Men & Women: Sterilization

[DivaDiamond007]

To take the major vs. minor surgery issue out of the equation, look at this: http://www.essure.com/

Essure is an office-based or outpatient surgical procedure where coils are inserted into the fallopian tubes to create scarring. The result isn't immediate, but it leads to a permanent loss of fertility similar to a tubal ligation (but less invasive).

So compare that to vasectomy...do I think a young woman asking for Essure is more likely to be turned away than a young man asking for a vasectomy? Absolutely. And there's the double standard.

ETA: Ksinger, I don't think anyone asks for hysterectomy as a form of birth control, and most doctors don't push it unless they think a woman's quality of life will be improved (e.g. resolution of anemia from heavy bleeding from fibroids, survival after taking out a cancerous uterus, etc.). Most women seeking permanent sterilization are talking about a tubal ligation.

I truly am aware of that it is mostly unlikely, but it was mentioned in the same breath as a tubal, and in a world where people as for and receive plastic surgery to make them look like cats or lizards, or where a 60 year old woman can find a doctor to restart her ovaries so she can get pregnant, I'm sure someone at least, has asked for a hysterectomy at a young age.

You'll have to forgive me though if I have a jaundiced view of the medical profession's view of women's reproductive organs. Considering the almost insane frequency of hysterectomies for what frequently amounts to paltry reasons, somebody is quite clearly pushing them, and I don't believe that pushing originated with patients. And by that you may assume I have a personal axe to grind about this issue. But I'm one of those patients who doesn't suffer from being overawed and swayed by another person's idea of what my quality of life "ought" to be. I'll just say I'm fine healthwise and leave it at that. But I will say that if I had been more "compliant" I would now be missing a rather important piece of myself.

Good points. I do think there are 2 separate issues being discussed here...(1) the double standard of female vs. male sterilization; and (2) jumping straight to hysterectomy when there's a problem with the uterus. I'm certainly not trying to be argumentative or to single you out, ksinger, but I'd just like to say that I don't really understand many women's attachment to their uterus. When I had appendicitis, they took out my appendix. When my mom had gallstones, they took out her gallbladder. And if I develop some problem with my uterus that threatens my quality or length of life, it's coming out, no questions asked! My uterus is no more important or special to me than an appendix or gallbladder. Just my personal view, and obviously not everyone sees things the same way.

Oh, and for those who are concerned about the uterus leaving a big void for other organs to slip into, no worries...the non-pregnant uterus is a really small organ, smaller than the palm of your hand. It's also in the pelvis rather than the abdomen, which are separated by a membrane called the peritoneum, so your abdominal organs will not slip into your pelvis.

I agree with you completely, jstar.

I started this thread to get opinions on the double standard of female v. male sterilization and the ease in which men are able to get a vasectomy and women are often persuaded to use hormonal methods rather than have either a tubal or hysterectomy. Obviously, a hysterectomy is major surgery, however, if a women is done having children and doesn't want to deal with periods for the next few decades then why should she be denied the surgery? Millions (?) of women and men presumably have cosmetic procedures under general anesthesia that are equally as risky. How is a hysterectomy any different than that?

I am also not one that is emotionally connected to my uterus, tubes or ovaries. I feel I am just as much of a woman with them as I am without. I probably wouldn't consider something as major as a hysterectomy if I weren't having medical issues relating to my uterus but my situation has me really thinking about the double standard that exists.

 

[somethingshiny]

DH's aunt is having a hysterectomy as I type. It's being done laprascopically, staying over one night and a 2 week recovery. I was amazed at the new techniques!

DH and I have been discussing vasectomy lately. We actually want more kids, but with our risk of a heart defect, we're contemplating cutting the lines to more children. Our dr has said that he will ONLY do a vasectomy on a married man, with the wife's consent. (My brother had to bring in a note from his wife, lol). Our dr also said that he will do a vasectomy on a married male of any age if they have 3 children, but a male who has 2 children has to be at least 30, and a man with no children he won't even consider until he's 40 yrs old. So, in our area, there is definitely no double standard.

In general, I'm appalled by the double standard shown by the OP. I'm all for birth control, but I think if a man has a vasectomy he should be up front about it with any potential serious relationships.

