Showing posts with label public health risks. Show all posts
Showing posts with label public health risks. Show all posts

Thursday, January 17, 2008

More Medical Questioning: Cough & Cold Meds

Okay, so I've written about the vaccination thing. I have my reservations. And questioning vaccinations is a countercultural thing, certainly. The FDA doesn't readily give statistics on deaths from vaccinations, and if they did, it wouldn't be reported in the media. So consider this, from CNN:

In 2007, the FDA completed a review that found there were 54 reported child deaths from decongestants and 69 from antihistamines between 1969 and fall 2006.

It is part of the ever-increasing hype about over-the-counter (OTC) medications. In the past several years, we have seen Phenylpropylalamine pulled completely as a decongestant because some people who were abusing it had heart attacks. Then, we have witnessed as Pseudoephedrine (which has always had mild-to-serious heart problems as a side effect--it makes my heart race horribly; I can't take it) has been restricted, put under lock & key, anyone who wishes to purchase it subjected to a near background-check, and now gradually it is being replaced by Phenylephrine--so that we don't go make Meth out of it. And now we're being told that none of it is safe or (possibly) effective.

Well, I don't particularly want to give a child under 2 all of these drugs anyway. And when I do use medicines, even for myself, I tend to use moderate doses, I do not tend to re-dose on schedule, usually waiting at least 6 hours--really as the symptoms dictate, and I tend to wait until the symptoms are really uncomfortable before dosing. So I am not a pill-poppin' momma by any means. But I do think that there is a little too much hysteria in this case. I believe that what is happening is that the safest stuff is being taken off the market, leading to more prescriptions & doctor's visits, and also leading to rash actions--perhaps the administration of a larger dose to a smaller child out of ignorance. But mostly, I believe that this is inspiring false panic.

Consider: there were 54 reported child deaths from decongestants and 69 from antihistamines between 1969 and fall 2006. Okay, let's do the math. That means that in 37 years, of all of the millions of children who received multiple doses several times a year, 54 children died of decongestants and 69 died from antihistamines. That's 1.46 deaths per year from decongestants and 1.86 from antihistamines. Most were in children under 2 years. Well, for starters, take the fact that as long as I can remember, the package labels said, "under 2 consult a doctor" or "not to be given to children under 2." Then, control for overdosing (I was twice given overdoses of cold medicines when I was young--once I was under 4 years) and re-dosing too soon, or too may times in a 24 hour period. Consider that two medicines containing the same drug or different ones in the same category may have been administered simultaneously. Then (and only then) consider the possibility of allergic reactions. How many people do you think died of peanut allergies in the same time frame? Perhaps we should remove peanuts from the market. Or strawberries. Or milk. Now consider that they group "decongestants" together for the purpose of the analysis and "antihistamines." Well, let's see. . . In the time frame mentioned, at least 3 different decongestants were available, one of which has been taken off the market and one is increasingly difficult to get. So which one(s) caused the deaths? As for antihistamines, I can name Diphenhydramine, Chlorpheniramine Maleate and Brompheniramine Maleate off the top of my head. Again, to which one(s) are they attributing the deaths? And why was it necessary to group them all together? Hyperbole? To make their results statistically significant? And why are they vilifying cough meds, too?

Let me reiterate. . . I am cautious about medicines. Very cautious. Others may not be. If they are not effective, that's different. But why are the same people who say that vaccinations are unequivocally safe trying to scare me about my medicine cabinet?

Tuesday, January 15, 2008

HIB, Hep B, and Chicken Pox, Oh My!!

The Chiclette goes in for her 2 month check-up on Thursday, the one on which they bombard this little developing immune system with all kinds of nasties--all for her good, of course. Now, I have mentioned before that I exercise caution with the recommendations of doctors. I have a skepticism about--well, everything, but about medicine in particular. I am not against all vaccines, however. I am merely cautious. The vaccines I received as a child are familiar territory, though they are questioned by many, and even linked to onset of autism in some children. Measels, Mumps, Rubella, Diptheria, Pertussus, and of course, Polio, are vaccines I tend to consider "safe," though I know many would question this. At any rate, I know that the vaccines have been around for a long, long time, and have been studied, and judged to be as safe as 50+ years of research can make them. My son, to be 11 on Friday, received all of the recommended vaccines. Until the chicken pox vaccine. I had heard the cautions about vaccines even then, but thought that the benefit was worth the slight risk. Until the chicken pox vaccine.

