Sunday, February 25, 2007

Changing of the Gardasil

I can't believe I'm standing with uber-conservative fundamentalist Christians on the topic of Merck's new wonder drug, even if our reasons may differ.

Since June when a federal advisory panel voted unanimously to recommend all girls and women ages 11 to 26 receive Merck's new vaccine for the virus that causes genital warts, Gardasil, which in clinical studies proved to prevent cervical cancers by preventing infection from four strains of the human papilloma virus, I have been waiting for government entities to mandate its use.

Merck, before abruptly halting it's lobbying efforts Tuesday, quietly poured money into pushing its revolutionary new drug -- which, for the record, costs $360 for the three-shot regimen needed for effectiveness -- on state legislatures across the country, hoping they will mandate the costly prevention for all girls beginning at age 11.

The drug company won't say how much it spent on this endeavor, but one might imagine such non-disclosure could mean the grand total is a boatload. Why just imagine, if even a small percentage of states pass measures to require parents vaccinate their girl children against HPV, the company stands to have a lucrative payday ... at least until its patent runs out or until the drug is approved for our boy children and the process starts all over again.

Now it seems New York is on the bandwagon, with legislators calling for laws to do just that: make it imperative that all girls get the series before they become sexually active.

Let me just get a few things off my chest:
I know that HPV is the most common sexually transmitted disease in the world, and particularly devastating to underdeveloped and impoverished nations.

I believe Merck's vaccine is safe and effective.

I fully expect Ittybit to get this vaccine when she turns 11, even if I have to pay out of pocket for it (currently most insurance WILL* cover this preventive measure).

I think the idea that HPV can be completely prevented by morally responsible living is akin to sticking one’s head in the sand.

I think that discovering that cancer can be caused by a virus is INCREDIBLY exciting for the future of medical research.

BUT ...
Do I want government telling me how to raise my child?

What if I were afraid of the repercussions of vaccines on cognitive development?

What if I was convinced of anecdotal accounts of parents who believed their kids were adversely affected by inoculations instead of peer-reviewed research showing no link between childhood vaccinations and autism?

What if *shudder* I believed in my heart of hearts that giving her the shot would be akin to giving her the keys to a lifetime of debauchery and moral decay?

In short, what if I were someone else?

I suppose there are still choices I could make. I could pull my kid from school and take her education on at home. Sure, I could fight the good fight and buck the laws of man. But should I have to, especially where medical decisions are concerned?

I think it's wonderful that this discovery has been made. I think it's a valuable health care tool that all people -- even boys when the drug is approved for use in the other 49 percent of our population -- should seriously consider. Like many have said, I believe there are more pros than cons in giving it to children.

However I wonder if Gardasil, in its current $360 form, will be made available to the developing world and those marginalized by inadequate medical coverage, where the need is arguably the greatest? Even in this country, doctors are reportedly not stocking the vaccine because they say insurers* aren’t reimbursing them appropriately.

I know this issue may one day go the way of seat belts, the infant car seat and, most recently, the ban of trans fats in NYC restaurants, but I can't help but want government to make its recommendations, decide such discoveries are worth funding for those least likely to afford it, and then step off and let folks make their own decisions.

And to tell you the truth, I'd just feel a lot better if a single drug company didn't stand to reap the benefit of a government mandate. I keep wondering why the rush? Where's the fire?

Seriously, if our government can require this for girls ages 11 and older why can't they require drug manufacturers make some concessions, too. Like lower the price? Oh, yeah, our government isn’t allowed to negotiate for lower drug costs; silly me.

Sunday, February 18, 2007

Asking all the wrong questions

Last month TODAY show host Meredith Vieira asked Web log diarist Melissa Summers of Suburban Bliss, on live television, to explain the difference between a mom and a babysitter when it came to drinking on the job.

She wanted to know why the double standard: If you wouldn't let a babysitter drink while they were watching your children why would you?
And the gloves came off.

All over the Internet mothers wielded pitchforks and demanded blood. Many of them ask why the media is so insistent on holding mothers at arms length and dropping them in a pit together to see which of them survives the rumble?

