Rub Some Dirt On It

I want my child to grow up dirty – in all her blackened bare feet, tangled hair, mud pie baking, snail racing, tree climbing, scraped knee-ness glory. I will be that weird mom that yells to her kid, “Rub some dirt on it and get on with your life”.

But I am not delusional about the medicinal properties of dirt. Dirt is good but rubbing dirt on your kid will not make them immune to measles, so just in case please vaccinate your kids in addition to letting them get dirty. Because dirt is not a miracle worker, but vaccines actually are.

I am equal parts enraged and bemused by the Anti-Vaccine movement that has gained considerable momentum in the past twenty years and has seemingly exploded in support and action since 2013.

And while I am a big supporter of the old adage, “If you have nothing nice to say, just STFU.”. In this instance, I believe honesty is the best policy. Honesty trumps politeness. Honesty trumps keeping quiet. Honesty trumps minding your own business. Because some choices we as parents make should not be a choice at all.

The first time I heard about this notion that vaccines were potentially dangerous or that some moms choose to forgo them was long before I myself considered becoming a mother, it was around about 2010, I was twenty-seven and was chatting to a mother to two young children.

I cannot remember how or why we got onto the topic, but vaccinations came up. She was vehemently against it, she said that none of her children were ever vaccinated and never would be. Vaccines, in her opinion, were incredibly dangerous and the risk their administration posed to her children far outweighed any protection they provided, a benefit which according to her was also debatable.

She had incredible tales of the danger of vaccines; “they are grown on the livers of live monkeys”, “they have mercury and other toxic chemicals in them”, “they weaken the child’s immune system”, “they can cause autoimmune disorders, why do you think there are so many kids with asthma nowadays”, “they don’t even work, it’s all a money making scheme by the doctors and big pharma”, “why when there is an outbreak of measles or whatever else, the majority of people who fall ill are vaccinated?” and the most common and popularised argument – “vaccines have been directly linked as a cause of autism”.

This was the first time I had ever heard of such a thing, I mean I was fully immunised and there had never been any debate as to whether I would be, my mom did as the doctor advised and immunised all three of her children. And we turned out fine, didn’t we?

I turned to Google to see what it had to say on the matter and I was amazed to see that it indeed was a real thing – people were against vaccinations and were choosing to not vaccinate their children.

And from that moment I concluded that these individuals were either incredibly gullible and would believe anything or were incredibly ignorant and didn’t fully understand the scientific research proving vaccines safe, and instead, they chose to believe an actress whose most significant achievement was appearing in Playboy magazine.

Now, I am no medical professional, no scientist, I do not currently, nor have I ever worked for a pharmaceutical company and I know very little about medicine or the development of vaccinations.

I am, however, semi-literate, live in a third world country in which people die every day from preventable and treatable diseases and I have an interest in history. And this is what I have to say on the topic.

  1. Vaccines biggest strength has become its biggest weakness

Vaccines are widely regarded as the greatest medical advance of the 20th Century. And this success has also seemingly been its downfall because it has been so successful that the moms of today, those aged fifty and under, in affluent and developed corners of the world from Cape Town to LA to Perth have had the luxury of collective amnesia.

Our generation has never seen the effects of the diseases, against which we vaccinate, in full force. How many of us have had our child suffer a permanent disability at the hands of Polio? Or had half our child’s school class die from a smallpox outbreak? Or have given birth to a child that is marred by blindness, deafness and a damaged heart because you were exposed to German Measles (or Rubella) in the early stages of your pregnancy?

I venture to say none to any of the above questions. Vaccines have allowed us as a civilisation to in some instances and areas of the world eradicate infectious diseases like smallpox and polio.

The first ever vaccination against an infectious disease was pioneered at the end of the 1700s in Britain, it was developed to fight smallpox, which was a massive killer around the world. In the 1600s and 1700s, 1 in 13 of all deaths in London was caused by smallpox. When the vaccine was introduced in 1796 the number of deaths caused by the disease sharply declined, and over the next 100 years, the disease was all but irradicated, as it accounted for 0,01% deaths in 1900.

Interestingly, in 1980, the WHO officially certified the global elimination of smallpox, the first ever eradication of a disease in human history, and at the time the organisation recommended that all countries cease vaccination and that all laboratories should destroy their remaining stocks. Surely if there was some massive conspiracy theory by big pharma, doctors and the medical fraternity they would have continued to vaccinate against this disease and reap the monetary benefits?

