All posts by James Pate, MD, FACOG

I am a board certified OB/GYN physician in Saranac Lake, NY. My practice includes traditional obstetrics and gynecology as well as medical and surgical services specific to the needs of minorities of gender, sex and sexual orientation. I strive to provide personalized, comprehensive and compassionate care to all of my patients.

How Marijuana Use During Pregnancy Could Harm a Developing Baby’s Brain – Scientific American

Whereas marijuana is not a major health risk for most adults, prenatal drug exposure can be harmful to unborn babies. Previous research has shown infants exposed to cannabis in the womb are 50 percent more likely to have a lower birth weight. Now three new studies presented Tuesday at the Society for Neuroscience annual meeting here suggest prenatal cannabis exposure—at least in rodents—could have serious consequences for fetal brain development.
— Read on

Get Your Life on Track for Parenthood

Guest post by Ashley Taylor

Image via Pixabay

Parent: A job that puts you on call 24 hours a day, seven days a week and doesn’t offer a paycheck. In fact, you can expect to spend hundreds of thousands of dollars over the next couple of decades — not counting college costs.

Parenthood may not make for the most compelling classified ad, but it’s a job hundreds of thousands of people around the world — including many with disabilities — take on each day. And, while it’s definitely daunting, there are ways to prepare for the countless duties you’ll encounter as a parent. Here are a few words of advice to get you started.

Get Your House in Order

If you’ve been in your home for a while, you may already have some modifications in place. Childcare can present some new challenges, however, so it is important to take a look at your home through that lens. Perhaps installing grab bars in tubs and showers will make maneuvering around your bathroom with a wet baby more manageable, according to advice from HomeAdvisor. Or maybe you need to reevaluate the flooring in your home considering you’ll be carrying a kid around. If you have mobility issues, removing tripping hazards and opting for non-slip floor coverings will not only help you, it will also be a boon to your baby as he or she learns to crawl and walk.

Some parents with disabilities may also want to invest in adapted products specifically designed to suit their needs. For instance, some manufacturers sell cribs with a side door to allow caregivers who use a wheelchair to comfortably put babies to bed or pick them up. Such specialized products can be expensive, however, so you might opt to make modifications to standard products to create a better fit for you family.  There’s a wealth of advice available online and from other sources on making childcare easier for parents with disabilities.

Get Your Finances in Order

In addition to making modifications to your home, you should also evaluate whether your finances need a little renovation in the months before a baby joins the family. Experts advise expectant parents to start trimming debt and getting better acquainted with their budget as soon as they know a baby is on the way. Considering all the new costs that come with kids, it’s likely most people will need to change their spending habits to prepare for parenthood.

Also make sure the beneficiaries on all your accounts are up to date, pen a will, and purchase life insurance if you don’t already have a policy. One expert quoted by Parents recommends insuring yourself for at least six to eight times your gross annual salary.

Get Your Health in Order

If you are carrying a child, odds are good that you are trying your hardest to eat right and otherwise take care of your mental, physical, and emotional health to give your developing baby the strongest start possible in life. You should plan on carving time out of your busy childcare schedule to maintain those healthy habits once the baby is born. And, even if you’re not carrying the child, you should also be minding your own diet and exercise routine to provide support for your partner and prepare to set a good example for your future family.

Expectant parents may also want to look into special training and therapy programs that can better prepare them for parenthood. For example, professionals may be able to teach ergonomic techniques that make typical childcare chores safer for parents and children alike or instruct prospective parents on best practices for tackling tasks such as feeding and diapering with a parent’s specific disability in mind. Asking your healthcare team for advice and resources early on will give you time to find the help you need.

Parenting is certainly one of the most difficult jobs on the planet. But, with a little planning and preparation, you can sharpen your skill set to be ready for the challenge.

Mercury in pregnancy

There are many environmental contaminants that modern humans are exposed to on a regular basis including air pollution, heavy metals, pesticides, plastics and industrial chemicals and fuels. They permeate our spaces inside, outside and on the job. In fact, every pregnant woman in the U.S. is exposed to at least 43 different chemicals. These exposures may result in adverse effects for both mother and child and should be avoided as much as possible. A well known contaminant is mercury, a naturally occurring element, and our exposure is usually from one of two common forms: methylmercury (meHg) and ethylmercury (etHg).

Methylmercury (meHg) contamination in our environment is largely from coal-fired power plants. It is hazardous even in small amounts and typically enters our diet through the consumption of fish, which accumulate it in varying amounts depending on the species. meHg is known to cross the placenta and to accumulate in the fetus at higher levels than in the mother. Toxic levels may result in permanent damage to the fetal brain resulting in impaired neurodevelopment and reduced cognitive performance. On the other hand, there are many benefits to eating fish. Fish are high in protein, low in saturated fat and are rich in many micronutrients including omega-3 fatty acids such as docosahexaenoic acid (DHA). DHA has been shown to have a role in early fetal brain development and may be protective against adverse problems in pregnancy such as preterm birth, fetal growth restriction, gestational diabetes and preeclampsia. Benefits continue for breastfed infants and for children who consume fish. To derive the highest benefits of seafood consumption while minimizing the risk of meHg exposure it is recommended that mothers eat a 4 ounce serving of approved seafood 2-3 times a week. Seafood options that are low in meHg include some fish (salmon, cod, tilapia, canned light tuna), crustaceans (shrimp, crab, lobster) and shellfish (clams, oysters, scallops). Please note that albacore (white) tuna has more meHg than the other variety of tuna so should be limited to no more than 6 ounces per week. See “Advice About Eating Fish” below for more information.

