The Ramblings of a Middle Aged Fertility Physician whose life revolves around Eggs, Sperms & Embryos....
Sunday, November 30, 2008
This is the first time I was made to feel like Jews
As a Christian, I occasionally remind my Jewish friends that I owe my faith to them. Indian tradition maintains that a few years after Christ's death, one of his apostles, Thomas (‘the Doubter’), sailed to Kerala to share the Good News with his co-religionists. Jews have lived in India for thousands of years, perhaps arriving on a mission from the court of King Solomon to trade in ‘elephant's tooth, peacocks and apes’. The Jews of Cochin are said to have been less than receptive to Thomas’s message, though he did make many other converts.
India’s ancient Jewish history, evidence of the country’s tolerance for people of all faiths, has long been a source of pride for us. But an even greater cause for satisfaction has been the fact that Indian Jews have never faced persecution. Indian Jews have flourished, and nowhere is that more evident than in Mumbai. Some of the city’s best-known landmarks, including Flora Fountain, have been built with donations from Jewish philanthropists who grew prosperous on trade and manufacturing. Most notable among them were the Sassoons, a family from Iraq. Their name is etched in plaques in at least four schools, a magnificent library, a dockyard and at least two of the city’s nine synagogues.
A more chilling reminder of the city’s role as a sanctuary for Jews is to be found on another set of marble tablets in a cemetery in Chinchpokli in Central Mumbai. One wall bears memorials to people who died in faraway concentration camps such as Auschwitz. It was donated by friends and relatives who found refuge here. Many of these exiles had arrived in India because of the intervention of Jawaharlal Nehru. “Few people can withhold their deep sympathy from the Jews for the long centuries of most terrible oppression to which they have been subjected all over Europe,” Nehru wrote, as he lobbied the British government to allow Eastern European Jews into India. “Fewer still can repress their indignation at the barbarities and racial suppression of Jews which the Nazis have indulged in during the last few years.”
Many of the exiles soon became an important part of Mumbai society, serving as catalysts for the modern Indian art scene. Rudolf von Leyden, Walter Langhammer, and Emanuel Schlesinger had brought with them full-colour reproductions of European masters and a world of ideas and discussion. They proved vital in helping the Mumbai artists discover a new way of seeing. These ideas found expression on canvas when painters such as M.F. Husain, F.N. Souza, and K.H. Ara founded the Progressive Artists Movement in 1947, bound together by the desire to find a new way to depict the stories of their newly independent nation.
Despite the significance of the contributions of the Baghdadis or the European exiles, the Jewish community that has left the deepest impression on the city are the Bene Israelis, who believe their ancestors were shipwrecked just south of Mumbai in 175 B.C.E. Centuries later, many of them migrated to Mumbai, where they built a synagogue in 1796.
Perhaps the best-known member of the community was Nissim Ezekiel, one of the pioneers of Indian poetry in English. My favorite of his poems is ‘Island,’ a tribute to my home city. The first stanza says, “Unsuitable for song as well as sense/ the island flowers into slums/ and skyscrapers, reflecting/ precisely the growth of my mind./ I am here to find my way in it.”
Though thousands of Indian Jews have emigrated to Israel over the years, many of those who stayed behind have an ambiguous relationship with the country that offers them the Right of Return. Among them is my friend Robin David, the author of City of Fear, a gem of a memoir that describes the horrors he witnessed as a reporter during the anti-Muslim pogrom in Gujarat in 2002. He also explains his frustration with Israel, a country to which he has attempted to emigrate three times, only to return. “I realised that the Promised Land was not my country,” he writes. “Even the strong fragrance of spices, wafting in from the Arab market through the yellowing Jerusalem sandstone, did not help. Just like Teen Darwaza [in Ahmedabad], but not quite home."
There’s another aspect to the relationship that goes unnoticed by most Indians. Each year, an estimated 20,000 Israelis take their vacations in India after finishing their three-year compulsory military service stints. Their 15,000-shekel bonuses go much further in India and, as one Israeli told me recently, “It’s nice to be in a place where you don't always have to watch your back.” The beaches of Goa and the slopes of Kulu and Manali rank high on the visitors’ itineraries. The massive numbers of Israelis in the subcontinent prompted the Brooklyn-based Lubavitcher sect to open its first Indian mission centre — known around the world as Chabad Houses — in Pune in 2000.
