Spare me the armchair experts!

My wife has just had a knee operation, which means she’s on crutches for the next fortnight. Having been out of hospital a full two days, we have been bombarded with visitors who all seem to know everything there is to know about knee operations and how best to recover from them. Which is good, because the next person who offers an unsolicited, unqualified opinion will need all their medical expertise to extract their own leg after I rip it off and shove it up their ass.

Now, I don’t profess to being medically trained. True, I spent six months working in an old people’s home as a medication technician, six months as a student nurse, six months as a medical secretary and a year as a doctor’s receptionist, and am the son of a pharmacy technician who spent every mealtime of my childhood talking about pharmaceuticals, but still, I don’t consider myself an expert because I’m not. I do, however, consider myself sensible in matters of healthcare – enough at least to be able to sift the nuggets from the bullshit, and where I am ignorant, trust the advice of those better qualified than me. I just wish others had a similar awareness of their own limitations.

‘How long did the operation take?’

‘Two hours.’

‘Oh, no, it wouldn’t have taken that long.’

‘It took two hours.’

‘No, it would’ve been an hour tops.’

‘Well, the surgeon told her afterwards that it took two hours.’

‘No, it would’ve taken an hour.’

‘Well, you know what? I’m going to trust the surgeon because I’m pretty sure he’s the one to know.’

Same with the stitches. ‘How many did she have?’

‘Two.’

‘Two? It must have been more than two.’

‘No, it was keyhole surgery. Two stitches, that’s all.’

‘No, she definitely had more than two.’

‘Would you like me to get the discharge summary and we can see who’s right?’

Then there’s the recovery period. She’s been told she won’t be able to drive for two weeks.

‘Oh, it’ll be much longer than two weeks.’

‘Or we could trust the experts and see how it goes, yeah?’

‘It’ll be longer than two weeks, you’ll see.’

Grrrrrr!

They’re also experts at how to navigate with a reconstructed knee.

‘When you go upstairs, you should do it backwards by sitting down and using your good leg to propel you up one step at a time.’

‘That’s not how the physiotherapist showed her how to do it.’

‘Well that’s how I’d do it. That’s what she should do.’

I’ll admit, I lost it a bit. ‘Or, how about this for a novel idea – why doesn’t she do it the way the medical professionals told her to do it? You know, the ones trained in anatomy and physiology who are experts in post-operative recovery.’

‘Alright, alright, I was only making a suggestion.’

‘A suggestion that would involve her dragging her bad leg up the stairs? Why don’t we just stick to the things we know about, yeah?’

I’m off that Christmas Card list!

Same with the meds – everyone and their grandmother thinks they’re a freaking expert.

‘What’s she taking for the pain?’

‘Paracetamol and Ibuprofen.’

‘Oh, there’s no point using Paracetamol, it’s not strong enough – I’ll get you some Nurofen.’

‘She’s already taking Ibuprofen.’

‘Well, she should try Nurofen.’

‘Nurofen IS Ibuprofen. They’re literally the same drug, only one’s four times the price.’

‘Well, Nurofen’s better than Paracetamol.’

‘You’re comparing apples and oranges. Paracetamol and Ibuprofen do different things in different ways – one’s a painkiller, one’s a non-steroidal anti-inflammatory. Anyway, the hospital said to take both.’

‘Well, it’d be better if she was taking Nurofen. I’ll get you some.’

Good Lord, it’s like talking to a brick wall. There again, why would I expect anything more from a person who, whenever we have colds, gets cross with us for not following her advice to take 5000% of the daily recommended dose of Vitamin C?*

Frankly, I am amazed there are so many trained pharmacists, physicians, surgeons and physiotherapists hanging around in a little village in the New Forest working as farmers, cleaners, baristas and shopkeepers instead of, you know, pharmacists, physicians, surgeons and physiotherapists.

I’ll tell you one thing though – for people so concerned with health, they’re taking massive risks with it – every time they open their mouths near me!

*If you’re interested in why this is so ridicuhous, the human body can only absorb a finite amount of Vitamin C and it pisses out the rest, but exceeding the daily recommended dose by so much risks diarrhoea, nausea and in extreme cases of prolonged use, kidney stones or even renal failure. And that’s before we bring up the fact that there’s no evidence Vitamin C shortens colds. Admittedly, there is some evidence to suggest that it can make cold symptoms less severe, but only if you start taking it before you’re aware you have a cold. Drinking down five effervescent Vitamin C tablets every day because you have a sniffle isn’t going to improve your lot in life other than by the placebo effect. But hey, why would I bother saying all this to someone who thinks Nurofen is better than Ibuprofen because it’s in a flashier box with a higher price tag?

 

 

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Medicine vs. Magic

When you’re a parent, people never tire of telling you what to do and how to do it, not in the form of advice, but in the form of judgement. And when it comes to health, they’re bloody insistent. With everything else you have to contend with, it’s damnably unfair to hear veiled criticisms of your parenting, especially when you’re in the emotionally vulnerable position of wanting to do the right thing with a screaming and thoroughly unhappy baby.

