There is no reason your patients should be experiencing pain in these situations, and failing to solicit pain feedback and control pain level is a quality and safety breach.
The AL #legislature voted Thurs to #protect#doctors doing IVF from #criminal or #civil#liability if #embryos they help to create are subsequently damaged or destroyed.
The fast action by both the House & Senate on bills to shield IVF came >2 wks after the state’s Supreme Court ruled that #FrozenEmbryos are people & that individuals could be liable for destroying them.
Singleton accused his colleague of relying too heavily on clinics &trial #lawyers in writing the measure,granting #doctors#immunity but not female #patients.
“We’re getting into a deep subj as far as when life begins & #abortion,” said Melson,a #Republican. “I’m not trying to take anybody’s rights away. I’m just trying to help these ladies. I’m sympathetic to their cause…”
Sen LarryStutts (R), an #OBGYN &the bill’s sponsor,…said discarded #embryos are “a small, small percentage”…. #law#Alabama
"The many #menopause myths your patients may believe
A look at the many preconceptions (and their related products) your patients may have about menopause."
This is a new story I wrote for the Medical Post/Canadian Healthcare Network which summarizes a talk at a recent #obgyn conference. The site is password protected but free for #doctors and #pharmacists in #Canada. Here are the first few paragraphs:
Myths, misinformation and questionable products for use in menopause abound.
So, what should doctors say when faced with patients asking about supplements, ‘estrogen imbalance,’ expensive tests, or social-media inspired treatments?
At the recent annual meeting of the Ontario regional conference for the Society for #Obstetricians and #Gynecologists of Canada (#SOGC), Dr. Alison Shea, assistant professor of obstetrics and gynecology at McMaster University, addressed these topics.
She emphasized that while information on the internet is highly accessible, menopausal management is highly individualized.
“What somebody may say on social media that really helped them, may lead someone to ask about (it),” she said, stressing that doctors should explain that “what works for one person might not work for you.”
Myths around menopause are common, and social-media material relating to menopause can be associated with product advertising. On Instagram alone, half of the menopause hashtags are for advertisements. And, according to BNN Bloomberg, the global market for menopausal products hit US$15 billion in 2021.
The selling of products should set off alarm bells, Dr. Shea said.
High profile brands
Some high profile brands associated with menopausal products that patients might mention include GOOP, Stripes, the Galvenston Diet, and the Balance #Health App.
Actor Gwyneth Paltrow’s GOOP, and Naomi Watts’ Stripes, both sell various products with little to no science behind them, she said. Yet, some of the Stripes products are decent, such as vaginal moisturizers which are hylaronic acid based. But its advisory board is lacking, consisting of only one ob-gyn, a dermatologist and a journalist.
The creator of the Galviston Diet has some helpful content, but their goal is to sell various products, Dr. Shea said. Some of the supplements appear to be fine for healthy aging, but they may not do much for menopausal symptoms.
The Balance Health App from the U.K. tracks menopause symptoms. This can be useful, but there are free and paid versions.
The vocabulary of menopause myths
Estrogen imbalance: This is the idea that high #estrogen or “estrogen dominance” are the underlying cause for bothersome menopause symptoms and need to be kept in check.
“We know this is not true,” Dr. Shea said. While fluctuating levels of estrogen can stimulate endometriosis, or stimulate some fibroid growth, lower estrogen levels are more responsible for bothersome menopausal symptoms
"Estrogen dominance" is sometimes used to describing an ‘imbalance’ of estrogen and progesterone. However, this is not a scientific term. Some patients may purchase progesterone cream products to help with the supposed imbalance, but progesterone does not work well through the skin. And if it were absorbed it may contribute to a worsening of mood symptoms in some. The only time estrogen may need so-called balancing is if there is an overgrowth of lining the uterus, or proliferative endometrium, she said.
Probiotics are also being sold claiming to influence estrogen metabolism in the gut, but there’s very little evidence.
Copied verbatim from my IG/FB posts with minor edits for names and local slang.
POD 365.
I am alive, but at what cost? The physical, psychological and professional damage is profound; I still live with chronic, albeit much less pain from how damaged my nervous system and brain has become; I still live in abject fear that the next time pain lances through me it’s getting cleaved with a claymore and not just a papercut; I still live running and chasing, held back from things I should have attained, compromising, sacrificing, wasting my youth playing catch-up.
