I’m beginning to wonder if belief in NCB and homebirth pseudoscience will be an example of natural selection in action. The increased death rate of homebirth, the increased rate of death and disability associated with withholding vitamin K, the increased death rate of children who are not vaccinated mean that children whose parents believe in pseudoscience have less chance of surviving to reproductive age, weeding out whatever deficiencies led parents to these poor decisions in the first place.
Don’t believe me? Consider Mandy’s story:
I rouse myself enough to grab a diaper, and pull Ryder towards me. There is a puddle of blood on the bed. His umbilical cord stump fell off when he was just six days old, and it hasn’t stopped oozing since. A drop or two of blood each day. We weren’t worried. Now this? It’s like a wound… Starting to panic, I try to gather my thoughts enough to make a plan. We need to go to the hospital. It’s Sunday. This is a lot of blood.
Be sure to take a look at the picture that is helpfully included, showing the bleeding baby and the pool of blood.
There is the usual whining about the evil people at the hospital, then:
But Ryder’s bleeding times are very, very out of range. We’re going to admit him to the PICU. You’re going to speak to a pediatric hematologist and the pediatric intensivist. He needs a Vitamin K shot and a blood transfusion. I’m sorry.” The bed shook with my sobs. I held Ryder so tightly. They were going to have to start an IV. Another needlestick. They needed to draw more blood. My poor, sweet baby. This isn’t fair. This isn’t fair.
You bet it isn’t fair. Ryder is experiencing this pain because his mother thought she was smarter than pediatric hematologists.
The following morning, we were told that all of Ryder’s follow-up labs came back normal. He was officially given the diagnosis of “hemorrhagic disease of the newborn” which is caused by a vitamin K deficiency, and the reason that nearly all newborns birthed in a hospital are given a shot of vitamin K at birth.
So she’s learned her lesson, right?
Wrong!!!
Mandy had done her “research,” which had left her more ignorant than before, and despite what happened, she still believed it.
We chose not to get a Vit K injection after doing some research on the reasons it IS given. Hemorrhagic disease of the Newborn only occurs in 1 of every 10,000 newborns, and yet it is given to all. The dose given is something like 1000x what is required to prevent the bleeding disorder (forgive me, I can’t recall all of the exact numbers without looking them up again.). Vit k is also associated with increased risks of childhood cancers [Note: There is no evidence to support that claim.] The risk/benefit was high enough for us to decide that the risk felt safer – we trusted ourselves to recognize a problem if one arose.
It was just an amazing coincidence that Ryder didn’t get the vitamin K injection and then hemorrhaged. The real cause was mastitis (??!!).
I was taking large amounts of Vit K via spinach and kale smoothies, which was transferring through breastmilk… We had no issues at all until I got mastitis and was too sick to continue making sure I was elevating MY Vit K levels.
Spinach and kale smoothies? This woman is a walking parody.
And what about the next time?
In the future, I will probably STILL not give a vitamin K shot at birth, but try harder to be sure my own levels are sufficient.
This woman is a fool. She is extraordinarily lucky that her baby bled from his umbilical stump where she could see it. He could just have easily bled into his head and wound up dead or permanently brain injured. Having dodged a bullet, she drew the inane conclusion that she is bullet-proof.
She didn’t manage to kill her first baby, but you know what they say:
If at first you don’t succeed, try, try again.
Wow. My son also lost his umbilical cord early, but he’d had the Vitamin K shot. (Still needed to have his paediatrician cauterize it, though.) After realizing what could have gone wrong, we’re very thankful to have had his shot.
The comments are priceless. Vitamin K.
http://www.usatoday.com/story/news/nation/2013/08/30/babies-suffer-bleeding-disorder-after-parents-refuse-shots-/2750023/
More examples of educated mommas regarding Vitamin K.
http://community.babycenter.com/post/a44565955/vitamin_k_shot
This woman wants to refuse vitamin K for her natural twin birth. My experience shows she is at higher risk for preterm birth, a little more baby bruising during birth, and CS. But that not all she is demanding. God help her poor provider.
http://community.babycenter.com/post/a44487301/birth_preferences_birth_plan
My “birth plan” consisted of:
1) If my ex shows up, deny him entry.
2) No epidural (I was afraid of the needle in my spine — BIG MISTAKE)
3) Heavy metal during heavy labor — loop Iron Maiden’s “Flight of Icarus” when he begins to crown.
The rest I left up to my OBGYN, who’d been ushering babes into the world for over twenty years. I pity this woman’s doctor — but especially the nurses. It kinda makes you wonder why she’s even bothering with the hospital.
I wish I’d thought to ask for heavy metal during the birth. It would have been much more exciting than the ocean sounds they actually played.
Since the original story is gone, here is the link to the cached version for those who want to read it: http://webcache.googleusercontent.com/search?q=cache:GPcumucAfyIJ:themommydialogues.com/the-final-six-mandys-story/+&cd=1&hl=en&ct=clnk&gl=us
Worth a read, if only for the sensible comments who were horrified by her story and urged her to stop spreading misinformation.
Mandy’s story is gone
I’ve buried one of my children. Her death was completely not my fault, but I still think about it every day and wish I could have done something -anything- differently. This chick and her flippant attitude towards the harm she caused her baby makes me crazy.
I can see how that post would be very offensive to you. I’m so terribly sorry for your loss.
I am so very sorry for your loss, Sarah.
I’m very sorry for your loss!
I just can’t. Reading this made me SO angry for that poor baby and any future child this STUPID woman will have.
Ugh, I couldn’t get through it. When Nina was 12 days old, I had to rush her to the ER with a fever. It was horrible and terrifying. I can’t listen to this woman complain about the blood sticks that SHE caused her baby to endure when I had to watch my baby get a freaking spinal tap. I would have done anything to avoid that. This makes me so angry.
I went back to finish. “And then, I realized that I had had to live through my worst fear. It was exactly as bad as I thought it would be… but I survived. And Ryder was going to be just fine too.”
Seriously, f*ck her. I’m so glad *you* lived through *your* worst fear, with no further thought about your poor little boy and all the pain he had to endure.
And yes, we spent 10 hours in the ER too. They need to figure out exactly where you need to be. It’s a sign that doctors are doing a thorough job assessing the situation and not just listening to the f*ckwitted guesses of parents who are too stupid to give a vit K shot.
Grr.
That was exactly what bugged me. It was all about her, not about the child.
Shouldn’t her worst fear be her child dying? He very well could have if it was his brain bleeding instead of where his cord stump fell off. She learned NOTHING from this, which is scary.
Just read the original post. It’s worse than I thought.
Ok, of all the places to Co-sleep, PICU isn’t a good one. Babies have died from falling from hospital beds to the floor, or getting wedged down the side of the bed rails.
The reason that it wasn’t an emergency until they got the labs back, was because the kid was haemodynamically stable and not actively bleeding, and had lost maybe 20mls of blood (my read of the photo). That ISN’T an emergency, but a neonate with a badly deranged coag screen IS an emergency. New information made the difference.
I understand why sharing a hospital bed is dangerous (and you have to sign a release to do it at our local hospital) but what the option for exhausted parents with scared miserable children who need to be held?
This is my biggest beef with “baby friendly” hospitals. My husband was unable to stay the night with me as we had a child at home. I gave birth at 6 am and was up all day and then could only get them to keep my newborn in the nursery for two hours at a time. I had a 3b tear and was expected to take care of my newborn by myself 24 hours a day while still getting charged a separate room fee for the little one. I barely slept with my baby on my chest because I was so scared he would all off of me but he wouldn’t yet sleep alone in the bassinet.
If you are paying for the baby to be there, they should care for the baby if the mother physically/emotionally needs a break. “Baby friendly” hospitals are ridiculous. I am going to do the hospital tour ahead of time where my OB delivers, it’s not officially baby friendly but I don’t know what their nursery policy is. I’m a single mom, so if I have a really terrible birth I’d have to ask my mother or father to stay to help me, and I certainly wouldn’t get much sleep in that situation anyway, the noise would keep me awake, and I really would love to get one decent block of sleep to recover before heading home…
so fingers crossed they have a night nursery…
I did hospitals tours of the ones near me during the very very early days of pregnancy. One had a 24hr well baby nursery and the other didn’t (if you needed assistance at night you had to buzz for a nurse). It was an easy decision after that, because I wasn’t sure how things were go I wanted to have the option of support during the night.
Was glad I did. First time around my husband scored a bout of gastro and couldn’t stay with us, second time around I had a flare of an underlying condition and couldn’t care for my baby. Having the option available made a huge difference.
This is the only hospital my OB delivers at so I’d have to switch. I might call and ask if I can just take the tour now even though I’m too early to register. Out of the other 3 hospitals within 30 minutes, one had a nursery 4 years ago but I have no idea about now (it’s where my niece was born and it was a fairly small nursery, they encouraged rooming in but did not require it), one is “baby friendly” with a 50% c-section rate, and the other I don’t know much about but I’m not a fan of the area it’s in.
This is a great thread! Questions I never thought to ask before I picked my hospital. Going for my first class on Wednesday, so I WILL be asking then!
You`re getting excellent advice here. Here`s another BFHI horror story:
http://www.skepticalob.com/2012/12/a-cardiologists-experience-with-a-baby-friendly-hospital.html
Don’t birth anywhere that doesn’t have neonatologists on staff. (eg; is just a basic level 1 nursery) The on-call pediatrician that initially cared for my daughter did her best, and I begrudge her nothing, but the needs of neonates are very different from those of older infants, and if there is something wrong you want someone trained specifically for those needs. That’s the best advice I can give.
Good point, Tim. My hospital has a Level 2 nursery, in fact. I definitely checked that! Last year, a friend of mine had an emergency early c-section due to HELLP. Baby had to be airlifted to another hospital with a NICU, she had to stay put and not die. Didn’t see the baby at all for like 10 days. (Now, SHE has a right to complain that her birthing experience was stressful and traumatic!)
I did not think to check their policies on healthy newborns with not-so-healthy mothers, whether they are willing to support bonding while taking over some of the infant care to let Mom actually rest and recover if needed. I should have family around to help, but still. Also, if my plans to breastfeed fail, or don’t succeed immediately, will they hand me a warm bottle or give me a hard time? Things to think about!
For what it’s worth, the hospital I delivered at does not have a well-baby nursery but the nurses had zero issues taking the baby for the night so I could sleep. They keep them at the nurses station in the bassinet or hold them. I’ve been there multiple times and the babies they are watching are always being well taken care of. I’d had more than 40 hours of labor and 3 nights with very little sleep by the time my baby was born and it was a huge help for them to take her and just bring her back for feedings that first night. The second night they took her about half the time and my husband and I cared for her the other half, and then the third night we were home, feeling rested and well prepared to handle her needs.
