Dr. Thompson's Blog

San Diego Lost a Wonderful Man this Week

San Diego lost Father Joe this week. He dedicated his life to helping the homeless with housing, medical care and many other things. I was not raised Catholic but in seeing the enormous good that Father Joe did in San Diego, makes me wish other San Diego churches and houses of worship cared and did as much for the homeless as he did. I have not seen this happening and hope I am wrong. In Alexandria, Virginia there was a protestant church next to my daughter's office I always think of. Outside was a large sign saying " We are open three times a day if you desire to join us for a meal." In San Francisco there is also a wonderful church where the homeless line up daily for food. In this country where two billionaires are spending their money  going to space, just think what that money could for the 30 million hungry children and all the homeless we  have. 

This is an extremely difficult time for our country and we need to put aside our differences and find some solutions for the  hungry, the homeless, our poor education and medical systems and many other things. In a recent article in the New York Times by Nicholas Kristof he notes how poorly the U.S does on international  surveys about health, graduation rates from high schools, math, safety, and health care. 

It is hard to watch the lack of concern for others in many places, children who are abused and our lack of social services, psychiatric and drug care for those who need this help. We can do better.

Depression During the December Holidays

During December when many people are busy shopping, going to holiday events and cooking, I wonder how many realize how fortunate they are to have family and friends nearby or in close touch. I have two friends who are both only children. One is adopted and has no family and also lost her beloved husband several years ago. The other has children, but only one seems to keep in touch. Her husband died several years ago and her children put her in a retirement home which she greatly dislikes. They also took away her car, so she seldom gets out of her apartment and spends her days reading. How she has survived is beyond my understanding. I try to call frequently and hope that helps. I think we all need to be aware of people who are going through hard times and may be depressed. Even a telephone call now and then or a funny card can help. If someone has recently lost a child, a mate, or partner, the holidays are especially hard. When so many seem busy and happy, it must be hard not to be depressed. There is an increased number of suicides during the holidays and this is understandable. Some people are too proud to call a suicide hotline which could help. Just hearing a friendly voice can make a difference. There are medications that can help, but if someone is depressed, even making a phone call to a doctor or looking for a doctor in order to get a prescription can be too hard a task. Having a difficult time making decisions  is often a symptom of depression.  

The other problem for people who are lonely and depressed during the December holidays is that colds, flu, and pneumonia can be an added problem. Last year I pushed hard to get three older friends to see doctors because they all sounded as if they could have pneumonia. They all did and each paid a high price for not getting medical care right away. Pneumonia in the elderly and those with chronic medical conditions can be a real problem. Often individuals who are depressed don't get flu or pneumonia shots or seek adequate  medical care. I find that the best thing to do if the holidays are hard to handle is to do something for someone else. Also getting out and being around people can be very helpful.  Individuals who have  deep faith seem to handle the bad times often better than those without any religious connections.  So I think we all need to be aware of those around us who are having a hard time this month and help in any way we can.

Depression and Grieving During the Holidays

Holidays are often especially hard for those who have lost a child, a partner, a parent or a special friend. As others are attending holiday festivities, these individuals may be grieving and not feel like being with others or having fun. Then if an illness is added to the grieving, the quality of life can be very poor. The early darkness and longer nights can also add to the pain and grieving.  I have found the best answer is to get extra exercise, eat  well, and try to make dates with friends who understand the pain you are having. If you can find a way to reach out to others and also do something for someone else that will help. Treating yourself to a special bunch of flowers, a book you have wanted, or some other gift can lift your spirits. For me being around children can make the day much brighter. If the loss is recent, the holidays are especially hard. Time does help some, but the pain will always be there.  A mother who lost her son at age 15 to muscular dystrophy told me that you never accept the loss, but you adjust to it. I think that is very true.

Individuals who find great comfort in their religion often do better than others with the loss of a special person. I have been amazed at the strength I have seen in quite remarkable parents who lost their child to a progressive diseases. For some, counseling can be the answer and there are grief workshops that hospitals and other facilities conduct. Your physician should be able to give you some referrals or the Internet, special agencies, or social  workers can all be good resources. The most important thing is not to wallow in your grief, but to do something about it. Friends can just listen so much and if you overburden them with your feelings, they may begin to withdraw. When a child is lost and there are other children, remember that they too will be in pain. One mother who had two daughters lost one to a brain tumor and completely turned her back on the other daughter. I was told she cried at each meal and refused any counseling or help. Fortunately, the living daughter was an adult and turned to friends for help. How sad that the mother was so caught up in her own pain that she created a great gulf from her husband and living daughter. I am afraid  there will  be long-term effects. Children often feel that they may have helped cause a death and in the sibling workshops I have had I  have been amazed at the guilt and pain that some of the kids were feeling. It helped them a lot to be able to talk about their pain and know that others in the group were also  having similar feelings.

