Mirror Moms

Stop cervical cancer with preventative steps

Tue, 7 Feb 2012 00:00:00 EDT

By Beth Ann Downey bdowney@altoonamirror.com National organizations and local doctors want women to know that though cervical cancer is a devastating disease, modern medicine has made it easily detectable and preventable. A press release from J.C. Blair Memorial Health System, Inc. in Huntingdon states that 12,000 women are diagnosed with cervical cancer annual, resulting in more than 4,000 deaths each year. But preventative measures and regular screenings for the disease, called a Pap smear or Pap test, make it easy to combat. "We've seen an exponential drop in the disease because of increased screen-ing," said Dr. Patrick Fiero, an obstetrician/gynecologist at J.C. Blair. Fiero recommends wo-men get a Pap smear every year. Since the invention of the Pap smear by Dr. George Papanicolaou in the 1940s, it has reduced the death rate from cervical cancer by 70 percent. Fiero administers the first test for a young woman around age 18 or after first sexual contact - whichever comes first. Women between ages 35 and 55 are at the highest risk for developing cervical cancer, and getting it at a young age can decrease the capability to have children as well as contribute to other health problems later in life, Fiero said. "It is something that kills, and it can be pretty devastating," he said. "So it's a big concern." The human papillomavirus, or HPV, is the largest known contributor to causing cervical cancer. A three-shot vaccine for HPV was approved in 2006 for both men and women. HPV is also the most common sexually transmitted disease in the country, according to the press release. "Virtually anyone sexually active will get HPV some time in their life time," said Fred Wyand, the director of communications for the National Cervical Cancer Coalition based in Research Triangle Park, N.C. He added that HPV is not dangerous in most cases and is usually cleared away by the body, but should still be taken seriously because of its link to cancer. The NCCC's goal is to provide education and support for cervical cancer patients and their families, Wyand said. the key component to their education efforts is getting the message out there that cervical cancer is "virtually always preventable," he added. "It's the cancer that really never has to happen," he said. Fiero said some common misconceptions about cervical cancer are that HPV can spread without intimate contact, and that cervical cancer is genetic. "It is an environmental disorder," he said. "If a mom or a sister or a close relative had [cervical cancer], it's not the same risk as them having breast cancer or colon cancer." But unprotected sex, having sexual relations at an early age, having multiple sexual partners, smoking and giving birth to more than three children all increase a woman's risk for cervical cancer, according to the press release. Local visits to your physician or gynecologist are imperative to ensure that if a woman is at risk, the disease can be caught early and treated properly. "It's something we need to drive home to women, that it's a very important aspect of women's healthcare,"?Dr. Fiero said. Mirror Staff Writer Beth Ann Downey is at 946-7520.

Unusually large baby makes headlines, spurs discussion

Mon, 6 Feb 2012 00:00:00 EDT

At least where babies are concerned, bigger isn't always better. On Jan. 30, the Associated Press reported that an expecting mother in Des Moines, Iowa gave birth to a boy weighing in at 13 pounds and 13 ounces. Though only a tenth of 1 percent of all newborns weigh more than 11 pounds at birth, the AP reported, the newborn Asher Stewardson measured 23 1/2 inches long and was delivered without the aid of surgery. But local maternity nurses agree mothers should be thankful if their newborns can't compete with him - for it could mean complications for both mother and child. "It isn't always 'big baby means healthy baby,'" said Julie Vitko, the nurse manager of the Maternity and Nursery department at Altoona Regional Health System. The largest baby she can recall born at Altoona Hospital weighed about 12 1/2 pounds. Babies born big usually indicate that the mother contracted gestational diabetes, which affects 18 percent of pregnancies, according to the American Diabetes Association. Because this form of diabetes can pose a threat to both mother and child, Vitko said mothers should do what they can to prevent it. "It's very important that they have prenatal care," she said. "Good prenatal care is just essential." Larger babies can also cause an "exceedingly difficult" delivery, Vitko said. She said it is tough to imagine the nearly 14 pound baby being delivered vaginally, but it can obviously be done. Tammy Lemin, the unit director for the maternity ward at UPMC Bedford Memorial Hospital, said delivering larger babies can also result in complications like shoulder dysplasia, when the head comes out and the shoulder gets stuck. Lemin added that an 11-pound birth is the largest she can remember at the hospital. Less than 2 percent of newborns weigh more than 10 pounds at birth; the average child is around 7 pounds. Dr. Patrick Fiero, an obstetrician/gynecologist at J.C. Blair Hospital in Huntington, said he really can't imagine delivering a nearly 14-pound baby. "Whoever it was that delivered that baby had a lot of guts," he said. "I'm sure they sweated it through, and probably didn't realize it'd be that big." Fiero said it can be hard to estimate fetal weight because an ultrasound can only measure the hard structures of the baby - not the soft structures that contribute to weight. So when it comes to delivery, it can sometimes be a guessing game as to which method to use. "The main concern is for the health of the baby," he said. "So you want to do what's right for them." Mirror Staff Writer Beth Ann Downey is at 946-7520.

