Zachary's presents to us...

This is kinda late but it seems like I'm always late lately!

For Mother's and Father's Day the preschool that Zachary attends did "presents" for each of us. Zachary drew a picture at the top of the paper and at the bottom they put a My Mom (or Dad) is... sheet that they helped him fill in.

It really put a little bit of things in perspective as to how maybe Zachary sees us. And how we need to maybe change some things so that he sees us in the light we may want him to see us in.

Happy Mothers DAy!

My mom is 30 years old.

My mom looks prettiest when on Wednesdays, Thursdays, and Saturdays.

My mom likes to make pancakes, cookies and chocolate cookie bars.

My mom always says: "I can't have a cookie before dinner"

My mom is funniest when she sprays me with water and then laughs at me.

First of all, I'm not 30. I'm only 29. I told Zachary:

Hey, bubba balloo, mommy isn't 30.

Z: Oh yeeeaaaa!!! I forgot, you're 40!!!!

Eek! Are you kidding me child?? LOL.

I told Chuck after reading mine that it sounds horrible!!! "sprays me with water and then laughs at me"? But in Zachary language, I think that's a good thing. He LOVES playing squirt guns and I love playing them with him...and when I get him, I do laugh hysterically. So maybe it's a good comment. And I do love to bake...especially with him. It's the one thing that we can do together that he listens very well at and is a great helper. I enjoy that special mommy/son time with him. I also wondered what was so special that I did different on Wednesdays, Thursday and Saturdays, so maybe I could do it more often!

Happy Fathers Day!!

My Dad is 20 years old.

My Dad likes to have me help him cook.

My dad always says, "if I hit my brother I will go in time-out".

My dad is funny when he me and my brother laugh at each other and then everybody likes to laugh at me and my brother.

I love my dad because I like to play with him.

Chuck thought it was absolutely hilarious that Zachary said he's 20 and I'm 30 (and then 40) when in actuality Chuck is going to be 38 this year. But he does look young :)

The ways kids perceive things amazes me. Chuck HATES having Zachary help cook. That's something that I do. Chuck has no patience for it, because it's a task that needs to get done right now. Whereas I have no patience for playing games, like Chuck does. But apparently Zachary doesn't see it that way...which is okay in my book.

I love the fact that Zachary sees his and his dad's relationship as a laughing, playing one. It warms my heart to know that there is such a warm bond there that will help Zachary to become a strong, warm man.

There are days...

I just feel downright OLD.

Most days I don't even think about it. My day moves along at a regular steady pace. The same as the day before.

What made me say holy cow today?

I was on "myspace" checking my account and my best friend's little sister left me a comment. She's a few years younger than us. A year older than my brother.

I saw her age...and thought to myself

"nah, thaat's gotta be wrong. She can't be 26 because she's a few years younger than me...and *smacks head* I'm not 26 anymore!!!"

I just feel like since the boys were born I haven't aged. At all. Apparently, I have and so has the rest of the world.

My sweet-a-holic

You'd think I NEVER let Lucas have sweets. Which totally isn't the case...we just don't eat them all the time.

For Easter, my aunt and uncle bought us a 4 lb bag of Jelly Belly Jelly Beans. I love Jelly Belly's and we still have quite a few left!!!

One thing I've learned about Lucas is it doesn't matter where I put the jelly beans, he WILL find them and EAT them! Yesterday, I took them from one high shelf and put them on another high shelf. I was sitting here reading my mom's board and heard Lucas scrapping one of the kitchen chairs across the floor...really working hard at moving it INTO the living room. Sure enough he had refound the jelly beans, used the chair to climb up and get them and was happily snacking on a handful.

*sigh* The joys of raising my monkeys. That's what this blog should be called...My life and my monkeys!

And...if he can't find the jelly beans? The candle will work just as well. Nope, he doesn't eat wax, he's much smarter than that! For Valentine's Day, the boys and I made a candle for daddy with those little conversation candy hearts on it. If Lucas is feeling his sweet attacks come on and can't find the jelly beans, he'll sit down and start peeling those little hearts off of the jar and eating them. That jar is missing A LOT of candy hearts now.

If you ever come to my house, or see my boys, don't leave your candy laying around. It just may not be there when you come back :)

Back Later, and Links for the Interim

Y'all, the last of the grandparents died yesterday, my Grandma W. I'll be traveling over the next couple of days for the services, so will not be updating here. In the meantime, check out some of these other blogs:

Emergiblog - the life and times of an emergency department RN. Includes a very long list of medicine-related blogs in the sidebar.

Women's Bioethics Blog - exactly what it sounds like

The Lactivist - breastfeeding activist

Milliner's Dream - doula blog

Abortion Clinic Days - from abortion providers (please don't go there just to be hostile - these ladies make a valiant attempt to explain where they're coming from and what they do, and keeping things civil is appreciated)

Belly Tales - student midwife blog - posts may be infrequent b/c the author is moving, but you should definitely check it out later

Ideas for Women: Women's Health Research News - I definitely owe author Trisha some linkage

All About My Vagina - not just about vaginas

Broadsheet

Scarleteen Newswire - assorted sexual health things

Reproductive Rights Blog

Also:

Grand Rounds, a medicine-related blog carnival hosted this week by Medviews and including yours truly.

BlogHer - a whole network of female bloggers

Kaiser Network Daily Women's Health Policy Report

Spot the Inconsistency - More on Breastfeeding

Today's Tennessean (Nashville), alongside the article "Campaign targets bottle feeding," features an inaccurate headline that unintentionally spreads misinformation. The second box, which purported to list "benefits of not breastfeeding," actually lists drawbacks of not breastfeeding, or benefits of not formula-feeding, such as:

"3) Babies might have diarrhea, constipation or harder stools more often than breastfed babies.
4) Babies might need more doctor visits and are more likely to be hospitalized than breastfed babies"

I sent the paper an email - there is enough debate and confusion on this issue already without our major local paper adding to it with sloppy editing. Even without a passing familiarity with breastfeeding, a quick read over the box sets up some clear contradictions between the box's headline and content.

Related stories in today's Tennessean are Breast vs. Bottle Can Be Difficult Decision and Nursing Options. Good for them for trying to provide women with some info - let's just hope they get it right next time... and quickly correcting their error (see update below). This is a good reminder, though, not to take everything you read for truth, unexamined.

