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Hysterectomy
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SCVIR Changes Name to SIR
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Strong Medicine

 

Strong Medicine
Lifetime Television for Women
Sundays 9:00 p.m.

UPDATE

I apologize for not putting out this update sooner (due to death in my family) but I did want to make a few additional comments on this new TV show for women. (My original review follows this commentary.) As time proceeds and new episodes are aired, it is apparent to me that research behind both the show and the website is "slim pickings". It may take a while to cycle through shows already filmed that were based on poor research and I'm trying to be patient but, all in all, I've personally stopped watching the show for now.

The show's corresponding website and responses I've received to my concerns on postings that I've seen placed there by staff members do tell me that these people are trying to do something good with this show and website -- but are still stumbling around in the dark a wee bit. I suspect they just need time and a lot of audience and professional input to help guide them to better research and more thoroughly thought out script writing and web page development.

They've corrected many errors that were previously found on the uterine fibroids patient files pages and I am truly grateful for their responsiveness in correcting the misinformation previously displayed online there. Many of the items identified and discussed in the review below are no longer found on the website.

Ironically, the new information appearing on their web pages paints uterine artery embolization as a procedure not widely available and filled with complications while touting hysterectomy as the "definitive cure" (apparently with little to no complications!). In contrast to the episode they aired on this topic, they are now giving this procedure (UAE) what, quite basically, amounts to a "thumbs down." From touting it as a viable treatment option on air to panning it as "investigational" on their website they've certainly come full circle in their presentation of information on the topic. Sigh. From Bruce McLucas "liberal" to Massachusetts General "conservative" they've spanned the gamut of the two ends of the earth on this subject and managed, in the end, to simply not make any progress whatsoever on their presentation of information. At least they tried.

A few corrections/comments on their NEW information: Uterine artery embolization is available all across the United States. It's "not widely available" only because gynecologists are refusing to refer women for the procedure and some insurance providers are choosing to refuse coverage NOT because there aren't interventional radiologists willing to perform the procedure. Probably over 10,000 women have undergone this procedure to date with many of them in Europe now going on 10 years' history post procedure. That's hardly a "small" number of patients. In the U.S., there are women going on 5 years of history. I, myself, am at the 2 year mark and doing just fine, thank you very much. Also, they have maintained their decision to not link to or reference the doctors who perform UAE -- interventional radiologists. I simply don't understand this. At all.

On another note, laparoscopic myomectomy is also widely considered "investigational" within the U.S. as it too has a limited procedural history. Many gynecologists and insurance providers are not supporting it as a treatment option for uterine fibroids but ACOG, oddly enough, has not come out publicly declaring it as "investigational" as it did with UAE. I wonder why not? Even so, their web page developers don't seem to know this as they most assuredly listed laparoscopic myomectomy as an available and perfectly viable option for fibroids. It is and it isn't. Sort of like UAE....

Strong Medicine, July 2000
Lifetime Television for Women
Sundays 9:00 p.m.

A new, 60 minute TV drama dedicated to women's health issues recently premiered on the Lifetime Television for Women channel. Over the course of the last few months, I've followed the press releases for this show and enthusiastically waited with bated breath for its premiere. Whoopi Goldberg, an incredible woman in her own right, conceived and developed the idea for this show and her enthusiasm for the project was evident in every interview she gave. This is going to be good, I thought. Really, really good.

What could be better than a show produced and written by and for women with the basic premise founded in a health clinic run by two incredibly intelligent young women who made it past the patriarchal boys' room of medical school to run their own practice in their own clinic?

Janine Turner plays Dr. Stowe, a Harvard-educated surgeon in charge of research studies at Rittenhouse Hospital and Rosa Blasi is Dr. Delgado, a doctor whose inner-city clinic goes belly up, subsequently merging into the Rittenhouse Hospital.

Two excellent actresses in a show produced by Whoopi Goldberg with a storyline dedicated to women's health. Somebody wipe the foam from my mouth!

