Category Archives: health care

Give my daughter the shot!

            There is a growing trend in the U.S. not to vaccinate children.  Despite the fact that the American Academy of Pediatrics strongly recommends vaccination, despite the facts of the vast majority of reputable studies endorse the practice, and despite the fact that the diseases we are immunizing against are hideous, people righteously proclaim that they would never do anything so awful as to vaccinate their children.

            Well, dudes, here’s my question to you.  If vaccinations are so terrible (for whatever scientifically unsound reasons you with your vast medical training have come up with), why are you comfortable letting my kids take all the risk for yours?  Because, you see, you have a luxury.  You get to raise your kids in the herd immunity that the rest of us provide by actually vaccinating.  While people in third world countries clamor for vaccines, you get to sit back and say, “No thanks.  I’ll just let her kids do it for me.”

            Way to be part of the community.

            Are vaccines perfectly safe?  Um, no.  Any doctor will tell you there are some rare side effects.  But, let me ask you this: what exactly is it you do in your life that IS perfectly safe?  Driving a car?  Teaching your kid to ride a bike?  Allowing your precious vessel to eat fruits and vegetables that were grown near dirt and might choke her and could have had a fly land on them?  Everything we do has risks, peeps.  That’s the way life is in this day and age.  Vaccines do, too, which is why the doctors tell you to monitor closely after the shots.  But, um, rubella has a few more risks than the MMR.

            So, if you are sitting back and smugly pronouncing how you do not vaccinate, you are really riding on my kids’ coattails.  And you are putting your kid, tiny babies, and immune-suppressed people at some serious risk.  But don’t let that bother you.  You have a soapbox to tend to.

            And, for the record, the chicken pox vaccine is not perfect, you are right.  However, when it does work (the vast majority of the time), it keeps you from getting chicken pox.  So what? you ask.  Well, if you never get chicken pox, you can never get shingles later in life.  And shingles sucks in a big way.

            And, while I am on my soapbox, let me say a few words about “spacing it out,” which many people do to ensure their kids have to see the pediatrician every month for the first five years.  I think it is just ducky that your insurance or pocketbook allows you to do that.  That costs your insurance more, of course.  A cost they will eventually pass along to the employers who are already struggling to provide health insurance.  Which will make it even more tempting for employers to stop providing insurance.  Or more expensive for private individuals to pay for it.  Because, when you drive up medical costs for your insurance company, we all pay for it.  So, go ahead, use medical resources as you see fit, but please don’t bitch about the health care crisis you are so blithely contributing to.

            I trust the doctors I take my kids to.  I trust the medical schools they went to and the scientific studies they read.  And I don’t shop around for a pediatrician who will conform to my idea of what is the best medical treatment, because pretty much every pediatrician I have seen has stuck to the same story.  So, unless they are part of a vast conspiracy, they may actually be basing their advice on, you know, science.

NHS and strep

            We are the kind of family that believes in sharing.  If Zach picks up a little bug at school, he feels compelled to not only bring it home for his brother and parents, but to raise it to the third power before passing it along.  So, I was not surprised a few months ago when the boys and I all had sore throats together.

            There are sore throats and there are sore throats.  And I am one of those people who is unlikely to see the doctor unless my arm is hanging off by a tendon.  But, I do know when I have strep throat.  Since the boys seemed to have the same problem that I did, we all went in to the GP together.

            “Hmmm,” he said.  “That is quite an aggravated throat.  I had better culture it.”  He did not culture the boys, on the principle that they had whatever I had, and I was definitely the most willing patient.

            “Should I start on antibiotics?” I asked, since I knew full-well what was wrong with me.  No, NHS protocol is to wait for the culture, which I do understand.  Not wise to just hand out antibiotics to everyone who asks for them.

            The next day, I called up to get the results of my culture.  “Oh, that won’t be back today,” the receptionist said.  I knew she was mistaken.  It was a strep test; those suckers can be completed in the time it takes Benjamin to eat three strawberries.  I asked her to check, just in case it was in.  “No, not back,” she said. 

            “I’ll call back tomorrow, then.”

            “It won’t be here then, either,” she replied.  “Strep tests take at least a week to come in.”  A week?  A week?!  For a strep test?  And we were not allowed antibiotics until the culture came back.  So, my preschooler, my toddler, and me were supposed to walk around for a week with strep throat, waiting for the results of a test that I already knew the results of.

            Over the week, my throat got worse.  From what I could tell, so did my sons’.  Then, it got better.  We all seemed to be feeling better.  I stopped calling the doctor’s office.  And then, eight days after I had been cultured, the doctor called me.  I had strep.  “It would be best if we gave you all a course of antibiotics,” he said.

            Right.  So, apparently, NHS protocol is as follows.  Patients are to live through the incredibly painful symptoms and fight them off on their own. Only once they are feeling better are they to be treated for their illness. They are also to walk about infecting other people for a good week, because the money saved from taking eight days to get a culture back can then go towards culturing all the other people who were exposed to strep in the time that the doctor refused to diagnose them.

