俐媽的學生就讀北醫醫學大四，他們認真製作影片，宣導防治HPV人類乳突病毒的重要性。
防沾HPV人類乳突病毒，需要男生、女生共同參與，且未有性經驗的國高中生是接種疫苗的最佳對象！
希望大家不是只學下方的「俐媽英文教室」，而是真的能收看短片了解HPV，也歡迎醫護相關學系的學生可以留言在下方，補充更多資訊哦！
🎞影片連結🎞:
https://www.facebook.com/younghpvfighters/videos/2437521866504970/ ——————————————————
💉 俐媽英文教室—HPV衛教篇：
🦠 HPV = Human Papillomavirus 人類乳突病毒
🦠 condom (n.) 保險套
🦠 protective (a.) 保護性的
🦠 vaccinate (v.) 給...接種疫苗
—> vaccine (n.) 疫苗
🦠 genital (a.) 生殖的；生殖器的
🦠 wart (n.) 疣；肉贅
🦠 transmit (v.) 傳染
🦠 contagious (a.) 接觸傳染的
🦠 susceptible (a.) 易受影響的(+ to N)
🦠 uterus/womb (n.) 子宮
🦠 Pap smear test 巴氏塗片檢查(醫學上應用於子宮頸抹片檢查)
🦠 Condylomata Acuminata (n.) 尖型濕疣=genital warts（俗稱菜花）
🦠 Prevention is better than cure. 預防勝於治療。
——————————————————
❤️ 俐媽英文教室—花好月圓約會篇：
💘 appearance (n.) 外表
💘 personality (n.) 個性
💘 intimate (a.) 親密的
💘 speculation (n.) 推測
💘 flawless (a.) 完美無瑕的 = perfect
💘 monotonous (a.) 單調乏味的
💘 strangle (v.) 勒死；掐死
💘 impractical (a.) 不切實際的
💘 slip out (ph.) 無意中說出或洩露
💘 come in handy ＝ to be useful (ph.) 有用處
💘 hold your horses (ph.) 有點耐性；不要急
💘 screw around (ph.) 胡鬧; 不作正經事
—————————————————
接種疫苗的黃金時期，不要錯過！
.
#俐媽英文教室 #俐媽英文教室HPV衛教篇 #俐媽英文教室衛教篇 #俐媽英文教室愛情篇 #俐媽英文教室約會篇 #HPV #hpvvirus #hpvvaccination #preventionisbetterthancure

再來聊聊施打MMR疫苗跟懷孕

這兩年由於許多國家陸續有傳出麻疹及德國麻疹疫情的關係
因此也增加了許多施打MMR疫苗之後懷孕的機會與詢問

記得之前已經跟大家分享過好幾次了
先看這一篇👇👇👇👇

今天來聊聊孕期德國麻疹抗體及疫苗接種
https://drsu.blog/2018/09/26/super180926/

根據美國疾病管制與預防中心 Centers for Disease Control and Prevention (CDC)所公布根據的來自美國疫苗接種諮詢委員會Advisory Committee on Immunization Practices (ACIP)的臨床準則：

MMR疫苗於懷孕期間之接種不應該被當作考慮終止妊娠的理由
在接種疫苗前也不需要特別做懷孕測試

但我相信
很多人還是會擔心這個問題
現在
我的老友
施景中醫師也出來說話嘍

感恩施P讚嘆施P

傳送門在這裡👇👇👇👇
https://www.facebook.com/1274561183/posts/10219345118200076?s=1727931221&v=i&sfns=m

很遺憾的
不斷地還是會有孕媽咪來問我
不論是來門診或是傳訊息
常常起手式就是
某某醫師跟我說這樣不能留下來耶要叫我考慮終止妊娠

這樣說好了
在現在的醫療氛圍之下
醫師告訴媽媽這種情況還是有疑慮有可能有風險
對醫師是最安全的作法
省得哪天小孩有什麼問題來找醫師麻煩要醫師給個交代

你知道的
一旦有人跟你說有問題
然後我要跟你說沒關係的時候我必須要花上十倍的力氣
重點是
你還不一定願意聽我的

印象很深刻
有一個媽咪眉頭深鎖的來門診
就問了這樣的問題
蘇醫師蘇醫師
某某醫師告訴我這有風險建議我引產耶
即便
我花了10幾分鐘的時間跟她解釋

最後
她回答了

歐
我懂
但是
我還是拿掉好了

你
能夠了解我的感受嗎？

恩恩
就盡力吧
我們還是會堅持做下去的

新同學看一下
延伸閱讀👇👇👇👇

孕婦x德國麻疹疫苗(MMR)
https://drsu.blog/2019/04/12/super190404/

日本又流行德國麻疹怎麼辦？
https://drsu.blog/2018/10/27/super181027/

關於孕期麻疹感染
https://drsu.blog/2018/04/09/super180409/

孕婦X麻疹
https://drsu.blog/2018/04/20/super180420/

[MMR三合一疫苗 與 懷孕]

