My Wife’s Experiences with Uterine Fibroid Embolization

I never heard of fibroids until I learned early last year that my wife Jennifer had them. (Her mother had them as well, as did an aunt and a grandmother, so I think they’re at least partly genetic.) Fibroids of the uterus are what they sound like: Fibrous masses—noncancerous tumors—growing in the uterus. My wife had a lot of them, some of them quite large (up to six centimeters across).

Fibroids can do a variety of nasty things, such as interfere with pregnancy and cause heavy bleeding. My wife had severe anemia (for which she took iron pills), and she ended up in the emergency room once due to bleeding, which prompted us to get more serious about solving the problem.

The first OBGYN we visited (before the ER visit) wanted to cut out my wife’s uterus—do a hysterectomy—which struck me as an absurdly disproportionate “solution” relative to the problem. A hysterectomy would have required a six-week recovery, and obviously it would have made pregnancy impossible.

The second doctor my wife visited is an endocrinologist. He wanted to cut out the fibroids laparoscopically, through small slits in the abdomen. This was a considerably less-horrible alternative, but the problems were two-fold: a long recovery time and a high probability of regrown fibroids within a few years.

There is a lesson here: Don’t necessarily act on the first “expert” advice you hear from a doctor (or anyone else). The first doctor my wife saw gave her terrible advice. I chalk this up to the “hammer and nail” phenomenon: The first doctor happened to do hysterectomies, so that’s what she thought my wife needed. The second doctor happened to do laparoscopic surgery, so that’s what he thought my wife needed. In fact, she needed neither of those procedures.

Thankfully, we kept digging, and we learned about embolization. The idea is that a doctor runs a tube up through the main artery in your leg up to the uterus. Then the doctor strategically releases silicon particles to block or restrict the blood flow to the fibroids. Assuming this goes well, the fibroids shrink and are absorbed by or discharged from the body.

Jennifer learned that RIA Endovascular performs uterine fibroid embolization (UFE) in Denver. Checking around, we heard that RIA’s Dr. Brooke Spencer was excellent in the field. And she is.

After a consultation and a preliminary MRI, Jennifer had the UFE procedure done by Spencer on September 6 of last year. At the six month mark she got a second MRI, and the results are very good, with some fibroids completely gone and most others significantly smaller. (The remaining fibroids are expected to continue to shrink.) Her monthly bleeding and cramping is radically less now than it was before, and her anemia is gone.

We were extremely happy with Spencer’s work and with her willingness to answer our questions in minute detail. Indeed, we were very happy with the service provided by everyone associated with RIA. Likewise, we were happy with the service provided at Littleton Medical Center, where the procedure and recovery took place.

We did have a slight hitch in the recovery. The hospital staff put Jennifer on a morphine-class drug (I believe synthetic) immediately after surgery, but the next day when they took her off of that drug and switched her nausea medication she experienced some abdominal pain and some violent vomiting. They put her back on the morphine-class drug, changed her nausea medication, and kept her a second night. So UFE is definitely not an out-patient procedure, but Jennifer was back to work five days later.

Obviously neither Jennifer nor I are doctors, so anyone reading this should consult with a qualified medical expert regarding any medical issue. That said, in our case, we’re extremely glad we pursued UFE, particularly through RIA. So thank you Dr. Spencer and team!

July 7, 2016 Update: Last year my wife gave birth! It is my belief, although not a certainty, that the fibroid embolization allowed her to get pregnant. The procedure did not seem to interfere with the pregnancy. She did deliver early due to severe preeclampsia. Because she had a c-section, I actually saw her uterus. She still had some remaining fibroids, including one that might have interfered with baby positioning and delivery; but we still regard the embolization as an overwhelming success.

Run, Hide, Fight: Even the New York Times Gets It

Alon Stivi

The gun laws recently proposed (or passed) in Colorado and at the national level will not reduce violent crime. Something that will reduce the number and destructiveness of mass murders is citizens preparing for such attacks and responding appropriately.

Of course, your chances of ever finding yourself in the middle of a situation like that at the Aurora theater or the school in Newtown are extremely low. A tiny fraction of homicides are mass murders, and a tiny fraction of mass murders are the random and large-scale events that generate international headlines for months on end. You’re far more likely to die in a car crash than to die at the hands of a mass murderer.

Still, there is some chance, however slight, that you will find yourself confronted by a mass murderer, so it is worth some time thinking and planning how to respond. Perhaps surprisingly, even the New York Times picked up on this theme in an April 6 story written by Erica Goode. Following are some of the highlights from that article:

The speed and deadliness of recent high-profile shootings have prompted police departments to recommend fleeing, hiding or fighting in the event of a mass attack, instead of remaining passive and waiting for help. . . .