The last major outbreak of polio in the United States was in 1953 where 57 879 cases were reported and 3 147 of those cases resulted in death and many more of these cases would have resulted in paralysis or disability. According to WHO, polio mainly affects children under the age of five, so it is heart-breaking to imagine that the victims of this awful disease are pre-school children. If not for vaccinations, Izzy would fall into this vulnerable group.

It was in this decade – the 1950’s – that the first effective polio vaccines were developed, and it was in the second half of this decade and the beginning of the next that the polio outbreaks plummeted, and I mean plummeted, from the tens of thousands of cases and thousands of deaths in 1953 to 449 cases and 41 deaths in 1963. The number of cases and deaths has continued to decline, with only a handful of cases being reported yearly. The global push to end polio has reached its final stages, with just 3 remaining countries still working to eradicate this debilitating disease.

According to WHO, “vaccines have prevented at least 10 million deaths between 2010 and 2015, and many more lives were protected from illness (like whooping cough, mumps and measles).”

And this is the blissful ignorance that vaccinating has bought us. But with several decades of life without the horrors infectious disease reap on our children staring us in the face day-to-day, we have had the luxury of time and naivety to question the value of vaccinating, the ignorance to think that a vaccine’s benefits far out way its drawbacks and the arrogance to believe our Google degree in medicine supersedes that of an actual medical degree and countless years of experience at the frontline of disease and suffering.

All you have to do is talk to a historian and you will quickly gain a glimpse into the world before vaccines. Erika Holst, a historian, shares her opinion on the matter and recounts some of the writings from the 18th century she and her colleagues have encountered during the course of their work.

“I couldn’t help but notice that all my historian friends fell firmly into the camp of pro-vaccines. Even the crunchy ones, even the woman who home-schools her kids and gave birth at home in an inflatable pool.”, she says.

She explains further, “The reason for this is best summed up by my friend Kristen Wands, a curator in Wethersfield, Connecticut: “I read the letters and diaries of anguished 18th-century parents who lost numerous children to diseases we can prevent and treat today. I know what a world without vaccines looks like, and you wouldn’t want to live there.”

Holst goes on to share additional insight into a world where deadly illnesses are commonplace. “How necessary to live in constant readiness for death’s summons,” wrote Helen Edwards. Our ancestors lived with the acute awareness that death was never far from life, often ending correspondence “if you live” or “if I live”.

She goes on to say, “Try to imagine, for a moment, if every time your child got a runny nose, you wondered if that illness would be his last. Try to imagine loving your children and grandchildren, but not daring to assume that they would all grow to adulthood. Try to imagine families who had not buried their children being the exception, not the rule. Try to imagine if a quarter of the children you know would not live to see their fifth birthdays. Our ancestors, who watched their children die of the diseases vaccines prevent, would have given just about anything to have had them.”

Because I feel this particular topic requires the right amount of attention and due diligence, I don’t want to gloss over the issues and the facts, I have broken it into two parts so it is a little more easy to digest. So, look out for part two. Coming next week.

 

Plan for Nothing to Go To Plan (Part 2: The NICU)

I recently watched an episode of Black-Ish where Bow has to have an emergency C-Section to deliver her baby 8 weeks early. This episode ended with Bow being unable to get up to go to the NICU to see her baby, so she sent Dre and he is overwhelmed by a mixed bag of emotions at the sight of his tiny baby attached to a bundle of wires which in turn fed into a number of machines. This image stirred up a number of memories of Izzy’s first few weeks of life.

And I realised I never wrote the second instalment of Plan for Things to Never Go to Plan post. So, just over 12 months since the first plan went down the toilet, followed, unceremoniously, by almost every other best laid plan me and my new mom brain hatched, I thought I should return to the scene of epic plan fail – part 2.

JUST A QUICK RECAP: Five weeks before my due date and four weeks before my Ceasar date I was admitted to hospital in preterm labour. After four days of being in hospital, my placenta failed and Izzy went into distress which prompted an emergency C-Section. Luckily, the delivery went well and Izzy seemed in great health but a few hours after the birth Izzy had still not been brought into the maternity ward and we were informed she would have to spend an indefinite period of time in NICU due to a number of complications. So, for her first night in the world, my tiny baby (like Bow & Dre’s) slept in a machine, attached to wires and drips, lulled by the sounds of beeping, under the watchful eye of a stranger, her nurse Patience.

The next eight days would prove to be just as disconcerting as the first. Everything was so up in the air it seemed we would never know the comfort of solid ground again. Instead of the answers, we were desperate to have, we were almost always left with more questions. And the truth of a premature baby’s circumstance is that nobody can predict with 100% certainty what will happen – and even more truthfully nobody wants to in case they get it wrong.

