More Answers and Questions
by Debbie Braaten
THE REMOVAL OF ADDITIONAL ORGANS
Dr. Burke’s response to the question “can other organs be removed at the time of hysterectomy?” went straight to the point: yes. Most surgical consent forms contain language that permits other organs to be removed in order to control bleeding, complete the planned procedure, or manage an operative complication.
This is a great travesty. I have heard of so many women who believed only their uterus would be removed and woke up to discover both ovaries had been removed as well. This may be a condition of insurance as many of us who are insured are unconcerned with cost, but it is not okay to wake up and find a doctor you trusted with your life has removed organs without asking you first. Another organ often removed at the time of hysterectomy is the appendix which plays an important role in maintaining immunity. Dr. Mendelsohn, in his book Male Practice, says that the appendix may be important to the body’s resistance to all forms of disease. (p.88) I thought doctors were supposed to help us get well and do no harm.
I have understood hysterectomy refers to the removal of the uterus, and complete hysterectomy means the removal of the uterus and cervix. At different times throughout history hysterectomy has been used to indicate the removal of the uterus, cervix and/or one or both ovaries. How is it currently used?
Hysterectomy, she said, was the removal of the uterus and cervix.
I think Dr. Burke gave me two different answers: one including the cervix and one with the uterus only. She did say other terms like “partial” and “total” hysterectomy should not be used as they are medically incorrect and cause confusion.
That these terms cause confusion is pretty much the point, in my opinion. Many patients incorrectly believe complete hysterectomy is the removal of all female organs; the uterus, cervix, ovaries, etc., because that is what is implied. In other sources I’ve searched, hysterectomy is the removal of the uterus while ‘complete’ refers to the removal of the uterus and cervix. However, the vagueness of hysterectomy terms has continued to cause confusion for over a century. If a woman wants to know the organs removed, she can get a copy of her Operative Report from the hospital where her surgery was performed. Other medical terminologies for additional procedures are Hysterectomy with Bilateral salpingo-oophorectomy indicating the removal of the uterus, both fallopian tubes and both ovaries, etc.
When I asked Dr. Burke if the state of Maryland has a consent form, she was clear: no, the state of Maryland does not require a specific consent form for hysterectomy. When I asked a second time, she told me surgical consent consists of a discussion or dialogue about what needs to be done.
That surgical consent consists only of the procedure itself when surgical outcomes are life-changing is outrageous. Eliminating discussions of the unique contribution to health and well-being that only the sex hormones provide is ludicrous. Would this be done to men? Of course not. Men’s organs are protected because of their importance to pleasure alone. The equivalent testicles in men are ovaries in women (quoted from Elizabeth Plourde, Ph.D.). The functions of these endocrine organs are many.
It is common for those who have undergone surgery to develop adhesions, but this is rarely discussed. Having more than one surgery can make them worse. Pelvic adhesions are the post-surgical source of pain for many patients. Adhesions between structures that allow movement are responsible for higher levels of pain.12
I had undergone previous surgery to remove my gallbladder, and the only post-surgery difference was that I no longer had that organ and had to alter my diet. Gallbladder removal did not change my personality, but hysterectomy and ovary removal did. I cried every single day for nine years afterward, and though I do not cry every day now, after 25 years, the grief remains, and I still cry. The loss is incalculable.
A description of what is to be does not do enough to justify surgical consent, especially when outcomes are all-encompassing. Consent of hysterectomy and ovary removal would be more accurate if it included not only the physical, but the mental and emotional loss as well. The best description for the emotional and spiritual loss I have found is in a compilation of reflections published in the book, Misdiagnosis: Woman As a Disease, Karen M. Hicks, Ph.D., Editor written by Genevieve Caramanati, “Woman to Woman: What Women Don’t-and-Do Tell Each Other About Hysterectomy.”13 She tells of a woman who was describing her surgery outcome during a hysterectomy conference, “…I have to live my life – THE REST OF MY ENTIRE LIFE – in a state of pain and regret, in a state of being only half alive, in a state of never being able to wake up from this nightmare!” Her outcome is shared by hundreds of thousands.
