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House Healthcare Bill Rewards Activism on Women's Issues
Tweet Share on Facebook October 30, 2009 Comment (12)Corrected on 11/02/09: An earlier version of this article incorrectly identified Medtronic. The medical device company manufactures stent grafts used to repair abdominal aortic aneurysms.
Women may seem to be the driving force of health reform, given all the attention recently paid to gender disparities in insurance premiums. In fact, the massive health reform bill unveiled by the House of Representatives yesterday contains several sections that pertain just to women in terms of abortion coverage, pregnancy services, and prohibitions against excluding those with pre-existing conditions, specifically mentioning women who've been victims of domestic violence. While the bill does provide maternity coverage as part of a basic benefits package that insurers must provide in their coverage, it specifically says that public funding can't be used for abortions—which would include coverage under the public option—except where it's already allowed, such as in cases of rape or incest or where a mother's life is at risk.
But men aren't being ignored; they're getting their issues addressed, albeit in a quieter way. I met separately this week with two healthcare activists trying to push their issues onto the legislative agenda: Planned Parenthood President Cecile Richards, who is lobbying hard for increased reproductive health services and backed by 4 million grass-roots activists; and former Redskins quarterback Joe Theismann, who is trying to increase the prevalence of screening for a major killer of men and is relying mainly on a great smile and a hero's legacy. (The Redskins were Super Bowl champs in Theismann's time.)
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Sick with H1N1? 6 Ways to Keep From Infecting Friends and Family
Tweet Share on Facebook October 28, 2009 Comment (7)Last week, I wrote that my daughter had what appeared to be swine flu. Determined as I was not to catch it, I still came down with similar symptoms. So did my husband, and my younger son seems to have a very mild case. None of us have fevers, but we all have raging coughs. I can't help wondering as I hack away in my office whether I'm exposing my coworkers—some of whom have asthma or are caring for newborns—to a very real risk of infection. Perhaps I should take a hint from a coworker who yesterday forwarded me a study showing that H1N1, the virus that causes swine flu, remains contagious long after those first few can't-get-out-of-bed days.
The study, published last week in the American Journal of Preventive Medicine, found that H1N1 is most contagious within the first three days after symptoms appear but that infected individuals could still spread the disease after a week. About 30 percent of infected folks in the study—cadets at the Air Force Academy who were infected during a summer mixer—tested positive for the virus even though they had a temperature less than 100 degrees Fahrenheit. (My temperature never went above 99 degrees.) And nearly 1 in 4 of the samples collected from the cadets a week after onset of their illness still contained live viruses. The researchers found that having no fever and no symptoms didn't guarantee that a patient was no longer spreading H1N1.
Good to hear. So how many people have I unwittingly infected?
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Surgery for Breast Cancer: Complex Options, Difficult Decisions
Tweet Share on Facebook October 27, 2009 Comment (7)In a fitting send-off to breast cancer awareness month, the White House's North Portico this week sports a massive pink ribbon. And at a Friday event for breast cancer, first lady Michelle Obama said, "We have a healthcare system in this country that simply is not working for too many people with breast cancer." While it's nice that so much attention has been paid to this disease, I think women—myself included—still need a lot of education on the topic. Two weeks ago, I reported on a study that found that about 25 percent of breast cancer patients who qualify for breast-conserving surgery aren't getting it. I wondered why they insist on getting mastectomies when research shows they're not getting an increased survival benefit.
Well, I got some answers from astute readers who had personally faced the dilemma. One woman wrote: "I am in the middle of making these decisions for myself. My DCIS [ductal carcinoma in situ, potentially a precursor to invasive cancer] is large and the Dr. has given me a choice between lumpectomy and mastectomy and explained that the survival rate is close to 100 percent in either case. It's the fear of recurrence and that the NEXT cancer would be invasive and deadly that spurs me and other women to [have] mastectomy and reconstruction." Another wrote that having a mom and two aunts previously diagnosed with breast cancer, "I did what many women do with families like mine, they fight it hard and fast. I did double mastectomy with reconstruction." Others told me that they would have faced reconstruction even with a lumpectomy given the amount of tissue that needed to be removed; what's more, some were told the radiation treatments necessitated by a lumpectomy could make the surrounding skin more fragile and harder to stretch for reconstruction. All in all, in one woman's words, "The decision to have a mastectomy 'against medical advice' might seem illogical, but sometimes it is based on reasons that are very legitimate for a particular patient."
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Swine Flu Frustrations: Too Little Vaccine, Too Many Scare Tactics
Tweet Share on Facebook October 23, 2009 Comment (29)My daughter has swine flu—I think. She came home from school Monday with chills, headache, nausea, and, in her words, "feeling worse that I ever have in my life." By the next day, she had a fever of 102, a raging cough and a sore throat. A phone call to her doctor confirmed what I suspected. She probably has H1N1, but they're not going to test her or treat her with antiviral drugs and don't need to see her unless she develops breathing problems. Oh, but I should eventually still have her vaccinated against swine flu—just in case she doesn't have it now.
I would have gotten my daughter vaccinated two weeks ago at her annual checkup, but there wasn't any H1N1 vaccine available at that point. (The office didn't even have any seasonal flu vaccine left.) While the pediatrician does have some H1N1 vaccine in stock now, she told me it will probably be gone by the time my daughter's symptoms completely disappear and she can get the vaccine. I spoke to another frustrated mom this week who did manage to get her daughter, a classmate of my daughter, vaccinated—only to have her come down with flu symptoms 12 hours later. This is where vaccines have the potential to be wrongly blamed for causing the diseases they're meant to prevent. This girl was clearly infected with something, most likely H1N1, before she was vaccinated.