 

[Circe]

I'm given to understand that a hysterectomy is a much bigger undertaking than it's generally billed as being, because unlike a tubal or a vasectomy, which blocks or redirects certain bodily functions harmlessly, hysterectomy removes an organ which is still fulfilling a function throughout most of a woman's life. Synechdoche for/with a woman's eggs: they might be less viable or not be viable at all after a certain age, but they're still being produced by the body. Some people think the continuing function of these organs is a useless evolutionary holdover: some people argue that the body is a complicated machine that we don't fully understand, as yet, and that removing a piece of it can throw the whole out of whack. I've heard women who've had hysterectomies complain that their libido virtually disappeared, that they "felt older," etc.

I have no first hand knowledge on this, and I most certainly do not want to generalize and insult any woman reading this who has had a hysterectomy! But the things I've read and heard do make me very leery of hysterectomy as a casual procedure.

 

[ksinger]

I'm given to understand that a hysterectomy is a much bigger undertaking than it's generally billed as being, because unlike a tubal or a vasectomy, which blocks or redirects certain bodily functions harmlessly, hysterectomy removes an organ which is still fulfilling a function throughout most of a woman's life. Synechdoche for/with a woman's eggs: they might be less viable or not be viable at all after a certain age, but they're still being produced by the body. Some people think the continuing function of these organs is a useless evolutionary holdover: some people argue that the body is a complicated machine that we don't fully understand, as yet, and that removing a piece of it can throw the whole out of whack. I've heard women who've had hysterectomies complain that their libido virtually disappeared, that they "felt older," etc.

I have no first hand knowledge on this, and I most certainly do not want to generalize and insult any woman reading this who has had a hysterectomy! But the things I've read and heard do make me very leery of hysterectomy as a casual procedure.

Thanks Circe. My point exactly. It's not "attachment" to a body part, it's about not considering body parts as throwaway.

This:
".... if a women is done having children and doesn't want to deal with periods for the next few decades then why should she be denied the surgery? Millions (?) of women and men presumably have cosmetic procedures under general anesthesia that are equally as risky. How is a hysterectomy any different than that?"

Really? Comparing removal of an organ to a facelift? Please.

I think Circe addressed it pretty well. It ain't always the easy lark it's made out to be by doctors or even some women. Talk about taking on an attitude of the patriarchy and making it our own - just to see the attitudes on here about our own reproductive organs is pretty telling. Got nothing to do today? Hey! Have your uterus removed! Who needs it! What's next? Breasts? Hey, they just get old and saggy and cancer prone. Why not lop them off too, just to be safe or because they aren't pretty anymore.

I suppose in a world where someone will sell his kidney for an iPad, and there are doctors who will do those questionable procedures, I am not surprised to see this attitude. I will say this though, in a world full of people who complain vociferously against the high cost of healthcare, it is procedures just such as this - having an elective hysterectomy simply to relieve one's self of the inconvenience factor of being female, not because there is a true medical need - neither incapacitating pain or imminent threat to life, that add to the insane run-up of costs. Because you KNOW the doctor will code this such that the insurance company will pay for it. I certainly think that if it is NOT medically necessary, then the rest of us should not have to pay for it.

I have no undue attachment to any body part. I'm fond of all of them actually. I DO have an aversion to having any major surgery that is strictly unnecessary from a medical standpoint and that is justfied to me as "well, you may have problems in a few years". By that logic we should all have quite a few things removed or lopped off prophylactically.

If you and your doctor come the the decision that a hysterectomy is necessary and desirable, then by all means, have one. They can be lifesavers in a myriad of ways for some women. I've even sent a lady to my doctor and she ended up having one. SHE needed it, and anyone would have known it who heard her situation. But you can be quite sure there are a BUNCH of women out there who bowed to the DOCTOR'S bias and probably did not need one at all.

 

[DivaDiamond007]

I'm given to understand that a hysterectomy is a much bigger undertaking than it's generally billed as being, because unlike a tubal or a vasectomy, which blocks or redirects certain bodily functions harmlessly, hysterectomy removes an organ which is still fulfilling a function throughout most of a woman's life. Synechdoche for/with a woman's eggs: they might be less viable or not be viable at all after a certain age, but they're still being produced by the body. Some people think the continuing function of these organs is a useless evolutionary holdover: some people argue that the body is a complicated machine that we don't fully understand, as yet, and that removing a piece of it can throw the whole out of whack. I've heard women who've had hysterectomies complain that their libido virtually disappeared, that they "felt older," etc.