After having been performed for over 100 years, it is time women were educated about medically documented outcomes. In his book, Male Practice, Robert S. Mendelsohn, MD informed us that an increase in gynecological surgeons, coupled with a declining birth rate means more surgeons are graduating from medical school with fewer patients to treat and therefore will attempt to extract more income out of the patients they already have. The aforementioned, coupled with fee for service health plans, can only amount to more unnecessary gynecological surgeries. In a 1975 New York Times interview, a Baltimore specialist admitted, “Some of us aren’t making a living, so out comes a uterus or two each month to pay the rent.”14 This, clearly, is not health care.
The history of hysterectomy is steeped in derogatory attitudes toward women. In G. J. Barker-Benfield’s book, The Horrors of a Half-Known Life, a woman was expected “… to be dependent, submissive, unquenchably supportive, smiling, imparting an irrelevant morality, regarding sex as something to be endured…” When women attempted to gain new freedoms as when women entered the workforce during the Industrial Revolution or during women’s rights movements, physicians exploited their power to retaliate against and control women who were challenging male dominance by performing clitoridectomies and ovariectomies.15 Clitoridectomy was performed in America from the late 1860’s until1904 and possibly until 1925 as a means of controlling women’s mental disorders.16 As late as 1971, the uterus was declared as “… a useless, bleeding, symptom-producing, potential cancer-bearing organ” by a member of the ACOG.
In conclusion, women who lose their uterus and ovaries suffer permanent consequences which encompass every aspect of life from the physical to the spiritual. It affects energy levels and reduces one’s ability to engage with the world around them. How women are expected to continue on with their lives as if nothing had happened and without hormones their bodies may need just doesn’t make medical sense. Without the hormones produced by these organs or their bio-equivalent, one’s ability to function is greatly reduced. Added to this are the medical and dental bills which accumulate exponentially. Furthermore, the answers women seek are not answered by the great majority of medical practitioners. Why isn’t this taught in medical school?
Hormone cycles that affect women’s health continue to be ignored. In her book, Screaming to Be Heard, Elizabeth Lee Vliet, MD, explains how women’s health needs continues to fall through the cracks as the endocrinologist has “not focused on the ovary, since this organ this endocrine organ is the ‘turf’ of the gynecologist” while the gynecologist is focused on reproduction and surgery.17 While some changes may have incurred, it is not enough to make up for the 100 years of deceit that has been taking place.
Women deserve to have the facts about their bodies. They also deserve to know that more women in their 20’s and 30’s undergo hysterectomy than women in their 50’s and 60’s.18 Not only that, but there is less chance of dying from uterine cancer than a hysterectomy. Women also deserve to know there is no exact substitute for hormones produced by their own bodies as their bodies produce more when more is needed and less at other times. This constant signaling between organs to ensure health is lost after oophorectomy. Hormones that must come from outside of the body have their own timing, meaning there is an introduction, a peak and a decline, at which time they must be re-introduced to the body and, because of this, women may have to be under the care of a medical doctor for the rest of their lives.
Would it be okay with women if they experienced the post-surgical effects of exaggerated “menopausal” symptoms that never quite go away, incurable depression, an inability to feel their feelings, strife and conflict in relationships that are in direct correlation to the surgery’s outcome and a feeling of never quite belonging in a world they once did? It is demoralizing being in the presence of women who are much like we used to be, knowing we may never be able to achieve that type of energy again. A few years after surgery, I went to see an acupuncturist who, during that time, was able to use acupuncture needles as they had just been approved in the United States. That acupuncturist chose me as one of his patients to bring to Tai Sophia Institute of Maryland, now Maryland University of Integrative Health to meet with his former professor. During discussions, this professor determined that my element was fire. Prior to surgery, fire wasn’t just my element, I was fire, and it was my hormones that made this possible. That fire was responsible for everything human; my feelings, desires, aspirations, my presence, and more. After surgery the fire was gone.
In the mid-1980’s, I attended a workshop conducted by Rosalyn Bruyere, “Healing the Wounded Heart” which addressed the fourth chakra and transformation. From her workshop and book, I learned that the physical must come first (before the spiritual). In Wheels she says, “The process of life, … begins with the physical body.” This directly coincides with the effects that resulted from surgery, in that the ovaries must come first. They are the initiators of all that is human. The energy created by them is tremendous and is a requirement for living life. No amount of thinking or believing can re-create the energy of the ovaries. These organs and their hormones must come first.