I didn’t even have a particularly hard labor or any major complications. It was just long and I was tired. The nurses were all supportive and no one said a negative word about it. If anything, they encouraged me to let them care for the baby while I slept. It’s not officially a baby friendly hospital though (they also had no problems giving my baby a pacifier at my request).
so there is a hospital near me with a well baby nursery and that states they fully support the mother’s feeding choice formula or BF and have no plans to go baby-friendly on their website but I’d have to switch OBs. So I will keep it in mind as a last resort. Wish the hospital my OB delivered at kept the info on their website!
Even if you plan to exclusively breastfeed at home, it is so nice when you’re recovering in the first 48 hours to be able to give the baby to the (calm, alert) nurses in the well baby nursery and ask them to handle a couple of the middle of the night feeds so you can get an unbroken night’s sleep. The baby really is fine with that, and it gives the mother a much needed opportunity to rest and recuperate from the birth.
The well baby nursery is invaluable, and I personally would switch obs to guarantee access to one (although I am used to not knowing in advance who will deliver my baby anyway, so I realize my perspective might be different than an American’s).
Well, it’s a bit more complicated then that. At this point I can’t switch OBs anyway because my OB is the only one willing to prescribe me the medication I need to function (my non OB doctor who prescribed it pre pregnancy cancelled the prescription without even telling me when the PHARMACY informed him I was pregnant without telling me either). I’m still really angry that the neurologist didn’t even tell me he was cancelling it and I had to rush to get a prescription in time from my OB who had approved continuing to take it during pregnancy. I’m hoping the hospital just has a nursery but I wish it said whether they did or didn’t on the website.
That’s horrible. Truly horrible. I hope everything goes smoothly for you from here.
Thanks. I still feel if the neurologist was adamant that he wouldn’t prescribe it for me anymore and my OB would have to be the one to prescribe it, I still should have been told so I didn’t find out when I went to refill it. I could have gotten the prescription weeks earlier from the OB who 100% agreed with continuing to take it. Needless to say I’ll be finding a new neurologist after this pregnancy. I ended up paying the extra copay to fill it at the local pharmacy instead of dealing with the stupid mail order pharmacy again once my OB prescribed it.
Isn’t it your ob’s job to explain the hospital policies to you and answer your questions?
The last hospital I worked at had a policy of 24 hour rooming in, which most mothers wanted — and I had to occasionally take care of a new mother who fainted from exhaustion in the middle of the night when she hadn’t enough colostrum to satisfy her hungry baby, had been nursing for literally hours, and hadn’t had any sleep since delivery. For Heaven’s sake, a bit of common sense! The average mother only gets two nights in hospital and then she’s got the baby 24/7 for years and years. The mother needs her rest immediately after even an easy labor — and if she is overtired, that CAN affect her milk supply which will make the constantly -BF cycle even worse.
OT: I’ve seen some discussion of the PBS/BBC show “Call the Midwife” in the comments from time to time, so please excuse if I am repeating an observation made previously. In season 2 of the show there is an episode in which herbalists (portrayed, interestingly, as domineering toward their husbands, also) are contemptuous of the midwives’ clinic care, only to seek their help. Season 2 also notes the mothers’ desire for pain relief in connection with the innovation of nitrous oxide gas for labor in the 1950s.
I really enjoy that show, though it may have some inaccuracies. In the episode with the herbalists, the mother was older, had no prenatal care, possibly had bladder infection since she was complaining of pain. She ended up with a surprise twin and almost bled out. The midwives (there are always two) had called in the doctor and her life was saved. The second twin was unresponsive so one of the midwives did “Eve’s rocking” to try to resuscitate the baby, and it worked.
That BBC show was a pleasant surprise – very pragmatic and not ideological at all. Shows the reality of giving birth at home with few resources.
To me, the maximum level of WTF in this WTF-laden story is reached by the picture. Your newborn is having a hemorrage, you are seld-admittedly panicked, and you take a picture? why??? What do you think it will achieve?
The only thing I can think of is that maybe she wanted to show the picture to the doctor. If it wasn’t that – well, again, that’s the only thing I can think of.
Did her baby give consent to have the picture posted on the Internet? Did GCC’s child give consent to have her picture of her in a collar in a CT scanner after falling down the stairs? What will they think or say when they are old enough to know? These women use their families lives and pictures as Internet shock and awe for ratings. Then when you repost them…
Agreed. One thing to snap a pic for the doctor’s benefit. Another to broadcast it to the world online. Then again, it makes a great poster for why Vitamin K shots are essential.
This was my thought as well. A picture like that is perhaps the perfect way to say, “Don’t let this be your baby. GET THE SHOT!”
That’s definitely my takeaway.
I actually appreciate pics and video from some parents. If there child’s symptoms are not evident when I examine them, a video/pic is often useful.
I always take pictures of rashes, and usually of swelling. If the picture isn’t good enough to tell the doctor much about the problem, it can help the doctor to place whether I (as a parent) am stoic, over-reactive or somewhere in-between.
This is good advice for parents, especially for something that’s NOT an emergency.
Perhaps even then, a picture like this could say “I’m not an overreacting helicopter mom…there really WAS blood all over the sheets.”
I wish I had brought poopy diapers to our lame pediatrician who thought I was exaggerating about greasy, unnaturally foul-smelling diarrhea with lots of undigested food. Every. Single. Day. For two years. One poopy diaper would’ve spoken 1,000 words.
In situations with bleeding, I’ve often had doctors ask me to estimate the volume of blood loss, which, sorry, I just have absolutely no way to do. I was able to get around it by using hand gestures to estimate volume of splotch, but a picture would have been more useful. So this one’s great – splotch, with baby in frame to establish scale.
Totally OT, the MHRA in the UK has released a new warning saying that codeine is now contraindicated in breast feeding women (because of the rare risk of overdose in neonate of ultra rapid metabolisers).
I await their response as to what I am supposed to prescribe for moderate to severe pain when paracetamol and non steroidals alone are insufficient (as I imagine they would be for CS or severe tearing).
Yes, we stopped using codeine containing products in breastfeeding women maybe 10 years ago because we have a big population of ultrafast metabolizers. We use hydrocodone or oxycodone instead if NSAIDS/acetaminophen not holding the pain.
Want to add that I took oxycodone for severe tearing. Worked like a charm.
I am NOT a good metaboliser of codeine.
Since 30/500 co-codamol 2QDS PRN is the default for CS pain I didn’t have a great recovery for the first day or two,
I don’t object to banning codeine for BF women, just to not suggesting an appropriate alternative. Because suggesting women endure severe pain without medication is not cool.
The UK estimates are 1-2% ultra fast metabolisers, and the only case in the literature of a fatal neonatalal OD I can find was in the child of a Somali woman.
We don’t use much oxy here, but good to know that is the next choice.
My main beef with the MHRA was that they haven’t so far offered an alternative…
One reason to be glad I won’t be breastfeeding… sick of arguing over needed medications…
If we have women with third or forth degree tears or tears that require the OR we often use epimorph (morphine in the spinal or epidural).
A T3 had 30 mg of codeine which is roughly equiv to 5 mg of oral morphine. So many will prescribe oxycet or Percocet or just oral morphine.
Dr Kitty, hydrocodone (marketed in US as Lortab and many other brands) is “premetabolized” codeine, and skips the step that can cause mischief for those with fast-metabolizing polymorphisms. It’s far safer, more reliable, just as inexpensive, and should have replaced codeine years ago.
Oh, this is not good advice! Even though oxycodone and hydrocodone do not metabolize to morphine they are both metabolized by the same enzyme in the liver that causes ultra rapid metabolism of opioids and their metabolites in some cases are even more potent than morphine. People with the ultra rapid polymorphism have been known to die from overdose of both of these opiates.
http://www.enttoday.org/details/article/2544431/Post-Operative_Pain_in_Children_Undergoing_Tonsillectomy.html
Thanks Sullivan for that info and the link.
There seem to be two separate issues with codeine. One is that many people lack the ability to metabolize it into a form with analgesic activity. They get all of the nausea but none of the therapeutic benefit. In this regard, hydrocodone is superior.
But the other issue– which I agree is more important, and you are correct about– is the danger of codeine and its metabolite hydrocodone to fast metabolizers, who end up with dangerously high levels of the active forms.
Yes, it has to do with the gene for the enzyme that metabolizes them in the liver. If you have only one good copy you metabolize opiates very slowly if you have no good copies you cannot metabolize opiates at all and if you have too many copies you can have varying levels of rapid opiate metabolism.
It’s not natural selection. It is medical neglect.
“We are pleased that he listens as we tell him that Ryder hasn’t had a vitamin K shot at birth and is probably not clotting because he’s vitamin K deficient.”
Another crunchy fuckwit, driving up the cost of health insurance. Why get a simple jab of Vit K when you can use ER and PICU resources instead?
Well homebirths are cheaper too you know, until you factor in those NICU stays for the oxygen-deprived brain-damaged children. Ugh.
I noticed the same thing. She sees nothing wrong with using intensive, expensive resources as a backup for fixing problems that she chose not to avert. She also seems blithely unaware that emergency doctors might have a whole lot of urgent cases–including ones far more urgent than hers–to manage.
Maybe she should be charged for her baby’s stay in hospital because this was preventable. She refused the vit K knowing the risks so you could say she was ‘informed’.
$1 for the injection or $500K (+) for the NICU admission.
A bill was put forth in Israel to charge parents for the cost of their child’s hospitalization should an illness arise from the parents’ refusal to vaccinate (health care normally being free and fully covered by the system).
I think it was rejected, but it’s not a bad idea.
I get the impression that she thinks that the doctor should have listened to her diagnosis of vitamin K deficiency, given her kid a vitamin K shot, and sent them on their merry way.
That’s not how it works. Vitamin K is only a precursor for the clotting cascade. Once there is active bleeding, as in her child, vitamin K is not going to make a difference. FFP is needed.
“An ounce of prevention is worth a pound of cure”
or something like that.
Do mothers who refuse Vit. K for their infants also refuse the heel stick for PKU? What’s the risk factor for PKU [once upon a time I knew the statistics, but I’m having a senior moment]? And that makes me wonder about whether babies born at home are even tested for it, and how many babies then suffer from this completely preventable condition?
And what about neonatal jaundice? Most physiologic jaundice is harmless, but it can be a major problem as well, ultimately also leading to brain damage. Who follows babies after homebirths? Ditto mothers with diagnosed/undiagnosed gestational diabetes, whose babies can become hypoglycemic easily. Does one just wait until seizures begin?
Yes. There are quite a few people refusing any newborn screening (aka: the PKU test). The tests vary in the US from state to state as to what tests are included.