After attending pre-natal classes and lots of time spent in the College of Google, I learnt about something called, skin-to-skin, where a baby is cuddled naked against the naked chest of her mom (or dad), this has proven to assist newborns in regulating their body temperature, heart rate and obviously has major bonding benefits. This sounded like an amazing way to nudge a brand new Earthling into the crazy world. I had planned for lots of skin-to-skin time. Unfortunately, when your daughter is in an incubator and attached to wires and drips, skin-to-skin is not impossible but it is definitely not the dreamy soft focus vision that comes to mind.

For almost the same reason my plan for breastfeeding was foiled. Not only were the drips and wires an added layer of difficulty to an already challenging task, the level of privacy in a NICU is almost zero. For those who are lucky enough to never have been inside a NICU it is busy, bright and confined (some might say cramped), so when it comes to doing anything you are never far away from the next someone trying to do their own something. I had begun pumping from day one to get my milk going but the first time I actually tried breastfeeding was a few days later in the NICU, with only a rickety hospital screen shielding us from the rest of the bustling hospital ward.

It was all a bit too much for me, so I decided to wait for her to come home before I tried that again. Instead, I became a dairy cow. While in hospital, I would wake up every two or three hours, express for about 45 minutes, walk my small but precious produce to the NICU, a floor up and on the other side of the building, to be ready and waiting for Izzy’s next feed. A hospital is a lonely, and eerie, place at 3 am, especially when you are gingerly shuffling around in slippers and three-day old PJs.

I carried on with this routine until I left the hospital and then once home, through out the night, I would build a store of barely half filled little milk bottles, supplied by the hospital. Every morning I would arrive with my Tropika-branded cooler bag containing my stash of milk (labelled in Sharpie with name, date and quantity).

Another incident that caught me by surprise had little to do with Izzy and everything to do with post-birth hormone pandemonium. On the evening of the third day, Will had left to go home and spend some QT with our fur-babies, I was on my own and out of the blue a tear rolled down my cheek, then another, then another, then another. It was not a trickle, it was not a stream, it was a torrent of tears. So what would any self-respecting woman do – she SMSed her bestie for advice on how to turn it off.

As a mother of two she responded to say it was fine, don’t fight it, they will stop eventually, its normal and giving birth releases a roller coaster of hormones. Her advice was punctuated by the perfect summation; “Having a baby is not for sissies.”.

This interaction had a dual effect, one was relief that I was not going stark raving mad, and two, a fresh round of flooding as my bestie had recently immigrated to America and I was once again reminded why I needed her here with me, not 2000 leagues over the sea in stupid Palo Alto, I mean FFS WTF.

Yet another plan thwarted, the plan to have an experienced and composed best friend nearby to hold my hand, had to happen virtually not physically.

In fairness, not all plans that went awry upset me – for one thing, we never so much as witnessed (never mind tackled) the dreaded tarriness of a baby’s first poop – called meconium. I for one do not feel less of a parent for dodging that bullet.

The NICU is a place of complicated and unpleasant feelings. But perhaps the most loathsome feeling we had as parents in that room was something I can’t label but was akin to gratitude tinged with smugness. We were by far the luckiest parents in that room, Izzy was never on a ventilator, feeding tube and her complications were seemingly benign compared to some of the other baby’s. Therefore it was hard not stare and try to imagine what the family next door or across the ward were going through and thank our lucky stars that our baby’s suck reflex was strong, that I had had steroids so her lungs were strong and that she was only four weeks early versus eight. Seeing others even teenier than our little spider monkey with ventilators covering their mouths, feeding tubes snaking into their noses in addition to the monitors and drips was almost too much to look at but at the same time, morbid curiosity meant we did.

The day Izzy was released could not have come sooner, my husband and I were both struck by such relief to be away from the distress of the pediatric wards, it is a place where a group of strangers together simultaneously experience the worst and best moments of their lives all the while isolated in their own little biome of hope and despair, anguish and joy, grit and helplessness, self-control and vulnerability.

How ironic that in less than 48 hours we would be begging to return our daughter to the familiarity of hospital and the protection of its trained professionals.

Plan for Nothing to Go To Plan (Part 1: The Birth)

Izzy is now 15 weeks old and it feels like those 15 weeks have been the longest of my life. Especially when I think back on all that has happened in just under four months, almost all of which did not go according to my perfectly laid out plans.

