Physical Test 80 Crack: Benefits, Risks, Sources, and Tips
But, first, it's time to go behind closed doors. That's where we talk about issues that we sometimes avoid, often because of shame or fear. Today we want to talk about so-called crack babies. And if you think about it, that term tells you everything you need to know about the way children who are exposed to crack during the height of the epidemic were dismissed, demeaned and even feared.
Physical Test 80 Crack
At the time there were all manner of pronouncements about how children who were exposed to crack in utero were destined to a life of physical and mental disability. John Silber, the former president of Boston University went so far as to say that "crack babies won't ever achieve the intellectual development to have consciousness of God," unquote.
Two decades later, we're still learning about how drug and alcohol exposure by pregnant affects their children. But it turns out that children who are exposed to crack cocaine before birth are proving these worst case scenarios were all wrong. And we're joined now by several people who know about this. Joining us are Mary Barr and her daughter Nisa Beceriklisoy. Mary is an activist who discusses her past crack cocaine use while pregnant with Nisa. Nisa is about to go off to college.
Ms. BARR: Well, the crack baby myth hadn't been, you know, advertised as much as it was later on. You know, I didn't want to drink, I didn't want to smoke cigarettes, I didn't want to really do anything while I was pregnant. But one of the reasons I kept using during my first pregnancy was because, well, like, I always like to say if pregnancy was a cure for addiction, we could just go out and get all the female addicts pregnant, and, hey, no more addiction. But it's not a cure for addiction. So, even though I thought about stopping, it wasn't that easy.
MARTIN: Did you grow up hearing what was being described around kids who had been exposed to crack in utero? Were you ever exposed to any of that? Because, you know, kids can be mean. And, you know, sometimes when kids find out something about another kid, they just use it to kind of hammer them with. And I just wondered if you had ever had heard any of that kind of conversation and if it affected any sense of who you were or what you wanted for yourself.
Ms. BECERIKLISOY: I'm a little bit eccentric. Not that I'm, like not out of, really, the ordinary, but they all kind of thought, like, I'm really funny. I kind of make crack a lot of jokes and, like, I think they said that I had ADD and it was a little bit hurtful, but it was mostly just them trying to be funny. I think the last time was I was in my AP bio classroom and my teacher was, like, she was talking somebody brought the conversation to babies who were exposed to drugs and she said that oh yeah, crack babies, they have horrible lives. They all are born like they're about to die. They're addicted to drugs their entire life. It's just a very sad existence.
Dr. BELL: The fear was that women who were pregnant who were using crack cocaine would cause some brain changes in their infants. The concern since crack is a stimulant - cocaine is a stimulant - was that these areas in the brain that dealt with the issue of stimulation like attention deficit disorder or even bipolar disorder might be overly activated or somehow distorted while the baby's brain was developing. So there were all these really silly ideas about hyper aggressiveness, attention deficit disorder, manic depressive disorder in these children.
MARTIN: If you're just joining us, this is TELL ME MORE from NPR News. Back in the '80s and the '90s there was a panic about children being exposed to crack cocaine in utero. Now some of those kids are all grown up and doing amazing things. And we are joined by one of them, Nisa Beceriklisoy, along with her mother Mary Barr and Dr. Carl Bell, who joins us from time to time to talk about medical issues and issues around mental health.
And I joined the STEP program and during that program I was allowed to go to GED classes. And I took my GED test and I thought, okay, whatever I fail they'll tutor me in, but I passed. I passed the first time took it with a really high score. And that was the beginning for me because, you know, even before I was in the street I was raised being told I was stupid, I was, you know, ugly, I would never amount to anything. But here I got this high score on GED and I thought, wow, maybe I'm not so stupid.
Many plaque deposits are hard on the outside and soft on the inside. The hard surface can crack or tear, allowing platelets (disc-shaped particles in your blood that help it clot) to come to the area. Blood clots can form around the plaque, making your artery even narrower.
A provider will perform a physical exam and review your medical history and risk factors. They may order noninvasive tests to help diagnose PAD and determine its severity. If you have a blockage in a blood vessel, these tests can help find it.