 

The Supreme Court's Rulings Against Women's Health

There was a time when Supreme Court justices were lawyers and not politicians. Now it seems that we have five right wing, extremely conservative Republicans on the Court who are doing everything they can to destroy a woman's right to make choices about her body and her health care. The five men have continually ruled in favor of corporations and the rich. Do they have any idea what allowing companies, such as Hobby Lobby, to not provide IUDs and the morning after pill, will do to poor women? Hobby  Lobby is just trying to save money. There is absolutely nothing in the Bible that says a woman  must have children she can not adequately support. When a woman can't afford to pay for an IUD or the morning after pill, she will seek an abortion, if she cannot afford a pregnancy.

If the justices wanted to decrease abortions they made the wrong decision. Of course, they were simply going along with what their rich Republican donors demanded. How very sad. I am sure some of the  truly great justices of the past must be rolling in their graves. The legacy of this Supreme Court is going to be a very sad one, as is that of the Republican party.

How I wish these same five men could work in inner city clinics as I have and seen the utter terror of a woman facing an unwanted pregnancy or of children who were abused because the mothers were depressed and overwhelmed with too many children.

Texas and Back-Alley Abortions

I get chills when I hear accounts of women going to back-alley abortion doctors, but that is what is happening in Texas. If the Republicans have their way, all clinics that provide abortions would be closed. It is puzzling to me that those who are against abortions, such as Paul Ryan, also want to take the safety net away from poor, often single mothers who will end up having more and more babies they will not be able to feed or clothe. These babies have little chance in life, particularly if they are often hungry, get bad or no medical care, and little education.  

Laura Bassett wrote in The Huffington Post that 75 abortion clinics have closed in Texas and women are going over the border to Mexican doctors to have abortions. Often these are not done under sterile conditions and the women may develop severe bleeding or infection. It seems as if we are going back to the 1920's or 30's. What kind of a country is this that we are going backward, rather than forward? What many Repulbicans do not understand is that many clinics that provide abortions, also provide general health care for poor women. Then, we have the twenty-four Republican governors who will not expand Medicaid because they hate President Obama so much.

Having cared for teenage girls who became pregnant, I know what this can do to a girl who is 13, 14, or 15. If the  pregnancy is allowed to continue, it sets the course for the girl's life. She and her infant have little chance for a good future.

Poverty and Medical Problems

I do not understand how the twenty-rour Republican governors, who state they are Christians, can refuse Medicaid expansion in their states. Do they have any idea what this is doing  particularly to our nation's children? Children who don't get good  medical care or any medical care are being set up often for on-going medical problems. Our nation has the worst poverty of all the modern countries. That is a crime. In addition, the Republicans have taken away eight billion dollars in food stamps and refused to extend unemployment benefits which also means many children and their parents go to bed hungry. Then, there are the schools that will not give a child lunch if their parents cannot pay. What kind of a country are we living in?

I  have worked as a pediatrician in the inner cities of Los Angeles, Oakland, Rochester, New York and San Diego and seen chidlren who cannot learn or pay attention in school because they have not had enough to eat. We need to help people without money learn where they can get help and also what foods provide the most nouishment for the  least money. As our school systems are being deprived of more and more money, education is suffering, as are our children The Republicans should be deeply ashamed.

I live in a small town overrun by people with tremendous amounts of money and yet on many blocks in the small village I can usually count two or three homeless people. These are people who may a have mental illness but are not able to access mental health care. The Republicans are doing everything they can to prevent the Affordable Health Care Act from working. We all should vote and get rid of those who are trying to destroy this country.

End of Life Care for the Elderly

As people are living longer, it is extremely important that family members know how to handle problems  arising as the end of life approaches for an elderly person. Unfortunately, there are few doctors interested in this kind of care and I have heard horror stories about what some doctors have done and said. A good friend is dying of liver cancer and her son was told by the young doctor, who took over from her much loved older doctor, that the man should just take his mother home and let her die. The doctor said this in a crisp way with the unsaid message of "Don't bother me any more." I was appallled. The doctor did not give the mother any prescriptions for her nausea or her sleeplessness, nor did he refer her to Hospice. I suggested Hospice and their doctor and nurse are now offering good care.