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Why Women Should Push for Healthcare Reform
Tweet Share on Facebook October 21, 2009 Comment (34)Supporting the government's healthcare reform efforts should be a no-brainer if you're a woman. That's according to Marcia Greenberger, copresident of the National Women's Law Center, who testified at a Senate hearing last week that the health insurance industry is rife with "unfair and discriminatory practices...including gender rating, the exclusion of healthcare services that only women need, and pre-existing-condition denials." For instance, women can be denied insurance if they've ever had a cesarean section or been the victim of domestic violence, she said. The NWLC today posted on its website this video, in which women declare that they, as females, are "not a pre-existing condition."
Greenberger and her colleagues are fighting for the final healthcare bill to right what they see as some very serious wrongs. A new NWLC report, which examined the most popular insurance plans in every state, found:
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HPV Vaccine: Women Now Have a Choice Between Cervarix and Gardasil
Tweet Share on Facebook October 19, 2009 Comment (13)Two recent pieces of news will change how we protect ourselves from the sexually transmitted human papilloma virus: The Food and Drug Administration has approved the use of the Gardasil vaccine in boys and men ages 9 to 26, and a new HPV vaccine, Cervarix, for girls and women ages 10 to 25. What this means is that HPV infections may drop precipitously, with both boys and girls getting vaccinated. It also means that girls and women will have a choice between two vaccines.
Concerning the first development, vaccine experts previously have told me that in order to make a dent in the vast number of women who become infected with HPV—about 80 percent at some point in their lives—men need to be vaccinated as well. While the government's Advisory Committee on Immunization Practices is expected to vote Wednesday to recommend routine vaccination for boys, what's not known is whether parents will get their sons vaccinated. Gardasil was approved to protect against genital warts, but these occur pretty rarely in men (only about 1 percent of the time), so they and parents of young boys may not feel the need for "altruistic" immunization just to prevent transmitting the infection to others. On the other hand, as my colleague Bernadine Healy pointed out in this column, HPV has been linked to a number of cancers that strike men, including anal, esophageal, and penile cancer.
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Body Image Lessons From a Fired-for-Being-Too-Fat Model
Tweet Share on Facebook October 15, 2009 Comment (8)Filippa Hamilton wants the world to know that she, a perfect size 4, was fired from Ralph Lauren for being too fat. I'm happy to help the 5-foot-10, 120-pound supermodel spread the word because I think her message is a good one. I heard her on a radio show last night saying she refused to shed pounds for the modeling gig because she knew she was at a healthful weight and didn't want to go lower. (Her body mass index of 17.6 means she's actually already underweight.) In an interview earlier in the day, Hamilton told the Today show's Ann Curry that she decided to go public about her April firing after recently seeing a photo-shopped image of her in a Ralph Lauren ad looking anorexic.
"It's not a good example when you see this picture; every young woman is going to look at it and think that it is normal to look like that. It's not," she told Curry. "I saw my face on this super-extremely skinny girl, which is not me. It makes me sad. It makes me think that Ralph Lauren wants to have this kind of image. It's an American brand...and it's not healthy, and it's not right."
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Abortion Down, Contraception Up: Recipe for Health Reform?
Tweet Share on Facebook October 14, 2009 Comment (32)Global abortion rates are down—from an estimated 45.5 million in 1995 to 41.6 million in 2003, according to a report issued Tuesday by the Guttmacher Institute, a nonprofit research center that supports abortion rights. A key reason for that drop, the report said, was that the proportion of married women using contraception worldwide increased from 54 percent in 1990 to 63 percent in 2003 as pregnancy prevention methods became more available and socially acceptable.
That's the good news.
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Why 1 in 4 Early-Stage Breast Cancer Patients Still Opt for Mastectomies
Tweet Share on Facebook October 13, 2009 Comment (22)For more than 20 years, breast cancer patients have been overtreated with mastectomies, experts contend, instead of with breast-sparing surgery that removes just the lump and a little of the surrounding tissue. The good news is about 75 percent of women who qualify for breast-conserving surgery are getting it, according to a survey of 2,000 women published in today's Journal of the American Medical Association.
The study found that for those who still opted for total breast removal, the decision was sometimes based on a surgeon's recommendation and sometimes against medical advice. In fact, nearly 9 percent of breast cancer patients opted to get a mastectomy when their doctors didn't state a preference either way or when their doctors actually urged them to get breast-conserving surgery. "Our findings suggest that patient preferences play an important role in initial receipt of mastectomy, especially in the absence of a surgeon recommendation favoring one procedure over another," wrote the study's authors.
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Why Do Women Have Sex?
Tweet Share on Facebook October 8, 2009 Comment (24)Why do women have sex? It's an intriguing question once you get beyond the obvious reasons: to perpetuate the species and because it feels good. Two University of Texas researchers wanted to dig deeper to find out what specifically drives women to go to bed with their partners. They conducted an online survey of more than 1,000 women ages 18 to 87 and found, to their surprise, that women aren't all that different from men. The survey asked women if they have ever had sex for one of the 237 reasons identified by the researchers in a previous study. If their response was yes, they would then be prompted to describe a specific sexual experience. The researchers Cindy Meston and David Buss incorporated the findings into a new book, Why Women Have Sex. Here are excerpts from my interview with Meston. (You can listen to the full podcast below.)
Listen Now: Why Women Have Sex
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What are the biggest reasons women have sex?
The No. 1 reason is because they're attracted to their partner, followed by their seeking of physical gratification. Lower down on the list, the reasons were connected to love or emotional bonding. This sort of knocks down the stereotype that men have sex for pleasure while women have sex for love. Personally, for me—in my 17 years treating women who have sexual problems—it's reassuring to see that most of the women who participated in our survey are having sex for the pure physical pleasure of it.
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