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“And since US is routine the OP didn’t have to mention it. So the OP had every right to Omit Routine tests, even if the pt. never heard of ultrasounds, the Doc would order it anyway.”
Please reread what you wrote above. It sounds like you’re just out to attack anything that comes by your way. If what you wrote above is accurate, what was her entire point of #2 (diagnosis and testing)? If the ultrasound is routinely done and conditions like this are diagnosed in a timely manner, why on earth is her point #2 being mentioned? Her point #1 – preventative care (with vitamins) should surely suffice. Why is she alerting everyone to be tested for this, when they’re already being tested for it?
Judging by the lack of prior diagnosis for her child and the lack of any mention of the sonogram test in this letter, it’s pretty safe to assume that she’s basically aiming this to people who follow her shitta. If so, a disclaimer should have been included.
Health – you keep on missing the point. The ultrasound is not the ALTERNATIVE OPTION, it is the REGULAR OPTION. The OP was recommending this test as the FIRST choice in testing. The AFP test is the alternative in most cases.
I would like to offer my apologies to the OP if I offended them in any way. My intention was only to bring the proper awareness to this disease and to point out the danger of omitting medical details when posting advice. I wish your child a refuah shleimah and may he/she lead a wonderful, full and active life.
Heath – I wasn’t recommending any info regarding my shitta. Just the opposite, the OP clearly left out information that wasn’t according to her shitta (no ultrasounds due to religious reasons*), hence my response to them. I wasn’t recommending not including the AFP test, I was suggesting that ALL info needs to be included.
If one has no prior knowledge about spina bifida, reading this letter informs you ONLY that there is the AFP test to diagnose it. If this letter is meant to help the public, it should have included the following summarized info:
” It’s best if this can be diagnosed during pregnancy. There are different methods in the way it can be done. The most routine method is the sonogram in which most women undergo during the 16-20th week of pregnancy. If you choose not to have the sonogram done or prefer an earlier diagnosis, there’s also the AFP Test method which can be requested from your doctor during the early weeks. The AFP test can have other implications as well, so that is best if its discussed with your doctor and your Rav.”
(*Being that ultrasounds are done as part of routine care, not having one done is mostly due to religious reasons)
First of all, the criticism is warranted because an ultrasound is part of routine care. Most spina bifida cases are diagnosed through that manner. Why are they suggesting that an AFP test be done as the first approach? It is usually not necessary (in regards to spina bifida) only if you opt out of the sonogram. They should have specified that this is an available option IF you have any issues with taking a sonogram. Presenting medical advice based on your personal choices alone is not ethical.
Furthermore, surgery in utero is becoming increasingly more popular in this field and in many other areas as well. Insurance companies are beginning to approve it more frequently as well, especially since they realize that the cost of the surgery will be lower than lifelong or extensive care. Even if would be done only sparingly, I still think parents have the right to be aware of the option. You never know if they will or won’t be approved for it (or find another way to have it done), if you don’t even give it a go.
I never discounted any value in taking vitamins, I actually fully support it as well. I was just pointing out that vitamins alone is not a guarantee that this situation won’t arise, so the proper medical advice is warranted.
As for Obamacare, I’m in complete agreement with you. Let’s hope and pray that this disaster is averted before it has a chance to be fully placed in effect.
I understand that the author is going through a difficult time, but when medical advice is presented to the public, it needs to include all relevant information. Spina Bifida is most commonly diagnosed through routine sonograms, usually by the 16th-20th week of pregnancy. Thanks to the wonders of advanced science and technology that Hashem has blessed us with, it is now possible to begin treatment while the baby is in utero. This surgery can substantially reduce the severity of the condition and in quite a few cases allow the child to live a full and active life.
By not including this information, it is being inferred that the only way to diagnose this condition is through the blood test and that treatment can only begin once the baby is born (will less optimal results). Sonograms are part of routine pregnancy care and are not done only if the patient refuses it. If there’s any personal preferences for not having a sonogram done, then please issue a disclaimer with your message. If its truly awareness that you’re trying to raise, then a good portion of the letter should have been devoted to the sonogram and surgery in utero. Taking vitamins is not a guarantee that this condition will be avoided (I’m not discounting its benefits). If parents are told that their unborn is being diagnosed with this disease, wouldn’t you want them to be aware of all options, including the one that offers the best possible results?