Tuesday, August 13, 2013

Running update:
Mileage since our return from Canada:
8/5  3.1 miles in 27:43
8/9  7.6 miles in 1:16:32
8/12  15.1 miles in 2:29:18
I’m starting to get in some decent long runs now, and I’m pleased to say I actually negative-split today’s run, meaning I ran the second half faster than the first half!

Jane update: 
I took the kids to Boston with Grandma this weekend to visit our great Aunt Anne.  (As Jane says, “She’s great in two ways!”)  We visited the newly-renovated New England Aquarium, spent a morning in the Boston Public Gardens and rode the swan boats, and visited our favorite haunt, the Museum of Science.

NF update:
I was recently taking care of a newly pregnant patient, a first-time mom who was very anxious, who had many typical questions about what exposures might harm her baby (e.g.  Is it safe to use mouthwash?)  I generally try to answer by describing any available research on the subject or, if no studies are available, explain the mechanism by which something is safe/unsafe (e.g.  It’s not absorbed in significant amounts into the bloodstream and therefore doesn’t cross the placenta to the fetus).  Barring that, I say “we have no evidence” that a particular exposure is harmful if there has been no association to birth defects reported.  This discussion is particularly important in cases of miscarriages which, with rare exception, are not caused by anything to which the mother was exposed.  I make sure to say this to my patients aloud, and tell them that I want them to hear my voice saying it when they wake up a 3am and their emotional brain has taken over their logical brain and they are agonizing over what they should have done to prevent the loss.  (“I shouldn’t have eaten that tuna sandwich!”)  Maternal guilt is a powerful thing.

Now imagine you aren’t dealing with a new pregnancy and worrying about exposures causing potential birth defects—imagine you actually have a child with a genetic defect that will cause her pain and suffering.  You wake up at 3am with your emotional brain overwhelming your logical (physician’s) brain and you wonder if you did one too many fluoroscopies in your first trimester because you couldn’t cancel them because you didn’t want anyone to know you were pregnant yet.  How do you deal with that maternal guilt?  You grasp at the kind, tactful words of Dr. Scott Plotkin at MGH, who reassured this new NF mom that if fluoro caused NF, we’d see much more NF in the children of fluoroscopists than we do.  (But even sometimes at 3am I don’t believe him…)

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