Sunday, October 25, 2009

What I Would Like to Say to the Pediatrician, if She'd Only Listen

Ages ago, it seems, rented life and Anastasia said I should blog about my disillusionment with Western medicine. And in thinking about it, I realize I have two specific experiences to relate about this that show different problems: the way Western medicine cuts us up into pieces and specific problems with the way medications and interventions are tested in this country.

But first, I'm going to mention what Western medicine is great at: saving lives. I wouldn't be alive now if it weren't for great emergency medical intervention. I fell into a swimming pool as a child and wasn't breathing and my heart stopped. I don't think it's an exaggeration to say that the defibrillator is the reason why I am alive and can complain about Western and U.S. medicine's shortcomings. So I'm very grateful for what Western medicine is good at and wouldn't hesitate to take myself or Absurdist Baby or whoever to the emergency room or doctor or whatever. But gratitude for Western medicine's achievements should not blind us to its shortcomings.

Western medicine (and much of Western civilization including the academy, to the academy and knowledge's detriment, I believe -- but this is another story) cuts up knowledge into pieces. Now, of course, one does need to put brackets on things in order to analyze. But I think Western medicine takes specialization too far. Here's my story: when I was ten years old, I was diagnosed (if that's what you can call it) with spastic colon. The doctor was singularly unhelpful about this, basically just saying I should write down what I eat, figure out which foods (if any!!!) were giving me trouble, then avoid them when what I really wanted was a cure-all pill. (This doctor's approach to spastic colon assumes that g-i pain doesn't come from food combining, which I could talk about at length, for example, or a muscular problem or stress, but I digress.)

As I grew older, I noticed that my period greatly affected my g-i tract problems. I mean Greatly. There were certain foods that would instantly have me on the floor in pain. Over a period of at least fifteen years, I recounted this issue to a bunch of different doctors -- both GPs and OB-GYNs who all responded with "mmm. . .that's weird." I took a fabulous alternative class on herbs and yoga for women at one point and was given a whole double-sided piece of paper about how different hormones of the women's normal cycle actually need different foods and vitamins and the different herbs and stuff to take for each, including the "right" time to eat chocolate (as if there is ever a wrong time!). I even once saw a book in the rack at a pharmacy that focused on a special diet for women based on where they were in their cycle. (I didn't buy it and wish, even now, that I had. Or at least had the title!) But I could never get the medical establishment to give me much of an explanation for the interaction between my g-i tract and my reproductive system.

Finally, at Planned Parenthood, I mentioned this to the nurse practitioner who was doing my pap, and she said "oh well that makes sense. During your period, you get small uterine contractions, so if you have g-i tract problems, those contractions are going to make them worse." Now, maybe it was just that this nurse practitioner at Planned Parenthood was frigging awesome and actually took the time to think about it. In fact, I'm sure that a huge part of this problem is that if doctors can't instantly categorize a problem or maybe if it doesn't sound serious enough to merit further study, then they just don't spend any thinking time on it at all. But I take this to mean that doctors don't usually think about the way that their system is connected to other systems. My father, who has much worse g-i tract problems than I do, has countless examples of this over-specialization affecting diagnoses and treatments.

Another experience I have leads me to seriously question the way treatments and pharmaceuticals are tested in this country. When I was in my early twenties, I was looking for a birth control method that I would have better luck with than the pill. I had asked for Norplant, because I knew I didn't want to get pregnant in the next five years, but my gynecologist said that was really for women who were institutionalized or otherwise in extreme situations. But there was this other similar thing called Depo-Provera, where I'd only have to get a shot every three months. Because Depo often suppresses one's period, as it did in my case, this seemed like a wonder-drug for me (because of those terrible spastic colon-period cramps that make me want to go bundle up and suck gin through a straw -- and I don't like gin!). I was on it and off of it for the next ten years. Years later, when I was in Grad City, I decided I wanted to go back on it and my doctor asked me how long I'd been on it before. At least five years, on and off. And she told me that Depo-Provera had released a recent "black box warning" saying that women should only be on it for a year and a half because it can decrease bone density! WHAT??? I'd already been on it for five frigging years! And NOW they were warning women??? Where was the detailed ten-year studies on the damn contraceptive before they released it??? Well, that's just not the way the system works. I'm glad they continued to do testing. But it upsets me that there have been so many cases of finding out how bad a drug or treatment is only after it's been on the market for a number of years.

