Questions and courage will help the Kids

Tweet

I'm continuing with my theme of how to help young Moms in our communities, because no-one grows up in isolation and we can all play a part - however small - to help lift vulnerable kids out of the mire of despair and give them a chance of making something out of there lives.

Today the CDC reports that 1 in 5 teenage births is a "repeat" and that's a massive challenge for young people to take on and to survive! What that sort of information suggests to me is that it's not just a matter of better birth control - that's vitally important too, but even after decades of information about the pill and condoms only 22% of teenagers used effective methods of contraception - but's it also involves education, literacy, numeracy, parenting skills, having someone they can trust (and for many, that person may not actually be in the community where they currently live), learning the basics of budgeting money, good health information, basic dietary advice to fit their location and their income .. it's a long list and it needs to be accessible to the Mom wherever she is: and that's where the genius of social media may help us play a big part.

Question: Would you be prepared to offer simple, on-line support to a young Mom in your area?

I ask this because it does raise the issue of how much do "I" want to be involved: how can I protect my own identity: what if "they" get to depend on me too much, and "I've got my own problems to contend with"? All of these questions and more need to be asked and some answers found before any website is "switched on": and you, my dear friends, have some of the answers and many of the questions that need to be aired.

But you know what? Despite the tension between our desire to help and our worries about what might be asked of us, none of it compares to the probably life long misery, hurt and destruction that many of these young Moms and their kids face if we people of good will don't at least attempt to do something, however small or seemingly insignificant.

This project will take months/years to get "legs", but I have real faith that eventually something of worth will be created to help those who are most vulnerable. I hope some of you will join me in the journey.

SPREAD THE WORD

image

Pap smears: are we doing a good job?

Tweet

Public health screening tests for things like Breast Cancer, Prostate cancer and Cervical cancer are never far from controversy. And NO screening test is a 100%, gold-plated certainty to pick up all the cases of cancer that it is designed to detect. Also, more and more malignancies are being found to have some form of environmental link -

• Smoking and lung cancer
• Alcohol and bowel/breast cancer
• Hepatitis C and liver cancer
• Papilloma viruses and Head and neck plus Cervical cancers

   so prevention is a much better approach than shutting barn doors after horses have bolted!

Also, although we tend to assume that Pap smears are a simple procedure, like getting your passport checked at immigration, from a practical point of view - both for the patient and the practitioner - they are sometimes far from easy to perform!  For instance, strange though it may seem, the Cervix is not always easy to locate by an inexperienced Practitioner who does not have their examination room set up to perform them on a routine basis. Anatomically, in a woman who is overweight and not very "agile", and who has lax pelvic structures,  it can be very difficult to directly view the cervix as it is doesn't come with a label, nor is it distinctly a different colour to the rest of the surrounding vaginal structures!

But even in those cases where the experienced person can perform the screen and send the "smear" off for cytological examination, again the results cannot be claimed to be 100% certain. However, there are certain broad guidelines that are used to reduce the risk of missing early, treatable Cancer of the cervix, and these guidelines are based on age. BUT EVEN THEN THESE GUIDELINES MUST BE TAILORED TO THE INDIVIDUAL NEEDS OF EACH WOMAN.

In 2012, the U.S. Preventive Services Task Force, American College of Obstetricians and Gynecologists and American Cancer Society recommended that:

1. Cervical screening should begin at the age of 21
2. Screening should be every 3 years and not annually.
3. Screening is NOT necessary for women who have had a Hysterectomy for non-cancerous reasons.
4. Screening is not necessary for women over 65 who have had several previously normal Pap smears.

Current national policy in Australia is:

1. Routine screening with cervical smears should be carried out every two years for women who have no symptoms or history suggestive of abnormal cytology.
2. All women who have ever been sexually active should commence having a cervical smear between the ages of 18 and 20 years, or one or two years after first intercourse, whichever is the later.
3. Cervical smears may cease at the age of 70 years for women who have had two normal cervical smears within the last five years. Women over 70 years who have never had a smear or who request a cervical smear should be screened.

From a recent CDC report, it appears that many women - 22 million in fact - may have had unnecessary Pap smears. The reasons behind this massive failing are probably not limited to the US: they're just far more honest about it!

My take on all of this? Sex is literally in our DNA, but we have to be aware that casual sex can cause permanent damage! As far as cancer of the cervix goes:

• We need to improve our rates of vaccination with the most effective HPV vaccines currently available. 
• We need to educate the most vulnerable groups on how to best protect themselves with vaccination and condoms. 
• We need to screen those groups who are known to be more at risk (and at this stage I would tend to favour the American guidelines over the Australian ones). 
•  Finally, those who are screening for Cervical cancer should only be screening those at risk and there should be no place for "over-servicing" of inappropriate cases.

references:
CDC
RACOG

image

Bring on Bali

Tweet The favourite daughter is going to Bali with her family on Saturday, so there is a tornado of activity with packing, last minute preparations and dealing with those unexpected hiccoughs, before heading to the land of palm trees and plaited hair!

So what preparations should families take before heading off to exotic, and not so exotic holiday destinations?

Probably the most important things to pack are sunblock,  tropical strength insect repellent and dressings for minor grazes and cuts that inevitably occur just when you thought you didn't need them! If you are intending to go to areas or countries where hygiene standards are not as stringent as here in Oz, then be prepared for a dose of the "trots". Most cases of gastroenteritis are self limiting, but it's pretty miserable to have to endure for 24 to 48 hours whilst the world falls out of your bottom!! Good personal hygiene is essential, and make sure that what you eat is well cooked: and look out for those salads and eggs/chicken that might not be cooked all the way through. The key to surviving Gastro is to keep hydrated: you can get sachets of dry powder containing all the salts that the body is losing down the toilet: you just add the powder to bottled water so that you replace not only the fluids that you lose, but also the salts, that if not replaced, leave you feeling washed out.

But in many areas of the world there are exotic diseases that require vaccination: this raises the problem of how many shots, and when to have them and what are the side effects. I always go to the CDC in the US which always has comprehensive and up to date advice for travel to all parts of the world. So here's a link to the CDC:

http://wwwnc.cdc.gov/travel/

I'll also add it to the "tool bar" on the right for future reference, check it out, especially for all those who intend to travel abroad. Unfortunately it's too late for the favourite daughter, but I have assured her that I am prepared to do a home visit if she needs it!!