Posts Tagged ‘diagnosis’
Recent events have left me pondering a topic that I have tried to avoid discussing due to its controversial nature – abortion. But, I feel I should put down some of these thoughts as it might encourage a discussion of it.
Abortion is a highly emotive topic and one that cannot be entered into lightly. I have never had to face the issue first-hand and I really thank God that I have never been put in that position. But I know people who have. None of them, however, chose abortion. I only know second-hand about their own feelings. Since I have not known anyone personally who chose abortion, I cannot present their side.
I know women who do choose abortion have their reasons for doing so, and I know the anti-abortion activists have much to argue against in that. However, I am not here to preach either side. I am not the one to live with the consequences of the decision these women make.
The point I do want to make is that women shouldn’t be forced into one decision or another. The pro-choice advocates would cheer for that, but I don’t think they get the point, either. It seems the general public only hear about women being coerced (by various groups) into keeping their child. They don’t hear about women who are bullied into having abortions.
Three women of my acquaintance have had to face the “choice”. All three were in stable marriages, so the situation is rather different from the young unmarried mother. One was much older and couldn’t face the idea of having another child late in life. Furthermore, she was getting very sick from the pregnancy. She didn’t know what to do and chose to wait it out. The decision was eventually taken out of her hands when she miscarried.
The other two discovered that their foetuses had birth defects. One was in her early twenties, the other in her late thirties. The younger one couldn’t and wouldn’t believe the diagnosis, but the older one realised it was due to her age. Both were very religious, though they adhered to different religions and different theological beliefs. That may have contributed to their decision not to have an abortion.
What distinguished these two from the first one was that their doctors continually advised them to have abortions throughout the pregnancy. They were both made to feel as if their opinions and beliefs were insignificant. In this day and age, this is unforgivable in the medical profession. The prognosis for the first child was extremely poor, the second barely less so, but this did not excuse the behaviour of the medical team. By the end of the pregnancies, the doctors were forced to accept that they would be delivering either a stillborn or a child expected to die.
Both sets of parents were prepared for all eventualities. The first was able to hold her child as he took his last breaths, the second delivered a stillborn daughter. Neither regretted their decisions. They were able to carry their child to term, felt all the movements the child made and developed a bond for the unborn, and then grieve a natural loss.
These women were able to stand up to their doctors and make their own decisions. But, how many other women are coerced into having abortions? How many of them regret it?
It seems not a day passes that you don’t read something about autism. Data states that one in 100 have some form of autism. Though I will not deny that autism exists, it seems everyone has some form of it, such that anything and everything can be excused because of it. It has become a scapegoat for people’s problems. Minor social dysfunction is attributed to autism. What ever happened to the day when someone can just say they have difficulty with social interaction, rather than be classified as a disorder? Can’t we leave these diagnoses to the most severe and obvious cases?
There is so much debate about the importance of having a diagnoses. It is important when there is clear and defined treatment and there are objective data to follow to assess the effectiveness of treatment. For example, blood pressure can be checked, treated, rechecked. Similarly, diabetes can be measured and treated. Less obvious, but still treatable are psychiatric diagnoses such as severe depression. Milder forms fall into those borderline categories because most normal people will experience highs and lows in their life.
But anxiety and depression are no longer the fad diagnoses. It’s autism. I’ll bet everyone who was formerly diagnosed with ADHD, social anxiety disorder, borderline personality disorder, etc., is now being redefined and re-diagnosed as having some form of autism. Is there really any objective measure – a specific gene defect or some biological marker that can be used to diagnose this? If not, what will the next fad diagnosis be?
Now, I know that there are no biological markers for such things as severe depression and schizophrenia and such, but anyone who has been around such people can clearly say something was wrong. Schizophrenics go into phases when they are not normal (of course, many sane people can easily mimic them, but that’s not the point – normal people don’t do it unless they are trying to be manipulative for some reason). Major depression occurs without an inciting event, such as grief. These people cannot understand why they are so depressed and are helpless to improve their moods. Though there are no objective measures, science has been able to identify certain hormones involved in these mood disorders.
But, what about autism? All we have are a set of behavioural disturbances. In severe cases, they appear somewhat retarded. But mild cases where people are high-functioning, how can they really be classified as autistic? Why isn’t it some form of mild retardation? Why isn’t it just severe social anxiety? Why isn’t it just normal but extreme shyness? And is there really any “treatment” for these cases? No! It’s just ridiculous. I have a big issue with it because if I’m not careful, my children might be considered autistic and I know they are not. I will go out of my way to point out their lack of social interaction and will not hide behind silly scapegoat diagnoses.
I often get headaches for the few days surrounding my cycle, but I don’t believe I truly suffer from menstrual migraines. Yet, I do believe that some of those headaches are migraines and a few may be related to the menstrual cycle. However, I do not suffer from the regularity of true menstrual-related migraines.
Menstrual migraines are believed to be associated with the drop in estrogen that is seen at the end of a monthly cycle (and the beginning of menstruation). It can start anytime from about 2 days before the flow of menses and end a few days after. Migraine sufferers may only experience these headaches around their cycle, while others may have their migraines exacerbated by it. Yet, inexplicably, others may experience migraines outside this relationship.
