Seattle Mama Doc

Verbatim: Pink Ones, White Ones, Good Ones

PinkWhiteExam room 3. Me at the computer, a 16 year old patient sitting on the exam table. We’re discussing her starting oral contraceptive pills for birth control. After her exam and a lengthy discussion, we talk about the pink ones, the white ones, the row of green ones, the ring, the depo shot, and the patch. I’m reminded of my mentors in pediatric gynecology who taught me that if you choose birth control that a girl is interested in trying (if it is the appropriate dose and safe for her) often her compliance in using it improves and her reports/experiences of side effects lessen. Translation: girls are more likely to take the pill correctly and continue to take it if they are motivated to use it. A dangerous reality when it comes to marketing directed at teens. But a good reality if you’re working to help teens avoid unwanted pregnancies. She has her mind set on the pill. I move on to the choice of what pill she has in mind, if any. I uncover concrete sincerity. One of the best responses to my question yet.

Me: “Is there a particular birth control pill you want to start with?”

My patient: “A really good one.”

Hopes, Dreams, And Predictions

Twenty Ten, Two Thousand Ten. However you say it, we have arrived. Welcome back to school days. The rigor of productivity. We had the tantrum of the century this AM at our house which we’ve decided to include in our new in-home, Swanson special list of “mega-tantrums.” In medicine, mega is inserted into terminology as if to clarify like in, “mega meatus.” Translation: a big meatus. Re-entry to real life is mega-tough stuff. In the hope that we can continue to live out our previous week’s break from the route schedule that is upon us, I’ll hit rewind and go back 3 days. Read full post »

The Juggle: Working And Breastfeeding

ShadowA study in Pediatrics highlighting the importance of breastfeeding and the challenges for working moms was published earlier in 2009. Today, it circulated through a business journal and got some more attention.

I read the study today for the first time. Then I re-read it a number of times. I talk about breastfeeding with moms and parents in clinic on a daily basis. I certainly know the challenges of trying to breastfeed through a transition back to work. I also know how hard it is not to be able to do what you set out to do.

I had my go. With my first son, I saw about 9 lactation consultants in the first week. I am not exaggerating. Me with those women hovering over me trying to help while my little man screamed his head off. The beginnings of motherhood. I breast fed, finger fed, pumped breast milk, finger fed, breast fed, then pumped my way into a sleepless oblivion. Read full post »

Magic

magicSometimes good health feels like magic.  Lately more than ever.  I’ve had a number of friends and family diagnosed with serious medical problems and medical set-backs in the last few weeks.  Like patients that I have been fortunate enough to care for with serious illness, it scares me, makes me sad, sometimes wakes me up at night. These episodes in illness are disorienting to the order of things. These diagnoses, uncertainties and realities are especially weighty this month amidst bags of gifts, holiday music, lit trees, and piped-in joy. Fear amidst cheer. Ultimately, these diagnoses and fears feel really real and make the rest of life blur. I suppose I just feel more angular, vulnerable and then compassionate right now. Ever-aware of the good health that surrounds me, too. Perspective defined. Read full post »

Another Day, Another H1N1 Recall

OuchlessOuch. Another recall. But this time for the ouchless shot, the nasal mist H1N1 vaccine. The CDC announced last night that there is recall of about 4.7 million doses of nasal spray H1N1 immunizations. These are nasal spray vaccines used in children (and adults) over the age of 2 years. This is just a set-back in protecting our country (and the globe) from the harms of H1N1. No, not a safety concern. Not conspiracy. Rather, a concern that doses are losing potency over time. Think shelf-life. The issue or concern is that these shots may not have the potency level we want over time to remain effective. It’s like that old watercolor you made for your mom in 5th grade fading in the sun.  Or when you run out of Kool-Aid mix and you stretch it to make more.  The worry is these doses may be less effective with time. Read full post »