The news of Mary Lambert's pregnant fetus spread like wildfire across the intertubes, the flames fanned by social media.
A pregnant woman in Portland, Oregon was hospitalized this week with extreme stomach pains, and doctors were extremely shocked at what they discovered.
Mary Lambert, who is 8 months pregnant, went to Silverstein Memorial Hospital in Portland when she thought she might be going into labor. Doctors examined her, and initially could not figure out what was causing Lambert’s pain. After an ultrasound to check on her baby, they were taken aback to find that her unborn daughter was also pregnant.
“I have never in my life seen anything like this.” Said Dr. Joseph Goldsmith, a pediatric surgeon at Silverstein. “I don’t think anyone has. This is the first time that an unborn baby has become impregnated. It’s so far beyond rare that we didn’t know it was possible.”
There was an obvious reason that this complication is so rare - it's a Hoax.
... But, of course, the report is fanciful nonsense. No unborn baby is pregnant, in Oregon, or anywhere else. The fictional report originates from the fake-news website, Empire News.
In fact, nothing published on Empire News is true. A disclaimer on the site notes:
Empire News is a satirical and entertainment website. We only use invented names in all our stories, except in cases when public figures are being satirized. Any other use of real names is accidental and coincidental.
The internet is replete with tall tales and rumor-mongering. It pays to check out the sources before passing on incredible stories. Be careful out there.
One final note - there is a condition called Fetus In Fetu which can occur as a complication of embryogenesis during a twin pregnancy. In this condition, a nonviable twin fetus becomes enclosed within a normally developing twin fetus. This condition became the inspiration for Stephen King's The Dark Half. This, however, is far from the short-lived saga of the pregnant fetus.
For more information or to schedule a sonogram, please call (718) 925-6277.
Monday, June 30, 2014
Monday, June 23, 2014
It Ain't Over 'Til It's Over
This morning, I found this disturbing story from India.
A man upon finding his first born baby deformed created a ruckus in government women's hospital on Wednesday alleging that the administration had changed his baby after delivery. Dozens of villagers gathered in his support in the hospital and shouted slogans against the doctors. The man stated that he had twice got the sonography of his unborn baby done from a privated doctor who claimed that the baby was perfectly normal.
According to sources, Farhan of nearby Gagwana village, was very excited about his first child and he took his wife for sonography in her third and seventh months. "The doctor told me that the baby was perfectly alright and we were happy with it," said Farhan.
On Sunday, Farhan's wife delivered the baby in a government hospital and afterwards the baby was brought to the couple. "The child was deformed and we were shocked to see that. When I enquired the doctors, they said that the baby was born deformed," added Farhan.
Farhan again went to the same private doctor who had conducted the sonography of his wife, "The doctor claimed that it is not possible after looking at the sonography report that the baby would be born deformed," Farhan said.
Farhan on Wednesday came back to the hospital and returned the baby to the hospital administration demanding to return his real child, "They changed my baby with another and I demanded DNA test before taking the baby," said Farhan.
Dozens of villagers from Gagwana also gathered in the hospital and created ruckus. They shouted slogans against the hospital administration. Police was also called on the spot to control the situation.
Having a child with a birth defect is obviously difficult but when it's unexpected, it literally gut-wrenching for all concerned. At issue is the question: what are the reasonable expectations after an apparently normal 20 week scan?
In the Netherlands, Baardman et al reported on the introduction of a routine 20 week scan increased the detection rate for serious congenital heart defects. However, at best, 15% of the defects went undetected before birth.
Magriples and Copel analyzed a series of 901 patients who underwent ultrasound screening with referral for a targeted exam if an abnormality were suspected. The babies were then examined at birth. There were 28 abnormalities in total. Of these, 5 or 17.8% were missed. In general, the more severe were detected while some of those missed were more subtle.
So what's the take home message? Trying to perform a physical exam on someone who is inside someone else is often exceedingly difficult. Moreover, prenatally, the sonographer is not looking at the finished product.
As Yogi Berra once said in 1973, "It ain't over 'til it's over." To contact me or to schedule an ultrasound, call (718) 925-6277.
A man upon finding his first born baby deformed created a ruckus in government women's hospital on Wednesday alleging that the administration had changed his baby after delivery. Dozens of villagers gathered in his support in the hospital and shouted slogans against the doctors. The man stated that he had twice got the sonography of his unborn baby done from a privated doctor who claimed that the baby was perfectly normal.
According to sources, Farhan of nearby Gagwana village, was very excited about his first child and he took his wife for sonography in her third and seventh months. "The doctor told me that the baby was perfectly alright and we were happy with it," said Farhan.
