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Duggar Family Expecting 20th Baby: Obstetrician Offers Advice

OMG, Michelle Duggar is pregnant again.  Is she competing with the wife of Feodor Vassilyev?  Vassilyev was pregnant 27 times between 1725 and 1765 and gave birth to 16 pairs of twins, 7 sets of triplets and four sets of quadruplets. 67 children survived infancy making her the woman who had the most documented number of children in the world. Vassilyev had a history of multiple births. What’s Duggar’s excuse?

I’ve written about Duggar before out of genuine concern and received over 2,000 comments on the Basil and Spice website.  Many were unkind.  People like Duggar because of her affable personality but want to ignore the facts: with each subsequent pregnancy, her life becomes fraught with danger.  Her last pregnancy was extremely high-risk, complicated by pre-eclampsia and the emergency premature delivery of her daughter who only weighed 1.3 pounds at birth. It was a very close call. According to Answers.com, the Duggar family gets paid an estimated $25,000 to $75,000 per episode on the reality television show on Channel TLC. So, is it perhaps the show’s ratings that have prompted this 45 year old mother of 19 children to have yet another child? Is it the Baby-Doll syndrome where women have multiple children because they like the baby doll effect of having a newborn? I’m still scratching my head. However, I would be remiss if I did not, as an obstetrician offer some advice (albeit unsolicited) regarding the dangers of extreme parity (aka a great number of pregnancies). It was the same advice I offered almost 2 years ago: Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

FDA Approves Tetanus/Diphtheria/Pertussis Vaccine For Adults Over 65

BoostrixMost of us are familiar with the need to achieve immunization against tetanus (“lockjaw”) and diphtheria. Fewer are familiar with the need to immunize against pertussis (“whooping cough”). Boostrix is a vaccine used to achieve immunity against all three. Until recently, there had not been a vaccine approved by the Food and Drug Administration (FDA) against pertussis intended for use in elders (ages 65 years and older). On July 8, 2011, the FDA approved Boostrix for use in this population of seniors.

The link to the FDA announcement is http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm262390.htm

Whooping cough is not a trivial disease. It is a highly communicable infectious disease caused by the bacterium Bordetella pertussis. It is transmitted by respiratory secretions or large droplets from the respiratory tract of an infected person. In children, whooping cough is typified by Read more »

This post, FDA Approves Tetanus/Diphtheria/Pertussis Vaccine For Adults Over 65, was originally published on Healthine.com by Paul Auerbach, M.D..

When Public Health Legislation Is More Effective Than Physician’s Advice

Last month, my family was involved in a scary traffic accident en route to the Family Medicine Education Consortium‘s North East Region meeting. I was in the left-hand eastbound lane of the Massachusetts Turnpike when a westbound tractor trailer collided with a truck, causing the truck to cross over the grass median a few cars ahead of us. I hit the brakes and swerved to avoid the truck, but its momentum carried it forward into the left side of our car. Strapped into child safety seats in the back, both of my children were struck by shards of window glass. My five year-old son, who had been sitting behind me, eventually required twelve stitches to close a scalp laceration. Miraculously, none of the occupants of the other six damaged vehicles, including the truck driver, sustained any injuries.

Family physicians like me, and physicians in general, like to believe that the interventions we provide patients make a big difference in their eventual health outcomes. In a few cases, they do. But for most people, events largely outside of the scope of medical practice determine one’s quality and length of life, and Read more »

*This blog post was originally published at Common Sense Family Doctor*

Study Investigates The Role Of Fluid Resuscitation In Treatment Of Life-Threatening Infections

Dehydration is a common phenomenon in those suffering from infectious diseases, particularly if the diseases cause vomiting and/or diarrhea. We are all familiar with having the “stomach flu,” “traveler’s diarrhea,” or food poisoning. However, severe infections of all sorts can cause profound illness, debilitation, and fluid losses. In many developing countries, very large numbers of small children are afflicted with non-gastrointestinal infectious diseases that rapidly cause relatively large fluid losses, and therefore profound, life-threatening dehydration, which is manifested in part by dangerously low blood pressure and subsequent failure to deliver precious liquid, nutrients and oxygen to the tissues of the body. This is called “shock.”

The following discussion is cutting edge information, but not simplistic or necessarily easy to understand or apply. However, I have learned that my readers are often volunteers in settings where intensive care medicine must be applied, and want to read more than simple approaches to therapy. So, I am going to do my best to interpret for you what has recently been published in the New England Journal of Medicine in an article entitled “Mortality after Fluid Bolus in African Children with Severe Infection” (N Engl J Med 2011; 364:2483-95) written by Kathryn Maitland and her colleagues.

The focus of their investigation was Read more »

This post, Study Investigates The Role Of Fluid Resuscitation In Treatment Of Life-Threatening Infections, was originally published on Healthine.com by Paul Auerbach, M.D..

Pediatric Ventricular Assist Device Is Gaining Wider Use In The U.S.

Ventricular Assist Devices (VADs) are small pumps that take over the work of the heart in pumping the blood through the body. Patients who need a heart transplant, but for whom there is no donor heart available, might be given a VAD for what’s called a bridge-to-transplant while they wait for a donor.

PediMag, the pediatric version of the adult device, CentriMag, is an external device designed for short-term use in infants with heart failure. PediMag can also be used to support children after heart transplant surgery if they experience organ rejection and need time for their hearts to rest and heal, according to Jonathan M. Chen, MD, Surgical Director of Pediatric Heart Transplantation at Morgan Stanley Children’s Hospital of New York. Dr. Chen has extensive experience treating children with heart failure and has recently authored an account of his first successful use of the PediMag as a biventricular bridge-to-transplant in an infant.

The PediMag ventricular assist device is Read more »

*This blog post was originally published at Columbia University Department of Surgery Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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