The best response is to bite back your annoyance and say, ‘Thank you for your advice, but as the mother/father of [insert baby’s name], I will make the decision as to what is best for my child.’ It’s short, polite, to the point, and reminds them where the power truly lies.

But it doesn’t stop you wanting to throttle them with their condescending attitudes and ridiculous ideas.

It’s like a friend of mine who is on a personal mission to stop me giving Calpol to my baby, because paracetamol is bad, it’s bad for babies, it damages their liver, it’s unnatural, and all that jazz. Whenever she discovers I still use it, she turns into an evangelical preacher and acts like I’m slowly and deliberately poisoning my child.

With Calpol.

I’m not saying that paracetamol is safe – overdoses do damage livers – and nor do I advocate dosing kids up on paracetamol as and when you feel like it, but when it’s necessary, and when it is administered carefully, at the right doses, then there is nothing wrong with it. Izzie has an ear infection and a high temperature, as I discovered yesterday afternoon when I rushed her to the doctor’s after she projectile vomited all over Lizzie. The doctor prescribed Calpol to bring down the fever. Simple.

But, according to my opinionated friend, I’m practically killing the baby by giving her paracetamol, and I should avoid using it until I’ve tried some alternatives.

‘What alternatives?’ I asked. ‘Child Ibuprofen? Because I have that too.’

Nope, lectured my forthright friend. Homeopathic remedies.

Ah. Magic water and wishful thinking, then. Glad we had this conversation.

Until a few years ago, I thought ‘homeopathy’ was simply another way of saying ‘alternative medicine’. I figured it was herbal remedies like St John’s Wort, cinchona bark, and suchlike. But that’s not homeopathy at all.

Homeopathy is a medical system invented in the late 1700s that posits that ‘like cures like’ (hence the ‘homeo’ part of the word). Its essential belief is that if you put something that causes an illness into some water – say, something that causes a headache – then dilute that water down almost exponentially until there’s unlikely to be a single molecule of the original substance left, that water is somehow energised and imprinted with the ‘memory’ of that substance and will therefore be able to cure headaches.

There’s another word for water that contains no molecules of any other substance:

Water.

Homeopathic remedies contain precisely zero active ingredients and are therefore precisely useless. And ‘like cures like’ has no basis in science whatsoever. That’s not just my opinion – the National Institute of Health and Care Excellence (NICE) does not recommend homeopathy is used to treat any ailment, the NHS say there’s no good evidence that homeopathy is an effective treatment for any health condition, while a 2010 House of Commons Science and Technology Committee report concluded homeopathy is no more effective than placebos (http://www.nhs.uk/conditions/Homeopathy/pages/introduction.aspx).

No matter how much you talk about Nature with a capital N, or the Law of Similars, or how substances leave a quantum imprint behind, I do not believe in homeopathy. I will take science and evidence over magic and fairy dust every time.

Then there’s the close relative who has this crazy notion that the best way to cure a cold is to consume vast quantities of vitamin C, and so tries to get us to overdose every time we have the slightest sniffle. The fact the human body can only absorb a finite amount of vitimin C before excreting it out, and excessive amounts give you diarrhoea, means it’s not the best advice, ta.

And don’t get me started on amber necklaces helping with teething. This whole ‘Baltic Amber contains up to 8% succinite, an anti-inflammatory and analgesic that will be absorbed into the baby’s skin to ease pain, cut drooling, and stimulate the thyroid’ is pseudoscientific claptrap. You show me a substance that is strong enough to exist for millions of years at excessive temperature and pressure, yet is weak enough to leak out when brought to a baby’s body temperature. I’d respect them more if they went right ahead and said, ‘It works by magic,’ or even, ‘We don’t know why it works, but it does,’ than duping people into thinking there’s a scientific basis for this. And since the same people who advocate amber necklaces also disparage modern medicine as ‘dangerous’, aren’t they worried that they have no control over the dose of succinite their baby receives?

I’ll end by paraphrasing GK Chesterton: it’s good to have an open mind, but don’t open it so much that your brain falls out!

After the Cold

You look around your house, a shell-shocked survivor of the tornado that has swept through. Stained clothing lies scattered over chairs and banisters, dirty muslins screwed up in every corner. Tissues, and pieces of tissues, and the wrappers from cough sweets, litter the floor like patches of melting snow. And over it all lies an icy silence.

The storm has passed.

 

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“I’ve seen things you wouldn’t believe…”

I struggled to make dinner this evening. Partly it was because I forgot to take my antidepressants two days running, leaving me horribly light-headed and with pupils like pinpricks; partly because in the endless round of buying vapour rubs, cough syrups, tinctures, ointments and snake oil salesmen’s charms, we’ve run out of food.

It’s a contest from Masterchef. I wandered around the kitchen, doing an inventory in a daze. One egg. A clove of garlic. Some carrots, best before two weeks ago. Strawberries that can walk by themselves. Some unidentifiable white substance lurking at the back of the fridge. And some oats. Make a dish out of that.