Two years ago, I travelled to Pune to interview Rabbi Betzalel Kupchick, who ran the centre. By offering his hundreds of Jewish visitors a year free meals and the chance to chat in Hebrew, Rabbi Kupchick believed he was opening an opportunity for dialogue. “There are many ways that God brings people to Him,” he told me patiently. “Here, without the pressure of family and society, Israelis are more open-minded. Often, this is their first exposure to spiritual things. When they're come to India, they’re searching.”
Mumbai’s Jewish community doesn’t have much to do with the Israeli visitors. The ultra-orthodox leanings of the Lubavitchers have been regarded with some suspicion by liberal Indian Jews. That divide disappeared on Wednesday night. When I spoke to Robin David on the phone on Friday, he was still trying to make sense of it all. “The Indian Jewish identity is the only one that hasn’t been created by persecution,” he said. “We’ve never felt scared. This is the first time we’ve been made to feel like Jews.”
That, to me, has been among the most tragic casualties of this terrorist attack. In a barrage of grenades and bullets, a part of the Indian dream that’s 2,500 years old has now been buried in a pile of bloody concrete shards.
By Naresh Fernandes
Editor of Time Out Mumbai
Saturday, November 29, 2008
Shame on Us!
Vote out this incompetent weak, government and speak out against these impotent corrupt politicians!
Vote for zero tolerance against Pakistan and any other hostile neighbour.
Stop this drama of Indo-Pak friendship tours/talks.. anything...boycott everything Pakistani....hurt their economy so their bankrupt government does not sponsor ISI/terrorism.
Look at Israel... 4 million citizens with 40 million hostile neighbours but no one dares pick up a fight with them..
Don't believe anything politicians say from across the border.
Start with convincing our pseudo-wanna-be-politicos like Mahesh Bhatt & co to stop all these pseudo-friendship tours to hostile neighbouring countries... their states kill and maim us repeatedly and we go wagging our domesticated tails to get patted on our backs by these masters of ISI...
And please stop lighting candles at the Gateway of India. We have been doing this after every terrorist attack on Mumbai.
If Javed Jaffrey is not happy staying in India, he should be free to go settle in Pakistan.
Shame on us!
Friday, November 28, 2008
Thursday, November 27, 2008
Post-natal Depression Misdiagnosis
Joanne Morgan was initially diagnosed with post-natal depression following the birth of her first child Thomas. But tests later revealed she had a rare pituitary gland disorder called Cushing’s disease.
I tucked my baby Thomas into his cot and dabbed my eyes – maybe I was being weak, but I’d been feeling so bad lately that I could hardly cope.
“I had no strength in my legs, no energy to carry my baby upstairs or to even bend down for anything.
“By 11am I was ready to go back to sleep, I couldn’t keep my eyes open.”
Joanne Morgan had started to feel exhausted halfway through her pregnancy with Thomas. Her blood pressure had risen and she was advised by doctors to rest.
In her 20th week she was told that she may have pre-eclampsia.
She said: “I was a first-time mum – it was no beautiful experience, but I was sure that I’d pick up after the birth.
“But after Thomas was born I wasn’t feeling any better – worse if anything. I felt totally washed out.
“Some days I was so tired that I’d fall into a deep sleep, not even waking when Thomas cried.
“And there were some odd changes in me too. I had acquired a lot of facial hair and a ‘buffalo hump’ at the top of my spine. I’d shot up from a size 12 to 20.
“The weight had settled around my middle, face and shoulders. I looked flushed and had big red stretch marks. I felt a mess.”
After seeing her GP, who took blood tests, Joanne, who lived in Llandrindod Wells, was told that she was probably suffering from post-natal depression and was given a prescription for the anti-depressant Prozac.
“I wasn’t convinced, but I had been feeling very down for quite a while,” Joanne, now 39, said.
“I didn’t know what was wrong with me.
“I couldn’t cope with Thomas and I felt that my life was falling apart.”
The turning point for Joanne came when her mother suggested she speak to her former employer Kate who worked as a doctor in London – Joanne had previously worked as a nanny for her family.