Research on mass shootings over the last decade has bolstered the idea that people at the scene of an attack have a better chance of survival if they take an active stance rather than waiting to be rescued by the police, who in many cases cannot get there fast enough to prevent the loss of life. . . .

In the absence of a police presence, how victims responded often made the difference between life and death, Dr. Blair said.

In 16 of the attacks studied by the researchers [at Texas State University], civilians were able to stop the perpetrator, subduing him in 13 cases and shooting him in 3 cases. In other attacks, civilians have obstructed or delayed the gunman until the police arrived. . . .

“The take-home message is that you’re not helpless and the actions you take matter,” Dr. [J. Pete] Blair [of the university] said. “You can help yourself and certainly buy time for the police to get there.”

Here is the video from the Houston’s Office of Public Safety mentioned in the article:

I’ve produced two videos and an interview on the matter.

The interview (with my father), available at TOS Blog, is “Linn Armstrong on Self-Defense and Guns.”

I also conducted another interview on video with my dad:

And I conducted an interview with Alon Stivi (with whom my father has worked), who developed a program for Attack Countermeasures Training.

So don’t be paranoid, but do be prepared.

Image: ACTCert.com

Surviving Attacks at School and the Workplace: Alon Stivi’s Attack Countermeasures Training

Alon Stivi, CEO of Direct Measures International, recently attended an event in Grand Junction, where he agreed to a short interview. Stivi developed a certification program in Attack Countermeasures Training to help school administrators, teachers, and office personnel effectively respond to active shooters and terrorist attacks.

One of the points Stivi makes is that renewed military action in the Middle East (which seems very likely to me within the next few months) could spur terrorist organizations to step up their attacks on American and other western targets. And “we need to be prepared,” he points out.

A Few Thoughts about Volunteer Search and Rescue

Recently I helped (a little) with a search and rescue effort in Utah. The upshot is that two Colorado men—including a family friend—crashed their vehicle off the side of a cliff northeast of Price, resulting in fatality on impact. Yet, because the vehicle was so hard to see and locate, it was not found until more than a week after the crash and several days after the men were reported missing, even though more than 100 friends and family members had traveled to Price to help with the search.

Here my goal is to offer a few reflections on the search in the hopes that, should others find themselves in a missing persons or search and rescue situation, they might have a little better idea of what to expect.

It has never been so clear to me the living hell created by not knowing what happened. We didn’t know what happened to the men or whether they were still alive. That uncertainty leads to high emotions, hard feelings, exhaustion, and continuous speculation. In such a situation, one must make a special effort to remain civil and productive and not do anything that gets in the way of the search.

There are four basic scenarios for any missing persons case: either the person is lost, injured in an accident, the victim of foul play, or trying hard not to be found. In this case, the second scenario was most likely, but we could definitely rule out only the first scenario. But within each remaining scenario, there are a thousand, a million, possibilities.

The key is to add plausible scenarios to the list of possibilities, while not losing focus on the most obvious explanations. In this case, the most likely explanation was the correct one: the men drove their car off the road in rugged country on the way to their base camp.

One mistake I made was to assume that, since the area had been searched so thoroughly after a few days, both by air and by ground, there was little chance the vehicle was actually in that area off of a road. But the country was so rugged (check out the satellite imagery of the map) that the vehicle was impossible to see from the road. Because the vehicle was so mangled (see the video from KSL Salt Lake), it was nearly impossible to identify from the air; it blended in with the surrounding rock features. (Finally the vehicle was found when a volunteer hiked down a rough incline to look down a cliff.)

Carbon County Deputy Sheriff Wally Hendricks told some members of the team that, during a search, you may need to look behind the same tree (or down the same cliff) six times before you see what’s there. So don’t assume that, just because an area has been searched once, it shouldn’t be searched again. Focus on the most likely routes and devote multiple searches to those.

That said, keep the search as organized as possible to limit unnecessary passes of less-likely areas. The man who stepped up to organize the search kept a large map on the wall and copied more-detailed sections of that map for the searchers. His single-page maps contained several square miles and showed all the dirt roads; typically an assigned search grid was two miles square. (It took my team an unexpectedly long time to cover a grid, but then there were multiple roads, some of which we had to walk.)

One advantage to staying organized and searching by grids is that you minimize the number of tracks over an area. This increases the chances of seeing tracks that may be related to the missing persons.

Take plenty of time to cover a search grid. Be thorough. Get out, walk around, look off the side of drop offs. As the search’s organizer pointed out, you may need to cut your engine and listen for the sound of a car’s horn. Try to mark a particular grid off the list as definitively as possible.