            There have been times I have seen NHS as a minor inconvenience, one I am more than willing to put up with on the principle of everyone having medical coverage.  There have also been times I have been shocked at the incompetent doctors.  And, although I know many of you felt our rash experience was just a bad doctor, it was actually just one in a string of encounters that showed me that NHS is not doing its job, that this universal health coverage often means no coverage at all.

            I do not know what the answer is.  I do know it is not NHS.

NHS and my son

Last week, I posted this post and this follow-up post on an experience I had with the National Health Service (NHS).  You all made some excellent comments (and I apologize I have not replied to many; I am a sinking ship here).  A few months ago, I also posted this.  Today, we present another encounter this expatriate family has had with socialized medicine.  Hopefully, this week or next, there will be one more post in this series.  As before, comments and respectful discussion are very welcome.

            At first I thought it was diaper rash, but that made no sense because he was daytime potty trained.  Probably not diaper rash, despite the delicate location of the angry red bumps.  We tried creams.  I suspected that if I took him to the doctor too quickly, he would tell me it was just a rash or eczema and send me along home on the assumption it would clear up on its own.   

We have private insurance, which in the UK means that we have additional coverage on top of NHS, so that if we are referred to a private physician, it is covered.  We have to go through our NHS general practitioner first, of course, as he is the gatekeeper.  So, after two months of creams, we took Zachary to our NHS general practitioner.

            “Eczema,” he declared.

            Really?  I myself have eczema, and this did not fit the usual profile.  It was persistent, and it did not go away with the usual creams.  The doctor gave me a new one, with nice things like hydrocortisone. 

            Two months later.  Same GP, since under NHS there are no pediatricians unless the child has a special condition. 

            “Eczema,” he said, seeming bored with my insistence on a treatment.  A new ointment.

            Two months later, we came back.  “Eczema.”  I was starting to feel pretty sorry for my two-year-old son, who had now been walking around with red, itchy bumps for almost six months, but the doctor seemed rather unconcerned.

            “You know,” I said, “since we do have private insurance, perhaps we could see a dermatologist, just to be sure.”

            “Fine.  Who would you like to see?”  He found a name, wrote out the referral.  “I’ll be interested to see how this comes back,” he commented.  “I suspect she will tell you it is eczema and there is nothing to be done.”  Stupid, pain-in-the-ass, spoiled American wasting the medical resources on her demanding notions that everything be treated immediately. 

            One week later, J took Zach to the private dermatologist.  “Looks bacterial,” she commented.  “Let me culture it, but I think we should get him on antibiotics and an antibiotic cream.”

One more week.  No more “eczema.”

NHS and me (part two)

For part one of this two-part post, click here.  All respectful comments welcome; I hope this post will encourage an intelligent conversation about health care.

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            So, the next morning found me arriving at the Early Pregnancy Unit at 8:15 AM.  The clinic opens at 8:30 on weekdays to care for things like bleeding in pregnancy and other such scares, and they do scans until 1:00.  Women experiencing bleeding at other times of the day, as I had learned the previous evening, are instructed to return at a more civilized hour.

            Apparently, I was not the only pregnant woman in SW London a little nervous that morning, because there were already four other people ahead of me.  I sat down to wait.  Too anxious to open the book I had packed for good measure, I fell back on the world’s oldest pastime.  I people-watched.

            The woman who came in right after me was probably a few years older than I am.  She wore a wedding ring, but unlike some of the other women in the waiting area, she was sans father, just like me.  I came to the conclusion that she must have other children, and the baby’s father was probably administering oatmeal and toothbrushes while she sat and waited to see how her pregnancy was doing.  I sort of wanted to strike up a conversation with her, this woman I had determined was in a situation much like my own, but this is England, and such things aren’t usually done.

            Next to me was another woman, this one without a wedding ring.  I look, you must understand, not to judge whether someone has conceived a child out of wedlock, but because she was there with a child, perhaps just under two years old, and I sort of wondered whether there was a man who might have provided a bit of childcare so that she could come for her scan without a stroller and a diaper bag.  Chances are that there was a man, of course, but he was already at work, worrying the whole time about his partner, their child, and their unborn baby.

            The woman, however, seemed completely unconcerned.  She was wholly focused on the little boy, playing little games and offering him peanuts as he sat in his stroller.  As I watched them ever-so-subtly out of the corner of my eye, I pondered a few things.  From their clothes and accessories, it was clear they did not have much money, and I wondered whether, exhausted from caring for her child all day and the first trimester of a pregnancy, she might go to a night shift when someone else took over care of her child.  I thought about the snack puffs her son dropped on the floor that she left lying there, and wondered why she did not pick them up.  Mostly, I contemplated what I always think about when I see something like this: how in the hell do other people get their kids to sit contentedly in a stroller that is stationary?  Is it something kids are just born with, or is there some trick of parenting that convinces a child to remain happily seated even after the ride as come to a full and complete stop?  Is there a class I can take to learn this skill?

