healthcare, law

Do you go to bloggers for advice about life and death decisions? I don’t.

Many thanks to a reader who contacted me on Facebook this morning. This person probably spared you all another rant on a topic I’ve already covered. I was considering writing about Delta Airlines’ proposal for all U.S. based airlines to share their “no fly” lists. But then I got this message, and I must admit, it left me scratching my head.

The commenter evidently didn’t want to leave a response on the blog itself. They found my official OH Facebook page and decided to leave me a somewhat well-written and, at least on the surface, reasonable response to a post I recently wrote about COVID-19. They wrote I shouldn’t be writing such “strong opinions” against the use of Ivermectin in the treatment against COVID-19, reminding me that I have a “public” audience who might be negatively affected by my comments. They reminded me that no one should claim any “definitive knowledge as yet”– I’m assuming about COVID-19– and implied that my opinion lacks a “rational basis”.

I don’t know a thing about this commenter, nor does s/he know much about me. Based on what I could see on Statcounter, this person with a very bare Facebook profile, comes from Las Vegas and read two posts over the course of about three minutes. He or she probably doesn’t know that I have a master’s degree in public health. Perhaps he or she would not be “impressed” by that. In any case, earlier in the comment, the person “informed” me that sometimes physicians prescribe drugs off-label. That’s not news to me, and in fact, I even mentioned that in the post I’m assuming was referenced in the message. That post was mostly my positive opinion about Judge Charles Cunningham of Louisville, Kentucky, who recently ruled that the wife of a COVID-19 patient could not compel hospital doctors to prescribe Ivermectin off-label to treat COVID-19.

I write that “I’m assuming”, because the commenter didn’t specifically reference a blog post in their message. Regular readers might remember that I recently took down my generic “contact” page, because I kept getting comments from people who didn’t specify the posts to which they were referencing. Statcounter is a pretty good tool, but not everyone who visits my blog shows up on it. If there isn’t an IP trail on Statcounter, and the specific post isn’t mentioned, I’m sometimes left wondering which post to address. It wasn’t the first time I got a comment with no reference, so I determined that the contact page wasn’t helpful and removed it. And now, I’m thinking the Facebook page probably isn’t helpful, either, since I’ve run into the same issue this morning.

Anyway, this person who wrote to me evidently thinks that patients or their loved ones should be able to go to court to demand that legal experts force medical experts to prescribe medications for off-label use. And the person subtly chastised me for disagreeing with that idea by posting a strongly worded opinion piece on my blog. Then, at the end of their message, they wrote this:

NO ONE should claim any definitive knowledge as yet – which defaults to each of us knows what is in our own best interests. And in a life or death situation, anyone who interferes ought to be imprisoned, or worse. Think about how you would feel if the situation were reversed, and perhaps you will avoid making such strong opinion calls, without a rational basis – you have a public audience. Who knows how much harm you could cause…. thank you…”

On the surface, I guess the above portion of the comment sounds reasonable enough. Most people would like to make their own decisions about “life or death situations”. But there’s a reason why people go to medical school to become physicians. There are good reasons why physicians must be trained and licensed before they can practice medicine and make treatment decisions for others.

I don’t go to lawyers or judges for medical treatment decisions. I go to competent healthcare professionals who have specific training and experience in treating medical issues. If I, as a competent adult, choose not to go to a healthcare professional and seek alternative care from someone else, that might be my decision and it might only harm me. Some people would probably think it unwise, but I suppose it would be my “right”. And if I had a disease that wasn’t contagious, maybe that would be okay, if ill-advised.

When it comes to COVID-19, I think we have to consider the impact one person’s decisions might have on another’s. COVID-19 is an extremely contagious and potentially deadly virus, and it seems to be getting more contagious with each new variant. There aren’t enough hospital beds to take care of all of the people who need them, to include people who have other medical problems besides COVID. Ivermectin is currently not approved by the Food and Drug Administration for treatment against COVID. Is it being studied by researchers? Probably… but at this point in time, Ivermectin is NOT currently supported by the medical community for use in treating COVID-19. That is a fact. I don’t know if Ivermectin ever will be named the key to conquering COVID-19, but at this point, it is still not recommended.

