sleepy docs

I was reading an article in the American Journal of Ob/Gyn and thought you might like this quote-especially if you're doctor missed your delivery.

"The average practicing obstetrician gynecologist works hours significantly in excess of those allowed for younger resident physicians. In addition, obstetrics remains the only medical specialty in which the attending physician is rountinely expected to both manage a critical and potentially life-threatening process for 2 patients during labor and at the same time seeing office patients or performing elective surgery. Although some might see this as part of the general devaluation of women and children's health care, patient expectations are at least as much to blame. Given the realities of clinical practice, it is simply impossible for every woman to be delivered by the obstetrician of her choice, without accepting the occurrence of sleep deprivation-induced congnitive impairment of that health care provider." Aug 2009 pg 136.

There are times when I will have the on-call doctor deliver one of my patients because I'm just too tired to think straight. I hope you all understand that it is really in your best interest. We really do want the best care for you. I love to deliver my own patients, and would deliver all of them if it were safe. There are some areas, like in Arizona, where they have laborist; physicians who just stay in the hospital and deliver everyone's patient that may come in. In these places you will have about a 1 in 15 chance that your doctor will deliver you. I hope it doesn't come to that everywhere but with new health care policy etc. it may even happen here. (No plans for it in the near future!) Just a little insight I thought you might like.

whats with the Vit D?

Vit D. deficiency is something that is fairly new. It has been surprising how many women, even in sunny areas, that are low in vit. D. Vit D. is used for calcium absorption and calcium is used for bone growth and muscle function. Being low in vit D and calcium can affect your bone density as well as your muscle function. There may be other benefits of vit D as well that are still being studied. These benefits may include decreased colon cancer risk, better prognosis with breast cancer, and decreased risk for pre-eclampsia in pregnancy.

It is thought that since we are staying out of the sun and drinking less milk-both sources of vit D-may be the cause of so many people having low levels.

So what do you do? First, get your vit D level checked-a simple blood test. If it is low then you may need supplementation. The amount you need will depend on how low your levels are. If severely low you may be put on 50,000IU's for 8 weeks. If borderline, you may just be given an over-the-counter vitamin. Pregnant women should probably be taking around 2,000IU. It is important for pregnant women to have adequate vit D for the health of your baby's bones.

There is no known "toxic level" of vit D. but megadoses are not recommended. In fact, some supplemention with vit D and calcium may cause kidney stones.

Again, I've been surprised at the number of tan, active women who have had low vit D levels. I've also been surprised that many of these women feel better when on their supplements. They feel stronger and will some increased energy.

If nothing else, enjoy a little sun (with SPF of course) and drink your milk!