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June 04, 2009

Preventative Measures

Preventative Measures

by Nancy

My neighbor Donna, the president of our book club, is having her ovaries removed. 

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Gentlemen, you are excused from today's blog.

Donna is an athletic, upbeat Canadian--an enthusiastic special education teacher, the only woman I know besides Oprah who wept over Edgar Sawtelle (don't get me started) and she raises gorgeous peonies along the white picket fence in her back yard.  Her strapping sons look just like her---tall with thick dark hair cut short, but fetchingly so. She's not a girly girl, but there's no doubt she's a flourishing woman with a full life, a rich laugh and that charming Canadian "oo" in her accent. But because her family has an extensive history of ovarian cancer, Donna has decided to solve the problem before it gets a chance to start--hence the removal of perfectly healthy organs.

I'm not sure how I feel about this. Perhaps because my own family history features causes-of-death that can't be solved by the removal of anything (that is, until somebody figures a way to surgically suck the fat from my arteries or the sugar from my bloodstream) I haven't contemplated such dramatic precautionary steps. So I was stunned when Donna cheerfully announced she might not make our next book club meeting because she'd be recovering from having her ovaries out.

I wanted to ask her more questions, but we had to discuss The Blue Sweater and try our hostess's cheesecake.  (Has anyone else read The Blue Sweater?  Did you believe the anecdote about the sweater? Because although the book was inspiring and uplifting and engendered good discussion--all things a good book club book should do---the sweater story rang totally false to me---like an editor's suggestion, not something that really happened. Just saying.)

Donna seemed to find her decision easy.  She'd thought about it, and it didn't appear that her self-worth or feminine identity was tied up--so to speak--in her female organs. 

I found myself wondering if maybe Donna made her decision easily because ovaries aren't visible. 

Breasts, now, are surely another story. If your mother, grandmothers, sisters and aunts all developed breast cancer, would you have your breasts removed? Unlike your ovaries, your breasts are--uh---right out there. Surgically removing them would be disfiguring yourself, right? Cutting off a part of yourself that some women find impossible to get along without. Not just physically, but surely emotionally, too, voluntary breast removal is an even more difficult decision than Donna's. And here's a study that says prophylactic breast surgery only prevents 90% of breast cancers. Is that sufficient guarantee for you? (Most estrogen is produced in the ovaries, and it's estrogen that causes some breast cancers to grow.  So the ovaries gotta go, too, in that prophylactic mastectomy.)

What would you do? Roll the dice and take your chances? Go in for monthly health exams and blood tests to make sure a bad disease hasn't gotten a foothold? Or would you vote for total removal and never look back?

What's more important to you? Your breasts or your life?

Your ovaries or your life?

(And how much different is having your ovaries removed than, say, asking your daughter to get the Gardasil shot to prevent cervical cancer? Except that Gardasil isn't a surgical intervention, but you are forced to have that uncomfortable sex discussion with your teenager? Have you done that?  Or were you fortunate enough---like me---to have teenage daughters come of age before that particular drug came on the market?)

Me, I had a partial hysterectomy in my early forties.  I got to keep my ovaries, but everything else?----I couldn't wait to get rid of it.  Two kids and too many days of finding blood in my shoes convinced me that I was totally ready to ditch my sorry uterus. I haven't regretted that operation for a single instant.  But I know wise women who dig in their heels on this subject.---Some women just don't want to lose their female parts for any reason.

Now, with Donna heading to the hospital in a few weeks, I'm starting to wonder:  Should I have had my ovaries removed, too? Because ovarian cancer--silent and insidious--is one of those diseases you really don't know you have until it's very late in the process.  Should I have gone the hormone replacement route?

But I've got cardiac issues to consider, so hormone replacement is one of those complicated problems I just don't want to start struggling with----yet.  Sure, now that my hot flashes are few and far between, I know I'm going to have to start thinking about a little hormone bump.  But it's so damn complicated! Do hormones help with heart disease? Or cause more problems?  Read the latest study, and you'll find conflicting evidence by the second paragraph!  Every few months, some medical journal or other publishes another conflicting article that makes me shake my head. 

When will women's health issues ever be simplified?

Probably never.

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I can't help thinking that a man with prostate problems gets a simple blood test and knows where he stands.  But women like Donna are taking drastic measures.

