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Mercy San Juan has four sets of triplets – and a pair of twins, too
Angela Wheeler of Granite Bay looks at Zoey, one of three triplets born to Wheeler and her husband, Terry, on Monday at Mercy San Juan’s neonatal intensive care unit. Zoey and her brothers, Mason and Lucas, are doing well.
The 26 beds in the neonatal intensive care unit at Mercy San Juan Medical Center being filled is not unusual. But more than half the infants coming from just five families is rather remarkable.
For the first time since the Carmichael NICU was founded in 1989, there are four sets of triplets in the collection of rooms making up the haven for tiny or struggling babies. There also is a set of twins.
A few of the babies are propped up on phototherapy lights to treat their jaundice, some are hooked to breathing tubes and monitors. Others are simply small versions of healthy newborns.
“Babies are so resilient,” said nurse Lori Wolf as she tried to elicit a burp from 4-pound Semaj Davis, who was born Jan. 11, just shy of 29 weeks, along with a brother and sister.
“I don’t think most adults could get through what these babies do – although they can get sick really fast, they also get better fast,” Wolf said.
Multiple births are increasing with the rise of fertility treatments such as ovulation-inducing drugs, artificial insemination and in-vitro fertilization. Older mothers also are more likely to conceive multiples spontaneously than younger women.
Still, less than two of every 1,000 babies born in 2006 were part of a set of triplets, according to the Centers for Disease Control and Prevention. That year, the most recent live birth figures available, there were 137,085 twins born; 6,118 triplets; 355 quadruplets; and 67 quintuplets and above.
Sarah Watson, 24, a dental assistant from Magalia, had been trying to get pregnant for about nine months when she learned she had polycystic ovary syndrome. She started taking an ovulation-inducing drug and was pregnant three months later.
When her doctor told her she was having triplets, she said, “I just started bawling – I was terrified. But then I thought, ‘If God thinks we can handle three, we’re going to have three.’ “
Angela Wheeler, 41, who does marketing for a bank and lives in Granite Bay, had been trying to get pregnant for nine months when she underwent fertility treatments.
The first thing to go when she learned she was having three babies was the car: Wheeler needed something to accommodate five car seats for her 6-year-old stepdaughter, 3-year-old daughter and the triplets. She and her husband, Terry, an attorney, got a minivan, picked names and stocked up on supplies.
On Monday, Mason, Lucas and Zoey came during a scheduled C-section in their 32nd week of gestation. While 37 to 40 weeks is considered a normal pregnancy, doctors aim for 36 weeks for twins and 32 weeks for triplets.
The three – who weighed between 2 pounds, 9 ounces, and 3 pounds, 9 ounces at birth – appear healthy.
“It’s a blessing,” Angela Wheeler said.
Babies stay in the NICU until they can eat, are gaining weight and have no breathing or heart rate problems.
Staff members sometimes put the multiples together in a bed to emulate the womb experience.
“I just think it’s fun to watch how they end up molding to each other, kissing each other, and sometimes yanking tubes from each other,” said nurse Teresa Madison.
Watson and her husband, Cory, a pharmacy technician, have been staying in Carmichael since the babies were born Feb. 7 at almost 31 weeks.
Luke has grown to 5 pounds and Hannah to 4 1/2. Taylor, at 3 pounds, 1 ounce, is fighting necrotizing entercolitis, an intestinal infection.
“I always thought we were meant for bigger things in life and I think this is it,” their father said. “It’s going to be challenging and a lot of work, but I think we’re up for it.”
Nearing her 1-month birthday, Alexia Casillas rests Friday in Mercy San Juan Medical Center’s neonatal intensive care unit. Multiple births, of which there have been a flurry recently at the Carmichael hospital, have increased thanks to fertility treatments.
Kaiser has free screenings on cataracts for the needy
Surgeons perform a cataract operation as part of the Mission Cataract USA program. Kaiser Permanente’s Point West Medical Offices will have free exams on April 17 this year for people with no insurance.
