When the Pope Plays Doctor, Women Die

A pregnant woman presents to an Irish hospital with ruptured membranes and cervical dilation at 17 weeks of pregnancy.

This is called an inevitable abortion.

When the mother begins to develop fever and abdominal pain, infection has set in.  The treatment – antibiotics and delivery of the baby, no matter what the gestational age or viability of the fetus. Delaying delivery risks maternal sepsis and death.

There is no debate about how to manage this clinical situation.  There are clear standards. Even in Ireland.

In current obstetrical practice, rare complications can arise where therapeutic intervention (including termination of a pregnancy) is required at a stage when, due to extreme immaturity of the baby, there may be little or no hope of the baby surviving. In these exceptional circumstances, it may be necessary to intervene to terminate the pregnancy to protect the life of the mother, (italics mine) while making every effort to preserve the life of the baby.

(HT to @scanman for finding these Irish regulations.)

An yet, for some unknown, god-awful reason, doctors responsible for the care of Savita Halappanavar decided that in their “Catholic” country, they were required to wait until the fetal heartbeat had stopped before terminating her non-viable, life-threatening pregnancy.

“Savita was really in agony. She was very upset, but she accepted she was losing the baby. When the consultant came on the ward rounds on Monday morning Savita asked if they could not save the baby could they induce to end the pregnancy. The consultant said, ‘As long as there is a foetal heartbeat we can’t do anything’.

“Again on Tuesday morning, the ward rounds and the same discussion. The consultant said it was the law, that this is a Catholic country. Savita [a Hindu] said: ‘I am neither Irish nor Catholic’ but they said there was nothing they could do.

“That evening she developed shakes and shivering and she was vomiting. She went to use the toilet and she collapsed. There were big alarms and a doctor took bloods and started her on antibiotics.

“The next morning I said she was so sick and asked again that they just end it, but they said they couldn’t.”

At lunchtime the foetal heart had stopped and Ms Halappanavar was brought to theatre to have the womb contents removed. “When she came out she was talking okay but she was very sick. That’s the last time I spoke to her.”

At 11 pm he got a call from the hospital. “They said they were shifting her to intensive care. Her heart and pulse were low, her temperature was high. She was sedated and critical but stable. She stayed stable on Friday but by 7pm on Saturday they said her heart, kidneys and liver weren’t functioning. She was critically ill. That night, we lost her.”

Mr Halappanavar took his wife’s body home on Thursday, November 1st, where she was cremated and laid to rest on November 3rd.

What Savita’s husband is describing is medical malpractice, pure and simple, committed by doctors practicing medicine according to the standards of the Pope rather than the profession to which they belong and the country in which they are licensed to practice.

It is tragedy and an abomination.

Were these doctors practicing out of fear and ignorance of the laws, or out of their own religious beliefs?  Did they think they had no legal recourse but to ignore clear medical standards, or did they deliberately ignore them?

We will need to await the results of the investigation into this tragic case to learn the answers to these questions, but one thing is clear.

When the Pope plays doctor, women die.

My First Curry

I think I’ve just found a new weekly dinner staple for this family.

Curry.

Fast, delicious, comforting and spicy. Adaptable to almost anything you’ve got in your larder without a trip to the store. In this case, we always have a bag of shrimp and a box of peas in the freezer, a few onions and carrots in the drawer and a can of tomatoes on the shelf. (A potato or yam would not have been out of place added to this mix…) And while the coconut milk is delicious, it’s not essential to a great curry.

I do realize that I will have to start keeping cilantro around more routinely. I think I’ll add it to my herb garden in the spring.

Shrimp Coconut Curry

This is not an authentic Indian curry recipe. It started out as this recipe, but I forgot to use the open can of coconut milk in the rice, so I decided to add it to the curry instead. I also added garlic and a few more spices –  it just seemed like the right thing to do.

What I ended up with was not far from authentic. This curry is similar to those originating in the Kerala region of India. It’s pretty mild as curries go, and not bad for my first try at this genre of meals.

Coincidentally, a patient today dropped off a big bag of spices she brought back from the Kerala region of India, so be prepared for even more authentic curries to come.