Update: Their online content person responded to me, letting me know that the headline was correct in print, and the online caption has now been corrected to "Four Risks of not Breastfeeding." Yippee!

Update#2: Apparently the Tennessean was a little uptight about my use of their errant graphic in this post, because I received a second email asking that it be taken down. Hey, I'm uptight about bad editing and the spread of misinformation. In any case, I took the offending image down, which I believe complies with their Terms of Service but not at all with larger principles of fair use.

Update#3: Aunt B responds, in classic Aunt B style (i.e., smart, funny, and right)

Technorati Tags: breastfeeding; formula feeding; infant formula
MeSH Tags: Breast Feeding; Infant Formula

National HIV Testing Day

Tuesday June 27th is National HIV Testing Day, so go get tested. To find a testing site near you, search the HIV Testing Resources directory (you can search specifically for free testing). A list of campaign events is also provided by state on the NHTD website.

Update: In the state of Tennessee, health departments offer free testing. A map of local departments with contact info is available. (Thanks to Nashville is Talking for the heads up on that)

Technorati Tags: HIV; National HIV Testing Day
MeSH Tags: HIV Infections/diagnosis

Bill to Focus on Postpartum Depression

Via Belly Tales, a bill (S.3529) has been introduced in the Senate (on 6/15) by sponsor Robert Menendez (D-NJ) and co-sponsor Richard Durbin (D-IL) which would provide grant funds for expanded education of new mothers about postpartum depression, and require follow-up care with these mothers to screen for the condition. It would also generate additional research on PPD, via the National Institutes of Health.

Read the bill text (the legislation will be referred to as the "Mom's Opportunity to Access Health, Education, Research, and Support for Postpartum Depression Act" or the "MOTHERS Act.")

Senator Menendez's press release

The Amercian College of Nurse-Midwives endorses the Act

The Seattle Post-Intelligencer: Grief Becomes a Force for Change

PPD Information:

Postpartum Depression - American College of Nurse-Midwives

Depression During and After Pregnancy - National Women's Health Information Center

Postpartum Depression and the "Baby Blues" - American Academy of Family Physicians

Postpartum Depression - MedlinePlus

Recognizing Postpartum Depression - NPR's All Things Considered, commentary from a rural job counselor

Postpartum Depression - Planned Parenthood

Postpartum Depression - March of Dimes

The Postpartum Blues - March of Dimes

Technorati Tags: legislation; postpartum depression
MeSH Tags: Depression, Postpartum

THE doctor appt.

Well, the boys are incredibly strong and healthy boys! Yay! Zachary is still off the charts in height and 90th percentile for weight and Lucas is 90th for height, 75th for weight. Dr. said that they are very well proportioned. She also said Chuck and I are the poster children for what parents should be doing *puffing out my chest just a little* She was surprised at how well we have the kids eating and drinking, etc.

But onto the biggest reason I wanted to talk to her.

She started off by asking me how preschool was going...to which I answered not so well. And I kinda described some of the basic stuff...he was bouncing off the walls, unable to focus, etc.

Dr. begins to tell me that they don't like to diagnose ADHD this early in children.

So then I say, "well, I don't think that's it completely" and handed her the list I made up of all the weird things that Zachary does or says or behaves. (like punching himself in the head if he's overstimulated). Why didn't I just explain it all to her in detail? Because true to form, Zachary was BOUNCING off the walls.

Dr. did have Zachary do a series of things to see where he was at developmentally...just really simple stuff. One of the things kinda surprised her...and me really.

She asked him "Zachary-go pick up that car please?"

He did.

Zachary, can you put that car on the chair?

He did. and stepped next to the chair.

Zachary, can you put the car behind your back?

So he stepped in front of the chair.

Her reaction?? "OHHHHHH. Okay."

I think she was a little surprised that he didn't pick up the car and put it behind his back like even I would have. Like I've said, Zachary thinks outside of the box.

So, all said and done she said that it definitely sounds like something else is going on and that we need some help with it before school starts (THANK GOD!!) so she referred us to a supposedly GREAT neuropsychologist. I think the fact that I explained to her that Chuck was bipolar also convinced her that maybe something else was happening.

I asked about seeing an Asperger specialist and she said that it could be a couple of other things too so she wanted to rule out all the other options.

So, now to try to get in with the psychologist. Wish us luck.

Utter Stupidity

My name is Rachel and I have a MySpace account. With that out of the way, I got a "bulletin" from someone today that purports to quantify how much of a "badass" one is. 100 items are listed, each one worth a point, and the scoring system is as follows:
10-20= goodie good
21-30= a little rebelious
31-40= getting hot baby
41-50= rebel
51-60= total bad girl/boy
61-70= You are a pain in the *ss!
71-80= f**king bad *ss
81-90= cant believe you made it this far
91-100= see u in hell

Okay, let's start by acknowledging the stupidity of most of the "survey" bulletins that go around MySpace. Particularly when they are spread around by people closer to 30 than 20. Not to mention that this particular one was clearly geared toward the young, with items such as:
21) missed curfew
36) wore black nail polish
53) been to a concert
62) seen an R rated movie in theaters
64) skipped school

Okay, fine, it's a stupid, juvenile tame-waster. But let's look at some of the items you get a point for:
17) cut yourself
24) been to a therapist
25) been to rehab
65) had an eating disorder
79) been sexually harrassed

That's right kids, cut yourself, get touched inappropriately, and throw up your meals, and you too can be a total badass! I don't know why, but I'm completely infuriated by this, and by the near-30 guy who passed it along.

The Breastfeeding Campaign

Last week I mentioned a new breastfeeding campaign from the Department of Health and Human Services. There are currently two television spots, one featuring pregnant women in a logrolling competition, and the other featuring a pregnant woman riding a mechanical bull. The main messages of the ads are "breastfeed exclusively for 6 months," and "you wouldn't take risks before your baby is born, why start after?" Click the links above to view the ads; you can also read the transcripts for each ad. The complete set of print, television, and radio materials for the campaign is available here.

