29 September 2008

Paracetamol

I want to blog more about Perth trip, but the camera is recharging so I can't get the photos off the camera.

So I want to blog about scientific stuff.

I'm a pharmacist, I recommend paracetamol for babies all the time. It works, we consider it safe as a professional group and there are very rarely any issues over safety if given responsibly. People do make mistakes and overdose their babies and that can cause trouble, but generally, it is a safe, effective and useful medication for babies and young kids.

Recently, there's been some news about asthma and paracetamol. That children given paracetamol once a month at an early age, regularly, seem to develop asthma at a higher rate than children. The news article cited states:

And seven-year-olds are more than three times more likely to have asthma if they were given paracetamol at least once a month in the previous year, compared with children who did not get paracetamol.

Three times ey? That's shocking. Well. I'm sure it isn't quite as blinding as that; but I'd have to check the paper to make a better summary. As it might be a relative risk of 0.1 becomes 0.3.

I also work for the evil evil pharmaceutical industry. We have lots of drugs that do nasty stuff to people. One of our drugs has a listed side effect where a known relationship exists between the drug and the side effect (in an almost MC Escher way) of unexplained death. That's right, one of our drugs kills people, we know it does, but we have no idea why.

I also recommend that people watch an episode of The Hollowmen from a fortnight ago. We've discussed this episode at work. It is quite truly, the sharpest review of the industry I've ever seen. Especially when the company says it can't lower the cost of the drug anymore because of the cost of developing it, upon which the company chef walks in and says "Would your guests require wine?"

Anyways, the problem with a large study of 200000 children is the sheer power of numbers can show up very very rare situations; ultimately best described as weak signals that may not have any clinical or real life significance at all. If 600 children developed asthma on paracetamol and 200 on placebo/nothing, that would mean that the average child had a 0.4 % total risk over seven years of developing asthma. That's one in 250 children.

This issue has raised its head before - both pros and cons for the industry of drug peddlers. Powerful studies can show more signals - efficacy and safety. Powerful studies are expensive. Only pharma has the money to do big powerful studies that are conducted under strict regimes. Powerful studies have been abused for lots of reasons - mainly for marketing reasons by pharma.

This drug X is 22 % more effective at lowering blood pressure than drug Y, (when drug Y was a fairly poor performer compared to drug Z and really the comparison should be between Drug X and Drug Z).


Anyway, I think I'm saying caution. With any big study, the cause and effect is often hidden. My Occam's Razor suggests that children with asthma were more likely to be unwell in their initial years then children who were not - mainly because asthma is a chronic disease involving mast cell destabilization and histamine release, which leads to the swelling of the lung tissue and anaphylaxis. It has to start somewhere somehow; I just doubt (even with my pharmacy and pharmaceutical hat on) that paracetamol is that trigger.

Flight over

There's something about getting to an airport on time that makes me nervous, anxious. Always.

This trip was no exception. Usual last minute jitters (literally, have you unplugged the microwave), running to Ray next door to hand over the keys and swearing poetically (bloody shit) when stuck on the citylink at 11am, paying a toll and still driving at 30 kmh. We even managed to almost leave passports and tickets at home, I kid you not.

Anyway, I think N knew we were up to something as she had refused to sleep the night before and was fairly fidgety all morning. Seeing a 5 month old fidget is like watching a person with movement disorder. She would be, in cycle, looking at her hand (both sides) then arcing her back, and then stretching her left arm upwards. And repeat.


Hey look, something over there


For the first couple of hours on the flight she was unsettled. I was praying it would not be too much more than the first 30 mins. I looked forward to watching Son of Rambow. But the unsettledness meant I did not swipe my card and watched the flight path for 4 hours.


Plenty of leg room on these new flights

Deepti spent most of the first two hours after take off on her feet pacing up and down the aisle. Some sleeps were short but finally exhaustion kicked in and she slept for a good 45 minutes on the spare seat. Round one to flying on day flights! The flight attendants even took Naina up to the front of the plane for a while.

Mum and Dad were extremely excited to see Naina. I think we were the "extras" on the set. Judging by many baby photos with grandparents, this is a common theme.

22 September 2008

Bath times

Saturday was a bit of a revelation day. It was Miss N's five month birthday, which is amazing in itself. With all the nappies, sleepless nights, gas incidents, crabby mornings and crabby evenings, we forgot to do much more than go yay. I mean it, that's all she got. Six month will be a bigger occasion. The months roll past so quick.

Anyway, the revelations were two fold. First N doesn't want to be lying down in the car anymore. She lifts her neck quite well so we'll be switching to the seat soon.

The other thing is bath time. She's keen to sit up at bath time and play. This is especially exciting. Hopefully unaided sitting soon!



Separated at birth

Speaking of separated at birth. Some people say N and I look a lot a like at the same age. Poor girl. Frankly, I can't see the resemblance.



Lies, why do I fill my own house with lies. Man that's some nice threads there on the right.

And of course just to make the 70's flash back complete; that is some bitchin' good hair.

Visitors

Deepti's had a flood of visitors, with the news of her and Naina's imminent departure to Perth for a month.

Most interestingly, the Australian mother's group dropped in today. Side point, Indian mum's (apart from Deepti of course) are a bit weak kneed. On the slightest hint of a breeze or too much sun, they tend to cancel things. The Australian mother's group, there very different breed.

It was literally the stormiest day in Melbourne in months. Four brave mum's and their prams all came over.

Anyway, Naina gets very excited around other babies. She starts screaming a long and continuous scream. We have footage of today; Naina and another baby on the bed looking at each other. Naina gets excited realising there's someone else as immovable next to her and starts screaming. Well, a sort of squealing actually.

