2013-05-24T14:45:17-04:00 Catherine Pearson http://www.huffingtonpost.com/author/index.php?author=catherine-pearson Copyright 2008, HuffingtonPost.com, Inc. HuffingtonPost Blogger Feed for Catherine Pearson Good old fashioned elbow grease. tag:www.huffingtonpost.com,2012:/theblog// 2013-05-24T10:49:54-04:00 2013-05-24T10:49:57-04:00

Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/
Further, nearly one-third of the women admitted that they had, at some point, decided not to fill a prescription written by their doctors or simply stopped taking a drug for a chronic illness or serious medical condition, versus just 20 percent of men. That gender gap could have serious implications for the health of women in the United States, researchers claim.

"People who are not adherent have poor health outcomes," said Dr. Katrina Firlik, a neurosurgeon, co-founder and chief medical officer of HealthPrize Technologies, a company that devises strategies to boost medication adherence and that published the survey.

For example, she said, heart disease is "the number one killer of women and high cholesterol, hypertension. These are [risk factors] where it's hard to get people to stick to their meds."

Researchers hypothesize that many factors play a role: forgetfulness, cost issues and confusion about how a medication should be taken. Some people may quit a medication because they feel they no longer need it or because they are experiencing side effects.

The question of whether women avoid their prescribed medicines is both relatively new and complex. Much of the research that initially posed the question came from companies within the pharmaceutical industry that have a vested interest in getting both women and men to take their drugs. There is also the fundamental problem of distinguishing between occasional forgetfulness and more serious patterns of neglect.

"Where things start getting murky is when talking about what 'poor adherence' is," said Jennifer Cocohoba, a clinical pharmacist and associate professor at the University of California, San Francisco's School of Pharmacy, who was not involved in the research. "Most studies arbitrarily pick 80 percent, and that probably works for many chronic diseases, like diabetes and hypertension. [But] others will argue, 'is that really the appropriate threshold?'"

Yet a small, growing body of research suggests the gender gap in drug compliance is real, and not just a problem invented by pharmaceutical companies.

According to a sweeping 2011 review, nearly 70 percent of the studies analyzing HIV medication adherence found that women were less likely than men to take their antiretroviral therapy drugs, which halt progression of the virus. A 2009 study that looked at nearly 7,600 heart failure patients found that women also were less likely to take their prescribed meds. A May review in the American Heart Journal -- led by researchers with Brigham and Women's Hospital, and CVS Caremark -- found that women were 10 percent more likely than men to be non-adherent.

But the findings are not completely consistent across various conditions. Just last month, a study published in the Journal of the American Geriatrics Society found no differences in adherence among more than 2,000 men and women prescribed anti-hypertensive medicines.

"Adherence is complex, and gender may be one of the factors that influences how someone takes medicine -- there may be different barriers for women than there are compared to men," said Cocohoba.

For now, explanations for why women may be less likely to take their medications are simply conjecture.

"We definitely have theories," said HealthPrize's Firlik. "One would be the whole caretaker issue. If a woman is a mother who has high cholesterol, it's likely that [her] child's asthma or her own mother's cancer takes precedent. She's less likely to pay attention to her own chronic issues."

That theory is not just rooted in stereotypes about women's priorities and roles in the home. The company's survey found that women do have a tendency to put others' health before their own: 20 percent of women said they were more likely to follow the prescription plan for their pet than for themselves.

"In general, women are much more likely to research medication side-effects on the Internet and from their friends and relatives," said Dr. Marianne Legato, a professor of clinical medicine at New York's Columbia University and director of the Foundation for Gender-Specific Medicine, who said women are often "self-appointed guardians of their family's health."

But women also express fears about how medication could affect them. "Many of my female patients report, 'I am being very sensitive to medications and fear that the dose you might prescribe will be too strong for me,'" Legato continued. "I have never heard this from a male patient."

However, she cautioned that data on adherence is "very hard" to come by because patients often report taking a medication when they have not.

Though the impulse might be to wait to act on non-compliance until more data is available, the potential consequences of non-adherence are serious for individuals and for the health care system at large. Non-compliance is responsible for at least 10 percent of all hospitalizations in the U.S., according to one estimate, and costs the health care system up to $289 billion per year.

"I think it's OK to be critical of seeing things like this," said Cocohoba, of the HealthPrize survey. "But I do think that when [we're] talking about big, chronic diseases, like diabetes and high blood pressure, the data is clear that Americans are pretty bad at taking their medications the way they should."]]> tag:www.huffingtonpost.com,2012:/theblog// 2013-05-23T08:49:01-04:00 2013-05-24T11:40:16-04:00

Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/ Londoner Karen Athwal, 25, had what she thought was her dream job and was building what seemed like her dream life -- until she was blindsided by a layoff. Getting axed forced her to own up to the pressure she felt to appear perfect to her family and friends. It also propelled her to re-imagine her future -- 2,000 miles away. Here, as part of our series on young women who dramatically changed their situations to live with less stress, Karen tells us her story.

I became the manager of a new makeup brand’s store in London in 2007 -- I ran the day-to-day. I had been there for two-and-a-half years and thought I was going to stay there awhile. The owner and I had regularly talked about it. But three months after I began renting an expensive apartment, I got a phone call. The London office wasn't making [enough]. My boss said, “I'm sorry, Karen. There's no longer a position here for you.”

I was literally shattered. I found myself in a brand new apartment with really high rent that I realized I could no longer pay. I didn't want to admit I was failing, that I had lost this high-flying job. For three months -- three months -- I paid rent that I could not afford because of my stupid pride. Finally, I called up my mom and dad, who also live in London, and I was like, "Look. I'm going to have to move back in with you.” It's a horrible feeling. You’re moving forward, and suddenly it’s all taken away from you.

I looked for work for 18 months. I didn’t have any money coming in, and I could not afford to go out with my friends. I was alone. The pressure started to show. I developed acne all over my face, out of nowhere. I started losing weight as well. I had [spent time] in Marrakech [Morocco] before, and I had a little bit of savings left. I thought, "Look, I can either be really sad and depressed here, or I can take a month out, relax, and get myself together." My boyfriend was living there, too.

When I came back, I trained as an English language teacher, but I still wasn't getting anywhere. Then one day I was surfing the net, and I came across a job in Marrakech, as an English teacher and nanny to a small girl. I moved there in August 2011, and I stayed with that family for three to four months until I came across another opportunity, writing content for an online magazine and travel guide. Three weeks later I was hired. It seems as though when I really push myself out of my comfort zone -- when I just go for it -- things develop from there.



So much of my stress has lifted. The cost of living is very, very low. I am able to enjoy going out to dinner, going to cafes and being able to have more of a social life, something I couldn't do in London where it was always a stretch financially. Now, my salary isn't great -- there's that line where you're just barely comfortable, and I'm there -- but I'm saving so much more.

I'm much less materialistic now, less selfish. My new apartment is definitely a lot smaller. Having that extravagant apartment in London was a big deal. The thinking was, "You have this great new home; you made it." But I felt like I was always competing with the people around me to have the latest in everything, to be able to go out for fancy lunches and brunches. I would take, maybe, an hour and a half to get ready every day. My hair always had to be good, my makeup had to be good. There was so much pressure to look the part, but the weird thing is that I always felt inferior.