The ads have generated a fair bit of controversy, because of the intended feeling of guilt many women think the ads are designed to generate if a woman does not or cannot breastfeed for 6 months. This seems to be a fair criticism, given that many women know breastfeeding is best, but may not have the support they need, particularly in the workplace, to breastfeed exclusively. There are some good comments over at Feminsting describing the difficulties some women had when trying to breastfeed. A Chicago Tribune editorial, "The Breast Police", also addresses reasons why women can't meet this goal, and says the HHS tactics are unnecessary, given that 70% of mothers at least attempt to breastfeed. NBC Nightly News also covered the ad campaign, and has accompanying video.

The National Women's Health Information Center has a ton of breastfeeding information up, including coverage of the HHS campaign, but some of the information provided suggests the challenges that women will have. Among the recommendations:

"Breastfeed on demand" - in the section on Coping with Breastfeeding Challenges - how are women supposed to do that at work, where babies aren't welcome?

One section of the "Challenges" addresses going back to work, and says,
"After you have your baby, try to take as much time off as possible"
"Don't be afraid to request a clean and private area where you can pump your milk. If you don't have your own office space, you can ask to use a supervisor's office during certain times. Or you can ask to have a clean, clutter free corner of a storage room."

In the Frequently Asked Questions:
"Will breastfeeding tie me to my home?: Not at all! Breastfeeding can be convenient no matter where you are because you don't have to bring along feeding equipment like bottles, water, or formula. Your baby is all you need. Even if you want to breastfeed in private, you usually can find a woman's lounge or fitting room. If you want to go out without your baby, you can pump your milk beforehand, and leave it for someone else to give your baby while you are gone."
Doesn't this assume 1) you can always take baby with you (like to work); 2) there actually is always a "women's lounge or fitting room" available (are women with babies only going out to shop?); 3) you have the resources to have someone to help who can feed the baby pumped milk if you do have to go out? The website does say, "Breastfeeding is more than a way to feed a baby, it becomes a lifestyle." How many women can afford to let that become their lifestyle, when money is needed to provide for the whole family?

I can imagine that many, many women do not have the option to "take as much time off as possible," and don't have supervisors who are going to respond kindly to requests for accomodation. Are these recommendations completely out of touch with the situations of most working women? They seem to presume an office-type, professional environment. What of women who work at McDonald's, in factories, on farms? Are these employers going to allow women to take extra time off or take extra breaks to pump? Their babies might be most in need of the health benefits of breastfeeding, and they may be least able to provide them.

La Leche League provides a nice rundown of breastfeeding-related legislation, so women can at least know their rights. Let's look at Tennessee's law:

Tenn. Code Ann. § 50-1-305
1999 Tn. ALS 161; 1999 Tenn. Pub. Acts 161; 1999 Tn. Pub. Ch. 161; 1999 Tn. SB 1856

(a) An employer shall provide reasonable unpaid break time each day to an employee who needs to express breast milk for her infant child. The break time shall, if possible, run concurrently with any break time already provided to the employee. An employer shall not be required to provide break time under this section if to do so would unduly disrupt the operations of the employer.
(b) The employer shall make reasonable efforts to provide a room or other location in close proximity to the work area, other than a toilet stall, where the employee can express her breast milk in privacy. The employer shall be held harmless if reasonable effort has been made to comply with this subsection.
(c) For the purposes of this section, "employer" means a person or entity that employs one (1) or more employees and includes the state and its political subdivisions.

Do you see the wiggle room in there? An employer is only required to try, not to actually provide necessary break time or appropriate areas. You just don't have the extra space? Extra break time would disrupt operations (such as in low-wage workplaces)? You're all set - don't worry about it.

So how many U.S. women do breastfeed? Are they all completely unaware of the benefits? According to CDC data for 2004:

70.3% ever breastfeed; 36.2% at 6 months (14.1% breastfeed exclusively); 17.8% breastfeed at 12 months; 38.5% are breastfeeding exclusively at 3 months. So women are starting out strong, but fewer are breastfeeding as time passes. Maybe they're returning to work, eh? Because they have to?

Married mothers are more likely to ever breastfeed (76.5%) than unmarried mothers (57.2%). Because they don't have the support to stay home or just leave the baby with somebody who will feed the pumped milk? Same thing holds up for poverty - more money = more breastfeeding. So... think there might be some societal or economic barriers to exclusive breastfeeding?

The point, after all this, is that educating women about breastfeeding does not seem to be the problem. Reducing the barriers to making that a reality is the problem, and the HHS ads address that not at all.

Blogs covering it:

Mad Melancholic Feminista: The Politics of Breastfeeding

St George Blog: Driving While Pregnant

Angry Pregnant Lawyer: Get me a beer and a smoke while I hop on this bull

One Tired Ema: Late to the Party

Broadsheet: More on Breastfeeding from the Times

Huffington Post: Maia Szalavitz: Breast Feed or Else? NYT, HHS Boost Sketchy Science, Neglect PPD

Technorati Tags: breastfeeding; formula feeding; infant formula
MeSH Tags: Breast Feeding; Infant Formula

Back from unintentional hiatus...

Next time I'm not going to post for over a week, I'll let y'all know. Things have been a little crazy around work and home, and I just haven't had the time or inclination to blog. I'll be doing a lot of catching up this weekend; some stories will be a week or so old, which I know seems like forever in the blogosphere, but I think they're important nonetheless.

Asperger's Syndrome

Well, today I head out to the pediatrician for both boy's well kid check ups. It got pushed back a little bit in order for both boys to go at once. I'm anxious about today's check up for Zachary because I'm going to discuss with the dr. my concerns re: Zachary and his behavior and the possibility for it.

I met a woman, through the grace of God, about a week and a half ago who's son as Asperger's. There have been four things that I've looked into for Zachary but not one of them has fit all the bills for Zachary's behavior and learning problems/paths. I have absolutely no idea how Cody and I got on the subject of our sons, but we found out that they are AMAZINGLY alike, despite the 3 year age difference.

Once we were talking about Asperger's and behavior, the very first thing she asked me was "Does he play with your ears?" WHAT? I was astounded...how did she know that? WEll so does her son, and apparently according to the specialist it's very common with Asperger's children. I've always found it weird that Zachary plays and rubs our ears but thought it was just a quirk of him...and maybe it is. I'm hoping to have some concrete answers soon. (not today)

But so many things add up now.
His inability to focus on certain things, and yet his extreme intelligence for mathematics and complex problem solving.

The aptitude for him to get SOOO involved in a project (usually his games) that he'll pee himself without knowing or thinking about it. And the fact that you physically have to get his attention when he's in "the zone".