When she addresses the first chakra or kundalini in her book, Wheels of Light: Chakras, Auras, and the Healing Energy of the Body, she claims the first chakra is life force itself. The red quality associated with this chakra, “– the essence of fire – sets all of the power in one’s life. The red quality of our blood, our sexuality, the quality of our drive, the quality of our financial substance or prosperity all reside in the first chakra.” (p. 161) She also tells us that many functions and energy rhythms of the body are controlled by hormones. (p.47)
There are other sources that allude to the powerful nature of hormones. Napoleon Hill, author of Think and Grow Rich, concludes that those who are the greatest achievers had the highest sex drives.19 He speaks of the “emotion of sex” as a powerful force that one must transform through sex transmutation in order to create power for action. He explains, “Destroy the sex glands, whether in man or beast, and you have removed the major source of action… Sex alteration takes out of the male… all the FIGHT that was in him. Sex alteration of the female has the same effect.”
It was important for me to add something about J. Marion Sims, who has been heralded the father of gynecology. Between 1845 and 1849, he performed experimental surgeries on female slaves. One of them was Anarcha Westcott who developed a dangerous condition as a result of instrument damage inflicted on her while Sims delivered her baby. He operated on her 30 times without anesthesia. Dr. Mendelsohn believed the only reason she didn’t run away was because she was heavily sedated with opium. Mendelsohn claims Sims to be the appropriate father of gynecology, because of “… his obsession with surgery and his lack of compassion for women who endured the incredible torture he inflicted on them…” as this is “…still reflected in the behavior of many who practice this specialty today.”20 His statue was removed from a New York City Park on April 17, 2018.
Although I am not a practitioner in the medical field, I have armed myself with 20 years of information gleaned from medical professionals and other medically-inclined publications. I have also attended workshops and conferences dedicated to hysterectomy, ovary removal and hormone replacement. I have met with local and state representatives with organizations such as the International Academy of Compounding Pharmacists as a patient of compounded medicine, which is now the Alliance for Pharmacy Compounding, as a member of Voice for Hope and Maryland Wise Women. During my time as a member of Maryland Wise Women, I submitted a letter to the Maryland Representatives of ACOG, American College of Obstetrics and Gynecology regarding my views of hysterectomy reform.
Hysterectomies and oophorectomies have a long history of being performed on different populations in America as a means of social engineering and has included people in institutions, Native Americans, and slaves. It is a disgusting practice as there is often no understanding of the surgery’s destructive after-effects. It is even more vile as it reflects a rejection of humanity, as if the traits of populations deem them unimportant and that their existence doesn’t matter.
The hormones my body needs must now come from outside of me in the form of hormone replacement. During the past few years, the Covid-19 epidemic has made a difficult situation even worse. Access to these hormones has been limited by the FDA (not a safety measure) and finding a knowledgeable physician continues to be near impossible. Because this hormone replacement, the hormone replacement I need and is healthy for me is not covered by insurance, I must be out-of-pocket and has been leading me into financial ruin. Access to these hormones should not be based on who can pay, but on those who need it. The organs removed from my body 25 years ago were healthy, and their removal did not solve the pelvic pain I sought medical help for. What a sacrifice!
ENDNOTES FOR PART IV
13 Carminati, Genevieve. “Woman to Woman: What Women Don’t—and—Do Tell Each Other About Hysterectomy”. Misdiagnosis: Woman As a Disease. Karen M. Hicks, PhD, Editor, 1994, pp. 161-168.
14 Male Practice, Robert S. Mendelsohn, MD, pp. 104-5.
15 Male Practice, Robert S. Mendelsohn, MD, p. 33.
16 The Horrors of the Half-Known Life, G. J. Barker, p. 120.
17 Screaming to Be Heard, Elizabeth Lee Vliet, MD, p. 354.
18 HERS, Hysterectomy and Education Resource Services, Facts, Nora Coffey, Founder.
19 Think and Grow Rich, Napoleon Hill, p. 161.
20 Male Practice, Robert S. Mendelsohn, MD, p. 34.
(This is the fourth part of a series by Debbie Braaten sharing her experience with the challenges navigating the emotional and medical labyrinth which followed her 1996 hysterectomy and the revelations that followed. Parts One, Two, and Three can be visited through these links.)