Unadopt

This week, I met a nice family of four who are missionaries and lived in South America for 10 years. This past summer, they visited friends who still live there. They were introduced to a four year old child whose family was killed earlier this year. Over the past few months, they have been undergoing the process of adopting this child and bringing him to our community.

I talked with the family and they told me of the very detailed process that they have to go through - endless paperwork, at home visits from state agencies/officials, etc. Even though it seems like a lot of hastle to me, the family is very happy that they are going to have a new edition.

Last night, I read a story about a Virginia couple who is trying to "unadopt" a child after caring for him for six years (BBC). The background of this child is troubling. His birth parents abused drugs. There were issues of physical abuse and suspicions of sexual abuse. All of these were believed to cause mental illness in the child which required medication treatment.

This foster mother stated that she became concerned three years ago when the child sexually abused a six-year old and a two-year old. She also states that this is when she learned of the child's troubled past. What's interesting is that she could have filed a "wrongful adoption" lawsuit, but did not. Instead, she has chosen to "dissolve the adoption" which requires the child's consent. The child has not consented.

This foster mom states that she was not informed at all of the child's troubled past during the adoption process. I find this difficult to believe. With the patients I have talked with in the past, all kinds of information about the foster family and about the foster child are learned, processed, and shared with everyone involved.

The concept of "dissolving an adoption" is fascinating to me. Can someone really divorce their foster child? How would that work? A child is in foster care and then a family decide to legally adopt the child. Then, maybe years later, the family decide to divorce the child? I'm really confused about this whole concept.

Update - Like a Foster Mom: I was talking about this Virginia story earlier today with someone at the hospital and she mentioned that pop star Madonna is in the African nation of Malawi visiting that impoverished nation. According to Times Online, Madonna and her husband just today have taken custody of a 13-month old boy and are going to adopt.

Malawian law does not allow for inter-country adoptions, and generally requires people who want to adopt to spend 18 months being evaluated by Malawian child welfare workers. But it seems even this is no obstacle for the Material Girl after Malawian officials, who refused to elaborate, indicated that such restrictions would be waived for the couple.

Don't get me wrong. I don't think this is a bad idea. In light of what I've learned today about adoption (thanks to your comments), I wonder what this child will be like 5-10-15 years from now. A Material Guy for the Material Girl? We'll see.

Smarter sex

First of all, I'd like to welcome all of you who found this post on a google search (and no I don't have a you tube movie that goes with this). Contrary to the title, this doesn't have anything to do with ED. HA!

But, since I have you here anyway, I wanted to share two interesting studies which pose the same question: Are men smarter than women? Before you start throwing stuff at me, just read below and decide for yourself.

A recent study of 100,000 high school students showed that men have a 4-5 point IQ advantage over women. (This was reported by the Financial Express) Matt Katz from the Lansing State Journal is very happy about this in his article called Are Men Really The Smarter Sex?

Whoooh-hooo! We're No. 1!

It has finally been proven that men are smarter than women. According to a study from Britain, men's IQ scores are five points higher than women's, and men are 5.5 times more likely to have a score of 155 (which means you're a genius).

Don't believe the British? In Canada, another study analyzing SAT scores found that males ages 17 and 18 are more intelligent than females.

Take that women! What do you think of that? Now, before I really started rubbing it in to everyone here at the office, I ran into an article from CNN.COM. Apparently, men are smarter, except then it comes to going to the emergency room during the big game.

A drop in the number of men going to the emergency room during sports broadcasts on TV is followed by a surge afterward, reports an ER doctor who reviewed case numbers over three years at the University of Maryland Medical Center in Baltimore.

Oh well. I'm so disappointed. I thought that I found the answer to this time old question of who's smarter. I guess the research and the debate will continue.

Surgery vs contacts

If I ask you which is safer: eye surgery or wearing contact lenses - you'd probably pick the latter, right? In an article from WebMD, researchers looked at the complications of the eye surgery called LASIK and compared them to complications of wearing contact lenses. The research will be published in this month's edition of the Archives of Ophthalmology. Gee, guess what the findings were? Bias? You be the judge.

