Pelvic Pain & Hysterectomies

Jimmtti Meager-The Gynecologist.The young woman's (Amy) had given birth recently, and she entered the emergency room screaming, "I am going to die." I called her obstetrician, Dr. Meager. He had already treated her for a bladder infection and now felt she must have a partially retained placenta and endometritis (uterine infection). He decided to take her to surgery and due an endometrial (womb) scraping under general anesthesia. During the procedure, she died. Amy actually had infective endocarditis and died from acute pericarditis. I don't know why but patients often seem to have insight about their impending death.Dr. Meager was a faculty jerk. We didn't like each other. He used to love performing hysterectomies at the public's expense. I had to fill on his behalf the state's required form in order for him to get approval to perform the procedure. Only a few patients had an actual medical necessity for the procedure, like cancer. The rest had a large uterus and/or fibroids or run-of-the-mill "pelvic pain." I would often write, "Patient has chronic pelvic pain associated with fibroids, uterine collapse, and urinary incontinence. Patient's symptoms are such that she fears urinating in public and has associated painful intercourse (dyspareunia)"; I had no choice but to perform the pre-operative examination on such women.Dr. Meager was a staunch anti-abortionist. One day he called me to assist him during surgery. As he was performing the hysterectomy, he quickly noted that the woman was pregnant. I checked to see what doctor had done the pre-op examination that failed to document her menstrual history and perform a routine pregnancy test. I won't mention the poor doctor's name. The woman got a hysterectomy and an abortion via Dr. Meager.Later while on call for obstetrics, a young woman came in to be checked for "labor" pains. I checked the young woman, and I felt her pelvis was too small and that a vaginal delivery would be unlikely. Dr. Meager disregarded my concern and sent her home. A week lady, there was a mess when a vaginal delivery was performed. Her baby suffered an injury to the arm and more.Dr. Meager had a bunch of women with "bladder symptoms" and urinary frequency. Though he kept treating them with various antibiotics, I noted that the women had stress associated urinary frequency. They didn't have bladder infections. One poor woman I checked said to me, "Why is that when my husband enters me my neck hurts?" Well, I know that the penis is not that big, so I interviewed her as a psychiatrist. It turned out that the woman feared having sex with her husband who was into "sick habits" and had been urging her to participate in-group sex. I spoke to the husband, and I informed him that his sexual activity were inappropriate. She got better.One morning, Dr. Meager's buddy was doing a hysterectomy on a woman with Alzheimer's for presumed "pelvic pain." This is why I argue today that primary care doctors and allied healthcare professionals must do the pap smears. If a woman has pelvic pain, she should be examined carefully, have a pap smear and be checked for sexually transmitted diseases. A pelvic sonogram, at Medicare fees, should only cost about $150 through a hospital. A pelvic sonogram should be performed by a respectable hospital, not at those in and out diagnostic trailers you see at many clinics. These women should be carefully examined for dysfunction, anxiety and/or depression due to external factors. A gynecologist should not be considered a primary care physician. By the way, a competent midwife delivered me.Importantly: for 2007, medicare pays: $324 for upper endoscopy with biopsy; $579 for treatment of retinal lesion; $25 for complete electrocardiogram; $104 for cardiovascular stress test; $92 for office visit, new patient; $59 for office visit, established patient; $114 for additional 30 minute of critical care; $1,902 for single CABG (coronary artery bypass graft); $1,356 for total hip arthroplasty and $793 for insertion of intracoronary stent. If you're uninsured or a cash patient, you may pay up to times as much. Thet hree most common causes of bankruptcy are: Medical Bills; Loss of Job; and Loss of spouse.If you have no insurance, insist on paying what Medicare allows. Together, we can make it a legal requirement.

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