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Fact Check

I Want Data: Pregnancy When You Have A Rare(ish) Disease

By February 29, 2016 No Comments
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“Can’t you just look at the monitor and tell me when to push?” I asked my nurse. “I feel like I need more data to tell me whether or not I’m getting any closer to having this baby.”

I had been pushing for more than three hours and the epidural left me with little physical data about how my contractions were progressing. After what seemed like an eternity, my nurse looked at me and said “How’s this for data?” She then picked up the intercom and announced “Delivery Room 3.” Soon a sea of medical personnel showed up to help deliver my baby.

As a scientist, I like to have information. This was especially true when I was in active labor, but my quest for data on pregnancy and childbirth actually started about a year earlier. My husband and I are both scientists, so we tend to approach things systematically and with data in hand. So when we decided it was time to start a family, I started to look for information.

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Categories: Chronic Illnesses + Conditions, Pregnancy, Birth + Family Planning

Is Monsanto Behind Cases of Microcephaly in Brazil?

By February 17, 2016 12 Comments
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I am a medical doctor and professor of public health, and I am also the father of a beautiful daughter and uncle to the world’s best niece.  We also live in Rio de Janeiro, Brazil.  We are being inundated with information and misinformation about Zika and its correlation to microcephaly.  There is a lot of fear, which is the perfect environment for people to spread false information.

When I saw friends sharing an article based on fear and not facts, I knew I had to comment due to my background.  If you have not seen this article, you can read it here, but it claims the reported increase in microcephaly in Brazil is caused not by Zika or any other virus, but a larvicide called Pyriproxyfen.  Larvicides are used to kill mosquito larvae and since Zika is spread by mosquitoes this bit of misinformation could cost lives.

The article references a mysterious document purportedly written by “Argentine doctors.” The organization that undersigns it is the “Red Universitária de Ambiente Y Salud”, which is a loose affiliation of individuals dedicated to fighting the use of pesticides, agrotoxics and the like. Perhaps the biggest clue that the information in the document is not trustworthy is that the name of larvicide called into question is repeatedly spelled wrong throughout.

I will address the claims made in the executive summary of the document point by point.

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Categories: Ages + Stages, Chronic Illnesses + Conditions, Disability + Disability Advocacy, Infectious Disease + Vaccines, Newborns + Infants, Science 101 + Mythbusting

Can Bleach, Turpentine or Miracle Mineral Solution Cure Childhood Ailments?

By February 16, 2016 4 Comments
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Would you ever consider swallowing bleach or turpentine? What about giving yourself an enema with bleach? To most of us this sounds horrible, but a small group of well-meaning but terribly misguided parents is choosing to feed their children these toxic substances in hopes of curing everything from the common cold to autism.

While small amounts of bleach can get your white clothes white, and turpentine can strip paint and varnish off furniture, no adult or child should ever ingest either of these substances in any form. As a pediatrician and a parent I can’t imagine ever feeding my child or a patient bleach or turpentine. I’ve struggled to understand why any loving parent would ever feed them to their children.

What’s most concerning about this trend for me is that parents are doing this because they believe bleach or turpentine will cure their children.  In addition many parents mistake the signs of significant damage (chemical burns, shedding of the intestinal lining, lethargy etc…) as signs that the bleach and turpentine are effectively ridding their child’s body of ‘toxins’. In fact it’s just the opposite.

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Categories: Accidents, Injuries, + Abuse, Disability + Disability Advocacy, Science 101 + Mythbusting

Zika and Pregnancy: What You Need to Know

By January 19, 2016 2 Comments
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The Zika virus has been in the news a lot lately because it’s been linked to a cluster of cases of microcephaly in Brazil and Columbia. Microcephaly is a rare birth defect where the fetus’ brain does not develop fully in utero, and as a result, the baby is born with an abnormally small head and multiple neurological disorders.

Public health officials have been aware of Zika for decades, however, it was only believed to only cause mild flu-like symptoms with few, if any, lasting negative outcomes. The virus is spread by mosquitoes and recently cases as far north as Mexico, Hawaii and Puerto Rico have concerned public health officials in North America.

On January 15, the Centers for Disease Control and Prevention (CDC) issued a level-two travel alert for Latin America and the Caribbean, with a special note for pregnant women to avoid those areas. Since then we’ve been asked about Zika by a number of readers. We reached out to Dr. Waleed Al-Salem, a tropical medicine specialist and father based in Liverpool, England, to have him answer your questions.