Now, I wear a good pair of jeans and a white t-shirt or button-down, which I accessorize with a printed scarf. I'm obsessed with ballet flats. I stick to what makes me comfortable and what I feel good in.

Here, it's a simpler lifestyle. In London, everyone was very much obsessed with "busy-ness" because when we're busy, it looks like we've made it. It's a crazy mentality. Now, I realize I have a lot I can do with my time. My boyfriend and I go to the farmer’s markets together. We pick up fresh food and we cook it together. I make the time to talk to my family and friends. When we want to travel somewhere, we go.

When I was at the cosmetics company, I thought, “I'll just carry on working, I'll be a high-flying career girl, and I'll live in this great pad alone, and I'll have my fashion and go on holiday with my girlfriends.” That was literally how I saw the rest of my life -- being alone and 100 percent focused on my career. Now that has really, really changed. I see women daily who have businesses of their own, who have families, and who can still relax. Now I am in the process of starting my own business. That dream hatched as soon as I moved to Marrakech -- maybe it was the new surroundings?

I think, if I'm totally honest, that I didn't push myself enough before. I was too scared to leave my comfort zone, and that made me feel such pressure. Yet I was so afraid to give up my lifestyle and have everyone look at me and say, "Oh, she failed." Losing that job was the best thing to happen to me. I don’t know how long I’ll say in Marrakech. [But] there is no fear to jump anymore, I'm ready to take the leap.


Karen is not sure how long she will say in Marrakech, but feels the move helped make her more brave.

This conversation has been edited and condensed.]]> tag:www.huffingtonpost.com,2012:/theblog// 2013-05-21T18:04:18-04:00 2013-05-21T18:11:30-04:00

Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/ Moore, Okla., she was reminded of the men and women she treated after a deadly tornado ripped through her hometown of Joplin, Mo., in 2011.

The licensed psychologist with a private practice in Joplin scrambled to keep up with a "flood" of requests for mental services and counseling in the weeks and months following the tornado. At first, she saw people with acute symptoms of fear, anxiety and grief. But two years later, one of the first questions she asks patients with intense anxiety or panic attacks, marital or relationship problems, or new depression is how badly their lives were affected by the tornado.

"I'm seeing people who have resisted treatment, who may have denied that they needed help, and who now present with longer, more chronic issues," McGregor said. "I'm sensitive to how much trauma impacts our lives later on down the road."

As the aftermath of the Oklahoma tornado unfolds, experts are already trying to predict its psychological toll. "There's a divide in the academic literature on this," said Dr. Joseph Trainor, a core faculty member at the University of Delaware's Disaster Research Center. "Some research results suggest there are high levels of PTSD [post traumatic stress disorder]. Others suggest that PTSD, although it does happen, affects a much smaller population."

A sweeping 2008 review in the journal Psychological Medicine found that rates of PTSD following an event like a tornado or earthquake are lower than rates in the wake of man-made disasters. That review revealed a significant range of PTSD rates following a natural disaster, from around 4 percent of a given population up to 60 percent, depending on the study. But most studies put estimates in the lower half of that range.

One reason why most survivors of natural disasters do not experience PTSD is that the events tend to create what Trainor called a sense of "therapeutic community," which is free of blame.

"Families pull together, communities pull together, people pull together and you see tons of helping behavior," he said. "It's this idea of a shared identity, and a shared loss."

Jim Hamilton, a professor of psychology at the University of Alabama, is studying the psychological effects of the deadly 2011 tornado in Tuscaloosa on undergraduate students there. His research, which is ongoing, supports what he called a more "tempered view" on the prevalence of PTSD. It appears to have affected about 4 to 8 percent of the students, he said, adding that for the most part, students were sheltered in their dorms about a quarter of a mile from where the tornado hit. They were nonetheless subject to the "abject terror" of being in the tornado's predicted path, he said.

"Almost everybody was shaken up; everyone was anxious and discombobulated -- literally. Our landmarks were gone. Trips you've taken 100 times, all of a sudden you're thinking, 'where am I?' But the vast majority didn't feel the need to see a counselor about it, and the vast majority don't need to," Hamilton said, adding that relatively few people used the free mental health services available in the aftermath.

But he found that those who lost their homes were more likely to suffer severe psychological effects than those who were not as directly affected, he said. "Our sense of who we are, and our psychological stability, has a lot to with our sense of place in our home," Hamilton said. "It's where your history has evolved. It's like losing a bit of your identity."

Stephanie Hartwell, graduate program director and professor of sociology with University of Massachusetts Boston, said that as experts try and help survivors of the tornado, it is essential to bear in mind the difference between PTSD, which is a formal, clinical diagnosis, and trauma, which is expected after a jarring transition. How well survivors fare psychologically has to do with whether they have experienced trauma in the past, because the accumulation of trauma can be problematic, as well as the level of support they receive, she said.

Indeed, the power of community to help facilitate healing is something that McGregor experienced first-hand in Joplin.

"It's an acceptable thing to talk about, and to process openly, and hear that other people are struggling with as well," she said. "This happened to a community. Every day, people still have to drive through it. We have to see those naked trees and those piles of rubble."

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Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/ Fresh out of college, Kate Sheehan worked for several Fortune 500 companies in New York City, eventually zeroing in on corporate communications. At 27, she became the speech writer for the CEO of one the largest financial services firms in the world. But less than a decade later, Kate, now 34, finally paused and asked herself if she was getting true joy from her work. Here, as part of our new series on young women who left their stressful paths behind, Kate tells us how the answer led her to make what she calls the scariest but most empowering choice of her life.

It was a very demanding job, and the expectations were intense. I enjoyed that in a lot of ways -- I was really excited to have this huge opportunity, to work for and learn from the CEO directly -- but I was easily pulling 12 to 14-hour days. I found it really difficult to date or maintain friendships or make any time for myself. But because I was so young, I felt, "I have to keep charging."

After a few years, the CEO retired. I wanted to try something new, but I did not know if it would be OK to stop and take a deep breath. I was so young to have had the kind of experience and exposure I had amassed at that point. I was afraid -- panicked -- that if I stepped back or reevaluated what I really wanted, I would lose opportunities.

I spent the next three years trying to [talk] myself into enjoying a variety of roles. One of the things that kept me with the company was concern about what it would mean to step back and lose the momentum I'd gained, but it was also that I really loved the people I worked with. And it was still hard for me to answer the question, "What job do you want?" At 30, then 31 years old, and given how hard I had been working, I felt silly not to know my response.

At some point, I just realized [it was] the wrong question. It's not, "What do I want to do?" it's, "What kind of life do I want to have?" In my 20s, I was all about trying to get as far as I could, as fast as I could within a great company. I also wanted to pay off my student loans by the time I was 30, which I did. When I moved into my 30s, I still wanted to work hard, I wanted to learn, I wanted to grow, but I realized how unfulfilled I was. I realized I'd never stopped, not once, and reevaluated my goals. I’d never stopped and said, "Are you on the right path for you?"

I had been thinking for a long time that I wanted to go out on my own, but I wasn't brave enough. I thought I had to have much more experience, better networks … but every part of me emotionally said it was time to move on, even if I didn't necessarily know how I was going to make it work.