Kaiser Permanente will offer screenings to area residents who may be eligible for a free eye cataract surgery. The screenings will be April 17 at the Kaiser Permanente Point West Medical Offices, 1650 Response Road, Sacramento. Appointments are mandatory and must by made my April 9.
To sign up, or to request more information, call: (916) 973-7159.
The surgeries are part of Mission Cataract USA, an annual program where doctors provide surgery to people who have no health insurance and can’t afford the operation. Kaiser Permanente physicians and staff have volunteered for for 15 years and will perform as many as 20 free cataract surgeries in early May.
Valley Democrats Cardoza and Costa are key to big health care vote
WASHINGTON – With a Capitol Hill showdown only days away, two San Joaquin Valley congressional Democrats remain crucial and undecided votes on a controversial health care bill.
The pressure is building on Reps. Dennis Cardoza of Atwater and Jim Costa of Fresno. In some ways, they hold the bill’s fate in their hands – as well as several political futures: the president’s, the party’s and their own.
The White House has summoned both in recent days. Television ads and Republican talking points target them.
“I have had good friends who have called me in recent weeks, who have made good arguments on both sides,” Cardoza said.
Costa went to the White House on Thursday night. A week ago, it was Cardoza’s turn. As a counterweight, corporate opponents of the health care bill have been running television ads urging viewers to tell Cardoza to vote no. Phone bank operators have been deluging both offices, also urging a no vote.
Inevitably, bargaining over one issue blends into another.
Costa said last week that he used some of his time with President Barack Obama to urge more consideration for the valley’s water and employment needs. Obama said he understood, Costa reported.
In a memo, Republican leaders identified the two Valley lawmakers as among those who would ultimately determine the success or failure of the legislation. They are both part of the Blue Dog coalition, whose members have more moderate voting records than other Democrats.
In November, Cardoza and Costa joined the majority in approving the initial House bill by a 220-215 margin.
Since then, negotiators have revised the package, but the final bill, well over 1,000 pages, isn’t expected to be available for inspection until Monday. The Valley lawmakers say they can’t commit until then.
“We’ve gotten the summaries, but we don’t know what the actual language is going to be yet,” Cardoza said.
Costa, too, stressed that “I want to see the bill in print, what we’re actually voting on,” before making a decision.
Costa and Cardoza both support elements in the health care package, including insurance coverage for those with pre-existing conditions and portability of coverage when employees change jobs. The bill’s final cost remains a potential concern for both.
Both lawmakers oppose federal funding of abortions, though they are leaving to others the details of how to write the necessary legislative language.
Because of congressional vacancies, House Speaker Nancy Pelosi needs 216 votes. No Republican is expected to vote for the health care package, leaving Democrats to pick their own way.
Politically, legislators see danger everywhere.
Failure to pass the bill would invariably brand Obama and congressional Democrats as weak or inept. That would hurt the party in November’s elections. But in conservative-leaning San Joaquin Valley districts, support for Obama and Pelosi could also be costly.
In this environment, even modest clues invite interpretation. Cardoza, for one, seemed to emphasize last week the problems of uninsured San Joaquin Valley residents and the pain of rising insurance costs.
“We have real problems with a lot of my folks not having insurance,” Cardoza said.
An estimated 28 percent of the residents of Costa’s congressional district in Fresno, Kings and Kern counties lack health insurance, according to the Physicians for a National Health Program.
An estimated 22 percent of the residents of Cardoza’s congressional district in San Joaquin, Stanislaus, Merced and Fresno counties are uninsured.
The Valley’s uninsured population is much higher than in other parts of the country.
Cardoza and Costa both cited funding for new medical schools in their votes in November. The original House bill authorized $500 million over five years for new medical schools in underserved areas.
The University of California, Merced, was an unnamed but presumed beneficiary.
The health care package to be considered next week omits the medical school funding.
Instead, Cardoza noted, the Obama administration in its fiscal 2011 budget request is seeking $100 million next year for the same purpose.
