160. Cancer Phobia

A few months ago Helen's mother passed away from ovarian cancer; several years ago the mother had undergone surgery for breast cancer.  Most breast cancer is not hereditary, but the BRCA1 and BRCA2 mutations dramatically increase the risk of breast cancer, hence Angelina Jolee's decision to undergo bilateral mastectomy.  That Helen's mother tested negative for BRCA1/2 provided little reassurance: "There's breast cancer in my father's family as well."

So she wants to "take it all out," meaning removal of uterus, ovaries, and fallopian tubes.  Our offer to frequently screen with ultrasounds and not-that-accurate blood tests.  For now she's satisfied with waiting for the BRCA1/2 testing that her family practice doctor agreed to order (pending approval by a genetic counselor or will talk with her in a few weeks).

Even if this test is negative, I expect Helen to return with her request.  I don't think I could justify a hysterectomy, or even the safer laparoscopic removal of ovaries.  But first there needs to be more time between her mother's death and a final decision about surgery.

159. To BF or not to BF, that is the Question.

Breastfeeding--either directly or by pumping ("induced lactation")--has a list of benefits that grow with every review.  Breast milk components change as the baby's nutritional needs evolve; it contains antibodies that enhance the newborn immune system. It's easier to digest, and breast-fed babies are less likely to develop asthma and diabetes, or become obese.  And they have a decreased risk of Sudden Infant Death Syndrome.

But some babies just do better with a bottle, and filling a bottle with pumped milk is easier said than done for some women. Forget the psychological second-guessing; formula just works better for both Mom and baby
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Kelly tried nursing, then the pump, but now just wants to formula feed. She denies depression, but feels stressed out by the pressure exerted by her family who want her to continue pumping. Do these people not know what it means to support a new mom? The difference between encouragement and badgering? Apparently not.