現在日本麻疹疫情有點蔓延，許多育齡婦女打了疫苗，卻又剛好懷孕了，怎麼辦? MMR疫苗的R代表"德國麻疹"，是會引起先天異常的病原"TORCH"中的R，惡名昭彰。

許多孕婦和醫師討論後，會選擇把小孩引產。

===========================
一念可以為善；或，也可以無意中挽救了一個小生命。

底下這個孕婦，16年前不知道懷孕而打了MMR疫苗，在忒忑不安中，經人介紹找到了我。

小孩後來出生了，現在是一個漂亮的混血小女生，笑容非常燦爛可愛。

當年的我，其實一點不像這個媽媽寫的，是個權威醫師，那時我當主治醫師才第5年吧，其實還很嫩。

總之我的一念之仁，間接幫助了這個媽媽保住了這個小孩。我也沒想到我的幾句話，可以給她這麼大的信心。

媽媽是一個非常感性的人，像電影的台詞般:「I would risk my life and everything to save her.」

因為女兒可以說就是她生命的一部份。

她文字很感人，我也深深感動，幾天前收到這信，得到她同意分享。希望多幫助一些人。

==============================
施醫師您好,

我是XXX的媽媽，她是16年前您的專業判斷救下來的孩子。八年前我們全家搬到美國德州，一直沒有機會向您道謝。我在六年前潦草地寫下這文，今天是美國時間XX的十六歲生日，我想將此文貼在此向您說謝謝，並附上她的照片，邀您一起分享我們的喜悅。

-------------------------------------------
10年前的某一天，我一個人坐在空盪盪的候診室，一手拿著醫生的名片，一手握著手機等待先生接起應答，先生問結果如何，我已經淚流滿面話不成句，看著醫生的名片，想要理智地告訴A醫生的建議是拿掉孩子，但我說不出口，把醫生的建議翻譯成問句，我們該怎麼辦? 這個孩子又能怎麼辦?

想起自己的粗心，在懷上孩子的那一個月，為了申請綠卡打了MMR疫苗，接著到秀姑巒溪泛舟，完全不知道肚子裡有個生命正在蘊育…直到有天出外景，看到食物就想吐，攝影師一句開玩笑: 「妳是不是懷孕了?」我才驚覺有可能，回程停在便利商店買了支驗孕棒，是藍色，但不是十分確定，那一晚無法入眠，不知為什麼非常焦躁。

第二天到婦產科,做了超音波檢查,胎兒已經五個禮拜大，一顆像粉圓般大小的小生命，有了心跳，我又驚又喜，接著向醫生詢問懷孕期間打了MMR疫苗有沒有影響。醫生先是責怪為什麼如此不小心，接著向我解釋醫學界有個說法，MMR疫苗有可能會生出不正常的孩子，要有心裡準備，但他建議為了免於接下來九個月的憂慮，還是建議拿掉孩子，不然等到10週以後再拿掉，對母體也會有影響，然後遞給我一張名片要我考慮。

在接下來的幾週，先生和我不斷上網找資料，想找到不必拿掉孩子的醫學論證，他找到一篇英文的醫學報告，說MMR疫苗99%不會威脅胎兒。先生寫了信給他在台大醫院遺傳學部門任職的朋友，他推薦一位學長，是台大婦產科的權威醫師(後來看報才知道)，他看了先生拿出來的報告說，不是99%、是100%不會有問題,然後解釋大家如何誤解MMR疫苗與病毒strain的差異。很快安排我們到超音波室，檢查胎兒的活動情形，看起來很好。他說疫苗不會有問題，有其他問題再來找我! 就這樣很有信心地離開診間，但一則醫學報告加一位專業醫師的說法，雖然增強了信心，但心裡還是不免擔心，萬一…

總之，後來先生和我決定不管孩子生出來如何，我們都要面對，我個人對肚裡的孩子已經有無法言喻的歉疚。這個孩子讓我成為一個母親，讓我先生成為一個爸爸。這個孩子讓我體驗到生命本身如此令人驚奇!