Ingredients

  • 2 tbsp canola oil
  • 1 lb shrimp, peeled and deveined
  • Salt and pepper
  • 1 large sweet onion, diced
  • 2 medium carrots, diced
  • 3 large cloves garlic, minced
  • 1 large fresh tomato, diced (or a 14 oz can of diced tomatoes)
  • 1 cup frozen peas
  • 1 1/2 tbsp curry powder
  • 1 tbsp coarse grain mustard (or mustard seeds if you have them)
  • 1/2 tsp ground cinnamon
  • 1/2 tsp ground ginger (better yet, use fresh ginger if you have it)
  • 1/2 tsp turmeric
  • 1/2 tsp cumin
  • 1/8 tsp ground red pepper
  • 1 can coconut milk
  • Chopped cilantro for garnish
  • Cooked basmati rice

Directions

Start your rice cooking.

Toss shrimp with some salt and pepper. Heat 1 tbsp oil in a Dutch oven over medium-high heat. Add shrimp to pan; cook 2 minutes until just pink. Remove from pan.

Heat remaning tbsp oil in the pan. Add onion and cook 2 minutes, stirring constantly. Add garlic and cook another minute. Add spices and cook one more minute, stirring constantly. Add coconut milk, peas, carrots and tomatoes – bring to a boil. Cover and reduce heat to medium-low; simmer till carrots are soft, about 5-10 mins. Return shrimp to pan to heat for a minute.

Serve immediately over rice with cilantro garnish.

Chili – A Spicy Meal for A Bittersweet Season’s End

It’s always bittersweet, closing our Endless Mountain cottage for the season. We don’t get there enough even in season as far as I’m concerned, so this quick hello and goodbye is almost painful.

Our busy schedule in the city means we do not arrive till after dark on Saturday. Only one other house in our little enclave has lights on, and it feels strange and deserted – so different from summer.

The season is farther along here on the mountain – The trees are already bare and the back porch is awash in 3 inches of leaves. We can see our breath even in the house, and the olive oil on the kitchen shelf is thick and cloudy. Fortunately, the water is still flowing freely through the pipes. We start a roaring fire in the fireplace and set to work making a pot of chili for dinner.

A few minutes after Mr TBTAM heads off down the mountain for a few last minute ingredients, the power goes off, leaving me in darkness. I manage to quickly reset the circuit breakers in the electric panel on the front porch and then, feeling a bit unsettled, call my older brother Al on FaceTime to keep me company while I cook until Mr TBTAM returns. This was probably not a good idea, because every few minutes Al interrupts the conversation to ask me “What’s that face at your kitchen window?” (Big brothers never change…)

Finally Mr TBTAM returns. We forgo the frigid dining room and eat our chili from bowls while sitting together on the love seat that we have pulled over in front of the fireplace. It’s too cold to move much farther from the fire, so we just spend the rest of the evening on the love seat, reading. A few more electrical resets later (the blower attachment on the fireplace insert was the culprit) the baseboard heaters are finally cranking up and we retire, gratefully, to a warm bedroom.

Sunday dawns bright and unseasonably warm, and we set to work. I strip the beds, wipe down the bathrooms, empty the fridge and kitchen cabinets, scrub down and unplug the fridge, and sweep the kitchen floor. Having seen a few droppings on the kitchen shelf that morning, I decide to set a few mousetraps for our seasonal guests. Mr TBTAM runs the laundry and rakes the yard – an enormous job that takes him all morning. Then our neighbor offers me his leaf blower and I do the back deck and patio – a job that usually takes an entire afternoon –  in 30 minutes! We stop midway through our labors for another bowl of chili – this time sitting on the porch in the warm sun admiring the fruits of our labors. After that, we bring the porch furniture and bikes into the house, make one final sweep and get into the car for the long ride home.

Another season in the Endless Mountains has come to a close. Every year I fantasize about winterizing the place, but seeing (and feeling) the place so deserted has convinced me that I prefer to leave it as it is  – my little Brigadoon, disappearing in late fall and reappearing in Spring.