I moved back to Cape Cod, [Mass.], where I grew up, temporarily, for family reasons. I was still working remotely for my old company, and I never thought I was going to stay. But three months turned into six months and about nine months in, I decided to stay. I had been dreaming about building a business that supported the life I wanted, and there was something about being on Cape Cod -- I was inspired by the people around me, in this beautiful geography, who were making it work. I started to think, “I could make a more independent path work for me as well.” I felt inspired by the natural surroundings, by being close to the ocean where I grew up. Emotionally, mentally and physically, I had more space to create.

I'm seven months in now. I started a communications consultancy and a local lifestyle guide with two amazing women entrepreneurs I connected with when I came back.

The big difference is the pace. In the corporate world, it's not 9 to 5 anymore, it's more like 7 to 7, and beyond that, you have to be available [on your iPhone or Blackberry] all the time. The business is the priority, and everything else fits in around that -- or it doesn't. Now, I find my days are equally long, but the way I compose them is different. Almost every day includes some sort of physical activity. I actually have time for a dog -- Scout, my rottweiler chow mix -- and I take her for long walks by the ocean. I am also much more involved in my community now than when I lived in New York City. There are these great independent female business owners here, and we support each other. We barter, and we help each other make it work.


Kate with her dog Scout, whom she regularly takes on long beach walks.

Looking back, I was extremely stressed for the last several years I spent in the corporate world, but I don't think it's fair to say that all of the stress came from the corporation itself. Part of it was being in a very demanding environment, but part of it was the pressure I put on myself to go, go, go. Now, my stresses feel different, because they're stresses of my own, deliberate choosing. I feel financially stressed in a way I didn't a year ago, certainly, but I knew that I was stepping away from a steady paycheck. Dating is harder here than it was in New York City, but for now I feel like building my business is my boyfriend, and my dog is my baby, and that's where I'm really focused for the next year.

I still have moments -- daily! -- where I think, "WHAT. AM. I. DOING? Have I lost my mind?" But I work through those moments. I do that by thinking, "This is a gift to myself." There are a lot of women doing what I'm doing, but they're doing it 15, 20 years later. I don't want to be someone who, 15 years from now, has horrible health problems and who hasn't created a life that feels really meaningful to me.

I suppose walking away from a corporate job may sound like leaning back, but I feel like I'm leaning in -- into my own life, in my own way.


An image Kate took while kayaking on the Cape. She describes this spot at Sandy Neck Beach as one of her favorite places to be.


This conversation has been edited and condensed.
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Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/ Diagnostic and Statistical Manual, the first major revision in almost 20 years to what is widely considered the "bible" of modern psychiatry.

But while it is brand new, DSM-5 has already generated extensive media coverage and controversy, leaving parents whose children have mental health issues scrambling to determine what, if anything, the revisions mean for their son or daughter's care.

"Most of the transition from DSM-4 to DSM-5 will occur behind-the-scenes from the vantage point of parents and children who receive services," Dr. Steven Meyers, a professor of psychology at Roosevelt University and a Chicago-based clinical psychologist, told The Huffington Post. "Psychologists and psychiatrists often do not even provide parents with a detailed elaboration of the specific subtype of the child's disorder, because the distinctions can be fairly technical."

There are some major changes that parents will likely notice, Meyers said. Among them is the decision to group Asperger's syndrome under the broader umbrella of autism spectrum disorder going forward.

"Parents of Asperger's children often know this disorder by name and make a differentiation," Meyers explained. "Having a new label placed on the same set of symptoms may be confusing, and even unsettling, if it challenges how they have conceptualized their child's problems."

Geraldine Dawson, chief science officer of the nonprofit Autism Speaks, said the move to drop Asperger's as a separate disorder will be felt mostly by parents seeking a first-time diagnosis for their son or daughter.

"There is no reason to re-diagnose a child who already has a diagnosis of an autism spectrum disorder, such as autism or Asperger's syndrome," Dawson told HuffPost. "That child will continue to qualify for an autism spectrum disorder."

Parents should also be aware that there is a new diagnostic category known as "Social Communication Disorder," she said. It includes children who have difficulties communicating socially, but who do not display the repetitive behaviors that are often a hallmark of the autism spectrum.

DSM-5 also introduces a new depressive disorder, called "Disruptive Mood Dysregulation Disorder," in order to help address concerns about potential over-diagnosis and over-treatment of bipolar disorder in children. From the mid-1990s to the early 2000s, the number of children diagnosed as bipolar increased almost 40-fold, studies have found. The new diagnosis may capture some of those children and applies to kids up to 18 who show persistent irritability and frequent episodes of extreme behavioral problems.

But mental health experts stressed that for the most part, the changes in DSM-5 affecting children are technical and should not alter their day-to-day treatment. A Centers for Disease Control and Prevention report issued this week found that between 13 and 20 percent of children in the U.S., or up to one out of every five kids, is living with a mental health disorder.

"I think these changes will really come into play more [for parents] once an electronic medical record requires a specific diagnosis, or if payers require it," said Dr. Matthew Perkins, medical director with the New York State Office of Mental Health's Division of Children and Family Services. Dagnostic changes can be slow to trickle down to all health care providers, particularly because many physicians stick largely to what they initially learned in training, he added.

"Parents should ask about and be aware of their child's particular diagnosis, especially if it will impact insurance reimbursement for services, or determine the eligibility for special education services at school," Meyers echoed.

The previous iteration of the DSM -- DSM-4 -- was released in 1994 and updated in 2000. Various drafts of the latest iteration were made available publicly and gathered more than 13,000 responses from consumers, advocates and health care providers.]]> tag:www.huffingtonpost.com,2012:/theblog// 2013-05-17T13:20:34-04:00 2013-05-17T13:20:54-04:00

Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/
A provocative new investigation suggests that lowering a child's risk of developing attention deficit hyperactivity disorder, or ADHD, could be added to that list. It found that children who developed the disorder were less likely to have been breastfed.

"In the last 20 years, we've re-confirmed what we have known for centuries with good science: There are many benefits of breastfeeding, and this may well be one of them," said Dr. Ruth Lawrence, a professor of pediatrics at the University of Rochester Medical Center and editor of the journal Breastfeeding Medicine, which published the new study this week.

A team of researchers in Israel looked back at the breastfeeding histories of more than 50 6- to 12-year-olds diagnosed with ADHD. They compared them to two control groups -- one comprised of the study group's ADHD-free siblings, and one with children of a similar age who had did not have ADHD.

The rates of breastfeeding were substantially lower among those diagnosed with ADHD. Forty-three percent were breastfed until they were 3 months old. By comparison, 69 percent of their siblings and 73 percent of the children in the second control group were breastfed for at least three months.

And just 29 percent of the children with ADHD were breastfed until they were 6-months-old, compared with 50 percent in the siblings group and 57 percent in the general control group. According to the authors, those differences suggest that prevention, or partial prevention, of ADHD could be added to the list of breastfeeding advantages.

However, the researchers acknowledge the limitations of the study, which did not establish clear cause and effect because it did not consider every factor in a child's upbringing.

"You can never know in a very basic, statistical way whether you have controlled adequately for other variables," said Dr. Andrew Gerber, an assistant professor of clinical psychiatry at Columbia University who did not work on the study. "You do the best you can, and I believe these authors tried, but it's very hard to take a study like this and infer anything."

"Is it plausible that there are aspects of breastfeeding and bonding with the baby that are important and can have wide-reaching implications for development, both intellectually and emotionally?" Gerber said. "Yes. But does that mean in a concrete way that lack of breastfeeding leads to ADHD? The answer to that is almost certainly 'no.'"