She was referred to see a private gynaecologist who asked whether she had pronounced stretch marks and said he was certain Joanne had Cushing’s disease, which is caused by a tumour on the pituitary gland.
The disease can cause increased weight gain, heavy stretch marks, fatigue, anxiety and depression. In people with Cushing’s disease, the pituitary gland, which is situated at the base of the brain, produces excessive and often dangerous amounts of the hormone cortisol, which regulates metabolism.
The pituitary gland is about the size of a pea and is situated behind the nose.
Joanne, who now has a daughter Cerys after undergoing IVF treatment, said: “I was so relieved that someone believed I was ill, I wasn’t upset about the illness.
“Tests found 10 times the normal amount of cortisol in my system. If the condition had been left unchecked. I could have had a stroke or a heart attack.”
Joanne was later admitted to the University Hospital of Wales, in Cardiff, for further tests to determine whether the excess cortisol was being caused by a tumour on the pituitary gland. They revealed a non-cancerous tumour and decided to operate.
The mother-of-two, who now lives near Newark, in Nottinghamshire, was in theatre for three hours and was kept in hospital for three weeks. Despite feeling “very poorly” for the first week after surgery, her flushed face began to calm down and steadily she recovered.
“Three months later I was feeling far more lively. I went back to work part-time and I could at least give Thomas the attention he needed.
“Part of my pituitary gland had been cut away so I then had to take replacement hormones.
“If only someone had recognised the symptoms earlier before my self-confidence took such a battering.”
Pituitary gland The pituitary gland is in the bony hollow beneath the brain and behind the bridge of the nose.
The pea-sized gland is also known as the master gland as it controls all the body’s hormones.
The world’s tallest man, Ukrainian vet Leonid Stadnik who is 2.57m tall, reportedly started growing at the age of 14, after undergoing brain surgery, which stimulated his pituitary gland.
But most pituitary disorders are caused by a benign tumour on the gland and can cause a vast range of symptoms, including infertility, raging thirst, growth of hands, feet and facial bones, abnormal weight gain and even fragile skin and visual problems.
But because pituitary disorders are relatively rare and many of their symptoms are non-specific, such as constant headaches and weight gain, diagnosis can be slow and many patients can find themselves isolated and distressed as their quality of life diminishes.
Once diagnosed, treatment often involves surgery and radiotherapy and patients may have to take hormone replacement drugs for the rest of their lives.
The Pituitary Foundation has found that the hormonal changes can also cause psychological and psychiatric problems.
And because many patients know no one else with the same problem, it can be traumatic to cope with.
Wednesday, November 26, 2008
Shrinking Economy Puts Baby on Hold
The Last Four U.S. Recessions Have Been Followed by Declines in the Country's Fertility Rate. Maternity wards may get a bit quieter in about nine months.
That's because recessions and babies apparently don't mix. It's been true for the last four recessions, and experts are predicting a similar downturn now. There's plenty of bad economic news out there: the crisis on Wall Street, record foreclosures, high prices for gas and food. A recent study by the American Psychological Association showed that 80% of Americans are stressed about the economy.
At times like this, demographers say, Americans postpone starting a family and think twice about adding a baby to a family that is already struggling.
Tony Marks, a mortgage broker in Florida, and his wife, a schoolteacher, have been married for just over two years. "We honestly thought we'd have kids by now, but have put it on hold because of financial issues," says Marks, who is 31.
His industry has been hit hard, and the couple have lost a lot in their retirement accounts because of the stock market slide. Also, they are helping his wife's sister, who is struggling to pay her mortgage and can't sell her home because she owes more than it is worth.
"The economy has definitely affected our plans for starting a family," he says.
It's no surprise couples may be thinking twice: The annual cost of raising a child is between $10,930 and $12,030, according to the most recent estimates from the United States Department of Agriculture. These estimates are for a child living in a middle-income family with two kids and two adults.
In current times, many couples also must evaluate the cost of fertility treatments. In vitro fertilization costs on average more than $12,000.
Although some doctors say they haven't yet seen a change in patient load, demographers stress that the results won't be apparent for a while -- pregnancy after all lasts on average 38 weeks. Couples report that money concerns are an increasingly big part of family planning discussions.
Although a number of factors, including demographic and social trends, contribute to the fertility rate (the number of babies born per year per 1,000 women between the ages of 15 and 44), the economy also appears to affect the numbers.
