Category — medicine

The Vancouver Uncover the Cure walk is coming at a great time for me – so I’m putting on my nicest underclothes and walking 5K in beautiful Vancouver, BC to help raise awareness and money for those less supported below the belt cancers.

Many of my family members have struggled with (and beaten) colon cancer, ovarian cancer and other below the belt issues – help me reach (and exceed!) my $300 goal by going to my personal page and making an online donation.

A $10 donation (super easy and totally safe) will get you a tax receipt – and I promise there will be photos of me in my fancy pants on the streets of Vancouver.

If you have suggestions for costumes – tell me in the comments! It has to be tasteful and cover all my naughty bits (there will be children there after all) but I’d love to hear the creative things you come up with!

Back in July, I wrote a post called To hell with condoms – get a vasectomy! in response to an article I’d read in Details magazine.

To recap that post: The article talks about the joys of free-wheeling sex with no need for condoms since a guy who’s had a vasectomy can’t get anyone pregnant. The article then goes on to give details of a couple of schmucks who think women are essentially crazy bitches who want nothing more than to oops an unwilling guy into fatherhood.

My response was that the writer of the article was irresponsible for failing to mention that vasectomies are pretty damn good at preventing pregnancy, but not STDs. I was also a little horrified that the article seems to support unsafe sex with multiple partners – “swinging from the chandelier sex” – with no mention of ensuring both/all participants safety.

Anyway, since that post went up I’ve had a lot of comments on it (well, for my blog it’s a lot of comments) and as of today that post has been viewed over 800 times.

In the last month, here are the search terms used to find that post (and my comments in italics):

• how old you have to be to get a vasectomy (in Vancouver, most clinics seem to think 30 is a good age)
• lied about vasectomy to be promiscuous (way to spread disease and cause unwanted pregnancies jerk)
• dating a man who’s had a vasectomy (well, you’re unlikely to get pregnant)
• vasectomy std condom
• do you still need to use a condom if you’ve had a vasectomy (you do if you’re worried about STDs)
• pregnant condom vasectomy
• vasectomy for 23 year old (I’d wait a little longer – but that’s just me)
• can a woman become pregnant after her man has had a vasectomy (less than 1% chance)
• should i get a vasectomy (Google is not a Magic 8 Ball – talk to your doctor)

I think what worries me most is that people have the idea that vasectomies put an end to STDs. As though the inability to get a woman pregnant also bestows magical, disease-repelling powers. This is most certainly false.

I’ve noticed too that not one of the search terms used to find that post since it went up in July has had anything about getting tested for STDs. Not one.

If you’re not sure about yourself – get tested. If you’re worried about catching one from your partner, get tested together.

A lot of people will say “But, I’m in a long-term monogamous relationship! I haven’t got a disease – and neither does my Significant Other!”

And if you both came to that relationship as virgins – then yeah, you’re probably safe. But if you didn’t, if you’ve had other partners and had unprotected sex with any of them or had some random one-nighter where you’re not sure if you were safe or not then getting tested is a good way to set your mind at ease.

I figure it’s a way of being respectful of yourself and your partner to say “I’m no angel but I know I want to have something serious with you – so I’m getting tested to make sure nothing I’ve done in my past affects our future together.”

As for screwing around with random people – if that’s your thing then be prepared to be safe about it. Condoms don’t take up a lot of space. Put one in your jacket pocket or your purse – even if you’ve had a vasectomy or have been told that you’re safe because he had a vasectomy.

I probably seem like a pushy bitch when it comes to condom use – but I feel very strongly about it.

I also want to address the most recent comment on the July post from JR.  JR said that condoms “have a failure rate of 10-15%” and that vasectomies only have a “failure rate of 0.1%”.

Let’s get something cleared up about the failure rate of condoms: ‘typical’ use of condoms has a failure rate of  10 to 18%. Typical use means you are NOT using the condoms properly. Perfect use of condoms has a 2% failure rate and coupled with spermicides and other contraceptives that rate falls further.

‘Typical’ use of condoms includes:

• Uncovered contact with your partner before putting on a condom (pre-ejaculate contains sperm!).
• Not rolling the condom down the entire length of the penis.
• Staying inside your partner after ejaculation and allowing the penis to become flaccid.
• Not holding/securing the condom as you pull out of your partner.
• Not washing yourself thoroughly after removing the condom.
• Improper storing of condom (in wallet, direct sunlight etc.).
• Tears in the condom from removing it from the packet (i.e., with teeth, sharp fingernails etc.).
• Using oil-based lubricants with the condom (oil breaks down the latex).
• Using a very old condom (they can dry out and break down even in the packet).
• “double-bagging”  (i.e., using two condoms at the same time) this actually increases the risk of condom failure.

‘Perfect’ use of condoms is making an effort to NOT do the things on the above list – and even then, you have as much as a 2% chance of sex leading to an unplanned pregnancy.