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Categories: Ages + Stages, Chronic Illnesses + Conditions, Disability + Disability Advocacy, Infectious Disease + Vaccines, Newborns + Infants

Just Because You Disagree, Doesn’t Make it Child Abuse

By January 11, 2016 1 Comment
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Humans are terrible judges of risk.  We are all awful at it, and it’s not our fault, our brains are hardwired to struggle with risk.  In addition, our risk thresholds are all different.  For example, there is a pine tree in our neighborhood that kids love to play under.  One mother won’t allow her daughter to touch the needles out of fear that she’ll prick herself and will then be afraid of the tree.  I’m OK with my son touching the needles on the tree.  I’ve judged the risk that he will injure himself and the associated trauma as low, and the other mother has judged the risk of injury and trauma as high.

Neither of us are right and neither of us are wrong.  Neither of us are bad parents.  Neither of us love our children any less than the other.  We’ve each simply made an assessment of risk and our threshold is different.

When I told a friend about the pine needles her response was, “that’s child abuse.  She’s not letting her have a full childhood, she’s teaching her kid to live in fear of nothing.”  The other mother may have been what others consider to be over protective, but it was far from child abuse.

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Categories: Accidents, Injuries, + Abuse

Recent Reports of Skin-to-Skin Benefits Fail to Mention Key Infant Safety Risks

By January 5, 2016 1 Comment
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Last week, news of a recent study trickled  across my newsfeed, touting the benefits of skin-to-skin contact with infants. That study, published online by the American Association of Pediatrics,  presented evidence in support of Kangaroo Mother Care (KMC), which is a method that involves infants being carried and held with prolonged skin-to-skin contact (S2S).

As is often the case, though, the mainstream media picked up the story and ran with it, touting the potential benefits of the practices, while making no mention of any risk. But there are risks – and I believe a parent needs to be aware before putting the practices into place.

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Categories: Accidents, Injuries, + Abuse, Ages + Stages, Newborns + Infants, Science 101 + Mythbusting

Your ‘Stomach Flu’ Isn’t a Real Thing, You’ve Caught Something Much Grosser

By December 16, 2015 2 Comments
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The stomach flu isn’t a real diagnosis – there’s no such thing.  I remember finding that out as a kid and being confused; after all, everyone around me had had it at one point or another. How could everyone be wrong? We’ve all used this term at some point to describe an illness that’s forced us to pray to (or sit with) the porcelain gods. However, it turns out it’s one of those generational quirks of language that’s been passed down, and it’s not founded in science.

The viruses or bacteria that we attribute to “the stomach flu” are very real, however, as I can tell you from personal experience.  There’s just no such thing in epidemiology as a family of viruses or bacteria called “the stomach flu.”

Let’s start off by defining what the flu is. “Flu” is short for influenza, which is a viral infection that affects your respiratory system, namely your nose, throat, and lungs. Symptoms include coughing, congestion, fever, and muscle aches. According to the CDC, there are 3 types of influenza viruses: A, B, and C. The seasonal flu is typically an A or a B type, and it runs in cycles that are heavily skewed to wintertime in the United States. The C type is considered milder, and isn’t seasonally dependent or the type that’s a cause for epidemic concern. All three types are spread through contact with an infected person’s respiratory secretions, meaning contagious droplets of water that you inhale or get in your eyes, nose, mouth, when an infected person talks, coughs, or sneezes around you. Ewwwww.

The stomach flu, on the other hand is what we colloquially call a variety of digestive-related illnesses that involve distressing gastrointestinal symptoms (i.e. vomiting, diarrhea, stomach cramps, etc.) combined with malaise, and a low-grade fever, when in reality it’s a form of gastroenteritis (“gas-tro-enter-EYE-tis”). Gastroenteritis is caused by viruses and bacteria (and rarely, parasites) that infect the digestive tract, none of which are members of the influenza family.

I repeat: the “stomach flu” is a virus or bacteria that has much grosser consequences, and is not at all related to influenza.

Viral gastroenteritis is the most likely culprit when it comes to most of the so-called “stomach flus,” and it’s typically the result of one of two groups of viruses: Noroviruses or Rotaviruses.  And, ick alert: you typically catch it from direct exposure to an infected person, exposure to infected fecal bacteria (poop), or exposure to things cross-contaminated by fecal bacteria like food that’s been handled by contaminated hands, since it’s so hard to completely sanitize against, as any Celebrity Cruise worker can tell you.

Grossed out yet?Norovirus flu FINAL

A read-through of this horrifying in-depth article from
National Geographic on

the science of the Norovirus
describes how it causes your body to become a walking germ factory; how hard it is to kill it on surfaces including your own skin, and how easy it is to infect those around you as you’re purging liquid from your intestinal tract cells at a rapid rate, and loading up each gram of your diarrhea with five billion Noroviruses. You read that right. Five billion. As for the infectiousness of your vomit? I’ll just leave this article on a the Norovirus Vomit Machine here. I can’t even.