What I do know is that some people are taking it upon themselves to self-medicate with the drug. Most of them don’t know what they’re doing. Some of them are getting very sick and, no doubt, taking up hospital bed space needed by people who don’t routinely take drugs intended for veterinary use. So the fact that it’s being widely touted by certain groups as a “cure” or effective treatment is, in my view, irresponsible and potentially dangerous.

Moreover, even in the case of “off-label” use for drugs (and I once had a doctor who prescribed a drug for me for “off-label” reasons), there’s usually a consensus that the drug is useful for that purpose. At this point, I haven’t seen much support for Ivermectin to be used in that way by reputable medical professionals. I’ve only seen it touted by people who are pushing conspiracy theories.

Even if Ivermectin is a great drug for COVID-19, and I have not yet seen any compelling evidence that it is, it should certainly not be used by laypeople who have no experience with its use. People should not be going to their local feed and tack shop, buying up horse wormer to ward off COVID-19. That’s my opinion, of course. You can take that for whatever it’s worth.

As someone with a master’s degree in public health and actual work experience in epidemiology, I think I know how to research these things. However, I will admit that I don’t have all of the answers. I just know enough to find someone who knows more than I do and listen to what they have to say. I think that’s a pretty wise way to live life, but your mileage may vary. So far, it’s served me pretty well.

I do think it’s interesting that many people who wouldn’t get a COVID-19 vaccine because “it’s [wasn’t] FDA approved” (a situation that is changing) and “we don’t know the long-term effects of the vaccine”, are all into using Ivermectin off-label to treat COVID-19, which is definitely not FDA approved. We’ve seen some real and documented evidence by trusted entities that COVID vaccinated individuals are staying out of hospitals and not getting as sick as unvaccinated people are. Most of what I’ve read about Ivermectin treatment in COVID-19 cases is that people are overdosing on it and getting sick. I don’t know about you, but that makes me think that taking Ivermectin isn’t the smartest idea.

Moreover, an article by The Guardian from July 2021 reports that a “huge” study endorsing Ivermectin as a COVID-19 treatment was withdrawn over ethics concerns. I will admit that I haven’t looked for anything from September that refutes this article, which basically states that a lot of medical providers were defrauded, but I do know that July wasn’t long ago. And as a run-of-the-mill blogger, I’m not going to take the time to go poring through medical journals for an opinion based blog post that gets maybe 25 hits in a day.

The person who wrote to me this morning reminded me that hospital doctors must “toe” the “party line (and it’s “toe”, not “tow”) or they’ll get fired. The person also wrote that the “ban” against Ivermectin is “politically motivated.” As I mentioned up post, this person appeared to be writing me from Las Vegas, which means he or she is residing in the United States.

They might be interested in knowing that I live in Germany, where Ivermectin is also not recommended for treatment against COVID-19, outside of a clinical trial. So, if banning Ivermectin for COVID-19 use is “politically motivated” in the United States, am I to believe that the ban is also “politically motivated” in Europe? Because Germany is not the only European country that does not recommend the use of Ivermectin for treating the coronavirus. Here’s a link from March from the European Medicines Agency, which is as official in Europe as the CDC and the FDA are in the United States. Likewise, the World Health Organization also recommends that Ivermectin only be used in clinical trial settings

In other words, Ivermectin should probably NOT be used by any old physician who is throwing everything against the wall to see if something sticks. Who knows what the motivation is behind those physicians who are touting off-label use of Ivermectin? Perhaps they are politically and financially motivated. As a matter of fact, how do I know what my commenter’s motivations are for taking the time to write to me after having spent about three minutes reading two posts on this blog? Why does it even matter to that person what my opinions about Judge Cunningham and Ivermectin use in COVID cases are?