Cardoza serves on the leadership-controlled House Rules Committee, which will play a crucial behind-the-scenes role in coming days. The panel sets rules for how bills are put together and debated, and often is lambasted by Republicans for cutting off GOP alternatives.
Congressional action is expected to be concluded by next Sunday.
Rules vary for discarding medications in capital region
One woman who called the Don’t Flush Your Meds hotline not long ago wanted to know what to do with one of her father’s old prescription drugs – which, as it turned out, had expired in 1963.
“She was cleaning out his medicine cabinet,” said Sabina Rynas, who manages the Don’t Flush Your Meds program for the Sacramento Regional County Sanitation District. “Good thing she held onto the medication, so she could finally dispose of it properly.”
With the abuse of prescription medications on the rise, their proper disposal is a growing safety issue. It’s also an environmental issue and an ongoing concern for the elderly and their families.
“Usually, the people who call have bags and bags of medicine, everything from over-the-counter cold medicine to morphine,” said Rynas.
Water treatment plants can’t routinely process discarded and excreted pharmaceuticals out of the water supply. The science is thin, but studies indicate that as a result, the drinking water that reaches 46 million Americans is laced with trace amounts of pharmaceuticals.
“It’s not like you drink three glasses of water and feel the OxyContin,” said Rynas. “It’s more like thousands and thousands of gallons.”
Similarly, research has shown that enough excreted birth control medication has leached into the watershed to disrupt the endocrine systems of amphibians and fish in some parts of the country.
“The fish change sex,” said Rynas. “Male fish develop female organs, to make it simple. There’s no evidence that this will affect humans’ health in any way.”
The fear is that the intentional dumping of meds down the drain will only exacerbate the amount of drugs in the water supply.
So what should consumers do with expired or unused meds? For years, patients were routinely told to flush them – but now, it depends on several factors.
For most drugs, the Don’t Flush Your Meds program and the California State Board of Pharmacy follow current and rather complicated U.S. Food and Drug Administration guidelines.
Consumers should keep most old meds in the original vial, scratch out identifying patient information and mix the meds with water and a tiny amount of something that no one would find palatable, such as kitty litter, cleaning powder or coffee grounds.
“You have to render them unusable,” said Paul Lofholm, past president of the California Pharmacists Association.
Then, the instructions continue, the consumer should seal the vial with tape, then further seal the taped vial in a small box or margarine container.
Finally, the consumer should toss the sealed and tainted meds in the trash, having thwarted any possibility that wayward children, marauding pets or druggie-minded scavengers might accidentally overdose on discarded medication.
Exceptions to this process include a list of controlled substances – morphine, Demerol, OxyContin and other drugs. Because of the risk of accidental ingestion, the FDA continues to recommend that they be flushed down the sink or toilet.
Alternatively, Sacramento County residents can turn in most meds – except controlled substances – at county waste management’s North Area Recovery Station. West Sacramento and Folsom residents can turn over unused medications to local police.
“They rightfully belong back at pharmacies,” said Lofholm. “We’re used to the disposal of drugs.”
Since 2000, hospitals, pharmacies and nursing homes have been required to contract for the incineration of expired prescription drugs, he said. Yet consumer take-back programs at pharmacies aren’t legal in many areas – including Sacramento County, said Rynas.
State law allows unused and unopened prescription medications to be collected from nursing homes for redistribution at low cost to needy Californians in some counties.
LEARN MORE
For more information on the local disposal of unused or expired meds, call (916) 875-7000 or go to www.dontflushyourmeds.com
Sacramento County budget cuts change mental health treatment
Dave Da Vigo meets with a psychiatrist at The Effort, a nonprofit clinic that has been inundated with patients suffering from mental illnesses since Sacramento County reduced services – 1,000 new patients since July. “We have hired three new psychiatrists, but we can’t do it fast enough,” said Robert Caulk, the clinic’s executive director.
