Saturday, May 28, 2011

Hate This/Love That: Bacteria Edition

Hate This:

Bacteria and I are not friends. Well, some bacteria. I have had a few nasty run-ins with some BAMF strains (Mom, don't Google BAMF), like Clostridium difficile, and Whatevertheheck causesUTIs. I highly recommend hand washing, food safety techniques, and using alcohol and/or bleach to sanitize stuff. Of course, I'll also tell you to skip antibacterial soaps containing triclosan, since that stuff will mess you up (and by you I mean your hormones).

So when I had two nasty colds in a row, and my sinuses were reaching critical mass after 3 solid weeks of abuse, I finally was diagnosed with a sinus infection and got those cool antibiotics that work in 5 days and are equivalent to 30 doses of regular antibiotics. Yay!

And naturally, since these things come in threes (note: most things don't come in threes), I was also recently diagnosed (today) with a UTI (yes, this is a third thing, because each of those colds counted as one thing). And I picked up even more antibiotics! A three-day course, this time.

As the infection slowly dies within me and those tiny, dead bacterial bodies are expelled from my vessel, all I can think of are the casualties of war on my side. You know, that other bacteria. The ones that are my friends. The ones in my colon. All they're trying to do is protect me from baddies like C. difficile and other nasty gut bugs, but they take it in the rear when antibiotics enter the scene (ya see what I did there?). That's why "diarrhea" (I am so, so sorry for using that word in this safe place) is almost always on the side effects list for antibiotics. Those good guys in your colon are keepin' you regular . . . and occasionally giving you gas, but you can't be too picky here.

With every one of those tiny deaths in my colon, I am more sensitive to evils that might attack, you know, my colon. Which brings me to the second half of this entry:

Love That:

Probiotics. I don't know why doctors don't prescribe them every time anyone has gut issues or takes antibiotics. I'm not sure how much they help during antibiotic treatment, but at least afterward they essentially repopulate your desolate colon after Hurricane Poopsalot or the Antibiotic Tsunami wreak death and destruction. Acidophilus and Bifidus are probably the most popular ones, but you can get all kinds of blends, and they are the good bacteria Red Cross. My favorites are (1) these chewables that taste like powdered yogurt, and (2) actual yogurt. A nurse once recommended Florastor, so sure, I'll plug that too. Just not with a link, because it's expensive. If you need me to help you click to it, you probably can't afford it.

Anyway, if you love your guts—and trust me, you LOVE your guts—you'll keep some of these around to keep them populated with a massive army of tiny protectors.

Oh, and today I also love my AZO at home UTI test strips. I'm not a huge fan of nonessential doctor's office visits, and I am a huge fan of knowing what I need to do and taking care of myself. It's an independence that comes once you get over giving yourself shots and start to think, "What do they even do at these checkups, anyway?" (Okay, they do plenty, but I can at least avoid anything unnecessary with a few tricks and a 24/7 nurse hotline.)

Anyway, I had some flipping awful back pain the other day. With no other symptoms for the pain, I decided to use a strip. Peeing on strips in a clinically appropriate situation is a hobby of mine. I got the high score for white blood cells! That's exactly what Charlie Sheen means by winning, I think. But at my OB appointment, my doctor said the pain sounded more pregnancy related, and my test there came back normal. They sent it off for a culture, and thank goodness, because apparently I am an infection machine. I wouldn't have questioned it if they said it came back with nothing (the back pain went away), but thanks to a penchant for pee sticks, I'm not letting an asymptomatic UTI turn into pyelophrenitis or pyelonephritis or whatever. Boo yah. Take that, UTI bacteria, I WIN!

Friday, May 20, 2011

Hate This/Love That: Name Brand Diaper Edition

Hate This:

I pretty much can't stand Huggies. I mean, their diapers aren't all that bad. We actually use Huggies wipes because they were the first wipes we used that didn't irritate Finley's adorable and sensitive behind. But the diapers tend to chafe, and I find them to be exactly the same quality as generic diapers, but more expensive.