孩子從產道半推半拉出來後，沒有哭聲，身體全身發紫，那一刻我連呼吸都很謹慎，那一刻真的一點聲音都沒有，先生和我都屏息，一切好像都在真空狀態，護士不斷拍手孩子的屁股。不知道過了多久，孩子哭了，哭得好大聲，我先生再也無法站，頓時蹲下掉下開心的眼淚。我不知道什麼時候開始哭，只知道我的眼淚是熱的，而那哭聲就像天使的哭聲，那麼清脆有力，那麼好聽。那個孩子就是現在的XX，我要盡我所能愛這個孩子，保護這個孩子!

女兒的出生,要感謝這過程中的很多人，讓這個天使有機會來到人間，帶給我們這麼多的酸甜苦樂，這一路我們都在學習，即便是現在。孩子十歲了，人生的試煉沒有間斷，對孩子對我們來說都是!但我感謝,非常感謝她的到來。雖然她的到來，改變了人生裡的很多計畫，但我身為一個母親,從來沒有後悔。女兒，不管妳現在或將來會如何，爸爸媽媽對妳的愛從來沒有改變，也沒有因為妹妹的加入而有稍減…..不管發生什麼事，妳的家人都是妳最強的依靠。看著妳成長就是身為媽媽的我最大的成就,最大的樂趣。

女兒，生日快樂!
媽媽不知如何停止愛妳,從妳還是小粉圓的時候…..

===========================

其實我門診還有其他類似孕婦，也還在懷孕中呢。

根據大規模文獻，目前沒有孕婦因為注射MMR疫苗而引起先天德國麻疹症候群(CRS)。根據研究，引起CRS的viral strain，也和疫苗的viral strain不同。

停一下，妳還可以再想一想。

From website literature

"Very large measles-rubella vaccination campaigns, run between 2001 and 2008, have targeted women of child-bearing age in South America and Iran [2] [3] [4] [5] [6]. Comprehensive, prospective surveillance of pregnant women during these campaigns has provided further substantial evidence of the safety of measles and rubella containing vaccines in pregnancy.
During these campaigns over 30,000 pregnant women inadvertently received MR vaccine. The vaccine had been given either during pregnancy (the majority were less than 12 weeks pregnant) or up to 30 days before these women had conceived.

In the above studies about 3000 women were susceptible to rubella, meaning they were not already immune and so at potential risk of the virus passing to the baby. Extensive follow-up of the outcome of these pregnancies was very reassuring. Whilst a very small number of babies were shown to have been exposed to the weakened vaccine virus in the womb, no babies developed Congenital rubella syndrome (CRS)."

裘莉醫師：割乳後　罹乳癌機率從87%降至5%
2013年05月14日16:04

現年37歲美國好萊塢女星安潔莉娜裘莉（Angelina Jolie），今日在《紐約時報》投書表示，為了降低罹患乳癌和卵巢癌的風險，進行了割除雙乳的手術。而裘莉也在文中提到，她的主治醫師向她表示，割乳後罹患乳癌的機率為從87%，降至5%。

另外，裘莉也提到，整個手術療程為時3個月，分為3階段進行。其中有一個手術階段是將引流管插入乳房，她直呼：「好像在拍科幻片一樣。」裘莉也說，手術最後一個階段就是將填充物植入胸部，她表示接下來需要花幾年時間來做復健，「但相信結果會非常美好」。

切除雙乳防癌／安潔莉娜裘莉：無損我的女性特質
2013-05-14 Web only 作者：吳凱琳編譯

美國女星安潔莉娜‧裘莉（Angelina Jolie ）14日投書《紐約時報》，表示為了預防乳癌的發生，進行預防性手術，切除乳房。

一切都源自於她母親早逝帶給她的傷痛。

她母親因罹患癌症，年僅56歲便離開人世，「我的孩子們常問我，我會不會也像自己的母親那樣早地離開他們，我總是告訴他們別擔心，」但事實上，安潔莉娜‧裘莉心裡明白，經過醫學檢查，證實她體內帶有BRCA1 基因。女性若遺傳到這種基因，罹患乳癌和卵巢癌的機率將大增。安潔莉娜‧裘莉的醫師預估，她罹患乳癌和卵巢癌的機率分別為87％與50％。