Basic Chili

While there are a lot more complex recipes out there, ours is a very basic chili. The recipe below is heavier on the meat than the beans, but we vary it.  You can substitute a 12 oz can of tomato sauce for the tomato paste and water. Add a second can of beans if you want to stretch it for a larger crowd.  Serve over rice to stretch it even more, and add a side salad for a complete meal. I’ve fallen in love with sheep’s milk yogurt and no longer use sour cream to top mine.

Ingredients

  • 1 tbsp olive oil
  • 1 large onion, medium dice
  • 1 large green pepper, medium dice
  • 2 cloves garlic, minced
  • 1 to 1 1/2 lb lean ground beef
  • 1-28 oz can whole tomatoes
  • 1 small can tomato paste +1  cup water, beef broth or beer
  • 1-15 oz can red kidney beans, rinsed
  • 2-4 tsp Chili powder to taste (some brands are spicier than others)
  • 1 tsp paprika
  • 1 tsp cumin (optional)
  • Kosher salt and fresh ground black pepper to taste
  • 1/2 cup sheep’s milk yogurt or sour cream
  • 1 cup shredded cheddar cheese

Cooking Directions

Heat oil in large pot and saute onions and peppers till soft (about 5 mins). Add garlic and saute another minute. Add ground beef and saute, breaking it up with a wooden spoon,  till no longer pink. Add remainder of ingredients and cook for 30 minutes over medium-low heat. Serve hot in bowls with with cheddar cheese and sour cream or yogurt topping.

You Grew On Me…

like a tumor. Tim Minchin on that malignant kind of love.

I’ve left it too late to risk an operation
There’s no chance at all of a clean amputation
The successful removal of you
Would probably kill me too

Brilliant as usual.

Report from Red Hook – Hard Hit by Sandy

Red Hook after Sandy – Image from redhookrevcovers.org

This report from my friend Jenny, who took off work yesterday to volunteer in Red Hook, a waterfront area in Brooklyn that was hit hard by Sandy.

I am very pleased I went. I was working with a community center and adjacent church to service the Red Hook Homes (Houses?) a vast public housing complex (7000 residents according to Wikipedia). Some of the complex hasn’t had heat or power for 10 days, and the parts with electricity didn’t have heat in some cases. The church and center were serving breakfast, lunch and dinner to the ambulatory, as well as giving out food and blankets and some other things. They had electric radiators, but the public housing authority (or Con Edison) told them not to give them out, because they would crash the grid for those with power. The demand for all this, including the heating of the center, appeared to be huge.

I helped set up for breakfast, then went out to deliver food with a partner to list of people who can’t get out because they can’t negotiate the stairs with the elevators out. The wisdom of the recommendation of having male-female pairs of volunteers quickly became evident – the male is useful given the probably high level of crime, and the female is useful to persuade people to open their door. There was quite a difference between the lighted and unlighted buildings – in the latter, some parts were in complete darkness even during the day (we had flashlights), and people were reluctant to open their doors. When they did though, they were so grateful for the ready-to-eat meals we had. Many of the buildings stank – the trash chutes are not being emptied. For this reason, some residents had windows open despite not having heat. Lots of the people I delivered to didn’t look very old for the state of their health. Generally, whether at home or in the center and church, people were miserable.

After finishing the list after a few hours, my time started to be used less efficiently and more volunteers showed up, so I decided to go home.

Jenny

If you want to volunteer in Red Hook, as Jenny has, you can contact the Red Hook Initiative (info@rhicenter.org) or NYC council  SRelief@council.nyc.gov).

You can also find opportunities at redhook.recovers.org, a website that links those in need in Red Hook with those who can help.  This site is part of a wider effort started by sisters Caitria and Morgan O’Neill, who have created a website in a box (Recovers.org) that communities can use to organize in times of disaster. Other NYC neighborhoods using recovers.org are Astoria, The Lower East Side and Staten Island.

Caitria and Morgan are trying to spread the word so that municipalities actually set up and learn how to run a recovery in advance of trouble, as part of the infrastructure for emergency preparedness. Thanks to TED.org for spreading the word about this amazing effort.