But by far the worst thing they offer is their "Enjoy the Ride" "rewards" program. Trust me, they worked hard to earn those scare quotes around "rewards"; in spite of using these wipes for a year now, I have yet to get ANYTHING from it. Besides that, I am NOT enjoying the ride, if by ride they are referring to their ugly, badly designed website and their nonexistent rewards.Not only does logging every code require (a) three screens' worth of BS, (b) two modes of verification—where I bought the dang wipes and one of those illegible text filters—and (c) clicking a RIDICULOUS number of times, but redeeming the points is somehow even more annoying. I have options: sweepstakes, instant win, donate, and catalog. Since there's never anything under donate (seriously, these A-holes won't let me just get rid of these things to help March of Dimes in some tiny way), and the catalog only ever allows you to purchase coupons for more Huggies products, I choose "Instant Win." Translation: "Lose, but Not Before Watching Annoying Animation." I click several buttons to verify that yes, I want to spend my idiotic points on this. I watch the moronic animation. I lose. I click to confirm my loss. I have disposed of 2 points. There is no way for me to just dump in all of my points to just get rid of them. Even though the program they use to dole out "rewards" would hand out the same instant win/loss result, they get some kind of sick pleasure out of me watching a cartoon mom watch her ugly cartoon baby fart in a bathtub.

Thanks, Huggies. My "reward" for using your product is apparently the desire to smash my computer monitor. If anyone wants my Huggies points, I will email you the codes, and where I bought them. The anti-robot code and Huggies BS is up to you.

Love That:

I can't get enough of Pampers. I love the diapers, and how they're super soft on my baby's super soft skin. They're the only diaper that never leaves nasty crinkle marks. The newborn ones have mesh that catches meconium nicely, plus a wetness indicator so I can keep baby dry. The sizes above are (like the newborn ones) super absorbent, soft, and of the utmost quality. We switched to cheaper Luvs for a while, but when I realized that through Amazon Mom I could switch back to Pampers for only a few bucks a month, I did it in a second. Admittedly, it was mostly because the Luvs have a perfume that was driving me nuts, and Pampers smell fine to me.

The rewards program, "Gifts to Grow," is fantastic. The website is easy to navigate, the points are SUPER easy to enter (I can even enter multiple codes at once), and the rewards are fantastic. They have donation options, toys, shutterfly packages—that's how I'm getting baby girl's announcements printed!—everything actual moms actually want. And you actually get things when you spend your points. You can even choose to buy multiples of most things if you want to use more points. It's like shopping, instead of like a torturous trip to a gas station in the middle of Hell where you have to scratch that nasty silver crap off of hundreds of little cards to find out you've won NOTHING—oh sorry, I stopped talking about Huggies "rewards" earlier. Anyway, Pampers rewards can be used to actually purchase things you want.

And they're not stingy with them, either. I have plenty of points to get those baby announcements, and by the time I buy them I will have enough more for maybe some cute thank-yous or at least a small donation to a charity that helps kids. They give away points through their Facebook page, through extras when you purchase, and as freebies in registry packages. They're not kidding; there are actual rewards to buying Pampers besides putting something soft on your kid's butt.

While no diaper, no matter how hard it tries, can stop the most horrible of inevitable blowouts, and in that respect all diapers may be equal, I choose Pampers for superiority in every other way. Well, except price. They're the most expensive mass-market diapers you can put on your baby that you have to throw away afterward. Still, to me the few bucks a month is totally worth it.

Oh, and as an aside about Pampers wipes: I love them. The boy may be allergic to them, but I used what was left in the pack to remove makeup or refresh my face. They're fantastic as far as wipes go, with an actual weave to them instead of being like thick, wet, quilted TP. So if you see me in Target buying some, it's because (a) I'm hoping baby girl isn't allergic to them, or (b) I ran out of face wash and they're just so . . . nice.

Monday, May 9, 2011

Makena Drama: I Will Never Escape

It almost makes me sick to be dealing with this yet again. I confirmed with my doctor's office that the FDA was allowing compounders to create 17P (hydroxyprogesterone caproate), and asked my CVS/Caremark pharmacy not to send me another $100 (copay) refill for the last 5 shots of Makena. After all, why spend $100 (and let my insurance pay KV Pharmaceutical) when my compounding pharmacy could produce the same drug and make a profit with just me paying them about $35 for the same amount?

I have had a bit of a cold, so I put off calling my local specialty pharmacy until Friday, thinking they could get the drug to me by Tuesday, when my 32-week shot is due. Last time they filled the scrip it was the same day I brought in the order. The pharmacy rep told me that they could no longer compound 17P. "Aha!" I said, "but the FDA reversed that decision, and now compounding pharmacies can make 17P!" Seriously, am I the only person in Colorado on this drug? And then the other government issue shoe fell.