Vieira's question comparing moms to babysitters came out of a puff piece about women who gather together at play dates and simultaneously pop the cork on a bottle of wine. It turned into a debate, led by Vieira and flanked by "expert" Dr. Janet Taylor, about whether mothers should drink at all in the presence of their children (unless of course there's a man around, or in the event of a neighborhood/backyard barbecue ... you know, where men might be socializing, too). That to do so would not only be modeling bad behavior, but also jeopardizing the health and well being of the children.

The reasoning? Just in case these silly women all get schnockered, a kid falls on his head and requires a trip to the emergency room. Lordy, who would be able to drive?

I've been watching the backlash with some degree of humor.

Are they serious? They were not talking about bringing a bottle of vodka to Mommy and Me. They were talking about a single glass of wine while the kids are tearing up the yard. Who would worry about that? Would you not call an ambulance in the case of a REAL emergency anyway?

But I know there are people out there whose lives have been indelibly marked by ravages of alcoholism, and they are applauding the segment.

They say social drinking in this country is horribly misunderstood. That folks don’t really understand their own tolerance, no matter what they think it to be.
That in fact, statistically, 1 in 10 people has a problem with alcohol and doesn’t even know it.

And when you know this, why would you risk having any amount of alcohol when you are driving the kids around.

I still don't think asking a mother to define the difference between herself and a babysitter when it comes to "drinking" on the job is a fair question. Being a mom shouldn't be considered a job as much as a part of life. Alcohol is a legal substance, sold in restaurants, bars and other places where driving to and from is necessary. The same question would never be asked of a man who takes junior to the ballgame and washes down his hotdog with a beer. NBC wouldn’t film a story about such an outing.

And I think that when we are talking moderation, the issue really shouldn't be such a lightning rod. One glass of wine when combined with an hour and a meal or snack does not a health hazard make.

But perhaps the fairer question would have been How do you KNOW what your tolerance is and that you haven’t exceed it? And if you see someone exceed their limit what would you do?

It might have even added emphasis if the barrage of questions included the more personal "Have you EVER drank more than you intended?"

Those are fair questions.

This month Albany County Legislator Ann Comella reportedly refused a limousine ride home after a night out at a bar. Instead she got into her car, drove the wrong way on Alternate Route 7, crashed into another motorist and died.

She wasn’t caring for children at the time, but she was drinking socially. And apparently she thought she was in fine shape to drive.

Those are the questions we should be asking ourselves –- women and men, mothers and fathers -- every time we set out to just have one drink.

Sunday, February 11, 2007

Things could be worse ...

At the risk of sounding all cheese and whine I will be listing some of the things that have happened during the last month or so that could have (and in some instances did, albeit ever so briefly) send me over the edge. Help yourself:

1. Sleep. Not getting any.

When I'm not typing away furiously, making all kinds of notes and records for some nebulous future -- wherein Ittybit will grow up, read all this drivel and extol the virtues of her dear old mum to the treetops -- I am trying go get her to accept her human need for shut-eye: namely the eight-hour-interval, non-disrupted sleep with a side of REM if-you-please kind of slumber.

It's been a kind of one step forward, two steps back sort of dance.

While I pine for the luxury of sleeping in that enormous bed I once foolishly mocked, I've been practicing for a future career in the circus, performing various coil-like contortions from the cramped confines of a toddler bed for a combined total of three hours (at least twice) per evening, in a probably ill-advised effort to coax her to sleep.

If this continues much longer I fear I will require constant chiropracty, or at the very least a change in bedroom furniture for the little insomniac. I wonder if they make king-sized toddler beds?

2. Baby? What Baby?

Oh sure Thing 2 is doing swimmingly so far. ... But the Heartburn is back. I was expecting its grand return in two months but it surprised me with only a two-week respite followed by that familiar burning sensation when I sit up, lie down, lean over, drink water, eat anything or just think about any of the previous activities for even the briefest lengths of time.

And not only has gestational Heartburn made its return, it's brought with it a new friend: Nasal Congestion. So Burns and Phlegm are best buds, and are working on creating a tri-part alliance with my arch nemesis, Insomnia.

This is not what I had in mind when I envisioned a Bundle of Joy. This would be JOY without the J.

3. Child care. ... What are you gonna do?

So it turns out my perfect childcare situation just got a little less perfect. The woman I have referred to here as “The Other Mother” reminded me that she’s only got so much room in her unregistered house for tots. And this new one … isn’t going to fit.