Things like neonatal jaundice can sometimes be helped by exposure to sunlight and increasing feeds/stooling (bili is excreted in the stool). But I do not know if kernicterus is/will make a comeback due to refusal of testing/treatment.
I have a feeling that neonatal hypoglycemia (undetected from a homebirth) will be treated by me as a “newborn with seizures” in the ED. Or maybe just “lethargic” (low gluc, but not low enough to cause seizures).
Thank god we don’t have that large of a homebirth population here. Plenty of non-vaxxers, though. Perfect for a huge international destination and entry point for flights from foreign countries that still have endemic diseases.
Who follows babies after hospital births, come to that? Seizures do not automatically mean brain damage, and brain damage does not automatically mean seizures. By the time a diagnosis is inescapable – and that can be anything from months to years, looking back to the circumstances of birth tends to be avoided, for fear of litigation.
Brain damage is almost literally unthinkable for most – and not much talked about, either. I did once get told off for using the words on a board for children with cerebral palsy. Babies are born either healthy or dead in most people’s imaginations, so when people say they “know the risks” I don’t think they include this one. Most of the interventions are ways of avoiding brain damage – fairly successfully these days. To me, avoiding interventions that might make a difference is incomprehensible, but the fact remains that most will get away with it.
I am having some difficulty with these threads – because I don’t feel that our lives are “agony”. I don’t think providing plausible explanation for one’s child is our greatest problem, and I don’t think that being wracked with guilt is all that helpful, either. These women were foolish, but also unlucky. Originally I hung around here because I think people should be a lot more aware that brain damage is a real risk, it ought to be more openly discussed and understood.
Some of them do. Our Bradley instructor was kindof blase on the topic of the state screen “well heel sticks are very painful! the chances of having one of these things is very small , but on the other hand, if you do have one its critical it get noticed. you just need to make an educated decision for yourself” – which to me even suggesting that it should be optional is criminally irresponsible. the consequences of not having one of those metabolic conditions diagnosed quickly are extremely dire and catastrophic.
Very painful! Bollocks!
They use the smallest size of diabetic lancets!
Heels have fewer nerve endings than fingers.
I’m pretty sure anyone who says they are very painful hasn’t seen a baby get many. Mine was hypoglycemic and didn’t stabilize for a week or so, so she had a ton of heel sticks and never made a peep when they cut her. Screamed bloody murder when they squeezed after though 🙂
My kid had to be tested repeatedly for 24 hours due to being 4 grams over the weight limit. He screamed bloody murder every time. Not sure if it was from the stick or the squeeze, because the nurses refused to let me hold him–or even his hand–during the procedure.
Man did we see a difference in hospitals when she got taken to boston with regard to that. The hospital we gave birth at would take her out of the room to the nursery for glucose checks and to get a new IV in when it infiltrated, and wouldn’t let us in there. When we got to the NICU @ Children’s, the nurses encouraged us to stay by the isolette for everything, hold her hand, let us give her the sugar water during sticks, etc. Just a totally night and day difference to how they handled care. The only thing they said we couldn’t be present for was if they had to put in a PICC (which they were on the verge of doing after a string of IV failures) because they needed a totally sterile environment to do it.
I wonder if the higher volume NICUs have that as a kind of standard for care. We had a similar experience, Tim. Our daughter was in the NICU at Strong in Rochester for HIE and the drs and nurses there were AMAZING. We were allowed to be there whenever we wanted as much as we wanted. We couldn’t hold her at first because of the cooling treatment. But one night I watched the nurses all brainstorm how to get all the medicine she needed into her without adding more IV lines. At that point I think they knew she wasn’t going to live, but they still treated her with dignity and gentleness.
It makes sense in a lot of ways. The staff at a high level high volume NICU is going to be better trained/more skilled at their jobs naturally (You have to be the best of the best to get a job somewhere like that typically) , plus they know that the situations they are dealing with are typically more drastic/more serious and so they are going to be more sympathetic towards the parents wanting to be involved in their childrens care at some level just to make them feel better.
I am so sorry for your loss – no parent should have to go through that, and far too many do.
The refusal to hold is sometimes because you hinder the procedure. Most healthcare workers know how to hold a kiddo so that the procedure has a greater chance of success (speed, accuracy, etc). Parents, though well intentioned, sometimes make it worse.
My son needed a blood draw at one year (and he is huge…a very strong fighter). The phlebotomists asked if I wanted to leave (lots of parents do), and I said that I’d hold him. They started to demur and I said, “Just watch”. And proceeded to put him in a full body bind where he couldn’t move AT ALL. They were impressed (never seen a parent with such mad skillz) until I told them what I did and that I used said skillz daily.
My daughter is going to get her kindergarten vaccines soon and I’m sure I’ll be using my skillz again.
Do you ever do the superman trick?
It’s good if you need to get access to face or head.
Give the kid a blanket or sheet, tell them it is a cape like superman, which will make them super brave if they wear it, but they have to wrap it tight for it to work…and then swaddle them.
Works like charm, and keeps their hands out of the way.
We use that one for quick suturing (usually face) on kids that we aren’t sedating. The nurses love it. But for quick things like ENT exams, kid sits in parent’s lap with kids legs clamped by parent’s crossed legs (so their butt is supported), one arm clamped across torso and both arms, the other clamped across forehead. Held tight enough, no kid can break out.
That’s the one the nurses showed us when it came to giving my 3yo injections (other methods failed – eg bribery). My husband would hold her like that and I gave her the injection.
It was so hard to do. We’d have to grab her, pin her down and give her this painful injection. It is far more painful (especially at first) then other injections I’d had for IVF or vaccinations – it gives a burning sensation under the skin and left hard itchy lumps after wards. It went against everything we were trying to teach our daughter about bodily autonomy.
Luckily she is now able to let us do the injection without pinning her down and luckily the site reactions have calmed down. It has also been worth it for her health-wise and the specialists are very happy with her progress.
What’s weird is that the L&D nurses were totally fine with me holding him for the heel prick. It all went very smooth. The post-partum nurses were a different species. They insisted on doing the very same heel sticks in another part of the room. I wasn’t even allowed to hold my son’s hand.
My son has had two blood draws (at 1 and at 2.5). In both cases, the phlebotoist taught him how to hold our son to immobilize him. Worked really well. I got to watch and sing silly songs for distraction. Went as well as could be expected.
I did all the holds for the vaccines. In all cases, I never had the impression there were other options.
The nurse had to prick twice, it took forever, my kid screamed bloody murder the whole time and his heel was completely blue the day after. I think I can say safely it must have been painful as heck (not a reason not to do it, of course).
I think , probably either your kiddo was a bleeder, or the nurses were not so good at their job TBH. It really should not be that bad, my daughter was getting cut every 2 hours for 7 days straight and she never had any bruising or anything like that from it. But you’re right – even if it does hurt, it needs to be done. So important.
I have a burqa-lady patient who doesn’t homebirth, but does go home a few hours after giving birth,too early for the test. Usually her MIL,who’s a nurse, comes over and does the test for them. This last time, she asked if our clinic would do it – apparently the lab in Sheba hospital will mail it to you if you need it.
There is a safety net in Israel in the form of [1] home visiting by a nurse from the mother’s HMO [kupat cholim], and [2] the system of free well-baby clinics [Tipat Halav], some of which do home visits as well. Jerusalem’s late, lamented Misgav Ladach hospital, which had a reputation for NCB, had quite a few women who discharged themselves 6 hours after birth, and we followed up all of them.
I went home early with all three, thanks to the early discharge system for low-risk mothers which provides CNM home visits and a few Child Health Nurse visits after a minimum 6 hour wait at the hospital after delivery. I really like sleeping in my own bed, and there was no real reason to stay any longer. I was in the ward for between 10-12 hours after all of them, due to having a nap and waiting for a paediatrician to give bub the all clear before leaving. The CNM does the heel prick test at home, as well as weight + jaundice checks – she was surprised that I explained what the heel prick test was for to a curious 4 year old! We went back in to the hospital for appointments on different days for the hearing tests and a hip ultrasound (family history).
See, that’s a good system. When I was born, my parents took me home, then the hospital called the next day and said, “You need to bring her back in for heel stick tests.” So they did, and were kind of annoyed that the hospital hadn’t mentioned this urgent test when they’d offered to let us go early. Two days later, another call that they didn’t get enough blood and need to bring me BACK to repeat the test again.
Now, all of this is going on in the absolute dead of winter with temperatures far below zero on the Farenheit scale, so bringing a newborn anywhere is a scary, complicated scene with half an hour of wrapping the 6-7 pound baby in 6-7 pounds of clothing, starting up and pre-warming the car, then dashing for the car, buckling baby down as fast as possible, and shutting the doors.
Then, two months later, they got a call that the lab to which my sample had been sent burned down, so they’d need to do it a third time.
Home visits for newborns! It’s a darned good idea!
I just realised that I meant that as a response to Esther’s comment, but I’m glad you like the idea. It seems to work pretty well, and I really enjoy being able to go home with support as long as everything is going well. The other thing that I like is that they go over the safety stuff (safe sleeping, normal weight gain, umbilicus healing, bathing, vaccines, etc) as well as providing gentle PTSD/PPD screening + referrals if necessary, and it’s more than just once.
”We need to go to the hospital”’….”We’re going to admit him to NICU”…
Imagine a world where there was no hospital, no NICU, not even any knowledge about Vit K or hematology or the coagulation system – to come in to rescue us all, whatever decisions we have chosen. The medical system doesn’t demand respect, or understanding, and these people rely on it being there to rescue them. Over and over. Such hubris.
I wonder whatever happened with that woman with the twins, who was “eating her words” after she said hospitals were largely unnecessary and then I think one of her twins had a cord prolapse or something, and was fighting for life in the NICU. I do hope the baby was ok…she was one who actually learned, unfortunately the hard way.
Is the 1 in 10,000 risk for this, among those who’ve been given the shot, or based on populations who don’t use vitamin K shots? I’m curious if this statistic is accurate in this case, given he was not given the shot at birth. Was his risk of developing the problem higher than that 1 in 10,000 statistic she quoted?
Ok, I just looked up some info and found this quote from a WHO position papter: “significant unexpected bleeding occurs in 2.5 to 17.0 per thousand newborns not given vitamin K” A lot higher than that 1 in 10,000 she had quoted. http://archives.who.int/eml/expcom/expcom16/COMMENTS/VitK.pdf
That is a LOT higher. Thanks for looking that up!
I knew a baby who ended up in the NICU for days with bleeding on the brain, seizures, etc because mom had a homebirth where the Vit K shot was not administered. It was my first clue that homebirth wasn’t all that it was claimed to be, and you can bet that the Vit K shot was the one “intervention” I insisted on when I had my own baby in a hospital! And seriously…it’s a vitamin.