How he gets SOOO overexcited when put into new situations or with new people, then because of that excitement punches himself in the head.

How he CANNOT tolerate a change to his routine or order of his toys or stuffed animals. That will create a total meltdown.

How he takes everything so extremely literally and get so upset that you are calling him "turkey" when his name is Zachary.

How he so desperately wants to play with other children and can't. He doesn't seem to possess the ability to interact with others AT ALL. He has no idea of personal space or boundaries. And other kids don't like that. I don't know how many times I've picked him up from school and found him playing with himself. And he gets so upset by it, but can't seem to make that change.

His inability to understand my "angry face"....I've always found it weird that he doesn't get "the LOOK" and yet Lucas does.

I've had people tell me "oh, I hope it's not that" but in some ways I really do. It would answer so many questions and also help to lead us on the correct path to helping him adjust and learn in a better, more positive way. I really want him to succeed in school and things aren't looking too good at preschool.

So we'll see where we go this afternoon. I'm hoping for a great referrel for testing.

"Breast Feed or Else"

The New York Times has an article today, "Breast Feed or Else," which reviews the benefits of breastfeeding(for both baby and mother) and the risks of formula feeding. It also describes some of the barriers mothers face when attempting to breastfeed, such as workplace policies. The tone of some of the health officials quoted may spark heated reactions; according to the article, "Dr. Haynes, of the Health and Human Services Department, said, 'Our message is that breast milk is the gold standard, and anything less than that is inferior.'"

I'll update this post later with more on the article, the evidence, breastfeeding resources, and the chart of CDC survey results on people's perceptions of breastfeeding vs the reality.

Technorati Tags: breastfeeding; formula feeding; infant formula
MeSH Tags: Breast Feeding; Infant Formula

LGBT AIDS Anniversary Coverage & General Health Resources

Organizations:

AIDS@25: HIV & AIDS Media Resource Guide - from the Gay and Lesbian Alliance Against Defamation, this site provides information on how and when HIV/AIDS has been portrayed in television and film, a glossary of terms, and links to additional resources. A timeline and information on hot topics are forthcoming. (Hat tip to Ellen/the Pittsburgh Connection)

25th anniversary of first reported case of AIDS a time to recommit to the fight - press release from the Human Rights Campaign

Mass Media:

25 Years of AIDS and The Early Faces of AIDS (Blade Blog) - Washington Blade (DC)

AIDS at 25: The lessons of the past help drive the goals of the future - MetroWeekly (DC)

25 Years of AIDS: 19 Years HIV Positive - essay at metroG (Southern CA)

How AIDS Changed Us - San Francisco Chronicle

25 Years of AIDS in New England - In Newsweekly (Boston)

Monday Marks 25th Anniversary of AIDS Pandemic - The Advocate

An unhappy birthday: AIDS at 25, lives lost, lives changed - PrideSource

General Health Information:

Gay Men's Health Crisis

Gay and Lesbian Information - Avert.org

10 things gay men, lesbians, and transgender persons should discuss with their healthcare providers - Gay and Lesbian Medical Association

Lesbian Health - National Women's Health Information Center

GayHealth

Health and HIV/AIDS - National Gay and Lesbian Task Force

The SafeGuards Project

Lesbian Health - Planned Parenthood

Learn More About Health Issues - National LGBT Health Awareness Week (click sidebar links)

National Coalition for LBGT Health (advocacy organization)

Lesbian Health Research Center

Mautner Project

GLBT Health - Seattle/King County Public Health

Sexual Orientation and Health Issues - Richard M. Johnston Health Sciences Library

If you have resources to add to this list, please feel free to email me (see profile).

Technorati Tags: AIDS; GLBT; gay; HIV; HIV/AIDS; lesbian
MeSH Tags: Acquired Immunodeficiency Syndrome; HIV; Homosexuality, Female; Homosexuality, Male

Birth Stories

Belly Tales (one of the midwifery blogs) has been posting a series of birth stories, which represent the varied personal experiences of assorted women.

There are numerous other websites where women tell the stories of their childbirth experiences. A few of them:

American Pregnancy Association

Waterbirth International

Pregnancy.org

March of Dimes (NICU-focused)

You can find many more (of varying website quality) using this search, and midwifery-specific birth stories using this search. Blogged stories can be found using the Technorati tags below.

Something to ponder: What of online birth stories that represent birth practices that were not really appropriate for the woman described? It seems as though there is a vast potential for misinformation through the description of experiences that perhaps shouldn't have gone as they did, whether the teller is aware of it or not. Absorb with caution.

Technorati Tags: birth; birth stories; childbirth
MeSH Tags: Home Childbirth; Natural Childbirth; Parturition

Preconception Resources

The following resources address preconception care for women in general, as well as for those with pre-existing diabetes and hypertension. It does not address gestational diabetes, gestational hypertension, or preeclampsia, as those are "post-conception" problems. Also, see the previous post on HIV Before and During Pregnancy.


General Information:
Pre-pregnancy Healthcare - UCLA Healthcare
Preconception Care - CDC
Before You're Pregnant - March of Dimes
Your Pre-Pregnancy IQ - March of Dimes
Trying to Get Pregnant?: Before you Start Trying - National Women's Health Information Center
Care Before and During Pregnancy - National Institute of Child Health and Human Development
Folic Acid and Pregnancy - Nemours Foundation
Safe Motherhood: Promoting Health for Women Before, During, and After Pregnancy - CDC
Risk Factors Present Before Pregnancy - Merck Manual Home Edition
Preconception Checklist (PDF) - Wisconsin Association for Perinatal Care
Becoming a Parent booklet (PDF) - Wisconsin Association for Perinatal Care
Folic Acid (Easy to Read) - National Women's Health Information Center
Ovulation Calculator - National Women's Health Information Center
Pregnancy Pointers for Women with Psychiatric History - National Alliance on Mental Illness