Symptoms of menstrual migraines are similar to any other migraines. Some experience auras while others may not. The headaches are usually one-sided, though it may spread to the other side, and are usually described as pounding. The severity differs from individual to individual and episode to episode, but it can be quite severe. Other associated symptoms, such as visual disturbances, nausea/vomiting, dizziness, and confusion may be present.
I do get migraines and most of the time, I get the nausea/vomiting/dizziness more than the headache. It can be quite incapacitating. These migraines are usually triggered by some kind of stress, but sometimes the only “stress” I can identity is the start of the cycle. That is why I believe some of them are menstrual migraines. However, because I do not get them every month, I do not consider myself one of those who have a true diagnosis of menstrual migraines.
I make this clarification because in recent years, menstrual migraines have been getting public attention, especially when drug companies are trying to market medications for the treatment of such things. I am not a pill pusher and do not like the idea of taking a pill for anything and everything. However, I am not averse to taking some Tylenol for pain occasionally.
I may not get migraines, but I often get headaches around my cycle. I attribute this to the tightening in the muscles in my upper back and shoulders as a result of cramping. I know this must be the case because I can feel the tension as I do neck exercises to work it out, or when I massage myself and can feel the pain in the muscles from the scalp down to the upper back and shoulders. I just wish I had more willing masseurs. It’s hard to reach back and give yourself a massage without causing other parts of your arm to go sore.
Headaches are common, but it’s surprising that menstrual migraines are also very common amongst women. It may explain why migraines are much more common in women than in men.
One of my most common complaints, though not a serious health issue, is constipation. Now, I realise that to actually have a diagnosis of constipation it should be a change in bowel pattern, such that it is not normal to myself. Everyone’s bowel habits are different – some go twice a day, while others may not go more than once a week. I fall somewhere in between, but there are other symptoms I suffer when I know I have constipation. One of those symptoms is bloating. And last night was one of those severe nights of bloating.
I was unable to sleep because every position was uncomfortable. I felt I needed to vomit to release everything inside my stomach. The stretching of the bowels was painful and as I rubbed my belly for comfort, it felt like I was distended from pregnancy. A large, loud burp relieved some of the pain and distention, but immediately, it would build up again. I had to sit, leaning forward to ease some of the pain.
In the past, I would turn to liquid antacids for relief. It did not always help and for many years, I have taken nothing. Yet, last night I was wishing for some. I had to turn to a peppermint lozenge. Why? Because I know that mints are one of the no-nos for people who suffer from acid reflux. (It may be that I have a problem with acid reflux due to my love of mints, which may be the culprit for all this bloating.) However, I understand that the mechanism of action is that mints lower the pressure in the lower esophageal sphincter, that muscle that separates the end of the esophagus and the stomach. This muscle relaxes in order to allow food to enter the stomach and contracts to prevent food from returning to the esophagus. Mints act to relax the muscle, which exacerbates acid reflux. However, I felt I needed it to relax to release all the trapped air. Whether or not it worked, or whether the gas finally dissolved on its own, I cannot say. But, I do know that eventually, I felt sufficiently comfortable to return to bed.
Now, I’ve tried to identify the triggers for the bloating, but it never is constant. I can be eating the same thing day after day and not have a problem and then bang! I’m bloated. The one thing I can associate it with is constipation. If the bowels are blocked up at one end, gas cannot pass through that end. So, when I feel bloated, I try to burp. Excessive burping warns me that my bowels are blocked.
People may not find passing gas very pleasant, but it is a necessary and vital part of life. Kids love it, though – they think it’s hilarious. Now, one should be careful not to encourage them to fart too loudly in public or amongst crowds, but one should not discourage them from relieving themselves when necessary, either. They should do it tactfully and others should tactfully try to ignore it.
Is bed-sharing harmful to babies? According to experts, it may be. There has been much concern about crib dead and they blame some of it on bed-sharing or sofa-sharing. They point out that the babies at greatest risk are those of low birth weight, have respiratory problems, or if the parents smoke or drink alcohol. Of course, their advice does make sense. However, the babies at highest risk of crib death from bed-sharing also seem to be those at highest risk for crib death in any sense. So, does bed-sharing really make a difference?
I will not go against medical advice in suggesting that it is OK, but even the experts say that a blanket warning to parents is not appropriate. I will say that we shared our beds with our babies and they did not suffer from it. Of course, they were and are healthy babies and we do not smoke or drink. Therefore, we were at low risk to begin with. I will not say that it was the most comfortable situation all the time, but we are no worse for wear.
There is still no explanation for much of sudden infant death. When it first came to light, there was suggestion of child abuse. Later, it was found to be much more mysterious, but sometimes showed signs of abuse from suffocation or “shaken baby”. As it received more coverage, attention turned towards diagnosing some undetected physical problem. So, we ended up with some heart and lung defects that can cause babies to suddenly stop breathing – called apnea. Other causes came to light, such as reflux. However, reflux came about (sometimes) due to medications given to treat apnea. But, people forget that many of these physical conditions had been around even before SIDS or crib death came to attention. Children born with birth defects were monitored carefully and if they did suffer negative consequences, it was not classified as crib death because there was a known cause for it. SIDS was a diagnosis given to those babies who died under mysterious circumstances.