You see, in my mind, vaccines were reserved for childhood illnesses that killed children--polio, whooping cough--and posed a genuine public health risk. But chicken pox was only a mild nuisance for most children, keeping them out of school for a week or two, which wasn't really an issue, I guess, unless there was no one available to care for them at home. So my son did not receive the chicken pox vaccine. He got two very mild cases of chicken pox from exposure to children at school who had been vaccinated recently and were "shedding" the virus. That strengthened my opinion that the vaccine was not really advisable.

When I was in the hospital after having my Doodle, I read in the papers about the vaccine against Human Papillomavirus and was instantly against the idea of vaccinating pre-teen girls for an STD. It seemed hasty, unnecessary, inadvisable. Not to mention discriminatory--to subject the girls to a vaccine, the safety of which is not entirely known, when presumably they were getting the virus from boys. Besides the fact that this was hardly an air-borne illness. Let's face it, STDs are highly preventable. So my attitude towards vaccinating my daughters with Gardasil? Over my dead body, thanks.

I relaxed my vigilance some when it came time to vaccinate my Doodle. I don't know why, but I shrugged and did a "What the heck" when it came to the chicken pox, possibly because it was easiest at the time, or perhaps because my son had felt the adverse affects of not being vaccinated in a culture where vaccination was the norm--and was infected as a consequence of this being the norm. So I figured I would skip a step or two and make it easier when she had to go to school (eventually). Of course, I did not realize that Texas allows parents to opt out of any vaccine. Evidently all one has to do is file the paperwork. So Doodle has had all of the "mandatory" vaccines, but has not had the ones that are only required if she happens to attend daycare. Since her last round, I have read more about adverse affects of Gardasil (HPV) and the vaccination for chicken pox, and it makes me wonder about all of this all over again. Not to mention that link Jen posted about the use of aborted fetal tissue to make vaccines. Great. So here I am, wondering what to do. . . again.

Because this is no easy matter. Any time we refuse medical treatment or tests, we are going against the grain. It feels like gambling, and health is nothing to gamble with. I have less of a problem when it's just me--but when it's my children and I take a risk, it feels, well, wrong. Culturally we are told that doctors are superior to just about everyone, and should not really be questioned. This changes from place to place. I have to say that people in New Orleans that I knew seemed to question medical practitioners more--even before something went wrong--than they do in this corner of Texas. I'm sure there's another corner of Texas I could name where the questioning is more intense still--at least in some circles. But that's decidedly countercultural. And so if I follow my instincts and refuse one or more of the vaccines, I feel like a bad parent. For what? For doing what I feel is right, and for gambling on the chance that my child will not contract whatever they are vaccinating against. The last time I faced a decision like this, I was deciding whether to treat my child for an enzyme deficiency that I knew she didn't have while they retested her after botching the first screening so that she and 3 other babies came out positive. She was about 3 weeks old. I won that bet, but it was agonizing.

This week, she faces several vaccines, and I am not particularly comfortable with all of the vaccines, the fact that they are given simultaneously, the fact that they will be administered even if the baby has a cold, or the fact that parental consent is generally assumed, and that these vaccines are deemed "mandatory" for my children by state boards. At two months they receive: Prevnar, DTaP, HIB, Polio, and Chicken Pox. Possibly Rotavirus also. She has not had any vaccines at this point. I refused the one in the hospital--Hep B--because, well, I don't see it as necessary, as it is transmitted sexually or through a transfusion. I can't say I know much about Prevnar or HIB. I believe both of my earlier ones had them. I feel like a cop out admitting that I haven't done the research. DTaP is familiar territory, as is the Polio. Chicken pox--well, you know how I feel about that one. And I don't feel comfortable with the Rotavirus vaccine. It sounds like a daycare vaccine to me. You know, so the workers don't get sued for not washing their hands. I just can't see that it's more crucial now than it was 2 years ago. The main goal seems to be to prevent trips to the hospital and the doctor's office. So it's an insurance company vaccine, too--it saves them money.

And you know what socialized medicine means to me? More of this shoved down our throats, with less recourse if side-effects occur, and less choice in the matter!

Saturday, February 3, 2007

What if?

Imagine that there is a chemical that could be injected into young children that would counteract the cancer-causing carcinogens that come from smoking tobacco. Further, imagine that the state in which you lived began to mandate this treatment for all children, since many children at some point in their lives take up smoking, try smoking, or are exposed to smoke. Presumably there would be resistance to such a practice. After all, not all of the children who would be subjected to the (admittedly easy) treatment would actually be affected, since not all children actually take up smoking, try smoking, or are exposed for long periods of time to cigarette smoke. Moreover, this "cure" for lung cancer, by removing one of the major obstacles to the habit, might actually allow for an increase in consumption of cigarettes, thereby increasing sales and indirectly funding the tobacco corporations. Well, this might be enough to get most people upset. After all, why subject children to a treatment that would benefit today's most vilified corporations?