Diabetes:
Pregnancy with Type 1 or Type 2 Diabetes - Women's Health Matters
Pregnancy and Diabetes: Plan Your Pregnancy to Avoid Complications - MayoClinic.com
Diabetes & Pregnancy FAQs - CDC
(includes "What can happen to a woman with Type 1 or Type 2 diabetes who becomes pregnant?" "What can happen to the baby of a woman with Type 1 or Type 2 diabetes during pregnancy?" and "How can a woman with diabetes who wants to get pregnant prevent problems to herself and her baby?")
Before Pregnancy - Type I Diabetes - American Diabetes Association
Complications: Having a Healthy Pregnancy with Diabetes - March of Dimes
Diabetes: Preconception Counseling - State of Florida Agency for Health Care Administration
Preconception Risk Reduction: Diabetes in Pregnancy - March of Dimes


Hypertension:
Pregnancy: When You Have High Blood Pressure - MayoClinic.com
Your Questions Answered: Medications and Getting Pregnant - American Heart Association
High Blood Pressure During Pregnancy: March of Dimes
How can Women with High Blood Pressure Prevent Problems During Pregnancy? - National Heart, Lung, and Blood Institute
Women and High Blood Pressure - National Heart, Lung, and Blood Institute
Management of Chronic Hypertension During Pregnancy: an Evidence Report - Agency for Healthcare Quality and Research
(this is pretty technical, but it is basically a set of questions and answers regarding the medical evidence for treatment of hypertension during pregnancy)
Pregnancy Complicated by Disease: Hypertension - the Merck Manual Home Edition
Technorati Tags: preconception; pregnancy
MeSH Tags: Preconception Care; Pregnancy; Pregnancy, High-Risk

Cellulitis Resources

This is not strictly a women's health issue, except that I looked up information on it for a woman. This and the next post are going to be from materials recycled from non-work-related reference questions (except for that "nude photos of Heather Mills McCartney" thing...). Don't worry - I would never, ever tell who asked the question, so send me yours anytime.

The basics: bacterial infection of the skin/tissue (lots of people get this on the legs); swollen red area that may be hot or tender; usually a strep or staph bacteria, beginning at the site of a bruise, cut, or other injury; spreads rapidly; VERY important to get treatment quickly when symptoms are noticed (seriously, no fooling around, can lead to very serious illness/death); treatment with oral antibiotics, or hospitalization w/ IV antibiotics if more advanced.

Cellulitis - MayoClinic.com
covers signs & symptoms, causes, risk factors, when to seek medical advice, screening and diagnosis, complications, treatment, prevention

Cellulitis - Merck Manual Home Edition
gives a general overview

Cellulitis - eMedicine
provides more clinical detail on the topic

Health Information: Cellulitis - Brigham and Women's Hospital
includes a good list of prevention tips

Cellulitis - Encyclopedia section of MedlinePlus

Technorati Tags: cellulitis; skin infections
MeSH Tags: Cellulitis; exclude orbital cellulitis

Topic Updates: AIDS and HPV Vaccine

The posts on the 25th anniversary of AIDS and the newly approved HPV vaccine have been updated with additional coverage and resources, and will be continuously as new items appear.

FDA Approves First Vaccine Against HPV, Leading Cause of Cervical Cancer

The FDA approved Merck's Gardasil vaccine today, which is intended to prevent infection with human papillomavirus strains that have been shown to cause cervical cancer, precancerous lesions, and genital warts. The vaccine was approved for use in women aged 9-26 years, and is expected to cost $120 for each dose in the 3-shot regimen, for a total of $360. According to Merck's website, the company "has created a new patient assistance program for vaccines. Through this new program, Merck will provide free vaccines to adults who are uninsured and who are unable to afford vaccines. Merck vaccines, including GARDASIL, will become available through this program in the third quarter of 2006."

Coverage of the story:

FDA Press Release

Merck Press Release

New York Times, and another

Washington Post

National Cancer Institute Press Release

Women's Bioethics Project 1 and 2

And Now, the HPV Vaccine - Slate

FDA OKs first cervical cancer vaccine - CNN

Nuns, Cows and the Cervical Cancer Vaccine - Medgadget (and related press release from Rochester Medical Center)

Related Resources:

HPV Fact Sheet - National Cancer Insitute

Gardasil Questions and Answers - FDA

HPV Vaccines for Cervical Cancer - National Cancer Institute

HPV Vaccine Questions and Answers - Centers for Disease Control and Prevention

Human Papillomavirus (HPV) Infection - Centers for Disease Control and Prevention

Make the Connection - this site, sponsored by Merck, provides information on the HPV/cervical cancer connection. And, hey, you can get a free bracelet (which is not made out of rubber).

Also:
In searching for resources on this topic, I came across this post (pretty high up in the Google results) disparaging the vaccine as "worthless" and "potentially dangerous." Says the author, Dr. Mercola: "By the way, Gardasil is completely worthless if you already have one of those viruses. The other bad news: Five women treated with Gardasil near the time of conception eventually had children who now suffer from birth defects, a problem for which Merck denies responsibility." Vaccines are intended to prevent infection with a virus, not to treat those who already have a virus, by definition. As to the second point, I haven't read through all of the trial reports, but the product labeling (PDF) states:

"During clinical trials, 2266 women (vaccine = 1115 vs. placebo = 1151) reported at least 1 pregnancy each. Overall, the proportions of pregnancies with an adverse outcome were comparable in subjects who received GARDASIL and subjects who received placebo. Overall, 40 and 41 subjects in the group that received GARDASIL or placebo, respectively (3.6% and 3.6% of all subjects who reported a pregnancy in the respective vaccination groups), experienced a serious adverse experience during pregnancy. The most common events reported were conditions that can result in Caesarean section (e.g., failure of labor, malpresentation, cephalopelvic disproportion), premature onset of labor (e.g., threatened abortions, premature rupture of membranes), and pregnancy-related medical problems (e.g., pre-eclampsia, hyperemesis). The proportions of pregnant subjects who experienced such events were comparable between the vaccination groups. There were 15 cases of congenital anomaly in pregnancies that occurred in subjects who received GARDASIL and 16 cases of congenital anomaly in pregnancies that occurred in subjects who received placebo. Further sub-analyses were conducted to evaluate pregnancies with estimated onset within 30 days or more than 30 days from administration of a dose of GARDASIL or placebo. For pregnancies with estimated onset within 30 days of vaccination, 5 cases of congenital anomaly were observed in the group that received GARDASIL compared to 0 cases of congenital anomaly in the group that received placebo. The congenital anomalies seen in pregnancies with estimated onset within 30 days of vaccination included pyloric stenosis, congenital megacolon, congenital hydronephrosis, hip dysplasia and club foot. Conversely, in pregnancies with onset more than 30 days following vaccination, 10 cases of congenital anomaly were observed in the group that received GARDASIL compared with 16 cases of congenital anomaly in the group that received placebo. The types of anomalies observed were consistent (regardless of when pregnancy occurred in relation to vaccination) with those generally observed in pregnancies in women aged 16 to 26 years."