On Sunday, Farhan's wife delivered the baby in a government hospital and afterwards the baby was brought to the couple. "The child was deformed and we were shocked to see that. When I enquired the doctors, they said that the baby was born deformed," added Farhan.
Farhan again went to the same private doctor who had conducted the sonography of his wife, "The doctor claimed that it is not possible after looking at the sonography report that the baby would be born deformed," Farhan said.
Farhan on Wednesday came back to the hospital and returned the baby to the hospital administration demanding to return his real child, "They changed my baby with another and I demanded DNA test before taking the baby," said Farhan.
Dozens of villagers from Gagwana also gathered in the hospital and created ruckus. They shouted slogans against the hospital administration. Police was also called on the spot to control the situation.
Having a child with a birth defect is obviously difficult but when it's unexpected, it literally gut-wrenching for all concerned. At issue is the question: what are the reasonable expectations after an apparently normal 20 week scan?
In the Netherlands, Baardman et al reported on the introduction of a routine 20 week scan increased the detection rate for serious congenital heart defects. However, at best, 15% of the defects went undetected before birth.
Magriples and Copel analyzed a series of 901 patients who underwent ultrasound screening with referral for a targeted exam if an abnormality were suspected. The babies were then examined at birth. There were 28 abnormalities in total. Of these, 5 or 17.8% were missed. In general, the more severe were detected while some of those missed were more subtle.
So what's the take home message? Trying to perform a physical exam on someone who is inside someone else is often exceedingly difficult. Moreover, prenatally, the sonographer is not looking at the finished product.
As Yogi Berra once said in 1973, "It ain't over 'til it's over." To contact me or to schedule an ultrasound, call (718) 925-6277.
Thursday, June 19, 2014
Vitamin D: Let The Sunshine In
As a follow-up to my previous post on sunscreens, I need to point out that there is a downside. We are in the midst of a global epidemic of vitamin D deficiency.
Vitamin D ... regulates the functions of over 200 genes and is essential for growth and development. There are two forms of vitamin D. Vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D status depends on the production of vitamin D 3 in the skin under the influence of ultraviolet radiation from sun and vitamin D intake through diet or vitamin D supplements. Usually 50 to 90% of vitamin D is produced by sunshine exposure of skin and the remainder comes from the diet. Natural diet, most human consume, contain little vitamin D. Traditionally the human vitamin D system begins in the skin, not in the mouth. However, important sources of vitamin D are egg yolk, fatty fish, fortified dairy products and beef liver.
Vitamin D3 deficiency can result in obesity, diabetes, hypertension, depression, fibromyalgia, chronic fatigue syndrome, osteoporosis and neuro-degenerative diseases including Alzheimer’s disease. Vitamin D may even contribute to the development of cancers, especially breast, prostate, and colon cancers.
Why is sun avoidance important?
...Exposure to sunshine each day helps human body to manufacture the required amount of vitamin D. However, due to fear of developing skin cancer most people avoid the sun exposure. To prevent vitamin D deficiency, one should spend 15 to 20 minutes daily in the sunshine with 40% of the skin surface exposed. High concentration of melanin in the skin slows the production of vitamin D; similarly aging greatly reduces skin production of vitamin D. Use of sunblock, common window glass in homes or cars and clothing, all effectively block UVB radiation – even in the summer. People who work indoors, wear extensive clothing, regularly use sunblock, are dark skinned, obese, aged or consciously avoid the sun, are at risk of vitamin D deficiency.
Balance, Daniel san - Balance.
For more information, or to schedule an ultrasound, call: (718) 925-6277.
Vitamin D ... regulates the functions of over 200 genes and is essential for growth and development. There are two forms of vitamin D. Vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D status depends on the production of vitamin D 3 in the skin under the influence of ultraviolet radiation from sun and vitamin D intake through diet or vitamin D supplements. Usually 50 to 90% of vitamin D is produced by sunshine exposure of skin and the remainder comes from the diet. Natural diet, most human consume, contain little vitamin D. Traditionally the human vitamin D system begins in the skin, not in the mouth. However, important sources of vitamin D are egg yolk, fatty fish, fortified dairy products and beef liver.
Vitamin D3 deficiency can result in obesity, diabetes, hypertension, depression, fibromyalgia, chronic fatigue syndrome, osteoporosis and neuro-degenerative diseases including Alzheimer’s disease. Vitamin D may even contribute to the development of cancers, especially breast, prostate, and colon cancers.
Why is sun avoidance important?
