health and illness: January 2006 Archives

I wish that I could work in a place like this


random thought

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I was watching Life on the Rock tonight. The guest of honor was an Olympic quality cross-country skier, along with her husband and 4 year old son. She mentioned (among many other things) that she uses natural family planning.
I thought for a while about that while she went on talking about the other challenges of being a devout Catholic in the star athletics environment. I remembered all the news items about this that and the other scandals involving 'performance enhancement steroids' - especially the male sex hormones (Testosterone, androstendione, DHEAS, etc.) And then I thought about something else - and I wonder if there is a cultural blind spot here.
Many female athletes (Maybe even most) use supplemental female hormones to enhance their training and performance by manipulating their menstrual cycle. It is pretty well known that one can delay or prevent bleeding indefinitely through continuous use of everyday type oral contraceptives. The progestin (synthetic progesterone) component of oral contraceptives is usually made by tweaking testosterone until it looks to the body sort of like progesterone (at least, close enough to block the normal actions of ones own progesterone). So why is it that male athletes can't boost their own testosterone but female athletes can use synthetic hormones to tweak their estrogen/progesterone levels (and eliminate the menstrual cycle). Is it intent (i.e. contraception) that makes it OK?

a wonderful compendium of articles


seasons and trends

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I've worked in OB for 20 years now, and one thing I've noticed is that things tend to arrive in clusters. For example, we'll have several patients with twins, and then none for a while. We'll have a run on premies and then a run on going overdue.
Right now it's really challenging, because we are having a run on moms with serious mental illness complicating their pregnancies. We thankfully have many good medications that enable men and women to live close to normal lives, despite serious conditions like schizophrenia and bipolar disorder. But these medications carry risks, especially to unborn children. The newer drugs seem to be more effective with fewer side effects - at least for adults. But a recent release from the FDA about Paxil reminds us all that the unborn infant has special needs to be considered.
On the other hand, a mom who is unable to eat for fear that all her food is poisoned is not going to be able to care for herself or her unborn child. A mom who is manic and believes that she can fly is a risk to herself and her baby. A mom who is severely depressed and won't even get out of bed for days is not going to be in the state of physical health that we would all want for her.
By the very nature of mental illness, many of these moms get pregnant without intending to. Some are victims of abuse, and others simply can't connect the dots that lead from sex to pregnancy. Psych drugs are notorious for altering the menstrual cycle, and some ladies become convinced that their medications have made them infertile.
Anyhow, I request prayers for some of the moms in whose care I participate. As a midwife, I'm not the primary caretaker for these moms - but I do participate in the care planning process, try to help the resident physicians to negotiate the often tortuous process of getting the right help for these ladies, and of course I pray for them.
Isn't it St. Dymphna who is the patron saint of the mentally ill? Are there others? I seem to recall an itinerant priest who is invoked for mental illness and the homeless, but I can't remember his name.

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About this Archive

This page is a archive of entries in the health and illness category from January 2006.

health and illness: December 2005 is the previous archive.

health and illness: February 2006 is the next archive.

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