I have no first hand knowledge on this, and I most certainly do not want to generalize and insult any woman reading this who has had a hysterectomy! But the things I've read and heard do make me very leery of hysterectomy as a casual procedure.

Thanks Circe. My point exactly. It's not "attachment" to a body part, it's about not considering body parts as throwaway.

This:
".... if a women is done having children and doesn't want to deal with periods for the next few decades then why should she be denied the surgery? Millions (?) of women and men presumably have cosmetic procedures under general anesthesia that are equally as risky. How is a hysterectomy any different than that?"

Really? Comparing removal of an organ to a facelift? Please.

I think Circe addressed it pretty well. It ain't always the easy lark it's made out to be by doctors or even some women. Talk about taking on an attitude of the patriarchy and making it our own - just to see the attitudes on here about our own reproductive organs is pretty telling. Got nothing to do today? Hey! Have your uterus removed! Who needs it! What's next? Breasts? Hey, they just get old and saggy and cancer prone. Why not lop them off too, just to be safe or because they aren't pretty anymore.

I suppose in a world where someone will sell his kidney for an iPad, and there are doctors who will do those questionable procedures, I am not surprised to see this attitude. I will say this though, in a world full of people who complain vociferously against the high cost of healthcare, it is procedures just such as this - having an elective hysterectomy simply to relieve one's self of the inconvenience factor of being female, not because there is a true medical need - neither incapacitating pain or imminent threat to life, that add to the insane run-up of costs. Because you KNOW the doctor will code this such that the insurance company will pay for it. I certainly think that if it is NOT medically necessary, then the rest of us should not have to pay for it.

I have no undue attachment to any body part. I'm fond of all of them actually. I DO have an aversion to having any major surgery that is strictly unnecessary from a medical standpoint and that is justfied to me as "well, you may have problems in a few years". By that logic we should all have quite a few things removed or lopped off prophylactically.

If you and your doctor come the the decision that a hysterectomy is necessary and desirable, then by all means, have one. They can be lifesavers in a myriad of ways for some women. I've even sent a lady to my doctor and she ended up having one. SHE needed it, and anyone would have known it who heard her situation. But you can be quite sure there are a BUNCH of women out there who bowed to the DOCTOR'S bias and probably did not need one at all.

ksinger: I was referring to the comparative risk of being under general anesthesia for a hysterectomy v. an elective cosmetic procedure in my previous post. I was merely pointing out that having any type of surgery carries risks. It goes without saying that one should discuss the benefits/risks pertaining to any type of surgery with their doctor before going under the knife.

I do agree that there are women out there that are pressured into having a hysterectomy when there are other treatments available to those having reproductive problems.

I also want to point out (to everyone here) that I am not considering having a hysterectomy simply because having periods is inconvenient for me or as a method of birth control. I have recently been diagnosed with something called Lynch Syndrome, which I had never heard of until just a few months ago. My risk of uterine cancer has been determined to be 98.4% (!) higher than that of the general population. The hysterectomy would be prophylactic in the sense that it is preferred to avoid cancer at all costs; but also due to the fact that I have developed very heavy periods. To the point where I can't leave the house. Obviously, given my age (29) and the fact that I have 2 young children, something must be done. Adding to the mix, I have a blood clotting disorder that prevents me from taking any type of hormonal medications. Because of this I am unable to take BCP's to control the bleeding. It is a complicated issue and I don't even know what to think of it yet. Prior to the Lynch Syndrome diagnosis (and prior to my husband getting a vasectomy) I was told by my primary doctor and OB/GYN that a hysterectomy was out due to my age. I was given the option of an ablation (Nova Sure) but ablations only work about 50% of the time and can mask cancer.

 

[jstarfireb]

Just to echo Pandora - not everyone can afford to adopt. Most people can, however, afford to produce a child from their own body.

True that. This got me thinking...isn't it ironic that it's so financially easy to make a baby, yet so much harder (again, financially speaking) to afford to raise one? Another discussion for another thread, but oh well.

ksinger, I'm sorry for offending you, and I tried to make it clear that I wasn't singling you out, just making an observation about people in general, which I find interesting and thought-provoking. I do think a lot of women (not necessarily you) are very emotionally attached to their uterus, ovaries, breasts, etc, as if the body parts are what make someone a woman. I would like to point out something regarding your Wikipedia quote..."benign" in medical terms simply means "not cancer." It doesn't mean that these hysterectomies are unnecessary. Most hysterectomies are elective, but they're done to stop heavy menstrual bleeding or otherwise improve quality of life. My mom, for example, had such heavy bleeding that she became anemic with a hemoglobin of 8 (normal is over 12 for women). She actually got an endometrial ablation, not a hysterectomy, but she was much more energetic and happy after her heavy periods stopped.

