MR. IVF (賴醫師女兒的父親節感文，IVF 是試管嬰兒的簡寫)
So who is this Mr. IVF?
In certain contexts a man is perhaps identified and placed according to his occupation. Society will often aid in this catagorisation and will deparcate the person according to popular convention. However, on the 8th August, this same man is defined in a completely different way. He is known as a 'Father'. Suddenly, society asks us to re-evaluate the persons closest to us as private individuals who have taken on the enormous task of raising children. What we often use to define these people is perhaps no longer valid, or does not take on as much significance. For example, the amount of time and energy devoted to work is not necessarily desirable any longer as we view these individuals as fathers. We start to consider how these individuals spend their time and how they interact with their families. We start to see the hopes, aspirations and effort invested by these individuals into their off-springs in the anticipation of something greater than themselves.
Dr Lai is no exception. Although he is deeply committed to ensuring good outcomes for his patients and always treats them with compassion and respect, I see him as 'Dad', not Dr Lai. Both he and my mother have always wanted me to have all the opportunities they can possibly give me. And this included the best education in the best environment they could envisage. The method in which this was achieved may be old-fashioned, but the intent was there - to make me a well rounded individual who could appreciate the sciences and art. They have supported me through my development and encouraged me to achieve as much as I could or wanted to.
Those that have come across my father will probably agree that the most noticeable qualities about him is how gentle and generous he is. He will go out of his way to give someone a hand with the utmost humility. His belief in the goodness of people does not seem to waver or to be eroded by cynacism. My father's concept of 'self' is very much in context of his family and society. He will place himself in service of his family and friends first and foremost. Some may even feel that his generosity and selflessness are sometimes abused, but these are the essential qualities that define him and that he cannot shed without losing his integrity.
My father also has an amazing capacity to listen. When he listens; he listens with an open mind and with acceptance. He is not in any way autocratic. So many times I have pushed the boundaries in my own struggles to define myself, and my father has always given me the sense that he tries to understand and to accept the way that I think.