Also, take detailed notes of the search grid. This will help the organizer determine whether to send additional teams through that grid. For example, while walking a rough road I saw a small pond, and somebody had cut a hole in that pond. It turns out the pond was irrelevant to our search, but the fact that I saw the hole caused me to spend more time there and report it to the organizer. Then another team returned the next day to check out the pond more thoroughly. I still don’t know why somebody cut the hole in the pond. But it occurred to me that perhaps another searcher did it to check the pond; if that’s the case, that’s the sort of information that would have been useful in a search report.

All that said, people are going to make some mistakes. So don’t accuse, and don’t feel bad if you miss something. Recognize that tensions are high, people are extremely tired, and emotions are raw. Keep focused on the goal: find the missing people. Take what you have and work with that in a constructive way.

Be careful! You are not helping the situation by becoming lost or injured yourself. Stay rested, fed, and hydrated. Don’t push your vehicle beyond its capacities. Make sure the search organizer knows where you are, who is in your party, and how to get ahold of you. As in medicine, first do no harm. (Again, if somebody does make a mistake, don’t accuse, and don’t feel bad; return to constructive action as quickly a possible.)

Recognize the leaders of the group, and support them. There will be (or should be) two key leaders. One is the organizer of the volunteer search. This person should be responsible for organizing the search pattern, handing out search assignments, collecting search reports, and processing that information. In our case, this person had a second-in-command, and that was vital to keeping the assignments going out and the reports coming in. That organizer (and only that organizer) should interact with the local authorities to coordinate the broader search effort.

The second key leader is the person who facilitates the flow of information. This person (or, in our case, two people) should make contact with the authorities, with the volunteer search organizer, with the family and searchers, and with the media. The media accounts regarding this search were basically accurate and thorough because somebody was assigned to send out official media releases. Obviously this person should have some familiarity with the media (or at least be a decent writer). In our case, a Facebook page facilitated the distribution of these releases and related information.

Thankfully, we had a very organized search. I could see how a disorganized search could result in a great deal of tension and counterproductive action. Do what you reasonably can to identify and assist the leaders (or to become one of the key leaders if you have the experience and demeanor for it).

It was a terrible time with a tragic outcome. The silver lining, as several pointed out, was seeing so many friends and family members stepping up so valiantly during this difficult time.

Be careful out there. Take every reasonable precaution not to become a missing person yourself and to keep loved ones safe. But if the worst happens, and you find yourself in a search for missing persons, get an idea of what to expect and focus on productive action toward finding your loved ones.

See also “Integrating Aerial Photography in Search and Rescue.”

The Tragedy of Fatal Hazards for Children

A single death due to an unintentional firearm discharge is one too many. When the victim is a child, the heartbreak can run especially deep.

But is the death of a child due to an unintentional firearm discharge any more or less tragic than the death of a child due to a car wreck or drowning? To think reasonably about the problem, we must put the dangers we face in context.

Earlier today the Denver Post falsely claimed that, based on recent figures, “more than 500 children in the United States die in gun accidents each year.” The actual figure for 2007, as the Post acknowledged in a correction, is 112 (as I reviewed at length earlier today). And yet, while I think journalists should strive to report the facts accurately, at a certain level the precise numbers are not the most important issue. What is most important is that each of these deaths, whatever their total number, represents a profound tragedy, a life forever snuffed out.

And yet life is full of risks. All sorts of things, not just firearms, can be hazardous if abused, both to adults and children. Obviously the proper goal is to reduce all deaths due to unintentional injury to as close to zero as feasible, everything else equal. The problem is that trying to force down the number of unintentional injuries can result in offsetting harms. For example, there is a very simple way to reduce the number of auto fatalities to zero: ban all automobiles. Yet obviously that would severely harm people in other ways. The same goes for firearms.

The fact is that firearms are useful for self-defense. Forcibly taking people’s guns away, or forcing people to render their guns inoperable for self-defense, would increase the numbers of home invasions, murders, and other crimes.

The Post rightly reports the general problem of gun fatalities in its related stories. In the case of the 2007 figures, the context for the statistics is a story about two 5-year-old children fatally shot in Colorado. In one case, a three-year-old shot a five-year-old with a “family friend’s gun.” In the other case, a child shot herself with her father’s gun. Those stories are painfully tragic to read about; obviously the families involved will never fully recover.

The Post includes some relevant context: in the first case the gun’s owner may be charged with “child abuse resulting in death and criminal negligence.” When the debate about gun laws raged in Colorado several years back, I rightly pointed out that general child-abuse laws already on the books account for all instances of needlessly putting a child in danger.