TBTAM Earns HON Certification

If you find yourself wondering if the medical information you’re finding on the web is trustworthy and reliable, look for the Health on the net (HON) certification. HON is a non-profit group based in Geneva, and is one of the first sites designed to guide both patients and doctors to reliable health information on the web.

HON-certified sites undergo a rigorous review to assure they meet the 8 standards set by HON for trustworthy medical information.

1. Authoritative: Any medical or health advice provided and hosted on this site will only be given by medically trained and qualified professionals unless a clear statement is made that a piece of advice offered is from a non-medically qualified individual or organisation.

2. Complementarity: The information provided on this site is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician.

3. Privacy; Confidentiality of data relating to individual patients and visitors to a medical/health Web site, including their identity, is respected by this Web site. The Web site owners undertake to honour or exceed the legal requirements of medical/health information privacy that apply in the country and state where the Web site and mirror sites are located.

4. Attribution: Where appropriate, information contained on this site will be supported by clear references to source data and, where possible, have specific HTML links to that data. The date when a clinical page was last modified will be clearly displayed (e.g. at the bottom of the page).

5. Justifiability: Any claims relating to the benefits/performance of a specific treatment, commercial product or service will be supported by appropriate, balanced evidence in the manner outlined above in Principle 4.

6. Transparency: The designers of this Web site will seek to provide information in the clearest possible manner and provide contact addresses for visitors that seek further information or support. The Webmaster will display his/her E-mail address clearly throughout the Web site.

7. Financial disclosure : support for this Web site will be clearly identified, including the identities of commercial and non-commercial organisations that have contributed funding, services or material for the site.

8. Advertising policy: If advertising is a source of funding it will be clearly stated. A brief description of the advertising policy adopted by the Web site owners will be displayed on the site. Advertising and other promotional material will be presented to viewers in a manner and context that facilitates differentiation between it and the original material created by the institution operating the site.

I’m proud to display my HON certificate in my sidebar, and encourage you to look for it in the sites you visit for medical information. But be careful – A lot of quackery sites may simply use the HON image and falsely claim they meet the standards. That’s why HON certificate displayed should always includes a verification link back to HON. And there are a lot of great sites out there that have not applied for HON, so its absence is not necessarily a bad thing.

I must admit that I am a bit disappointed to see that HON has certified Drugwatch.com – an ambulance chasing site put up by a bunch of lawyers looking to find clients to sue Pharma. Drugwatch shows up on the front page of almost any search for the drugs for which they are searching for litigants – Yaz, Accutane and the SSRI’s are frequent targets. I wish HON would take another look at that certification.

How to Use HON to Limit Internet Searches to Trustworthy Sites

Google is getting much, much better at preferentially displaying quality info sites at the top of medical searches, and distinguishing ads from real content. They came up with some great finds on the first page of searches I did for major terms such as HPV, herpes and Menopause.  But if you have concerns about what you are seeing in a search, you can use the HON tools to focus your results within HOn certified sites – and without ads.

HON Plugin – If you find yourself spending a lot of time separating the real info from the crap when it comes to medical info on the web, consider downloading the HON Plugin so your search results will display the HON certificate right in your search results.

HON Site Search – If you don’t want to use the toolbar, you can search directly from the HON site

HON Select – You can also use HON Select to conduct searches for medical information from MeSH® terms, authoritative scientific articles, healthcare news, Web sites and multimedia – all in one search.

Try a HON search for yourself and see what you get

Search only trustworthy HONcode health websites:

Hurricane Sandy Relief – Time to Pay it Forward

If, like me, you are feeling blessed and grateful that you made it through the storm last week unscathed, here are just a few websites to find opportunities to volunteer your time and resources to help those less who were less fortunate.

Add additional volunteer opportunities in the comments section. And pass it on.