Next month our book club is reading the biography of Mary Todd Lincoln.  It's long, I hear. And fully describes Mary's various mental health issues which I can't help thinking were partly hormonally caused.  If you've read the book, let me know what you think.

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Comments

>>>I can't help thinking that a man with prostate problems gets a simple blood test and knows where he stands.<<<

No. Not even close.

In order to make sure a guy does not have prostate cancer, they do a biopsy. This involves, to make the description blunt and fast, sticking a needle gun up his butt and firing a needle through the abdominal wall into his prostate to take a sample. Not once or twice, but NINE times. Even with a local anesthetic, it hurts. And there is a lot of bleeding. And he pees (and ejaculates) blood for a couple of days.

Been there, done that...and all to find out that I'm cancer free and just have to learn to live with a larger than average prostate gland.

I assure you that I have the utmost respect for women and what they must go through in the medical realm.

But it ain't quite a bowl of cherries for us guys.

Yee Gods as the lady says in The Music Man. This is such a hellofa decision. When they found cancer in my left breast, 10 years after the cancer and radiation burns of the right one..........it was easy. NOT. I did decide to have a double mastectomy b/c I couldn't deal with any more fear of death.
As a double D all my adult life it was a big deal. The radiation burns from the first cancer sealed the deal. Now I look like an eggplant in many ways.......but a flourishing one.I am working on a plan for tattoo work.............my docs do not understand.
In my case the radical double revealed lympf node involment which made the whole issue moot. Many chemo days dressed to kill!I took the test about the genetic connection b/c my sister and I needed it for our girls.Luckily, in Pgh, I fit into a study so my sister and I didn't have to pay the whole thing.
No regrets.....coming to know this new body is crazy but my life goes on. And now I can thank you all for getting me thru the bad days and to my daughter's July 4th wedding! Thanks to you all.

I lost my baby sister to metastatic breast to bone cancer in 2001. If my insurance covered an elective double mastectomy I'd do it. 90% heck, that's better odds than she had.

Yikes, Doc. That post made me want to lie down with a cold compress pressed...somewhere. Which I was going to do anyway, but I guess this is not the day to complain about my horrible summer head cold.

Mary Todd Lincoln: I don't know about hormonal, but imagine suffering debilitating depression and grief while under constant scrutiny as First Lady. IMO, she's much a tragic figure as her husband.

Mo mother was one of 10 girls. Four of them have died, all from cancer (two breast, two others). A fifth managed to survive breast cancer. Those are freakin' terrifying odds. I have often considered having an elective mastectomy and possibly having the ovaries yanked as well. It's something I will continue to debate.

Cosmetics don't factor into the debate at all.

But thus far, my cousins and I seem to be doing okay, and trust me, we're all at ages when it wouldn't be surprising to have cancers start popping up. It makes me wonder if there was an environmental reason behind those previous cancers instead of a genetic one. Of course, that might simply be wishful thinking ...

What a decision to make. Genetics is one set of laws no one can argue with, and it's got to be difficult to go in that direction.

Doc nailed it. It should be a felony charge for a physician to say "This won't hurt," or "It *might* sting just a little," and then one learns the hard way that doctors are liars. When a grown man is on the table, wishing with all his heart his own mother would walk in the door and make this sadistic son of a bitch STOP, it's not a good moment.

All any of us can do, male or female, is stay on top of things as much as we can and make informed decisions.

Nancy, I'll keep a good thought for your friend....

Thanks to a change in law last year, it's now possible to be genetically tested for the Brc gene linked to ovarian cancer without worry of being punished by your insurance company. (Personally, I still don't trust them.)

My neighbor, who is battling a cousin of ovarian cancer, was tested for the gene and came up positive - as did her mother and sister who have absolutely no manifestations of it. So it's a crap shoot.

A former editor of mine had her ovaries removed in her 40s and went on to lead a much more exciting life, traveling around the world, etc....She got a lot of freedom from that.

Thats said, I might finish this post, walk outside and be squished by a truck. Life ends.


Jeez, this stuff is frightening.

I waited about 6 months to see if there were adverse reactions to the Gardasil shots in the news, then we ran to have my daughter get the 3 rounds of shots. I barely gave the uncomfortable discussion a thought as compared to reducing her chance of cervical cancer by 90%.

This is kind of a hijack, kind of not - an NYT blog about a man going thru menopause. I kid you not.

http://well.blogs.nytimes.com/2009/06/02/my-brief-life-as-a-woman/?em

Sarah, I saw that menopause piece yesterday and meant to link it to this blog. Thanks!