            When she got up to go in for her scan, rolling her completely placid child in ahead of her, I started watching a woman who clearly did not have other children.  There were two reasons I suspected this woman was terrified of losing her first pregnancy, and neither had to do with the business attire that had no breakfast spills on it.  One reason was the anxiety in their eyes.  It was not stronger than mine, but it was more confused because her entire status as a mother was hanging in the balance.  This was not a woman who had been through the ropes; she was a woman afraid of being hit in the head with one.  The other reason I suspected she did not have other kids?  She had a man with her, while J was at home overseeing the troops before school and other forms of childcare kicked in.

            And, there were a few other women waiting, although it seems inaccurate to call them women.  They themselves were children, girls with small, round firm bellies and teenaged boys by their sides.  Because, of course, teenagers can get pregnant, too, and their pregnancies can have scares, too.  Not that these girls looked frightened.  The stereotype of the pregnant teenager is a little girl, cowering in the corner, terrified about her future.  These girls looked strong, in control, as though they had no idea that the sky could fall tomorrow.  Teenagers –pregnant or otherwise — never seem to know that the sky could fall.

            And we were called in, one at a time, according to our numbers.  The woman pushing her toddler in an umbrella stroller, leaving a trail of snack puffs behind.  The career woman with a briefcase and a husband in expensive shoes.  The teenaged girl with the big hoop earrings.  Me.  It did not matter how we got pregnant, whether we were married, how many degrees we had, what age we were, or if we could afford to buy a drink at the vending machine.  They saw us in the order in which we had arrived. 

            An hour later, I left, sonogram in hand and smile on face.  There was a heartbeat, and there was a brain, a good start as far as babies are concerned.  It was 17 hours later than I would have liked an answer to my questions.  It was less attentive prenatal care than I am used to.  But was it, perhaps, the level of care that I needed?

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Tune in next week for a very different experience we have had with the NHS…

NHS and me (part one)

Part one of a two-part post.  Part two will post tomorrow.  I will close comments today so no one feels pressured to comment until reading the second half tomorrow.

Updated to add: This happened two weeks ago.  There is no reason to be worried about me at all.  Thank you to those of you who have sent me concerned emails.

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              Now that you know my big secret, I can tell you about the trip I made to the A & E (otherwise known as the Emergency Room), which will give me a chance to comment upon the NHS (National Health Service), which will give us all a chance to have a rousing debate about health care, which will raise the intellectual level of this blog about 73%. 

            So, I had some bleeding, and I won’t get more detailed than that because there are some men who read this blog.  I had bleeding with Zachary, too, so I know it does not always mean the dreaded M word, but I have been around the block enough times to know that bleeding during a pregnancy is usually something to get checked out.  So, I called the community midwife, who told me to go to the A & E.  Having dealt with NHS a few times in the last few years, this sounded to me a little suspicious, a little too direct, as it were.  So, I called my GP, whose receptionist confirmed.  I should hightail it over to the A & E.  Fortunately, J was working from home, so he took the boys and I took a cab.

            I waited maybe 30 minutes, then I was called in to speak with the nun who was cast as bouncer in this particular hospital.  She sent me to pee in a cup.

            Let me pause to explain that, since we did not have to do any fertility treatment for this baby, it has felt rather unearned, not real, even.  I kept thinking maybe there was another reason for the missed period and the two pink lines.  So, I was actually a bit anxious about the pregnancy test at the hospital and was relieved to see that the nun also came to the conclusion that I am pregnant.

            My relief was short-lived.  After calling the gynecologist on duty, my nun turned to me.  “You’ll need to come back tomorrow morning for a scan.  They don’t do scans at this time of day unless they want to rule out an ectopic pregnancy.”

            “And they don’t think I have an ectopic?”

            “No,” she replied, which was a relief, because given the options, I’d rather go with a non-ectopic pregnancy.  Of course, I would prefer to hear that from a medical professional than from a nun, but I guess the doctor has some way of determining the placement of the embryo by talking to a nun on the telephone.

            And, then it happened.  I do not do these things on purpose, I can assure you.  In fact, I find it as mortifying as a loud fart in a small elevator with four Calvin Klein underwear models.  I burst into tears. 

            You see, the thing is this.  I understand that there is not much that can be done if it is a miscarriage, and I understand that nothing was going to change between 4:45 in the afternoon and 8:30 the next morning.  But, my GP and my midwife had both told me I would be seen immediately at the A & E, where instead all I got for my efforts was another cab ride home.  In the U.S., we had good health insurance and lived near a lovely hospital, so when I had bleeding with Zachary, I was scanned that very night.

            Had I been more familiar with NHS, I probably would have been less emotional at the news that I would not be getting an answer immediately.  As it was, I was frustrated that a system that is supposed to be rather centralized has primary care providers and emergency providers singing a very different tune.  And, let’s be honest, I just really wanted to know.