Birth Control Pills Lower Uterine Cancer Risk

In a study of risk factors for uterine cancer,  prior use of the pill was associated with a marked reduction in risk among women having a prior endometrial sampling-

We observed that OCP use before the benign endometrial biopsy or D&C was associated with more than six times lower likelihood of endometrial cancer. Similar findings in the general population were reported by othe  investigators. Estimated protection with use of OCPs ranged from 20% with 1 year of use to 80% with 10 years of use.

This protective effect of OCPs against uterine cancer is not news to us docs, but bears repeating for the public. Between the recalls, the FDA rulings and the lawyers, women rarely hear anything good about the pill.

More good news about OCPs here.

Fracking and Drought – Bad Company

I recently heard a piece on the radio about farmers in the United States who are being forced to sell livestock because they cannot raise them in drought conditions that are plaguing America in the wake of one of the hottest summers in history.

It got me thinking about how fracking uses water. A lot of water – two to four million gallons per well. I found myself wondering how many areas of the country that are at risk for drought also have shale gas in play.

Notice how much overlap there is between the two maps?

Just sayin’….

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Maps from droughtmonitor.com and gasland.com. Here is another map from the Energy Information Administration showing the same thing as the gasland map. 

Sisters – An Election Day Parody

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My four sisters and I gathered a few weeks ago for a girls-only weekend – the first time we had done so since our Fran died a little over a year ago. Fueled by wine and laughter, and inspired by the spirit of our exuberant contest-loving sister, we decided at the last minute to enter the Prairie Home Companion Duet contest with this little parody we wrote of Sisters from the movie White Christmas – a Polaneczky girls collective favorite.

Unfortunately, our duet (well, it’s actually a trio but don’t tell Garrison…), although graciously accepted a few hours past the deadline, didn’t make the finals.

That’s okay. We still think it’s great – if not off pitch in a few spots. (There was no time for perfection.)

We also discovered that if you play it say, 20 times in a row, especially when your companions are sick and tired of hearing it, or when they are trying to fall asleep, or when there’s a pleasant lull in the conversation – it’s even better!
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Music by Irving Berlin. Lyrics by Pat Federoic, Mary Lou Rittenhouse, Rosemary Jenkins, Ronnie Polaneczky & Peggy Polaneczky. Karoake Soundtrack from Pocket Songs Karaoke “Sisters in the Style of Better Midler & Linda Rondstadt.” Performed by Ronnie, Ro and Peg.

Why and When Women Have Abortions

A well written editorial by Wendy Savage in the Guardian should be required reading across the globe for anyone who needs or wishes to understand the reality in which women make reproductive choices.

Savage wrote the piece in response to comments by Jeremy Hunt, Britian’s newly appointed secretary of health, who wants to lower the abortion limit in that country from 24 to 12 weeks.

Jeremy Hunt, the newly appointed secretary of state for health, has unwisely shown his bias against the legal abortion limit laid down by the1967 Abortion Act and amended by the 1990 Human Fertilisation and Embryology Act. He told the Times in response to a question about when life begins: “Everyone looks at the evidence and comes to a view about when they think that moment is and my view is that 12 weeks is the right point for it.” It is hard to understand what evidence he has read that leads him to the bizarre conclusion that the limit should be reduced to 12 weeks.

Savage challenges Hunt’s assertion that the evidence supports his views by first showing us how the current limit of 24 weeks in the UK was decided –  based on medical science,  not personal opinion.

In 2007 the House of Commons science and technology committee published its 12th report on Scientific Developments Relating to the Abortion Act 1967. It concluded that although improvements in survival of babies born over 24 weeks had occurred since the upper limit was reduced in 1990, that was not the case for those under 24 weeks. This was based on the first Epicure study, a study of 4,000 premature babies (born from 22 to 26 weeks) treated in all the neonatal intensive care units in the UK and Eire, in 1995.

Since then the second national study of babies born in 2006 has been published and there is no significant change in the number of extremely premature babies surviving.

She explains how an arbitrary limit of 12 weeks makes no sense in the real world, where free access is not universal and where obstacles to abortion abound  – some of those obstacles within the very health system that Hunt now leads.