But I’m still alive, and I have so many people to be thankful for. My endo surgeon and hepatopancreaticobilliary surgeon, for spending those six life-changing hours with me; my pain management attending, for his patience as I failed every single conventional pain medication, my intern year seniors, for desperately trying to get me to eat; the 9B nurses, who had to deal with me throwing up endlessly; and the head of benign gynaecology, who gave me the time and space to pull myself together to commit to the op… not to mention those not even directly involved in my care - mentors who stood by me every step of the way, the nurses who hugged me and gave me chocolate when they found me crying and crying and crying in the ward pantry, classmates who came to see me preop and postop, friends who sat with me in-game on pain-filled sleepless nights, and even the faculty who were incredibly accommodating throughout M5… the list goes on…
Objectively, post-excision life is better now.
I don’t spend every waking moment drowning in pain.
I don’t get accused of trying to skive if I have to take sick leave and explain myself to deaf ears.
I don’t have to titrate a whole fistful of analgesia, antiemetics, laxatives and PPIs anymore.
I can walk, and even run again.
And I can wear pants!!!!!!
Oh right, and I too am a doctor now, despite and in spite of my body failing me.
Painful periods are NOT NORMAL. I have been gaslit all my life by people around me - family, friends, doctors, the media, random people who think they know better - that it is normal for a period to be painful and that I need to suck it up and deal with it. NO. Absolutely not.
Pain is a fundamentally pathological process and should be respected and treated as such. ONE IN TEN women suffer from endometriosis, whether they know it or not.
It is not fair - abusive, even - to anyone experiencing pain of ANY KIND to be told it’s all in their head, they just need to be strong, or any other manner of gaslighting.
There is a cause and a cure, and it is negligent if not outright maleficent to not act on it.
She Trusted Her First OB-GYN Because He Spoke Spanish. Now She’s 1 of 94 Women Suing Him for Sexual Assault.
The #Utah Supreme Court this week is hearing arguments in the case, which will determine if what 94 women say they experienced was #SexualAssault or medical #malpractice.
Columbia University Deals With Revelations About Its Decades-Long Failure to Stop a Predator
Medical students have protested and survivors have expressed outrage following ProPublica’s investigation into how Columbia ignored warnings that former OB-GYN Robert Hadden was abusing patients.
Effect of COVID-19 vaccination and booster on maternal–fetal outcomes: a retrospective cohort study
“COVID-19 vaccination protects against adverse maternal–fetal outcomes, with booster doses conferring additional protection. Pregnant people should be high priority for vaccination and stay up to date with their COVID-19 vaccination schedule” #pregnancy#vaccination#COVID19#Medicine#Science#ObGyn
Contrary to what “Time” says, education is the first and foremost method of preventing not only anti-vaccine movement but also other pseudo-scientific and sectarian movements, such as anti-GMO, anti-nuclear, anti-5G etc. But this required country-wide improvement of access to education on all levels, which is incompatible with the US model of education being paid, premium service for people who can afford it.
I would suggest it also helps reduce climate change sustainably:
If we define climate change as human-induced changes, then educating women, and promoting first-world standards of family planning, contributes to reducing the rate of increase of the human population.
It's for everyone to do their own root-cause analysis of course, but I'm always gobsmacked that no one lobbies for this.
No OB-GYNs left in town: what came after Idaho’s assault on #abortion
"Across Idaho, doctors are leaving, looking for states where politics don’t dictate how they practice medicine. The consequences of Idaho’s anti-choice laws hit Sandpoint fast and hard, hollowing out medical care for women within months. For years, the town had a maternity ward that delivered as many as 350 babies every year – now it has nothing. The OB-GYN ward shut down this spring and doctors have been fleeing the state in a steady stream, seeking shelter in places where their work doesn’t put them at risk of criminal charges or big lawsuits."
PS: These authors recognize that not all OA journals charge APCs (#DiamondOA). On the one hand, their data only show a decline in submissions from the south for APC-based OA journals. But their imprecise writing attributes it to OA as such.