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Well, it's been a busy week and an extremely productive one in terms of

uterine fibroids awareness in this nation. Last Friday (June 1) I

headed to Washington, D.C. to attend a conference on Gender Based

Medicine hosted by the Society for Women's Health Research.

http://www.womens-health.org/

It was a good conference -- and more productive than I originally

imagined it would be. First of all, it was very nice to finally meet

Heleen LeRoux from Rochester and learn a bit more about the battle for

funding mifepristone research that just seems to never end. (Heleen --

you'll be happy to know that I pushed hard on the funding issue for

mifepristone research and informed many a legislative aide that this

drug is much more than an abortion pill.) It was also nice to have the

opportunity to meet additional women from this list group along with

even more physicians who are interested in fibroid and hysterectomy

alternatives research.

Marcy Gross, Senior Advisor on Women's Health for the Agency for

Healthcare Research and Quality (AHRQ), was a delight to meet and also

very helpful with dispensing advise on how to propose more fibroid

research funding through their agency. She also indicated that the

full, evidence based report on the " Management of Uterine Fibroids "

should be available soon. The summary is still available here:

http://www.ahrq.gov/clinic/utersumm.htm

She was also kind enough to fortify me with plenty of copies of the

summary to distribute to Congressional Representatives (and/or their

legislative aides) that were on my meeting schedule for later in the

week.

Conference presentations spanned the gamut of women's health issues,

including cardiovascular disease (the #1 killer of women in this

nation), diabetes, calcium deficiency vs. PMS (and how both of these

seem to have identical symptoms and both seem to respond to calcium

supplementation), HRT (with a most interesting diatribe against

long-term HRT use as well as HRT use that is prophylactic and not

specifically addressing menopausal symptoms), alternative health care --

including a quick and dirty on all the typical herbal remedies that

women use to treat abnormal bleeding as well as menopausal symptoms,

embolization for fibroids (with Dr. , an interventional

radiologist from Florida, giving the presentation), obesity, and female

sexual dysfunction (a rather questionable attempt to pitch a book by a

young man from Hawaii).

The most interesting point that caught my attention had to do with

cardiovascular disease. A Cedars-Sinai cardiologist from California,

Dr. Bairey Merz, showed an overhead map of the U.S. with states ranked

by prevalence of disease. It caught my eye because the very states that

were identified as having the highest statistics for heart disease in

women, looked remarkably similar to the map I've seen of the prevalence

of hysterectomy in this nation. Is there a relationship? Well, it

definitely made me wonder whether or not the stats would be a close

mirror all the way through with all the states.... anyone know if this

has been looked at like this before?

Dr. Bairey Merz is currently involved in a multi-million dollar study

that's looking at developing better techniques for diagnosing heart

disease in women -- a study that's been examining the protective value

of phytoestrogens. Of all the presentations, this one was the most

informative and compelling. Ironically, although cardiovascular disease

is the #1 killer of women in the U.S., it ranked rather low on funding

in at least one funding table presented by the CDC. The #1 funded

disease? Breast cancer. Over and over again. Breast cancer. Strong

patient advocacy apparently pays off. Maybe if heart disease wasn't

killing so many women there'd be more left alive to advocate for

funding.....

http://www.newswise.com/articles/2000/1/BEANS.CED.html

Beyond cardiovascular disease, the presentation on obesity made me feel

fat, the dinner discussion of diabetes made me reject my dessert, the

calcium research that was presented made me wonder about my vegan

daughter's own PMS and the vitamin deficiencies it probably represents

along with the myriad of painful symptoms she suffers through monthly,

and the female sexual dysfunction talk made me realize that I know way

too much about female sexual dysfunction because I was sorely

dissatisfied with the glib presentation that said little to nothing that

was informative on female sexual function/dysfunction and even contained

woefully incorrect statistical references to published literature.

Since I'm not a physician, I also wondered whether or not physicians who

attend conferences like this transfer the presentations to their own

personal lives (as I did) or do they only gather the info for their

patient population? Hmmm. Any doctors in the house who care to comment

on this?

The last day of the conference was spent with the Women's HealthCare

Coalition learning about how to approach Congress on the issue of

funding women's health research. During the luncheon, I was extremely

fortunate to be seated with Vivian Pinn, NIH Associate Director for

Research on Women's Health and Director for the Office of Women's Health

Research.

http://www.wellesley.edu/Anniversary/pinn.html

:) Come on now. Please tell me that there isn't anyone on this list

group who would honestly believe I would pass up an opportunity like

that one to steer the discussion towards fibroids! Pinn told me she

needs letters from women AND researchers to support the research agenda

on fibroids. Intelligent letters. No threats, no demands -- just

strongly worded letters requesting more funding for research on

fibroids. She definitely has fibroids identified as a top

priority....but she needs more from us in order to keep this proposed

priority in her annual report. She specifically suggested that women

with fibroids, along with their physicians, open their mouths and come

out of the closet on this issue. Get out your pencils and paper.....