As first reported by The New York Times this spring, recent Centers for Disease Control and Prevention data revealed a significant upswing in the number of children diagnosed with ADHD, a chronic mental health condition characterized by hyperactivity and impulsivity, among other things. Eleven percent of school-age children have been diagnosed with the disorder, sparking more questions about its cause.

But the roots of ADHD are still a mystery. Research increasingly suggests that a combination of genes, and environmental, or non-genetic, factors may play a role.

Gerber said that if future studies confirm that breastfeeding has a direct, protective effect against ADHD, it would likely stem from the fact that breastfeeding promotes early mother-infant bonding, which has been shown to influence the course of children's emotional and intellectual development.

"[These findings shouldn't] put mothers in a position where they think this particular ingredient is so crucial, that if they can't do it, they're bad moms," Gerber said. "What matters more in emotional and intellectual development is that they be competent, comfortable mothers. For some moms, that means breastfeeding."

Breastfeeding rates in the United States are on the rise. According to the most recent government figures, 47 percent of mothers were still breastfeeding at 6 months and nearly 26 percent were breastfeeding at one year. The American Academy of Pediatrics, a major U.S. pediatric organization, recommends that mothers breastfeed their babies exclusively for the first six months and continue for at least one year while supplementing with appropriate foods.

"This is a very exciting possibility, but it's not the final answer," said Lawrence.


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Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/ It took Brian and his wife, Susanna, a lot of research and trial and error before they got their daughter, Arizona, help that really worked. Their 6-year-old was originally diagnosed with sensory processing disorder and eventually Asperger's. Here, as part of our series on families of children with mental health issues, the Los Angeles-based dad talks about the challenges parents face in connecting with the right resources for their children, the importance of early intervention and where his daughter is today.

Early Flags
When Arizona was an infant, she was basically allergic to everything -- soy, dairy, nuts, wheat, rice, cats, dogs, etc. The initial manifestation was a body rash: She had hives and eczema. By the time she was 2, there were certain developmental markers she hadn't hit. For example, she never crawled, but we just assumed that was related to the allergies.

There were also some things that my wife's sister, who has a couple of kids just a little bit older than Arizona, noticed that we probably wouldn't have for a long time -- certain things she wasn't doing, or should be further along with. Our daughter liked to play by herself; she wasn't as social as the other kids. She was repetitive in her play and wasn't very affectionate. She didn't make eye contact -- that was a big one. She'd have it for moments, but not sustained connection.

We started to do some research online and went down this rabbit hole, trying to gather information on what was going on. There was, really, nothing available. The information is fragmented and it feels unreliable. There's a lot of contradictory thoughts about what you're dealing with and how to treat it. We began seeking advice from medical professionals and, initially, we were told everything was fine and that children develop at their own pace ... not to worry.

The Moment We Knew
For six months after, until Arizona was about 2-and-a-half, we were blissfully taking the advice that we were getting.

But at some point we realized, there's still something going on. We didn't need anyone to tell us.

Arizona has always been a sensory child -- different textures, like sand, and loud sounds, like a balloon popping or the hand dryer in the restroom -- those are hard for her. We realized that we were communicating with her, and she wasn't really processing it, so we would start giving her too many prompts, too much input, too fast. She would freeze up. Affection was a bigger issue for me than for my wife, because Arizona was more affectionate with her. But she didn't snuggle, she didn't cuddle. She never sought our attention, like, "Hey Mommy, Daddy, look at this!" There was none of that.

It's a pretty heavy moment. You feel great loss, you think the worst -- your daughter is never going to be able to function and grow up and have a normal life. It's mourning, and it's scary, because you have no idea what's happening … no idea what to expect for her.

Looking For Help
My wife was incredibly diligent and, thankfully, was able to stay at home and spearhead the process of making sure our daughter was getting the treatments she needed. But parents really have to figure this stuff out on their own.

We saw a lot of doctors, and had many different diagnoses along the way -- the beginning was sensory processing, and that stuck with her. We had an early autism diagnosis from a developmental pediatrician, which was good, because it opened us up for services. Now Arizona's diagnosis is Asperger's, but at some point, we sort of stopped paying attention to all the different titles and names; we were just seeking the best help for her.

Our Care Map
We were very fortunate to get involved early, and our daughter worked incredibly hard -- she still does -- to get over some of the things that are hard for her.

We started with speech therapy, occupational therapy and a behaviorist, probably three times a week. Arizona was in a developmental preschool, and she had "social skills" on Saturdays. We did neurofeedback, but we felt like it wasn't doing what we thought it should, so we stopped. It's a process. You try a lot of things and if they aren't working, you stop.

We also did things that were more fun -- we took her to a gym, where she would learn balance and work on her gross and fine motor skills. We did rock climbing -- she absolutely loved it -- and it helped her develop upper body strength. She does horseback riding, which she loves. It's her favorite thing.

We originally put her in a more typical school that she tested into. When we brought her in we were so nervous, but she was amazing -- she answered everything right, just not necessarily in the way they expected. There was a picture of a bicycle that was broken into pieces and the idea was to see if kids could figure out what it was. When they asked Arizona, she said, "It's a unicycle!" Sure enough, the picture only showed one wheel. The woman testing said she'd never had anyone answer it that way.

Ultimately we decided to put her in another school that turned out to be amazing for our daughter, called Cheerful Helpers Child and Family Study Center. It focuses on academics as well as social and emotional development.

The Help We Wish We'd Had
We looked for information, and we looked hard, but there was not a lot of guidance. As a parent, the first thing that happens after you do research is you feel a little bit better because you have some information, but then you need support and advice, and that was hard to find.

I felt passionate about finding a way to make information more widely accessible to others who shared my experiences. I'm the CEO of a digital agency, RED Interactive Agency, and we partnered with the Child Mind Institute to develop digital resources to protect and promote children's mental health. Together, we collaborated to develop a website for CMI, the Speak Up for Kids campaign and the Symptom Checker.

It's not about getting treatment with them specifically, it's just about trying to give parents a place where they can go. Because when you first find out something's going on, if you can find a life raft to hold onto for a little bit, it's such a help.


The tool helps to narrow down what the potential issues could be and take next steps.

Where We Are Now
Our daughter is extremely bright and happy. She is still very independent, but she's also very social and loves children, adults and animals. She seeks out relationships. She's loving and nurturing -- she has a lot of stuffed animals. She loves horses, and now cats. She puts them in a little baby carrier, and takes care of them.

The hard work Arizona did early on was critical. To this day, she still does OT, speech and behavior -- they help give her tools to continue to become a contributing, happy person -- but it's now down to a couple of a days a week. She'll always be a little quirky, but we see that as a good thing. She's unique and original. She is amazing.


Brian, with his daughter Arizona.


This conversation has been edited and condensed.]]> tag:www.huffingtonpost.com,2012:/theblog// 2013-05-13T00:01:00-04:00 2013-05-13T13:38:30-04:00

Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/ banned the inclusion of free formula samples in gift bags regularly given to mothers when they leave the hospital, and many institutions have put baby formula under lock and key.

But a provocative new study suggests feeding babies who experience significant weight loss after birth tiny servings of formula may improve breastfeeding rates in the long run.