...Exposure to sunshine each day helps human body to manufacture the required amount of vitamin D. However, due to fear of developing skin cancer most people avoid the sun exposure. To prevent vitamin D deficiency, one should spend 15 to 20 minutes daily in the sunshine with 40% of the skin surface exposed. High concentration of melanin in the skin slows the production of vitamin D; similarly aging greatly reduces skin production of vitamin D. Use of sunblock, common window glass in homes or cars and clothing, all effectively block UVB radiation – even in the summer. People who work indoors, wear extensive clothing, regularly use sunblock, are dark skinned, obese, aged or consciously avoid the sun, are at risk of vitamin D deficiency.
Balance, Daniel san - Balance.
For more information, or to schedule an ultrasound, call: (718) 925-6277.
Monday, June 16, 2014
Sunshine On Sunscreens
Once again, summer beach and pool days are upon us and we need to remind ourselves to deal prudently with exposure to the sun's rays. Sunscreens are the most widely promoted means of protection but there are more than a few caveats.
No Spray Ons - Too easy to miss a spot.
No super high SPFs - EWG advises avoiding products higher than SPF 50.
No oxybenzone - There can be significant absorption into the bloodstream, with an estrogen-like effect.
No retinyl palmitate - EWG recommends avoiding as research shows synergistic effect with sun exposure for tumor development.
No combined sunscreen/bug repellent - combining screens with repellent may increase repellent absorption.
No sunscreen towlettes or powders - FDA sunscreen rules bar these.
No tanning oils - products with SPF lower than 15 are worthless.
For more info, check out more useful info at EWG.org.
Let's be careful out there. H/T TotalBeauty.com Also, for more info or to schedule an ultrasound, call 718 - 925 - 6277.
No Spray Ons - Too easy to miss a spot.
No super high SPFs - EWG advises avoiding products higher than SPF 50.
No oxybenzone - There can be significant absorption into the bloodstream, with an estrogen-like effect.
No retinyl palmitate - EWG recommends avoiding as research shows synergistic effect with sun exposure for tumor development.
No combined sunscreen/bug repellent - combining screens with repellent may increase repellent absorption.
No sunscreen towlettes or powders - FDA sunscreen rules bar these.
No tanning oils - products with SPF lower than 15 are worthless.
For more info, check out more useful info at EWG.org.
Let's be careful out there. H/T TotalBeauty.com Also, for more info or to schedule an ultrasound, call 718 - 925 - 6277.
Monday, June 2, 2014
New Fertility Hope For Chemo Patients
From this weekend's New York Times:
A commonly used drug can help young women with breast cancer retain the ability to have babies, apparently protecting their ovariesfrom the damage caused by chemotherapy, researchers reported here on Friday.
The treatment could provide a new option for dealing with one of the painful dilemmas faced by young cancer patients — that doing the utmost to save their lives might impair or even ruin their fertility. Researchers said the drug, goserelin, which temporarily shuts down the ovaries, appears to protect women from the more permanent premature menopause that can be induced by chemotherapy. In a clinical trial, women who were given goserelin injections along with chemotherapy had less ovarian failure and gave birth to more babies than women receiving only the chemotherapy.
“Premenopausal women beginning chemotherapy for early breast cancer should consider this new option to prevent premature ovarian death,” the study’s lead author, Dr. Halle Moore of the Cleveland Clinic, said at a news conference here at the annual meeting of the American Society of Clinical Oncology.
This is wonderful news indeed for many young women awaiting chemotherapy. There is one catch, however. On the GoodRx website, Zoladex (Goserelin) is listed as:
This drug is considered a specialty medication, which means:
It is very expensive. A typical fill can cost $1,326 or more for 1 kit of Zoladex 10.8mg.
Patients in need of this drug will usually find most of the cost paid by an insurance company, government or non profit organization. If you are uninsured or need help with your co-pay, the manufacturer may also offer assistance.
Most retail pharmacies will not stock this medication. The manufacturer may offer more information on how to fill this prescription.
Physicians and patients considering this therapy as always should do some homework first.
For more information, or to schedule an ultrasound, please call: (718) 925-6277.
A commonly used drug can help young women with breast cancer retain the ability to have babies, apparently protecting their ovariesfrom the damage caused by chemotherapy, researchers reported here on Friday.
The treatment could provide a new option for dealing with one of the painful dilemmas faced by young cancer patients — that doing the utmost to save their lives might impair or even ruin their fertility. Researchers said the drug, goserelin, which temporarily shuts down the ovaries, appears to protect women from the more permanent premature menopause that can be induced by chemotherapy. In a clinical trial, women who were given goserelin injections along with chemotherapy had less ovarian failure and gave birth to more babies than women receiving only the chemotherapy.