Many teen mothers uninformed

Mon, 6 Feb 2012 00:00:00 EDT

ATLANTA - A new government study suggests a lot of teenage girls are clueless about their chances of getting pregnant. In a survey of thousands of teenage mothers who had unintended pregnancies, about a third who didn't use birth control said the reason was they didn't believe they could pregnant. Why they thought that isn't clear. The Centers for Disease Control and Prevention survey didn't ask teens to explain. But other researchers have talked to teen moms who believed they couldn't get pregnant the first time they had sex, didn't think they could get pregnant at that time of the month or thought they were sterile. "This report underscores how much misperception, ambivalence and magical thinking put teens at risk for unintended pregnancy," said Bill Albert, a spokesman for the Washington, D.C.-based National Campaign to Prevent Teen and Unplanned Pregnancy. Other studies have asked teens about their contraception use and beliefs about pregnancy. But the CDC report released recently is the first to focus on teens who didn't want to get pregnant but did. The researchers interviewed nearly 5,000 teenage girls in 19 states who gave birth after unplanned pregnancies in 2004 to 2008. About half of the girls in the survey said they were not using any birth control when they got pregnant. That's higher than surveys of teens in general, which have found that fewer than 20 percent said they didn't use contraception the last time they had sex. Some of the teen moms were asked what kind of birth control they used: Nearly 20 percent said they used the pill or a birth control patch. Another 24 percent said they used condoms. CDC officials said they do not believe that the pill, condoms and other forms of birth control were faulty. Instead, they think the teens failed to use it correctly or consistently.