About five seconds into the squealing, the other baby starts screaming. Apparently this happened twice today. Something in the water I think.

You know the phrase
"Separated at sometime-five-months-ago"

Perth trip

Rolls closer. The flight anxiety increases and decreases. Prams - do we take them do we not. Food - breast or bottle. Wipes and nappies. Ahhhh. I just want to get on the damn flight!

Otherwise, we're all good. We're keenly awaiting news of Anna's # 3 and Andrew and Kate's #1. And seeing all the babies too. Oh and their parents as well.

12 September 2008

Sleep

Baby sleep. Naina's not a good sleeper, yet. I'd be interested to hear when Max, Isobelle, Hamish, Eva, Jinu are good sleepers yet and if so, when they became good sleepers.

Naina has been up and down; some nights she's great in bed at 830 and peaceful until 7 am with occasional food nibbles. This contrasts with her crappy nights, where no rest till 11 or 12 and then up every hour or so. Still can't complain too much. Or can I?

We've just entered a bad sleep phase. N started falling asleep at about 830pm for an hour each night then waking up screaming, miserable, sniffling, her whole body shaking. This would happen night after night and no consoling seemed to work except turning on the light, standing in front of the heater and talking and laughing and making faces and noises. By the time she stopped screaming, sniffling and weeping, she'd be wide awake and unable to go back to sleep for an hour or so. This actually happened twice in one night, which meant that we were so exhausted we slept till 11 am (all three of us) totally ruining Miss N's sleep pattern that whole weekend.

So, being a scientician, and as Homer would say (trying to be understanding) is it gas?

Well, we've assumed it is and have tried dosing N at about 800pm with her last feed with Infacol. It seems to be working well, no wake up screamings since. A relief. Except tonight. We cut the dose; she woke up again, but not as intensely unhappy. Some water and a feed and she settled again. Back to the drawing board I think.


Perth trip

We're coming to Perth - clan Shrivastava. This should be interesting. This is a test run for a big India trip next year.

I'm trying to convince myself that N won't be like those other kids and will only cry on take off and landing and sleep peacefully in between. Considering it is a four hour flight to Perth, I'm not all that confident.

I'm also nervous when I consider how much stuff is required for a trip to the local Chinese Indian (300 metres away), not to mention a trip to Perth. Baby bag. Check. Milk. Check. Diapers. Check. Wipes. Check. Infacol. Check. Toys. Check. Pram. Check. Baby. Check. Gzzz.

I booked day flights. Someone will no doubt say that was the cause of all the problems (after we get to Perth and say how terrible the flight was). Maybe I shouldn't complain and just say it was fantastic!

There's things happening 2

We've been quiet on the blog for a while now.

We don't lead a very exciting life (looking at you, people getting married soon, people recently travelling to Korea, or people giving birth about now), so the blog is often just photo updates.

I work like a dog 11 days out of 14 and spend hours on public transport. Deepti seems to spend a lot of time dancing a jig trying to get N to sleep during the day or sitting on benches in shop centres. There's the usual routine:

730am: AS wakes ups.
820am: AS wishes DS and NS a good day. Drives to tram stop.
840am: AS on tram. Pressed up against window because Melbourne public transport is a dog.
905am - 530pm: AS Work like a dog
900am - 630pm: DS awakes with NS. Routine of wake eat play sleep. Dance jig.
630pm: AS Gets home, eat watch news and play with N
830pm: N in bed. DS follows out of exhaustion
930pm: AS follows DS and NS to bed.

Repeat on a theme 11 days out of 14. Except the eleventh day, the dog works even harder. No witty banter am afraid there either. Oh wait hang on: look daddy, one dog's sick and the other is pushing it to hospital (Graham Kennedy...).

Naina seems to enjoy stuff. Like lying at the front door looking outside on to the lawn and at the sky. Going for walks in the pram. Playing with mum and dad. Her reflexes are getting better and I am sure I saw her lifting her head today. She grabs things quite quickly (and of course puts them in her mouth) and finds somethings more funny than others.

Over the weeks and months, an essentially blank look has become more and more awake. She recognises me quicker and quicker when I come home at the end of the day. What uses to take 10 to 15 seconds of look, daddy, is now 1 to 2 seconds and then big smiles. Lots of laughing and smiling and lots of giggles. Just how we love her to be!

There's things happening

Miss N is exploring the world via her mouth. According to what i have read they do this because they're bored, they like the taste of human flesh (I made that one up), they enjoy tasting new things, and it helps them calm down. At least that's the internet for ya.

She's managed my hand:


Deepti's chin (checking camera's still on her of course)


Her own fist (whole fist can fit, with some gagging noise)


And her foot, her beloved foot:

01 September 2008

Naina, 2, MCHN, Nil....

Breaking news, Naina got weighed today. Over the 12 days since her last weigh in, she's put on nearly 250 g.

I got a little triumphant there. I think having a baby under the microscope is an intensely stressful time, like my parents probably had for me. As some of my previous posts suggested, I do get defensive about her, probably more so than I should. It is hard not to. So many emotions are tied up with her, many things in our life that make us happy and make us sad.

I'm really glad our little Miss N is putting in the occasional big stride in weight terms (wow mixing metaphors or what). She's taking it one day at a time, not looking too far ahead, not getting too far ahead of herself, she can only concentrate on her own game and not others, she'll play the ball, not the man, it's a big ask. Phew, eight metaphors in one paragraph. She's kicking goals now. Nine, nine I tell's ya.