“Premenopausal women beginning chemotherapy for early breast cancer should consider this new option to prevent premature ovarian death,” the study’s lead author, Dr. Halle Moore of the Cleveland Clinic, said at a news conference here at the annual meeting of the American Society of Clinical Oncology.
This is wonderful news indeed for many young women awaiting chemotherapy. There is one catch, however. On the GoodRx website, Zoladex (Goserelin) is listed as:
This drug is considered a specialty medication, which means:
It is very expensive. A typical fill can cost $1,326 or more for 1 kit of Zoladex 10.8mg.
Patients in need of this drug will usually find most of the cost paid by an insurance company, government or non profit organization. If you are uninsured or need help with your co-pay, the manufacturer may also offer assistance.
Most retail pharmacies will not stock this medication. The manufacturer may offer more information on how to fill this prescription.
Physicians and patients considering this therapy as always should do some homework first.
For more information, or to schedule an ultrasound, please call: (718) 925-6277.
Tuesday, May 27, 2014
Polycystic Ovarian Syndrome: A Silent Misery
From The Daily Star:
A young girl, 15 years old, struggles with acne ever since her periods started. And not too long ago, she noticed dark thick facial hair around her chin and over her cheeks, something that can be socially crippling in school. No amount of waxing, threading and bleaching helps and this 15-year-old is miserable.
A couple has been trying to conceive for nine months with no positive result. In a country with an over-population problem and a serious lack of understanding of infertility and sexual health, there are usually misunderstandings on the varied number of reasons as to why a couple may not be able to conceive. There are grumbling in-laws, a lot of finger-pointing and blaming, usually the women, which does little to help the situation.
A 27-year-old woman has very irregular periods. She has gained a lot of weight over a year or two. She feels bloated and uncomfortable with friends and family being rather insensitive to her recent weight gains. Not having periods regularly also makes her scared about her future, especially when she thinks about marriage and children.
A 22-year-old woman feels extreme pain in her lower abdomen. When she is rushed to hospital, the doctors suspect appendicitis but ultrasounds show that her appendix is fine. However, because she has a sexually active relationship with her boyfriend and does not want her family or even her doctor to find out, she provides limited information on her symptoms which leads to inconclusive diagnosis.
What do these women have in common? They have Polycystic Ovarian Syndrome.
For reasons that are not well understood, in PCOS the hormones get out of balance. One hormone change triggers another, which changes another. For example:
The sex hormones get out of balance. Normally, the ovaries make a tiny amount of male sex hormones (androgens). In PCOS, they start making slightly more androgens. This may cause you to stop ovulating, get acne, and grow extra facial and body hair.
The body may have a problem using insulin, called insulin resistance. When the body doesn't use insulin well, blood sugar levels go up. Over time, this increases your chance of getting diabetes.
The cause of PCOS is not fully understood, but genetics may be a factor. PCOS seems to run in families, so your chance of having it is higher if other women in your family have it or have irregular periods or diabetes. PCOS can be passed down from either your mother's or father's side.
For more information or to schedule an ultrasound, please call: (718)925-6277.
A young girl, 15 years old, struggles with acne ever since her periods started. And not too long ago, she noticed dark thick facial hair around her chin and over her cheeks, something that can be socially crippling in school. No amount of waxing, threading and bleaching helps and this 15-year-old is miserable.
A couple has been trying to conceive for nine months with no positive result. In a country with an over-population problem and a serious lack of understanding of infertility and sexual health, there are usually misunderstandings on the varied number of reasons as to why a couple may not be able to conceive. There are grumbling in-laws, a lot of finger-pointing and blaming, usually the women, which does little to help the situation.
A 27-year-old woman has very irregular periods. She has gained a lot of weight over a year or two. She feels bloated and uncomfortable with friends and family being rather insensitive to her recent weight gains. Not having periods regularly also makes her scared about her future, especially when she thinks about marriage and children.
A 22-year-old woman feels extreme pain in her lower abdomen. When she is rushed to hospital, the doctors suspect appendicitis but ultrasounds show that her appendix is fine. However, because she has a sexually active relationship with her boyfriend and does not want her family or even her doctor to find out, she provides limited information on her symptoms which leads to inconclusive diagnosis.
What do these women have in common? They have Polycystic Ovarian Syndrome.
For reasons that are not well understood, in PCOS the hormones get out of balance. One hormone change triggers another, which changes another. For example:
The sex hormones get out of balance. Normally, the ovaries make a tiny amount of male sex hormones (androgens). In PCOS, they start making slightly more androgens. This may cause you to stop ovulating, get acne, and grow extra facial and body hair.
