About a month ago, during a routine obstetrical visit with one of my patients, she surprised me by telling me she found out she was having a baby boy. At first, I thought she meant that during an ultrasound, the technician had told her the sex of the child. But she said “No,” that a girlfriend of hers had recommended a new kit she could buy on the Internet — which allegedly is 99.9 percent accurate in determining the sex of the baby, and that for $275, she could test herself at home, and send it off to the company for the results.

At first, I was taken aback because I hadn’t heard of any such kit. But more importantly, I was upset that she did not share this information with me prior to doing the test so that I could advise her on whether or not taking this test was a good idea.

I always have a problem with people worrying too much about the sex of their unborn child. I guess I can understand it to some extent for families who want to plan ahead, who want to know whether or not to paint the room pink or blue, or to think about things like circumcision. But with all the potential problems and challenges women face in creating and carrying a child to term, it’s unfortunate that sometimes people get side-tracked with insignificant details — and it strikes a nerve with me, because it brings up the topic of sex selection.

Today I read a story about six mothers in New York City who are suing Acu-Gen Biolab Inc., makers of the Baby Gender Mentor test, because their test results proved wrong at the birth of their children! I guess they felt the company had committed fraud. I tried to reach the company today to ask them some questions, but no one wanted to speak with me.

Looking at their Web site, I couldn’t gather a lot of information, but I began to understand what the “science” is behind their test kit.

For years, in the medical community, we have known that fetal cells circulate freely in the maternal bloodstream. Many geneticists have looked at the possibility of studying these fetal cells in the maternal circulation for the purpose of testing for genetic disorders like Down syndrome. But none of the data has proven it to be a good alternative for genetic testing. Yet this company has been promoting this technology to patients directly as a “safe, quick and easy way to determine the sex of your baby.”

I don’t know what federal regulation this business has been operating under. It would be nice to see what kind of guidelines they’re using, because the last time I checked, medical laboratories need to be licensed and laboratory tests must be ordered by physicians.

Finally, what are the ethics behind such a business? Are women going to use this alleged test to decide that they might want to terminate a pregnancy because now they know the baby is not the sex they wanted? It sounds like a stretch — but you’d be surprised…

Are mothers who get faulty test results going to think that their babies were switched at birth in the hospital? And what about these women that are suing?

This case is a perfect example of wasted dollars, a perfect example of unsubstantiated medical testing, and a perfect example of the types of businesses that need to be scrutinized in this country if we’re going to see any effective health care reform.

Today we heard of a shooting at the Holocaust Museum in Washington, D.C. that appears to be the work of a single gunman, whom authorities believe to be a man in his late 80s by the name of James Von Brunn. If this is the suspect in custody, he is actually a World War II veteran and vocal member of the Holy Western Empire, which at this point, seems to be a white supremacy group.

It is sad to see people resorting to violence to settle their differences. And we have to be aware that we still need to be vigilant in our efforts to protect ourselves — despite the feeling of some Americans that security measures in this country have become too intrusive. It’s important to support our men and women in uniform, who at both the local and national levels, do a terrific job of keeping our country safe.

What this man did was an act of terrorism — domestic terrorism.

But the big question is: What’s the psychological profile of this shooter? If you look at some of the psychological profiles of past shooters, they are all different in their own way. However, there always seem to be some common themes.

Most of these people are angry at someone or a group of people, and share a psychotic belief that their misfortunes are predicated on the actions of those they hate.

Usually they are loners — they feel rejected by others or by society as a whole.

For some, substance abuse and depression are common themes, but even knowing these common themes, it is almost impossible to differentiate between who will just withdraw from society and who has the potential to snap and hurt innocent people.

I pray for those hurt in this tragedy and hope that we are able to create systems that could perhaps better identify high-risk people and prevent future tragedies from occurring.

Almost 25 million Americans have some sort of flying-related fear, from nerves and anxiety to full-on aviophobia.

And now, recent news of what we now know was the tragic demise of Air France Flight 447 on Sunday night over the Atlantic Ocean has awakened a fear in many people who might not usually dwell on it.