*Cue metallic horror film sound effects.

In a matter or seconds I went from happily pregnant, working mother providing health insurance and a stable income to her growing family, to the fear of being on the brink of financial ruin because finding an infant daycare placement is akin to finding a needle in a haystack.

So while that drama is still unfolding, the initial panic has subsided thanks in part to the holding out of hope that there is a daycare facility out there willing to take a smart-alecky toddler who thinks monsters are the next best thing to puppy dogs ... even if it breaks my heart to break up the party.

In my best Scarlet O'Hara way, "I can't think about that right now. If I do, I'll go crazy. I'll think about that tomorrow."

4. If you don't stop, I'm pulling this car over

That thumping sound that I was ignoring from mile marker 34 of Interstate 787 to mile marker 44, when the car started to disco, was indeed a blowout.
This was no mere flat party but a pieces-of-rubber-littering-the-highway kind of bash.

I could complain that it was the coldest day of the year, and that I dreaded having to walk on the treacherous highway to safety and a phone, seeing as how I never did replace the cell phone’s car charger since it broke last month –- but I didn't even have the chance to feel the least bit sorry for myself.

No sooner had I stepped from the car after digging out my hat and mittens -- and cobbling together enough juice from the broken charger to get even the smallest of small signals -- than the brilliant flashing lights of the Help Truck pulled up behind me.

In 10 minutes I was back on the road, headed to the tire shop.
I have to say, it's a little disconcerting for a person like me not to have enough time to worry about all the what-ifs.

Sunday, February 04, 2007

Be careful what you wish for ...

"Do you want to know what you're having?"

I could barely stop myself as the 'YES!' threatened to gush out, giving me no time to prepare for the answer.

"You know?" I asked lamely, stalling for time, as if the ultrasound technician was playing a cruel trick on me.

Last time around we barely found out what variety we'd be having by the end of the third trimester. Ittbit lashed out violently at the wand of power even before the woman behind the monitor ever reached for the jelly. She drew up her legs and hid from view, refusing to play nice.

But this kid, it would appear, has no problem showing off.

Still my head wanted more time. I wanted to consider all the possibilities Thing 2 would offer, and all the implications that could come into play. I wanted more time to wonder and less time to plan.

A girl would mean they could share her Taj Mahal-sized bedroom, clothes and a bond that only sisters can know. A boy would mean food in the house would FINALLY get eaten and The Dad would no longer feel adrift in a sea of XX chromosomes (even the two dogs are female).

But a girl could mean the potential for hurtful comparisons and competition. And a boy would mean our lopsided house would have to yield its pitiful guest bedroom (a place we laughingly refer to as a guest prison for its cell-like size and windowless views) to the second born. In other words, the kid will get robbed.

Not the least of my concerns was the first born's own desire to have herself a sister in the second born.

From the moment I told her she was going to be a big sister she’s been talking about her sister. I've reminded her that it very well could be a boy, and she gives me the look of concern; like any moment someone in a white coat is going to come and take me away. "No. I'm having a sister."

Time was ticking away. For the lady in the lab coat only milliseconds had passed, but for me it seemed an eternity. I had to know. I couldn't endure some notation on a report, filed away in a folder with my name on it, hidden from me. I loathe surprises.

"Yes! Yes! I want to know."

She turned the screen a little more in the direction of my craning neck and pointed. "Those are definitely boy parts."

I can barely describe the emotions that swept through me. I was unexpectedly elated, worried and nervous. I spent the rest of the day wondering how was I going to tell Ittybit?

Just come out with it. Honesty is the best policy.

"Honey, I found out today you're having a brother."

Her eyes exploded into tears. "But I don't want a brother," she wailed.

I scooped her up and told her the upside. "Oh honey, a brother is a wonderful thing. It's really better than a sister. You won't have to share your room, you won’t have to share your best girl toys. It will be wonderful, you'll see."

"But I don't want sister either," she cried. "I don't want a brother OR a sister."

"But honey, remember we talked about this?"

"Yes, but I wanted a BABY."

"Well that's good, because that's what we're getting. I promise."

And with that she stopped crying and smiled.

"Oh, OK. Can I have some more peanut butter?"