She told me that the Colorado Board of Pharmacy would not allow them to compound it. I looked up the board—it's the state pharmacy licensing agency, responsible for (a) licensing, and (b) enforcing laws through licensing, not licensing, revoking licenses, etc. They're not a legislative agency, so I was confused as to how they'd have anything to do with me and my 17P. Naturally, since I have nothing better to do, I called the state professional licensing organization and they connected me to a very nice man at the Pharmacy Board.

He directed me to the Colorado Revised Statutes (i.e. Colorado legislation), namely CRS 12-22-121(18)(c):
(I) A prescription drug outlet shall not compound drugs that are commercially available except as provided in subparagraph (II) of this paragraph (c).
(II) A pharmacist may compound a commercially available drug if the compounded drug is significantly different from the commercially available drug or if use of the compounded drug is in the best medical interest of the patient, based upon the practitioner's drug order, including, without limitation, the removal of a dye that causes an allergic reaction. If a drug is compounded in lieu of a commercially available product, the patient shall be notified of the fact.
Translation: unless I'm allergic to the commercially available form, I HAVE to buy it.

It's really not a bad law. It's made to protect manufacturers from compounding pharmacies simply stealing away business by making whatever drugs they want. When you look at the way most drugs go through the processes of creation, approval, patenting, going generic, etc., it makes total sense. This whole Makena thing is just so F'd up that the only way for the commercial drug to have competition was through compounders, since no other commercial options are available. The drug is over 50 years old!

The problem stems from KV Pharmaceutical "developing" a drug that already existed, and from the FDA's promise of orphan drug status that would give them a monopoly. Orphan drug status, of course, only goes to drugs that affect a small number of people. Thanks, FDA, for screwing those of us in the minority with the "rare" problem of preterm labor. At least they shaped up in the end, but unfortunately I am still screwed into getting another rush order of the expensive stuff.

I'm going to say that if KV couldn't make the drug at a competitive price, they shouldn't have made it in the first place.

I continue to be baffled by the high price of Makena. I get the difference between the compounded version of hydroxyprogesterone and the commercial version: KV Pharmaceutical is mass producing the drug, ensuring that dosing standards are met exactly, and regulating the quality of the drug. Mass production is usually a cost-saving measure. It's because of mass production that factory-made items are less expensive than hand-made items. Efficiency cuts costs.

But what if mass production isn't efficient and doesn't cut costs? The high price of Makena is a result of one or both of two things: price gouging because Makena had the "orphan drug" monopoly that eliminated competition, or high production costs, meaning Makena is produced less efficiently than at compounding pharmacies. If it's so expensive solely because of inefficiency of production, then we need to look at whether the dosing and quality regulation they do is really worth the added expense over the dosing and quality control individual compounders do. Certainly compounders are held accountable for any mistakes, as was made clear when the FDA began to allow compounding pharmacies to compete with Makena again so that women could get this important drug. Essentially they said that though they'd allow pharmacies to compound the "orphan drug" without punishment, these individual pharmacies would still be held accountable for the safety, quality, and sterility of their products. I don't know about you, but I trust a smaller local firm with a lot to lose over a giant pharmaceutical company that has a lot more resources and power to fight or hide anything substandard in their product.

So the benefits offered by Makena, in all its commercial glory, have debatable value. No, since the FDA seems to think the commercial production is valuable, I'll say they have definite value. But shouldn't the consumer be able to decide how much value? Can't I say how much mass production and standardization is worth to me? It's not worth as much as Makena costs, that's for sure. And now laws that were made to protect both consumers and drug companies from knockoff drugs are keeping me, yet again, from getting the meds I need at a fair price.

Sunday, May 8, 2011

My Mom

There are lots of moms out there, of lots of different types. There are moms who can cook anything, and my mom can do that, though by the time I could appreciate an excellent meal without flopping down at the kitchen table and saying "EW!" my father had taken over much of the cooking so my mom could get her business degree.

There are moms who are smart, and my mom has always been one of those. Shockingly so. She has the ability to think critically, analyze situations, and make plans of action like nobody else I've met. I used to help her study for classes by drilling her with her own notecards as we drove around town, and as a result my understanding of economics was quite well established by the time I hit college. And that's not the only thing my mom taught me. She is singlehandedly responsible for my knowledge of algebra (though that was more of an endurance/persistence/patience effort than intelligence on her part), and actually got me liking math. I mean to the point that I would do it in my spare time, and wound up actually enjoying multivariable calculus at 16. Enjoying it. And I'll lay that squarely on my mother's shoulders.