Hard to know if it’s the moms or the midwives who are guilty of being wackadoodles. We attempted a homebirth (mistake, I know) and our midwives planned to do the Vit K shot. Yes, the parents had to consent. But they carried it and advocated for it. Like with hospitals, parents had the right to refuse the Vit K shot. We wouldn’t have dreamed of refusing. And in the end, I’m delighted that a stalled labor led us to the hospital for delivery.
I think it was the parents, they are also vocally anti-vax, anti-circumcision, etc. Good to know some midwives do advocate the shot, though. It’s something!
And yet these idiots would gladly give their children useless and unnecessary supplements and homeopathic “remedies” if it came in a earthy looking bottle from Whole Foods >:(
The funny thing is , whole foods is owned by a greedy as hell ultra capitalist who is just exploiting a niche he saw profit in. (Well off white people with guilty consciences)
Their mac n cheese is yummy though!! And their cookies and muffins.
http://www.foodnetwork.com/recipes/alton-brown/baked-macaroni-and-cheese-recipe/index.html
http://www.foodnetwork.com/recipes/alton-brown/stove-top-mac-n-cheese-recipe/index.html
You will never eat box mac and cheese ever again. Experiment with the kinds of cheese you use – my favorite right now is making the baked with smoked mozarella and fontina, and putting some pancetta in the topping.
I honestly had no idea that when American said “mac n’ cheese” they meant something from a box until I saw it in a shop here that sells (overpriced) US food for ex pats!
Macaroni, and white sauce with grated cheese… Why would you make it from a box?
A pretty good percentage of my fellow countrymen have literally never cooked anything from ingredients in their entire lives, you have no idea. I’ve had people ask me how to make mashed potatoes before.
Why do you think high blood pressure is so prevalent here? People eat everything from a box or a can, so their diet consists of 5-10 grams of sodium a day.
Since you like variations… There is an easy Jamie Oliver recipe which combines macaroni with cauliflower and has a topping with breadcrumbs, pancetta, cheese and rosemary. It is yummy, and my go to quick and cheap winter warmer for lots of people.
Here is a recipe.
http://www.strandsofmylife.com/jamie-olivers-30-minute-cauliflower-macaroni-cheese/
Seriously good.
You can chuck some of the pancetta into the macaroni and add extra cheese. I do, it’s yummy,
Goooood question. I grew up eating the box kind, and then had the real kind when I finally was an adult and making my own food. And holy cow! I’ll never go back. It’s basically the same price to make it from scratch, just as easy, and tastes a hundred times better.
I’m lazy and call any macaroni & cheese (whether it’s from a box or made from scratch) mac n cheese.
In Canada (or at least on the East Coast) we definitely think of Kraft Dinner (as we tend to call the boxed stuff by its brand name) as something entirely different from “macaroni and cheese.”
My favourite macaroni and cheese dish has lobster in it. SO delicious and decadent.
Terrance and Phillip always mention “Kraft Dinner” on South Park, since they’re Canadians.
And panko-makes a lovely topping
no, not the boxed kind they sell – they sell fresh mac n cheese in the prepared food section. its yummy.
Thanks for that!!
I love that Mac and cheese. (Although I have to say that Beecher’s Mac is the best. Even if you don’t live in Seattle and have Pasta and Company or the Beecher’s store at Pike Place-get the frozen Beecher’s or get their recipe online. Totally worth it)
Perhaps there is a market for biodegradable syringes with leaves printed on them?
OT: What is wrong with Whole Foods? (Question is serious – coming from Europe, this far WF is the place where I could find good quality food that matches the standards provided by basically every corner grocery store over there. And Wegman’s, but there is no W. in every state. My classic this far is from some not-so-fancy grocery store, front label says apple sauce, 100% natural, back label says Ingredients: apple sauce, high fructose corn syrup. Wow, is this clever or what.
I have never seen people THIS fat before having moved to the US, I just could not even imagine. And there IS something about the food here: a common phenomenon, for example, that exchange high school students all gain a few pounds while staying here for a year, and then they all go back home and drop the weight just by going returning to their usual way of eating.)
To be fair, exchange students from the US usually gain weight too. Exchange years (I’ve had a few) tend to be filled with trying a lot of new yummy food and a bit of stress eating. Not to mention just learning what a normal serving is in a lot of foods.
Also, yes, WF has some good produce, and some good deals, but it is also referred to as Whole Paycheck.
Or Whole Wallet.
WF is the nearest grocery store to me, and they have a lot of really good stuff. However, they also have stuff which is nutritionally identical to the regular grocery store stuff, but is labeled “natural” and costs 2-3 times more. Some folks (lazy decision making again) think that just because it comes from there and has a picture of happy children on it, it must be good for you.
So, I get my good cheese and whatnot there, and my ordinary stuff like oatmeal and canned peas at their competitor a bit further away.
If you are in the Chicago area, you can go to Bobeck’s and get the good stuff without all the pretense.
A very good use of Whole Foods, indeed. We can’t do dairy, but if we could, we’d likely buy some cheese there. But the staples…super over-priced.
There’s nothing inherently wrong with Whole Foods. But shopping there is often used as a status symbol, it is generally what amounts to a luxury supermarket. And the company markets to the segment of the population that believes that “natural”, however you want to define that, is always better. As CC said, even when the items are quite literally the same as something you could buy elsewhere, it’ll be touted as natural at WF with a bigger price tag.
As per my below, wholefoods is owned by a big L libertarian, and he has fought tooth and nail to keep unions out of his stores. It’s not really a HORRIBLE place to shop, but it’s not a very ethical place to shop IMO.
While I will admit that Whole Foods is overpriced, it is often because they sell things that you can’t get elsewhere. Things that likely cost more to produce AND that have a larger mark-up.
Our favorite Whole Foods things:
Gluten-free, humanely-raised deli meats that are freshly sliced. Especially tasty ham and salami.
Fabulous fresh olives and pickled peppers
Cashew Butter (their 365 brand is cheaper than anywhere else…good for our family because most of us can’t do peanuts)
Mirin (they sell an Eden Organics one that doesn’t have strange additives in it)
Gluten-free crackers, pizza dough, etc. (though we try to buy or through buying clubs because it’s cheaper)
Sometimes WF sells unusual fruits/veggies that aren’t available in a conventional grocery store: broccoli rab, morels, jicama, Japanese eggplant, etc.
I do have to say that their produce is fabulous. Some of the stuff at our local grocery store is pretty sad looking.
I have noticed in our area, Whole Foods carries wines from smaller production, lesser known wineries. Before a few of them had tasting rooms on this side of the mountains, the only other way was to order the wine online. Whole Foods has carried them from the beginning.
I spent 6 weeks in the US after 19 years in Israel without a single trip overseas. Wow, I thought, now I can get all the goodies I loved in the first 28 years of my life when I lived in the US. After less than a week of pigging out, I had such stomach upsets and heartburn, I went back to eating Israeli-style. Everything in the US was either too sweet, too salty, or too fatty.
LOL, I gained 20# the few months I was in Israel. The food is so good, the giant falaffels and sesame candy was too much for me. Had we not walked miles everyday, it would have been double.
I did notice there aren’t any people quite as big as the ones here in America, in any other nation I have been in. I think it’s because most areas are totally car dependent. When you never walk anywhere, it compounds the weight gain.
The Mediterranean and Israeli way of eating is encouraged to Americans/Canadians by health experts all the time in the news and media etc., but that doesn’t mean people will eat that way, or even eat enough of the food to make a healthy difference in their lives. People here just don’t (on average) get enough exercise anymore. We are also a fast food nation, too.
Nothing is wrong with Whole Foods… they get a sizable chunk of our grocery budget! It’s just an example to illustrate the power of branding/marketing without thoroughness and a critical eye.
OT but, huh?
http://www.trueactivist.com/measles-mumps-rubella-vaccine-finally-linked-to-autism-in-multiple-court-cases/
Already eviscerated at Respectful Insolence: http://scienceblogs.com/insolence/2013/08/14/an-zombie-antivaccine-meme-rises-from-the-grave-again/
“The dose given is something like 1000x what is required to prevent the bleeding disorder”
Anyone know the actual numbers for that?
Vit. K is a water soluble vitamin. Get too much of it, and what you end up with is expensive urine. The vitamins which can be toxic if overdosed, such as Vitamin A, are fat soluble, and get stored in the cells. Water soluble vitamins, which are most of them, are excreted by the kidneys. That’s one of the reasons that taking huge doses of most supplements is worthless.
Surely you meant to say that Vitamin K is fat-soluble.
yes, thank you for correcting me. This is what comes of retiring — my brain hiccups occasionally.
Vitamin k is fat soluble, along with A, D and E. the water solubles are c and the b vitamins.
So, if it’s fat soluble then it would be possible to overdose and excess Vit k wouldn’t just come out in urine?
Yes, but the dose given is not high enough to cause an overdose.
Are these the same people who think that children who are circumcised as infants should be able to sue their parents? If so…well, I would hope the same logic might apply to vitamin K refusal.
Is this condition random or does a sibling having had it increased the chances of another baby getting it? I wonder if she’s being even stupider…
It may have a genetic component, I suppose. I would at least be open to the possibility. But I try to think logically, silly me.
So not only does this idiot not seem to feel any remorse for the fact that her decision caused her child immense pain (and could have left him disabled or dead to boot), but she is completely ignorant about the drain on resources that she caused. Her son ended up requiring a bed in the PICU, blood, extensive tests, and skilled nursing and specialist care. Every single bit of this could have been avoided by giving him the vitamin K injection. Note that I am NOt begrudging the child treatment, but I am very angry that someone’s “educated” decision resulted in a whole lot of medical care that would never have been necessary had she opted for a simple preventative measure.
Well to be fair, A NICU stay and lab draws etc aren’t fun for anybody, but I wouldn’t say they cause immense pain. Now a brain bleed would have caused immense pain. A GI bleed probably not.
I wonder why they don’t just make a law that if the parents opt out of the vitamin K injection for their child then the child has to have it orally instead? That is an option that some parents choose to do. You have to have the O.B. order it right before the baby is born. When I was born nearly 45 years ago, I was given vitamin K orally, there was no Hep. B shot and babies didn’t have their blood drawn unless there was a medical reason. They found out a baby’s blood type by testing the blood from the cord or placenta and asking the parents their blood types.
Yea….a law would never pass much less work. How would you enforce it? We don’t even legally mandate vaccination in this country.
There used to be no seatbelt or car seat for babies laws either, but that changed. Don’t kids on bicycles have to wear a helmet now? I think that is a law now, too.
