smfinch

Very disappointed in the answer to a very specific question from Casey regarding any available research about the accuracy of a potential prenatal diagnosis percentage. What followed seemed to be a non-answer explaining that doctors really try to get these things right, which of course we all understand and then a patronizing description about how to discuss a potential diagnosis with the doctor. That was not her question. Her question was…how often does research show these diagnosis percentages are accurate. With the prevalence of more prenatal screening, stories like Casey’s are more and more common and I believe the impact of stress on a pregnant mother in these situations cannot be overstated. What I do think is lacking is thorough counseling prior to administering some of these tests, which seem now to be standard, without explaining what they are testing for and why, and consideration on the part of the parents how they might USE this information. My midwife, counseled me by saying “it’s helpful to know what you might feel comfortable doing with this information, and how it might change your decisions”. I neglected any testing other than the 20 week ultrasound bc I knew that was right for me. I realize all issues don’t present as a result of testing…but a lot do. I have several friends who had genetic screening results flagged, sometimes for the possibility of very severe anomilies, only to result in severe anxiety, further expensive work up, and at the end of the day, a healthy baby. It’s a legitimate question to ask about the accuracy of some of these test results or doctor’s analyses given how expensive and life-impacting our care is. IS there research indicating accuracy of potential diagnosis percentages?

I feel very torn about the newborn exposure/kissing recommendation, and I was hoping to see more data on this with regards to physical and mental health outcomes for moms and babies. While a “lying in” period has been common across many cultures forever, that doesn’t necessarily mean isolation for the purpose of avoiding germs. Historically, many cultures will have a woman and newborn rest separately, but with women coming in constantly to care for her; it’s more about bonding and recuperating. In practice, a lot of families are just so involved with those early day demands that they don’t go a whole lot of places…I sure didn’t. But the few places we did go, and the people we did see through visits were a lifeline to me during this time where you feel isolated enough. Post-partum mental health is a real issue here. What I am observing is that a lot of families are just slogging through on their own perhaps with occasional the help of one relative and sometimes not even that. I do think there is a cost to this and I wonder if this message of social avoidance during such an already isolating time is really helping women and babies. I had my baby over 10 years ago and my message from my pediatrician was very different. We were encouraged to “take him everywhere” and enjoy family as our physical needs allowed, using common sense like avoiding people with colds, etc. and I was also told that nursing him would be protective for him, and I was hoping to see some data on how true that is today. He got passed around, snuggled, and yes, kissed. So, while I completely understand that avoiding a spinal tap (yikes) is goal for some people, I do wonder about the cost to our long-term health by avoiding people in a way that I just don’t believe we’ve evolved to do. I feel like if you can demand that I sit in doctor’s waiting room with him at 2 days, 2 weeks, 1 month, etc. etc., then maybe we can socialize with some of our support systems, or take him shopping.

To work with your point here, recommendations are made when they believe the benefits outweigh the risks. It’s also “rare” for bad things to happen during colonoscopies…but they do. Their are risks with the anesthesia, perforating the bowel (one reason they DON’T use anesthesia in Europe as a standard), other bruises and infections, etc. They apparently believe that lowering the age would harm more people than benefit. It’s why it’s super important to discuss individua risks, if they are known, and personal preferences with a doctor who will listen and take them seriously.

When you mentioned that Cologuard and colonoscopies have similar rates of mortality reduction…I took some pause. I do see your reasoning for why that might be the case. But I’m also curious about how we separate out the idea that maybe an individual who takes the time to do ANY consistent cancer screenings might also lead lifestyles that lower colon cancer risk or improve survival outcomes. In addition I’m curious about the true effectiveness of early intervention with colon cancer screenings with regards to preventing distant metastatic cancer. My understanding is that while more effective than say, mammography, colon cancer screening has been more effective at reducing localized colon cancer than metastatic…which is the one that will kill you. I feel like the the elephant in the room is that screening programs, even yearly ones, are not great at catching those really aggressive cancers that unfortunately seem to disproportionately affect young people. This isn’t to say they aren’t important…but I think we are overstating the impact of early detection when we mention younger patients, many of whom are too early to screen, as they are the ones most likely to have really aggressive disease that are unlikely to be caught “early” or don’t respond to treatment. We desperately need other tools to detect and most importantly prevent these cancers. I wonder if cologuard and colonoscopy have similar effectiveness because they typically detect less aggressive disease.

Best answer. Totally agree. I’m team Vacations for Everyone!!!

Please, please, please let the grandparents spoil the grandkids. I grew up with only one grandmother. She spoiled the hell out of us, but she was also “tough” in other ways. She was gone by the time I was 13 and I still miss her and that sense of being the best thing since sliced bread. Grandma’s house is supposed to be a soft place that allows for more indulgence than normal. It gets tough when it’s also a regular source of childcare, as most likely a childcare programs would have more structure/rules. But my personal feeling is that I would never go into a facility and tell them how to run it. I can share concerns, but ultimately, it’s their choice on how to operate. Same for Grandma. Your situation sounds like how my folks and in-laws treat my son. He’s a prince in their house, but he’s still polite and grateful. If it’s affecting his behavior, I’d consider switching gears, while still allowing indulgent grandma time that’s regular, but not as frequent. Do what you think works for you, but I’d try to strike a balance and pick the most important issue, i.e. school, and explain attendance is mandatory at his school and whatever else happens, he’s gotta go, while expressing gratitude that your son has such loving and fun grandparents that spoil him. Remember they raised the woman you chose out of every person in the whole world. Children desperately need as many people in the world that love them and they need them at different stages of their lives. My biggest perk when I married was gaining THREE grandparents from my husbands side, that yes, still spoil my husband (and me!) and also sneak cookies to their great-grandchild.

Hi! 43 years old here with pretty regular, short, periods, but I have been irregularly experiencing an issue where in the second half of my bleed (between day 2 or 3) I experience intensifying pain that feels very ovarian which is followed by an awful sensation of feeling full and bloated a few days. Sometimes the GI distress feels very high, sometimes very low. I have had pelvic ultrasounds which have confirmed the presence, and then later the absence of cysts on both ovaries. I also have been told I had a fibroid, which had “resolved” 3 months later. I have had about 4 episodes like this (every 2-3 months) over the past year and after some imaging and monitoring (CT, repeat ultrasound, physical exam) my practitioner doesn’t seem super concerned or interested. The digestive distress is the most annoying part as it lasts a few days. I understand that they saw cysts…but it it typical to have their rupturing ONLY occur during my period, and with very consistent timing? My only suggestion for management was to try the pill, but I am very hesitant to do that after 10 awful years trying to find the right type for me and experiencing every side effect under the sun. I’d just like to understand what is going on/ who to ask, etc. One positive, is that these episodes are decreasing in intensity and longevity. But I’d still like to know.

I might be in the minority, but I find an increase of 1.45 days, in women with regular cycles, to be significant, when you consider how much individual fluctuation it takes to move this number. I myself experienced an extreme shortening of my cycle with both the initial vaccine series, booster, and one out of 2 known infections (4 days, 7 days, and 12 days shorter, respectively). My period post-infection was also really atypical in terms of heaviness and pain to the point of affecting my day-to-day. My post-menopausal mother experienced bleeding. I have lived my entire life without having any significant disruption to my cycle despite many illnesses, including a very severe flu infection. I don’t find it “scary,” as it was short-lived, but I do find it interesting and I wish we had more research and explanation about the relationship between our immune system functioning and our menstrual cycles. My own doctor experienced a similar phenomenon but really didn’t have much insight into the “why” it happened and most of us just like to understand what is happening with our bodies.