Parents held responsible for underage drinking

Wed, 1 Feb 2012 00:00:00 EDT

NEW YORK - Parents of teens: If you think a drinking disaster at your kid's party can't happen at your house, not with your kid, because he's a good kid, it's time to wake up and smell the whiskey bottle tossed on your lawn. Because of the high risk of underage drinking and driving, many parents open their homes to partying teens as a way to keep them off the roads. What some may not know is that liability laws can leave Mom and Dad vulnerable to lawsuits, fines and even jail time if underage drinking is found to be going on under their roof. Parents can get in trouble even if they didn't know about the drinking. That's what a Menlo Park, Calif., father said he is up against. Bill Burnett, a Stanford University professor, was arrested the night after Thanksgiving over a basement party thrown by his 17-year-old son to celebrate a big high school football win. Burnett said he and his wife had forbidden alcohol at the party and were upstairs at the time police received a call about possible drinking by minors. In fact, he said, he had twice made his way to the basement to check on the merry-making. He spent a night in jail and was booked on 44 counts of suspicion of contributing to the delinquency of a minor. Each misdemeanor count carries up to a $2,500 fine and nearly a year in jail. Burnett questioned the deterrent value of laws that hold parents legally responsible even if they didn't know there was alcohol at the party. "In this case, I think arresting a parent isn't going to prevent kids from drinking," he said. Eight states have specific "social host" laws that say parents can get in trouble if underage guests are drinking, even if no one gets hurt, according to the National Institutes of Health. (Some of those states allow parents to serve alcohol to their own children in some situations.) Sixteen other states have laws that hold Mom and Dad legally responsible for underage drinking under certain circumstances - for example, if a teen who drank at their home got into a car accident, NIH said. In other states, parents can get in trouble under more general liability laws. Stephen Wallace, a senior adviser at Students Against Destructive Decisions, or SADD, which used to be called Students Against Drunk Driving, said that with an increased awareness of the dangers of underage drinking, law enforcement authorities are increasingly relying on social host liability laws to go after parents. While he acknowledged that teens are adept at finding ways to drink on the sly, he said he is all for anything that gets at the problem of underage drinking. He said he finds it troubling that the Burnetts said they saw no alcohol consumed at their party. "Parents need to say to kids, 'You shouldn't be drinking at all, and you certainly can't do it here because we can be put in jail,'" Wallace said. According to SADD research co-sponsored by the insurance company Liberty Mutual, more teens are saying that their parents allow them to go to parties where alcohol is being served - 41 percent in 2011, compared with 36 percent two years ago. Also, 57 percent of high school students whose parents allow them to drink at home said they prefer to drink elsewhere with their friends, Wallace said. At some parties, the parents themselves supply the booze. In other cases, the kids bring it, sometimes with the hosts' knowledge. "Some parents feel helpless," said David Singer of Demarest, N.J., who has 17-year-old twin daughters and a 20-year-old son in college. "Some parents feel they need to look the other way in order to help their kids fit in with the cool crowd. And some parents believe, 'It's better under my roof than who-knows-where.'" Like Burnett, Singer said he doesn't condone drinking by his underage kids under any circumstances. And yet he found a whiskey bottle in the yard after a party thrown by his son. Burnett acknowledged he made a mistake but said he doesn't believe police crackdowns like the one at his house do much good. "All of this is probably going to go underground and result in a more dangerous situation for kids," he told the online news network Patch. "I really don't think it's up to the police to help me parent."