Vivian W. Pinn, M.D.

NIH, Office of Research on Women's Health

EPS Location

6120 Executive Blvd., Room 150A

Rockville, MD 20852-4909

Beyond the conference, I spent an additional 3 days walking the Capitol

and talking to every California Congressional Representative's

legislative aide or leaving materials with office staff that pointed to

the need for their support of HR 1672 Uterine Fibroids Research

Education Act 2001. In all, California has 52 Congressional Districts.

I don't believe I missed a one. At least, the blisters on my feet are

telling me that I didn't miss a one! In addition, I pitched the idea of

a companion bill to Senators Boxer & Feinstein and came away feeling as

though this is a very real possibility.

I was most impressed by aides who chose to share with me their own

personal stories. Now, mind you, by and large these aides are very

young men and women generally fresh out of college and/or interning a

year in Washington, D.C. while working on a political science, law, or

international affairs degree. Young = under the age of 25 in most

cases. (A few were older -- but they were the rarity, not the norm.)

These young people may not have known much about uterine fibroids, but

they most certainly knew the ramifications of hysterectomy. Many of

them shared stories of mothers or grandmothers who had undergone

hysterectomy. One aide told me how her grandmother died during

hysterectomy surgery, another told me of her own mother's hysterectomy

and how it " changed " her forever, and yet another talked about how

hush-hush the discussion of hysterectomy was in her own family growing

up. She never knew why her mother had a hysterectomy and was curious to

learn more about why women end up with this surgical outcome. All

seemed perplexed over the need for this surgery and all were extremely

interested in learning more about uterine fibroids and how they,

personally, might be able to impact change for future generations of

women in this regard.

This isn't the first time that I've felt that young men and women of

college age are our greatest allies in pushing forward the research

agenda on uterine fibroids and alternatives to hysterectomy treatment --

but it was the most overwhelming emotionally. They were receptive.

Indeed, several left messages on the NUFF phone line within 24 hours of

my visit proclaiming support and cosponsorship for this bill from their

Congressional Representative. For those who didn't do this, it was

clear to me that they need to learn more than what I could impart in a

5-30 minute visit before they could truly understand the importance of

this bill.

Coordinators for the Women's Political Caucus have suggested the next

step to possibly be an educational briefing. So, that's the next item

on the agenda to work towards. There is support out there ladies. Lots

of it. But in order for our voices to be heard, we must be willing to

speak up loud and clear. If you live in the Washington, D.C. area,

please drop me a line so I can share with you ways in which you can

continue to carry this message to Congress and the NIH. Also,

California is only 1 state. If you live in another region of the U.S.

and haven't written to your Congressional Representative yet, I urge you

to do so today. You can learn more about this bill at:

http://thomas.loc.gov/cgi-bin/bdquery/z?d107:h.r.01672:

If you don't see your representative's name on the list of cosponsors

for this bill, please search for their web information and write them a

letter. You can find their mailing (email & snail mail) information

here:

http://capwiz.com/fmf1/dbq/officials/

We need everyone's help on this one. There are still quite a few states

where not a single representative has signed onto this bill yet. Also,

quite a number of medical groups have sent in letters of endorsements

and some of them are even sending members to D.C. next week to visit

their representatives. It will take a lot of work to get this bill the

attention it truly deserves. Won't you please help?

------------------------------------------------------------------------

Margaret Mead said it best -- " " Never doubt that a small group of

thoughtful committed citizens can change the

world. Indeed it's the only thing that ever has. " -- and those of you

who receive my email regularly know this phrase by heart by now. I

announced last week the change in Blue Cross coverage for uterine artery

embolization for fibroids in Oregon and now Oregonian columnist Margie

Boule has written an update on that change in policy in conjunction with

an update on the story she wrote about Patty Nomie's pursuit of UAE in

Oregon.

Personally, I don't believe that Blue Cross would have changed its

policy if it were not for media involvement. There were indeed other

women before Patty Nomie (and some since Patty) who set out to appeal

their denials with Blue Cross of Oregon, all to no avail. Many before

Patty (and many still in Patty's prior denial boat) did everything she

did -- and then some -- and still received denial letters. Here's a

prime case (and most typical) of denials and communication between a

patient and Blue Cross:

http://www.proberts.net/uae

This was a well organized, incredibly intelligent battle fought by

and her spouse, , in pursuit of coverage for UAE for

's fibroids. It bought her nothing but denial after denial.