My mom was ahead of her time in mothering skills. She practiced attachment parenting before it was cool, and fostered our intellectual growth at home both before we entered formal schooling and after. She read my brother and me books and helped us participate in sports and learn musical instruments. She put us to work around the house and showed us how to clean, cook, gather kindling, prepare firewood, and start fires (in a totally safe, non-arson type way). She took us outdoors and showed us birds and animals and crazy awesome dangerous nature things. She taught us to stand up for ourselves and others, and to keep values that were difficult or unpopular growing up.

You'd think a mom with outdoors skills and brains and patience wouldn't be one a girly-girl either, but my mom was. She taught me about makeup and skincare and proper nail painting techniques. We still sometimes get to shop together for clothes or makeup.

And that's the part of my mom I discovered as an adult. She is a fantastic friend. We watch reality TV together, shop together, eat together. We discuss books and news. She is always, always there to help me when I need it. She is interesting and thoughtful, so we never run out of things to talk about. She is a good advice giver, but knows when not to advise. She is generous with everything she has.

Her mother could have named her Prudence or Hope or Charity or any of those other somewhat terrible "value" names, but instead she named her Rose. Roses are beautiful and strong, with thorns to protect themselves and solid roots to grow tall. They climb toward light, and bloom so fantastically that no other flower quite compares. Of all of the good things my grandmother could have called my mom, I think she picked the most fitting name, because my mom truly is a Rose.

Friday, May 6, 2011


Sometimes it feels like my life is falling apart. Other times, it just feels like the stuff I need to live my life is falling apart.

Like Saturday, when I had a lovely trip to the zoo with my family and friends, and came out to find my windshield broken by a stray golf ball. And by "stray," I mean it was irresponsibly driven across two lanes of traffic, a superwide ramp down to a parking garage, and the fences/nets put up by the golf course—oh wait! there weren't any!—into the car we traded down to to get rid of our car payment. You know, because we need that money for the baby we're expecting in about two months.

I would've loved a "golf course nearby" sign. Or maybe even three feet of fence over the parking lot wall that would have saved me from this whole problem. Instead I got a nasty windshield replacement bill, and a lesson to purchase a lower deductible plan for my auto glass, because I have zero control over what happens to it.

And Sunday I got Finley's cold. It took him a solid 3-4 days of fever to start showing symptoms, but it hit me like an unwelcome golf ball when in the morning I woke up with a massive headache, sore throat, crapped out sinuses, and a really tough time speaking. I figured a couple of days would see me through the worst of it, and by Tuesday I really felt awesome for my 30-week check up (all is well, baby is good, and even a very on-time delivery is starting to loom close enough to make detailed plans for).

Naturally after the doctor's appointment high, my cold fell right back into place. Super. So that second thing I need to live my life, that is a face I can breathe through, is totally broken too.

Then, at 11:30 PM tonight, when my very average sized husband threw himself exhausted onto the bed, the bed riser broke. And it scraped the crap out of our bed leg. AND it somehow pulled a screw out of the bed and discombobulated the entire corner support. Unfortunately since most of the storage in our house is under that bed, and it's not exactly bed-riser season at Wal-mart, I had to use my superhuman pregnancy strength to recombobulate the bed corner and find the exact right old textbooks to prop up the bed leg so we could at least sleep for the night.

Here's my crossed fingers and toes hoping it doesn't collapse again before we can get it more permanently fixed.

My windshield, my face, my bed—this is starting to seem like either a really weird dream or a set of nasty omens. Or on the other (and more likely) hand, it probably seems that way because of the congestion-interrupted sleep I've been getting (and not getting).

But fortunately, the thing that isn't falling apart is my happy little fetus and her well-sealed home. My stretch marks are definitely growing, but the fantasy of an eventual tummy tuck is enough to comfort me (who knows if that will actually happen). By biggest pregnancy worry is VBAC or repeat CS (yes, they do both suck), and that's simply fantastic. Also fantastic is having the strength and ability to walk around for hours, play with my son, and occasionally have a night out with the hubs. Some things might be falling apart, but I, for once, am not.