Some 91% of abortions now take place below 13 weeks and delays in the system have been reduced considerably, but some women still face difficulties from GPs who make them wait for unnecessary pregnancy tests or refer to a hospital consultant whom they know does not perform abortions. About a third of GPs are not prochoice and they should tell women this and refer to another partner who does not share their views but this does not always happen despite the GMCC guidance. Sometimes women are erroneously told that they are too far advanced in the pregnancy to qualify for an abortion, and younger women are more likely to accept the doctor’s view. These problems are less common today than 10 years ago.

She explains how it is that some women don’t come to their decision to have an abortion until the second trimester.

Research by Ellie Lee and colleagues published in 2007 into why women present late found that irregular periods was cited by a third, and a fifth continued having periods. A third were using contraception. In a quarter their relationship had broken down and a quarter were frightened of telling their parents. Women could give more than one reason and 41% were unsure about having an abortion and a third suspected they were pregnant but did nothing about it-possibly using denial as a defence mechanism. This shows that however good the service, there will always be women who present in the second trimester.

Finally, she tells us why the 1% of abortions that occur in later gestation will always be necessary – because some fetal anomalies, many incompatible with life, are not diagnosed until later in gestation.

Although the nuchal screening test for Down’s syndrome is available in most areas now, and allows a termination soon after 13 weeks compared with after 20 weeks when an amniocentesis was needed, other abnormalities are not picked up until the anomaly scan which is done at 18-20 weeks. Women are often devastated to learn that their planned and wanted pregnancy has not developed normally. They need time to come to terms with this and decide whether to continue with the pregnancy or have an abortion. Sometimes more sophisticated ultrasound to look at structural defects in the heart or genetic studies to see if there is a chromosomal abnormality are needed to make a diagnosis so the woman and her partner can make a fully informed decision. This all takes time and reducing the limit, as David Cameron would like, to 20 or 22 weeks would put more pressure on women and might even increase the rate of abortion at this later stage.

The one piece of evidence Savage leaves out is that limiting access will not prevent abortion, but will only serve to move it into settings where the procedure will be unsafe. The decline in maternal mortality that occurs when abortion becomes legal is undeniable. We cannot go back.

This is the real world that women and their families inhabit. 

It’s a world where not every pregnancy is planned, where not all women are in the position to determine when and how they become pregnant and where  not every pregnancy is diagnosed in time to allow for abortion before an arbitrary 12 week time limit. A world where the healthcare system actually works against early abortion, and where devastating fetal anomalies still occur and are not always diagnosable early in pregnancy.

The evidence shows that the best way to limit abortion is to increase access to contraception

And the best way to limit the gestational age at which abortion occurs is to stop trying to limit abortion in the first place.

Buying a Hybrid

Our new Ford C-Max SEL

It was time to buy a new car. Our wonderful 2003 Ford Taurus had 130,000 miles, and we’d put in quite a bit of money  in upkeep and repairs in the past year. Nothing unusual, just the things that start to go after that many years and miles. TIme to move on.

With all the ranting we do against fracking (our cottage is on the Marcellus Shale), the decision to go hybrid was an easy one. But could we get the mileage we wanted in the car we needed at a price we could afford?

Our priorities were –

  • Price – We knew hybrid meant more money than we’d ever spent on a car before. (Our Taurus was an end of season used dealer  model for just 14K – did I mention we are cheapskates when it comes to cars? ) But there is a break even point on hybrids, and we knew we had to just do it.
  • Mileage – We were looking for something comfortably above 35 MPG city and highway. The higher the better.
  • Cargo room  – Our Taurus has a generous 16 foot trunk, and that’s barely enough for us on trips to the cottage, where the lack of local supermarket means schlepping groceries as well as luggage  for 4.
  • Comfort – Our Taurus is really, really comfy, especially in the back seat. But our kids said they’d rather have to use a pillow in the back seat on a long ride than sit with suitcases, so cargo room was more important.
  • Power Drivers Seat option  – I’m not tall. I need to pull the seat way up to drive and then back again to get out of the car comfortably  And I often adjust during the ride. I thought this would not be an issue with any model car. But I was wrong.
  • Solid feel – Mr TBTAM has an issue with lighter cars for both safety and drive feel. Not a deal breaker.
  • Leather interior – our Taurus leather interior still looks like new after 9 years.  No compromises on this.