I’m sure, to some extent, most of us feel some level of anxiety or vulnerability as our flight turns the final corner on the runway before accelerating and finally taking off. For some people, it’s nothing a sedative or a pre-flight cocktail can’t quell.

But for those people with a real fear of flying, just the thought of that pivotal moment in their trip can be enough to bring on the sweaty palms and racing heart. And for some, that fear is enough to keep them permanently grounded.

Now, we all know that probability-wise, the risks associated with driving a car are significantly higher than those associated with air travel — with research showing that the latter has actually gotten safer over the last couple of decades.

In fact, statistically speaking, the lifetime odds of dying in an air travel accident are 1-in-20,000 compared with 1-in-100 for an auto accident. And according to the NTSB, highway fatalities account for more than 94 percent of all transportation deaths — airplanes included.

But even though we understand that logically and statistically speaking, our chances of getting in a car accident are much greater than anything happening when we fly, it’s often the fact that we relinquish all control over our own well-being — for however long it takes us to get from point A to point B — to the pilot and his crew.

And for people prone to anxiety or obsessive compulsive disorders, this loss of control and the vulnerability we feel can become overwhelming, triggering a panic attack or worse. So it’s important for people suffering from these disorders to make sure they always carry their medication with them while they are traveling.

Other common phobias that can contribute to a fear of flying include claustrophobia (fear of enclosed spaces) and acrophobia (fear of heights).

Fortunately, today there are places to get help with your fears. Support groups and therapy are two options that have been around for a long time. But more recently, airlines have started to offer classes with flight simulators to help would-be passengers confront their anxieties and become more comfortable with the experience.

So while it may seem like there has been a lot of aviation incidents between the news coverage of the “Miracle on the Hudson” in January, and the fatal crash involving Continental Connection Flight 3407 in Clarence, NY just a month later — considering the fact that there are more than 87,000 flights in the skies over the U.S. on any given day — flying is still one of the safest way to travel.

Perhaps what leaves so many people feeling unsettled and fearful after this most recent accident is the mystery behind it. After a horrible tragedy, part of the healing process is to come to terms with what happened and try to make sense of it all. But as the days pass and the world looks on as investigators try to piece together the clues, it seems in the end, there will be more questions than answers as to the final moments of Flight 447.

A recent story about a 17-year-old Boy Scout who died suddenly during a 7.7-mile hike in Florida has everyone wondering what went wrong. Every time I see a story like this, where an unexplained death occurs in a young person – especially an otherwise healthy teenage athlete – it makes me wonder whether it’s a good idea to have in-depth annual physicals performed on adolescents contemplating participating in high-endurance sports.

Most children get an annual physical as required by state law to attend school or play sports. I have three children, and for the most part, their physicals constitute a review of systems, blood pressure, weight and height documentation, vital signs and maintenance of vaccination schedules.

So the question is: Should adolescents have more in-depth assessments done to evaluate the status of their cardiovascular health?

This of course is a controversial question to ask because doctors can’t seem to agree on what tests should be done. And with the swelling numbers of uninsured Americans and the escalating costs of preventive medicine not covered by insurers, we’re immediately challenged with the dilemma of who’s going to pay for cardiac testing, and what happens if we do find something wrong?

A perfect example of this is the current criticism of prostate cancer screening. Many studies are now suggesting that these screenings may lead to unnecessary procedures and negative side effects — that ultimately are ineffective in changing the course of the disease.

Now I can understand evaluating the effectiveness of prostate cancer screening versus cost and quality of life issues – especially because of the nature of the disease and the age group that it typically affects.

But when it comes certain heart diseases in the adolescent patient population, we’re not looking at quality of life issues – but often, the difference between a life saved and a life lost.

One condition in particular that I think that teenagers should be screened for, is hypertrophic cardiomyopathy (HCM). This is a genetic condition that affects one out of 500 people and is the leading cause of heart-related sudden death in people under 30. And unfortunately, if it goes undetected, most parents only find out about HCM after their child dies on the field or court.