In any case, what I really want to address in today’s post is this person’s parting shot to me.

Think about how you would feel if the situation were reversed, and perhaps you will avoid making such strong opinion calls, without a rational basis – you have a public audience. Who knows how much harm you could cause…. thank you…

So basically, the commenter seems to think that because some people might somehow construe my opinions as “medical advice”, I shouldn’t express myself on a blog because I might unintentionally cause them “harm”. Or, at least that’s what I think I’m reading. And people who read my blog are not smart enough to think for themselves and are coming to me for advice on life and death issues. Right. Does this person think the same thing about people who express opinions on social media platforms?

This is a blog. It’s not even a very popular blog. On a good day, I crack about 200 hits. The vast majority of people who read this blog are total strangers to me. Anyone who goes to a blogger for medical advice, particularly when the name of the blog is “The Overeducated HOUSEWIFE” and not “The Overeducated Physician”, is not long on common sense. Why would any sane person go to a self-proclaimed housewife for medical advice? But I guess, since this person seems to think I have so much power because of my “public audience”, I’ll put up a legal disclaimer.

If you are seriously unwell and need medical assistance, I think you should seek the advice of a competent and licensed healthcare provider in your area. You should not go to a personal blog written by a total stranger for medical advice. I would hope that notion would be common sense, but now I realize that some people need to be explicitly told. So thanks to this morning’s commenter for that. I’ll make a note of it.

As always, I wish everyone who reads my blog continued good health and success in life. And please, if you are going to send me a Facebook private message on my OH page, do me a favor and reference the post to which you are referring. Or, even better, simply comment on the post itself. I usually provide links on the official OH page for those who don’t want to make a WordPress account.

condescending twatbags

Repost: American woman has uterus transplant that fails. The Internet goes berserk.

This post appeared on my original Overeducated Housewife blog on March 10, 2016. I am reposting it because it relates to today’s post.

Last night, just before closing my eyes for the day, I ran across this article from The New York Times. It’s about a 26 year old woman from Texas named Lindsey who longed to have a baby naturally.  Born without a uterus, Lindsey had known since she was a teenager that she would never be able to carry a baby.  The news was clearly devastating.  Still, she grew up, got married to a man named Blake, and adopted three sons.

Lindsey is the first American woman to undergo a uterus transplant.  The transplant was done on February 24th in a nine hour operation at the Cleveland Clinic’s hospital in Weston, Florida.  At first, the surgery was deemed a success.  Lindsey had received a uterus from a woman in her 30s who had died suddenly.  She was pictured sitting in a wheelchair, smiling… looking very hopeful, surrounded by benevolent looking doctors.  Though uterus implants are cutting edge medicine and are just now being explored in the United States, they have been done successfully before.  Swedish doctors have done the transplants on nine women resulting in five births.  Lindsey and her medical team had every reason to hope that she too would be successful.

Then, the day after that photo was taken, there were complications and the transplant failed.  Lindsey was suddenly back in the news.  The New York Times promptly reported the setback in a second article. 

I will admit that the second article is the one I saw first.  I noticed the first one when it was first published, but never got around to reading it.  That first article included the information that Lindsey and Blake had already adopted/fostered three boys.  Still, the idea that she should adopt first never crossed my mind.  I figure everyone has the right to make their own family planning decisions, as long as those decisions don’t harm other people.  Moreover, medical research has the potential to help many.  As long as patients are informed about the experimental nature of a new treatment and understand the risks, I can’t help but admire the ones brave enough to be first.

I probably shouldn’t have read the comments on the news article, though they did inspire me to read more about Lindsey and her brave decision to be a part of medical history.  So many people were saying that Lindsey should “just adopt”, not realizing that she had already done that.  Even when they were made aware that Lindsey is already a mother and had adopted three kids who needed homes, a lot of them stubbornly derided her decision to try for the transplant.  Others suggested hiring a surrogate, which is another avenue that can be fraught with challenges.