Our exposure to ethylmercury (etHg) is largely through vaccination; etHg is a metabolite of thimerosal, the most widely used vaccine preservative to prevent germ growth. Compared to meHg, etHg is metabolized and eliminated by the body at a much faster rate. It is impossible to reach toxic levels of etHg from thimerosal containing vaccinations, regardless of multiple or repetitive exposures. Many well designed studies have demonstrated that there is no evidence of harm from the low levels of thimerosal present in some vaccines. Likewise there is no evidence linking thimerosal exposure to autism, a neurodevelopmental disorder. While multidose vaccine vials of the influenza vaccine continue to contain thimerosal (individual dose vials do not), the World Health Organization (WHO) considers this to be safe in pregnancy and infancy.

In conclusion, reducing exposures to environmental contaminants is important for human health and especially for pregnant women, infants and small children. Given the benefits of dietary fish in pregnancy and in fetal development, it is recommended to regularly consume a small amount as part of a balanced diet. Staying within the limits established by U.S. government agencies will prevent reaching toxic levels of methylmercury (meHg). In contrast, exposure to ethylmercury (etHg) from thimerosal containing vaccines is safe in pregnancy, infants and small children as it cannot reach toxic levels in the amounts given.


We all fall down

Losing weight is a long and difficult challenge. It requires incredible self-control and persistence. It is all too easy to “fall off the wagon” and to not want to get back up. It actually takes a lot of energy and resolve to get up and try again, often to simply regain lost ground.


On 6/20/12 I mustered the courage to engage my personal “battle of the bulge” yet again. As you can see from my weight record, I have fallen down several times since 2012. The important thing however is that I keep getting back up.

I have struggled with weight issues the majority of my life. Sometimes I like to say that I inherited the “fat gene” from my parents but genetics is only part of the picture. My relationship with food is actually the greater culprit. The art of eating is learned, such as what is eaten, how much, how often and why we eat it.

“Waste not, want not” is an idiom that applied to my dinner table growing up; my parents forced me to clean my plate every meal regardless of how full I was. On the more pleasant side, dinner was always followed by dessert.

Improper eating can also be triggered by emotion. We all want to feel good, satisfied and happy. Food can be comforting when eaten alone or when enjoyed with others. It can be used for celebration as well as depression. It can help take your mind off of things you’d rather not think of. Food can stimulate the reward center in our brains and can in fact become a powerful addiction and a dangerous friend. For my path to begin I had to recognize this, that I had eaten for many reasons other than hunger. I could no longer continue this unhealthy relationship with food.

Diets do not work. There are no magic foods, exercises, herbs, supplements or medications that have been proven to help people lose a significant amount of weight and to keep that weight off over time. The only way to achieve this is through a change in lifestyle. This means eating in a way that is healthy, satisfying and able to be continued for the rest of your life. If you choose to temporarily eat in a unique way (a diet) or to use products you think will help you lose weight, what will happen when you stop? How will you maintain your weight without having learned how to change your lifestyle permanently?

In order to change my eating lifestyle my relationship with food has become very supervised. Hunger alone is an insufficient mechanism for me to control my eating habits. Now I try hard NOT to clean my plate. I eat slowly and try to stop eating the moment I feel satisfied, not when I am full. I now take the time to consider what I want to eat, why I want to eat it and if it’s worth the Calories. I imagine that it will always be this way. I will always be tempted to eat more than I should for reasons like I listed above. And that is okay. I can be observant and continue to make conscious decisions regarding my food choices.

As I have written before, MyFitnessPal has been instrumental in helping me to keep track of my eating habits. I continue to be surprised by how an innocent-looking food can be harboring a huge amount of Calories. Talk about sticker shock! Checking Calorie content before I eat allows me to make an educated decision about whether or not I really want to eat it. That’s not to say that I don’t splurge occasionally. I just consider the cost and decide if it’s worth it.

Calorie counting is a lot like balancing a checkbook. If I overspend I get in debt but if I under-spend I save. My daily Calorie allowance is my budget. If I overeat I gain weight and if I eat less than my allowance I lose weight. Sometimes I want to go out and eat more than my budget allows. I can “earn” extra Calories to eat by burning them with exercise. If I go the to gym and do the elliptical for 30 minutes, I burn 300 Calories. That’s 300 more Calories I can eat for the day.

My favorite meal of the day is dinner. I want to eat as normal of a dinner as possible so I budget accordingly. I simply eat less for breakfast and lunch. My typical breakfast is 1 cup of FAGE Total 0% Greek Yogurt mixed with a Del Monte Fruit Cup and a packet of Truvia (~250 Calories) or an omelette of 6 egg whites with 1 egg yolk and salsa verde (~250 Calories). For lunch I eat a protein bar (Nature Valley or Clif Bar, ~200-250 Calories). If I’m really hungry before dinner I choose low Calorie snacks such as string cheese (~80 Calories). For dessert I like to eat either a JELL-O Sugar-free Pudding Snack (~60 Calories) or Ghirardelli Chocolate Square (~60 Calories).

And then there is dinner. recommends a plate that is 1/4 protein, 1/4 starch, 1/4 fruit and 1/4 vegetables. My personal plate is more like 1/2 protein, 1/4 vegetables and 1/4 starch. I confess that I don’t eat as much fruit as I’m supposed to. Good appetite suppressants for me are coffee and pickles. Go figure!

Now I am more than halfway toward my goal weight. I look skinny enough perhaps by my picture, but I am still overweight by my BMI (see earlier post). It’s been a long road but I can see the finish line… well, at least the beginning of a less steep and difficult road up ahead.