Nice to see the men of the blog stuck it out today.--And made insightful contributions. (William, you endear yourself more every day.)

Mary Alice, you're a goddess among us.

It's all so scary . . . and so hard to find an absolute answer. I know I'm lucky that I don't have any of these "inheritable" cancers in my family (but, of course, it doesn't keep me from worrying about them at 3 a.m. when I have some vague pain somewhere). I think I'd be like Donna and go for having the ovaries yanked out - - - but that's easier to say when I don't have to schedule the surgery.

Sarah's right (as usual!)--so I better enjoy it as much as I can for as long as I can.

Nancy, if anyone would know a contrived story, it would be you. I trust your instincts on The Blue Sweater. (And hope my book club doesn't choose to read it.)

Damn cancer has its tentacles in every family somehow, it seems. My own mother and five of her six sisters, and their mother, all had uterine cancer, and they all had to have hysterectomies before they would have gone into menopause. When I went into early perimenopause in my late 30's none of my older relatives could give me any insight into what was going on. None of us have had it, not any of the 20+ female cousins (knock wood). Skin cancer, yes, and lots of lung disease from smoking. But that's it, so far.

Ovarian cancer is insidious stuff, and is the culprit for several deaths (and ongoing illnesses) in our lives, including my sister-in-law. She, and another friend at the same time, battled the disease for 12 years. It changed everyone's lives around her, including her children, who were 12 and 9 when she found out she had it. The girls, especially the older one, ended up taking care of her because her jackass husband left her at that same time. Our niece is now 30, and she's the oddest combination of old soul and child. She didn't have a chance to BE a kid when she was one, sadly. I will ask them when I see them in a couple of weeks whether or not they would have their ovaries out if they found out they had a genetic marker for cancer. I'm guessing they would.

I have serious objections to Gardasil, chief among them that the government was pushing it so hard. Truthout.org has a great series of articles about this drug, and the company's attempts to have its use state-mandated. It's scary stuff, especially since there are also lawsuits about side effects pending:

http://www.truthout.org/article/selling-gardasil-rest-world

One of my daughters has had the shot, but the other two listened to me. All three of them are in long-term committed relationships, and I seriously doubt they are at risk. I recognize there is a chance for infection from unfaithful partners, but to my mind the risk from the shot is worse. Your mileage may vary, of course.

Well, aren't we just a ball of sunshine today?

Doc - I appreciate the candor. I won't even try to compare it to what women go through during the 'normal' course of OB/GYN appointments, labor and childbirth. This is because I have on helluva headache today. Sinus? Hormones? Allergies? Who knows. If only I had simply a limp dick, I'd have so many answers.

Ok - kidding and Doc and William - I really do appreciate your insight. And I'm not minimizing what you go through. I just had to, you know, say it.

Kathy, too bad there wasn't a do-not-drink-coffee warning on your post!

My gynecologist once told me that if a man lives long enough it's inevitable that he get prostate cancer. And if it's caught in time it's rarely fatal.

You have to remembere that people pay good money for that prostate check...

...just not always from the doctor.

I have a friend who had breast cancer several years ago and had one breast removed. It was an early stage of cancer so she didn't need chemotherapy or radiation afterward. But now, seven years later, her doctor is suggesting having the other breast removed, because her chances of getting breast cancer in that breast are very high. She's struggling with this, not sure what to do. I'm no help because I just don't know what she's going through.

As per ovaries, mine haven't worked properly for years now, having gone through premature menopause. But my doctor is an expert in menopause, has written books about it, and she's got me on birth control pills for the hormones. Obviously not for the actual reason anyone takes birth control pills. I'm so used to taking hormones that it's second nature and I'm healthy so I'm not worrying about it.

Yikes - so much to discuss here!

First, a note direct from the National Cancer Institute: Most cancers do NOT "run in families." That is, although there is a hereditary component to some cancers (notably *some* forms of skin, colorectal, and breast cancers), most incidents of cancer arise for complex combinations of causes we don't really understand very well. We have limited or no control over some of them, and a great deal of control over others. A healthy lifestyle that includes a proper diet, adequate exercise, and protection from UV radiation is the single best preventative measure most of us can take. And, oddly, among the most difficult. Why is that, I wonder?