Hypertrophic cardiomyopathy is a condition in which the heart muscle becomes abnormally thick, making it harder for the heart to pump blood and sometimes interfering with its electrical rhythms. HCM tends to run in families, and children of parents with the genetic mutation for the disease have a 50 percent chance of inheriting it.

The reason HCM often goes undiagnosed, is because it rarely presents any noticeable symptoms. And while it can lead to severe cardiac problems at any age, but I would argue that if the condition is identified in the teenage population, proper monitoring could lead to a decrease in sudden, unexpected death among athletes.

Many states are looking into mandatory cardiovascular assessment of young athletes in an effort to identify patients at risk. Still cardiologists are not sure what the best method of screening should be — whether routine electrocardiography or echocardiograms prior to the start of the sports season would provide the most cost-effective, comprehensive data to aid in identifying athletes at risk.

I know that this debate will go on for quite a while, but I think that any parent with a teen or child participating in sports should have a conversation with their pediatrician.

Today I read an incredibly tragic story about a 2-month-old baby in Pennsylvania who died of sudden infant death syndrome (SIDS) because her parents were allegedly too drunk and high on cocaine to notice.

The parents, Jennifer Nicole Gaster and Daniel Keith Martin II, both 30, stood trial Monday on child endangerment charges alleging that after a night spent snorting cocaine and drinking beer and vodka, the couple was too incapacitated to notice their baby was dying.

This is not the first time we have seen a parents with a history of drug and/or alcohol abuse lose a child to SIDS. In February of 2007, a Michigan woman pleaded guilty to charges that claimed high levels of cocaine in her breast milk had killed her 5-month-old daughter. Although the cause of death was originally thought to be SIDS at the time the baby died, further testing proved otherwise, and at the trial, the mother admitted to using cocaine two or three times the day before the baby died.

Traces of cocaine can remain in breast milk for more than 48 hours after a woman uses it — and the transmission from mother to infant has been linked to respiratory failure, seizures, increased cardiovascular risk, central nervous system damage, irritability and addiction — just to name a few.

Babies are at high risk for SIDS if they:

o          Are born to mothers who smoke or use drugs

o          Have low birth weight or premature infants

o          Are exposed to environmental tobacco smoke

o          Sleep in a crib packed with soft objects and loose bedding

o          Are placed to sleep on their stomachs

o          Are between the ages of 1 and 6 months

Please be advised that most drugs are transmitted through breast milk. If you are abusing any kind of drug – especially cocaine – the effects can be deadly.

I was very happy to learn Tuesday that the last of the Suleman octuplets is finally home  to be with his brothers and sisters. Jonah ― the last to be sent home ― was the smallest of the bunch, weighing just 1 pound 8 ounces when they were born nine weeks early.

Click here to see pictures of Jonah and his siblings.

But now, the real challenge begins. Let us not forget that these infants were premature and that this last baby stayed in the hospital for almost 12 weeks. There is a lot of data that has been published and analyzed looking at some of the hurdles that premature babies must overcome in their early years.

To me ― as a person who delivers babies for a living ― I also have three of my own ― I am aware of the significance of paying attention to the way kids grow and develop, and how important that attention is in preventing some of these children from failing to meet their full potential.

For parents of full-term infants, paying close attention to developmental milestones is sometimes an afterthought. But for parents of premature babies, keeping track of movement, visual, social and developmental milestones could make a world of difference in identifying problems and finding solutions to meet their needs.

Most premature babies meet their milestones and catch up by the age of 2. But depending on how early an infant is born, their development may lag anywhere from 6-8 weeks in development usually during the first year of life.

It’s important to use your child’s adjusted age when tracking his or her development. For example, if your baby is 21 weeks old, but was born five weeks early, his or her adjusted age is 16 weeks (or 4 months).

