Noddy, very interesting way of thinking. This is the way I tend to think.
A second opinion is absolutely needed in any case.
About ten years ago, Mrs. Walter was due to have one, as an emergency case.
But istead of the hysterectomy, she got an even more urgent surgery for lumbar disc herniation.
Hysterectomy isn't a topic anymore (though hot flashes and other menopause-related things carry on ... ).
I have no experience in this area, just adding an ear. Even if it is the wrong body part.
Urs, I also would get a second opinion to check out different alternatives.
There is so much accomplished via laparoscopies nowadays, that having
a complete hysterectomy isn't necessary any longer.
Of course I have no experience there either, except having had a laparoscopy a few times due to cysts.
I second all those who advice a second opinion. I had a hysterecttomy whe I was 28 for a condition, endometriosis, that they treat in other ways today. That was 27 years ago. Having said that, I don't miss my uterus either. Have you had all of the children you want?
If it is the concensus opinion of you doctors to have a hysterectomy, don't fear that you will have any lasting affects. I forgot if you said. Will you have your ovaries removed as well?
No, Swimpy, just the uterus. The rest stays in.
I have no children and do not want any so that is no problem.
So there are no problems with hormones or loss of hormones or whatever? That was my understanding from what my doctor said. But now some people said that removal of the uterus will mix up the hormones and make me age faster (?).
Not true. The hormones will still be produced by your ovaries. You will be fine. You will not age faster. I think a lot of people blame the surgery for all of the ills that befall them afterwards. Those things were probably going to happen anyway.
Remember the "empty nest syndrome"? Remember the myth that all symptoms of menopause were because the woman was mourning the end of her childbearing years and grieving because she was no longer a person of value?
A lot of nonsense is still around.
Your ovaries will do just fine without a uterus.
Info on this (uterine fibroids) from today's NYT:
http://www.nytimes.com/2007/08/07/health/07cons.html?_r=1
Let me know if the link doesn't work and I'll copy + paste the article.
Thanks, sozobe. The link works. Very interesting.
Noddy and Swimpy, I like they way you are thinking! Yes, I agree - it is easier to just blame something like this. My mother had a hysterectomie many years ago. She is 71 now and looks and feels great. If this is aging faster I have no problem with it!
If you don't NEED a hysterectomy, and there are alternatives, why have it?
Get a second opinion. Explore your options. Like anyone else, doctors are quick sometimes to go the route that's easiest and MOST PROFITABLE for them.
I don't think that it is profit-related - doctors here get their money according to our "physician fee schedule". (Besides, I could imagine that it is done in hospital and not ambulant at urs' doctor's practise.)
Don't know what's going on over there but over here, it is most-definitely profit-related. EVERYTHING is profit-related.
A fullblown hysterectomy means more money that your insurance company will have to cough up for the couple of days in the hospital as opposed to a few hours as an out-patient, more money for the doc simply because it's a more invasive and intense type of surgery, more money to the anaesthetist for having to keep you under longer. That goes for the rest of the crew, nurses and such, as well.
eoe wrote:Don't know what's going on over there but over here, it is most-definitely profit-related. EVERYTHING is profit-related.
A fullblown hysterectomy means more money that your insurance company will have to cough up for the couple of days in the hospital as opposed to a few hours as an out-patient, more money for the doc simply because it's a more invasive and intense type of surgery, more money to the anaesthetist for having to keep you under longer. That goes for the rest of the crew, nurses and such, as well.
Everyone has encouraged urs to get more opinions. A hysterectomy is major surgery and should never be taken lightly. I just want to reassure urs that if that is the concensus medical opinion, it is not the end of the world.
eoe wrote:Don't know what's going on over there but over here, it is most-definitely profit-related. EVERYTHING is profit-related.
A fullblown hysterectomy means more money that your insurance company will have to cough up for the couple of days in the hospital as opposed to a few hours as an out-patient, more money for the doc simply because it's a more invasive and intense type of surgery, more money to the anaesthetist for having to keep you under longer. That goes for the rest of the crew, nurses and such, as well.
I agree to a certain extent. Some of us health care workers(the rest of the crew) are paid an hourly wage
Tuesday, Jul. 17, 2007
Are Hysterectomies Too Common?
By Coco Masters
More than 600,000 American women this year will undergo a hysterectomy, or removal of the uterus. That rate is among the highest in the industrialized world. By age 60, one in three women in the U.S. will have had the surgery, and in more cases than not, they will also have had their ovaries and fallopian tubes removed during the procedure. Doctors have long turned to hysterectomy as a treatment for conditions that range from heavy periods to ovarian cancer, but its widespread use concerns some critics, who say it's tantamount to female castration.
So, what are women to do? The truth about the health effects of hysterectomy lies somewhere in between the extremes, and experts say the key is to educate patients on the alternatives to surgery.