One of the reason we have few doctors interested in caring for dying, elderly people is that there is little money to be made for this kind of care. It takes a compassionate, caring M.D., who did not go into medicine to make a lot of money, to provide this kind of medical care. So family members may need to do considerable research to find the right doctor if Hospice is not wanted. Remember there are doctors who specialize in pain management. These are usually board-certified anesthesiologists. The local medical society should be able to give you the name of one of these doctors or a good social worker at your local hospital should also have a name and be able to offer other help as well. A good social worker is worth his or her weight in gold.

Sex Education and Abortions

In watching the news, it almost seems as if the United States is regressing rather than moving forward. Many Repulbicans seem to want to take us back to the 1930's or 40's. When I heard that Texas, North Dakota, and Arkansaw legislators wre introducing bills to get rid of sex education and abortions, I found it hard to believe they could be so ignorant. I wondered what these men would do if there own daughters became pregnant at thirteen or fourteen? Would they insist the girl carry the pregnancy to term and then have the child adopted? Sex education is very important in these days of early sexual activity. The churches may preach that sex without marriage is wrong, but that has little or no impact on many teens. Many girls don't think they can get pregnant because they have no true idea of how a pregnancy is conceived. i know this becasue I have taught many sex edication classes in both public and private schools. I have always been amazed at  some of the girls' ignorance about sex, even the girls who were sexually active.

I had no problem in writing contrasceptive prescriptions for girls who were sexually active.  Yes, I always tried to tell them all the problems that could occur if they were having sex. Some did get pelvic inflamatory disease (PID) and one or two even contracted gonorrhea. A few became pregnant and had abortions. These were principally girls from affluent homes. Many of their parents were too busy with social activities or working to have any idea of what was going on with their daughters. I hope the mothers and doctors in Texas, North Dakota, and Arkansas  put pressure on the legislators, so the bills do not pass.

Teenage Pregnancies and Texas

I was astounded to learn today that Texas leads the nation in the number of babies born yearly to teenage girls. The current statistic is that 130 babies are born to teenage girls each day in Texas. How ignorant some Texans must be to prevent schools from giving sex education in 50% of their schools and closing 50 Planned Parenthood clinics. Do these people have any idea what they are doing to the babies and their mothers? A baby born to a teenage mother may also then become a teenage mother and many will be on welfare for the rest of their lives. Not only is there a terrible cost to the girls and their babies, but the cost to tax payers in Texas will be enormous. I have cared for pregnant teenagers and also given many sex education talks. I was always surprised at how little the girls knew about how babies were conceived and most had no idea of what the future would hold for them if they became pregnant. Marian Wright Edelman of the Children's Defense Fund is often quoted as saying that these girls "have written their life script" by becoming pregnant.

Another problem with teenage girls becoming pregnant is that their diet is usually bad and they also don't get adequate medical care or take vitamins. Thus the incidence of  disabilities is higher than in other age groups. Once again society will pay a high price, as will the girls. I hope that pediatricians and family doctors in Texas will band together and protest the closure of the clinics and the lack of sex education in the schools.

Certificate Health and Nutrition Practitioners

A friend sent me a new book a neighbor had written about what we should eat based on Biblical sayings. The friend knew how concerned I was about people who acted as experts without adequate medical training because we had had many long discussions about this. I had also shared with her accounts of the great harm some practitoners' advice had caused; some patients even dying. 

I think patients must be extremely careful not be be taken in by an indiviual who offers advice when they have had, for example, just a few weeks course leading to a certificate, but not the many years that physicians or dietiticans spend in training. A two weeks certificate, plus time spent working with a practitioner of alternative medicine does not equip anyone to give advice about medical treatments or diet. In glancing through this new book, I was appalled at some of the recomendations. They were exceedingly dangerous. Yes, there are far too many physicians who don't practice good medicine, don't listen to patients, and don't seem to care. I think the answer for patients is to always get a second opinion if there is any doubt about medical care and not to rely on people  who have just a certificate from a questionable training program. There is also a great deal of misinformation on the Internet, though there is also some good information. So by asking lots of questions and finding an M.D. you  trust and who knows you and your family, you should  get the best care.