Saffron

etta166 Wrote: ------------------------------------------------------- > I wonder if the reluctance to introduce another > vaccine into the childhood vaccine timetable has > anything to do with the MMR scandal? Yes, it is a legacy of the Wakefield scandal. The NHS openly admitted that public trust in the vaccination programs was also a major problem/concern when recently introduing the whooping cough vaccine, and it is also probably one of the reasons holding back routine administration of the shingles vaccine. So even though the NHS robustly jumped on the anti-Wakefield bandwagon (and rightly so), it is nevertheless allowing itself to be manipulated by his legacy. The chicken pox vaccine can and does save lives and prevent hospitalisations (as does the shingles vaccine). If people don't want their children to have the vaccine I do totally and fully respect that. However, since a safe effective vaccine is available, the NHS should provide parents with the choice. As it is, people who can't afford the vaccine are unfairly punished in this. The argument that administering CP vaccine universally across the UK would result in an increase of shingles cases can be easily negated by simply offering adults (who have previously had CP) the shingles vaccine, which safely and effectively reduces the incidence of shingles and its severity. We can talk statistics till the cows home, but it's not totally about numbers, is it? Let's face it, people play the lottery --presumably hoping to win-- on stats much narrower than those for the complication rates of CP. CP and CP-related complications are not just about statistics. They're about biological relevance. As an esteemed colleague of mine says, "How many times do you have to cut the head off a chicken to prove it's dead." So my point is, that even though it's rare, children do die of CP. The statistics may not seem impressive, but to the parents of that dead child, the statistics hardly matter do they? Would you tell those parents that they're "over-emphasing" the issue? I also find it illogical to say that just because hospitalised children make a full recovery, that we don't need to be concerned with preventing their hospitalisations in the first place. For example we don't say that because most people recover from car crashes that we won't try to prevent motorway collisions. And we don't say that because children with broken bones usually heal with no permanent damage, so we won't try to prevent broken arms. That mercola link is 3 years out of date, and it's the first thing that pops up on Google when you enter 'shingles epidemic'. Hardly what can be referred to as well-researched. I'd be happy to read what Ben Goldacre has to say about it, if he'd care to publish it in a peer-reviewed journal. After reading the facts for themselves, not everyone will choose to take the CP/shingles vaccines, but they should at least be made aware of their availability. The CDC webages are a good source of information on both CP and shingles. This non-scientific article also provides good summary information, along with the citations for three recent journal articles from JAMA and the J of Int Med: http://www.examiner.com/article/increasing-incidence-of-shingles-is-easily-preventable-vaccinate. xx

I found the websites very confusing, plus some nurseries will try to bend the rules to their advantages. Phone and speak to the Family Information Services for the area in which your nursery is. For example, if you live in Lewisham but the nursery is in Southwark, it's Southwark FIS that you need to contact. I also found FIS were quite good about getting back to me on email. Contact info is on the website, eg http://www.southwark.gov.uk/info/926/advice_and_support_for_families/545/family_information_service/1 . xx

If people don't want the CP (or other vaccines) it is their right not to do so, which I respect. However, I've come across many parents who would have had their children vaccinated against CP, but they were not aware that a vaccine is available. I'm disappointed that not only does the NHS not offer it, but it doesn't even try to make parents aware of it -- and I do find that hard to respect -- Especially, as I stated previsously, the reasons for not doing so do not appear to be medical. Despite the fact that most children will make full recoveries from CP complications, they would indeed not have required hospital admission at all if they had been vaccinated. If the medical oath is to do "no harm", the NHS in its medical capacity does parents a disservice by not offering, and not making parents aware of, the CP immunisation. http://www.cdc.gov/chickenpox/vaccination.html http://www.cdc.gov/vaccines/vpd-vac/varicella/unprotected-story.htm

Lewisham has also been offering the BCG to under-1s, but I'm not surprised that not everywhere is offering it b/c it isn't the best way to fight TB on a population basis. As of a couple years ago, the stats were such that ~10,000 children needed to be vaccinated with the BCG to prevent 1 case of TB. However, research has shown that the far more effective way to control TB is to target it at its source by improving housing and hygeine for vulnerable populations, eg the homeless or people living in overcrowded unsanitary conditions, as well as chronic drug users. The medical reasons for giving the BCG to infants are that it protects against miliary TB (a particularly damaging and difficult to treat form of TB infection where TB spreads outside the lungs to other organs of the body), and that it protects again TB-related menigitis: both of which are life-threatening conditions for infants. This is common medical knowledge, which can be found in many places including the WHO website, so it's a little surprising than a GP would not be aware of this. The BCG gives 60-80% protection (depending on which studies / what populations you observe) that lasts for ~15 years. This is also common medical knowledge. So even if you had the BCG as a child or teen, if as an adult you have been in direct contact with TB infected individuals, you should have a Mantoux test which is diagnostic of TB. Indeed many coutries rely only on Mantoux testing and do not offer the BCG. This appears to work well incombination with improved living conditions and hygeine for vulnerable populations in first world countries. However, for many poor countries where TB is endemic, the BCG though not fully effective is still the best line of defense for preventing miliary TB and TB menigits in infants.