"It's a small, carefully managed volume of formula, so that the baby is still hungry for the next breastfeeding," study author Dr. Valerie Flaherman, an assistant professor pediatrics and epidemiology and biostatistics at the University of California, San Francisco, told HuffPost. "It's also temporary use with a predefined endpoint," Flaherman said. The approach may also help relieve maternal anxiety that mounts when brand-new babies lose weight, sometimes spurring aggressive formula feeding.

The study of 40 babies who had lost 5 percent of their birth weight and whose mothers' milk had not yet come in randomly divided the newborns into two groups. One group was fed two teaspoons of infant formula with a syringe after each breastfeeding session for the first few days after birth, until their moms' milk came in. The other group was breastfed exclusively. After that, some mothers supplemented breastfeeding with formula.

When they were assessed one week after birth, all the babies were still breastfeeding, but only 10 percent of the infants who had been given small doses of formula initially were still receiving it, compared with nearly half of babies in the second group.

At age 3 months, nearly 80 percent of the babies who were given formula early on were breastfeeding exclusively, compared with 42 percent in the second group. The findings were published in the journal Pediatrics on Monday.

"There's deep concern in the breastfeeding advocacy community that this will be over-interpreted," said Flaherman. "The solid majority of babies do not need formula, but the opportunity to use [it temporarily] to help some moms achieve the goal of continued breastfeeding can be a good thing."

"I worry that the headlines from this study will translate into 'A Six Pack of Formula Back In Every Bassinet!'" said Dr. Alison Stuebe, an assistant professor in maternal fetal medicine at the University of North Carolina School of Medicine, who did not work on the research. Stuebe said the next step would be to replicate the findings, ideally using donor human milk, to see if they hold up.

"This is very different from the way that formula supplementation is handled in many U.S. hospitals," Stuebe added. "Overall, one-quarter of breastfed infants are given formula by day two of life, and that number reaches as high as 40 percent in some areas."

In an accompanying commentary in Pediatrics, Dr. Lydia Furman, a pediatrician with Case Western Reserve University School of Medicine, Ohio, warned that "early limited formula is not ready for prime time." She commended the study's researchers for challenging existing paradigms, but questioned the use of 5 percent weight loss as a benchmark for inclusion in the trial. That level of weight loss generally does not put babies at risk for poor outcomes.

Breastfeeding continues to be a hot topic in public health, with campaigns hammering home the message that breast is best for babies' health. The American Academy of Pediatrics recommends that mothers breastfeed exclusively for the first six months and continue up to one year or beyond while supplementing with foods.

But while breastfeeding rates have improved in recent years, many women resist. Forty-seven percent of mothers in the U.S. breastfeed exclusively at six months, according to the latest Centers for Disease Control and Prevention estimates, and 25 percent do so one year out.

Many women report feeling unsupported in their efforts to breastfeed and attacked when they stop.

"Support for breastfeeding will improve outcomes. This study highlights one way to do just that," said Dr. Carl Seashore, medical director of newborn service at the University of North Carolina's Women's Hospital, who joined other experts in characterizing the new research as interesting, but preliminary.

"There are many others," Seashore continued, "spanning public health campaigns, public acceptance of nursing mothers, prenatal education, lactation support in the birth window and first weeks -- to months -- when needed, and support for workplace pumping."

]]> tag:www.huffingtonpost.com,2012:/theblog// 2013-05-10T13:32:33-04:00 2013-05-11T07:28:03-04:00

Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/ Being a mom to three children -- an 8-month-old girl and 4- and 6-year-old boys -- is stressful for anyone, but for Jennie and her husband, Jim, who own a Mexican restaurant in upstate New York, the challenges have been acute. Alex, their eldest boy, has been increasingly consumed by the tantrums and obsessions that are hallmarks of oppositional defiant disorder (ODD), OCD and ADHD. As part of our series on families of children with mental health conditions, Jennie opens up about the fear, sadness and isolation her family experienced in their journey to get Alex the help he needed.

Early Signals
In retrospect, there were signs from birth. Alex would cry a lot and has never been a good sleeper. He had GERD [a digestive disease] so we attributed a lot to that. When he grew out of it, around 1, he seemed pretty happy for a while. But there were things. On walks with his babysitter he would pick up every piece of trash or lint and put it underneath his stroller. It wasn't something he seemed to be doing for fun; it was obsessive.

He is our first child, so my husband and I didn't have experience. We'd ask other parents, "Does your kid hit another kid when he doesn't get a toy?" And they would say, "Yeah, yeah. That's typical." Or, "Does your kid have tantrums?" And they'd say, "All toddlers have tantrums." But it was the intensity. It was overwhelming. We also started noticing sensory issues, like [Alex] not liking the way certain socks felt, not liking his hair combed, not liking his teeth brushed and not liking the bath.

Worsening Symptoms
The tantrums got worse and worse. Some kid might be playing tag and Alex would just tackle him, like it was a fight to the death. He didn't get that line of, "We're just playing."

He became more obsessive compulsive about things. I'd have to try and open the door handle five times, exactly, before we got him out of his car seat. If I didn't do it, he would erupt. Sometimes, the tantrums would last for two hours and they were really violent. He'd hit and throw things, and he was getting stronger.

Between ages 2 and 4, things escalated and escalated.

Searching For Help
People kept saying things like, "Oh, he's just tired. He's cranky." [So] we looked for different solutions, like seeing a naturopath and trying homeopathic remedies. We tried a gluten-free diet for months on end. I read every parenting book out there, thinking, "He’s just spirited!" We took all media and screens out of the house for months, thinking maybe that was contributing to this hyperactivity and aggression.

When he was 4, we took him to a developmental pediatrician who diagnosed him with autism spectrum disorder. We were surprised because Alex was very, very verbal. On one level, we embraced the diagnosis, because it was validation that something was there. At a certain point, we had begun to feel that maybe we were just really bad parents … maybe we were just failing. But on another level, it didn't really help, because it wasn't so much that we were having trouble getting Alex to talk or make eye contact; it was his tantrums. It was him bouncing off the walls to the point where it would take him two hours to unwind and go to sleep.

As time went on, we saw a psychologist, we saw a pediatrician, we saw a naturopath, too. He also received a diagnosis of ADHD and obsessive compulsive disorder. We said we'd never put him on medication, but we went back to the pediatrician who diagnosed him and said, “This isn't working, he isn't functioning. It's really, really not OK.”

Around the time he was going into kindergarten, they put him on an ADHD medication -- not a stimulant, but something to calm him down -- and it did make a difference, but his other behaviors were getting worse. We ended up putting him on an SSRI as well.

Our Breaking Point
By the time my daughter was born last year, Alex had just spun out of control. We couldn't get him to do anything -- it was harder and harder to even brush his teeth. He would make himself throw up. People would say, "Oh have you tried a sparkly toothbrush? Have you tried a rewards chart?" And we were like, "Yes, we've tried everything." So he had a mouthful of cavities and we were feeling incredibly guilty and stressed.

The tantrums got more violent. He'd give his brother bloody lips. He'd get ideas into his head that somehow his younger brother had wronged him -- it could be something like, “He's wearing a red shirt and I don't like red shirts, so I have to get him.” We tried our best to explain it to his brother, but he was 3 years old -- so little. We'd say, “Your brother has a boo boo on his brain.”