Now, of course these two issues are likely related. They probably did not catch the bone density issue because at first they were looking for problems to a woman's reproductive system. My understanding of the scientific method (and my friends in the sciences can please weigh in and correct me) is that in order to test whether there's a relationship between two things, someone has to think of it first and then develop a reliable test. Now doesn't this mean that if people do not ordinarily think of a medication causing a certain kind of problem or issue, then they do not test for it? So then doesn't it matter a great deal, with potentially tremendous consequences, whether people in medicine think of the different systems as interrelated or separate?

And this is why I'm pretty skeptical of new medications. When a medicine came out for spastic colon (also known as IBS), I didn't run out to get it. Though I've been on antidepressants, I haven't been at all surprised to find out their adverse effects on reproduction, for example. (My midwife told me that Zoloft and Prozac have led to brain center problems related to labor -- specifically, that women have problems going into labor naturally -- which did not happen to me, but though I don't understand all the cause-and-effect involved, I believe is possible just from my own experiences.)

And all this, of course, affects the way I look at immunizations for Absurdist Baby. I'm not worried about autism particularly, though there is an interesting correlation between vaccinations and autism in msg-sensitive people that I believe everyone should look at (put out by this woman who used to work in the food science industry until she got so disgusted with what she found out, specifically about the harm of MSG). I'm much more worried about the problems people are not looking for because they're not likely to get tested. (Don't get me started on the wisdom of vaccinating at birth for diseases that are transmitted sexually. ) I feel fine about the polio vaccine and others that have been around for a long time. But I am very skeptical about the ones that are new or the ones that immunize for things like chicken pox, which are just annoying but not terribly dangerous for most people. And if I'm worried about things that may not be tested because people aren't looking for them, and they might adversely affect people who are very young and still developing in some basic ways? Well, how can I just suddenly develop blind faith in this country's medical system and not question anything when it comes to the most precious person in the world to me?

This is why I a person who started out just wanting the right pill to cure all my problems became totally granola-y and will eagerly sign papers that say I have a religious objection to immunizations. As my midwife says, I feel pretty darn religious about not giving my baby interventions that are potentially harmful. For frigg's sake, this baby has eaten nothing but organic food in his year of life! How can I give him things that I don't know enough about to know whether they are okay or not? I realize that this is a thorny issue and parents approach it in a number of good ways and I don't believe that people who disagree with me are necessarily wrong, but with my own experiencing of the medical establishment not looking for connections and finding out too late that certain interventions may be harmful, I just don't know how else I can be a thoughtful and cautious parent.


Kate said...

You know, even as someone "on the other side of the fence" on the vaccination thing, I am otherwise completely of the same mind as you regarding western medicine. And as someone who knows a lot about reproductive physiology, I am pretty appalled your doctor never put that together -- the menstrual cycle and GI stuff have been tied for a LONG time, it's just obvious because of the effect of prostaglandins during menses. It's why so many women get diarrhea during their periods. Argh.

There is a relatively new scientific discipline trying to undo the damage of traditional medicine, trying to put people back together where they have been cut up. I could tell you more via email (don't want to further un-pseudonymize myself!). But I am actually hopeful that we will start to shift this stuff in the coming years.

rented life said...

If I wasn't so sick I'd write something lengthy about my terrible experiences. Recently I was told there was no cure for my hand/wrist pain, until I spoke with my brother (a to-be personal training with insane knowledge on how bodies work) and he was like "oh yea just do this and this and this and it'll get better, but it'll take time." Well I have time! Add that both husband and I have been misdiagnosed for things and that I kept complaining to different OBGYNs about pain and it took years before someone finally listened and provided a cheap and easy fix.

When we talk about having children, I do worry about the vaccination thing. My cousin just had a baby in Spril and they got her the flu shot and the H1N1. I just am not sure about the H1N1. It's not been out long enough.

Kate--I wonder if the discipline you are talking about is the same one I've been reading about. I will try to remember to e-mail you when I feel better.