Based on their review of several large studies, ophthalmologist William Mathers, MD, and colleagues concluded that daily contact lens wearers have about a one in 100 chance of developing a serious lens-related eye infection over 30 years of use, and a one in 2,000 chance of suffering significant vision loss as a result. The researchers calculated the risk of significant vision loss due to LASIK surgery to be closer to one in 10,000 cases.

The articles goes on to outline the bad habits of contact lens patients - whether it's not making sure your fingers are clean before inserting contacts (prevents infection) or sleeping with your contact lenses in. The big finish to the article is describing the advances in LASIK surgery over the past 15 years.

The bottom line is this. There are people who take good care of their contact lenses, and there are people who do not. Just like there are good surgeons who have low complications and not-so-good surgeons who have more complications. Do your own research before considering surgery or any medical therapy for that matter. That's your Dr. A Health Tip Of The Day. HA!

Grand Rounds

If you haven't already checked it out, Dr. Jon Mikel from Unbounded Medicine has Grand Rounds 3.3 this week. The graphic above is very creative as well. Sections include: Editors Choice, Physician Stories, Nurses Stories, Student Stories, Patient Stories, Public Health & Insurance, Humor and Volunteer. Very well done. Happy reading!

By the way, thanks so much for your feedback on the poll questions. I'm looking for any and all advice for my cholesterol presentation - whether you're a doc, nurse, patient, or anyone else. Great advice so far! And, I have some things to think about on this BAD idea. Still not sure what to do with that, if anything....

Poll question

Since it's four weeks before Election Day in the United States, I'm going to ask you, the faithful Doctor Anonymous reader, a poll question. Actually, two poll questions, because I'm seeking feedback on a couple of things.

A week from today, I'm going to be giving a talk at our local community hospital. The target audience are people who have heart and lung problems - ie, patients who have had heart bypass surgery and/or patients with lung problems like emphysema. Here's the topic: Dr. A talks about Managing Your Cholesterol. Now, mind you, I did not pick this topic. This was suggested by the group.

Serious Question: Here's what I'd like to know: if you were me, what information would you like these people to know about managing cholesterol?

Yesterday, my pal Penrick from I've got a few things to say, made this suggestion, in response to my post called Happy World Post Day, "You should start a Blog Anonymous Day yourself. You start discussing it a month before and let the word of blog spread." What? A worldwide Blogaholics Anonymous Day? Is this for real? Can this work?

Non-Serious Questions: If a worldwide Blogaholics Anonymous Day would actually happen, how would you promote it? I would imagine that I would ask people to post something about BA on their blog all on the same day - what would the topic be? What other things need to happen to make BAD (Blogaholics Anonymous Day) successful?

Thanks for any feedback that you have. I'm definitely doing the cholesterol talk next week. As for the BAD thing (isn't that a Chris Isaak song?), I'm not sure if I want to try to pull that off, yet. You'll have to convince me of that.

News briefs

Coumadin Black Box: Coumadin is a blood thinner that is used in a variety of health problems including blood clot prevention. Yes, you have heard right, technically, it is rat poison. Last week, the company that makes name brand coumadin issued a "black box" warning about "potential fatal risk of bleeding" in patients -- article from NewYorkBusiness.Com.

For those that may not know, some people consider the "black box" warning the highest warning that the US FDA issues to warn doctors and patients of potential medication problems.

Now, this is not anything mysterious. Everyone has known that coumadin has this potential for years. This is not another "FDA screwup." Here's the rub. Either take the coumadin and face potential side effects like bleeding. Or, don't take the blood thinner, and, for those that need coumadin, run the risk of blood clots which lead to things like stroke. I'm not sure what the answer is, but I do know that our phones here at the office have been ringing off the hook today with questions.

Total Lettuce Recall: The E.coli saga is continuing. The Mercury News is reporting today that a California company is voluntarily recalling some of its crops of lettuce after finding E.coli in a sample of irrigation water. First spinach, then beef, and now lettuce. As long as they don't recall Diet Coke and donuts, I think I'll be fine. We'll see what gets recalled next.

Cleveland doctor arrested in Cyprus: Yazeed Essa was arrested over the weekend as he attempted to clear customs is Cyprus. (CNN.Com)

Prosecutors have said they believe Essa, an emergency room doctor, was having an affair with a nurse and wanted to be free of his 38-year-old wife. Prosecutors characterized the killing as a "divorce substitute."