Now let’s take a look at some of the milestones the American Academy of Pediatrics says parents can look out for around 16 weeks…

Motor:
o Brings hands together, or to mouth
o Lifts head and pushes on arms when on tummy
o Reaches for objects
o Turns or makes crawling movement when on tummy

Language:
o Turns head to follow familiar voices
o Laughs and squeals
o Combines sounds more often (for example, “aaah-oooh”, “gaaa-gooo”)

Activities:
o Grasps more and reaches for objects
o Brings objects to mouth
o Increases activity when sees a toy

Social/Emotional:
o Is increasingly interactive and comfortable with parents and caregivers
o Shows interest in mirrors, smiles and is playful
o Is able to comfort himself

For more guidelines and milestones at different ages, click here.

Remember: Always watch for progress and do not be afraid to ask for help from doctors, teachers or other family members.

Again, I am pleased that all eight of the children have made it home safe ― I just hope that Nadya Suleman pays as much attention to their progress as she has to publicizing their births, because it should always be about the kids.

When I talk to cancer patients and survivors alike, I’m always inspired by their motivation, optimism and undeniable will to carry on the fight to beat their disease. Learning of a cancer diagnosis is a very hard thing for both the patient and the family.

But it’s especially hard when that patient is a child. These children face challenges on a level that most of us will never experience in our lifetime. And trying to explain to a child that they have cancer is a devastating task for both parents and health care providers.

Now imagine trying to explain a cancer diagnosis to an autistic child who now has to deal with the strict regimen of cancer therapy. His survival is completely dependent on the compassion and commitment of his parents, as well as the health care team that’s treating him.

Click here to read the report.

This is why I’m so outraged that a 9-year-old autistic boy has died from non-Hodgkins lymphoma. Jeremy Fraser lost his battle with cancer after his mother allegedly failed to provide him with the medications that he so desperately needed. Non-Hodgkins lymphoma is a very treatable cancer, but it requires adequate treatment that could range from months to a year. In fact, doctors had given Jeremy a 92 percent cure rate — assuming his mother would do her part in helping him complete treatment.

According to the reports that I have read, Jeremy was heading in the right direction, but was supposed to follow up at home with a very crucial phase in the treatment. But after his mother canceled a dozen chemotherapy appointments, and neglected to fill at least half of the prescriptions vital to the success of Jeremy’s treatment, he was returned to the hospital with only a 10 percent chance of survival — and in the end, it was too late.

I’m certainly mad at the lack of parenting skills that Jeremy’s mother has shown, but I don’t know if I should also be mad at the health care center that was treating him. Where was the follow up? Why not try to find out how this child is — especially if he has missed several appointments for chemotherapy treatment?

A child with cancer has died — not because if his disease — but because the negligence of the adults that should have been looking out for his well being. May God bless him and keep him safe.

I want to know what you think.

Eight states are considering passing legislation that would require random drug testing for people to receive food stamps, unemployment benefits or welfare.

Click here to read the article, “States Consider Drug Tests for Welfare Recipients”

Supporters of this legislation feel that it’s necessary in response to an ever-growing population of Americans applying for government-funded aid as a result of the economic downturn. These lawmakers feel it would help to identify the potential health risks and the probability of those receiving aid getting back on their feet when the economy turns around — and that it would also send a clear message: In America, you don’t get something for nothing.

Why not get tested? Millions of Americans are drug tested at random for their jobs every day — the same Americans whose taxes are funding government assistance programs like food stamps, unemployment and welfare. And as American citizens, we need to take responsibility for our own well-being and that of our families.

Now, I’m not getting down on the millions of Americans who may be down on their luck, or for whatever reason, must rely on government aid to help them through tough times while they try their best to get back on their feet. But then if that’s the case, a random drug test should not be a problem, right?

But there are two sides to every argument — and there may be a couple of questions worth asking when considering this proposal …

What about the unintentional effects that limiting aid to a family — especially one with children — may have in failing to provide them with necessities as basic as food on their plates? We don’t want to punish the children for their parents’ actions. But then, in some cases, with severely drug-addicted parents, how can we be sure that the money is going to support the children, rather than to support the habit?

