10 things your doctor may not tell you about hysterectomy – Guest blog by ‘The UNHysterectomy’ author Holly Bridges

Hi Everyone:

If you suffer from debilitating pain and other consequences of out-of-control uterine fibroids and are unsure what to do about them, you’ll want to read every word written by today’s guest blogger Holly Bridges.

10 things your doctor may not tell you about hysterectomy

Holly Bridges

Thank you Holly for your courage to step forward to help other women about a very sensitive topic.

Wendy Vineyard

10 things your doctor may not tell you about hysterectomy

A lot of women ask me why I decided to write my new book, The UNHysterectomy. Solving Your Painful, Heavy Bleeding Without Major Surgery, which I published in April.  My answer to that is simple:  because I had to! 

After being diagnosed with severe uterine fibroids in 2006, and being told I needed a hysterectomy to solve my monthly bloodbaths, I set about trying to gather as much information as I could before making my final decision.  And I have to tell you, what I learned is just too darned important – and shocking – to keep to myself!

In a nutshell, women are getting a raw deal when it comes to their reproductive health.  Every day in this country, women are being prescribed hysterectomy to solve a variety of conditions including fibroids, polyps, cysts, endometriosis and adenomyosis when there are at least 10 less invasive medical and surgical alternatives, not to mention natural therapies.  Yes, many women choose hysterectomies because they have tried everything else and simply want their suffering to end.  I get that; however, for those women are still on the journey, there is a distinct lack of information being given to women and this just simply has to stop.

In a nutshell, here are 10 things your doctor may not tell you about hysterectomy that you absolutely must know in order to make the most informed decision possible over the course of treatment that is right for you.

  1. Hysterectomy is the most common major medical procedure performed on Canadian women, second only to Caesarean section.  Although numbers are declining, every year, some 47,000 women undergo the procedure – and here is the most shocking thing of all – between 60 to 80 per cent are medically unnecessary and are performed for benign, non-cancerous conditions that could be treated through less invasive procedures.
  2. Despite an explosion in high tech procedures that could increase patient safety and decrease healthcare spending, most Canadian women still undergo hysterectomy as the standard of care for the treatment of Heavy Menstrual Bleeding (the new clinical term for menstrual bleeding that affects your physical, mental, emotional and financial quality of life).
  3. There are at least 10 minimally invasive alternatives to hysterectomy that are available nowadays that doctors are simply not telling their patients about – things like hysteroscopic endometrial ablation, hysteroscopic myomectomy, uterine artery embolization, MRI-guided focused ultrasound, a hormone-releasing IUD, hormone therapy, and natural therapies, among others.
  4. Some of these procedures, such as ablations, can now be done on either in an operating room or on an outpatient basis in special minimally invasive surgical suites (there are only a handful in Canada), some take as little as 90 seconds and require no anaesthetic!
  5. Canadian hospitals must pay for some of these procedures out of their global operating budgets which means gynecologists have to compete against oncologists and cardiologists for the same pot of money.  This leads many hospitals to either not offer the procedures at all, or ration them annually!  Once their quotas are filled, women are left to bleed and go back on the waiting list until the next year – all unbeknownst to the women on the waiting list. 
  6. Gynecologists in Canada earn more to remove a uterus than to leave one in.  The average hysterectomy pays $500 whereas a myomectomy, which removes only the troublesome tissue, only pays $250 yet requires more surgical skill and takes longer to perform!   Where is the incentive for gynecologists to upgrade their skills if they will earn less doing it?!
  7. Gynecologists get pressure from their hospital administrators for performing less invasive surgeries than hysterectomies because they tie up operating rooms longer.  A gynecologist can perform say five hysterectomies per operating room day, but only two myomectomies, for example.  Doctors are actually asked to justify why even those these less invasive surgeries are proven to be better for women!
  8. Despite national surgical guidelines encouraging gynecologists to perform hysterectomies vaginally or with the assistance of laparoscopes, 54 per cent of all hysterectomies in this country are still being done through open incisions, thereby increasing the risk of organ perforation and post-operative infection.
  9. Rural women have a hysterectomy rate that is 46 per cent higher than the national average!  Variations in hysterectomy rates have nothing to do with how well or unwell women are – they have to do with the skill set of the gynecologist prescribing the treatment.  It’s called “Who you see is what you get syndrome.”
  10. You have the right to insist on the least invasive, most cost-effective, safest procedure possible to treat your Heavy Menstrual Bleeding.  You are under no obligation to take the first procedure that is offered to you.  If it means firing your doctor, and going back to your family doctor for a referral to someone who specializes in less invasive surgery, then so be it!

Hysterectomies cost Canadian taxpayers $192 million a year.  A recent study by the Canadian Institute for Health Information said that if every province achieved British Columbia’s low rate of hysterectomy, we could save our health care system $20 million a year!  That same money could be used for patients who really need surgery, such as cancer or heart patients. 

So how can we as women make this happen?

·         Insist on receiving the least invasive treatment available, whether you choose to have a hysterectomy or not.

·         Fire your doctor if you have to and move on to the next one until you get what you need.

·         Insist on mitigating treatments that will control your bleeding while you shop around.

·         Pass the word to every woman you know that minimally invasive gynecology should be the standard of care for women, not the exception.  It was only when women with breast cancer started demanding an end to mastectomies that we started seeing more lumpectomies and the birth of the pink ribbon campaign. 

·         Politicians set health care policy and they respond to political pressure.  So far, women have been silent on the issue of unnecessary hysterectomy and the time has come to make some noise.

·         Write a letter to your provincial health minister demanding the creation of community-based clinics like the ones we have for bariatric medicine; if we can treat obesity in the community, we can treat heavy, painful periods, too.

·         We need to start talking about periods more openly.  If we can advertise Viagra on the NHL playoffs, we can talk about Aunt Flo, too.

If you or someone you know and love is suffering from the ravages of abnormal uterine bleeding every month, there is help available.  You do have options.

With my hand over my heart, I can honestly say that everything you need to know is spelled in the book, chapter by chapter. And every word is medically accurate as it was edited by my own gynecologist, Dr. Sony Singh, a world-renowned surgeon at The Ottawa Hospital.

Remember girls – it’s all about options.

Ask. Insist. Persist.  And you will get the answers you need and deserve.

HOLLY BRIDGES is a Canadian patient, author and advocate. She spent 15 years as a CBC Radio and Television journalist and talk show personality across Canada and is an award-winning writer with 30 years’ experience in journalism and communications. She first wrote about her experiences with heavy menstrual bleeding in More Magazine and Readers’ Digest. The UNHysterectomy is her first book. She lives in the Canadian capital city of Ottawa, Ontario, with her husband and two children.

The book is available through Holly’s website at www.unhysterectomy.com.

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