epidemic growth of heart disease & the limits of hom

[lynnpax]

Dear list members,
I came across the article below on Medscape.
Is the stent procedure the new hysterectomy as far as unnecessary
surgery?
Should we not treat stent recipients w/hom?
Does anyone on the list have experience treating px w/stents?
I feel this discussion is important because of the epidemic growth of
heart disease.
Are there good alternatives to stents?

Also has anyone on the list had experience treating a hysterectomy px
that had the uterine "sling"?
I also just had my second woman come in w/breast implants.
(I had a woman come in a few years back but she had the implants
removed before we began.)

I would like to get a better grasp on what hom should address and
it's limits, in preparation for the many px w/plastic and metal
objects left in them that we will see.
At this point I feel comfortable recommending tissue salts in these
cases but not hom.
Thanks for your consideration,
Lynn pax
http://www.medscape.com/viewarticle/551723?src=mp

Vascular Disease Expert Commentary
The Rush to Stent: A Cause for Concern
Posted 02/09/2007
Frank J. Veith, MD

Antibiotic Treatment for Many Outpatient and Inpatient Bacterial
InfectionsLearn more about high-dose, short-course therapy, including
PK/PD parameters, clinical benefits, and doctor and patient benefits.
Vascular disease management is in the midst of the endo-revolution,
and there are many and powerful motivations for both patients and
health professionals to jump on the endovascular treatment bandwagon.
Every day, vascular surgeons and other vascular interventionists from
multiple disciplines are bombarded with reasons to perform exciting
new endovascular treatments using ingenious devices or innovative
improvements in guidewires, catheters, balloons, stents, and
endografts. These treatments may help patients and are usually
gratifying to perform and financially rewarding. In addition to
vascular specialists, patients and their referring physicians would
prefer such high-tech, low-morbidity procedures. Hospital executives,
administrators, and industry are supportive because their bottom
lines are augmented.
Vascular specialists have other incentives for treating patients with
the glitzy endovascular devices, including accumulating endovascular
case numbers for credentialing purposes and expanding the scope of
their practice with patients and lesions previously treated by other
specialists. Last, vascular specialists have a well-founded fear of
missing the boat and being excluded from using endovascular
techniques, with dire consequences to their professional survival.
For all of these reasons, a feeding frenzy for the utilization of
endovascular treatments and devices has evolved for those involved in
vascular disease management. And because of all of these motivations
to use endo devices unrelated to patient outcome, some of us may be
losing sight of our primary goal: doing things that are good for
patients.
This frenzy -- and one of my major causes of concern -- is most
striking with the use of intravascular stents, particularly those
placed at the carotid bifurcation, a site of opportunity for vascular
specialists from many disciplines. Are we forgetting to ask ourselves
the question: "Is placement of this stent in this patient indicated
and justified?" If this question were to be asked and answered
honestly, no one would ever place a carotid stent to treat a 30% to
40% stenosis in an asymptomatic patient, which I have repeatedly
observed at "live case" demonstrations around the world. This trend
to treat benign lesions is also reflected by the high percentage (70%
to 90%) of asymptomatic patients reported in most carotid stent
registries and trials. No good evidence exists that procedures in
such cases are beneficial to patients. Moreover, since the likelihood
of a poor outcome in patients with benign lesions is low, such
needless treatment carries artifactually and misleadingly low adverse
event rates. In this era of audits, this may benefit the treating
physician, but it may also incorrectly suggest the superiority of
carotid stenting vis-a-vis endarterectomy. In any case, this tendency
to treat lesser lesions is of little or no value to patients, and it
raises healthcare costs unnecessarily. Carried to the extreme, it
will result in the stenting of near-normal carotid arteries with
outstandingly low adverse event rates, but with little or no patient
benefit.
What is to be done about this rush to stent, this cause of concern? I
have no solid answer. However, I believe that most physicians who
treat vascular lesions are conscientious and well motivated to help
their patients. Perhaps if we all can recognize the problem, we will
ask ourselves the right questions and be better able to resist the
temptations and pressures to treat or place stents for the wrong
reasons in patients who do not need them.

[Bonnieallenart]

In a message dated 2/21/2007 3:27:29 P.M. Eastern Standard Time, lynnpax@earthlink.net writes:
what is a uterine sling?
thanks,
bonnie
________________________________

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[Jean Doherty]

Maybe you mean urethral sling which is used to support the bladder neck and can be most useful if stress incontinence. Wonder about the use of thiosamine undoing these procedures if used for any other scar tissue. Whether it could have been avoided by remedies for prolapse is another question.
http://www.webmd.com/urinary-incontinen ... e-in-women, Best Wishes Jean
________________________________

[lynnpax]

Yes. Thank you Jean...
a urethral sling.
There must be many women w/this sling.
--- In minutus@yahoogroups.com, Jean Doherty wrote:
the
scar
prolapse
hysterectomy px
what's