於是，她做出了常人難以想像的重大決定：切除雙乳，預防乳癌發生。

整體療程開始於今年2月2日，歷經乳房組織切除與義乳重建等手術，直到4月底，總計9星期的療程全部結束。安潔莉娜‧裘莉形容，整個過程就像是科幻電影的場景般，休息幾天之後，便可立即恢復正常生活。

更幸運的是，她的乳癌病發機率從87％驟降為5％。她也沒有因為乳房切除手術而感到任何的不適應，「我並沒有因此感覺自己不再像是女人，我反而覺得自己做了很勇敢的決定，而這個決定絲毫未減損我的女性特質。」

在文章中，她特別感謝人生的伴侶布萊德‧彼特（Brad Pitt ），「在經歷手術過程的每分每秒，他都一直陪在我身旁。我們倆都認為這是對我們的家庭最正確的決定，這個決定也讓我們彼此更為親密。」

文章最後她特別提到，之所以決定公開自己的隱私，目的是期望幫助更多女性選擇正確的醫療方式，遠離癌症威脅。根據世界衛生組織統計，每年死於乳癌的女性高達45.8萬人，或許她的經驗可以提供參考。不過，究竟預防性手術是否是治療癌症的最恰當方式，恐怕有待醫療專業的評估。（吳凱琳編譯）

安潔莉娜‧裘莉投書《紐約時報》「My Medical Choice」全文

My Medical Choice
By ANGELINA JOLIE
Published: May 14, 2013

MY MOTHER fought cancer for almost a decade and died at 56. She held out long enough to meet the first of her grandchildren and to hold them in her arms. But my other children will never have the chance to know her and experience how loving and gracious she was.

We often speak of “Mommy’s mommy,” and I find myself trying to explain the illness that took her away from us. They have asked if the same could happen to me. I have always told them not to worry, but the truth is I carry a “faulty” gene, BRCA1, which sharply increases my risk of developing breast cancer and ovarian cancer.

My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman.

Only a fraction of breast cancers result from an inherited gene mutation. Those with a defect in BRCA1 have a 65 percent risk of getting it, on average.

Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. I made a decision to have a preventive double mastectomy. I started with the breasts, as my risk of breast cancer is higher than my risk of ovarian cancer, and the surgery is more complex.

On April 27, I finished the three months of medical procedures that the mastectomies involved. During that time I have been able to keep this private and to carry on with my work.

But I am writing about it now because I hope that other women can benefit from my experience. Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action.

My own process began on Feb. 2 with a procedure known as a “nipple delay,” which rules out disease in the breast ducts behind the nipple and draws extra blood flow to the area. This causes some pain and a lot of bruising, but it increases the chance of saving the nipple.

Two weeks later I had the major surgery, where the breast tissue is removed and temporary fillers are put in place. The operation can take eight hours. You wake up with drain tubes and expanders in your breasts. It does feel like a scene out of a science-fiction film. But days after surgery you can be back to a normal life.

Nine weeks later, the final surgery is completed with the reconstruction of the breasts with an implant. There have been many advances in this procedure in the last few years, and the results can be beautiful.

I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don’t need to fear they will lose me to breast cancer.

It is reassuring that they see nothing that makes them uncomfortable. They can see my small scars and that’s it. Everything else is just Mommy, the same as she always was. And they know that I love them and will do anything to be with them as long as I can. On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity.

I am fortunate to have a partner, Brad Pitt, who is so loving and supportive. So to anyone who has a wife or girlfriend going through this, know that you are a very important part of the transition. Brad was at the Pink Lotus Breast Center, where I was treated, for every minute of the surgeries. We managed to find moments to laugh together. We knew this was the right thing to do for our family and that it would bring us closer. And it has.

For any woman reading this, I hope it helps you to know you have options. I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.

I acknowledge that there are many wonderful holistic doctors working on alternatives to surgery. My own regimen will be posted in due course on the Web site of the Pink Lotus Breast Center. I hope that this will be helpful to other women.

Breast cancer alone kills some 458,000 people each year, according to the World Health Organization, mainly in low- and middle-income countries. It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live. The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.

I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options.

Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.

Angelina Jolie is an actress and director.