Those don’t introduce anything INTO the body of the person involved.
In New York state it is the law that the baby has to have the vitamin K shot. They do not except exemptions on that one. If you refuse they’ll call C.P.S. and have it done anyway.
I’ve spent a few long nights in the hospital myself, with a chronically sick little kid. I’ve known mothers whose babies had cancer — and one who watched her six year-old die from an inoperable brain tumor.
In no way does this writer’s baby deserve to suffer — no one’s does. But reading her bitching about the unfairness of it all — coupled with her arrogance and disdain toward the medical staff — makes me dizzy with fury. Instead of pretending this was a good decision she should be a voice for other babies whose parents might make this mistake. She should advocate for the vitamin K shot and for not taking bad medical advice from the Internet. And she should be so grateful that it wasn’t worse.
Yes, but all of that would require her to humble herself and admit she was wrong. As we’ve seen, not many NCB mothers are willing to do that (at least openly), and those who do tend to be blocked, ignored, or torn to shreds. I admire any person who will stand up and admit they made a mistake- sadly, not many do.
Some people really are immune to reality and good advice. They seem to also be fond of hyperbole and overdramatization. I bet there’s a correlation – someone should do a study.
I was reading an article in Psyscology Today that ties in with story quite nicely. It was about anxiety. The author made a really good point that anxiety was a protective mechanism the early humans and we all likely the descendants of the anxious ancestors because they were more likely to take steps to prevent mishaps from happening, no matter how remote the chance of these mishaps might be. They were the ones to survive and have anxious children. NCB movement doesn’t like that healthy anxiety, which is too bad.
Actually, I wonder if the NCB zealots are playing on the natural anxiety of expectant moms.
No, they have anxiety. It’s just about the wrong things. They worry about the things they’ve seen in friends and neighbors, or on TV. They worry about learning disabilities, allergies, cancer, school troubles. They stress over murderers and pedophiles, or freak fatal accidents involving toys.
They don’t worry about their child dying of contagious diseases or childbirth complications or hemorrhagic disease of the newborn, since most of that is now preventable and therefore outside their experience.
Our brains SUCK at risk analysis, and the media posting rare bad stuff all over everything just makes it worse.
I wish I could find it now, but there was a really interesting study once on what parents worry about needlessly–and what they tend to overlook. The key takeaway was this: your kid is really unlikely to be a victim of terrorists, murderers, pedophile strangers. Biggest risks were: car accidents (leading cause of death for little ones) and drowning.
And as for murderers and pedophiles, they’re much more likely to be family than strangers.
I love this comment. Our brains really do suck at risk analysis. I study this in context of geological hazards but since I’ve started reading this blog I can’t stop thinking about how it relates to birth as well!
In this framework it’s understandable that someone would perceive more potential costs than benefits to a simple vitamin k shot – it’s an emotional reaction based on prior experience, general attitudes, and greater trust in whomever’s giving misinformation. These gut instincts served us for millions of years of evolution and still serve us in situations where there is insufficient time for a more logical-rational analysis. I think it’s important that health care providers understand that we think this way – the human brain is just bad at logical risk analysis and gut trust is a much bigger factor.
Although, this woman is mind-boggling — I can only think that it’s a very stubborn form of cognitive self-preservation that she was so angry at the hospital experience, and that she can’t see that getting the simple shot would have prevented all this mess and trauma. I do hope she is able to recognize her error by the time she has her second child.
They do stuff like say that circumcision could kill a child, so never let your kid get one, but then let their kids run around unvaccinated, because circumcision is WAY more dangerous than say, polio.
That might come down to “believe what your friends say.” Which sometimes makes sense. Many decisions just aren’t worth the effort of a full risk-benefit analysis, and simply taking the word of someone you trust is a reasonable way to choose.
If a friend says, “That mechanic is a crook, never go there,” I will probably listen, assuming that I don’t currently have evidence to the contrary and there’s more than one mechanic in town.
Which house to buy is a decision worth research, math, talking to multiple sources, maybe drawing charts and graphs. Where to get your oil changed doesn’t really matter, as long as the price is reasonable and the worker is competent.
The problem is when people start applying “lazy decision making” tools to decisions with major consequences.
I read the blog post and looked at the photos. I wish I hadn’t to be honest. It’s very full on – the photos are distressing and the writing style is histrionic.
I wonder about this type of ‘mummy blogger’. They seem to really draw out the emotion. I’ve had my share of emergency hospital trips and can’t imagine writing anything like this, or taking a photo of a close up of my kid’s IV.
It probably doesn’t help that I’ve been following the truth-about-ruth blog, which has led me to the Eli warrior blog. I don’t think she’s faking this, but there seems to be a need for sharing and generating emotion from this incident which doesn’t seem heathy to me.. My mum and my husband would be shocked and horrified if I ever posted something like this about my kids.
The blogger’s post was to shock and awe, and ultimately give her “street cred” on why her whackadoodle beliefs are justified. After reading her article, I was also horrified that she would post pictures like that and then tell everyone how she would do it again. Just gross.
That’s just awful. That poor baby. If I had f****d up that badly, I’d be screaming from the rooftop how every single mother needed to say YES to the Vitamin K shot. Yes, I’d use the photo for shock and awe. Though what disturbs me is that if my baby were bleeding all over the sheets, I would scoop him up and drive him to the ER. It would never occur to me to take a photo.
It always kills me when people get angry about having to wait even though they TOLD the doctors everything they need to know. I’m just like, “And just who the hell are YOU? You refused the vitamin K injection for your baby. You have zero right feel upset about anything but your own actions.”
This story made me so sad because it was 100% preventable. One little shot in the thigh could have prevented so much trauma. It resonated with me because I can totally relate to her emotional response to the needle sticks. My son was born healthy but quickly was showing lethargy and breathing problems. After a chest x-ray or two, days of needle sticks for blood draws (half of them didn’t produce enough blood for a reliable test), he was finally diagnosed with Neonatal Polycythemia. The doctors and CNMs were concerned about infections because I had group B strep and they were concerned I didn’t get the antibiotics early enough, maybe. I’m so glad I didn’t “discover” the NCB movement until AFTER my son was born. Unfortunately, I got exposed to it a few months after my son was born because of an advice forum I was involved in and I made the terrible mistake of watching “The Business of Being Born”. Even though my hospital induced labor didn’t go the way it was portrayed in that “documentary”, my very limited exposure to the NCB movement was enough to cause severe guilt and reignited my mild Baby Blues that I had for a short time after my son was born and pretty much plunged me into full blown depression. I researched futilely for a link between being induced and Neonatal Polycythemia. I was apparently trying to blame myself and the doctor who ordered my induction when I was over due and my blood pressure was through the roof. (I’m sure my husband didn’t mean to do this consciously, but he took a picture of me hooked up to the monitors and my blood pressure was displayed and so it I ever feel my induction was unnecessary I can look at that picture and remember that, yes, my blood pressure was REALLY that high). I don’t know why I am rambling or why reading that story brought all that emotion back. My son is a very healthy and active 3 1/2 year old and he has no effects what so ever from his first week in the hospital. I am just going to say that the Skeptical OB website saved my sanity and brought me out of my NCB guilt ridden haze. I remember reading it for hours night after night (I think I have read nearly every posting) and getting my eyes opened to the fact that the few granola crunchy homebirth moms that I know who had great outcomes are very fortunate to have healthy children after their homebirths and that I made the very right choice by choosing a CNM (our small town hospital JUST got it’s first real OB/GYN like a year ago) who works under doctors and only births in the hospital.
Touching story! I need to start a tally of these birth stories…
the woo crowd believes vitamins are the cure for everything, except, apparently, the things they actually are a cure for. WTF?
Yes, but it’s an *injected* vitamin, which NCBers and the like seem to think that makes it chemically different than the kind of vitamin you eat. Hence her belief that she just needs to eat more kale next time and her next baby won’t have the same problem. I have heard the same BS about vaccines–“natural” immunity that you get from having been exposed to a disease is somehow better/more effective than the “unnatural” immunity you get from a vaccine. So it’s better to get whooping cough and recover from it than it is to be vaccinated against whooping cough, because you’ll end up with more effective “natural” immunity. Which is so very stupid because you had to actually get the disease to become immune to it, forgetting of course that immunity is the end goal. So in order to avoid getting the disease you need to get the disease first. These people are so stupid it just boggles my mind.
No, the problem is not that it’s an *injected* treatment. The problem is that it is a *doctor endorsed* treatment.
Yup. Ran into a woman claiming the same thing after nursing her school-aged daughter through a full-blown case of pertussis, complete with asphyxic, vomiting coughing fits.
“It was no big deal! See? She’s still alive! And now she has natural immunity.” Great, so it’ll last 8 years instead of 6?
meanwhile, my kids got a couple of shots, that hurt them for less time than it took to get to the ice cream place, didn’t get the disease, and are also immune.
I’ll take that trade any day.
But the crunchies love getting their vitamin B12 shots for energy…
There really is an irony to it all. The alties complain that doctors only treat symptoms, and don’t prevent disease. But then they also refuse vaccination, which is the epitome of preventative medicine, while using stupid crap like homeopathy, which, while obviously bullshit, even if it DID work as advertised, is solely about treating the symptoms (like cures like) without any thought of what’s actually causing them.
It’s a vitamin, FFS. I like to give people the benefit of the doubt, but I’m scratching my head to make excuses here.
Aren’t crunchies usually falling all over themselves to get more vitamins?
Wait. It just hit me. My sis in law worried and worried about her second daughter last year because the umbilical cord took so long to heal up and looked kind of nasty. I don’t remember the details but now it makes me a little queasy.
My son’s umbilical cord took MONTHS to heal. Our crappy hospital we were forced to deliver at (by HMO rules) told us it would take “awhile” to heal and would ooze and smell bad and not to worry about it or pester the doctor about it. (Damn HMOs.) So after 6 weeks of green ooze, we begged the pediatrician to help us. Had to be cauterized multiple times for it to really heal.
Fortunately, we did the vitamin K shot. No bleeding. Just yucky.
Ooze and green discharge and a bad smell are NOT normal and could be signs of omphalitis.
A reddish pink moist stump suggests a granuloma, which needs cautery-silver nitrate works well and is quick, easy and painless.
I know! I was an overwhelmed, exhausted new mom and stupidly trusted what the hospital docs told me. It was not to be the last time I got AWFUL medical advice simply because the HMO was under strict cost-cutting pressure. (It was one of those Kaiser-like HMOs that run their own hospitals.)
It was diagnosed as a granuloma. The stump was, in fact, reddish pink and moist. It’s just that it was oozing discolored puss too. The pediatricians had to do the silver nitrate cauterization 3 or 4 TIMES before it worked completely.