On 29 June 2016 Isabelle was born, via emergency c-section, four weeks earlier than expected. This was due to a failing placenta which sent her into distress as she wasn’t getting enough oxygen. I was already in hospital after being admitted four nights earlier with a bad kidney tract infection that had caused preterm labour. Doctors tell me the two were unrelated and actually, it was lucky I was in hospital and being monitored so the distress was caught early.

On the Saturday I was admitted with the kidney tract infection, I discovered my Gynae was away for two weeks, so now I was meeting her replacement, a lumbering bear-like elderly man with the bedside manner of a tactless bulldozer. I had never been to a male gynaecologist. And only one other man had ever been “down there” – my husband. Having suffered from a disorder called Vaginismis (a whole other story for a whole other blog), examinations are difficult at the best of times. However, on being told of my disorder, my new doctor misguidedly thought an inordinate amount of lube would solve the problem of any discomfit – it didn’t. Having my cervix checked in my bed in the labour ward, where all that seperated me from the three other pregnant women and their families during visiting hours was a thin blue curtain, was a definite highlight.

Despite any of his shortfalls, I have to say he was dedicated, thorough and available. I don’t think I could have been in better hands even with my actual doctor.

Anyhow, on the day I was told I would be going home, I had my usual 5am tracing (a test of the fetal heart rate and the uterus wall) and I could tell after 15 minutes the nurses were concerned. A short while later they began the test again but now for an hour (I had only ever had it for 15 minutes), so for an hour, I tried to remain calm playing Candy Crush because when my heart rate went up so did the baby’s. After an hour the doctor reviewed the results and had me wheeled down to his rooms ASAP to have an ultrasound. On a side note, my unshakeable doctor kindly used a bottle warmer to take the edge off the lube and in his haste to get the scan going he squirted the melted gel all over me (face, hair, chest and most importantly tummy). But who cares, we all wanted to know what was wrong and one Robyn Williams impression from the movie Nine Months wasn’t going to distract us for long. The scan did not deliver good news. So, instead of going home, I was told that in a 1 hour I would be going into surgery. In 1 hour and 15 minutes I would be holding a baby, my baby.

My response to this news was to ugly cry with fear, shock and the fact that this was not the way it was supposed to go. I had a plan. I mean for goodness sake the nursery wasn’t even finished. I wasn’t going to be able to shave my lady bits at home in the privacy of my own bathroom. I hadn’t yet packed my hospital bag nor her hospital bag. I hadn’t wrapped up at work – who would facilitate the workshop I was meant to be running in two days? How could my daughter be a Cancerian, she was due to be a Leo like me? Oh, the things your stupid brain thinks of when you are freaking out.

Thankfully my husband was with me that day and my sister arrived for moral support soon after I got the news. I was wheeled into theatre without having seen or spoken to my mom or dad as they got there too late. The speed at which the surgical team (Gynae, assistant surgeon, nurses, anaethetist and paediatrician) were mobilised was incredible, and an indication of the danger.

On another side note, at one point I looked over to my left and noticed a teenage girl in scrubs, only to be told this schoolgirl would be observing my c-section as part of a job shadowing programme. Of course she would, why wouldn’t my surgical team include a 17 year old red head with no medical experience? Anyone else want to watch me at my most vulnerable and exposed, how about the guy with the sweetie and sandwhich trolley?

The actual birth was incredibly quick once the spinal block was in effect. The most time was spent stiching me back up. Once again, my plans were chucked out the window. I had envisioned my daughter being placed on my chest, skin to skin, and she would stay there all the way to the maternity ward. Instead she lay on my chest for three minutes before she was whisked away to be examined by the Paed. Her apgar scores (a standardised measure of a newly born infant) were excellent, we were told they wanted to take her to NICU briefly for a blood sugar test. My husband went with her. Twenty or so minutes later I was wheeled into the recovery section, where my husband found me. Our daughter would be staying in NICU for a couple of hours, but they would bring her down to me as soon as they could. So, off I was wheeled to the maternity ward, without a baby.

After several hours, my husband went to find out where the baby was. Bad news. Her blood sugars were all over the show, her platelets were low and she had an infection, which would need intravenous antibiotics. The doctors were worried, not very worried, but worried enough to make us VERY worried. We were told that she would need to be in NICU indefinitely – maybe three days, maybe three weeks.

Again my plan of having my tiny bundle of joy in a basinet next to my hospital bed on her first night on earth was foiled. We didn’t even have a name for her yet as we hadn’t really had a chance to meet her properly.

So, for her first night in the world, Baby Tayler slept in a machine, attached to wires and drips, lulled by the sounds of beeping, under the watchful eye of a stranger, her nurse Patience.

Definitely not the plan.