In my mind, I’m haunted by the memories of crying, sneezing, coughing, puking, and snot, endless snot. What started clear and runny turned thick and yellow-green – at this stage she blew vast snot bubbles from each nostril that spattered everywhere when they burst. Later, it turned into this sticky jelly-like substance, not dissimilar to the glue they use to fix bank cards to letters or CDs to the covers of magazines. It would get stuck all over her face, and I’d have to peel it off in strings. Now, as the cold fades away, it’s a healthy snotty green, and only visible when she sneezes – that’s when it hangs from each nostril like two little worms. Lovely.

I think the worst thing about the whole experience was little Izzie’s distress. You’re meant to protect her, you’re meant to take away the pain and discomfort, but there’s very little you can do to make a sick baby feel better. You can’t explain what’s going on, get her to blow her nose, give her a decongestant. I tried as many things as I could – held her in a hot, steamy bathroom, used vapour rub, nasal spray, Calpol, cough syrup, cuddles. I even tried to use an aspirator – kind of like a pipette where you squeeze a rubber bulb, put the attached tube up the baby’s nose and release the bulb to suck all the snot out – but frankly, more was dripping out on its own than I managed to get in the pipette, so I abandoned that one. And I didn’t bother putting pillows under her mattress to prop her up – given how much she moves about in her sleep, she’d have ended up upside down at the bottom of the cot with the blood rushing to her head.

And so much for three days coming, three days here, and three days going. I mean, the worst of it is over – her temperature is down, her nose isn’t running, her appetite has returned, and she only sneezes from time to time – but her throat still rattles with phlegm that she’s struggling to bring up, and she still has a nasty cough. Apparently, the average baby has eight colds in its first year, lasting ten to fourteen days. Since she turns six months on Friday, and this is her first proper cold, either she’s way below average or the next few months will be hell!

Now if only I could shake the cold she’s given me…

Medical Paranoia

I sometimes wonder how people survived in the past without the modern medical industry and its intrusion into every stage of life. How did they manage without someone measuring weight, length, head circumference, and comparing it to a chart to make sure their babies were developing properly (50th, 75th and 75th percentiles respectively, in case you were wondering – tall, thin and big-brained, just like all the best supermodels)?

And developmental stages: at the eight week check (well, nine, because our appointments were late coming through) the doctor told us Izzie should be smiling, cooing and following things with her eyes by now, as well as beginning to support her head, albeit unsteadily, and drawing up her knees and splaying her feet when placed on her tummy in preparation for crawling. Luckily she can do all those things, but what if she couldn’t? Would we worry about her health, or would we simply wait until she did them naturally at her own pace in her own time? I think we all know the answer to that.

In the past, they simply got on with things, and I don’t think it was necessarily a bad way to do it. Do we really need all of this data when humans have been raising children for hundreds of thousands of years? It’s like when grandparents visit and make little pointers on how to do things. I was feeding Izzie the other day when my mother said, ‘Make sure her nose is clear so she can breathe.’ Gee, thanks mum. I’ve only been doing this at least six times a day for nine weeks: how did I ever cope without you here?

Of course, modern medicine is great when things do go wrong, but given that we, as new parents, know so much, and so little, about the health of infants, we err on the side of caution and rush our kids to the doctor when a wait-and-see approach might have been more reasonable. So in the past week, Izzie has been prodded and poked, measured, evaluated, stuck with needles, dazzled, pulled and manipulated during two trips to the hospital, an examination from the Health Visitor, and an outing to the doctor’s.

Nine o’clock on Friday evening I discovered a watery lump on the back of Izzie’s scalp and was worried her squishy head had returned. Wait till Monday and see if it resolves in the meantime? Not a chance. What if it’s an infection? What if it’s a fractured skull? What if she’s going to die?

The doctor felt it, looked at me and said, ‘That’s her skin.’

‘But, like, when she was born she had this swollen squishy head thing, and it felt just like that.’

‘Uh-huh,’ he said, nodding. ‘It’s still just skin.’

Ouch.

Of some consolation was the fact that the waiting room for the out-of-hours GP at the hospital was packed with worried parents clutching babies and toddlers. The old maxim that you wrap your first child in cotton wool while you let the second juggle knives seems to be true: they were all only children (only childs?). A bump on the head, a sniffle, a funny-sounding cough – how did they used to manage without emergency rooms?

We have an ultrasound for Izzie today. Lizzie had hip dysplasia as a child, otherwise known as clicky hip, and so they wanted to screen Izzie against it. She had no problems when examined in NICU, no problems when examined at her eight week check, but to be on the safe side we need to look at the insides of her joints. Pain free but awkward.

When she grows up, Izzie will be amazed to discover that not only have we seen every square inch of her outsides, we’ve seen her hip joints, the four chambers of her heart, her brain and nasal cavity, stomach, kidneys, lungs, liver, bowels and bladder too. Nothing is private anymore.

I guess that’s the price we pay for modern medicine.