Those circumstances remain mysterious, although multiple hypotheses have been forwarded. Some say that babies sleeping on their stomachs may accidently suffocate when they roll their heads into their pillows and cannot roll them away again. Or, when they roll their heads they compress arteries in the next that supply the brain. Prior to this, it was recommended that babies sleep on their stomach because they breathe better that way. The current recommendation is to keep them on their sides. Other hypotheses include the presence of bacteria due to a change in the manufacturing of crib mattresses, excessive mucous in the nasal passages. Other hypotheses include many medical conditions. But, again, if there is a medical explanation for the death, it would not be classified as SIDS. Until they can connect all the crib deaths with some distinct explanation, we will never know the real cause of SIDS. Perhaps, what is classified under the umbrella of SIDS may be more than one condition. But, surely, we should be able to start grouping these deaths into categories. Statistics suggest that thousands of babies die of crib death every year. Could there be that many different diagnoses to explain all these deaths in the end?
So, if we do not know the cause of crib death, what can we do to prevent it? Really, there is nothing that can guarantee our children’s safety. However, if expert advice does not sound harmful in any way, then it would be appropriate to follow it. If it goes against any of our fundamental beliefs, then it might be best to discuss it with the doctor before going against medical advice. But, what about bed-sharing? It is an individual decision and should be discussed with the doctor or midwife. Of course, if a parent crushes their child, causing suffocation and death, it really is not crib death, is it? It would be accidental death or neglect.
Professor Stephen Hawkings is ill and in hospital. He has been living with ALS for 40 years and one wonders if he is finally succumbing to it. Amyotrophic lateral sclerosis (ALS) is a neurological disease that affects motor neurons, the cells in the spinal cord that receive and transmit messages to the brain and back to the muscles. These cells degenerate and die. In the majority of cases, the cause is unknown. ALS became widely recognised in the US when the famous baseballer named Lou Gehrig died from it. It has since been called Lou Gehrig’s disease in the US.
Most people with ALS die within four years of the diagnosis. The fact that Professor Hawkings is still living after 40 years is quite incredible. One wonders if there was some protection conferred due to exercising of the mind and body. Professor Hawkings has continued to live his life without allowing the disease to take over completely. He has managed to accomplish quite a lot in the last forty years. What has he done right? What genetic predisposition has allowed him to last this long? Perhaps, we will never know.
I knew of someone once who was diagnosed with ALS. After four years had elapsed and he did not die as expected, he came to despair and questioned whether he had received the right diagnosis. He and his family had made arrangements and I supposed they worried about the financial responsibilities if he did not die on time. It was rather a sad tale. On the other hand, I had a friend whose father died of ALS only six months after his diagnosis. It happened so rapidly that despite all the preparations, it was still quite unexpected. I think the two should have traded lives.
ALS is a devastating disease but we can all learn from Professor Hawkings’ example. No matter how terrible the diagnosis, we should all try to continue living and learning. Not just sit back and let the diagnosis take over control of our lives. Perhaps, the disease should be renamed in honour of Professor Hawkings.
A mumps outbreak made the news today. It appears that it is occurring at two universities in the north. Health experts are reassuring everyone that the outbreak is contained. They are putting the blame on the fact that when the single measles vaccine was switched to the MMR, not everyone was called back to receive the vaccine. Therefore, they are now seeing an outbreak amongst those in their early 20s. It is unfortunate, since those who suffer complications from mumps are those who are older. Parents who had refused the MMR in recent years due to concerns about autism need to be aware as their children may be at risk for developing mumps as well as the measles outbreak in the recent past.
The virus attacks the parotid salivary glands and sometimes, reproductive organs. The virus is very contagious and is spread through sneezing or coughing. It may take up to three weeks after infection before you show any signs of it, so you may be spreading it without knowing it. A person is contagious from about a week before any signs/symptoms to about a week after the signs/symptoms have shown up. The most common symptom is swelling of the parotid salivary glands giving a person the appearance of stuffing their cheeks. This may be associated with fevers, chills, fatigue, loss of appetite, pain with chewing or swallowing, sore throat, and headaches. Usually, the symptoms are mild and treated with analgesics/anti-inflammatory agents and plenty of fluids – mostly water. You should avoid anything that stimulates the salivary glands as this can cause pain.
Complications are rare but can arise in severe cases. These include deafness, decreased fertility due to inflammation of the testicles or ovaries, meningitis or encephalitis. Pregnant women who are infected may miscarry, but there is no evidence of any birth anomalies.
The best way to avoid getting mumps is through vaccination. It may not be 100% as is the case for contracting and surviving the disease, but it is very close. The MMR has been shown to be effective as well safe.
Doctors usually diagnose mumps through a physical examination. However, if there are complications and it is necessary to establish that mumps is the cause of the complications, there may be blood, urine or CSF (cerebrospinal fluid obtained through a spinal tap) tests that need to be run. It is always best to contact your doctor if you develop symptoms of mumps.