Do you see what that's saying? Rates of complications were basically the same between the vaccine and placebo, except when the vaccine was administered 30 days or less from the onset of pregnancy. This is actually not that uncommon - I received an MMR vaccine recently was told in no uncertain terms that I was not to get pregnant for a month. It's a complication worth noting, but could presumably be significantly reduced by educating women at the time of vaccination. It turns out that Dr. Mercola has "natural" medicine wares to sell - here's the FDA's warning letter to Mercola with regards to misleading claims about some of his products.

Previous Related Posts:

Women's Health News: FDA Committee Recommends Approval of HPV Vaccine

Women's Health News: HPV Vaccine Moves Closer to Approval

Women's Health News: Status of HPV Vaccine and Cervical Cancer Prevention

Technorati Tags: cervical cancer; FDA; Gardasil; HPV; Merck; vaccine
MeSH Tags: Papillomavirus, Human; United States Food and Drug Administration; Uterine Cervical Neoplasms/prevention and control; Vaccines

Stupid people

Seriously, I've had plenty enough of stupid people. I feel like I'm surrounded by them. Everytime I go somewhere, there is more stupid people. And they are raising a whole other generation of stupid people. I feel sorry for those kids.

Stupid person #1:
http://www.montgomeryadvertiser.com/apps/pbcs.dll/article?AID=/20060605/NEWS02/606050317/1009 Check out this article. This woman is suing for damages to her child that she tried to ABORT. That's right...she didn't want the baby, signed papers with Planned Parenthood stating that she was having the abortion and negating them of all liability to her body...but wait. The job wasn't done. So now the baby has problems. Don't you think that you would KNOW that you were still pregnant as you kept growing and started feeling the baby move and such. How can you sue for damages when you didn't want the child in the first place? Give the baby to someone who did and stop trying to make money off of the poor thing.

Stupid person #2: Pit bull owners who think it's funny to have a killer dog.

My new neighbor recently moved in and obtained 2 pit bulls. Now, I have nothing against pit bulls, per se. I do have something against dogs that were bred and trained to fight, abused and then removed from the home and then put next to us and our two boys. They charge the fence daily. I was explaining my concern to some co-workers. One of these people stated that they too have a pit bull.

"*snicker, snicker* Our dog broke his chain and ran across the street and killed the dog across the street. *more snickering* And now that he has the taste of blood he tries to attack everyone that comes over. He attacked my husband's niece. *smile, guffaw*"

What the hell is wrong with people?!?! Why is this funny? Why the hell would you even attempt to keep that dog alive, knowing that he was a trained fighting dog, attacked and killed another dog, and attacked your niece........especially with a 22 month old baby in the house???

Stupid people #3: People who ask for opinions and then get offended when it's not what they wanted to hear.

I HATE this. Don't ask for my opinion if you don't want me to tell you the honest to God truth. I don't usually sugar-coat things. I won't intentially offend you, but at the same time, I won't tell you what you want to hear.

If you are looking for validation that what you are doing is right, be a woman/man and say so. Don't try to hide behind the words: "let me ask your opinion" and then get pissy with me when I don't say what you want me to say.

Stupid people #4: Women who tell their young beautiful daughters that they are fat and need to go on a diet.

True story. I was at our local convenience store (same one I had my epiphany at!). A woman who was disgustingly thin (think meth lab addict thin) came in with her 8 or 9 year old daughter. She was beautiful...a very exotic mix of races. She had that tell-tale prepubescent tummy pouch that so many girls have right before they start their periods. And she didn't have it as much as I've seen some have.

Her mother was bad-mouthing her to me and the cashier from the moment they walked in!

-"Look at her, all she does is eat. She's gonna be so fat"
-"Seriously you need to stop eating so much you are getting fat"
-"Let me see that fat tummy of yours...come-on lift up your shirt. You need to be on a diet!"

Grrr...I was *this* close to punching her. Seriously. I wonder if she realizes that she is probably PUSHING her into a weight problem.

Stupid people #5: People who are old enough to know better not to say something down right rude!

Today, I was picking up the boys from school. Zachary ran out ahead of me and was climbing into the Jeep via the window. (something he KNOWS he's not supposed to be doing!) It's a Jeep Sport so it's kinda high off the ground and a guy (I was going to say gentleman, except he was anything but!) saw Zachary doing this and said "Wow, that's kind of impressive!" To which I replied, "yea, he's a little monkey". His reply?

"Huh, wonder how that works. I mean, considering, doesn't look like you could be one."

Um, seriously? I know I'm overweight and all, but that is just freaking RUDE! Shut up you beer-belly'd old man and go about your business and stay out of mine, Thank you very much!

Okay, I feel a little bit better getting that off my chest.

My epiphany

I've done it.

I've conquered yet another hurdle in my eating issues.

For this I'm extremely happy, even if it was for only one moment.

Monday night I went to the local convenience store and purchased a piece of pineapple/mango cake.

It sounded divine!

I couldn't wait to get in the car and rip it open and enjoy it. So on my way back to work, I did just that.

The first bite was not so good.

The second bite was worse.

So I figured, I'll try a third bite, right?

NASTY!

So I said to myself : "Self, this is the most disgusting piece of cake ever. I know that you paid good hard money for it, but seriously this is just nasty! Stop eating it!"

So, I did.

I listened to my inner voice.

After work, I tried it again thinking maybe something was wrong with my taste buds earlier.

It was still nasty! So I went home and threw it in the trash.

Yay for me! Normally, I would say heck no! I paid money for it and it is a sweet afterall...like it or not, you need to eat it.

So here's to more listening to that inner self!

My carnivores!

Hot on the heels of a post by Staci (http://stacischoff.blogspot.com) about "Is your kid a Vegetarian" I had a funny experience with Zachary today regarding, of all things, meat!