I’ll admit that it often pisses me off when people suggest adoption to people struggling with infertility, as if they’ve never considered it.  They make it sound like it’s the easiest, cheapest, most perfect decision.  It’s like they could just go to a child rescue and choose a kid whose picture “speaks to them”, go home, and raise the child happily ever after.  It’s not that simple.  Adoption is a big decision and comes with its own set of challenges.  Moreover, Lindsey had already adopted and wanted to try for a pregnancy.  She’s an adult, living in a country that supposedly embraces personal freedom.  It’s her body and presumably her money.   

A lot of people were saying that uterus transplants are somehow selfish and frivolous.  What I don’t think they understand is that this kind of research could also be beneficial to other people.  Every time healthcare professionals are able to explore the human body, it helps them to learn about how it works.  Maybe the uterus transplant surgeries could help doctors understand even more about how transplants work and what causes failures and promotes successes.  Maybe more knowledge garnered during a uterus transplant surgery could lead to better understanding of heart transplants or lung transplants… you know, surgeries involving vital organs that support life.  Of course, a uterus also supports life; a life separate from its owner’s. 

I also noticed that many of the comments were being made by men.  So many flippant males, people who never expected to give birth themselves and don’t understand that, to many women, having babies is a part of being female, felt the need to opine about Lindsey’s family planning choices.  It’s true that a lot of women never give birth and choose not to.  Quite a few women also only give birth once, because the experience of being pregnant is unpleasant for them.  But, for so many other women, being pregnant and having babies is a deep desire.  It’s something that so many women can do with ease.  When you can’t do it, for whatever reason, it hurts.  I wanted kids and presumably could have had them had I wanted to seek medical help (or a man who hadn’t had a vasectomy reversal).  For me, the desire to be a mom was not that strong.  For other women, it’s a very compelling drive.  I can’t judge them for that. 

I have a friend who endured many miscarriages.  She kept trying to get pregnant and would end up heartbroken time after time until doctors discovered that she had a hormonal imbalance.  She and her husband now have three beautiful sons.  It took years, lots of money, and plenty of patience, but they were able to achieve that dream and have that part of their lives fulfilled.  I wouldn’t be surprised if some compassion challenged jackass said to them, “Jesus Christ!  Why not just adopt?  Look at all the kids who need homes!  The world is overpopulated!”  It’s as if they’re saying, “Sorry lady.  Fate made you unable to have a baby, so you should just suck it up and deal with it.  To hell with your own plans and desires; God has spoken and you’re defective.”

My question is, who the fuck are these people to make these kinds of tone deaf comments to strangers?  Better yet, who are they to mention them to friends and family?  Why is it anyone else’s business how an adult plans their family?  Even though I am no fan of the way the Duggars live their lives, I still maintain that it’s their right to determine how large their family should be.  I would hope they wouldn’t choose to adopt, mainly because I think an adopted child in that family would suffer.  But even if I personally disagreed with adoption in their case, I still think people should have the basic right to make family planning choices that work best for them.  What works for one person doesn’t always work as well for someone else.

I, for one, applaud Lindsey’s bravery.  I’m sure the doctors who worked on her learned new things and honed their skills.  I’m sure this setback is devastating enough for all of them without idiots on the Internet belittling them for trying to advance medical science.  I wish the best for Lindsey and all the other women who are struggling with infertility, a problem that hits close to home for me. 

condescending twatbags

Adopting a child is not like rescuing a puppy…

Four years ago, on the original Overeducated Housewife blog, I wrote a rant about people who were upset about the advancement of uterine transplants. In that post from March 2016, I wrote the story of a 26 year old woman named Lindsey who had always longed to experience pregnancy with a baby of her own. But Lindsey had known since she was a teenager that it was not meant to be, because she was born without a uterus.