They were exasperated every time I brought my son in, as if there was something I was doing to cause this. The last time I brought him in, the doctor complained that in his 20+ years of pediatric work, he had NEVER seen a granuloma that was this resistant to treatment.
I am so thankful that my husband’s new job gives us real health insurance where we can see real doctors who aren’t under pressure to cut costs by denying treatment and telling new moms that they are overreacting helicopter parents.
I work in the NHS and I LIKE cauterising umbilical granulomas!
It is a quick, easy consultation where you get to do something useful, what’s not to like?
Some GPs will give the parents a script for silver nitrate sticks and a barrier cream and written instructions so they can do it themselves…it is that simple.
Granulomas don’t heal without cautery and every article I’ve read suggests that they may require multiple cauterisations before they resolve.
I’m sorry you ended up with a cut price grumpy pants service, which is not cool.
Nice to hear a doctor describe it as quick and easy, and that the literature says it often takes multiple treatments.
Yeah for friendly, helpful, knowledgable doctors like yourself!
My baby (born 5 months earlier) was “yucky” too, although not that bad. The pediatrician cauterized it. But that was part of why we were concerned when hers was quite a bit worse. And I want to say it was more blood-like… I didn’t see fresh blood, and I don’t want to be positive because I don’t remember all the details, but if I had read this story back then I would have definitely been worried big-time.
The downside of disposable diapers is that they are too good at keeping all moisture inside. In the hospital we tried to fold the diaper down so that the cord stump was exposed to the air and so would dry [we also put a bit of alcohol on it once a day]. But often the stump is inside the diaper, and stays damp. This can become infected, and certainly retards the drying-up and dropping-off process.
They have special diapers for newborns now, that have a cut-out for the cord stump so that it can be exposed to the air.
wow. Speechless
Why even go the ER? Isn’t there an herb, or a chant, or an EO for this problem? She trusts doctors to save her baby, yet refuses everything they tell her. Usually, I feel for the women who were taken in by charlatans, but not this one. This one is willfully ignorant.
You’re right. A little dried placenta would have cleared the problem right up.
Why did she take a picture?
Same reason GCC took a picture of her daughter in a C collar within a CT scanner after she feels down some stairs. Sucking up the drama to post on the Internet for attention. Children are injured, bleeding, or receiving tests that may come back with catastrophic results, and these drama queens are taking pictures for their blogs.
They’re emotional vultures. Normal people with healthy boundaries are not posting about their sick kids with all the specifics and all the photos for all the internet to see.
This story made my blood pressure go up! I shouldn’t have read it after reading the NPR blog about doctors being motivated to C section by money. I would love to see what Dr Amy has to say about that!
Me too. The comments section was particularly depressing.
First of all, a 10% difference is the same as zero difference, so the study showed nothing.
Second, there has been a concomitant rise in C-section rates in countries like the UK and Canada where obstetricians are salaried. If C-section rates are rising comparably in places that have no financial incentives for C-section, it is a very strong argument that reimbursement has little or nothing to do with the C-section rate.
Even us private OB’s don’t get that much more for a cesarean than a vaginal birth. The bulk of the added cost for a CS is what the hospital and anesthesiologists bill.
Well it really depends on the insurance …BCBS NSVD is 3600, C/S is about 4500. Medicaid just the delivery is a thousand just the c/s is about 1200. No OB is going to get rich this way.
I worked in billing at the large medical facility in Rochester MN before my son was born. We package bill for OB care and a CS package is only 1k more than a vaginal package. By package billing I mean we grouped standard prenatal care and delivery into one line item on the physician billing. We also charged the same if you chose our midwife team or OBs. Most women who chose the midwive team did so since there was a better chance you would actually deliver with someone you had seen before and then the rotating residence aren’t involved in your care. The facility bill was line itemed so that is where the OR fee and drugs were billed but it was usually only a few thousand more.
I get less because the recovery takes longer.
My OB bills about 350 dollars more for a C/S than for standard vaginal birth, about 200 dollars more than for a VBAC. The global billing prices are disclosed at your first appointment if you have insurance and at your first phone call if paying cash. I don’t see how she ends up ahead at all because of the larger amount of time involved in C/S, and the extra follow up visits.
And then I found this NPR article about doctors performing CS for $.
http://www.npr.org/blogs/health/2013/08/30/216479305/money-may-be-motivating-doctors-to-do-more-c-sections?sc=17&f=1001
As if homebirth midwives aren’t motivated by money, doulas aren’t motivated by money….oh wait.
It’s a fact, chose to deliver at the birth center owned by a midwife and it DOES cost more, even though she will be doing the exact same thing at the birth center as opposed to at your house.
Yeah, being a doula or non-nurse midwife is a pretty easy gig to get for someone with no education.
Exactly. In my area, the going rate for a doula to attend a birth is $750. That includes a visit to meet and greet, unlimited phone calls and texts, attending the birth and one visit after the birth. Post partum doulas are between $15-20 per hour, at a minimum of 3 hours for each visit. Attending 1 birth a week would make me the same amount of money it took for me earn in two weeks working full time as a nurses aide back in the day (and that was night shift work).
Well, I think that actually makes sense…when you give birth at home, you pay the midwife for her *services*. When you give birth at the birth center, you’re essentially paying rent for the birth center in addition to the doctor.
Hospitals actually do the same thing. It’s not always obvious in the billing. In fact, my onocologist practices out of a cancer clinic a couple of days each week, and when I pay out of pocket for my visits (depending on my insurance at the time, I only go twice a year for monitoring), I actually get TWO bills. One is for my doctor’s services, the other is for renting the ROOM that my visit is held in. Seriously, I could not make this up.
This isn’t to say that midwives aren’t trying to make money by promoting homebirth. But they charge more if you want to deliver in the birth center because otherwise there wouldn’t be money to have that facility.
Actually, it’s the fee they pay to have each room cleaned after a birth. The rooms at the center are birthing rooms plus the rooms where you have your appointment. Since you bring your own birth kit, it’s not for supplies (WHAT? Those gloves are supplied by me?). It’s just funny that there is an insistence that an MD is motivated by money and every choice is made with money in mind. I am less inclined to want to pay that rent (which, presumably is figured into the global fee or should be since you are using the same rooms for appointments as you would for giving birth in).
Yeah, learning that you have to buy your own supplies really made my BS meter go off. You pay all this money for birth “professionals” and they can’t bring their own supplies? WHY.
If you look at the c-section (33 1/3%) rates and what the medical experts say they should be (15% at the most), there is a big difference. Some of the motivation for some doctors is most definitely money, but some women just choose to have their baby born that way because they’re “too posh to push.” In 1991 my cousin had to argue with her doctor to have a VBAC with her second child. She told them that she waited the recommended 2 years or more before conceiving her second child and got her way. Her daughter was born after only 4 hours the natural way except for an epidural.
The medical experts say no such thing. WHO retracted their 15 percent recommendation, admitting that it NEVER had any basis in reality. It was just Marsden Wagner’s uneducated, unobstetrical (he was NOT an obstetrician) opinion.
And really? Between money and “too posh to push”, there’s no other possibility for you? Do you often push those vain women who are “too posh to push” on their pretty little heads, feeling profoundly sorry for them?
Really, I do think you have room for some more condescention. Just try it. You can do better.
I thought it was the A.A.P. that came up with the 15% rate, not the W.H.O. Of course there is an in between money and “too posh to push” for me, It’s called the woman’s choice on how she wants to give birth to her baby. I think you mean condescension, not condescention. You need to practice what you preach.
No, it was W.H.O. Why would A.A.P. give the guidelines for obstetrical issues?
The woman’s choice. So sweet. Where does the line between “choice” and “too posh to push” start?
Listen, we get it. Your cousin was a warrior natural momma who showed them all. Surprise, there are those losers who got advised that a c-section might be preferrable for them – and they are far more than 15 percent. And of course, there are those who wish they had been “too posh to push”. Especially when they visit their doctors for umpteenth time to deal with their fecal incontinence that is directly related to their vaginal birth. I’m sure they’d appreciate the fact that you group the c-section that would have saved them this problem right there with a procedure that was done by money-grabbing doctors, chosen by selfish women who were too posh to push, or chosen freely by women for no other reason that they wanted to choose it. Once again, where the line between choice and “too posh to push” start?
I’ll say it once again: the only ones who think that 15 percent should be the maximum are people who are not doctors.
” It’s called the woman’s choice on how she wants to give birth to her baby”
Then why are you so worried about it? Who cares what the C-section rate is? C-sections keep a lot of babies and mothers from dying “the natural way” too.
I’m not “worried” at all, just stating some facts.
Well, then there’s this:
http://rixarixa.blogspot.com.es/2013/08/low-platelets-and-postpartum-hemorrhage.html
At least the commenters were arguing for a hospital delivery.
Also, Rixa declined to answer…the only answers the questioner received was FROM the commenters. Really, she should listen to medical advice, not strangers on the internet, but if that if what she will do anyway, hopefully, she’ll listen to the strangers who are telling her to go to the hospital and not her idol who is totally blowing her off.
Rixa has to be the slickest NCB nutjob out there. She WILL NOT address issues of safety, because she knows the numbers. No, it’s all “autonomy” and “freedom.” But what about inept midwive? Women are entitled to birth how they want! But what about life saving measures impossible in a homebirth setting? Women are entitled to birth how they want!
Her not answering that question herself, but posting it on her blog and letting her commenters deal with it was a extremely calculated move. She can give the appearance about being all “homebirth is best for mother and child” while not risking getting called out for supporting unsafe choices. Unlike the lunatics at MDC, she knows exactly what she’s doing.
Because, really, who wouldn’t crowd-source their decision on progressive thrombocytopenia and homebirth?
apparently whether to chance catastrophic blood loss is a topic for internet advice in both infants and mothers…ugh
Wow, she just really doesn’t actually want advice, does she? No, no, all you people advising hospital, there must be something about this situation you don’t understand. Perhaps phrasing it differently will mean you tell me I can birth at home?
I get the sense from her post that she doesn’t get that “hemorrhagic disease of the newborn” is serious because it’s “just” a vitamin deficiency.
So is scurvy, so it must not be serious. Stupid sailors dying out of not-serious diseast, right? *sigh*
Interestingly, one of the reasons that “vitamins” are held in such high esteem is that the first few that scientists isolated and synthesized were like miracle cures. The blind could see, the lame could walk, etc. So the crunchy woo belief in vitamins — seems to originate in the success of science.
Vitamins are essential micronutrients. If you don’t have enough of them, bad things happen: hemorrhage, scurvy, beri beri, pernicious anemia, etc. If a vitamin deficiency is “no big deal” now, it’s because we have ready access to vitamins. Access which this woman refused on behalf of her child.
