I’ve had a recent discussion with a patient about if she should get an EPIDERMAL at delivery. I told her she shouldn’t get an EPIDERMAL but she may want to get an epidural.

Many women want to know if “natural” birth, without pain medication is better than if they get pain medicine. I can unequivocally say that both are good ways to deliver. Although an epidural may slow down labor it does not increase the chance of getting a c-section nor does it “hurt” the baby. Pain management in labor is a personal decision, one that is as individual as the baby you deliver. If a woman wants a “natural” birth without pain medicine more power to her, but if she tries and because of the pain wants to get an epidural she shouldn’t feel as though she failed. Every birth is a miracle regardless of pain medicine used.

Do you remember the Seinfield episode where Jerry couldn’t remember the first name of the girl he was dating? He knew her first name sounded like a female body part. Throughout the whole episode he was trying to figure her name out. He tried “Mulva”, and just as the episode was ending he remembered…”Deloris”.

Every day I here parents trying to figure out what to name their newborn babies. Some people choose family names, others choose unique and interesting names and others choose names that are easy to spell (true story, my mother chose my name this way). My wife and I chose our boys names because she is Irish and we wanted to have some interesting Irish/English names (Brayden, Quinlan, and Remington).

In yet another classic Seinfield episode, George chooses a name for his preconceived child…seven. Much to his pain, one of his friends liked the name enough that they were going to name their baby seven. George spends the episode trying to convince them that he is the only one that can use that name. Names are personal for a mother and father, so much so sometimes that they cannot see the ramifications of naming their child something ridiculous. Examples follow:

• Twins orangelo and lemongelo (orange Jell-O and lemon Jell-O)
• Placenta (this is afterbirth)
• Chlamydia (an STD)
• Gonorrhea (another STD)
• Syphilis (yet another STD)
• Y2K
• ESPN (men, don’t suggest this if you want to even try to have another child)
• Lasagna
• Starsky
• Vodka
• Elmo
• Meconium (a babies first bowel movement)
• Pee Wee
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I was just recalling a funny story while in residency. One early Tuesday morning a family came into L&D and checked in. The husband looked terrified and was carrying his wife’s bag over his shoulder. He set the bag down at the check in counter and nervously presented his insurance card to the secretary and said in a cracking voice: “We are here for my wife’s seduction.” I laughed to myself and thought, “I hope he means induction or we are in a lot of trouble”

This brings up a point that a lot of patients ask me about: inductions. Are inductions safe? Should I have an induction? What options do I have?
There are two types of inductions: elective and medically indicated. Medical indications include, maternal and fetal reasons. There are a multitude of medical indications. Some women have to deliver because their baby could be hurt if it wasn’t delivered. Other women have to deliver because they themselves are at risk.

The medical community or laypersons rarely question medically indicated inductions. Elective inductions on the other hand are a different story.
In my humble opinion elective inductions are legitimate options for women, if done properly. Properly you may ask, what is a proper elective induction? One in which a women is informed about all of the risks and or benefits associated with the induction.

In this age of medicine where people can electively choose to enlarge or change their body parts, electively choosing to deliver should be a legitimate option for all women if they are educated about all of their options. As long as it is safe, a woman should be allowed to deliver or not deliver, that is the answer.

Recently I asked a patient “What medicines do you take?” She replied “nothing.” Upon further interviewing her it came to light that she was taking an over the counter multi-vitamin and an herbal supplement she had bought at GNC. When I asked her why she didn’t tell me about these things when I first asked she said, “because, they were not prescribed by a doctor.”

The FDA has the same thought; it doesn’t regulate the OTC medicines, vitamins or herbal supplements to the same degree as a prescription drug. Some products are considered “dietary supplements” and are not regulated as stringent as a prescription drug. Why is this important? Two reasons: first, even FDA approved prescription drugs can have a downside i.e.…vioxx the cox-2 inhibitor, and second, a persons perception of the “medicines” they take can be detrimental (What you don’t know can an will hurt you).

What is my point? First, tell your doctor everything that you take that could be a medicine because many OTC supplements can have harmful interactions with prescription medicines. Second, don’t be fooled by the allure of being “natural”. Too many people think that the pharmaceutical companies are evil and the best medicine for their body is the natural stuff. Please, trust your doctor. We have taken an oath to help our patients, not to hurt you. Even if you think that the pharmaceutical companies are making bad drugs remember they are being controlled more stringently than the companies that make the so-called “natural” stuff.

We have all heard the old adage, "If it sounds too good to be true it probably is." This applies to all facets of life including in medicine. While we are making advances in all areas of medicine, people are expecting more and wanting results faster than ever before. Our "fast food" mentality is easily influenced by false promises of quick and easy results.

Weight loss is prime for the "snake oil" salesperson. Don't get me wrong, obesity is a huge problem in this country (no pun intended). A large majority of the diseases that cause our early demise (diabetes, heart attacks, strokes etc.) are increased or made more difficult to treat because of obesity. There are two main reasons for weight loss or gain: calories in and calories out. How many calories we take in is the "fuel" for our engines to burn. The calories we do not burn, we save in fat cells for the proverbial rainy day. The calories we burn are linked to our genetic make up. If you want to loose weight, then you have to either take in less or burn more (exercise and diet).

There are a plethora of diets (Atkins, Ornish, low glycemic index etc.) and each one may work. Every woman's body is different and may respond to one diet better than the next, but the key is: calories in and calories out. In studies, a physician observed Very Low Calorie Diet (VLCD) has been successful in helping people loose weight without surgery. Weight Watchers diets have been studied and have been shown to help women loose weight and keep it off. Which one should I choose? My response: any as long as you do it smart. Ask your Dr. and don't go for the quick fix.

We all want the quick fix. "I wish I could have a pill that would do it all." This is a fantasy! There are no magic bullets. Studies are being done now to look at obesity genes, but no medicine exists that can do it all. Many women are coming in requesting hCG (human chorionic gonadotropin). This is a sham! There are multiple studies that show that hCG (oral, sublingual or shots) does not affect weight loss or well being (S Afr Med J. 1990 Feb 17;77(4):185-9., Br J Clin Pharmacol. 1995 Sep;40(3):237-43)

Body image, or more specifically a distorted body image is the opening that unscrupulous people need to push their products or ideas in the name of treating obesity. Buyers beware.