The body may have a problem using insulin, called insulin resistance. When the body doesn't use insulin well, blood sugar levels go up. Over time, this increases your chance of getting diabetes.
The cause of PCOS is not fully understood, but genetics may be a factor. PCOS seems to run in families, so your chance of having it is higher if other women in your family have it or have irregular periods or diabetes. PCOS can be passed down from either your mother's or father's side.
For more information or to schedule an ultrasound, please call: (718)925-6277.
Monday, May 19, 2014
The New Pregnancy Test
When I began my career in medicine, pregnancy tests were relatively insensitive. You had to wait until about 4-6 weeks after the last menstrual period before the results could be regarded as reliable. Real time ultrasounds was a gleam in a few researchers' eyes. Most women with a tubal pregnancy had the diagnosis made when they arrived in the emergency room with serious intra-abdominal bleeding. The confirmative diagnostic test of choice was a culdocentesis - the insertion of a long needle into the abdominal cavity through the vagina. Aspiration of non-clotting blood was considered diagnostic of internal bleeding. An unruptured ectopic pregnancy was considered a reportable case. The treatment was removal of the affected tube at laparotomy.
All that has changed. Today, thanks to Dr. Yalow's development of radioimmunoassay, pregnancy can be diagnosed sometimes before a period is missed. Transvaginal ultrasaound can diagnose an ectopic pregnancy often prior to the onset of significant symptoms. Surgery is done, not via large incisions, but via small laparoscopes - the so-called "bandaid surgery." And often, tubal pregnancy is treated medically or even followed expectantly. These have been truly remarkable developments.
In fact, the new pregnancy test may well be the vaginal sonogram. The new protocol for a woman who is seeing her gynecologist for suspected early pregnancy to empty her bladder and save that specimen of urine for the lab. But today, the office doesn't run the urine test yet. Today, her gyn performs a vaginal sonogram. If pregnancy is seen, that's it - she's pregnant. Done! If a small embroy/fetus is seen, a measurement yields an estimated delivery date which is more accurate than that predicted by last period. Early diagnosis of twins can also be made. If a fetus is seen, so can the heartbeat be seen. Everyone is ahead of the game.
The flip side is if no evidence of pregnancy is found on the sonogram. Now, that urine test is crucial and should be run. Urine tests are far more reliable than they were in the 1960's and early 1970's. If the test is negative, pregnancy is doubtful. Conversely, if the test is positive, then blood should be taken right then and there to look for the level of pregnancy hormone - the Beta HCG. Further management would then depend on that level which could be available often in less than a day. An investigative work up which often took weeks can sometimes be compressed into a few days or less.
Of course, I am oversimplifying but the change in the investigation and treatment of suspected tubal pregnancy has been truly remarkable stuff.
For more information, or to schedule an ultrasound, call: (718) 925 - 6277.
All that has changed. Today, thanks to Dr. Yalow's development of radioimmunoassay, pregnancy can be diagnosed sometimes before a period is missed. Transvaginal ultrasaound can diagnose an ectopic pregnancy often prior to the onset of significant symptoms. Surgery is done, not via large incisions, but via small laparoscopes - the so-called "bandaid surgery." And often, tubal pregnancy is treated medically or even followed expectantly. These have been truly remarkable developments.
In fact, the new pregnancy test may well be the vaginal sonogram. The new protocol for a woman who is seeing her gynecologist for suspected early pregnancy to empty her bladder and save that specimen of urine for the lab. But today, the office doesn't run the urine test yet. Today, her gyn performs a vaginal sonogram. If pregnancy is seen, that's it - she's pregnant. Done! If a small embroy/fetus is seen, a measurement yields an estimated delivery date which is more accurate than that predicted by last period. Early diagnosis of twins can also be made. If a fetus is seen, so can the heartbeat be seen. Everyone is ahead of the game.
The flip side is if no evidence of pregnancy is found on the sonogram. Now, that urine test is crucial and should be run. Urine tests are far more reliable than they were in the 1960's and early 1970's. If the test is negative, pregnancy is doubtful. Conversely, if the test is positive, then blood should be taken right then and there to look for the level of pregnancy hormone - the Beta HCG. Further management would then depend on that level which could be available often in less than a day. An investigative work up which often took weeks can sometimes be compressed into a few days or less.
Of course, I am oversimplifying but the change in the investigation and treatment of suspected tubal pregnancy has been truly remarkable stuff.
For more information, or to schedule an ultrasound, call: (718) 925 - 6277.
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