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Vesalius' contemplation of genius
Today at work we had a thirty-year-old woman on birth control pills who formed a blood clot in her leg which passed up into her lung. She called 911 herself, saying she was weak and couldn't breathe. Her heart arrested after that and must've fallen, because her chin was lacerated. She was already dead when she arrived but was resuscitated in the ER and put in intensive care. After a while she had to be resuscitated again, and it was decided to keep her alive for organ donation. The clot in her lung had passed up into her brain, and along the way had fragmented. When the clot fragmented, it released enough clotting factors to cause a chain reaction of clotting throughout her circulatory system. Because this used up her clotting factors so quickly, she also began to hemorrhage everywhere. This is known as DIC, disseminated intravascular coagulopathy. She was scheduled to go to the operating room this evening, where she will be taken off of her ventilator and her organs will be removed for transplantation. She is probably already dead or will be dead soon.

She was just married last week. She just passed her bar exam. She was in perfect health.

I saw her husband, a young neurologist, laying his head on her shoulder. She was just laying there with a ventilation tube in her bleeding mouth. I'm not one to get worked up about things, and I'm pretty unaffected by most things I see, whether in the hospital or anywhere else, but...I don't know. This is pretty saddening to write about. I don't know whether I'd consider her really alive or whether we're just oxygenating the blood of a nearly dead body to keep its organs viable; but I think I, too, would take the chance to feel my wife's warm body until she leaves me.

I spoke at length with the vascular technician who worked with her, performing the tests that diagnosed her condition. She said she was so shocked by the whole situation. When she tested her the woman was literally laying in blood. The first thing she credited it to was birth control pills. She said she doesn't know what they're doing to them now, but you never used to hear of this. We also talked about the 19-year-old we had recently who threw a clot after being on the pill for three months. At least she got to go home with the admonition to avoid the pill.

I came home and told my wife I'm glad she doesn't use them. My wife and I are not that far from thirty.

Comments

( 19 comments — Leave a comment )
[info]kenosis wrote:
Oct. 5th, 2007 01:44 am (UTC)
My condolences to her family and friends. I went through DIC myself; it's pretty nasty stuff.
[info]ithryn wrote:
Oct. 5th, 2007 09:32 pm (UTC)
I've always meant to ask what exactly it was that you went through.
[info]kenosis wrote:
Oct. 6th, 2007 03:55 am (UTC)
It boils down to septic shock caused by my colon rupturing, which was caused by toxic megacolon, which was caused by Crohn's Disease, which was caused by ... ??? There were a few other complications too but there were a few big ones: DIC and thrombocytopenia are the ones that come to mind. I wrote about it years ago - I'd like to think I could do a better job of writing it all down if I revisited it now. But I don't remember as much anymore.

[info]yechezkiel wrote:
Oct. 5th, 2007 01:52 am (UTC)
[info]xallanthia & I recently made our final decision for her not to use birth control pills, which she has never done in the past, either. (We were pretty sure this was the decision we wanted to make, but we talked a lot about the options.)
[info]jojosmom wrote:
Oct. 5th, 2007 02:14 am (UTC)
That is heartbreaking. I've never used the pill and never plan to. Natural Family Planning is so much safer and has no side effects. (Feel that I must include this disclaimer, yes, I'm pregnant, NO, it was not a method failure!)
[info]aranel wrote:
Oct. 5th, 2007 02:37 am (UTC)
How awful. I can't imagine what her husband must be going through. Going back to an empty house or apartment, probably still full of unopened wedding presents, the pictures yet to come back from the photographer... it doesn't bear thinking about.

The first thing she credited it to was birth control pills. She said she doesn't know what they're doing to them now, but you never used to hear of this.

This site, sponsored by Public Citizen, the consumer watchdog group founded by Ralph Nader, claims that some of the "third-generation" (how weird etymologically, to think of contraceptives having "generations") pills are twice as likely to cause clotting as the older, "second-generation" ones.

And here it gets into the reasons behind the switch from the older, apparently safer formula:

Combination oral contraceptives contain both estrogen and progestins. Second and third generation oral contraceptives (OCs) differ in their progestin component. Third generation OCs contain desogestrel (available in the US), or gestodene (not available in the US), while second generation OCs contain norgestrel, levonorgestrel, norgestimate[*] , or norethindrone. Third generation oral contraceptives were developed in the 1980s with a goal of producing an oral contraceptive that had less androgenic adverse effects such as hirsutism and acne typically associated with the first and second generation oral contraceptives.

And then there's this:

The increased risk of death from a pulmonary embolus for women who took levonorgestrel OCs was 5.1 to 1(compared to non pill-users), but the risk of death from a pulmonary embolus for women who took desogestrel or gestodene containing OCs was 14.9 to 1.

So, if the study's right, we're talking about the third-gen pills essentially tripling your risk of this mode of death compared to the earlier version, and multiplying it by fifteen as compared to someone not on the Pill.
[info]annabellissima wrote:
Oct. 6th, 2007 08:01 pm (UTC)
Yes, I read where they said that the 3rd generation pills cause about 25 cases out of 100,000 of blood clots.