Relatively mild compared to what? The course of chicken pox is potentially more complicated than mumps. Chicken pox, even in healthy children, can lead to auto-immune encephalitis. And the generally help rule that chicken pox is worse for adults than children has many exceptions. That the NHS has failed to universally offer immunisation against varicella is due to a complex list of reason, very few of which are actually medically based. The US CDC website pages are a decent resource for more information on the vaccine itself and vaccination schedules.

That sounds like a good plan. xx

Would it help to phone NHS direct? You can ask for advice not only about treatment itself, but also about how to work the system. For example whom to contact, and exactly what to say to get seen as soon as possible. NHS direct: 0845 46 47. xx

The NHS has a mandate to vaccinate under-1s with BCG, and it's no longer routinely given to teens. The vaccine itself only has between 60-80% efficacy, with decreasing efficacy in older children and adults (that's why the age was moved down from teens to under-1s). One reason for this may be that increasing environmental exposure to mold/fungus with age develops an immune response that has some overlap with TB immunity. Many countries do not give the BCG at all, and instead rely on latent TB testing. However, due to the presence of TB in some London populations (mostly the homeless and chronic drug users), the BCG is being offered by the NHS to under-1s in order to provide protection against miliary TB, a particularly damaging form of TB in infants. This vaccination is at your dr's discretion, and you can still have it given to your child, even if she's a little older than one-year. You can also choose not to have this vaccine, if your child is not in contact with any high risk populations. xx

Print this out and take it with you to your GP or the A&E: http://www.ncbi.nlm.nih.gov/pmc/articles/pmc1488905/ Demand to be seen or immediately referred to someone who actually is familiar with the guidelines for treating major clinical depression during pregnancy. Untreated depression itself poses a risk to the foetus. You need to be seen immediately by someone competent. (In fact, print out this whole thread and take it with you to the drs!)

I'm looking for some inspiration, Forumites. I need recipe ideas for rice-based dishes or maybe a recommendation for a cookbook on rice. I'm looking mainly for savory/mains dishes that are child-friendly and easy to cook. Luckily Little Saff is pretty adventurous with flavours, although she's not keen on hot chili spices. Any idea/suggestions welcome! :)

There is also a lovely toy shop in Brockley, which doesn't have quite the price mark up as LL. It's called Gently Elephant, near Brockley Cross, just east of Telegraph Hill. It's a shoe shop, but they also sell toys. xx

susyp Wrote: ------------------------------------------------------- > thanks brilliant advice here. mirena coil not an > option either sadly. There is a new low-hormone IUD on the market in the States. It's being offered under the trade-name 'Skyla'. http://www.huffingtonpost.com/2013/01/09/skyla-iud-intrauterine-device-_n_2442434.html

Hi MrsS, sorry to hear you're having a rough time. Major depression during or following preganacy should not be left untreated to just hope for the best. I think you should go back to the A&E and demand to see a different doctor. I disagree that it would have been bad practice for the locum psychiatrist to prescribe you medication, citing "not seeing you again" as reason. As it stands, she's left you with a major medical condition (and make no mistake, depression is a medical condition) and no treatment. That's tantemount to negligence in my opinion. I think the psychiatrist has failed you in her duty to care. Despite the fact that she was not going to see you again, she would have been perfectly capable of making a written correspondence with your GP and midwife. That's very shoddy service, and she should be ashamed of herself. Did she even try to assess your depression? There is a straightforward self-assessment questionnaire she should have given you. Something similar happened to me postpartum, and it makes me very angry that highly vulnerable individuals like pregnant and postpartum women with depression get the brush-off. Do you have the means to see a psychiatrist privately? I can highly recommend Dr Jeremy Pfeffer, whom I have seen personally before my pregnancy and postpartum, office tel 020 7935 3878. He practices out of central and north London locations. Consultations are not cheap, probably in the region of ?500. However, in both instances that I sought his help, I was able to have a single consultation, followed by him writing a detailed letter to my NHS GP to recommend a course of action. Also, don't feel pressured into CBT if you're at a point where you don't feel comfortable with it. CBT is very highly recommended because there has been a lot of research on it to say that it's a good and effective therapy. BUT, if it's not your bag right now, then pressuring you to try it could just end up being really off-putting. Plus, there are many other types of therapy available. Finally, as a stopgap measure (or as additional support) would you be willing to try some acupuncture? Complementary therapies, like acupuncture, can also help you stay on the lowest dose of meds if you do end up needing them. I can personally recommend Giles Davies who practices out of consultation rooms in the ground floor of his home at 15a Barry Road: http://www.gilesdavies.com/contact.htm . Giles and his wife have grown children of their own, so he is very understanding about pregnancy and family issues, as well as being an excellent acupuncturist. Please PM me if you want to talk or want any more info. xx

Just to clarify, I don't mean I've distanced my myself (and my daughter) from people who have different beliefs. I mean that I've distanced us from people who have said one thing to my face (or a mutual friend's face) and another behind our backs. I was just using religion (or lack thereof) as an example, as it's a common point of reference. What I really struggle with are hypocrites. Imagine what they might say to your child behind your back?!