I respect and applaud his courage in his willingness to listen and to be challenged. I admire his humility in the way that he is always ready to accept he may be wrong. And I love him for the gentleness that he displays to everyone.
Happy Father's Day, Dad, and thank you for being exactly who you are.
2008年7月24日 星期四
2008年7月10日 星期四
次發性無月經
婦女曾有自發性的月經(不必使用藥物，月經就自己會照週期來潮)後，若有連續三次或以上，週期到了但月經還是一直不來，就算是次發性無月經。
先確定是否懷孕
曾有一位因週期過了四個月，但一直等不到月經的到來，因而由母親陪伴前來診所求診的未婚女性，她自稱：曾有過一次性經驗，但從頭至結束，一直有用保險套避孕。但透過超音波的螢幕，我們很清晰的看到胎兒的影像，其結果是她已是懷有四個多月的孕婦了。所以，次發性無月經應先檢驗是否懷孕。
造成次發性無月經的原因
除了懷孕外，腦部的病變是造成次發性無月經最常見的原因，其次則是卵巢機能不足或內分泌失調、貧血及子宮的疾病所引發的次發性無月經。
子宮疾病所引起的次發性無月經與內分泌系統完全無關，它主要是因子宮腔內的沾連所引起。
子宮若是小孩子的宮殿，則子宮內膜就像是宮殿內所貼的壁紙，而月經就是由子宮內膜所製造。
婦女的子宮腔內，若有正常的子宮內膜，也就不會產生沾連。子宮內膜若有損壞，則會引起沾連，而沾連的地方就是沒有子宮內膜，沒有子宮內膜的地方，也就不會也無法製造出月經。
因此，子宮腔內若有部分沾連，則會造成月經稀少的現象，若子宮腔內有著嚴重的沾連，也就無法製造月經，便成為次發性無月經的患者，沒有內膜的支撐，當然也就懷不了孕。
先確定是否懷孕
曾有一位因週期過了四個月，但一直等不到月經的到來，因而由母親陪伴前來診所求診的未婚女性，她自稱：曾有過一次性經驗，但從頭至結束，一直有用保險套避孕。但透過超音波的螢幕，我們很清晰的看到胎兒的影像，其結果是她已是懷有四個多月的孕婦了。所以，次發性無月經應先檢驗是否懷孕。
造成次發性無月經的原因
除了懷孕外，腦部的病變是造成次發性無月經最常見的原因，其次則是卵巢機能不足或內分泌失調、貧血及子宮的疾病所引發的次發性無月經。
子宮疾病所引起的次發性無月經與內分泌系統完全無關，它主要是因子宮腔內的沾連所引起。
子宮若是小孩子的宮殿，則子宮內膜就像是宮殿內所貼的壁紙，而月經就是由子宮內膜所製造。
婦女的子宮腔內，若有正常的子宮內膜，也就不會產生沾連。子宮內膜若有損壞，則會引起沾連，而沾連的地方就是沒有子宮內膜，沒有子宮內膜的地方，也就不會也無法製造出月經。
因此，子宮腔內若有部分沾連，則會造成月經稀少的現象，若子宮腔內有著嚴重的沾連，也就無法製造月經，便成為次發性無月經的患者，沒有內膜的支撐，當然也就懷不了孕。
包 生 男
曾有人引進生男育女的新方法，並聲稱其準確率是世界之冠，可是又拿不出科學證據。
筆者透過電腦網路尋找，也找遍全世界的醫學期刊，但都「查無此事」時，台灣的醫學界只能苦笑，以禮相待這位遠來的和尚。
到底準不準 ? 如有人敢宣稱「不準 」包退所有費用，而且附帶一筆鉅額的教育補助金時，其準確性或許會因資本利得而有所改觀。
事實上，在自然的情況下，生男育女各佔百分之五十的機會，以一百個個案做單位，套一個簡單的方式試算一下他的獲利性及準確性。
例如每次收費五萬元，如果所生的五十個女嬰完全退費，而另五十位男嬰則穩賺不賠，結果是不必做任何篩選，仍可以賺到二百五十萬。
因此，如果真有方法達到98%包生男的準確率，或許又會興起另一場的醫療及生態革命戰。 如果坊間有人宣稱有百分之百包生男孩子的方法，並喊價二十萬，失敗了，給予鉅額補償，則真的有人願意花二十萬為生男孩而如此耗費精神嗎? 套句台灣話─ 踢倒街 ─，就是「滿街」都是的意思。
問問婦產科醫師、看看農民曆，連廟公廟婆也都知道，甚至常有不孕症患者要求筆者為她們治療兼製作男生給她們。由於台灣男嬰多於女嬰，97年起已禁止醫師做胎兒性別篩選。
但因有廣大的市場要求，所以偏方、妙方會層出不窮，到底有多妙？需要的人須好好的計算一下，否怎則女嬰丟在嬰兒室，誰養她們呢?
筆者透過電腦網路尋找，也找遍全世界的醫學期刊，但都「查無此事」時，台灣的醫學界只能苦笑，以禮相待這位遠來的和尚。
到底準不準 ? 如有人敢宣稱「不準 」包退所有費用，而且附帶一筆鉅額的教育補助金時，其準確性或許會因資本利得而有所改觀。
事實上，在自然的情況下，生男育女各佔百分之五十的機會，以一百個個案做單位，套一個簡單的方式試算一下他的獲利性及準確性。
例如每次收費五萬元，如果所生的五十個女嬰完全退費，而另五十位男嬰則穩賺不賠，結果是不必做任何篩選，仍可以賺到二百五十萬。
因此，如果真有方法達到98%包生男的準確率，或許又會興起另一場的醫療及生態革命戰。 如果坊間有人宣稱有百分之百包生男孩子的方法，並喊價二十萬，失敗了，給予鉅額補償，則真的有人願意花二十萬為生男孩而如此耗費精神嗎? 套句台灣話─ 踢倒街 ─，就是「滿街」都是的意思。
問問婦產科醫師、看看農民曆，連廟公廟婆也都知道，甚至常有不孕症患者要求筆者為她們治療兼製作男生給她們。由於台灣男嬰多於女嬰，97年起已禁止醫師做胎兒性別篩選。
但因有廣大的市場要求，所以偏方、妙方會層出不窮，到底有多妙？需要的人須好好的計算一下，否怎則女嬰丟在嬰兒室，誰養她們呢?
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