Blow Your Stack Saturday Lax Postmortem Procedures: UK and US

 

I'm in the US. My father wasn't given a proper post-mortem, and it would have cost too much money to insist on one. The cause of death listed on his death certificate was listed as the vague "delirium."

I'm not suggesting that there was any wrongdoing in my father's death. There wasn't. He was given good care in the hospice. His health had been in decline for years, even preceding the major hemorrhagic stroke at 68 that left him handicapped. In retrospect, he had been having TIAs even in his 50s. His vascular system was a mess.

In the years following the big stroke, he had several smaller strokes. He developed vascular dementia and lost the ability to walk. He had been a college professor, but at the end of his life, he sat reading the same page of a catalog repeatedly. He was starting to sundown, and confused scenes on TV with reality. He also developed congestive heart failure, which caused fluid buildup in his trunk and extremities. 

When he died, his lower legs were dark purple and edematous. 

So no, there were no signs of foul play in my father's death, but the cause of death was not "delirium." It was vascular problems and congestive heart failure. We simply would have felt better if there was a more thorough report on the cause.

The U.S. Medical System's Obsession with Pelvic Exams

Image by OpenClipart-Vectors from Pixabay

A study published in JAMA Internal Medicine reveals a no-brainer: girls and women are traumatized by pelvic exams and avoid seeking care which involves them. Further, the study finds that many of these exams are unnecessary.

I've always wondered about the necessity of frequent pelvic exams. I have a history of sexual trauma, and I find those exams very traumatic. In fact, I went for almost 30 years without getting one. The only reason I ever went back to an OB/GYN was that I was experiencing post-menopausal bleeding. A D&C determined that I had simple endometrial hyperplasia with normal cells which means I have only a very slightly elevated chance of developing endometrial cancer (1.6%, that's one point six). I did not deem it necessary to have the radical hysterectomy which was being pushed at me. Had the D&C revealed complex hyperplasia or abnormal cells, that pushes the chances of developing endometrial cancer to 36% greater than normal, and I would have had the hysterectomy.

I refer to 2018 as the year that revolved around my uterus, and I do not see the reason to go through another battery of invasive pelvic exams and transvaginal ultrasounds which leave me feeling as if I've been raped by a robot. I've never had an abnormal pap test, I'm beyond my reproductive years, and I'm not sexually active. Further, the endometrial hyperplasia has resolved. I see no reason to submit myself to this humiliating procedure again. I'm not sure why the U.S. insists that women have this procedure every year when other first world nations do not.

"The American College of Physicians and the American Academy of Family Physicians advise against pelvic exams on women who aren’t pregnant and don’t have symptoms," Qin added.

Agreed.

I don't have any problem with getting a mammogram although I put that off for years. It's mildly embarrassing and sometimes slightly uncomfortable, but it isn't painful or invasive. Also, I can see a clear need for it. Someone in my age range is at a higher risk of breast cancer than someone in their twenties.

~Sly Has Spoken~

Image copyright juliahenze @123rf.com