Then Alex would turn his anger to us. We stopped going out to family functions, we stopped going out much at all. It became so bad, Alex punched and kicked me in the stomach when I was still pregnant.

In our darkest moments we thought, We can no longer handle him. We didn’t know how much longer we could have Alex continue to live with us, but he's our baby. Our first baby.

As frustrating as it was to deal with someone who was constantly kicking at you, and spitting at you and pulling your hair, I remember one day when he was sobbing in the midst of his tantrum and he said, "I am just never going to be happy, ever again." It was so heartbreaking.

A New Approach
We got a recommendation from a friend to go to the Child Mind Institute in New York City, because there aren't a lot of child psychiatrists where we live. We were thinking it was going to be a one-time trip -- we'd get advice on his medications and maybe follow-up on the phone. We were going to wait to go until the [new] baby was 2 or 3 months old, but Alex became so bad, we went when she was 3 weeks.

We saw a psychiatrist who gave him an ODD diagnosis and recommended parent-child interaction therapy. It would last twelve weeks, with sessions once a week. It was expensive and all the way in New York City which is a five-hour drive. I remember driving back thinking, We can't afford this. How are we going to do this with three kids -- a new baby -- and the restaurant? But it was a medical emergency.

I have to admit, I was very skeptical -- it seemed similar to play therapy, which we had tried and it hadn't worked. At the first session, Alex threw metal chairs and punched the doctor. But around Thanksgiving he started to improve and by Christmas, he was like a different child. The therapy was intense -- it was behind a two-way mirror, the parents have a wireless earpiece in the air, and the psychologist is behind the mirror directing you as you're playing with your child.

During our first appointment, the psychiatrist said, “I would love for you to try this therapy,” but also warned us that the next step, if Alex got more aggressive and violent, was an antipsychotic medication. That was devastating to hear about our 5-year-old.

I couldn't understand it. Alex has never been exposed to violence, or poverty and he’s in a loving family -- kids with ODD have often been really traumatized. But they explained to me that Alex's fight or flight response is very easily triggered, and toward the "fight" response.

Where We Are Now
You graduate from the program after the child is in a typical range, but I'm not going to say he never has tantrums or doesn't get upset. He still struggles a lot more than a typical child might -- he's never going to be "cured" -- but now we have tools to help.

I think Alex is going to great things. He loves animals. He's been taking horseback riding lessons for over a year and he went to nature camp this February. He recently saw a news story on a project they’re working on at Cornell University to save the elephants, and he says to me that he wants to go to Cornell and be an animal scientist. And I tell him, I can see you going there. I believe you.]]> tag:www.huffingtonpost.com,2012:/theblog// 2013-05-09T17:24:22-04:00 2013-05-12T21:47:29-04:00

Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/
One-quarter of the women surveyed underwent at least three medical procedures while giving birth, such as taking drugs to get labor started, taking drugs to speed-up labor or cesarean delivery, according to the "Listening to Mothers" survey. Twenty five percent of the women who were induced or who had an epidural said they felt pressure at the hospital to have the procedures, as did 13 percent of those who had a C-section.

"Our main message is that we're seeing very severe problems with maternity care in the U.S., and a piece of that is the high rate of intervention," said Carol Sakala, director of programs at Childbirth Connection, a nonprofit that works to improve maternity care in the United States and that led the survey research.

"Another would be underused practices that should be ... delivered, but aren't," she added.

The findings in "Listening to Mothers" came from an online survey of 2,400 mothers, ages 18 to 45, who had given birth in a hospital in 2012. The report is the third in a series that launched in 2002, and did not include women who had delivered in a freestanding birth center or at home.

More than 40 percent of the mothers said their care provider tried to induce labor, a percentage Sakala called "very high." National estimates that use birth-certificate data have put the national rate of induction close to 23 percent of all births annually.

When asked why they were induced, many women cited non-medical reasons, such as being full-term and wanting to get their pregnancy over with. The most common medical reasons cited were concerns that the woman was overdue or required quick delivery. (There are numerous medical reasons for inducing labor, such as high blood pressure brought on by pregnancy, infection or if the placenta has separated from the uterus.)

Thirty-one percent of those surveyed had a C-section, which is in line with national estimates from the Centers for Disease Control and Prevention.

But while Sakala argued the results laid bare major flaws in U.S. maternity care, the mothers surveyed generally rated the quality of care received very positively: 47 percent said it was "good" and 36 percent called it "excellent." Further, nearly 50 percent of women said they felt their providers were completely trustworthy.

"This is a really complex care experience, and it's a little mystifying for women, particularly first-time moms, in terms of what's going on and why," Sakala said. There are a lot of forces at play that are erroneously suggesting to moms that they needed this care, she argued.

Obstetricians were the primary attendants for 70 percent of the births, followed distantly by midwives, at 10 percent. Nearly all of the women indicated that they received additional supportive care during labor from a husband or partner, nursing staff, or family member. Only 6 percent of women worked with a doula, a trained labor assistant.

Correction: An earlier version of this story incorrectly listed the percent of women who felt pressure to be induced or have an epidural as 15 percent.

]]> tag:www.huffingtonpost.com,2012:/theblog// 2013-05-07T00:01:00-04:00 2013-05-07T00:31:59-04:00

Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/
The study found that the use of Pitocin to induce or augment labor was linked to unexpected admissions to the neonatal intensive care unit (NICU) and to lower Apgar scores -- a test to check newborns' physical condition in the minutes following birth.

"These results suggest that Pitocin use is associated with adverse effects on neonatal outcomes," said researcher Dr. Michael Tsimis, a resident in obstetrics and gynecology at the Albert Einstein College of Medicine at Beth Israel Medical Center in New York, in a statement.

Pitocin is a synthetic version of oxytocin, a hormone released naturally during labor that causes uterine contractions. It is typically given intravenously to induce labor or to speed it up when health care providers deem it necessary.

In the new study, presented at the annual clinical meeting of the American Congress of Obstetricians and Gynecologists on Tuesday, researchers looked at the records of more than 3,000 women who had delivered full-term babies at Beth Israel between 2009 and 2011.

Pitocin use appeared to be a risk factor for babies being admitted to the NICU and staying for at least one day. It was also tied to Apgar scores of less than 7. A score under 7 is a red flag, indicating that the baby needs medical attention, but is not an indication that the newborn necessarily has a serious medical condition or that he or she will have lasting health issues.

The Beth Israel study did not determine what actually caused the babies' troubles.

"If you're in labor and your labor stops, it's tricky to figure out [if there was a later] adverse outcome because your labor stopped or because of the Pitocin use," Dr. Siobhan Dolan, medical adviser to the nonprofit March of Dimes, told The Huffington Post. She called the new findings "interesting" and said they raised questions warranting further investigation.

"These findings could be explained if oxytocin was being used more commonly to deliver babies at earlier gestational ages or if the unborn baby was experiencing distress in utero," echoed Dr. Christopher Colby, chair of the division of neonatal medicine at the Mayo Clinic Children's Center. "I do not think any strong conclusions can be made about oxytocin in pregnancy based on this study."

Other recent research has begun to take a more critical look at the use of Pitocin, at the same time that broad efforts to curb the induction of labor before 39 weeks have picked up steam.

A 2011 Cochrane Review concluded that Pitocin did not seem to harm mothers or babies and appeared to shorten labor times by nearly two hours. But use of the drug did not lower cesarean section rates, which is one of the reasons why some doctors administer it, the authors wrote.