In the U.S., some 10% of patients who undergo hysterectomy do so to treat cancer of the ovaries, uterus or cervix. In such cases, doctors agree that the procedure is necessary. And these patients undergo hysterectomy in its most radical form, which involves removal of the uterus, cervix, the upper part of the vagina and the lymph nodes.
But the other 90% of hysterectomy patients opt for the surgery for noncancerous, non-life-threatening?-and some would say unnecessary?-reasons: 35% of women use it to remove fibroids (benign tumors in the uterus); another 30%, to do away with abnormally heavy bleeding during menstruation. Other common reasons for hysterectomy include endometriosis, or growth of tissue outside the uterus, and pelvic pain. Today, twice as many women in their 20s and 30s undergo hysterectomy as do women in their 50s and 60s.
Aside from cancer, "there's nothing in gynecology that has one treatment," says Dr. William Parker, chair of the obstetrics and gynecology department at Saint John's Hospital and Health Center in Santa Monica, Calif., and author of A Gynecologist's Second Opinion. "If you're only getting one option, it's likely that your doctor doesn't know how to do the others."
Take fibroids, for instance. Parker challenges the common misconception that fibroids can often become cancerous; the actual incidence of cancer cases in women with fibroids is very rare, less than 1 in 1,000. According to Parker, patients should treat fibroids by communicating with their doctor and monitoring how the fibroids make them feel?-whether they cause pain, bloating or heavy menstrual bleeding and whether they affect mood and energy levels. For patients who choose to remove fibroids, there are alternatives to hysterectomy: laparoscopic myomectomy eliminates fibroids through half-inch incisions made in the abdominal wall. In fibroid embolization, an interventional radiologist injects tiny polyvinyl alcohol particles, like miniature Stryofoam balls, into the uterine arteries to stop the flow of blood to the uterus and keep fibroids from growing.
To treat heavy menstrual bleeding, patients can use an interuterine device (IUD) coated with the hormone levonorgestrel, a type of progesterone. One study of Finnish women showed that two-thirds of those who used IUDs canceled their hysterectomy due to significantly reduced or stopped bleeding. The IUD has also helped hysterectomy rates fall in the U.K. to one-third of what they were a decade ago.
And for most cases of endometriosis, Parker says, women can be treated with medication or laparoscopic procedures. Given these alternatives, hysterectomy should be the last resort, Parker says, not the first option.
Rick Schweikert, program director of the HERS Foundation, a nonprofit organization that educates women about hysterectomy, says he would like to see the surgery go the way of tonsillectomy?-effectively phasing it out. HERS compares the procedure to castration and says its many adverse health effects far outweigh any benefits. A recent Foundation survey of women found that those with hysterectomy reported irritability, diminished sexual desire, fatigue and lost genital sensation. Other risks of the surgery include damage to the bladder and bowels. HERS says there are also economic reasons to curb the use of hysterectomy and estimates that $17 billion would be saved annually if doctors stopped performing the procedure unnecessarily.
In an August 2005 study in Obstetrics & Gynecology, Parker found that hysterectomy with removal of the ovaries increased women's risk of dying from heart disease. More recent studies also support the idea that leaving the ovaries intact benefits women's long-term health because ovaries continue to release significant amounts of the necessary hormones estrogen and progesterone after menopause. Still, physicians have not seen the expected decrease in the number of hysterectomies, and rates of oophorectomy are climbing. The reasons: Parker says that doctors have not learned many of the new alternative techniques, which can be difficult to master, and insurance companies continue to pay out more for hysterectomies than for alternative operations that preserve the uterus and ovaries.
Dr. Mary Jane Minkin, an OB/GYN and clinical professor of obstetrics and gynecology at Yale University School of Medicine, thinks that describing hysterectomy as a form of castration is as alarmist as it is inaccurate. Many patients benefit from hysterectomy. But she says the issue isn't black and white: "It all boils down to individualization of care." Minkin says women need to understand their particular condition, the risks they face in choosing hysterectomy and the treatment options available to them. Parker agrees. "It's really hard to change doctors' behavior," he says. "I'm trying to change women. They have a vested interest.
Time.com
That's very interesting, Miller. Thank you!
Ahem - William Parker is my gynecologist. Or was, as I've moved. (If I had anything serious now, I'd try to get back to Santa Monica to see him for a consult.) I feel very lucky that I had such a competent and thoughtful physician all those years.
He has also written, along with his wife, a book to give patients information about procedures and support increased patients' knowledge. I'll be back when I find the title of it.
Here's a website on Dr. Parker, and at the end, the title of the book for patients. I see it's been revised, which is good, as my only qualm in recommending the book was that the copy I have is fairly old now, and new procedures have been developed.
http://www.parkermd.com/
more on the book -
http://www.gynsecondopinion.com/
edit to add amazon link -
A2K Amazon link for A Gynecologist's Second Opinion, The Questions and Answers You Need to Take Charge of Your Health
http://www.ask4ufe.com/
Here's another good website I've found.
Not that I'm promoting one particular type of treatment, just that this is one that I know quite a bit about.