I think that social selection (in this case) is much stronger than natural one. If you oppose to all other world and cut connections and don’t adopt useful and effective strategies, your children won’t have as much opportunities and experience as other children of the same socio-economic group.
” weeding out whatever deficiencies led parents to these poor decisions in the first place.”
holy eugenics, batman! that is disgusting. Unless you have solved the nature vs nurture issue of human behavior I find this a completely deplorable thing to say. An alternate explanation is that a lack of adequate science education has made the average person susceptible to pseudoscience.
You must hate the Darwin awards, too.
I do. Yeah, idiots are idiots, but even if they die in the commission of an act of idiocy, it’s still the loss of a human life. There will be grieving parents, friends, whoever, and I think the idea that the death of their loved one is joked about would be devastating. I’ll call a moron a moron, but I don’t find it hilarious if they die before they have the opportunity to know better.
At least in the Darwin awards they are usually offing themselves. They’re not risking the lives of their kids.
I don’t have an adequate science education, and I know enough to believe those people Idiots.
And it is not impossible to get a good science education online. MIT put ALL his courses online. There are good skeptical blogs. You can find true science. Those people prefers the fuzzy feeling and the lies and faeries. It is not a problem of education.
The key to learning anything “on-line” as it were is you need to be able to distinguish reliable sources from unreliable. If someone is seeking information on-line because they eschew it from a doctor, they are pretty much, by definition, going to get bad info, because they are going to avoid actually medical expertise.
I have to agree with you there. I get what Dr. Amy was trying to say, but this is one of those times I hate the way she’s saying it. It seemed cruel.
Eugenecists *advocate* for weeding out “undesirables.” Amy is doing the opposite. It is tragic that the result of these parents’ ignorance may be the removal of their children from the gene pool, but *they* are the ones responsible. Let’s not shoot the messenger.
So let me clear my head. This women refused a Vit K shot for her kid because the shot is evil. But she had no problem to let the baby have IVs, blood transfusion and all the other works which give the baby more pain than one simple shot. Hun….. apparently the word “logic” was not in this women’s dictionary.
Oh but the risk of HDN is only one in 10 000 so you have o multiply the pain of the vitamin K injection by 10 000 and divide the pain of he labs IV and transfusion by 10 000 to take care of the relative risk right? 🙂
Oh, this makes me so angry, I could just throw my computer! I’m beginning to think these people are truly deranged. Their level of selfishness and neglect is horrific.
*facepalm*
In my ICP Moms group, there was a woman who was questioning the Vitamin K shot and thinking it wasn’t necessary, but those of us who aren’t into woo were telling her that it was ESPECIALLY important that she get her child the Vitamin K shot at birth because with ICP, our ability to get enough Vitamin K is impaired (hence our increased risk of hemmorhaging). Someone had the nerve to link to Mercola *facepalm again*.
I was planning on getting my daughter the Vitamin K shot long before I was diagnosed with ICP. I saw absolutely no harm in it. Now I’m especially glad because her umbilical cord fell out when she was just a few days old.
The ignorance and foolhardiness of this mother is terrible. What a moron.
This people are nutjobs. I’m starting to not feel much sympathy (especially the expecting moms in the comments).
I don’t get this. It’s a vitamin. Aren’t the alties into vitamins?
And it’s a preventative measure. One of the often repeated criticism of “mainstream medicine” by “alternative medicine” is that it never tries to prevent problems, only reacts. Why aren’t they entirely into this one?
Incidentally, in case anyone’s worrying, there are multiple studies out now demonstrating NO LINK between childhood cancer and vitamin K administration. It’s a known non-risk.
“Aren’t the alties into vitamins?”
They’re into defiance. Whatever an authority figure recommends, they decline on the grounds that it causes either cancer or autism.
Ironically, two things we know if we know anything at all are that vitamin K shots don’t cause cancer and vaccines don’t cause autism. There is simply no correlation at all.
WE know that, but they know better…
I can’t figure out how on earth they think vitamin k would cause cancer. It’s a vitamin, found in lots of healthy foods, particularly leafy greens. So if vitamin k causes cancer, well, so does kale.
I think they think something in the shot, like a preservative, causes cancer, not the vitamin. Or maybe the massive dose? ‘Cause there isn’t THAT much vit k in kale.
So how come they never worry about the preservatives in the unregulated vitamins at GNC but the ones packaged in a legit pharmacy are horribly dangerous…altie logic is giving me a headache.
Never mind the preservatives in the unregulated vitamins – what about the contaminants? I seem to remember a recall of a certain vitamin brand a few years ago due to heavy metal contamination:
http://leftbrainrightbrain.co.uk/2010/01/14/toxicmetals/
You would think that if a Vitamin K shot causes cancer, then so would getting vitamin K through breast milk because mom eats kale smoothies.
That shot is 20,000 times the normal dosage!!
(from memory that was the unreferenced number in mercola’s article)..
I suspect the excuse is the same one as is used to explain why studies of vitamin C didn’t show any anti-cancer effect: The vitamin K you get in a shot is somehow “wrong” and the stuff in kale is “natural” and therefore good.
In principle, excess amounts of some vitamins can increase the risk of cancer. IIRC, there was a study looking at vitamin A in smokers that found that supplements increased the risk of cancer slightly. But that was in a high risk population and megadoses, not physiologic replacement in a very low risk population. And, in any case, it’s been demonstrated to not be true.
It’s an injection, and doctors recommend it. That’s all anyone needs to know to explain why she refused it. How does she know what’s in that needle? Much better to buy a bunch of untested, unregulated stuff from the health food store. They wouldn’t lie to her to sell that stuff, now would they?
Thank you ChrisKid for leaving me an opening to rant on my absolute favorite topic. People, ‘supplements’ are explicitly excluded from the FDA’s usual requirements that drug be ‘pure, safe, and effective,’ Think about that the next time you’re in the vitamin aisle.
AD, that’s one my huge pet peeves as well. I got into it with our public library because they let some quacks hawk their “ADHD supplements.” First, they do a “muscle test” to determine which micronutrient you are deficient in and then they sell it to you….I was outraged and I asked the library if they were aware that those nutjobs were selling snake oil. The library people told me they didn’t know, that they didn’t support the sale of things in the library but that they did support dissemination of balanced information (these people were billed as a”natural methods of coping with ADHD” workshop.)
The library went on to present a more conventional workshop on ADHD ( which was my husband and he doesn’t sell anything) but, they booked the quacks again, I noticed, even after I pointed out the website with the supplement info, including the pyramid scheme to sell the supplements AND the helpful page for the salespeople on how to get around FDA inspections.
Does that include prenatal vitamins?
“Supplements” are friggin scary! From the guaranteed all natural supplement that will cure your arthritis (containing methotrexate) to the mineral supplement that makes sure you have your RDA (and more!) of arsenic and lead to the infertility aid that contained an abortifactant*, I’ve come to the conclusion that “big supplement” is a scarier beast than big pharma.
*And these are just the examples where the suspect elements were listed on the label. Who knows what’s really in them? No one, since the FDA can’t regulate.
Oh, but the PAIN, the horrible, PAIN of the injection! Inflicting that on a newborn will turn them into a cenobite going around purring ‘Ahhh, the suffering. The sweet suffering!’
Yay cenobite reference!
My friend who was pregnant along with me got a massive injection of Vitamin B to deal with morning sickness because, as they explained to me, the risk of hear defects was just too much with the antihistamine they prescribe (which I happened to be taking,) never mind that she’d had pre-eclampsia with her first and was planning a home birth with this one, which she had to call off and be induced (fortunately she accepted it) due to pre-eclampsia again. She got over her morning sickness, although I couldn’t help thinking about it being the end of first trimester anyway. We both have healthy baby boys.
WE know that the dose of Vit. K at birth doesn’t cause cancer, but a doctor prescribed it, so it can’t possibly be a safe natural preventative, even though it quite literally is.
Ironically, there is some evidence that the massive doses of antioxidants so beloved of alt-med types actually DO increase the risk of cancer. But these people just feel smart, not doing what the doctor says.
We
chose not to have it done, but also noticed when there was a problem
and addressed it immediately. – See more at:
http://themommydialogues.com/the-final-six-mandys-story/#sthash.wOxi8C7A.dpuf
We
chose not to have it done, but also noticed when there was a problem
and addressed it immediately. – See more at:
http://themommydialogues.com/the-final-six-mandys-story/#sthash.wOxi8C7A.dpuf
We
chose not to have it done, but also noticed when there was a problem
and addressed it immediately. – See more at:
http://themommydialogues.com/the-final-six-mandys-story/#sthash.wOxi8C7A.dpuf
We
chose not to have it done, but also noticed when there was a problem
and addressed it immediately. – See more at:
http://themommydialogues.com/the-final-six-mandys-story/#sthash.wOxi8C7A.dpuf
Yeah, that struck me as odd too. I’d have been concerned long before the 6th day. It also demonstrates that the claim that it only happened because of the mastitis is complete BS unless she had mastitis for 6 days. This baby never had enough vitamin K to survive–until they finally got him to the hospital and he got a shot.
And a blood transfusion…
I wonder if they gave him FFP. Vitamin K only provides the substrate with which to make clotting factors, not the factors themselves, so I’d be inclined to, especially with a bleed bad enough to need PRBCs.
Of course, now he’s been exposed to blood products and has the risk of alloimmunization, infection, and reaction. None of which was necessary if they’d accepted the very safe and simple prophylactic intervention.
I wonder about the FFP as well. The bleeding was going on for 6 days.
What is FFP?
Fresh frozen plasma. It contains the proteins that are needed for clotting.
Roughly, clotting requires platelets and fibrinogen. Fibrinogen is found in plasma.
Here’s a good enough explanation:
http://www.dummies.com/how-to/content/how-blood-clots-form-to-prevent-leaking.html
A more detailed and accurate explanation:
http://themedicalbiochemistrypage.org/images/coagulationcascade.jpg
How do you paste pictures here?
When you go to post, there is a little thing in the bottom left that says “Upload images”
You may need to be logged-in to have it
Thanks for this, I have been poring over this website for an hour now!
I wasn’t intending to get the image to post, just the link.
Surprise!
I read the story before you made this post, Dr Amy.
I was reminded of one of Jack London’s stories. I haven’t read it in English but it went along the lines of, ‘Can a man ever tell a woman that she’s a pig?
Can I tell a mother that’s she’s a pig of a woman? I’d gladly do it with Janet Fraser but my, is the world turning into a pig farm?
Women like this disgust me on a visceral level.