I do agree that any major surgery, including hysterectomy, is not a walk in the park, and people SHOULD take it seriously. But my point is that I don't think too many are being done and for not good enough reasons. I've never, ever heard of a hysterectomy being done for birth control, for what it's worth.

 

[fountainfairfax]

As someone who had the Essure procedure done at 38 (which I know is old in context to this discussion but I was childless and a year away from getting married- both of which are situations where traditionally sterilization is discouraged,) my Dr said that he would have no problem performing any permanent form of birth control on a patient that he knew to be ready to take this step. He was one of the first doctors to perform Essure in our area and he told me that it was crucial to his medical ethics that he knew the patients well and understood the motivation behind their life choices.

Having been a patient for over 10 years, he had known me through numerous relationships/life changes and kept records of discussions about my decisions to stay on the pill and that my ability/inability to conceive was never a topic for discussion. He had notes how in the beginning of coming to his practice I was newly divorced, single and wasn't considering children at that time. He had more notes over the years how from time to time I would mention that the lack of a permanent relationship as a factor in not having children and that the year I turned 35 I told him about my niece being born and that I couldn't imagine being a mom as my sister now was. The following year I ended a relationship that was headed towards marriage because he wanted to start a family ASAP and my Dr even had notes regarding that the relationship had ended and that potential parenthood had played a role in my decision to split. After meeting my DH I apparently told the Dr how relieved I was that this guy never wanted children! During the exam I had pre-procedure, he made a point of telling me he had no doubt that if I had wanted to become pregnant I most likely could've very easily and I took the news as being kind of ironic and comical rather than thought-provoking. So he had no doubts this was the right decision for me.

While my Dr's note-taking may be extreme I think it really illustrates that many doctors who perform sterilization on women do so because they have a very good understanding of where the patient stands in her life-choices. I can understand why a Dr who does not have a long medical history of a patient may be reluctant, especially if a patient is young (or childless or less-than-settled in life.) I don't believe doctors have the right to make our reproductive decisions for us but I totally appreciated the thought and understanding my Dr brought to my discussion on whether or not to have Essure done.

 

[Mrsacornblue]

I think that a tubal ligation and a vasectomy are similar in terms of recovery and risk. A hysterectomy is in a seperate catagory and are usually not offered as a form of sterilization...usually done because they are medically necessary. I do think that women should be able to receive a tubal ligation without all the hype and pressuring not to do it from the medical community. When I was an NNP student, I witnessed the OB who worked in the free clinic trying to talk one of her patients out of a tubal ligation by repeating multiple times that it was permanent, was she sure it was her decision, ect. A vasectomy is permanent as well! Reversal is risky and not always possible. This mom had health problems that put her babies at risk as well as herself. She had two healthy children and was done, plus she was in dire financial straits that were not really conducive to bringing more children into the world! She was making a reasonable decision and it was sad the way the doctor treated her.

 

[ksinger]

Just to echo Pandora - not everyone can afford to adopt. Most people can, however, afford to produce a child from their own body.

True that. This got me thinking...isn't it ironic that it's so financially easy to make a baby, yet so much harder (again, financially speaking) to afford to raise one? Another discussion for another thread, but oh well.

ksinger, I'm sorry for offending you, and I tried to make it clear that I wasn't singling you out, just making an observation about people in general, which I find interesting and thought-provoking. I do think a lot of women (not necessarily you) are very emotionally attached to their uterus, ovaries, breasts, etc, as if the body parts are what make someone a woman. I would like to point out something regarding your Wikipedia quote..."benign" in medical terms simply means "not cancer." It doesn't mean that these hysterectomies are unnecessary. Most hysterectomies are elective, but they're done to stop heavy menstrual bleeding or otherwise improve quality of life. My mom, for example, had such heavy bleeding that she became anemic with a hemoglobin of 8 (normal is over 12 for women). She actually got an endometrial ablation, not a hysterectomy, but she was much more energetic and happy after her heavy periods stopped.