Remember that these are non-verbal as well as verbal. Your manner, your physical position with regards to the patient's (this may not be within your control), and your body language all contribute to the outcome of the consultation. Be relaxed and smile to radiate confidence. If they have had to wait a long time, a comment addressing this with an apology at the outset is often appreciated; it will give you a much better start and shows respect for their individuality.
Note that the first addresses the patient's concern, whereas the second addresses yours. The two may not be the same but each is important. If their greatest concern is not worrying you, jot it down and make sure you address it at the end of the consultation (even if it is just to reassure them). It is worth noting that research has shown that on average, physicians tend to interrupt a patient within 16 seconds of asking an opening question, whereas allowing them to speak uninterrupted may take an average of just six seconds longer.
Note current medication - this is important not only as a indication of what they are on but also a reminder of other existing conditions they might have but have forgotten to mention. Drugs may contribute to the current problem or influence choice of medication for it. The constipated patient may be taking co-codamol. The computer will record if medication is overused or underused and the date of last issue. Enquire about over-the-counter (OTC) remedies and possible herbal or other treatments. The latter are just as likely as prescription-only medicines (POMs) to have toxic effects or drug interactions, perhaps more so as they have not been so thoroughly tested.
There is no real dividing line between history and examination. During the course of the history, you will gather a wealth of information on the patient's education and social background, and to a lesser extent, there will be physical signs to pick up. Examination needs to be as focused as history. Try to learn and apply good technique. Quite simply, good technique is more likely to give a correct result than poor technique. The yield from examining systems that are not obviously relevant is too low to justify in such limited time.
The first part of any examination is to observe. Learn to observe. Look before you lay on hands. Examination of the cardiovascular or respiratory system does not start with the stethoscope. You may get valuable information from the facies, skin colouration, gait, handshake and personal hygiene (reflective of physical, psychological and social background). Note the red eye, the freckles on the lips of Peutz-Jeghers syndrome or the white forelock of Waardenberg's syndrome. A number of endocrine disorders may be immediately apparent.
Clearly, investigations should be justified in terms of costs and of potential risks they may pose for the patient. One of these risks is actually increasing patient anxiety (a well-established risk) - particularly in the event of an ambiguous or false positive result. It is better to establish what exactly a patient's fears are rather than going on to perform more tests or referring where there may not be the need.
Difficulties may emerge as a patient repeatedly presents with ongoing physical symptoms for which no cause can be found. Whilst some of these may be the harbingers of something sinister, common things are common and there may be an element of normal problems of daily living being turned into symptoms by an anxious patient. There is a risk of medicalising the patient in an attempt to answer their question, "What are you going to do about my [symptom], doc?" These patients may get dissatisfied with their own doctor and present to others. At some point the system cracks under the pressure of their demands and a test leads to a procedure which leads to a complication and a fresh round of presentations. Whilst following well-established paradigms of managing these patients (eg, be on your guard against manipulative behaviour, avoid referral or multiple doctor input, keep good records, communicate with colleagues), be aware of the new emergence of an actual disease entity and also of the underlying message ('I am depressed following my divorce and miss the attention I used to get'). See the separate Somatic Symptom Disorder article.
A comprehensive examination of the 100-to-1 crack versus powder cocaine sentencing disparity under which distribution of just 5 grams of crack carries a minimum 5-year federal prisonsentence, while distribution of 500 grams of powder cocaine carries the same 5-year mandatory minimum sentence.
"Crack baby" was a term coined to describe children who were exposed to crack (freebase cocaine in smokable form) as fetuses; the concept of the crack baby emerged in the US during the 1980s and 1990s in the midst of a crack epidemic. Other terms are "cocaine baby" and "crack kid". Early studies reported that people who had been exposed to crack in utero would be severely emotionally, mentally, and physically disabled; this belief became common in the scientific and lay communities. Fears were widespread that a generation of crack babies was going to put severe strain on society and social services as they grew up. Later studies failed to substantiate the findings of earlier ones that PCE has severe disabling consequences; these earlier studies had been methodologically flawed (e.g. with small sample sizes and confounding factors). Scientists have come to understand that the findings of the early studies may have been overstated. Commentators have characterized the phenomenon as a moral panic.