About Gardasil . . . a colleague of mine works on the HPV virus and I trust her implicitly when she tells me that the vaccine protects against only a fraction of the forms of the virus that can lead to cervical cancer. We don't know how well a single course of treatment will protect anyone who has multiple sex partners over her lifetime. Plus, why aren't we giving it to young men, who are spreading the darned virus? I am very glad my daughter was too old for this decision!

When my reproductive system went south about 15 years ago, it was a no-brainer to have the uterus yanked and, ultimately, the ovaries along with it. I breathe regular sighs of relief knowing that I can at least cross ovarian cancer off my list.

I'm lucky not to have a family history of breast cancer (we run to colon cancer in my family . . .), and am starting to pay more attention to large studies questioning the value of annual mammograms even for women over 50 who are otherwise not at high risk. (Results show a large number of false positive tests and a limited reduction in actual survival rates.) Would I do the double if I thought I was at risk? Yes. And get lots and lots of therapy, undoubtedly, along with some killer tattoos.

HRT? Yep, did that for 15 years - estrogen only, fortunately. Did the studies worry me? Sure -- at first. Then I realized that most of them stemmed from the Women's Health Initiative, the study population of which is health post-menopausal women. In other words, not me.

I am very, very glad that I have an educational background that lets me feel fairly confident doing these kinds of evaluations for myself! Even if it leaves me just as confused as everyone else :)

I haven't read Edward Sawtelle, but am looking for more good books. Would The Blue Sweater be a good choice? Even with the anecdote?

I have a friend whose daughter is a 3-year breast cancer survivor. She has two young children, and is seriously considering a double mastectomy and removal of ovaries. Being around for her children is much more of a priority than the cosmetic ramifications of surgery. Plus, breast reconstruction is possible.

I have had cancers in my family, but after watching my father live, and ultimately die, with Alzheimer's, I'm much more terrified of that. And that DOES seem to run in families.

I have to pitch one for the guys here, because my dad just had a prostate thingee and he said the pain of the follow-up exam almost took him out.

This is my dad, who, IRL, is a COWBOY. Who once contracted encephalitis from a horse. The horse died. My dad just stayed in bed for a few days. So if he's complaining, it has to be some damn big ouch.

Kerry, The Blue Sweater got a lot of people talking. But it's a typical book club book, if that's a genre now.--An American goes to Africa with a mission, makes mistakes, learns a lot, writes about another culture. Which is not to say I'm belittling.--But it's a formula now, isn't it? Read one, you've read 'em all? Not really. The micro-lending aspect made for good discussion.

As does the topic of women's health and what we all do to gather info, share with others, learn from everybody else's experiences.

***Hijack***

from CNN.com breaking news

'Kung Fu' star David Carradine has been found dead in a hotel in Bangkok, Thailand, according to his manager.

I just read the item on Carradine. His manager says he died of "natural causes", but he was found hanging in a closet. 72 years old. How very sad.

First Koko, now this...

BTW, I'm back. No truck squishing yet.

I have a friend whose mother and aunt died of breast cancer. Sure enough she was diagnosed with it. She elected to have a double mastectomy with reconstructive surgery all in the same operation. She liked it to having a boob job and a tummy tuck all in one. Her doctor is one of the leading reconstructive surgeons in the world. But wow what a procedure. 13+ hours on the table and another 5 weeks at-home recovery. Then she had the genetic testing which came back positve. She hardly hesitated before saying get these ovaries out of me. She had that surgery just a little over a year after the first surgery. Fortunately she did not have to undergo any chemo or radiation at all but she spent about 18 months having and recovering from surgical procedures related to genetic heredity. Her decisions for surgery were definitly made easier by the diagnosis(es) given by her doctors, but still it is a huge decision to undergo surgery, especially elective and preventive. Me, I don't think I could go that way. But I admire people who can make those decisions.

Good grief, I don't know what to respond to first. David Carradine? Ramona's Cowboy Dad?

My new neighborhood doctor is a serious believer in HRT and pretty much talked me into it. My best friend is seriously trying to talk me OUT of it. It never occurred to me to try it, and now that I have, I like it, but honest to Pete, it's hard to figure out the risk/benefit ration. Is there an (objective!) doctor in the house?

Harley, Kerry's right that the studies that show HRT is bad only studied women over the age of 65 who'd already gone through menopause. My doctor, Mary Jane Minkin, who is affiliated with Yale, has written a couple of books about menopause and pooh poohs the study.