The last four recessions in the United States have been followed by a dip in the fertility rate, according to economic data from the National Bureau of Economic Research and fertility data from the National Center for Health Statistics, a division of the CDC.
In the early 1970s, a recession lasted from November 1973 until March 1975. The fertility rate, 68.8 in 1973, fell for the next three years, bottoming out at 65 in 1976, the year after the recession ended. It climbed again the next year.
The early '80s brought more tough times. The economy was officially in a recession from January 1980 to July 1980 and again from July 1981 until November 1982. The fertility rate was 68.4 in 1980 and fell for the next four years to 65.5 in 1984. It increased again in 1985.
In July 1990, the country fell into a recession that lasted until March 1991. The fertility rate, which had been climbing throughout the late '80s, hit 70.9 in 1990, the highest rate in nearly two decades. However, the next year, following the recession, it started falling again and declined to 63.6 in 1997. After the dot-com bust, the country was in a recession from March 2001 until November 2001. Again, fertility rates dipped the next year, falling from 65.3 in 2001 to 64.8 in 2002.
Recession and Babies: The Current Economic Crisis
The NCHS data cannot provide any insight into the current economy's effect on the fertility rate. In addition to the length of pregnancy, it takes a while for the NCHS to compile data. The most recent birth rate information available is from 2005.
But using history as a lesson, Carl Haub, demographer at the Population Reference Bureau, says he expects to see a slight drop in the fertility rate in the United States. If the economy gets worse -- and people become as scared as they were in the mid-'70s amid the oil crisis -- the drop may be more dramatic, he says.
The shifts typically are not sudden -- in either direction. "There is a certain amount of lag time," Haub says. "When the economy improves, it is not like people rush out and say, 'Let's have a baby.'"
Khalil Tabsh, chief of obstetrics at UCLA, says he expects to see fewer families having third and fourth children, especially among the middle class. "If you have two kids and you aren't sure if you are going to lose your job, you are going to think twice about having another baby," he says. He has not yet seen a decrease in his patient load.
Hilton Kort, a fertility doctor and the founder of Reproductive Biology Associates in Atlanta, also says he has not seen a shift so far. Since he began practicing in vitro fertilization in 1983, he has not seen his business fluctuate with economy.
After Sept. 11, he even saw an increase as people worried less about material things and more "about what is really important, and that's having a family," he says.
In good and bad times, most of his patients are concerned about finances because many insurance companies do not cover fertility treatments. His firm puts patients in touch with companies that offer low-interest loans, and so far, those companies have not tightened requirements for credit.
The only economic impact he's seen so far? More patients are saying they'd like to have twins, a relatively common result of fertility treatments. Though he and other doctors have worked to reduce multiple births because of potential pregnancy complications, some couples want twins because they can only afford to complete the process once and they want two children, Kort says.
Jennifer Gniadecki, 33, and her husband also reconsidered their plans. Already the parents of two young girls, the couple wanted to try for a boy. Gniadecki, who does freelance writing for companies including Wal-Mart, is busy with work now but never knows how much she will have a few months down the road. If the economy gets worse, she fears she might lose her income.
Her husband works in online advertising, "but we can't trust he will keep that full-time job if there is a recession," she says.
The Chicago-area couple ultimately decided to cut back on spending but still try to conceive another baby. "It is knowing what's important," she says.
With a laugh, she adds: "The more children we have, the more likely it is that one of them will take care of us when we're old."
That's because recessions and babies apparently don't mix. It's been true for the last four recessions, and experts are predicting a similar downturn now. There's plenty of bad economic news out there: the crisis on Wall Street, record foreclosures, high prices for gas and food. A recent study by the American Psychological Association showed that 80% of Americans are stressed about the economy.
At times like this, demographers say, Americans postpone starting a family and think twice about adding a baby to a family that is already struggling.
Tony Marks, a mortgage broker in Florida, and his wife, a schoolteacher, have been married for just over two years. "We honestly thought we'd have kids by now, but have put it on hold because of financial issues," says Marks, who is 31.
His industry has been hit hard, and the couple have lost a lot in their retirement accounts because of the stock market slide. Also, they are helping his wife's sister, who is struggling to pay her mortgage and can't sell her home because she owes more than it is worth.