First off, I'm so extremely excited. We had order a 1/4 of a beef from a co-worker so that we would get a cheap price for bulk beef and good farm fed, organic beef at that! I grew up eating farm-raised beef from my family's farm and I loved it. It was quite a transition going from that to having to buy beef in the store.

Today was the day that the boys and I ventured out to get the 1/4 slab of beef. We had stopped by a mommy friend's house first and played for a while and had lunch. We took a walk down across her 4 acres to the river across the street. It was beautiful (but a little mosquito-y, which Zachary-the allergic one-was quick to point out!). But at least the boys got some of their energy out and were quiet and asleep on the 1/2 hour drive to get the beef.

Zachary woke up when I was opening the back door of the Jeep to put the meat in. He was so groggy, only having slept about 45 minutes (I took a wrong turn).

He looked at me in that hazy sleep and asked "Momma, what are we doing here?"

Me: "We are picking up our cow, remember?"

Z: (Watching them put 3 large boxes of meat in our truck) "Um, momma, how are we going to make a cow out of that?"

Me: "well, that used to be a cow and then they took it and turned it into meat."

Z: "Oh, okay!"

So I guess it's okay that they took the cow and made it into meat because there was no more discussion about why or how that happens. For that I'm extremely thankful!

From the mouths of babes though...everything is sooo literal. So beware the next time you talk about your meat!

Boys to Men

When does this happen? I mean I know little boys have all the same parts as men, but when and how does this happen?

Lucas Michael last night decided 12:30 am would be the perfect time to wake up. I don't think he's feeling too hot so he wanted to be rocked in the chair. So we rocked, he screamed, we rocked some more, he drank a glass of milk, we rocked some more.

He was laying on his back across my lap. He's 2. And he's on the taller side of a 2 year old so he doesn't exactly fit on my lap anymore. But I love it, so we work with it.

He had lifted up his shirt in that "I'm almost asleep" haze and was playing with his belly button. I though to myself:

Self, you should blog about that. About how he does some things that are so much like yourself!

Then it happened.

My little boy became a "man".

As I watched him half asleep and reminisced about all the wonderful times I've rocked him to sleep, he stuck his hand down the front of his diaper and promptly fell asleep.

Is this ingrained behavior in their little boy brains? Does God make them with the predisposition to sticking hands down the front of their pants? Because Chuck doesn't sit around and do that so I don't think it is a learned behavior. Ah well, I still love him!!! He's just growing up :)

HIV Before and During Pregnancy

In a previous post, I have collected numerous resources on HIV/AIDS related to the grim anniversary of the disease in the United States. However, women who are or wish to become pregnancy have special concerns, such as treatment during pregnancy, awareness of HIV status, and prevention of transmission to the child. Below are several resources which address these topics:

Information for Women:

Why does CDC recommend HIV screening for all pregnant women? - Centers for Disease Control and Prevention

National HIV Testing Resources - database of testing sites

HIV/AIDS and Pregnancy - National Women's Health Information Center; information on HIV drugs in pregnancy, steps to prevent transmission to the child, and paying for care while pregnant

HIV, Pregnancy, and AZT - FamilyDoctor.org; answers to FAQs

HIV, Pregnancy, Mothers and Babies - AVERT; information on planning ahead (including ways to reduce transmission at conception when only one partner is HIV positive), drug therapy, and prevention of mother-to-child transmission

Pregnancy and HIV - The Well Project; information on what to do before you get pregnant, HIV drugs and pregnancy, prenatal tests and delivery

Quick Reference: HIV and AIDS in Pregnancy - March of Dimes

Pregnancy and HIV Disease: Issues that positive women may face when they're pregnant - Project Inform

Technical Information (intended for clinicians, but provides some useful information):

Mother to Child Transmission - AETC National Resource Center; guidelines and clinician support

Perinatal Interventions - Women, Children, and HIV; overviews, clinical guidelines, best practices, policy analysis, and training materials.

Mother-to-Child Transmission of HIV - World Health Organization; general info, data & graphs, recommended readings, and policy advocacy and technical documents

Rapid HIV Testing of Women in Labor and Delivery - Centers for Disease Control and Prevention

Counseling HIV-Infected Patients who Want to Have Children

Technorati Tags: AIDS; HIV; HIV/AIDS; Pregnancy
MeSH Tags: Acquired Immunodeficiency Syndrome; HIV; HIV Infections

A Quarter Century of AIDS - A Collection of News and Resources

Numerous news outlets have been supplying coverage marking the 25th anniversary of AIDS. On June 5, 1981, the Centers for Disease Control and Prevention released a piece in its Morbidity and Mortality Weekly Report publication describing 5 cases of Pneumocystis pneumonia among homosexual men in Los Angeles. These men were later recognized as the first reported cases of AIDS in the United States. The following are news items marking a quarter century of the epidemic and our progress towards controlling it, and consumer health websites providing information on the disease. This is a long list of resources, but they are well worth perusing, even if only a little at a time.

Goverment News & Resources:

• Centers for Disease Control and Prevention
  
  • Pneumocystic Pneumonia - Los Angeles - the original U.S. report, from Morbidity and Mortality Weekly Report
    
  • Twenty-Five Years of HIV/AIDS - United States, 1981-2006 - Morbidity and Mortality Weekly Report
    
  • Evolution of HIV/AIDS Prevention Programs - United States, 1981-2006 - Morbidity and Mortality Weekly Report
    
  • Achievements in Public Health: Reduction in Perinatal Transmission of HIV Infection - United States, 1985-2005 - Morbidity and Mortality Weekly Report
    
  • CDC HIV/AIDS
    
  • HIV/AIDS - National Prevention Information Network, info for professionals on guidelines, surveillance, outreach
    
• AIDSinfo - info on guidelines, drugs, clinical trials, vaccines, and health. Includes the AIDSinfo Glossary
  
• 25 Years of AIDS Research at NIH - National Institutes of Health
  
• Drug Abuse and HIV - National Institute of Drug Abuse
  
• Office of National AIDS Policy
  
• Morbidity and Mortality Weekly Reports on HIV/AIDS, 1981-2006
  
• In Their Own Words: NIH Researchers Recall the Early Years of AIDS - National Institutes of Health
  
• NIH Commemorates 25 Years of AIDS Research: Timeline - National Institutes of Health
  

Mass Media:

• Newsweek (special series)
  