I do agree that any major surgery, including hysterectomy, is not a walk in the park, and people SHOULD take it seriously. But my point is that I don't think too many are being done and for not good enough reasons. I've never, ever heard of a hysterectomy being done for birth control, for what it's worth.

I'm not offended, although clearly I feel pretty strongly on this issue - the hysterectomy in general thing (and I admit this whole this HAS dragged a bit off topic) both from a philosophical feminist stance, and from personal experience of bias at the far end of the female life-cycle, rather than its start. As usual, I'm not inclined to go into my medical history, but believe me, from personal experience I DO know that "benign" in medicalspeak, has NOTHING to do with whether or not you can live with it, only that it won't actually KILL you. I will say this though, many doctors prescribe hysterectomy for some very common, NON life-threatening, and (not surprisingly really) self-limiting aspects of being pre-menopausal. The pushing for permanent removal of organs for something that can be treated in other less invasive ways and which will END in relatively short order, is just nuts to a medical conservative (in the sense of "conserve" and "if it ain't broke don't fix it") like me. And if it seems that you only hear good things about hysterectomies, I ask you to consider the normal human inclination to talk about the good stuff, but not about the bad, embarrassing stuff - like oh .... urinary incontinence or a fistula perhaps? Those not-so-wonderful possibilities that doctors frequently downplay when talking about this surgery.

So, we are going to have to disagree about the "too many and not good enough reasons". There are literally reams of information out on the web and in print publications addressing the overprescribing of hysterectomies AND caesarians. It's an oft-addressed and acknowledged issue even within the medical community itself, so I'm not sure how you can say it isn't happening. If this whole thread has been complaints about medicine's double standard towards women's reproduction, then I don't see why it should be such a hard thing to see that that double standard would manifest in our still-male-dominated medical profession as also performing unneeded procedures more often on women. The numbers bear this out, and as I've said, women have bought into it, and even some who haven't, get pressured (like I did) by the doctor, who is BTW, a top gynecologic oncologist specializing in female surgeries of all stripes. I respect his skills immensely and can't help but like the man as a person, but I am also am increasingly aware of this his bias. And I have a really hard time thinking that he is unique in that bias.

Just a few quickie links for you perusing pleasure...

http://www.susunweed.com/herbal_ezine/December04/menopausal.htm

http://www.ivanhoe.com/channels/p_channelstory.cfm?storyid=12036

This 3rd link is particularly interesting...
http://digitalcommons.law.ggu.edu/cgi/viewcontent.cgi?article=1307&context=ggulrev&sei-redir=1#search=%22unnecessary%20hysterectomy%22

 

[ksinger]

Excerpted from the 3rd link above, and addressing the use of hysterectomy for birth control purposes - for those who said they've personally never heard of such a thing. I realize this document is a bit old, but it hasn't changed all that much since when it was published. And there are loads of more current books out there on this topic too.

Consider my harping on this a heads-up and public service announcement to those women who aren't to my stage of life yet. Get ready for the push to rip out the plumbing ladies, because many of you WILL be pressured.


"Gynecologists are also using hysterectomy as a form of sterilization instead of the simpler and safer tubal ligation procedure." 46

46. Hysterectomy is significantly more hazardous than tubal sterilization, yet physicians are still performing hysterectomies for the sole purpose of contraception. Hibbard,
Sexual Sterilization by Elective Hysterectomy, 112 AM. J. OBSTETRICS & GYNECOLOGY,


Sex stereotyping pervades every aspect of our society, and the medical profession is no exception. 83
The incorporation of sexual stereotypes into medical diagnosis and treatment deleteriously affects the kind and quality of medical care women receive. 84
A physician's decision to perform a hysterectomy is often influenced by sex role stereotyping.811 Traditionally, a woman's importance was based on her ability to reproduce and raise a family. Consistent with this role, many gynecologists still measure the importance of her reproductive system in terms of her capability to bear children. After childbearing is completed, the uterus becomes non-functional and medically dispensable. s7

In addition, male physicians are more willing to intervene surgically on women's bodies than on those of their own sex.ss The casual way in which gynecologists remove female organs may be attributed to their failure to empathize with the emotional and physiological effects of such surgery.