Well, in watching the first 2 episodes, I can tell you they exceeded my wildest expectations for presenting television programming that not only had women in charge of medicine, but also had a diverse, multi-ethnic cast. Incredible. This would/could only happen on a channel solely dedicated and targeted to women. I just can't see any of the 3 big network channels ever doing this. Too bad. These women are terrific to watch.

Unfortunately, this review is about more than simply this show's premise and cast of characters. It's about another side of the stories that are being presented. It's about accurate and useful medical information. To open your door, reach out and invite in millions of women as viewers and then slap them in the face by dishing out slop for dinner is, well, irresponsible at best. What am I saying exactly? Medical inaccuracies and misinformation are abundant on this show. Inadequate research is apparent with almost every word coming out of the mouths of the two physicians in charge.

I'm despondent over this last turn of events. How could they do this? AHHHHH! Sigh. No, deep sigh. Let me give you an example of what has, specifically, upset me over this show.

Show #2: "Pre-Existing Conditions"

This show had a number of questionable storylines, but the one that captured my attention involved a "Mrs. Hong" who shows up at the clinic hemorrhaging from uterine fibroids. (As Executive Director of the National Uterine Fibroids Foundation, you didn't think I'd be writing about just any old medical show covering just any old topic, did you?) Apparently Mrs. Hong had undergone a "fake" hysterectomy at some quack shop and was of the belief that she no longer had a uterus. When she begins hemorrhaging, her daughter rushes her to the clinic where Dr. Delgado tells her that she will need a hysterectomy. Based on a manual exam. No diagnostics. No ruling out cancer. (Why bother to order any diagnostics if you're just going to do the hysterectomy anyway, right?) No ultrasound. No MRI. No nothing. Manual exam. Whammo....hysterectomy recommendation.

While this is a very typical example of the kind of medical care that many women receive in this nation, it is certainly not a commendable example.

To complicate matters, Dr. Delgado asks Dr. Stowe to perform the hysterectomy. Dr. Stowe agrees and then meets with the patient to also do a manual exam. This time, however, Dr. Stowe leaves the room with Dr. Delgado and announces to her that a hysterectomy is unnecessary -- she will do a uterine artery embolization, UAE, instead.

Dr. Stowe: "There's a new much less invasive outpatient procedure that will relieve Mrs. Hong's myomas and preserve her uterus. It's called UAE, uterine artery embolization. Schedule one and I'll do it. Happily. Perhaps you'd like to observe?"

Yikes. This women's generalist physician (or possibly she's an ob/gyn?) is going to perform UAE? I don't think so. Only interventional radiologists perform that procedure and considering the special nature of this medical professional group, it's more than highly unlikely that Dr. Stowe would do a UAE. It just wouldn't happen. On top of that, she certainly wouldn't do it without images first (ultrasound or MRI) and better information about the source of that heavy bleeding. Cancer is a possibility that should never be overlooked before leaping into a operating room and performing a medical procedure blindly.

Outpatient procedure? Did she say 'outpatient' procedure? Very few physicians in the U.S. offer UAE as an outpatient procedure, and I, personally, wouldn't recommend it. Imagine having this procedure in an outpatient clinic and then laying in bed at home some time later as your pain medications begin wearing off. It's extremely possible that you could be hit with excruciating abdominal cramping and intense pain off the richter charts that is not controllable with anything other than prescribed narcotics. Who will care for you then? While not every woman experiences this level of pain with UAE, most do.

My nitpicky list is long and doesn't end with the storyline on uterine fibroids. But I stop long enough to shoot off a few letters to Whoopi expressing my deep dismay over the situation. To my surprise I actually get a response. Well, not from Whoopi but from the Executive Producer, Tammy Ader. It's a pathetic pat on her own back for "informing our viewers that UAE exists." She writes to tell me that she is aware that UAE is not for women who wish to retain their fertility and that the show was very clear about using a character of menopausal age.