What's going on the world today? If you don't like your spouse, then just divorce her/him. What's up with murder (er, I have to say alleged murder)? If guilty, I hope this guy gets put away for a long time.

Happy world post day

Did you know that October 9 is World Post Day? Yup, you bet. It's a worldwide celebration of blogging and blog posts. Who knew that the blogosphere could have such a worldwide impact that an entire day is devoted to it.

Well, not really. This day is recognition of snail mail. Here are articles from the Universal Postal Union, South Africa, and Sri Lanka. The following quote is from the United Nations.

World Post Day is celebrated each year on 9 October, the anniversary of the establishment of the Universal Postal Union in 1874 in the Swiss Capital, Bern. UPU member countries across the world use the event to emphasize the important role of the postal sector in the daily lives of people and in the social and economic development of countries.

Oh well, maybe some day there will be real recognition for blogging and groups like Blogaholics Anonymous -- HA! Keep on blogging!

Blog chatter

I'm always flattered and humbled when I'm featured on another blog. And, this time is no exception. Mimi Lenox, one of the newest members of Blogaholics Anonymous, mentioned me in her Sunday Blog Chatter on her blog called Mimi Writes.

Now, if you'll excuse me, I'm going back over to Dr. A's and put my name on the BA map and make it unofficially official. It's time I admitted the truth. Which, of course, means that I have to tell my mother the sad saga of my secret addiction first. This could take a while since she doesn't even know what blogging is.

On second thought, this could wait a day or two. Couldn't it? Let's let her sleep in peace one more night.

Mimi has a second blog called Book Meme Central (where I'll also be featured *wink*). She describes this blog as the place where all Memes come to be immortalized. A comprehensive collection of book memes from across the globe. If you have a chance, check out these blogs. You won't be disappointed. Thanks Mimi!

Health care coach

Hey, this should be your primary care doctor, right? This article from Forbes.com describes what they call "health care transition coaches," who can help reduce patient's hospital bills and rate of re-hospitalization.

The "transition coach" works with patients on four main areas: medication self-management; the creation of a personal health record maintained by the patient; obtaining timely follow-up care; and developing a plan to seek care if certain symptoms appear.

The program was created to solve problems -- such as conflicting medical advice, medication errors and lack of follow-up -- that often affect patients during periods of transition between sites of care.

This article doesn't say who these coaches are, who pays them, and how they get paid. These are probably agents of the insurance companies, who already dictate how health care is delivered in this country.

The idea of a "health care coach" just sickens me. These concepts are exactly what should be happening in the offices of primary care docs. Unfortunately, this is probably not happening, and that's why these coaches were created. Just another symptom of the broken US health care system. If we treat the symptom and not the overall big picture, the status quo will remain and the frustrations will continue to grow.

Make it so

So, I was at Christies auction house yesterday checking out all the Star Trek memorabilia. I know I've told Michael C this before, but, hey, I admit to being a Star Trek fan - just don't call me a trekie, HA! For those who may not know, this sci-fi series has been around 40 years. In this article from BBC news, the auction lasted three days and there were over 1000 items sold.

The item getting the biggest sale was a model of the starship enterprise which sold for, get this, 576 thousand dollars! Did I read this right? I mean, it's a model. It doesn't fly. It doesn't orbit the earth. It doesn't come with futuristic space babes. What's the deal? I guess some people are WAY more into Trek than I.

When I was done there, I went over to Bangkok, Thailand to see a guy set a world record. In this article from CTV.ca, it describes a "Thai snake charmer" attempting to set a world record by kissing, yes, that's kissing, 19 poisonous king cobras.

One by one, the cobras were released onto a stage set up in a Thai beach resort town, as snake charmer Khum Chaibuddee kissed each beast and then moved on to the next.

Four additional snake charmers flanked the stage at each corner and a medical team waited on the sidelines with serum in case one of the snakes snapped, said a statement from Thailand's Ripley's Believe It or Not Museum, which organized the event.

This sounds strangely familiar, but didn't Mark Foley do the same thing while he was in Congress? Thank you, thank you very much! *running out of the room*