I am back from Panera's to pick up a sandwich and was nearly run over by a truck. My firt thought: "By God, Sarah predicted it this morning!"

Lest anyone think I don't understand female health problems, I should point out that my mom, who just turned 81, is a survivor of ovarian cancer, as are two of her three surviving sisters. I have 7 female cousins that survived cancers (3 ovarian, 2 breast, 2 kinds I can't recall) as well as 4 female cousins who did not survive cancer.

Besides cancer, the womenfolk of my family (mostly on my mom's side) have survived assorted viruses, ectopic pregnancy, miscarriages, heart disease, kidney problems, depression, a brain tumor, ulcers, neurological problems, menopause and a long list of other stuff.

Note also that a goodly number of them have survived one or more husbands.

Women: Tougher than you think

Dear God....

Kwai Chang Caine is no more. Let us hope he is with Master Po, watching down.

The moment I will always remember from KUNG FU:

"I seek not to know the answers, but to understand the questions...."

I was on HRT for years because of perimenopause. When the studies came to light that linked HRT to cancer, my doctor (along with many, many doctors) refused to prescribe any for his patients. After I had my hysterectomy (they took the ovaries cos doc said they didn't work anyway and it might save me problems in the future), he admitted that most every doctor over-reacted. All of the studies that linked HRT to cancer were on women who still had their ovaries. There was no link in women who had their ovaries removed. So I sign a waiver every six months & get my Estratest. And that is a good one because it has estrogen & testosterone, not progesterone & estrogen. Dear Hubby called the doctor to thank him for giving it back to me. :p

I started talking to my daughter about sex/reproductive health when she was 10. I didn't 'mature' until I was 13, but Dear Hubby's family were notorious for being early bloomers (she at least had my genetics on this one...12). I had no problem answering any question she had, even the uncomfortable ones like "Did you have sex before you were married?" (duh, it was the 70s. Thank goodness she didn't ask how many). She made the decision all by herself to get the HPV shot. She has been the advocate for her friends who just won't go to the dr for their yearly exams. She tells the tale of my friend who died from cervical cancer and how unnecessary it was. Two of her friends caved and went to Planned Parenthood for their exams.

My uncle died of colo-rectal cancer 2 years ago. So our entire family is entitled to a huge quantity discount on colonoscopies, lol. Just had mine & they found a couple of polyps that could have turned so I have to go back in 3 years. But I would have the girls removed in a heartbeat if it was a 90% guarentee that I wouldn't get cancer. These things get in the way. They are heavy & don't help with the asthma. :(

Although we don't have a history of cancer on my mom's side of the family, I'm all too aware that the disease often pops up in perfectly healthy families. That said, I don't spend a lot of time thinking about it, but at my age would probably not feel cosmetically challenged if my breasts or ovaries had to be removed to give me quality of life for a good number of years. Would I opt for reconstruction? Not sure. I chose NOT to go the HRT route after menopause (I had problems after having kids and was delighted at the thought of not having to deal with additional doctor visits and all sorts of 'let's try this' to make things better)and don't regret it. I DO take Boniva and up'd my calcium to help with bone loss. Is it necessary to have preventative surgery? I can only say that most of those who chose it have watched relatives go through the trauma of radiation and chemo, so perhaps they want to spare their families and themselves the same experience.
And Doc, my husband went through all that you described and then some to find out that he too has to live with a prostrate larger than average...and that they might have to do the surgery again at some point.
If I've rambled, I apologize. I just lost a friend to brain cancer at the age of 40. She had beaten it once but it came back with a vengeance. She left three small children. There was no preventative procedure for her, so perhaps those who have the option are wiser than we know.
Harley, I think it has to be a personal decision. What works for some isn't always beneficial for others. I didn't want to be a slave to more meds...and my doctor makes sure I am checked frequently so I'm fine with that. And thanks everyone for the info I DIDN'T know :o)

Nancy, I almost forgot. Haven't read The Blue Sweater, but the Mary Todd Lincoln was a good read. Not a happy read of course, but a good one. The woman has been much maligned for what we now know is treatible.
If you're looking for a little lighter read afterwards, I highly recommend Prayers For Sale. Both it and The Guernsey Potato Peel and Literary Society knocked my socks off. (And it was the first few pages that hooked me)

You're so right, Maryann. It IS a personal decision. I chose not to do HRT, after hearing Dr. Christiane Northrup on Oprah, and then reading her two books. For me, with my mother's history of uterine cancer, I thought it best to use soy progesterone to counter the hot flashes. It worked a treat; after a single application of a mere 1/4 teaspoon of cream I went from 40-50 hot flashes a day to one or two. What a relief.