Many individual institutions have also taken a hard look at their policies around Pitocin use. During the two-year period examined by researchers in the new study, Beth Israel implemented system-level interventions to manage when the drug is administered and how it is accounted for in patients' medical records. Those changes led to a significant drop in rates of Pitocin use.

Nevertheless, Pitocin remains the most widely used drug for inducing labor, a common procedure in the U.S. The Centers for Disease Control and Prevention estimate found that more 23 percent of pregnant women underwent induction in 2010.

And experts say it is far too soon to draw any conclusions about the safety of Pitocin for newborns based on the new study.

"There are times when it plays an essential role and times when it may not be needed," Dolan said. "I think we need more data before we can conclude it's not as safe as we once thought." ]]> tag:www.huffingtonpost.com,2012:/theblog// 2013-05-06T00:03:16-04:00 2013-05-06T00:03:17-04:00

Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/
A new study offers up one possible answer, claiming that women who ate a diet rich in protein and low in carbohydrates while undergoing in vitro fertilization had higher pregnancy rates than those whose ratio of protein to carbs was the inverse.

But the findings, while provocative, are highly preliminary.

"Protein is essential for good quality embryos and better egg quality, it turns out," study researcher Dr. Jeffrey Russell, director of the Delaware Institute for Reproductive Medicine, said in a statement. His research was released at the American College of Obstetricians and Gynecologists' annual clinical meeting in New Orleans on Monday.

Patients whose protein intake represented 25 percent or more of their daily diet, and whose carbohydrate intake was 40 percent or less, had pregnancy rates four times higher than those who ate less protein and more carbs while undergoing in vitro fertilization (the joining of a woman's egg and a man's sperm in a laboratory before transferring the resulting embryo to her womb).

Researchers asked 120 women undergoing IVF to keep a three-day nutritional journal before they had an embryo transfer. Forty eight women had an average daily protein intake greater than 25 percent, while 72 had an average intake under 25 percent. (The Centers for Disease Control and Prevention says it is generally recommended that people get between 10 and 35 percent of their daily calories from protein.)

There were no differences in body mass index (a measure of weight relative to height) between the two groups, and because of that, the researchers concluded that improving fertility may be linked to specific nutritional components in a woman's diet, more than to her overall BMI.

But Dr. Kathy Hoeger, Director of the Strong Fertility Center at the University of Rochester, N.Y., said that other factors might have affected the outcomes among the high-protein, low-carb group. Hoeger did not work on the new study.

"We don't have enough information about other factors," she told The Huffington Post.

"The question about high protein, low carb is still very uncertain with regard to fertility," Hoeger added, explaining that good scientific research on the links between diet and fertility is scant. Much of what is known has been extrapolated from preliminary animal studies, and the mechanisms that link nutrition and egg quality are not well understood.

But the desire for more information is there, evident in the numerous books, blog posts and articles on the topic.

"As a practicing fertility doctor, probably the first question every one asks me is, 'What should I be eating?'" Hoeger said. "Clearly this is something on people's minds."

Perhaps the most scientifically rigorous information available comes from a 2007 study, led by researchers at Harvard University, that used data from more than 18,000 women who participated in the Nurses' Health Study, one of the longest-running investigations into women's health in the U.S. Those findings were detailed in the much-hyped book "The Fertility Diet," which offered dietary guidelines for preventing and reversing ovulatory infertility (but not infertility resulting from issues like blocked fallopian tubes).

According to the Harvard researchers, women should avoid trans fats and focus on the quality of the carbohydrates they eat, opting for fiber-rich foods and avoiding simple sugars rather than restricting the quantity of carbs. Researchers also found that women who had more full-fat dairy products in their diets were less likely to have problems getting pregnant than those who opted for skim or low-fat options.

And that study, like the new ACOG research, has its limitations. Because it was an observational study, researchers were able to look at data from a large group of women and generate hypotheses, but could not test those theories directly.

"Dietary input is important and you can't just ignore it, but we don't know enough to say you should have this percent of carbs, and this percent of protein," said Hoeger. "We do know that extremes of diet are probably harmful."]]> tag:www.huffingtonpost.com,2012:/theblog// 2013-05-06T00:01:38-04:00 2013-05-06T16:48:09-04:00

Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/
Though the findings are preliminary, the University of Tennessee physicians who led the study said it may have implications for low-income women hoping to prevent pregnancy.

"We saw several contraceptive options that are more expensive in lower income areas, and that expense may limit access," researcher Dr. Nikki Zite, an OBGYN at The University of Tennessee Medical Center, told The Huffington Post. The findings were released Monday at the American Congress of Obstetricians and Gynecologists' annual clinical meeting in New Orleans.

The cost data came from MyFloridaRx.com, a website developed by the Florida attorney general and the state Agency for Health Care Administration to provide pricing information on the 150 most commonly used prescription drugs in the the state. The site provides the prices that an uninsured consumer with no federal discount or supplemental plan would typically pay, as reported monthly by pharmacies.

Researchers focused on the price of seven commonly-used contraceptives -- including various forms of the pill as well as transvaginal options like the ring. They cross-referenced the price information across various counties with median household incomes from the 2010 census.

Nearly every prescription contraceptive was more expensive in low-income zip codes, the researchers found.

In most cases, price differed by just a few dollars. For two of the contraceptives, the cost was significantly less in the wealthiest zip codes.

Researchers said they don't know the reason for the price discrepancies. Certain neighborhoods may not have a large, chain pharmacy that offers lower prices and runs specials, Zite speculated.

"There is other research that has shown that a lot of needs for health, like fruits and vegetables, are more expensive in lower-income neighborhoods," Zite added.

But Dr. Jeffrey Peipert, vice chair of clinical research at the Washington University in St. Louis Department of Obstetrics and Gynecology, questioned whether the findings held any broad implications for women in other parts of the country.

"Yes, if most women went to the pharmacy and paid for prescriptions out of pocket, this would have a major impact," Peipert said. But he pointed out that uninsured consumers have access to, and regularly utilize, other options, including federally funded clinics that offer free birth control, or one that offers services on a sliding scale based on income.

However, Peipert agreed that cost is one of the biggest barriers to prescription birth control access. "We have so many barriers in the U.S., and we have rates of unintended pregnancy that are far higher than other developed countries," he said.

Peipert led the Contraceptive CHOICE Project, which counseled young women on contraceptive methods and offered the method of their choosing at no cost in order to compare what women opted for, as well as efficacy rates. When barriers were removed, 86 percent of the women were still using a long-acting contraceptive method, such as an intrauterine device one year out, as were 55 percent of women using a non long-acting method, like the pill.

"The big question is why don't we, in the U.S., level the playing field so all women can have equal access to no-cost contraception?" Peipert said. "Why should we have any inequities at all?"]]> tag:www.huffingtonpost.com,2012:/theblog// 2013-05-03T17:09:42-04:00 2013-05-03T17:54:57-04:00

Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/ As part of Speak Up for Kids, an initiative led by Child Mind Institute to provide the public with information about children’s mental health, we will be running a series of stories about families whose children have been diagnosed with mental health conditions.