In February 2016, Lindsey underwent an experimental operation at the Cleveland Clinic in Weston, Florida. She was one of the first women in the world to have a cadaver’s uterus surgically implanted into her body, and was the very first woman in the United States to have the procedure done. Doctors had hoped she would be able to try to get pregnant two years after the surgery. Unfortunately, Lindsey’s uterine transplant quickly failed, and by the next month, she was undergoing another surgery to remove the transplanted uterus.

I read about Lindsey’s case in The New York Times, and then read some of the comments. To me, transplant medicine is fascinating and amazing. And yet, plenty of people were posting awful comments about Lindsey and how “selfish” she was for wanting to have a baby of her own instead of adopting one. Even when it came to light that Lindsey already has THREE adopted sons, many people were quick to criticize her, wondering why those three boys “weren’t enough” for her and speculating that they would feel “bad” because their mother wanted to experience pregnancy. I was pretty agitated by the stupidity of the comments about Lindsey’s case, so I wrote a rant. I will repost my first rant about this subject, since it’s relevant to today’s follow up rant.

Yesterday, I read the exciting news that another uterine transplant patient in the United States has successfully given birth at Penn Medicine in Philadelphia, Pennsylvania. The child, son of 33 year old Jennifer Gobrecht and her husband, Drew, is the second baby born in the United States after a successful uterine transplant. Jennifer Gobrecht, who was born with a congenital condition called Mayer-Rokitansky-Küster-Hauser syndrome, had believed she would never be able to experience pregnancy, since she was born with ovaries, but no uterus. Thanks to the dedication of skilled researchers, surgeons, and nurses, and her own bravery and willingness to be part of an experimental medical procedure, she’s received her miracle in the form of her baby boy, Benjamin. And yet… people are criticizing her.

I read comment after comment about this story on The New York Times’ Facebook page. So many people asked why she didn’t simply adopt a child. After I read an especially snarky comment from a woman who wondered why the Gobrechts didn’t simply adopt, I asked “How many children have you adopted?”

The commenter wrote a rude response indicating that she had never wanted children and didn’t see how my question was relevant. But a whole lot of women– probably women like me, who for whatever reason, have faced infertility themselves– liked my comment and totally saw where I was going with it. The commenter wondered why I would ask her how many children she’d adopted, implying that it was irrelevant and none of my business (which it isn’t). And yet, she wondered why Ms. Gobrecht and her husband chose to make the family planning choices they had! I guess it was lost on her that the Gobrechts’ decision to go ahead with the experimental uterine transplant was none of her business, either.

The commenter then wrote that Ms. Gobrecht’s decision to give birth to her own baby was essentially the same as adopting someone else’s baby. I guess she missed the part in the article in which it was explained that Ms. Gobrecht possesses ovaries, which means she has her own eggs. She was lacking a uterus, which is simply where the fetus develops and has no bearing on its genetics. So no, it’s not the same as adoption, because this baby shares DNA with his mother. And even if it was a case of a woman who got pregnant using donated eggs, it would still not be the same as adoption. For instance, there would be no risk of a birth mother deciding at the last minute that she wanted to keep the baby, a heartbreaking situation that many prospective adoptive parents face. And she would be able to experience the joy of seeing ultrasounds and feeling the baby’s kicks. Of course, she’d also experience the less pleasant aspects of pregnancy, but if that’s what she wants to do, more power to her. Who is anyone else to question her choice, if it’s available and legal?

Another commenter posted to my query that she’d adopted one child– then wrote “thanks”, as if she’d burned me good by proving that she’d put her money where her mouth is. To that commenter, I would (and did) say something along the lines of… “Good for you that you adopted a child! Here’s a cookie. But that doesn’t make your opinions about other people’s family planning decisions any more relevant.”