Menopausal age? Ohmygod, did she really write 'menopausal age'? Yep, she did. UAE is for women of peri-menopausal age -- not menopausal age. The character in the show thought she had undergone hysterectomy some time previously. If, in fact, this woman was no longer experiencing menstrual cycles and suddenly showed up in an ER with massive hemorrhage {supposedly from fibroids}, would UAE be the appropriate treatment? Not in my book. But on this show a manual pelvic exam was enough to beeline this woman into UAE. Wow. Am I nuts for thinking there's something wrong with this picture?

While watching the show, viewers were directed to the Lifetime Online website twice for more information on any of the storyline topics. So, I beelined it over to the website to check it out. I wish I had good news for you. I don't.

The website that accompanies the show is merely a mirror reflection of the poor research that was done to write the scripts and I sure hope the web writers don't seek out a 'Health on the Net' icon (or any other validation of integrity in the presentation of medical information) for their website because it would definitely force me to submit a formal protest to the HON Foundation. You can check it out by following this link:

www.lifetimetv.com/shows/strongmedicine/patientfiles/patientfiles02.html

Fertility retention is touted as a very real possibility and there are many references to Dr. Bruce McLucas' private practice located in a professional building near the UCLA Medical Center campus. It's a sales pitch job for a single physician's medical group. I scan all the links they provide looking for so much as a single reference to the Society for Cardiovascular and Interventional Radiology (SCVIR) and the doctors who actually perform UAE. There is none. Not a one. Not even a hint that interventional radiologists even exist or play a role in this procedure. On top of that, there is a tremendous amount of complete misinformation that has my mouth hanging in total disbelief. Here's a sample:

Side Effects
"Women who undergo a hysterectomy or endometrial ablation (removal of the uterine lining) have no recurrence of fibroids but become infertile.
"

What's wrong with this statement? Endometrial ablation only removes the uterine lining. It does absolutely nothing to prevent uterine fibroids from developing. Here's another:

"UAE is not widely available in the U.S. According to the UCLA Medical Group, whose Fibroid Collective has been instrumental in teaching and practicing UAE, only about 8,000 have been performed worldwide since 1996."

UAE is most definitely available all across the U.S. and you can locate a doctor performing this procedure by using the SCVIR doctor locator found on their website:

http://www.scvir.org/locate

Here's another nugget:

Get Tested
"...A woman will next undergo an endometrial (or uterine) biopsy, a hysteroscopy (using a thin fiber-optic scope to view the inside of the uterus) and laparoscopy (evaluating the outside of the uterus) to determine the size and location of the fibroids, and whether they're cancerous."

There is only one gynecological practice in the entire U.S. that I am aware of that REQUIRES hysteroscopy and laparoscopy as pre-diagnostic tests before referring a woman for UAE -- the one that's being "pitched" on this so called fact sheet appearing on the website. Indeed, most women do not require these two procedures prior to UAE at all. Furthermore, there are no tests that can truly determine whether or not a fibroid is cancerous. None. Fibroid tumor biopsies are inconclusive tests as they are only as good as the cell sample removed and not, necessarily, reflective of the entire state of the tumor.

I can't honestly recommend to anyone that they waste their time viewing this show or visiting the Strong Medicine website. But, if you can ignore the medical inaccuracies and just want to see an awful lot of incredible talent doing the best they can with a script that's 100% pure fiction, then this is a wonderful show. Just don't believe anything you hear (related to medicine) and definitely stay away from their website. If you want or need more information about the issues presented on the show, you are better served by going to any number of medical websites that are in abundance on the World Wide Web.

Whoopi, I love you babe. Love the concept. Love your heart that went into pushing forth with a show like this. Find a better research team for better guidance on the medical issues presented in storylines. Please.

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This page last updated Saturday, February 02, 2002