By the way, I wholeheartedly recommend Dr. Northrup's books. She doesn't say whether or not HRT is the "best", but rather she offers various options. What a difference a woman doctor makes.

Can one treatment for hot flashes be to order a whole bunch of those Blond Bond popsicles?

I tried so many holistic approaches to get rid of the hot flashes & other symptoms, but they never worked for me. I was thrilled that they worked for my sister, but I wasn't as lucky. But the combo I'm on now is working. I have the added bonus of osteopenia (the precursor to osteoperosis) and am taking Boniva for that. My mom has it, as did my grandmother, so I doubt if any of the medications I take have much to do with it.

I have just reserved a book at the library that sounds really interesting. "Hotel on the Corner of Bitter and Sweet" http://search.barnesandnoble.com/Hotel-on-the-Corner-of-Bitter-and-Sweet/Jamie-Ford/e/9780345505330/?itm=1 Isn't that a great title? I wrote a paper in high school about the Japanese internment camps (got an A+ and the teacher made me read it aloud in class) so this sounds very good.

Absolutely, Ramona. Order enough to write them off your taxes.

Totally OT, but I LOVED The Guernsey Potato Peel and Literary Society.

My sister had a lot of trouble when she first started menopause, and didn't want HRT. She went to a nutritionist and got a listing of herbal supplements and other natural remedies for different symptoms, and has done very well with it.

Karen (in Ohio) - saw your note about Dr. Northup. There is a long article in this week's Newsweek on Oprah and her guests. Dr. Northup gets a little beaten up in the article for some of the stuff she said on TV. Even she admitted that both sides of a medical argument aren't shown on Oprah. Now Dr. Oz? He came through with flying colors.

There is very very little cancer on either side of my family. However, I would part with my breasts without blinking. There are ways to do it and leave adequate tissue for plastic surgery. I'd love a nice set of perky tits at my age! LOL

Never had hysterectomy, but it wouldn't have given me a minute of lost sleep. My femininity is not wrapped up in my female organs or my breasts.

I don't take hormones. Don't need to.

Unless I'm with Sarah when the bus hits here, my family genetics are for a long life, no significant medical history.

One major problem with making a decision about HRT is the lack of meaningful clinical data.

This is, in part, because the Big Pharms choose to put their money into trials for more profitable drugs. Take a look at the ads for meds these days and you will see where the research money goes. It ain't breast cancer either - most of that funding comes from non-profits and quasi-private fundraising.

I loved the Guernsey Potato Peel book too. And, I just finished Loving Frank--which I think is ripe for discussion.

Since we're veering off with medical questions--anybody else have gallstones? I have multiple ones and they're "mobile"--which weirdly pleased me (I was glad they're not lazy or sluggish) until my doctor said they're more apt to cause problems when they're mobile . . . so, I'm scheduled to have the gall bladder taken out the end of the month (I wanted to do it sooner, but the doc is off to Italy for two weeks) . . . Has anyone here had this done?

I never paid much attention to Christina Applegate on "Married...with Children" and only saw the pilot episode of "Samantha Who?" but I was inwardly moved by her decision to have preventive breast surgery because of her mother's breast cancer. That had to have been a hard decision for a beautiful young woman her age and I have the utmost respect for her. I'm all for whatever medical decisions help you sleep better at night.

About Gardasil:
1]It only protects partially. There are more than two dozen strains of HPV, and it does not protect against all.
2]For now, no one knows if the protection it does confer lasts more than 5 years.
3]The least serious side effect is very painful injection sites. The worst is death [so far 9 cases]. Somewhere in between is a serious neurological condition [Guillain Barre Syndrome]
4] It is bloody expensive.
5]It is aggressively pushed by the drug reps for Merck, rather than by doctors. Merck is currently paying out huge sums in Vioxx damage lawsuits, and badly needs a new cash cow.
6]There is concern that women will think that having the immunization means they don't have to do annual Pap smears any more.


One of the OB/GYNs I work with tells mothers to buy their teenage daughters a box of condoms and instruct them in their use. "Condoms", he says, "protect against ALL known sexually transmitted diseases, and pregnancy as well, and is a lot cheaper."