Although, if you* respect someone, you don't generally rubbish them behind their backs! That was my point. If you really don't respect what they're doing, maybe you should consider why you're friends with them? It just seems weird to me, like back-biting. Not the kind of people I want to have around my daughter. This has been a difficult one for me personally because I've had to distance myself from people I thought were my friends. But everyone copes differently, I guess. *(Not you personally Bouncy, just general 'you' ;-) )

Although if rental fees are too high, this also effectively changes the availability of rental properties, no?

Huguenot Wrote: ------------------------------------------------------- > Houses are for living in. > This is not shoes or toasters. Hilarious and true! Non residential ownership, and ownership of multiple dwelling come up repeatedly as issues, and yet nothing ever seems to be done to address these. As LM says, it's a difficult issue. And a complicated one too. Sometimes I wonder if the complex nature of this issue is what prevents it being tackled proactively. Perhaps small changes over time would be better than any wholesale intervention?

uncleglen Wrote: ------------------------------------------------------- > There is a big difference between people who are > 'in the mire' and can't get out- and those that > choose to live off benefits and in the black > economy. (There is even someone proffering cash in > hand work on the general forum today) > The government are well aware that there is > wholesale fraud going on of the benefits system > and they may be using a sledgehammer to crack a > nut and people will suffer but otherwise there > would be a free for all. I still don't follow how that's connected to rental prices. So you think government corruption is holding back intervention in the housing market?

Church / no church wedding, kids/no kids at ceremony, christening / no christenting, meh. Lapsed. Whatever. We're not a religious household, but I'm fine with other people celebrating in whatever way suits, even if I don't personally 'get' it. It's their day, not mine. However, I have a harder time getting my head round this: People who don't believe in church/christening/etc, but still attend others' ceremonies and fawn over the bride/children/etc while secretly thinking the whole thing is stupid. Why go at all? I find that confusing. Who is the bigger hypocrite, the lapsed Christian, or the fake guest? (I think this is why Mr Saff hates weddings and will try everything to get out of going like a dog avoiding his bath!) Hmm, I guess that's something I have to work on accepting too.

LondonMix, that's a fascinating analysis. I hope there's a middle road in there somewhere.

LondonMix Wrote: ------------------------------------------------------- > The problem with some of H's ideas is that they > would spell the end of the rental market. House > prices would be lower, no doubt but renting would > be impossible unless it was carried out by the > government. I'm not sure that a city as dynamic > as London really could manage without rental > housing. Not sure I follow you. Can you elaborate on how the rental market would be killed by this?

True, BUT, blind faith and acceptance are not always two things that naturally go together.

The comment could also be attributed to a generational gap in values and attitudes on the part of the ladies at the other table. Wasn't it mentioned that they were in their 70s? Perhaps they deserve to be cut a little slack for their age/generational differences? Or perhaps they were just a couple of idiots. I can't say, because I wasn't there. It's just a thought.

uncleglen Wrote: ------------------------------------------------------- > You have led very sheltered lives if you do not > know, or have not heard of anyone who claims > benefits and also works for cash in hand. There > was a BBC undercover programme some years ago > about a clothing manufacturer somewhere around > Mile End and the superviser used to allow the > machinists time off to go and sign on!- Suited him > because he could pay low wages Be that as it may, it doesn't at all answer the question I posed previously. Which is... "So the idea is that moving them [unemployed people] out of London will free up housing stock? But is there any evidence that freeing up housing stock [in this way] would make it any easier for new graduates and first-time buyers to buy a house? (If indeed buying a house is an admirable goal for any number of reasons mentioned above...)" You see, with renters unable to save enough money for deposits, even if housing stock becomes available, what's to stop wealthy buyers from purchasing multiple homes then letting them out again? Cycle repeats. I think Huguenot had some very interesting suggestions. So then, the question is, What's holding London back from making these changes? (You can hardly claim that the unemployed on benefits are holding us back from making tax changes for owners of multiple dwellings!?!)

Just tell her honestly that you think the girls don't get along, and they should spend some time apart to avoid conflict? Otherwise, you could try a radically different approach. Turn the tables? Invite them for a playdate at your house. It's your house, your rules. Be very strict about observing and correting/admonishing any behaviour you don't like. Just make sure you apply the same standards to your own daughter as well. Why doesn't the other lady like her daughter's friends? Do you not get on well with the mother either? (You perceive her as manipulative?) Just curious.