We’re not yet empty nesters, so the tiny hybrids were out (great mileage, no cargo room). So were the hybrid minivans (great cargo room, not great mileage).

I’d been waiting for the C-max for two years, convinced that it would offer me what the Prius would not in terms of comfort and space. Then Toyota came out with the Prius V, and I knew we had to consider it.

Other Things We Considered

  • Going electric. Unfortunately, electric batteries eat into trunk space. Also, our garage is not yet equipped to charge us. (And where they are, it’s not cheap  – $98 a month or $3 an hour for charging.) Finally, most of our driving is distance – electric shines best for commuting. We could not see an advantage to electric at this point for us in NYC.
  • Giving up the car altogether. We were car-less our first 10 years in NYC, and had survived. But the price (and often limited availability) of car rentals in NYC , our addiction to Costco, and the ability to pop down to Philly and family on a moment’s notice kept us car owners.
  • Diesel – we didn’t see a big advantage over hybrid, and the diesel high mileage cars were too expensive anyway.
  • Non hybrid cars with good gas mileage – None came close to the hybrids we were considering in terms of fuel savings. Plus, it felt like taking baby steps –  our environmental stance demanded a leap.

Why we did not buy a Prius

We thought the Prius V had everything we needed. But not quite. Here’s why –

  • The driver’s seat in the V is not power adjustable, even on the highest end model! (What’s that about, Toyota?) You need to pump a lever to raise and lower it and reach below to move it back and forth.
  • The comfort factor – the Prius V had more cargo room, but less head and leg room than the C-max. We weren’t sure the added cargo space was worth it.
  • The weight of the car. Mr TBTAM likes a more substantial feel to a car, and the Prius feels a lot lighter than the C-max. (Others might see this the other way around, and call the C-Max too heavy  – it’s all in the buyer’s eye…)

The 3rd generation Prius came very close to being what we wanted. It has a power drivers seat in the higher end models and beats the Cmax in mileage and price (though not by much in either). The cargo room was acceptable, and it looked great. But it is smaller, lighter and noisier than the Cmax. Most importantly to me, visibility seemed compromised – there is a blind spot on the front window if you pull up the seat as I do to drive, and the back window is split and seems small. Although they say you get used to the small rear window, I couldn’t see past the salesman in the back seat on my test drive.  (Hint to Totyota dealers – don’t sit in the middle next time you take a customer out for a test drive…)

In the end, the benefits in terms of price and mileage on the 3rd generation Prius were not enough to beat the C-Max for us.

Why we got the CMax-SEL

Mostly because I am totally in love with this car!  It has everything I want – 47 mpg city & hwy, power driver seat, decent cargo space (24.5 cu feet behind the second row), leather interior,  plus a few things I didn’t know I wanted  – back up camera, automatic foot operated hatch and sun roof.  And I could have given up the sun roof, but it really brightened the interior in a way I did not expect. (Another hint to dealers – if you want folks to buy sun roofs, take them out in a model that has one on a sunny October day…)

It seems as if I am not the only one who loves the C-max. While we were waiting for the salesman, another couple test drove the car we were looking at and by the time we came back from our test drive, they had already put an offer down on it. But that’s okay -it had options we did not need (like park assist – we know how to park, thank you). The one we’ve ordered will come in at our price limit – even with the sun roof – thanks to a dealer rebate.

I’ll post again after we’ve gotten our new car and driven it awhile

I am no stranger, after all, to post purchase regret. And real world mileage  can differ from posted MPG’s – though knowing my husband, he’ll be one of those hybrid drivers who tweak their driving style to get the best milage they can.

So stay tuned…

Now for the real question –

Does anyone want to buy a well-maintained used 2003 Taurus?

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Here’s a comparison on the three vehicles we looked at on Cars.com. And for the record, no one paid me to write this post. I just wanted to share our process thinking it may interest others making a similar purchase decision.