The scary thing was that the site was pro-pill, and was using this statistic to bolster the fact that the current pill "only" causes about 10 in 100,000 cases of DIC.
[info]makimonster wrote:
Oct. 5th, 2007 07:14 am (UTC)
Thank you so much for sharing this story. I really feel for this woman's loved ones, this is so tragic. Is it okay if I share this with some of my classmates at nursing school? I feel that this is something important to know.
[info]ithryn wrote:
Oct. 5th, 2007 09:27 pm (UTC)
Feel free. You can tell them about the younger girl with the PE, too.
[info]sbroadway wrote:
Oct. 5th, 2007 10:22 am (UTC)
This sounds awful...

I've actually got two other stories about pharmaceutical-induced trauma from the past week.

Last week, a guy at our workplace had a stroke in the office and was taken away by EMS. He was revived and is now recovering at home. Apparently in the weeks prior to this, he was on a medication that made him "feel drunk". In the week before the stroke he had been taken off the medication; I'm guessing the withdrawal must have had something to do with it.

And Monday, a child in the 1st grade class of one of my wife's coworkers decided to hang himself. That's right...the child's mother and brother walked in on a seven-year-old preparing to hang himself. ADHD medication is such an innocuous thing to call it.
[info]annabellissima wrote:
Oct. 6th, 2007 03:46 am (UTC)
And Monday, a child in the 1st grade class of one of my wife's coworkers decided to hang himself.

WT---?!

MESSED UP.

*sighs*

I dun wanna raise my kids in this scary world =/
[info]schneckerock wrote:
Oct. 6th, 2007 01:38 pm (UTC)
ugh. ADHD crap. I have an idea.. let's drug our children for... acting like children! or maybe to make up for where we lacked in parenting. first time the schools told my aunt to put my cousin on ritalin, she took him to the ped (same guy I went to as a kid) and he told her "needs more discipline."
[info]annabellissima wrote:
Oct. 6th, 2007 03:50 am (UTC)
Oh my goodness... that is so sad :(

I always talk to Sean about how birth control pills should be a social justice issue for women.

You hear about all these drugs that are taken off of the market because of the *possible* side effects, such as stroke, etc. Like that drug for elderly people that was pulled not too many months back. It seems that when it comes to just about any other medication or drug, the standards are so much higher - or at least when the drug starts killing people or giving them cancer, there is a class action suit and/or the drug is discontinued.

And yet, for some reason, we women are allowed a drug that can basically give us cancer and kill us - and yet it's allowed on the market. The pill, Plan B, these stupid new pills that only give us four periods a year... I swear... how is this NOT a social justice issue?
[info]annabellissima wrote:
Oct. 6th, 2007 03:57 am (UTC)
I was at the UPenn ob/gyn the other week and Sean and I were sickened by all the ABC paraphernalia and propaganda up on the walls. An exhaustive poster about every kind of birth control invented (except of course NFP and/or abstinence) and even a big happy poster about PLAN B. Yeah. Plan B. Made me wanna never go back again. But I have no choice until insurance woes work themselves out.
[info]mercyorbemoaned wrote:
Oct. 6th, 2007 03:33 pm (UTC)
There are class action suits against the manufacturers of Yasmin.
[info]annabellissima wrote:
Oct. 6th, 2007 07:55 pm (UTC)
So I Googled it, and it turns out that Yasmin is getting sued because of side effects that include panic attacks, anxiety, moodswings, nausea, etc.

While these are by no means AT ALL inconsequential things, they don't quite correlate to the well-known risks of the pill for blood clots, increased risk of stroke, and possible increase in breast cancer, etc. Not to mention the deaths that have occurred after some people have used Plan B, etc.

So why does the majority of the contracepting female population seem to think these side effects are acceptable, but anxiety and panic attacks aren't? Could the desperate need for sex, free from fear of pregnancy, really be so important that women would risk their lives? LAME.
[info]mercyorbemoaned wrote:
Oct. 6th, 2007 11:02 pm (UTC)
WHOA
[info]aranel wrote:
Oct. 7th, 2007 02:56 am (UTC)
Doctors and drug companies often aren't exactly up-front with women about the side effects, though, and most people just aren't up to the task of assessing those risk factors on their own.

I don't think the mood side effects are negligible, either. I'm constantly hearing anecdotal accounts of women who feel entirely unlike themselves, can't stop crying, etc. on HBC. I wonder how many relationships and marriages fail because the woman became a hormonal-emotional wreck on the Pill.
[info]erinmdmd wrote:
Oct. 9th, 2007 07:06 am (UTC)
As a teenager, I was put on ABC to control really erratic and heavy menstural periods caused by what I now know to be some pretty screwed up hormones (would have been nice to know about the hypothyroid years earlier, but it was faster for my PCP to write a script for ABC...why practice medicine :/).

I was already depressed when I started taking them (again, the thyroid), but I was literally suicidal before I stopped taking the meds (since they didn't fix anything anyway).
( 19 comments — Leave a comment )