As for vasectomies, JR is correct – there is a less than 1% chance of failure. Though, men must be cautioned that the rates of success do vary slightly depending on the surgical technique used and the surgeon himself.

I think vasectomies are pretty great at preventing pregnancy – it’s the closest you can get to a guarantee aside from abstaining (and what fun would that be?) – but a vasectomy DOES NOT prevent you from giving or receiving sexually transmitted diseases.

So, just to recap: I am NOT against vasectomies. I am against unprotected sex with multiple partners – vasectomy or not! – and I think that Details magazine was remiss in not addressing this in their article.

And JR, if you’re reading this, you should really refrain from identifying with truly “thoughtful and caring” men if you’re going to say women are “dumb” and refer to us as “stupid hormone ravaged PMS’ing c**ts!”

At least, that’s what the College of Physicians and Surgeons of Ontario say (see the National Post article here).

A new draft proposal by the college is looking to strip Ontario doctors of their right to exercise their religious or moral conscience when practicing medicine.

As it is now, a doctor can refuse to do things like prescribe the morning after pill, give a patient an abortion and can refuse to refer a patient to another physician who will do those things if the treatment being asked for goes against their religion or conscience.

I think the college is making a mistake with this approach.

I do agree that doctors should have to refer a patient they will not treat themselves – I don’t think it’s for a doctor to decide a patient shouldn’t be treated at all simply because the treatment goes against the doctor’s conscience or religion. Those patients the doctor will not treat should be referred immediately to a doctor who will.

Forcing a doctor to treat a patient when the doctor has made it clear the treatment in question goes against everything he believes in is a bad idea. I think no matter how careful the doctor is to treat that patient’s physical needs - the quality of care and compassion that is normally involved in medical treatment drops off pretty sharply when the doctor actively disagrees with a patient’s own moral or religious decision.

For instance, if I went to a doctor for an abortion and the doctor told me “My conscience and religion forbid this treatment, but since I don’t want to be disciplined or sued, I’ll do it.” Could I really trust that doctor to then be careful with my physical and mental well being? Do I want an important decision and procedure like that handled by a doctor who has made it clear he does not respect my right to have the procedure in the first place?

I’m pretty sure the answer is no.

Force these doctors to simply refer the patient elsewhere and, if necessary, end the physician-patient relationship so the patient can seek appropriate care with a physician who supports their right to the treatment they need or want.

The proposal states that ending a physician-patient relationship based on personal beliefs could “contravene the Code and/or constitute professional misconduct.” I think this is fairly asinine. I would much prefer my doctor say “I am going to refer you to another doctor who is accepting new patients, as my religious and moral beliefs are making it difficult for me to treat you with the respect, compassion and level of care you deserve.”

Instead, those cases where a doctor does want to terminate his relationship with a patient, refuse care of an existing patient or refuse to take on a new patient, the doctor must do so “for reasons related to his or her own clinical competence” according to the proposed code.

It seems to me that this approach encourages doctors who wish to live by their personal beliefs to lie. If a doctor lies about his “clinical competence”, does this mean the College can examine whether he should hold a medical licence?

The code also says the first step in ending a physician-patient relationship should be a referral to specialist – and in the case of a GP not wanting to do heart surgery or something equally specialized, this makes sense. I don’t want a GP trying his hand at a triple bypass surgery. Where the doctor in question does not want to provide a young girl with birth control pills because he thinks she’s too young to be sexually active or his religious and moral beliefs brand her as an adulterous slut- what specialist could you possibly refer her to?

The code advises the following in those cases: “…proceed cautiously.”

The well being of the patient should always come first – I agree with the College on that completely. However, sometimes the well being of the patient is best addressed by the physician admitting “I’m not the right doctor for you because of my religious or moral beliefs. Let me refer you to a doctor I think you’ll connect with better.”

That sort of honesty is what makes a physician good – that honesty ensures the patient will always come first.

The feeling of being processed is already rampant in doctor’s offices across the country. Patients get a maximum of 15 minutes and two issues to bring to the table before they are ushered out the door. If the doctor is spending any of those minutes giving poor quality care to a patient he was forced to treat, his ability to do his job is severely compromised.

Forcing a doctor to treat a patient they cannot be objective about or kind to will only serve to highlight and compound existing issues in the health care system. Make it a rule that no doctor can refuse a to refer a patient – if the doctor in question loses many of his patients because he refuses to treat them, he has no one to blame but himself. 

You can read the proposed code here. Click View Backgrounder under the Human Right Consultation section (this will allow you to view a .PDF file) scroll to the Physicians and the Ontario Human Rights Code link and click that for the full version of the proposed code.

If you wish to comment on the proposed code, do so no later than August 15, 2008 by sending a letter to:

Andrea Foti
College of Physicians and Surgeons of Ontario
80 College Street
Toronto, ON, M5G 2E2

or email Andrea at: afoti@cpso.on.ca

Anything done in Ontario can easily be adopted by other Provinces – so speak up now!