Including a final denial on May 18 -- less than 2 weeks before Blue

Cross of Oregon changed its policy entirely. Bottom line? Without a

media avenue to broadcast this story and let women know they are not in

isolation when it comes to their thoughts on keeping their uterus and

desires on avoiding major surgery, no woman will make headway with

corporate giants like Blue Cross. So, my sincere thanks goes out to

Margie for paying attention last fall when I went knocking on her

journalism door and even more thanks for taking on Patty's case and

reporting on her battle. Not only have you helped the women with BC of

Oregon and other affiliated state plans, but you've also helped those in

states who are still fighting this battle, like Blue Cross of California

subscribers. With so many plans now covering UAE, how can plans like BC

of California continue to hold out? I don't think they can. So, thank

you Margie. And thank you to Patty Nomie too -- a wonderful and

deserving woman who readily stepped up to the plate to make her story

public. And while I'm at it -- thank you to ALL of the members of the

media who have reported on fibroids and our limited treatment options.

There's change in the wind. I just know it.

I do believe our " ...small group of thoughtful committed citizens... "

has grown in size. :) What do you think?

Battle gives woman a measure of her own strength

Margie Boule, Oregonian

Sunday, June 10, 2001

The next time you hear a cynic say one person can't make a difference,

tell the cynic about Patty Nomie.

Read the rest here:

http://www.oregonlive.com/news/oregonian/margie_boule/index.ssf?/news/oregonian/\

margie_boule/lv_11boule10.frame

------------------------------------------------------------------------

Mind-Body Research Matures

Mounting evidence prompts NIH to embrace a once-marginal field

By Steve Bunk

The Scientist 15[12]:8, Jun. 11, 2001

For years, mind-body research has been conducted at the perimeters of

the scientific mainstream, but that marginalization appears to have

ended, as the National Institutes of Health funnels money and personnel

into interdisciplinary investigations of the relationship between mental

states and physical health. Oddly, the way mind-body medicine has

achieved this acceptance is by establishing the very molecular and

cellular evidence of the role that the mind plays in bodily health that

it once eschewed.

Read the rest here:

http://www.the-scientist.com/yr2001/jun/bunk_p8_010611.html

------------------------------------------------------------------------

Discovery Health

PULSE Episode 1213

Jun 13 2001 7:30 AM EST (4:30 PST)

Jun 13 2001 10:30 AM EST (7:30 PST)

Jun 17 2001 5:00 AM EST (2:00 PST)

Jun 17 2001 7:00 AM EST (4:00 PST)

This episode of PULSE TV includes a segment on uterine artery

embolization at UC and a member of the uterinefibroids list group

who, as it turns out, was the " turning point case " (much like Patty

Nomie was for BC of Oregon) for Blue Shield of California to begin

approving embolization coverage last summer.

I wonder. Just how much harder do we have to knock on Blue Cross of

California's door to get their technical assessment committee to get off

its duff and listen to women in this state?

------------------------------------------------------------------------

Well, this isn't one of my favorites in the world of health videos but I

do know there are always new women joining this list group with an

interest in hysterectomy surgery.....

Discovery Health

Laparoscopically-Assisted Vaginal Hysterectomy

Jun 15 2001 2:00 AM

Jun 15 2001 7:00 PM

Darlene Lanka, MD of Walnut Creek, California, performs a

laparoscopically assisted hysterectomy. The surgery involves removing

the uterus, fallopian tubes, and ovaries through the vagina.

------------------------------------------------------------------------

I missed this story back in April....a hysterectomy interfering with

fertility can be traumatic, that's for certain. Would it drive you to

take/keep someone else's child?

Detectives tell of girl's odyssey

St. sburg Times; St. sburg, Fla.; Apr 23, 2001; JOY

DAVIS-PLATT;SAUNDRA AMRHEIN

In a red file folder, Lazalia Urick carried immunization records, birth

certificates, police reports and an ink

impression of a baby's footprints.

For seven years, she thought that was all she would ever have of her

abducted daughter, Crystal.

Last week, though, a fresh sign of the girl emerged: a recent photo seen

at a Hernando County home.

On Sunday, two Hernando detectives told how that tip helped them make a

case in four days that others hadn't

been able to make in seven years. They tracked Crystal's odyssey from

Hernando County to Mexico to North

Carolina, and they arrested the woman they say took the girl as an

infant.

Read the rest here:

http://pqasb.pqarchiver.com/sptimes/main/doc/000000072728871.html?MAC=ba37208439\

f1a656518455dc966a683f & QIID=000000072728871 & FMT=FT

------------------------------------------------------------------------

Would you undergo a hysterectomy to decrease your chances of breast

cancer? A researcher in this story did....wonder how she now feels

about reports of prolonged hormone replacement therapy use increasing

risk of breast cancer?