  • How AIDS Transformed a Nation
    
  • The Crisis in Black America
    
  • A Challenge for Black Leadership
    
  • A Tale of Two Indias
    
  • The Life of a Virus Hunter
    
  • Bill Clinton: Fighting the Plague
    
  • Melinda Gates: The Virus and Women
    
  • Rwanda: An HIV Survivor's Story
    
  • Timeline: 25 Years of the AIDS Epidemic - includes photos
    
  • Photo Gallery: The Faces of HIV Today
    
  • AIDS and the Arts: A Lost Generation
    
  • Magic's Message
    
  • South Africa: Zuma Trial Hurts AIDS Fight
    
  • Living with HIV: A Teenager's Diary
    

• PBS Programming
• Timeline: 25 Years of AIDS - Frontline
  
• AIDS Continues to Shape U.S., World Policies - NewsHour
  
• The AIDS Crisis - NewsHour
  
• Brazil: A Model Response to AIDS? - NewsHour
  
• Frontline: The Age of AIDS - watch the full program online, also additional info, features, and links
  
• Ending AIDS: The Search for a Vaccine
  
• South African Diary: Living with AIDS - Frontline
  

• NPR Programming (listen online):
  
  • Diagnosing AIDS: A Pioneer Reflects - Weekend Edition
    
  • Stemming the Worldwide HIV Epidemic - Talk of the Nation
    
  • New Committments Urged on Global AIDS Fund - All Things Considered
    
  • U.N. Report Puts Global HIV Infections at 38 Million
    
  • My Mother, The HIV Patient - All Things Considered, Youth Radio
    
  • Epicenter of AIDS is Found: Africa, 1930 - All Things Considered
    
  • Out of Hiding, Into the World: Thembi's AIDS Diary - All Things Considered
    
  • AIDS Drugs Bring Hope and Challenges - All Things Considered
    
  • AIDS Deaths Disrupt Family Relationships in Uganda - All Things Considered
    
  • The Discovery of AIDS, 25 Years Later - Talk of the Nation
    
  • The Changing Face of AIDS, 25 Years Later - Talk of the Nation
    

U.N. Strengthens Call for a Global Battle Against AIDS - New York Times

AIDS, at 25, Offers no Easy Answers - New York Times

The State of AIDS, 25 Years After the First, Quiet Mentions - New York Times

Spread of AIDS is Slowing, UN Report Finds - New York Times

Circumcision Studied in Africa as AIDS Preventative - New York Times

Fight AIDS at a Store Near You: New Products Among Funding Sources Discussed at U.N. Meeting - Washington Post

U.N. Group Sets Compromise on AIDS Policy

Progress for Some, Hopelessness for Many - ABC News

Viewpoints: AIDS 25 Years On - BBC News

25 Years Into it, AIDS has a Face for Many of Us - Tennessean (Nashville)

Organizations:

AIDSAction

The AIDS Memorial Quilt

amFAR - The Foundation for AIDS Research

Black AIDS Institute

Broadway Cares/Equity Fights AIDS

Elizabeth Glaser Pediatric AIDS Foundation

Global AIDS Alliance

Human Rights Watch - HIV/AIDS and Human Rights

International AIDS Vaccine Initiative

KNOWHIVAIDS.org

Latino Commission on AIDS

National AIDS Fund

National Minority AIDS Council

National Association of People with AIDS

National Catholic AIDS Network

Student Global AIDS Campaign

UNICEF - HIV/AIDS

United Nations Development Fund for Women - Gender and HIV/AIDS

Health Information:

National HIV Testing Resources - search for a testing site near you and get answers to frequently asked questions

MedlinePlus: AIDS

AIDS-related Cancers - National Cancer Institute

Women and HIV/AIDS - National Women's Health Information Center

AIDS and HIV Questions and Answers - Planned Parenthood

HIV and AIDS - KidsHealth.org

HIV/AIDS Questions and Answers - Centers for Disease Control and Prevention

HIV Infection: The Basics - JAMA Patient Page

How to Use a Condom - American Social Health Association

How Do People Get AIDS? - KidsHealth.org

Living with AIDS - MedlinePlus

AIDS Medicines - MedlinePlus

AIDS and Infections - MedlinePlus

Your Rights as a Person with HIV Infection or AIDS - U.S. Department of Health and Human Services

Other:

AIDS Media Center: Global AIDS Resource for the Media

AIDS: The First 25 Years - AIDS Clinical Care journal

Face of AIDS: Global AIDS Film Archive

United Nations Development Programme: HIV/AIDS

World Bank: HIV/AIDS

Kaiser Network Daily HIV/AIDS Report

HIVInSite - current HIV/AIDS info

HIV and AIDS: History, Pictures, and Posters - AVERT

The History of AIDS

History of the AIDS Epidemic

AIDS clinical trials

HIV Infections clinical trials

HIV Vaccine clinical trials

Local HIV/AIDS Service Organizations in the U.S.

The HIV-AIDS Pandemic at 25: The Global Response - New England Journal of Medicine

AIDS at 25: The Timeline of an Epidemic - GlaxoSmithKline

Note: Locally, Vanderbilt is conducting HIV vaccine research - Vanderbilt HIV Vaccine Research Program

Technorati Tags: AIDS; HIV; HIV/AIDS
MeSH Tags: Acquired Immunodeficiency Syndrome; HIV; HIV Infections

Off Topic: An Open Letter to the Nashville Rage

I appreciate the Rage's coverage of libraries and librarians in the current issue. However, I should point out that working at a bookstore does NOT make someone a librarian, as the caption to the Becky Callaway picture currently suggests on your home page. Becky may well be a librarian by training, and librarians are certainly taking on non-traditional roles in increasing numbers. However, not everyone who works in a bookstore (in fact, most of them) or a library is a "librarian." Librarians have masters degrees in their field, with advanced, specialized training in information organization, retrieval, and provision. Working around books does not a librarian make, much like working in housing construction does not make one an architect. I suggest this page of the Department of Labor's Occupational Outlook Handbook for a more complete description of the profession. It's unfortunate that you were unable to make this distinction and profile any of a number of librarians in the Nashville area in conjunction with your themed issue. Perhaps this is why other news outlets employ librarians to assist in background research for articles.

Rachel, MLIS (rockin' the sexy librarian look)

Update: I received a prompt, appropriate response back from the Rage, indicating that they would have the web folks fix the caption.