My son didn’t even react to his Vitamin K shot. I can’t imagine watching him go through procedure after procedure because I didn’t take a simple preventive step. I hope this crazy woman got hit with one hell of a high copay for her foolishness. She was right about one thing – it wasn’t ‘fair’ to Ryder. But the person who had been unfair to him was her and her husband. I’d like to think he (the husband) has a brain cell or two and steps in next time since she’s clearly an irredeemable idiot.
I don’t even remember my sons getting theirs, but I doubt they noticed above the greater stimulation of being cold and wet. Once they were warm and dry, they were pretty chill about most things. When they got vaccines as infants, they’d cry a little, but settle pretty quickly, especially if we fed them right away…I don’t think they were permanently traumatised. I doubt Ryder will even remember his horrible PICU stay for that matter, though it certainly would have been better for him to fuss for a second for that shot at birth.
Hmm, a single shot in the thigh or, multiple IV attempts and blood draws, a blood transfusion (and its inherent risks), admission to a PICU, exposure to a dirty ED in the middle of the winter (hello Flu and RSV).
Medicine should be PREVENTATIVE, not reactionary! Idiot…
That principle was beaten into us at Univ of MD. If you sat around and waited for a situation to be emergent when you could have acted sooner your butt was chewed by your instructor until you swore you would never be so lazy and thoughtless again.
Someone very wise and smart has said, “The goal of intervention is to prevent emergencies, not respond to them. If you have an emergency, you acted too late.”
I don’t remember where I read it…
I’m often pissed off after I read the stories linked on this blog but this one may have set a new record.
“We didn’t understand why they treated us like it was no big deal and let us sit in the ER for 10 hours.” No, they knew it was a big deal. They just had other patients who were a bigger deal at that moment in time like, ya know, people having heart attacks and being pulled out of car wrecks. You know who wouldn’t have made you wait 10 hours in the ER? The pediatrician/L&D nurse or whoever who tried to give your baby the vitamin K shot in the first place.
Someone should keep track of this woman. If there’s ever a measles or pertussis outbreak in her area, we’ll know where to look for Patient Zero.
Would she rather have seen the ED staff panicking? Would that have sunk in more that her child could have died? Our job is NOT to panic.
I think a lot of people have watched too much ER.
The real ER (hate to spill the beans) doesn’t have a soundtrack. And we act more like Scrubs and less like Grey’s Anatomy.
Totally.
I don’t think people realise that not only was the medicine pretty accurate on Scrubs, so was pretty much everything else.
Seriously most doctors watch House and Grey’s Anatomy and ER and are all “FFS that would never happen”, but we’re laughing along with Scrubs, because it is funny and true ( not least that you need to get on the good side of the nurses and custodial staff).
I worked in an ER only briefly during residency, but my impression is that the average night in the ER involves a lot of people with constipation that they decided is an emergency at 3 am, a fair number of kids with sore throats or earaches and worried parents, some trauma but mostly quite minor, a number of people who were drunk enough to either do something stupid or be brought in because no one quite new where else to stick them until they sobered up enough to go home safely, and only very, very occasionally the sort of thing that you might see on the TV show ER. (Though it should be noted that I worked in an ER in Iowa. ERs in Detroit probably get a lot more exciting trauma.)
Advice I heard from a seasoned ER doc:
1. Stay off of motorcycles;
2. Never have more than two alcoholic beverages in one 24-hour period;
3. Be at home between midnight and 5 am. Nothing good ever happens after midnight.
To be fair, what good things would they expect to see in the ER at any time?
Also, knife safety rules? They’re there for a reason. I have an astonishing collection of stories about use of Swiss army knives gone wrong (none of them involve malicious stabbing either-just accidents.)
Seriously.
Bagels. Don’t slice ’em.
Also, don’t leave an open knife on a couch. Especially not one with cushions that the knife could slide in between. Especially not if you might want to sit down later, after you’ve forgotten about it. Ouch!
Yeah, also never slice when you are totally ticked off. I was mad at my mom, and took it out on my own finger. At 40 years old!
Reminds me of the Jens Lekman song: “Your arms around me”
“I was slicing up an avocado / When you came up behind me / With your silent brand new sneakers “
Lessee,
Take history
Assess patient
Order lab tests
Draw lab samples (repeat)
Run lab tests (coags are slow)
Evaluate test results
Call PICU to transfer patient
PICU calls back when they are ready for the patient
Ten hours IS a long time, but they were not letting them “sit in the ER”. They were doing all the necessary work to properly treat the patient.
They don’t have the first clue about what an emergency is.
When my wife used to be doing on-call stuff as a vet, she would get a call at 3 in the morning from someone because their dog has had vomiting with diarrhea – for three days now.
And then they think that 3 am is when it needs to be fixed.
My usual question for her when she got back was, “Was it really an emergency?”
he four ‘sick funds’ [HMOs] in Israel, to which every citizen legally has to belong [to the one of his choice], got so fed up with the “child with high fever for 3 days” who is brought to the ER “because it began to worry me” at 3 a.m. that they have all established connections to walk-in, 24/7 clinics to be used instead. If a parent takes a child, or in fact, takes himself, directly to an ER for a non-life-threatening situation, the sick fund will not reimburse for the cost of the visit. That has reduced unnecessary ER visits dramatically. The blessings of the Evil Socialized Medicine system!
My pet peeve is the phone call at 1750 (my doors close at 1800) about a child who has been unwell all day.
If it is an emergency, they are told to go to A&E, if it isn’t, but they need seen that night the Out of Hours GP can be contacted at 1800, otherwise I’ll book the next available appointment in the morning.
Me staying late to see them…not going to happen, because if I start doing that I’d never actually get home.
It happens in every profession. I joke about the Friday arvo client that has been sitting on an issue all week and needs to get something working before they head home for the weekend. And by joke I mean whinge..
Italy has something like that, too. You pay yourself if you go to the ER and it is not an emergency.
I should add that the Israeli sick funds have a 24 hour nurses’ line for medical advice and/or immediate (covered) referral to an er. Also, out in the Israeli “peripheria” there aren’t 24 hour clinics like you’ll find in the big cities, so the er still fills that role. The walk in clinics Antigonos mentioned are amazing though, and can handle a really broad range of injuries, illness and tests.
That would be wonderful. I went to the ER with what turned out to be mono and severe dehydration, but I’d much rather have gone to a clinic. However, it was 10 pm when I started having trouble breathing, so it was the ER or nothing.
Someone posted the link to the AAP statement yesterday about vitamin K and the lack of association with cancers. One of the interesting statements in there was how the later version (after 2 weeks) was more common in breastfed infants. IOW, breastfeeding is actually a riskfactor.
Of course, it’s not a reason to not breastfeed, but it’s also a pretty good indication that breastfeeding isn’t the way to prevent this.
Then again, she eats kale, so that makes her better than everyone else.
I eat cheeseburgers and my son gets the nutritional benefits of them when we snuggle skin-to-skin.
One day, when he is an old man, and you are long gone, he will pass a burger joint and be flooded with memories of dear old dad.
But, but, but, I thought breast milk was liquid gold , the cure all, and the only thing an infant needs!?
Say what you want about formula, it has Vit K (and iron)…
Not just kale, but kale in a SMOOTHIE. Yuck. [And I like kale, when cooked properly]
The most idiotic part? When she wails about how the tests and treatments are hurting her baby. Pop quiz kids! Who is responsible for Ryder needing all those invasive tests and treatments? You, Mandy, you.
See, there’s the problem. She HAS to know that, she has to realize that everything the family went through that day was 100% preventable. She can’t accept that it’s her fault, though, which is why she can’t admit that she made the wrong choice and she should make a different one next time.
Not even a twinge? Not even a ‘better safe then sorry?’ Not even a ‘Dr Bigpharma wasn’t quite as bad as I thought and actually seemed somewhat pleasant and knowledgeable’?
First time bad outcome I can get the rationalising but for the second kid as well… I don’t understand. Surely a little doubt creeps in somewhere?
I mean at what point does this become child abuse?
At this point.
Considering how sucky the experience is of taking a baby to the ER (ten tedious hours of near solitary confinement in an exam room) and the additional suckitude of spending time in the PICU (in a very nice room, TYVM) and seeing her baby hooked up…
She has AMPLE motivation to avoid a repeat experience. Yet her conclusion is not “That sucked, I hated it. I’ll trade a quick jab for going through THAT again.”. Her conclusion is “Sure, it happened once, but what are the odds of it happening again?”.
She’s still in denial. After all of that.
Okay – here’s one for the audience:
Is there any approach that would be effective with her?
Reminder: The umbilical stump had been oozing for six days. It took an escalation of the bleeding before she was motivated to take her baby in.
Would any approach be effective. No, because somehow, despite a fairly linear connection between not getting the shot and her baby hemorrhaging, she blames mastitis. Clearly, it was a lack of kale smoothies that caused this; not the refusal of the vitamin K injection. Willful ignorance is a scary thing.
In the US system, there is a total lack of followup. Unless the mother worries, no one is going to visit that kid postpartum as I did when doing my “district” rotation as a midwifery student in the UK, which requires that a patient and infant are legally the midwife’s responsibility until the 10th day after birth. Along with weighing the baby, and helping with nursing and infant care, we checked the cord stump every day,
CPS?
Social services, specifically children’s protective services.
I was suggesting that, not asking what it was
But if the odds are 1 in 10,000 and her first baby had it, she wouldn’t have to worry until she already had 9,999 more babies. That’s how statistics work, right?
Somebody correct me if I’m wrong, but I thought the the 1:10,000 is for the general population, which almost all receive the Vitamin K shot. So what is the rate for babies that don’t get it – no one even knows?
When I read it, that wasn’t what I was hearing at all. Despite the fact that these folks saved her baby’s life and they were in and out in a few hours, she went on and on about how mean the doctors and nurses were, and how they weren’t doing what she thought was best. It read like an account of someone taking her nine-year-old in for stitches after a bicycle crash, more about the massive inconvenience of the ER. I’m not sure she even realizes how close her baby came to dying.
I think this has gone beyond denial towards delusional, in the strict sense that delusion is a fixed, false belief which is not amenable to logic, reason or argument.
Not good.
Aren’t there oral Vit K drops available? Why didn’t she get those at least? Wouldn’t that be better than nothing? Or are those useless?
Also, she said she had mastitis and was unable to provide the proper nutrition via breastmilk. Of course we know that is crap since breastmilk is notoriously low in Vit K and it doesn’t matter what she was eating, but, we also know that formula is fortified with it, so supplementing until the mastitis was gone was an option as well. Well, these people think formula is poison worse than the Vit K shot, so that would never do, what was I thinking?
Oral vitamin K does not work well for prevention….but you are right that it would have been better than nothing.