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Wednesday, April 11, 2012 – Daily News FEATURES Premature babies now have a better chance TOR K: My sister recently gave birth prematurely, at 33 weeks. Thankful- ly, the doctors think my new niece will do well and should not have developmen- tal problems. I know that doctors are able to save more premature babies these days than they used to. What determines whether a "preemie" sur- vives? DEAR DOC- DEAR READER: I'm glad to hear that your new niece is doing well. Being born at 33 weeks means she was born seven weeks early. Your question remind- ed me of a colleague, Dr. Adam Wolfberg, who was in training here at Harvard Medical School. He want- ed to become an obstetri- cian specializing in high- risk pregnancies. He also wanted to conduct research into ways to improve the survival and function of "preemies." He and his wife, Kelly, had two kids, and Kelly was pregnant with their third. ly, Kelly went into labor very early, at six months. Their new daughter, Laris- sa, weighed less than 2 pounds at birth. She clung to life for several months — and finally made it. I asked Wolfberg about your question. Suddenly and ironical- Dr. K by Anthony L. Komaroff, M.D. When bleeding or infection is the trigger, labor is an adaptive response. Simply put, it is the body's attempt to end the preg- nancy in an effort to save the moth- er's life. labor. Most babies are deliv- ered about 40 weeks after the mother's last menstru- al period. Labor starts with a perfectly timed cas- cade of hormonal signals between the developing fetus and the mother. Con- tractions develop, the cervix dilates, and before long, out comes a well- developed, healthy new- born. But sometimes labor comes early. Early labor can be caused by compli- cations such as bleeding between the placenta and the uterus, or infection of the placenta that threatens the fetus. Sometimes, for reasons that we don't fully understand, the cervix dilates early, triggering Between 24 and 32 weeks of pregnancy, more than 80 percent of babies survive. With each pass- ing week in the womb, babies become less likely to suffer major complica- tions related to their pre- maturity. Wolfberg's daughter was born a little after 24 weeks, so she was at great risk of neurologi- cal and physical impair- ments, and of dying. Unfortunately, babies born before 24 weeks, weighing about 1 pound, are more likely to die than survive. Those babies that do live often suffer signifi- cant complications. These include severe lung injury, cerebral palsy, mental retardation, injury to their intestines requiring emer- gency surgery, and any of a host of less-severe injuries. We can hope that one day research will help to improve the prospects for such severely prema- ture babies, as it has in the past 40 years for less severely premature babies. Dr. Wolfberg tells the story of the struggle to save his daughter, and the science behind it, in the new book "Fragile Begin- nings: Discoveries and Triumphs in the Newborn ICU." You can find out more about it at: www.AskDoctorK.com. weeks or beyond, like your niece, tend to do very well. Sometimes they suf- fer mild behavioral or learning disabilities dur- ing childhood. But the risk of serious complications is relatively low. And almost every baby sur- vives. Babies born prematurely at 32 Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information. year-old senior in college and will graduate in May. There is a growing riff in my family, and most of it is due to my stepmother. She says horrible things about my family (and others) when she thinks no one is listening. But we've heard her. In fact, my grand- mother and I recently over- heard some awful remarks on the way to a family member's funeral. Dear Annie: I am a 22- does gets back to my dad, he claims we blame her for everything and blows up at us. I can barely speak to him any- more without accidentally starting a fight. Last year, these tiffs ruined my birthday and our family celebrations. Dad refused to come to Christmas Eve dinner and really upset my elderly grandmother. When anything she says or My stepmom ran up a massive credit card debt, and my father had to stop helping me pay for tuition halfway through the school year. It has gotten to the point where I'm consider- ing medication for stress in order to handle coming home during spring break. I really don't want to become one of those people who loses contact with her family, but this has been building for a long time. It's harder and harder to forgive and forget and behave as if nothing is wrong. What can I do to alleviate this situ- ation? — Too Much Drama in Virginia The Internal Revenue Service today reminded anyone unable to meet next week's tax deadline that they can easily get an auto- matic six-month tax-filing extension. And, the easiest and quickest way to get an extension is online through the Free File link on IRS.gov. anyone, regardless of income, can use this free service to electronically request an automatic exten- sion on Form 4868. Filing this form gives taxpayers until Oct. 15 to file a return. This is an extension of time to file; not an extension of time to pay. To get the extra time, taxpayers must estimate their tax liability on this form and should also pay any amount due. Taxpayers can e-pay what they owe using the Electronic Federal Tax Payment System (EFTPS), by electronic funds withdrawal or with a credit or debit card. Those who choose to pay by check In a matter of minutes, Social Security COLA impacts beneficiaries Has your 2012 