For most of her life, Franny had been a typical kid. She was quiet and sensitive, but also sunny, well-liked and energetic. She thrived in school. Then things changed. The middleschooler began having nightmares and eventually completely withdrew. Here, her mom, Edie, shares how she and her husband worked to get Franny help for the anxiety disorder uprooting her life, and "the amazing resilience that good treatment can reveal in very troubled kids."

The Moment We Knew
Franny began to exhibit severe anxiety issues in anticipation of a change of school that was due to start in 7th grade. She loved her school, but we decided to move her to a larger one that offered a broader horizon and where we thought she would thrive. We told her in the spring.

She started having dreams about the new school almost immediately, and her issues accelerated through the summer. She was talking, and it seemed she couldn't stop talking, about being anxious about school. She went to camp and she couldn't function. She told us she was taking showers just so she could [be alone] and cry. Franny was holding herself together on the surface, but there was a level of anxiety that was pulling the foundation out from under the house.

Once school began, she had a very, very difficult time adjusting and left after a month. She went back to the old school and felt better for about a week, then she completely withdrew. She ended up on a medical leave from December through the end of the year.

Life With Anxiety
Her anxieties would really mount at night. It was like having a little baby again that you can't put down. You wonder if you should Ferberize or stay with her. You go in and out of the bedroom every 15 minutes for three hours each night; reading; singing; meditating -- we tried every meditation tape for teens. Then you end up standing in the Duane Reade, asking the pharmacist, "What sleep aids are appropriate for 12 year olds?" And you think, "How did I end up here? What am I doing wrong?"


Franny drew this image right around the time she started at her new school. It reads, "Social anxiety/pressure at it's [sic] BEST."

Our Care Map
If I had read this article as a parent two years ago, I would have wanted to be reminded that good care -- and it is ongoing care -- means you need to have the right person or people, both in terms of the fit with your child and philosophy of care. You need the right assessment, and then you need the right treatment. And all of those can involve trial and error. You can get combinations of, say, the right person but the wrong treatment.

It took us about four months to get it right. The best treatment approach [for Franny] was cognitive behavioral therapy, but even after we figured that out, finding the right person took time.

The right assessment was also really important for us. I never thought I had the type of child who would need the type of questionnaire we filled out. We must have faxed back 28 pages of answers to questions like, "Did your child hurt animals as a kid?"

When we talked through the results -- we worked with the Child Mind Institute -- they said "OK, we've got some depression, some anxiety and panic issues that are off the chart." I recognized every element in Franny and I thought, "Finally. At least we're talking the right language here."

Our Darkest Moment
There was a patch when Franny couldn't leave the apartment; she couldn't stand to be in public; she couldn't stand to have people look at her. She couldn't walk in the park, she would shy away from the trees and bushes. Every appointment, we'd take this trembling kid and stuff her into a cab. Occasionally on the way back we'd say, "Can we walk a block?" She'd be about four feet behind, trembling. I don't think she'd be at all embarrassed for me to share that, she remembers how helpless she felt.

That was an extreme time, and I think there were moments when she felt like her parents had absolutely nothing to offer her any more. It's terrible to watch your child hurt and feel you can't help.

What I Wish We'd Known
I think schools are not that well prepared, and I think it is hard for educators, administrators and even some guidance counselors to quickly recognize the difference between someone who is having regular, middle school fears or homesickness and something this severe. No one said to me, "These are red flags. Get an assessment now."

As parents, we were trying to be proactive, but we could have used a push.

Where We're At
Franny sees a therapist weekly and a psychiatrist every few months, mostly just to check in.

She has been trying new things at her new school. She went on a group youth service learning trip, which meant getting on a plane with a school group, and this for a kid who couldn't take a bus across town a year and a half ago. She's entered in science competitions; she's trying sports.

There have been some nights before [she tries something new] when we've said, "Oh my gosh, are we going here again?" She has had some ups and downs, but so far she has met every challenge. Franny is really proud of herself. She knows how much she has done. We have a healthy, happy daughter trying new things.

This conversation has been edited and condensed.]]> tag:www.huffingtonpost.com,2012:/theblog// 2013-05-02T00:00:01-04:00 2013-05-02T11:47:08-04:00

Catherine Pearson http://www.huffingtonpost.com/catherine-pearson/
Prior research has raised some concerns over the presence of lead in lipstick, but the new study is the first to suggest that many popular lip products also contain cadmium, chromium, aluminum and other metals -- some at levels that may be harmful.

"We looked at nine heavy metals and found that all of them were present in most of the lipsticks, but not necessarily at really high levels," study author Katharine Hammond, a professor of environmental health sciences with the University of California Berkeley's School of Public Health told The Huffington Post. "Low levels of metals may not create a risk, but as the exposure increases, the damage can increase." The results were published in the journal Environmental Health Perspectives Thursday.

The researchers looked at eight different lipsticks and 24 lip glosses, bought at drug stores, department stores and chain specialty stores. Prices ranged from $5.59 to $24.

"The metals that we were really most concerned about were cadmium, chromium, aluminum and manganese," Hammond said, explaining that overexposure to each carries risks. Chronic, low level exposure to cadmium, for example, has been linked to serious kidney problems.

Glosses and lipsticks are of particular concern because of the potential for ingestion, Hammond said.

When used at what researchers called an average rate -- around twice a day -- the estimated intake exceeded acceptable daily levels for those metals, as established in prior public health efforts. In other words, they could pose a potential health risk.

But Hammond cautioned that the study is merely a first step that requires further investigation, both into the levels of metals in certain lip products, as well as what the health implications could be.

"I don't think that people should go into a panic, or abandon lipstick, but I do think this is a concern," she said. "I don't think this is trivial. It needs to be addressed."

Sharima Rasanayagam, staff scientist for the Campaign for Safe Cosmetics, did not work on the study, but reviewed it. "It's definitely a preliminary study and something that needs more research, but we're concerned about there being potentially toxic chemicals in lipstick and consumers not knowing about it," Rasanayagam said.

The Campaign for Safe Cosmetics, launched in 2004, aims to protect the health of consumers and workers by pushing for regulatory and legislative support for the elimination of dangerous chemicals from cosmetics. In 2007, it released a study that found that more than half of 33 lipstick brands contained lead at levels that are cause for concern.

The Food and Drug Administration has since looked into lead in lipstick and found that, generally, the amounts are very low and do not pose any safety concerns. It has not set limits for lead in cosmetics.

"The report does not provide any new meaningful information," said Linda Loretz, Chief Toxicologist for the Personal Care Products Council, a trade association for the cosmetics industry, in a statement. "The finding of trace levels of metals in lip products is not unexpected given their natural presence in air, soil and water. Very low levels are also found in drinking water and food."

All of which can make it confusing for consumers seeking information on what is in their lipstick or lip gloss and what, if anything, it means for their health.

"It's not practical for a woman to buy, say, 12 products and send them off for testing," Hammond admitted, adding that women have no real assurance that by opting for so-called "natural" cosmetics they can reduce their exposure. Metals, after all, are natural.

The Environmental Working Group maintains Skin Deep, a database of what it calls the "safety profile" of various cosmetics and body products. But, to date, it has only looked at lead in lipstick, not other metals, a communications representative wrote in an e-mail to The Huffington Post.

"Yes, we need to look at the levels [in lip gloss and lipstick]," Rasanayagam said. "But for some toxins, it doesn't matter if it's just a small level."

This story has been updated to include comment from Linda Loretz.
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