Thousands of mentally ill people who have been cut from county programs during the past year are straining the area’s health system, with hospitals and private clinics struggling to fill gaps in care.
Psychotic patients are crowding emergency rooms, facing long waits for care and triggering safety concerns, officials said.
County Mental Health Director Mary Ann Bennett said the cuts to county programs have prompted providers and administrators to consider new ways of delivering critical services.
In the future, she said, more patients may get federally funded care or treatment at smaller psychiatric clinics scattered throughout the county.
“We’re booked,” said Robert Caulk, executive director of The Effort, a nonprofit outpatient health clinic in midtown Sacramento that is getting spillover county mental patients. “We have picked up 1,000 new patients since July. We have hired three new psychiatrists, but we can’t do it fast enough.”
During the past year, the county has shuttered the crisis unit at its Mental Health Treatment Center on Stockton Boulevard, and closed 50 of the facility’s 100 inpatient beds. The center handles the most severe psychiatric patients in the county.
During the same period, the area’s four nonprofit “regional support teams,” funded by the county to provide outpatient care to people with severe mental illness, each cut their client loads from 2,000 to 900. Administrators referred patients elsewhere but don’t know how they are faring, said John Buck, chief executive officer at Turning Point Community Programs.
Some are bouncing back to regional support teams for help, said Buck. “Some, I fear, are running out of medication and ending up in emergency rooms.”
“Many have just given up and are out on the streets,” said George Ehrlick, 61, a former county patient now getting care for his depression and anxiety at The Effort. He said some patients who had beaten addictions are doing drugs again, and he knows of former county patients suspected of taking their own lives.
Ehrlick himself stopped taking his medications for months after he was cut from the county-funded program he’d been in for seven years. “When I came to The Effort I was a basket case,” he said.
Since Sacramento County began cutting services at its mental health center, area emergency departments have seen a 65 percent increase in psychiatric patients, said Scott Seamons of the Hospital Council of Northern and Central California.
“The public should know that they are going to see more people out of control in the ERs,” Seamons said. At any given time, emergency rooms are holding 12 to 15 mental patients.
As a result, said Bill Sandberg, executive director of the Sierra Sacramento Valley Medical Society, ERs are beefing up security and psychiatric staffing. “I have never seen emergency department directors so worried,” he said.
UC Davis Medical Center, located across the street from the county mental health center, is bearing the biggest load, but all hospitals are being affected, Sandberg said.
“Psychiatric patients experiencing flare-ups used to go to the mental health treatment center. Now they’re coming to us, and at first we were not prepared,” said Dr. Debra Kahn, a UC Davis psychiatrist.
Only the sickest patients are admitted for inpatient care, she said, and “we are maxing out all of the outpatient resources” to accommodate everyone else.
The Effort is receiving many of them.
The waiting room at the J Street clinic is constantly crowded with former county patients, many “in a state of desperation,” said Dr. Brad Briercheck, a psychiatrist.
“They’re having suicidal thoughts, they’re unstable, they’re off of their medications,” he said. Those in crisis are sent directly to hospitals.
The Effort is better prepared than most to handle the deluge of new patients because its clinic is a Federally Qualified Health Center, making it eligible for certain grants and boosting its Medicare and Medi-Cal reimbursement.
Jonathan Porteus, The Effort’s clinical director, said the county should consider a similar approach. “It would be a great alternative to the county funding mental health,” he said.
Officials are pondering the idea, said Bennett. Opening a series of smaller county clinics for patients who qualify for Medi-Cal also is a possibility, she said. One such clinic, with 12 beds, is ready to open in Carmichael, she said.
“Anytime you make reductions of the magnitude that we have made, you’re going to have a big impact on services and clients, and that’s very sad,” Bennett said.
“But all of this has forced some really creative thinking … Maybe some positive things will come out of all of this.”
George Ehrlick, who has depression, says he’s seen the effect of budget cuts on patients: “Many have just given up.”
Psychiatrist Brad Briercheck is seeing more patients who used to be served by the county.