Just last year, a contest in southern California called “There Ought to Be a Law,” yielded a disabled 16-year-old winner whose life challenges inspired his proposal of legislation to mandate random drug testing for all pregnant women on welfare. R.J. Feild was born weighing just 2 pounds, 2 ounces with traces of heroin, marijuana, methamphetamine, alcohol and cocaine in his system due to his mother’s drug use while she was pregnant.  And while the “R.J.’s Law” never made it into legislation, it brought to light an important issue.

But then what happens to people who test positive for drugs while on public assistance? Would the states flat-out refuse help forever, or would they help them get into a rehabilitation center to kick the habit? Right now, most states can’t even meet their Medicaid requirements for people to get routine health care. Perhaps a better plan might be to pump the government aid they would normally receive directly into rehabilitating them.

So I’d like to know what you think, because at the end of the day, we’re the ones funding these programs.

This is a great day for patients at risk of developing Alzheimer’s. This new test presented by a team from the University of Pennsylvania School of Medicine really solidifies other studies that have looked at potential biomarkers in patients with Alzheimer’s disease.

The test is very straightforward for the patient. The first step is to undergo a spinal tap, which involves inserting a very thin needle into the patient’s back and extracting cerebral spinal fluid from the spine. This is a similar technique to what many patients undergo when they get regional anesthesia for certain surgical procedures. It has minimal pain and minimal side effects, including headaches, which tend to be relieved with treatment.

Once the fluid is extracted, these doctors analyze the fluid for certain proteins, which have been already identified in patients with Alzheimer’s. One of those proteins is called tau and the other is amyloid beta42. These proteins correlate with the build-up of plaque in the patient’s brain, which leads over time to the degenerative effect of Alzheimer’s.

In the study’s results, the test accurately ruled out Alzheimer’s in 92.4 percent of subjects. I think that this study could lead to the test’s possible use in clinical settings especially to diagnose early cognitive impairments which could ultimately lead to Alzheimer’s in families with risk factors.

I can’t believe it took more than two years to charge the physicians involved in the case of Anna Nicole Smith’s death. It really shocks me that it took so long for these investigators to connect the dots.

Even from the preliminary data, it is evident that prescription medication had clearly played an important role in the cause of her death.

In fact, according to an Associated Press report, investigators found 11 prescription medications in her hotel room the day she died. More than 600 pills — including about 450 muscle relaxers — were missing from prescriptions that were no more than five weeks old when she died, and most of the drugs were prescribed in the name of Howard K. Stern, her lawyer-turned-companion. And actually, none of them were prescribed in Smith’s name.

So it makes me wonder, how is it possible that it took almost two years for charges to be brought on these doctors?

If you look at the confidential fax that was sent in September of 2006 by Dr. Sandeep Kapoor, the list of medications is a “who’s who” of narcotics, sedatives and sleeping medications and there is no scientific or chemical way that all of these drugs can be tolerated by the human body. These drugs are highly addictive and mixing them is basically the equivalent of a loaded gun in the hands of a child.

There’s a whole list of drugs she was on including: Four bottles of 2 mg Dilaudid; 2 milliliter bottles of Lorazepam (Ativan); two bottles of 350 mg Soma, a total of 180 tablets; one bottle each of 30 mg Dalmane and 400 mg Prexige, the latter a British drug; and one bottle of methadone, 300 5mg tablets. All of them are classified as different types of painkillers. Click here to see the confidential fax from Dr Eroshevich to Dr. Kapoor.

And clearly evident in the story written by FOXNews.com’s Roger Freidman Friday, are statements from Smith’s psychiatrist, Dr. Khristine Eroshevich, where she pleads with Dr. Kapoor to give Smith something to knock her out.

If Dr. Eroshevich felt Anna Nicole needed to be sedated, the proper procedure would have been to put her in a hospital setting where she could be monitored and cared for in a healing environment.

At the end of the day, it comes down to the fact that all doctors take an oath to “do no harm.” So how, in keeping with that sacred oath, could any doctor prescribe these medications knowing that the outcome could be deadly?