"The economy has definitely affected our plans for starting a family," he says.
It's no surprise couples may be thinking twice: The annual cost of raising a child is between $10,930 and $12,030, according to the most recent estimates from the United States Department of Agriculture. These estimates are for a child living in a middle-income family with two kids and two adults.
In current times, many couples also must evaluate the cost of fertility treatments. In vitro fertilization costs on average more than $12,000.
Although some doctors say they haven't yet seen a change in patient load, demographers stress that the results won't be apparent for a while -- pregnancy after all lasts on average 38 weeks. Couples report that money concerns are an increasingly big part of family planning discussions.
Although a number of factors, including demographic and social trends, contribute to the fertility rate (the number of babies born per year per 1,000 women between the ages of 15 and 44), the economy also appears to affect the numbers.
The last four recessions in the United States have been followed by a dip in the fertility rate, according to economic data from the National Bureau of Economic Research and fertility data from the National Center for Health Statistics, a division of the CDC.
In the early 1970s, a recession lasted from November 1973 until March 1975. The fertility rate, 68.8 in 1973, fell for the next three years, bottoming out at 65 in 1976, the year after the recession ended. It climbed again the next year.
The early '80s brought more tough times. The economy was officially in a recession from January 1980 to July 1980 and again from July 1981 until November 1982. The fertility rate was 68.4 in 1980 and fell for the next four years to 65.5 in 1984. It increased again in 1985.
In July 1990, the country fell into a recession that lasted until March 1991. The fertility rate, which had been climbing throughout the late '80s, hit 70.9 in 1990, the highest rate in nearly two decades. However, the next year, following the recession, it started falling again and declined to 63.6 in 1997. After the dot-com bust, the country was in a recession from March 2001 until November 2001. Again, fertility rates dipped the next year, falling from 65.3 in 2001 to 64.8 in 2002.
Recession and Babies: The Current Economic Crisis
The NCHS data cannot provide any insight into the current economy's effect on the fertility rate. In addition to the length of pregnancy, it takes a while for the NCHS to compile data. The most recent birth rate information available is from 2005.
But using history as a lesson, Carl Haub, demographer at the Population Reference Bureau, says he expects to see a slight drop in the fertility rate in the United States. If the economy gets worse -- and people become as scared as they were in the mid-'70s amid the oil crisis -- the drop may be more dramatic, he says.
The shifts typically are not sudden -- in either direction. "There is a certain amount of lag time," Haub says. "When the economy improves, it is not like people rush out and say, 'Let's have a baby.'"
Khalil Tabsh, chief of obstetrics at UCLA, says he expects to see fewer families having third and fourth children, especially among the middle class. "If you have two kids and you aren't sure if you are going to lose your job, you are going to think twice about having another baby," he says. He has not yet seen a decrease in his patient load.
Hilton Kort, a fertility doctor and the founder of Reproductive Biology Associates in Atlanta, also says he has not seen a shift so far. Since he began practicing in vitro fertilization in 1983, he has not seen his business fluctuate with economy.
After Sept. 11, he even saw an increase as people worried less about material things and more "about what is really important, and that's having a family," he says.
In good and bad times, most of his patients are concerned about finances because many insurance companies do not cover fertility treatments. His firm puts patients in touch with companies that offer low-interest loans, and so far, those companies have not tightened requirements for credit.
The only economic impact he's seen so far? More patients are saying they'd like to have twins, a relatively common result of fertility treatments. Though he and other doctors have worked to reduce multiple births because of potential pregnancy complications, some couples want twins because they can only afford to complete the process once and they want two children, Kort says.
Jennifer Gniadecki, 33, and her husband also reconsidered their plans. Already the parents of two young girls, the couple wanted to try for a boy. Gniadecki, who does freelance writing for companies including Wal-Mart, is busy with work now but never knows how much she will have a few months down the road. If the economy gets worse, she fears she might lose her income.
Her husband works in online advertising, "but we can't trust he will keep that full-time job if there is a recession," she says.
The Chicago-area couple ultimately decided to cut back on spending but still try to conceive another baby. "It is knowing what's important," she says.
With a laugh, she adds: "The more children we have, the more likely it is that one of them will take care of us when we're old."
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