Your friend, Nancy, might find the sudden, and severe, menopause she is about to go through once her ovaries are removed [if she takes HRT she is vulnerable to other cancers]to be much more trying than she expected.

My best friend just had a lumpectomy... results should be revealed today. She didn't wait due to the fact that her favorite aunt just died over the Christmas holiday after a many year bout with breast cancer.

The doctors have no idea what to test me for, other than the normal for women. Considering that my mom survived cervical cancer back in the 70's, and my brother had hodgkins. Mom's cousin died of lung cancer, but that was due to his smoking. And just last month, my cousin died of a soft-cell cancer...

Considering that I have already had the upper portion reduced greatly, if that were to be an issue for health, it would be a no-brainer. Take 'em. Although I would probably have to have reconstructive to at least look like I had something.

My brother died of Leukemia, my dad died of malignant melanoma and my mom survived cervical cancer. I get regular tests, have big hats and cool cotton long sleeved shirts so I am the palest of pale all year round. Other than than not much I could do. If I thought it necessary to get bits removed to save my life I would do it.

I have an auto-immune disease that has damaged my endochrin system so I am taking HRT because of this damage. Bio-identical estrogen cream and testosterone. As well as adrenal supplements from the naturopath. At 47 I had lower hormone levels than a post-menopausal woman . . . and peri-menopause symptoms just started happening recently. Once menopause happens the decision to wean off them or stay on will need to be made.

Thankfully I have 100% coverage of prescriptions on my work covered extended health plan as none of these are cheap.

My dad also had prostrate problems before he died, he was also a strong man and the whole thing overwhelmed him as well.

The one thing that most bugs me about Oprah is that she doesn't really listen to her guests, and she tries to steer the conversation around to herself. Drives me crazy, so I rarely watch her show. But Dr. Northrup's single bit of advice helped me so much that I read her books, and that's helped, as well.

I had a hysterectomy at age 37, but they left one ovary. Which does kind of keep me up nights, worrying about whether or not it's a ticking time bomb. The reason I had them leave it was so I didn't kick into menopause early, but then did anyway. That was annoying. Even more annoying was that my male doctor kept telling me I was too young to be experiencing what I knew was happening--it was all in my head, dontcha know. Then I switched to a woman doctor and when she gave me my physical I asked if she could test for hormone levels. She also said I was too young (by then I was in my mid-40's and had been going through this shit for years), but did the test anyway. The next day she called to apologize; my hormone levels were well within menopause range. So bottom line: Stick up for yourself, and if something feels wrong, it probably is, no matter what the doctor says. Medicine is an art, not a science.

After watching my mother's death by ovarian cancer (a long time ago), I don't know why anyone keeps their ovaries after a certain point.

A personal choice, obviously.

David Carradine. Koko Taylor. Damn. "The heart does not see with the eyes of time."

Speaking of the safety of using condoms, picked this up from the First Offenders site.
Turn the sound down a bit if you are at work.

http://www.youtube.com/watch?v=Uqt3Zb7BItA

Karen, I started my peri-menopause symptons at 33. My gyn at the time said the same thing. He patted my knee and said, "Honey, you are too young. You probably have too much estrogen instead of not enough". After another year of the same old thing (as someone put it...bleeding into my socks), I was about to change doctors when he retired. My first appointment with the guy who bought his practice started out with my saying to him "You have one shot to get this right. Have you read my chart? These are my symptoms. Am I too young for peri-menopause?" His correct response, "Absolutely not." It still took another 6 years to get the insurance company to agree to a hysterectomy (a really long, horrifyingly funny story). It was the worst experience of my life but the best thing I ever did.

Hmm.

Lots of uncomfortable life experiences here.

I've heard from a very reliable source that Gardasil is not all that it's cracked up to be, and that it can actually be quite dangerous.

And HRT - people are all over the map with that. But I do know that Premarin is a fancy name for one of it's main ingredients - Pregnant Mare Urine. You gotta love those drug companies marketing departments.

And that right there, Pammy, is one big reason I refused to take Premarin. The way they get that urine is to keep those poor horses pregnant, which uses them up. Plus, all the foals are then left to be rescued. One of my book club friends is involved in rescue operations for horses. It's scandalous.

Pammy - that is why I use the bio-identical estrogen (plant based) because Premarin - ewwww.

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