Thursday, June 28, 2012

Hopes for Healthcare Reform

I hate being told what to do. And if my way isn’t working, I’ll still figure it out myself. Because I sure as heck don’t want to try your way! [excerpt from an American kindergarten room]

Unfortunately, in the arena of healthcare, this seems to be the attitude most of us adopt, which amounts to crossed fingers, gritted teeth, and a lot of Americans with eyes squeezed shut, hoping really hard that nothing bad happens.

I recognize there are controversial measures in the Affordable Care Act. The most striking deficit, in my opinion, is the absence of a conscience clause for providers. But just as the leading Catholicauthority in the U.S. has not supported a complete repeal of the law, neither do I.

I believe the legislation for healthcare reform is a step in the right direction. (Ouch -- just got hit by the flaming dart arrows fired from the appalled consciences of many friends.)

To this point, health insurance has been unaffordable. However, only the independently wealthy can financially handle a medical catastrophe without health insurance. Nonetheless, hospitals are required to treat patients with life-threatening conditions (albeit the care is crap, sufficient only to push them through the exit doors, to be pursued by a relentless mob of collection agencies). I’ll go out on a limb here, but suffice it to say, I think everyone would be better off with health insurance.

Still, there are many Americans who work incredibly hard, often self-employed or at multiple jobs, for whom the holy grail of employer-sponsored healthcare is not available. (My family’s included in this group.) For this group, it’s not possible to pay out-of-pocket for anything other than the most basic wellness care, without financial assistance.

I can only yell so loudly about my right to life and liberty, without wondering if there should be some provision for the quality of this life. I’m not advocating Mercedes for all, or streaming cable television to every home. But is the right to life that our founders envisioned only a guarantee to continue breathing on American soil? (As long as you don’t have asthma. Then your right to breathe is contingent on your ability to afford the diagnosis and prescription.)

Seriously though, our inaction on healthcare reform is only perpetrating the status quo of quality healthcare for a privileged elite, substandard provisions for the most impoverished, and anyone in between settling for lack of care or medical bankruptcy.

In my opinion, the individual mandate that’s such a contested part of the Affordable Care Act, just might be a solution.

Monday, June 4, 2012

Craniosynostosis, Part II: The Birth Story

About a week before Joshua’s due date, after a morning of sporadic contractions, we drove to the hospital, expecting to be sent home, another set of overly-excited parents. But at 6 cm dilation and fully effaced, the nurses predicted we’d be holding our baby by lunchtime!

Craniosynostosis isn’t diagnosed before birth, although the plates of the skull seal early in fetal development, so we had no way of knowing that Joshua’s sagittal suture was already closed: his head wouldn’t be able to mold to the birth canal. I’d given birth just two years earlier with no complications, and a hold-onto-your-hat-this-baby’s-coming-now kind of labor, but Joshua wasn’t going anywhere fast. The attending doctor sent nurses to prep an operating room for C-section. He motioned to our attending midwife that it was time to give up pushing.

Somehow, in the hectic surrealism of that delivery room, my midwife seemed to stop time; her words cut through the chaos and concern around us, and she said, “Charlene, you’ve got three more pushes to get him out. He needs to get out now, and you can do it.”

1 in 500 babies are born face presentation (instead of the normal position of facing downward, chin to chest), and brow presentation is even more rare, with a C-section being necessary in almost all cases. But suddenly and somehow, Joshua dislodged and joined the anxiously-awaiting world, looking like he’d been in a bar fight, with a bruised, swollen face and black eye.

We thought trauma at birth was the source of Joshua’s subsequent fussiness, and wouldn’t realize until months later that his difficult birth was a symptom of craniosynostosis.

Bruised and beaten up by birth
Snuggled in and happy a few days later

Here's To Beating An Issue Into The Ground (On the HHS Mandate)

I'm tired of this issue.

I'm tired of seeing it in newsfeeds and reading articles about it everywhere and hearing complaints about it, from both sides. But we're belaboring a point that apparently still needs belaboring.

It's not about personal feelings toward Catholicism, whether one sees it as irrelevant and archaic or nourishing and alive. The religious conscience must be free to practice its beliefs: paramountly at home, communally at a place of worship, and most relevant in this case, in service to others in the public domain.