Colleges and suicide: When to call home

Wed, 1 Feb 2012 00:00:00 EDT

The email that arrived at Virginia Tech's health center in November 2007 was detailed and unmistakably ominous. It concerned a Tech senior named Daniel Kim and came from an acquaintance at another college. "Daniel has been acting very suicidal recently, purchasing a $200 pistol, and claiming he'll go through with it," the email read, adding details of a reported previous suicide attempt with pills. "This is not a joke." By the time Virginia Tech told Daniel's father, William Kim, about that email, it was too late. A few weeks after it was sent to the school, he spoke with his son for the last time, Daniel indicating all was well and after final exams he'd be home for the holidays. A few days after that, parked in his car outside a Target store near campus, Daniel fatally shot himself in the head. "If I'd known, I could have taken him to doctors, get him on medication, make him normal again," William Kim, who owns a Washington, D.C., convenience store, said in a telephone interview, grief still echoing in his voice four years after the fact. Virginia Tech's actions were all the more confounding coming just months after the murder-suicide rampage on the same campus by another student, Seung Hui Cho, which had supposedly prompted campuses nationwide to rethink their previous emphasis on confidentiality in treating troubled students. "Who is going to take better care of him than his parents?" Kim said. "I never had the chance to do anything for him. That's a terrible feeling." In an agreement finalized by a judge late last year in a multimillion-dollar lawsuit brought by the family, the Kims settled with Virginia Tech for $250,000, plus an endowed scholarship in Daniel's name. But William Kim also insisted that the agreement include language requiring Virginia Tech to notify parents of a potentially suicidal student unless it documents a reason not to do so. The university, which admits no fault, maintains the language reflects policies already in place there under a 2008 state law, and wouldn't have made a difference for Daniel Kim anyway. It continues to insist that, after sending local police to check on the student, and despite the detailed email, it had no reason to believe he was actively suicidal and didn't need to notify his family. But the family's attorney, Gary Mims, insists the settlement goes further than the state law, which applies only to students treated by university mental health services. Now, he says, Virginia Tech must at least consider notifying parents if it receives an indication from any source a student may be suicidal. Several experts described it as among the strongest such policies in the country. The issue of when colleges should notify parents their adult children may be suicidal remains fraught with legal, medical and ethical dilemmas. College policies, state laws and professional codes of conduct vary widely - and occasionally conflict. Some mental health professionals call the Virginia Tech settlement the latest step in a trend they welcome: Threats to safety increasingly take precedence over preserving confidentiality. They emphasize that, in many cases, involving parents is not only right, but helpful. "There's some good evidence if someone is really sick, that involving family in their treatment planning, the medication, helping them stay on track, are really good things to do," said Greg Eells, director of counseling and psychological services at Cornell University in New York, which has changed several policies to make notifying parents more common. "I think the [Virginia Tech settlement] is kind of affirming that." But many remain wary of top-down pressure on counselors to notify parents as the default option, even if such policies are well-intentioned and allow exceptions. Many students have just passing thoughts of suicide. Also, relationships with parents may be part of the problem. Involving them too readily might discourage some people from getting help, or complicate treatment once they do. "The less flexibility we have, it actually compromises care," said Mary-Jeanne Raleigh, director of counseling services at St. Mary's College in Maryland and president of ACCA, the American College Counseling Association. Overly rigid policies mean, she said, "I can't review what is best for the individual standing in front of me because the law is saying you have to x, y and z." Suicide is the second leading cause of death for college students behind automobile accidents. A 2010 survey of counseling center directors found at least 133 college students had taken their lives in the previous year. The better indicator is probably the rate, estimated at about 6 to 7.5 per 100,000 - though that's only about half the suicide rate for similarly aged people not in college. But while the research highlights the danger, it also sheds light on why these are tough calls for colleges. Warning signs aren't always as black and white as they were at Virginia Tech. A milder form of suicidal ideation - fleeting hopelessness or thoughts about death - is common among college-age students. A 2009 survey of 26,000 students at 70 colleges found that roughly half reported having had at least occasional suicidal thoughts. But more than half of those said such thoughts lasted a day or less. Roughly 6 percent of undergraduates reported they had "seriously considered attempting suicide" in the last 12 months. Colleges must determine who's most at risk - typically those who have made detailed plans and acquired means such as a weapon or pills. "Someone who's seeking help but says, 'I have to admit I have these thoughts five or six times a day and they're kind of scary' - that's someone I wouldn't necessarily feel compelled to call the parents right away," Raleigh said. "That's very different from the person I get a call from at 3 o'clock on a Saturday morning who's been drinking and has immediate plans to kill themselves." The 2010 survey of counseling directors found that when a client was considered a "suicidal risk" but didn't meet the state law criteria for involuntary hospitalization, 41 percent wouldn't notify anyone else without a signed release from the student. Only 13 percent said they would notify family; 22 percent said they would notify a superior, and 19 percent said it would depend on the situation. Why the hesitation to involve family? The data also show why colleges worry so much about any action that might discourage troubled students from seeking help: 80 percent of students who commit suicide, like Kim, never participated in campus counseling services. "I'm in favor of notifying parents," said Carolyn Wolf, a mental health lawyer who advises college officials. "These are kids who are 18, 19, 20 years old, they're legally adults, but I don't think they're developmentally adults at that point. Parents are much more involved in kids' lives these days for a longer period of time." Still, she said, "you need to give some amount of flexibility to those people who are in the trenches." Wolf advises parents to remember that FERPA, the federal education privacy law, has clear exceptions for risks to health and safety, as do state laws. HIPPA, the federal medical privacy law, generally doesn't apply to colleges. And while counselors and psychiatrists may be unable to discuss a student they are treating, those rules don't apply to anyone else on campus; faculty and administrators can call home about behavioral issues.