The medical choice between surgery and alternative methods of treatment is not always clear.S9 Consequently, a physician's judgment is often influenced by personal preferences, sexual prejudice, and financial gain.


Perhaps the most egregious behavior by physicians is their failure to inform women that alternatives exist to sterilization by hysterectomy. It is estimated tha t approximately sixteen percent of all hysterectomies are performed for the purpose of sterilization.
1711
In addition, a number of physicians contend that some hysterectomies are actually performed for sterilization purposes, but that the physician has indicated otherwise on hospital records so that insurance companies will cover the operation. 176

For sterilization, tubal ligation is the recognized alternative to hysterectomy. 177
The risks of complications following a hysterectomy are much greater than those associated with tubal ligation. 178

 

[DivaDiamond007]

ksinger: None of that defines what constitutes necessary, however. One person's opinion on whether or not a hysterectomy was necessary may differ greatly from another's - as is demonstrated in this thread! As far as I personally am concerned, I am DONE having children and TIRED of bleeding so much that I can't leave my home. I no longer need my uterus for anything - so why should I be forced to keep it?

This thread has really gone on a tangent, and as I've stated at least once before, I am really more interested in the bias that is shown toward women who wish to undergo sterilzation (by any method). In my personal experience it appears that men are much more easily able to obtain a vasectomy than a woman any type of sterilization.

 

[ksinger]

ksinger: None of that defines what constitutes necessary, however. One person's opinion on whether or not a hysterectomy was necessary may differ greatly from another's - as is demonstrated in this thread! As far as I personally am concerned, I am DONE having children and TIRED of bleeding so much that I can't leave my home. I no longer need my uterus for anything - so why should I be forced to keep it?

This thread has really gone on a tangent, and as I've stated at least once before, I am really more interested in the bias that is shown toward women who wish to undergo sterilzation (by any method). In my personal experience it appears that men are much more easily able to obtain a vasectomy than a woman any type of sterilization.

If "necessary" means mere opinion of the moment, the word pretty much loses any real empirical meaning. Something is truly wrong in the US, that we do more surgical procedures on women's reproductive organs than any other place on earth. I'm sure our organs and diseases are not really that different from those of women in say, Europe, but we surely don't receive the same care.

But since you want discussion of why women are treated differently, since you're interested in the reasons why young women get pushback on sterilization, in that third link of mine, the bias against women in the medical profession was addressed. It's still alive and kicking. IMO, and pretty much the view of those authors, the same societal sex bias that pushes older women towards hysterectomies (you're done/organs disposable), is the same that denies younger women elective sterilization (valuable potential breeder/young woman seen as childlike). It isn't rational but there it is. Bias is bias. So, I suppose discussion is unnecessary - it's pretty timeworn and simple. Of course, pushback on a hysterectomy as birth control in a young woman, could also be the doctor actually being conservative in his/her approach too, but I suspect more of the former.

I truly wish you the best with your surgery. I hope your doctor has sat you down and made sure that you understand ALL the possible ramifications and risks involved because they are somewhat different for young women than older ones. Doctors are notorious for not doing that, and for downplaying risks or throwing a consent form at you and acting like that's all that need be done, and when it's something we want, we are good at not looking at those risks clearly too. The fact that you are comparing the potential long-term side-effects of a hysterectomy - even a partial one - to the removal of an appendix tells me that it is very possible you have not had this talk or would just rather not think about the possible side effects, which can be debilitating and life-long, or require additional surgeries, if you're one of the unlucky ones.

I suggest this link. Read it or not. But I bet there's stuff on there your doctor didn't mention.
http://drvee.wordpress.com/2009/09/04/the-h-word/

You may not believe this, but I understand your mindset right now, the desperation. When you're in the middle of it, you just want it to STOP. But I'm pretty stubborn on not being cut without really REALLY good cause, and have a very defined sense of bodily integrity and believe that body parts are not disposable except under the most extreme circumstances. No one is going to cut on me to that level without trying a few other things first, or without a pretty pressing reason, like cancer, which I have had (it was not female related BTW).

Dealing with doctor pressure on this issue is not the first time I've dealt with the medical profession's penchant for trying to hustle people into unnecessary cutting. The first time I was just about your age in fact. I put my foot down, and in the final analysis, I was right: I didn't need surgery, I needed a better diagnostician, which I found. Saved me the knife that doctors are often too quick to resort to.

Again, good luck!