Horrors of science aside, viral gastroenteritis is rotten because in addition to the symptoms listed in our handy-dandy graphic in this article, it’s completely exhausting and there’s nothing you can do other than rest, stick with eating what you can hold down, which may or may not include the once-heavily recommended B.R.A.T. diet (Bananas, Rice, Applesauce, and Toast) to coax your stomach into digestion,  and to stay as hydrated as possible. Dehydration is the danger zone of these type of illnesses, which is where gastroenteritis can turn from miserable to deadly. It’s essential to replace liquids lost from loose stools and vomiting. For parents of kids who have had this, I’m sure you’ve had the hard task of trying to pressure these foods and liquids into your child who is exploding from both ends, and feeling like it’s all a waste because it’s coming back out as quickly as its going in. I’m sorry. You’re doing the right thing, though, since nutrients and liquids are critically important to maintain during these illnesses.

Norovirus

The Norovirus: Courtesy of the CDC

In my recent experience, I went to my local emergency room five days after my symptoms began, but only after I started to have heart palpitations and an unbearable case of heartburn. I managed to stay hydrated as I’d choked down an entire Pedialtye (ack!), but I was wrecked. The doctor attributed my illness to a nasty case of Norovirus, which is circulating in the San Diego area again, but he said those extra symptoms were actually from exhaustion and hunger – I needed more nutrients and rest. How could I get more nutrients if nothing was sticking in my stomach? I asked him. He said to keep eating anyway, since “your body has to finish shedding the diseased lining of your intestines for all of the purging to stop.” Fabulous, right?

Here’s the problem with waiting it out, however. You shouldn’t make the call to simply rest and switch to a BRAT-like diet on your own for you or your children and wait for the symptoms to pass for more than a day or two. Rest, hydrate, and bland diet, yes. However, viral gastroenteritis and bacterial infections (i.e. c.diff., salmonella and e.coli) that affect the digestive tract can initially look the same, be acquired through the same channels (contaminated food, etc.), but can’t be treated the same way.

You must treat the bacterial infections because they don’t just “run their course” without having massive impacts on you or your child’s system – and you likely need medical intervention like antibiotics to make them stop in a timely manner. Below are threshold recommendations per the Mayo Clinic, but your family physicians may have other guidelines so we urge you to contact them first:

Seek immediate medical care if in addition to the previously mentioned symptoms of malaise, stomach cramps, vomiting and diarrhea, you or your child havethe following symptoms:

Adults:

  • You’re not able to keep liquids down for 24 hours
  • You’ve been vomiting for more than two days
  • You’re vomiting blood
  • You’re dehydrated — signs of dehydration include excessive thirst, dry mouth, deep yellow urine or little or no urine, and severe weakness, dizziness or lightheadedness
  • You notice blood in your bowel movements
  • You have a fever above 104 F (40 C)

For kids, seek medical care if they:

  • Have a fever of 102 F (38.9 C) or higher
  • Seem lethargic or very irritable
  • Are in a lot of discomfort or pain
  • Have bloody diarrhea
  • Seem dehydrated — watch for signs of dehydration in sick infants and children by comparing how much they drink and urinate with how much is normal for them

For babies seek medical care if they:

  • Have vomiting that lasts more than several hours
  • Haven’t had a wet diaper in six hours
  • Have bloody stools or severe diarrhea
  • Have a sunken soft spot (fontanel) on the top of his or her head
  • Have a dry mouth or cry without tears
  • Are unusually sleepy, drowsy or unresponsive

As always, self-diagnosis is not the way to go when you’re dealing with an illness, particularly one that’s this high-impact – consult your physician or child’s pediatrician for an exam and testing if you have any of the above symptoms and have a concern about you or your child’s well-being. And remember, until you do, hydrate, eat, and rest as much as you can!

For illness spreading and prevention tips, see this helpful guide.

 

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Categories: Infectious Disease + Vaccines, Science 101 + Mythbusting

None of Us Are Above the Placebo Effect

By December 15, 2015 No Comments
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This is Weber’s Vitamin E Cream.  I put this stuff on everything.  I use it on my lips, on dry skin, on minor cuts and abrasions, I use it instead of regular moisturizer on my hands and legs.  It’s only available in Canada and whenever I go home, I stock up, because I consider it a necessity.  I swear when my kids are grown and they’re reminiscing about all the weird stuff that mom used to do, Weber’s Vitamin E Cream will be at the top of the list.

Does it work better than other products on the market?  Probably not.

Is there some sort of magical ingredient?  Nope.  If you look at the ingredients, it’s essentially petroleum jelly and vitamin-E.

So why do I use it?  Because I think it works, even though there’s no evidence that it works any better or worse than anything else.  It is my placebo and I’m OK with that. 

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Categories: Faith + Beliefs, Science 101 + Mythbusting