Social Security COLA increase changed your Medi-Cal status? Do you now find yourself with a higher share of cost or have you been disquali- fied from receiving extra help with your Part D drug plan and Medicare premi- ums and copays? Many dual benefitted beneficiaries were impacted and are in the midst of receiving Notice of Action letters from the California Department of Health Care Services or their local Medi-Cal office. If you have questions and need help navigating through your options, please give HICAP a call. We are your Medicare advocates regardless of your age, disability, or income. As a free ser- vice of Passages Adult Resource Center we are available Monday – Friday from 9 a.m. until 4 p.m., call 1-800-434-0222. HICAP does not sell or endorse any insurance product. Annie's Mailbox by Kathy Mitchell and Marcy Sugar Dear Virginia: You need to step back from the drama and understand that your father will always defend his wife. He isn't going to leave her because of your criticisms, nor is he willing to make her behavior an issue within his marriage. We recommend you spend as little time as possible around your stepmother, don't bring up her faults to your father and, when you graduate, move into your own place. Dear Annie: I have eight grandchildren from high-school age on up. None lives nearby, although I see them several times a year at family events. I truly love them all. Long ago, not knowing sizes or preferences, I stopped sending gifts and now send $100 checks for their birthdays and at Christmas. Some of them respond immediately with thank-you notes, emails or phone calls. A few grandchildren respond most of the time. But there is one I never hear from at all. What should a grandmother do? I enjoy being able to give them each a check and don't want to stop, but I admit that I'm getting more and more annoyed when I don't get a response, especially with the one granddaughter in her early 20s who never says thank you. If I send a card acknowledging her 3B Evil stepmother ruining family affairs Dear N.Y.: Maybe, but even if she does, it doesn't guarantee a change in her response. We suggest being more direct and then giving her one more opportunity to show her gratitude for your generosity. Call or email your errant granddaughter, and tell her you are never sure your gifts arrive because she doesn't acknowledge them, and it makes you wonder if perhaps she'd rather not receive them. Say that even a brief email would be much appreci- ated. Consider it a teachable moment. Dear Annie: This is for ''Steve in Ohio.'' My father-in-law was Frank, my sister's husband was Frank, and another brother-in-law was Frank. When our son was born, we named him Frank after my father-in-law. My sister named her son Frank. So did my sister-in-law. We also had two cousins named Frank. When we were together, things could get quite confusing and funny, but when someone called Frank Paul or Frank Peter, they knew they were in trouble. They are all grown now and just fine. The next generation is carrying on the tradition of naming their first son Frank. — Pennsylvania birthday, but without the expected check, do you think she would figure out the reason? — Schenectady, N.Y. or money order should make the payment out to the "United States Treasury." By filing Form 4868, a taxpayer will avoid the late- filing penalty, normally five percent per month based on the unpaid balance, that applies to returns filed after the deadline. In addition, any payment made with an extension request will reduce or eliminate interest and late-payment penalties that apply to payments made after April 17. The current interest rate is three percent per year, com- pounded daily, and the late- payment penalty is normal- ly 0.5 percent per month. Besides Free File, tax- payers can choose to request an extension through a paid tax preparer, using tax-preparation soft- ware or by filing a paper After Tax Time is Over April 17th We will still be here • Extension • Prior Year Taxes • Bookkeeping • Payroll P. Ralph Campbell, EA Enrolled Agent • Financial Services 530-529-9540 855 Walnut St. #2, Red Bluff CA Insurance Lic. 0C73069 Daniele Jackson Annie's Mailbox is written by Kathy Mitchell and Marcy Sugar, longtime editors of the Ann Landers column. Please email your questions to anniesmailboxcomcast.net, or write to: Annie's Mailbox, c/o Creators Syndicate, 737 3rd Street, Hermosa Beach, CA 90254. Use free file Form 4868 for six-month extension • People in parts of Indi- Form 4868, available on IRS.gov. Some taxpayers get more time to file without having to ask for it: combat zone to both file returns and pay any taxes due. • Members of the mili- tary on duty outside the U.S., as well as U.S. citizens and resident aliens living and working abroad have until June 15 to file and pay, though interest still applies to payments made after April 17. • Members of the mili- tary and others serving in Iraq, Afghanistan or other combat zone localities can typically wait until at least 180 days after they leave the Red Bluff Garden Club Invites you to attend their 51st May 4 & 5, 2012 Friday and Saturday 10 a.m. to 6 p.m. Annual Standard Flower Show "Fun & Flowers from the 50s" Home Arts Bldg., Tehama District Fairgrounds For Information or to enter call 527-9403 Huge Plant Sale Classic Car Show Kid's Flower Planting Activity ana, Kentucky, Tennessee and West Virginia, affected by tornadoes, severe storms, floods and other recent nat- ural disasters, have until May 31 to file and pay. Details on all filing and payment options are on IRS.gov.