The new Health and Human Services mandate, in its current legislative state, will require all employers to include abortion-inducing drugs, contraceptives, and sterilization procedures, in healthcare coverage, regardless of religious convictions that believe otherwise. The conscience clause that might exempt some organizations from the HHS mandate is so narrowly-defined that it does not include most Catholic schools and hospitals, outreaches of the Church, which exist solely because of the example of Jesus Christ, and the belief that he instituted the Church to carry on his compassionate work.

Following national outrage, President Obama offered a verbal revision, not written into the law, that would require insurance companies to offer these amenities for free. Yet there's an apparent oversight that nothing is "free" with unabashedly for-profit health insurance companies, and any "free" inclusion would no doubt be subsidized by increased premiums for the objecting organizations. Additionally, this illusory compromise still leaves self-insured organizations without a conscionable solution.

Where is our national identity? Have we forgetten that the freedom to live out personal religious beliefs is protected by our nation's Bill of Rights?

The Catholic Church is the largest charitable organization on the planet. Yet it seems we're being told, "You may hold any beliefs you want, as long as they only influence your life at home and at church, and as long as your Catholic behavior only influences other Catholics." We serve others not because they are Catholic, but because we are Catholic.

The morality of contraception isn't directly pertinent here (although it could be argued from a Catholic perspective that mandating the coverage of abortifacents is also an affront to the right to life, as mentioned in the document that kind of started everything). Regardless, whether one believes in some kind of "best practices" for sex, whether there are gray areas in the implicit guidelines of pleasure and procreation (or just pleasure, whatever), or whether it should all just be a free-for-all of anything goes, this should have no bearing on whether Catholics are free to practice their religion in the privacy of their homes or in service to the world, without government intrusion.

Craniosynostosis, Part I: Could you ask about the bump on the back of his head?

“Any questions for the pediatrician?” my husband, Wally, asked offhandedly, as he packed Joshua’s diaper bag for a 2-month wellness visit.

I flashed through my head and came up empty; yet in an effort to be a conscientious mom, I offered out, “How about the bump on the back of his head? Could you ask him if we should be concerned about it?”

It was the first wellness visit I would miss, but after dutifully attending the multitude of routine check-ups for his 20-month-old brother, Joseph, I felt okay trading an hour in the waiting room and ten minutes with the pediatrician for the opportunity to show up at work on time and reassure my coworkers that I was, once again, a functional member of the team (though not completely meeting their expectations for an energetic, rejuvenated mother, fresh from a leisurely 10-week maternity leave).
Wally sent me a quick update while I was at work: The doctor’s not concerned, since Joshua’s head is showing growth. But he’s referring us to a specialist, just in case.

I didn’t get a chance to read the pediatrician’s referral note until nearly 10 o’clock that night, still feeling dizzy from the lack of sleep that gets delivered with every new baby and trying to acclimate to the new working mom evening routine of abbreviated quality bath, stories, and bed time with our toddler and then the tedium of sanitizing bottles and breast pump parts for Joshua’s milk supply the next day.
Barely able to decipher “craniosynostosis” from the doctor’s handwriting, I managed to type it into my phone’s web browser for what I expected to be a quick Google check, all while pacing and bouncing with Joshua fussing in the Moby wrap. Everyone recognized he was an unusually unhappy baby, but easily attributed it to the half cup of coffee I gratuitously drank each morning, colic (whatever that is), anxiety from a rough birth (two months ago?), or the glaring conclusion that I felt from family, friends, and strangers alike: I just wasn’t in tune with my baby enough to soothe his needs.
Josh settled in his sling, a rare relaxed moment

As I scrolled incredulously through the images from the online search, I experienced a strange sensation of fear and dread, and yet, also relief. I recognized the elongated head, the misplaced cowlick, the broad forehead, things I had thought were just idiosyncrasies as Joshua’s head developed. Yet here they were, symptoms of something called craniosynostosis, a condition of sutures in the skull closing too soon, and not allowing the brain and head room to grow during the pivotal first year of life outside the womb.
I had a restless night, waiting to call the craniofacial specialist in the morning.

The normal sutures in a baby's head

The sagittal suture already closed in a baby with craniosynostosis and the effect on head growth