Stepfamily Stereotypes

Hurrah for your information {Cover Story, Nov. 24} on stepfamilies! We are alive and needing understanding -- not "Brady Bunch" mythology. May your help bring some stepfamilies out of the closet, where, unfortunately, the 1980s denial-riddled society encourages second (or more) marriages to hide. Yes, indeed, the word "stepchild" is still bantered about in polite conversation to mean "something treated in a second-class manner." How can we expect kids to adjust to new marriages of moms and dads when stereotypes still exist?

As a mental health practitioner specializing in stepfamily situations and a stepparent myself, I need to strongly point out the importance of group counseling (in school or privately) for children involved in newly formed stepfamilies. These youngsters are almost always, in some way, still grieving the loss of their biological parents' union. The behavior problems you mention and the attempts to create havoc in the new marriage many times are a result of this grief, and an inability to voice it at home when the struggling newly married couple is on a different emotional wavelength (where they have to be to make it work and beat the odds). Kids can receive peer support in such counseling groups, can share similar frustrations and can safely express sadness. Sometimes, this help can save the new marriage.

How sad that our first family won't think of themselves as honest-to-gosh stepfolks. ancy McGrath Schults

Takoma Park, Md.

Armed Assailants

We have been pleased to see the dialogue generated by Don Colburn's story "Guns, Rape and Responsibility" {Public Health, Nov. 3}. However, we feel that two important points have been omitted from that discussion. One is that of the 138,490 rapes committed in 1986, 59,240 involved assailants known to the victim. The other is that of all rapes committed that year, 30.1 percent were committed by armed assailants. These facts are significant.

Regardless of the statistics on acquaintance rape, women do not expect to be assaulted by someone they know. Therefore, if we are to urge them to carry guns for protection against rape, we must advise them to be armed at all times, even in social situations. That simply isn't a realistic, or desirable, thing to do. Further, if a full one third of rapists carry a gun themselves, of what use would the victim's gun be? Should she stage a shoot-out at the O.K. Corral; and, if so, would she be less or more injured?

It is our belief that the National Rifle Association promotes a self-defense strategy for women that is not only unrealistic, but one likely to result in still greater injury to them should they become a victim.

Anne Dawson Coordinator, National Network for Victims of Sexual Assault Arlington

Kissing Pets: Unnecessary Worry

Dr. A. Budd Fenton's article {Children's Health, Nov. 17} contains several inaccuracies.

Visceral larval migrans (VLM) is caused by ingestion of the second stage infective larval form of the dog and cat roundworm. Dogs and cats shed roundworm eggs in their feces. One to four weeks after, depending upon the parasite species and environmental conditions, these larvae develop. Therefore, contracting VLM by kissing a pet, even on the mouth, is highly unlikely.

Second, cutaneous larval migrans is a different disease caused by another intestinal parasite, usually the hookworm, whose infective larvae can penetrate exposed skin. This disease is most commonly contracted when people walk barefoot in contaminated environments such as park grass, beaches and sandboxes. Again, pet kissing is an unlikely mode of transmission.

While I agree with Dr. Fenton that pet kissing should not be encouraged, I think that he needlessly worries parents about transmission of these parasites to children in this manner. Supervision of their play environments, good sanitation and pet parasite control are much more important in disease prevention.

Strep throat, a common disease in people, may be transmitted to pets from people. The pet may then serve as a source of reinfection. For the pet's health and welfare, kissing should be discouraged. Steven J. Cohen, DVM President Northern Virginia Veterinary Medical Association Burke, Va.

Prostate Cancer: Defining Zero

Thank you for Larry Thompson's excellent cover story {Prostate Cancer, Nov. 10}. All men should read it. I found only one missing fact, which scared me and maybe other patients, until I could talk with my surgeon. That is, in the presentation on Dr. Stamey's work, you quote him as stating that the PSA {prostate specific antigen} test number should drop to zero and not increase after prostatectomy. The crucial piece is the definition of zero.

According to Dr. Charles Brendler, Johns Hopkins University Hospital, who did my work using Dr. Walsh's technique in August of 1985, zero is anything below 0.2 nanograms per milliliter, the background or so-called "female level." My PSA was 0.05 in February and 0.12 in August, an increase of over 100 percent but well within the "zero" range. Roger Thayer Potomac, Md.

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