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Tuesday, July 29, 2014

Pro-Vaccines and other medical issues

This is probably the most controversial post I will ever write on my blog, because overall I believe everyone should do what is right for them and I don't think it is my place to have an opinion about someone's personal life. The thing is that I am completely perplexed as to why these are controversial issues. My grandfather once told me that it was my duty to share my opinion about big issues within my field(medicine), because I have the education and information to form a well thought out opinion. So maybe it is all of the facebook statuses or the news articles, but I think maybe it is time to share my thoughts with others.

Vaccines
This is the most important part of this post and something I am actually very passionate about. I truly believe that those who chose not to vaccinate their children believe they are doing what is in the best interest of their child, but well-meaning people don't always make the right decisions. I am completely clueless why this is an issue and why with the recent emergence of preventable illness we are still arguing about vaccines.
I want to share a story about my first interaction with an anti-vaccine family. It was during my pediatric rotation and we had a 2 year old come in who had an abscess(collection of bacteria and pus) in her neck and was septic(bacteria in blood). I remember taking her history from her family and being floored when they said that she had not been vaccinated. The mother lay on the bed holding her while she wailed. Her father sit close by. They clearly loved this child dearly. But she was miserable and very sick. She had a very high fever and my supervising physician ordered tylenol to bring the fever down and something like IV ibuprofen(tordol) for pain relief. Shortly after the orders were entered the nurse came in and let us know the family had refused the medications, because they had too many ingredients in them. Everything we wanted to do medically was a struggle. We had a long discussion about antibiotics which they didn't want her to have initially and pain medications. Every time I went into that room the little girl was crying. It was heartbreaking, but not surprising. She was sick, was being refused pain relief, and had a fever of 103F. Her medical course was long, painful, and difficult to watch and when she finally was able to leave the hospital her parents were just as anti-vaccine as they were when they arrived. Something I still can't understand.
I think the most important thing when making decisions that are life-changing or life threatening is to be well informed. I am pro-vaccines and I believe it is the responsibilities of parents to protect their children from what could be deadly and dangerous illnesses that are preventable. I want to share some of the evidence based information that led me to this opinion and I hope some of you will take this information into consideration when making this very important decision.

1. While the cause of autism is still unknown, there are a large number of studies out there which debunk the vaccines cause autism myth. In addition, there have been several cases of autism in non-vaccinated children. 

2. Measles
  • In the last 7 months, there have been 18 outbreaks and 585 cases of measles in the United States. 
  • 1 in 2000 cases results in encephalitis(swelling of the brain) 
  • 20 in 1000 cases results in pneumonia
  • 1-2 in 1000 children who get measles will die. 
  • In 2012, 122,000 people died from measles globally--about 14 deaths an hour.  
  • Before the MMR vaccine, measles killed 2.6 million people a year globally.
3. Rubella
  •  Rubella causes congenital deformities in infants and roughly 110,000 babies are born with these defects every year globally. 
  • Before the vaccine, 1-4 in 1000 infants born globally were born with defects from the Rubella virus
  • Defects include deafness, cataracts, and heart issues.
4. Haemophilus influenzae type B
  • This nasty little bug is famous for causing epiglottis. A highly contagious bacteria that can lead to your airway closing off. It also causes meningitis, pneumonia, and ear infections
  • There were 12,000 cases of meningitis from H influenzae a year before the vaccine. 
  • As many as 1 in 20 cases of meningitis leads to death even with treatment and as many as 1 in 5 surviving patients who had meningitis will have long term brain damage, blindness, or deafness
  • Before the vaccine, 600-1,000 children died a year in the United States alone from H influenzae.
5. Diptheria
  •  Diptheria is a bacteria that causes a cold like illness that is accompanied by a thick coating on the back of the throat that can cause you to quit breathing. The bacteria can also attack the heart leading to heart failure or attack the nerves leading to paralysis
  • 1 in 10 children who get diptheria die and up to 1 in 5 children who get diptheria before 5 years old die.
  • Diptheria once caused 15,000-20,000 deaths per year in the United States alone until the vaccine became available.
There are a similar list of reasons for every illness we can vaccinate against. It is my opinion that every person's life is important. 1 death that was completely preventable is 1 too many. Many of the people who die from preventable illnesses are children who have their whole life ahead of them. Protect your children, your neighbors, and your love ones by getting the proper vaccinations. 

Birth Control
I will make this short. I believe that every woman should have access to the birth control of her choice and it is the responsibility of women to make good decisions. I recently read a buzzfeed post where women held up signs about why they didn't take birth control. I found many of their reasons to be based off of incorrect information and didn't quite understand how they saw the world, but I also think if you don't think BC is for you that is okay. Just don't make it your goal in life to take it away from other women. 

Trauma
1. Wear your seat belts. For the love of all things, just wear the damn thing. You are putting yourself and everyone else in the car at risk if you don't wear it. Not to mention the poor paramedic who has to try to save your life or the poor police officer who has to notify your family. Wear it!
2. Look for motorcycles! And for the bike riders, don't drive recklessly. Don't try to beat lights or swerve around cars. Some of the worse traumas I have seen in the last year have been people who were on a bike. 
3. Firework safety. Dynamite is dangerous. No seriously, it could kill you or leave you mangled or permanently disabled. Please use your common sense.

Drinking and Driving
1. Don't do it! 
2. 28 people die a day due to drunk driving in the US.
It is heart breaking for everyone involved. Call a cab, sleep in your car, call your mom. Whatever you need to do, but don't get behind the wheel of a vehicle if you have been drinking.

Other Notes
  • Quit smoking. This both is a personal and medical issue for me. For the last year, my grandfather has been battling lung cancer. He is only in his 60s. He quit smoking 10 years ago, but he was a regular smoker for almost 30 years. Do your lungs, heart, blood vessels, brain, and family a favor and put down the cigarette
  • Everyone needs a living will. Tomorrow is never guaranteed and there should be something put in place if you are unable to make your own decisions. 
  • Put your child in the proper car seat. The new recommendation is for you child to be in a rear-facing car seat until they are 2 years old.
  • Along those lines, do not leave your child in a car or your pet. No matter what. Even if it is only going to be a minute or 2. When it comes to this it is better to be overly cautious.
  • Be kind to each other. This doesn't really come from my years in medical school, it is just something that will make your life and the lives of those around you happier.
So that's it. My thoughts and information on the current issues that we talk about everyday. I hope the information is well received and that one day these will no longer be controversial issues. 

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