some called “pregnancy outsourcing”. Commercial surrogacy is a prospering industry in India, and for years childless foreign couples have seen this as their way to parenthood. Now, gay couples are getting more aware of the possibility.

In the U.S., laws governing adoption and surrogacy differs from state to state. In India, on the contrary, surrogacy is legal and losely regulated. It is also non-discriminatory on grounds of sexual orientation. Another very important benefit is the fact that very few Indian surrogate mothers will claim any legacy to the child.

The medical treatment is called In Vitro Fertilization (IVF), and the Indian clinics claim a high success rate as doctors are allowed to implant up to five embryos into the uterus at one time. In many other countries only two implants are allowed at one time.

Opportunities for gay couples to find surrogate mothers abroad have grown substantially in the last year, according to the Indian Surrogacy Law Centre, a legal firm based in Chennai. G.R. Hari, a partner in the firm, says “South Africa is now advertising access to such surrogacy, but India has the highest volume because procedures here are simple and more affordable than other countries.”

But while the proponents advocate the benefits stated above, the critics warn that the lack of effective legislation around surrogacy encourages exploitation of young, poor Indian women.

The first foreign gay couple to attain a baby through surrogacy in India were two Israelis in 2008. The price, including medical charges and the payment for the surrogate lies around 20,000 USD. From this sum, the surrogate mother receives around 8,000 dollars.

There will be a training meeting on March 21 with Dr. George Kent (a member of the SCVC Amigos Board) who will give a presentation about health and safety in Latin America. This will be changed to a parent and volunteer meeting so that all parents can be present to hear this information.

Currently, I am sitting in a sweaty room wearing a large ceremonial robe. It’s really difficult mixing these herbs while typing, but I must say I am impressed with the Wi-Fi I was able to install in this grass hut. Thank the Great Spirit for netbooks!

Ok, ok – lame, I know, and probably a little racist. Although judging by the income of Avatar (aka Pocahontas with funny little 3D glasses and explosions), I should expect a flood of views on this any day now. Alright – end snarkiness…..now.

This is not a blog about a shaman. This is a blog about a 22-year old college senior about to plunge into gross anatomy, histology all-nighters, and coats that are inconvenient to spill on. I start medical school in August, and in case you are like some loved ones who were not sure: yes, that is where you go to become a doctor. I am currently deciding between two medical schools to which I have been accepted: one top 20 school in a large city, and one top 35 school closer to home. Revisit days for these schools are fast approaching in April, and I will surely be chronicling those experiences.

While much of this past year has been focused on the medical school application process, I have tried to devote much of my remaining time to a task that has been avoided and procrastinated too frequently the past three years of college, establishing and evaluating myself as a man. Throughout my undergrad, I have found myself playing into the new stereotype that society has created for college age males: the overgrown boy, or man-child. Characteristics of the OBMC include the following:

• Feels it’s cool to be lazy, to slack and to lack motivation
• Defers to women too frequently, both professionally (in my case in class) and in relationships
• Lacks passion for life
• Does not seek to be self-reliant

The past year I have undertaken several steps to try to reverse these traits, including travel, service to community and taking ownership of my personal life, and these I will all touch on over the course of this blog. I am currently doing my best on the last one, seeking to achieve greater independence from my parents, whom I still do love quite dearly.

Just to clarify, I am aware of other blogs about both life as a medical student and manliness, and for the future in this blog, a man per my definition:

• Views women as equals and treats them with respect
• Is not constantly serious, and knows how to let loose
• Is not overly aggressive and testosterone consumed

I look forward to sharing my experiences!

MMM

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Grammarphobia – an irrational terror of grammatical terminology is common among those who underwent grammar lessons at school and those who did not. The first group might regard grammar as just one more abstract ritual to be endured while the sun shone outside; the second group might see it as a magical key to successful writing, unreasonably withheld from them by malevolent educationists – especially, in the UK, from I 960-90.
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Pediatric, or child’s wheelchairs are available in almost as many distinctive styles as adult Electric Medical Wheelchairs, yet with the extra benefit of being constructed to support a child’s smaller body type. You may discover a few more issues to consider before planning to buy a pediatric wheelchair, though, and this writing will explore those subjects. The two primary factors to decide on are the size of the wheelchair and the sort of support it provides the child. After those details are decided on, you might want to think about how to transport your child’s wheelchair. Finally, manufacturers create fun options to make the new wheelchair more child-friendly, so these should be explored also.

The primary order of business is to determine the proper sized wheelchair. As anyone knows, getting anything for children entails that you need to figure out the size he is at the moment in addition to how big he might get before he is done with the piece of equipment. This is sufficiently easy, since pediatric wheelchairs are available in capacities from 35 lbs to 250 lbs, and quite a few are intended to grow when required. If the child needs the wheelchair for a chronic condition, then an adjustable sized wheelchair will be a practical investment.

The next large factor is the child’s condition. Does the child need a lot of physical support, or do they need a four wheel or a 3 Wheel Scooter? Certain chairs have a series of straps and back and neck support for children who are unable to hold themselves up, and others have only the absolute minimum back support and no headrest of any kind. Will your child be able to move himself someday, or will he constantly need help moving the chair? Manual chairs are often made with accessible back wheels and push handles which may detach, or you could opt for motorized wheelchairs with joystick controls.

Transportation is another large issue when shopping for 3 Wheel Electric Medical Wheelchairs. How regularly must the child be loaded into your car daily, and how streamlined does that job need to be? A well made manual wheelchair made for travel can be easily transferred in and out of a regular family car presuming that the child is able to be moved to a car seat for the purpose of the ride. If that child is too heavy to lift often, if he is to weak to control a manual wheelchair or requires comprehensive back and neck support, then a motorized wheelchair is needed, along with a chair lift and a car intended to support it.

Finally, we ought to take the child’s enjoyment very seriously. Pediatric wheelchairs may be manufactured in several happy colors, and you can choose from a large group of colorful seat fabrics, appliques and customized backpacks to bring some personality and whimsy to the wheelchair. This will seem like unrelated details to many adults, but think about it; the child is the person attached to the chair; it should be as enjoyable as possible.

Janeway’s Immunobiology is probably the best immunology book that someonereally interested in immunology should take to the mythical desert island.One can enjoy it by its clarity from the basic graduate courses, and thenkeep reading it when doing research and pursuing hypothesis on the mostadvanced immunological topics. Many times I have found better organized andcomplete information on this book (even the old editions!) than on thelatest reviews on specialized journals. The intense and careful workdisplayed to promote the real understanding on the concepts and therelations between immune components is impressive. Even more, the successin explanation is such that the authour takes the risk to have his bookneglected as “too easy” by first time readers. However,immunology researchers in contact with the often chaotic and contradictoryimmunological literature can really appreciate the incredible amount ofcritical work invested and the intellectual gift of the author (authors) toabstract complex immune phenomena into nicely designed and biologicallyprecise “cartoons”. The focus on the evolutionary and functionalconsequences/origins of the immune mechanisms and structures makesJaneway’s book one of the most refreshing and valuable voices in asometimes too-technically oriented discipline. An impressive accomplishmentnever praised enough.

Product Description
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