Monday, August 22, 2011

French healthcare experience #5: Re-education

One major difference between post-partum care in the US and France has been the post-partum care for my lady parts. Note: while I tried not to be too graphic with this post, there are somethings I couldn't help so read with caution if you are sensitive to these kinds of things. And, no, there are no pictures.

Starting during my pregnancy, several of my friends told me that the French are quite interested in making sure women get their parts back in shape after birth. And the way they do this is through "re-education" therapy (yes, that it actually what it is called). Jokingly, my friends said it was because of the French obsession with beauty and sex. And, in fact, the mid-wives at the hospital told me that it would be ok to resume sex as soon as the stitches healed - in about 2 weeks - but that I should not do cardiovascular exercise until after finishing my re-education. Which is definitely different than the medical advice I got in the US which said to wait at least 6-weeks before doing either. As for the official reasoning I was given behind re-educations, the doctors and midwives told me it's to prevent incontinence. Either way, both sounded like good reasons. But, oh boy, I knew this was going to be an experience.

Re-education is basically electro-stimulation therapy for your vaginal muscles. When I saw my OB for my 6-week post-partum appointment, she even said, "the stitches healed nicely, now lets get you a prescription for the re-education. And you will want to start that soon." Maybe I should have vajazzled before going in to see her. She made me feel a bit self-conscious (more self-conscious then usual, anyway). So, my first session was last week with my mid-wife, 9-weeks post-partum. For twenty minutes, I was made to lay down on an exam table with a vibrator-like instrument inserted between my legs that is then attached by wire to a computer. I was given a prescription for the thing so it is mine to carry around with me to and from the mid-wife's office for each of the 10 sessions that I was prescribed.

If anyone has ever had electro-stim therapy as part of rehab for an injury, you can imagine what this is like. Once the contraption is hooked up to the computer, the mid-wife starts one of several different programs of electric impulses. The programs vary on intensity and duration of the pulses. The purpose being to cause the muscles to contract and, therefore, strengthen. And all of this with both kids in the room. Owen was eating his snack and playing with cars. Zack was nursing during the first session and hanging out in his carseat during the second, smiling at me as I made faces with each shock. Let me state for the record, I have now had 2 sessions and I would not call this an enjoyable experience. In fact, I would actually describe the second session as painful. And 4 days later, I am still a bit sore. But, since I am not the most dedicated kegel-ist and the alternative, according to my mid-wife, is that I risk peeing my pants every time I sneeze, I will continue the rest of my sessions.

One funny thing was that my mid-wife seemed genuinely shocked that they don't do this therapy in the US. And, she seemed sort of proud that the French were "more advanced" than the Americans in taking care of women after childbirth. I do have to say that this is just another example that I have come across of the French being much more supportive of preventive care and, especially, in regards to women's health. Which sort of amazes me given how paternalistic French society still is.

Monday, August 15, 2011

2 months old!

August 14, 2011

Growth parameters measured on August 10:
weight: 4,390kg (9lbs, 10oz)
height: 56cm (22 inches)
head circumference: 39cm (15.4 inches)

French Healthcare Experience #4: Vaccines

Zachary is now 2 months old! So, hard to believe. In addition to the developmental milestones that this age brings - smiles, coos, a little more head control - this is also the age for his first set of shots. And so, with a little bit of hesitation, I brought him to the doctor (Owen came along too as Sean was at work) last week for his shots.

Now, the first thing to know about getting vaccines in France is that you have to bring the meds to the doctor's office yourself. So, before the day of the appointment, you must get a prescription for the vaccines and go pick them up at the pharmacy. Since pharmacy's may run out of their supplies, it is always recommended to go several days in advance. So, for the past week we have had the vaccines in our refrigerator - a reminder each time we would go get some food of the upcoming event.

The other thing to know is that drugs are significantly cheaper in France than in the US. On average, our co-pay is less than 1 euro for our drugs and the total cost of the drugs themselves have never been over 20 euros as far as I can remember. This is for drugs such as antibiotics, pain meds (the tylenol and advil equivalents for kids are by prescription only here), cough syrups, etc. So, we were a bit surprised to see that the cost of the vaccines was over 100 euros though it was completely covered by our insurance.

But, other than that, the appointment was very similar to those we had in the US. Since August is the month of vacations in France, our appointment for Zack's 2 month well-child check was with the substitute doctor and not our regular physician. In France, substitute doctor (medecin remplaçant) is a profession, like substitute teachers. At our last appointment with our PCP, she assured me that her replacement this time was wonderful so I wasn't too concerned when I got to the office. Of course, I'm always a little anxious about seeing a new professional because of the language issue. I'm always a bit insecure about whether I will understand let alone be understood. But, in general, this physician was fine. She answered my questions with patience and even made a little small talk as she was preparing the needles (Zack had 2 shots). And, much to my surprise, despite her coldish demeanor towards Owen (who, after waiting for an hour at this point wanting me to play with him and was interrupting my conversation with the doctor to ask me questions), she even patted Zachary on the back a few times after I picked him up following the shots and offered a few words of reassurance to him, "C'est tout. C'est fini. Ça va." (That's all. It's finished. You're ok.)

For those interested to know, the vaccines are mostly but not entirely the same regimen as in the US. For children at risk, they give a vaccine for tuberculous at birth along with Hepatitis B. I'm positive that Zack did not get tuberculosis because I remember having a conversation with the sage-femme about it but I can't remember whether he had Hep B. The vaccines that Zachary got at 2 months are known in France as Prevenar 13 (for pneumonococcus) and Infanrix hexa (covers diptheria, polio, tetanus, Hib, pertussis, and Hep B) which I think is primarily the same as in the US though I remember in the US that Owen was also rotavirus too. Another difference is that here, as I handed over my check and carte vitale (health insurance card) to the doctor for payment, she handed me back a prescription for the next round of shots - to be given in 1 month. This surprised me because in the US shots are normally given in 2 month intervals. But, as I am repeatedly reminded, we are NOT in the US anymore.

Thursday, August 11, 2011

Funny faces

Zachary is a smiling machine (when he isn't crying, that is). But it's his other faces that make us laugh. Such beauties include these faces seen from August 5th:

And these:

And, of course, Zachary's smiles are precious:

Thursday, August 4, 2011

Zachary's first photo shoot

One thing that the French and US cultures both seem to share is the desire to feed upon the bleeding hearts of new parents. Baby products are expensive and abundant (though the French government pays out mother's money prior to the delivery to help subsidize your costs of setting up a nursery and monthly mother's money until the child is 3 years old to help pay for diapers and formula).

But I digress. In anycase, we learned within hours of Zachary's birth that regardless of whether you are recovering in a maternity ward in Boulder or Bordeaux, one of the first visitors you will receive is a photographer who offers to take pictures of the newborn and then tries to sell you a package of photos for an exorbitant cost. And, of course, between the sleep deprivation and the hormones, you give in and buy some.

So, without further ado, here are some of my favs from Zachary's first photo shoot, taken on June 15.

This one isn't a great angle but it's the only one of the three of us.
I am really sad that there are no professional photos of Owen and Zachary (since Owen wasn't at the hospital with us) but we have certainly made up for that with candid shots. :)