Gene Discovery: Brave New World

Research is likely to quicken cures; world wonders where to draw the

line

By A. Webster / The Detroit News

2/13/01

With extensive details of the human genetic code now published, a global

scientific adventure is under way that could cure diseases, launch new

areas of research and create new biotech businesses and products while

raising complex ethical questions for society.

Read the rest here:

http://detnews.com/2001/health/0102/13/a01-187455.htm

------------------------------------------------------------------------

I haven't had much time to scan the medical journals this week -- but

hope to get back to that task in the coming week. Best wishes to all of

you this week and always.

Visiting D.C. always takes my breath away and visiting the many

memorials is a humbling experience that I never pass up when in town.

One of my favorites is the Lincoln Memorial. I brought a poster home

this time -- " Abraham Lincoln's Rules of Conduct. " Here are a few of

his rules to help you breathe this week....

" The fact is, truth is your truest friend, no matter what the

circumstances are. "

" By all means don't say 'if I can,' say 'I will.' "

" I say 'try.' If we never try, we shall never succeed. "

Excellent words of advice that have withstood time. The bottom line is

always relatively simple. If we don't start SOMEWHERE on this path

towards change, then our daughters will be precisely where we have been

-- waiting for the next surgery date on some doctor's hysterectomy

calendar....

Carla Dionne

Executive Director

National Uterine Fibroids Foundation

1 (877) 553-NUFF

mailto:carla@...

http://www.NUFF.org

/list/uterinefibroids

" Never doubt that a small group of thoughtful committed citizens can

change the world. Indeed it's the only thing that ever has. " Margaret

Mead

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Guest guest

Hi Carla,

I don't know of any other women in Mpls. who are appealing. I will

check with my IR and ask him...I have been denied twice by Allina-

Medica and now have the choice of going for a next level of appeal or

an external independent review. I want to go for the external review

cause my IR told me he spoke with someone from medica and medica

isn,t even considering uae appeals that come their way and that my

best hope is for the external review.

>

> > How can a person best get the media involved, how do I decide

> > whom to approach and how to get their attention?

> > Thanks,

>

> Do you have a popular columnist in Minneapolis that everyone reads?

> Someone who writes about people and stories in the community on a

> regular basis? If so, pick up the phone and call him/her.

>

> This isn't something that happens overnight though. Most columnists

> have a lot of story ideas thrown at them every week. But, if you

don't

> call or write they'll never know your story is " out there " needing

to be

> told.

>

> Where are you in the appeals process for your UAE? Do you know of

other

> women in Minnesota who are also appealing? Any chance your IR would

> know this? Do you know of other women in your area who have been

denied

> coverage?

>

> carla

>

>

>

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  • 2 weeks later...
Guest guest

As I was reading through some of this transcript on the FDA meeting

one thing leapt out at me. Vicki Hufnagel mentions that she operated

on the patient she holds up as a case study, that she removed 50

fibroids after this woman had a UFE and she mentions that the woman

is still in the hospital. She also mentions that she is calling in

from California.

I understood that her license to practice in California had been

suspended. Has it been re-instated?

DeAnn

P.S. She mentions that she has no conflict of interest but there

seems to me to be a conflict of interest between a person who's

practice is made up almost entirely of myomectomies testifying

against a popular alternative to her surgery. Just a thought.

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Guest guest

As I was reading through some of this transcript on the FDA meeting

one thing leapt out at me. Vicki Hufnagel mentions that she operated

on the patient she holds up as a case study, that she removed 50

fibroids after this woman had a UFE and she mentions that the woman

is still in the hospital. She also mentions that she is calling in

from California.

I understood that her license to practice in California had been

suspended. Has it been re-instated?

DeAnn

P.S. She mentions that she has no conflict of interest but there

seems to me to be a conflict of interest between a person who's

practice is made up almost entirely of myomectomies testifying

against a popular alternative to her surgery. Just a thought.

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Guest guest

As I was reading through some of this transcript on the FDA meeting

one thing leapt out at me. Vicki Hufnagel mentions that she operated

on the patient she holds up as a case study, that she removed 50

fibroids after this woman had a UFE and she mentions that the woman

is still in the hospital. She also mentions that she is calling in

from California.

I understood that her license to practice in California had been

suspended. Has it been re-instated?

DeAnn

P.S. She mentions that she has no conflict of interest but there

seems to me to be a conflict of interest between a person who's

practice is made up almost entirely of myomectomies testifying

against a popular alternative to her surgery. Just a thought.

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