So maybe this scenario would be better, as it removes the economic objection: Imagine that there is an immunization developed that protects against HIV. Somehow, this immunization would adapt to the mutations of the virus, and prevent anyone exposed to the virus from becoming HIV+. Or I guess they might already be HIV+, since the immunization would be based on the virus in some form, but it would either be benign or unable to multiply or whatever. (My background is not scientific.) So in order to prevent the spread of HIV, and in order to prevent (as in the chemical treatment that protects against lung cancer) insurance and Medicaid expenditures, it is decided that a certain portion of the population must be immunized. This is a mandatory immunization. But because it is fairly costly, the most at-risk population would be singled out and required to participate. Once again this has to be done to fairly young members of the population, before they are sexually active, so the decision is made to screen children for character traits that would make them most at risk to contract the disease. This might cause some concern. Parents might fear that their children would be stigmatized by being identified as "pre-homosexual" or at risk for intravenous drug use later in life. Some might object that since anyone can contract and spread the disease, it is unjust to single out people with certain personality traits.

So the necessary funding is acquired, and now all children will be required to be immunized for HIV between the ages of 8 and 13, or they will not be admitted into public high schools. While this is not an air-borne illness unlike (oh horrors!) chicken pox, because this is still a public health risk, and because the treatments are still costly for the government and for insurance companies, all involved agree that it is necessary to impose this sanction on those parents who refuse this sensible precaution. Some might venture to suggest that, since not all people are ever exposed to the virus, indeed, some (though it might seem hard to believe) never even engage in the activities (including intra-venous drug use) through which the virus is contracted, this is an unnecessary precaution. Further, it might be suggested that since the consequences that deterred young people from engaging in activities (including intra-venous drug use) that promote the spread of the disease have been removed, the activities themselves would be rendered more attractive.

Clearly these scenarios are far-fetched. A vaccination could never be forced on us or on our children to prevent a condition that arises from the deliberate choices and unhealthy actions of an individual (an exception should be made for those who contract HIV through the actions of others, including blood transfusions, or perhaps the infidelity of a spouse; the only exemptions for smokers would be those who began smoking before the health risks were known, and these are a shrinking number). Or could it?

I was concerned when, while in the hospital after bearing my second child, a daughter, I read an article in the local newspaper about the immunization that has been developed against Human Papilloma Virus. Two things in particular worried me: first, that it was being promoted as an "immunization against cancer"; second, that those targeted for the immunizations were young girls, around the age of 12.

I am a minimalist when it comes to medical intervention. Which doesn't mean that I am against medical intervention altogether. I believe wholeheartedly in modern medicine when home remedies are exhausted or the condition necessitates bypassing home remedies, and I am very, very happy that Jonas Salk was a genius. But I am increasingly skeptical of the numbers of immunizations to which we are "required" to subject our children.

I am also worried about the messages that are sent to us and our children about responsibility--or perhaps the messages that are not sent to our children about responsibility. You see, dears, there is a preventative or a quick-fix for everything in life--indeed, for life itself! So when I learned of this immunization for an STD that they didn't talk much about when I was in sex ed, this "cancer causing virus" that affects young women, I was afraid. And now the illustrious governor of Texas is proposing exactly what I feared: the immunization of all young girls against HPV.

Now, to my mind, this is a punishment for those young women who remain celibate. It is also a punishment for those young women who are tricked or seduced, either by young men or by our culture, into not remaining celibate. Furthermore, it is punishment for young girls, by virtue of the fact that they have a cervix and therefore are susceptible to cervical cancer if they should happen to contract the virus from a young boy who has in turn caught it from another young woman and so on and so on. It also represents the removal of one more of the consequences of uninformed, indiscriminate sexual behavior (even among those who feel that they are well-informed, discriminate, and emotionally mature--these are also subject to the tricks and seductions of contemporary society). I'm not sure our inhibitions need to have any of the limited "checks" that still exist removed. But even if this were really a public health issue, I would have a further objection.

Don't get me wrong! There have been objections, but those objections have to do with financial contributions to the governor's campaign. It is only a matter of time before some other illustrious politician proposes the same, and it is rather an accident of fate that Rick Perry should have been paid off in such an obvious fashion instead of a less obvious one. So if this is about money, which it surely is, rather than about cervical cancer, then why not immunize all who can contract the virus? Aaah. . . Because boys can't really be harmed by it. So think. . . If boys couldn't get the virus, who would pass it to the girls, thereby exposing them to the possibility of cervical cancer? Exactly! So I propose this: either don't introduce mandatory vaccinations for anyone, or vaccinate boys only! I'll vouch for my daughters!