I think it’s awesome that some people want to adopt. It was never anything I was interested in doing myself, although I would have liked to have had a baby with Bill. As I have mentioned many times before, but will repeat for the new folks, my husband was talked into having a vasectomy when he was married to his ex wife. He has two grown daughters who, until very recently, were completely estranged from him. One of his daughters reconnected about three years ago, and Bill now Skypes with her and has gotten to see his two grandchildren via the miracles of modern technology. Because he loves me, and wanted me to have a chance to experience pregnancy, he underwent a vasectomy reversal. It was technically successful, although the procedure and recovery were definitely much more complicated than the initial “snip”. He was fortunate enough to have that procedure done free of charge, thanks to the Army and its doctors who need to maintain their skills. Unfortunately, for whatever reason, I never got pregnant. Ex, on the other hand, went on to have two more children with her third husband.

Back then, we didn’t have the money to pursue other methods of infertility treatment, so we eventually let go of the dream. At this point, I’m fine with that decision. I was ecstatic that my husband would even consider undergoing an invasive elective surgery on the most private part of his body so that I might be a mother. It felt to both of us like he was taking back a bad decision. In the end, that was enough for us, although we would have loved to have had a baby of our own.

Many women yearn to be mothers. Some of them are fine with adoption if they can’t get pregnant. Even people who can have their own babies may want to adopt, for whatever reason. It’s simply something they feel “led” to do. Then there are some people, like me, would rather not adopt. They have their reasons for feeling the way they do. Maybe you think their reasons are invalid, selfish, or even stupid, but your opinion doesn’t count when it comes to someone else’s family planning choices.

Adopting a child isn’t like picking out a puppy on a dog rescue Web site. You can’t just trot down to the local orphanage and pick one up after proving that your landlord approves and you have a pediatrician lined up. Adoption usually costs money and involves having other people check you out thoroughly– everything from home visits to financial inquiries. It can take time, too– sometimes years, even, although there are children in foster care who can be adopted with less hassle.

I’m quite sure most people would be offended if some stranger demanded to know why they chose to have children of their own instead of adopting. If you wouldn’t ask a fertile person that question, how could you dare ask that of someone who has struggled with infertility? It really is an insensitive and obnoxiously inquisitive question that is likely to put you in potentially awkward social situation.

Besides, while many people have been adopted and everything has worked out beautifully, sometimes adoptions can lead to heartbreak and misery. I won’t get into that now, since I have at least one more point to make before I close this post. Suffice to say, adoption has its pitfalls. It’s not for everyone. While I would never discourage anyone from choosing adoption, it’s a decision that needs to be carefully considered by people who are prepared.

The uterine transplant procedure is not even very likely to prevent most people who would otherwise consider adoption from adopting a child. It is simply one more tool in the arsenal against infertility. It will help the small cohort of women who, for whatever reason, lack a uterus. In other words, it’s not a huge crowd of people who would opt for a major, risky, invasive and expensive surgery in order to become a parent. It’s doubtful medical insurance will ever pay for the procedure, at least not in my lifetime, so the vast majority of people who might be candidates will probably not be able to afford it, anyway. I think the pro-adoption crowd can relax their sphincters now.

The final point I want to make is that I think uterine transplants are a good thing, not just because they give people like Lindsey and Jennifer Gobrecht the opportunity to experience pregnancy and give birth to their own babies, but because exploring any groundbreaking transplant procedure furthers the development of transplant medicine as a whole. You can bet that uterine transplants are being done right now because hearts, lungs, kidneys, corneas, and livers have been successfully transplanted. Now that uterine transplants are a thing, other parts of the body might follow. And with every new advancement and innovation in medical research, mankind is helped to understand the human body more.

Aside from that, uterine transplants have been done successfully in other countries, such as Brazil and Sweden. If the United States wants to be on the cutting edge of medical research, American medical researchers have to keep pushing into new frontiers. To do that successfully, people like Jennifer Gobrecht have to be willing to be part of the exploration. I, for one, am delighted that she was brave enough to come forward and was ultimately rewarded with a beautiful son named Benjamin. It really is a miracle. People should be applauding her for being a part of medical history instead of lecturing her about the wonders of adoption.