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Expectant Fathers: How To Prepare For A Healthy Baby

Some of the most endearing moments I have witnessed as an obstetrician involved observing men in the labor room. There was the hip Jewish dad from Brooklyn who brought his Anita Baker tape and played it while his wife was in labor. Because she was one of my favorite artists, I was constantly in their room under the guise of watching the fetal monitor, just so that I could listen to the music. Another memorable moment was the dad who cried tears of joy when his wife was returned back to her room after having a c. section. The love and admiration that beamed in his eyes almost tempted me to ask him if he had a friend (this was of course, when I was single). The point is, expectant dads can play a significant role in helping their wives or girlfriends have a healthy baby. Here’s how: Read more »

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

Pregnant Female Prisoners Must Remain In Shackles During C-Section Procedures?

“But for the grace of God go I.” My late aunt drilled that value into my six-year old head and it has never left. An article regarding a New York politician recently caught my attention. When New York State enacted a bill to ban the shackling of pregnant prisoners, a New York State Assemblywoman objected. The article goes on to discuss the case of Jeanna M. Graves, who, in 2002 was arrested on a drug charge and began a three year sentence. Graves was pregnant with twins and while in labor, was handcuffed during her entire C. Section. How utterly ridiculous.

Before a C. Section begins, a patient is usually given either an epidural or spinal anesthesia. On rare occasions, she is put to sleep with general anesthesia if the baby must be delivered emergently. On all accounts, the patient’s legs will either be numb from anesthesia or she will be sleeping. Why then does she need shackles? She’s certainly not in a position to run. Although I addressed this issue last August, it needs to be revisited again. Read more »

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

Pregnant Moms: Beware Of Shift Changes In The Hospital

At one time, a hospital would be called a 24-hour institution but now it’s a business. Within this business are shift workers that include nurses, technicians, clerical staff and even hospital employed doctors who are now called hospitalists.  In a teaching hospital resident physicians also work in shifts so the responsibility of patient care is always being transferred from one group of healthcare providers to another. Do they always communicate effectively? Regrettably, “no.”

Sign-outs, handoffs, shift changes, nurses’ report. These are the multiple names for the process where a departing  provider is responsible for letting the arriving provider know what’s going on with the patient.  According to statistics, 80% of medical mistakes occur during shift changes and 50 to 60% of them are preventable. Listed below is an excerpt from The Smart Mother’s Guide to a Better Pregnancy that teaches pregnant moms what things should be known during a shift change. Read more »

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

Pregnant And Itchy? It Could Be A Dangerous Liver Problem

If a pregnant woman finds herself scratching and itching during the third trimester, these symptoms should not be ignored. Each year, approximately 0.1 to 15% of pregnant women are affected by a liver disorder called Intrahepatic Cholestasis of Pregnancy or (ICP). ICP patients tend to develop symptoms of itchiness of their hands and feet that becomes progressively worse and then spreads all over their body. The itchiness usually worsens at night and if untreated can cause jaundice and several life-threatening complications to the unborn fetus. When a pregnant woman complaints of itchiness (pruritus) all over her body, the first order of business is to determine whether a rash is present. If a rash is absent, ICP should be suspected.

The liver is the largest gland in the body and in addition to filtering harmful substances such as alcohol it is also responsible for processing fats, carbohydrates and proteins. To process fat, the liver makes bile salts. In ICP, bile salts are increased which contributes to the symptoms of itchiness. Affected women will not only be plagued by pruritus but their unborn babies are at risk for stillbirth, preterm labor, fetal distress and abnormal heart rates. South American women and especially those from Chile have a greater risk of developing ICD as do women from South Asia and Sweden. Read more »

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

Oops: Pre-Term Labor Drug Does More Harm Than Good To Pregnant Moms

The Federal Drug Administration (FDA) recently issued a new warning about a medication that has been used for years and it has sent shock waves throughout my specialty. Terbutaline is an FDA approved medication that is used for asthmatic patients or patients who have significant narrowing of the airways. However for years it has been used as an “off-label” medication to treat preterm labor but now that’s about to change. An off-label drug means it hasn’t been approved for that specific use by the FDA.

According to the FDA, the injectable form of Terbutaline should only be used for a maximum of 24 to 72 hours because the drugs association with heart problems and death.  The FDA goes on to say that the oral version (pills) should not be prescribed to treat preterm labor because it’s ineffective and can cause similar problems. As an obstetrician, I feel utterly betrayed. The medication clearly had side effects that included shortness of breath and a racing heart. As resident physicians we were taught that the benefit outweighed the risks of having a premature baby and the patients should try to adjust to the medication. Read more »

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

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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