Notably, the Post has also pointed out the drowning statistics in stories related to drownings. For example, in 2009 the Post‘s Kieran Nicholsonwrote, “In 2005, there were 3,582 unintentional drownings in the U.S., according to the Centers for Disease Control and Prevention.” In another short story, the Post related, “The Consumer Product Safety Commission estimated 319 children younger than 5 died in pool and spa incidents in 2005.”

Obviously the magnitude of the problem does matter. If ten-thousand children died every year in spas or by firearms, that would be an enormously more pressing problem. In the case of firearms, various anti-gun activists have skewed the figures for partisan political purposes. For obvious reasons, news reporters should be careful not to fall for such claims.

Even when reporters get their basic facts straight, readers ought to bear in mind the general context that, of necessity, is not included in a particular news story.

According to GunCite.com, “Fatal gun accidents involving children (aged 0-14) also fell significantly, from 495 in 1975, to under 250 in 1995.” Again, the figure for all minors for 2007 was 112. The fact that unintentional shootings have fallen dramatically, even as gun ownership has risen, is a very good thing.

Using the CDC’s clever search function, we can compare deaths from different sources. For 2007, a total of 7,931 children age zero to seventeen died of unintentional injury. So the deaths involving firearms represents 1.4 percent of the total. When parents are evaluating risks, that’s a relevant figure.

Let’s check out the numbers of unintentional deaths by various other causes (same year and age group):

Firearms: 112
Drowning: 901
Fall: 123
Fire/Burn: 497
Poisoning: 398
Suffocation: 1,239
Transportation Related, Overall: 4,264

Again, the point is not that news reporters are obligated to provide such context when writing their reports; they are not. But readers should bear in mind that news reports generally do not include all the relevant context.

Parents should take reasonable precautions to prevent unintentional injuries, whatever their cause. Part of this means that gun owners should take precautions not to let any unauthorized or irresponsible person gain access to a firearm. As a group, U.S. gun owners have made great strides in curbing the numbers of unintentional gun deaths. Obviously, some small fraction of gun owners need to do better.

Tebowmania Article Published in Denver Post

The Denver Post published a recent op-ed of mine, “Tebowmania isn’t just for Christians.”

In this article I try to make sense of the overt religion of Bronco’s football star quarterback, Tim Tebow. On the surface, there’s much about this that seems odd. What if, I ask, “a star football player were as vocal about his Muslim, Hindu, or Scientologist beliefs?” And does God really care about who wins football games?

But, listening to some of Tebow’s comments during a recent game, I got a better sense of what religion does for him. I conclude that “what Tebow is able to do remarkably well is keep a sense of perspective about the game and his play,” and he uses religion for that end.

Read the entire article!

Mass Beer Blind Taste Test

Last night a friend organized a blind taste test of several mass-produced beers. This stemmed from an argument over whether Pabst Blue Ribbon (PBR) was an okay beer or a horrible one. Tasters were given six small lettered cups of beer; nobody knew even which brands they were (except we all knew PBR was in the mix). I collected five results.


Photo: The good Doctor Paul Hsieh applies his penetrating scientific mind to the problem of determining beer quality; from Picasa.

I did a two-stage ranking. First I marked beers as “okay” or “not great”; I marked three in each category. Then I ranked the beers in order from 1 to 6. Here was my ranking: Sam Adams Boston Lager, Modelo Especial, PBR, Coors Light, Stella Artois, and Pilsner Urquell. So, while I thought the Sam Adams was clearly superior to PBR, PBR still made my “okay” list.

Jennifer (my wife) and I had similar tastes, except she ranked Pilsner Urquell second rather than last. (I didn’t like it at all.) Here was her ranking: Sam Adams Boston Lager, Pilsner Urquell, Modelo Especial, PBR, Stella Artois, Coors Light. (It’s too bad the regular Coors wasn’t in the mix; I suspect that’s somewhat better.)

Paul ranked them as follows: Modelo Especial, Sam Adams Boston Lager, PBR, Coors Light, Stella Artois, Pilsner Urquell.

“H:” Modelo Especial, Sam Adams Boston Lager, Pilsner Urquell, Stella Artois, PBR, Coors Light.

“S:” Coors Light, Stella Artois, Sam Adams Boston Lager, PBR, Modelo Especial, Pilsner Urquell.

While Sam Adams ranked in the top half of everyone’s list, only Jennifer and I ranked it first. (I thought it was clearly superior to the rest, though not nearly as good as the craft beers I usually drink.) Everyone ranked PBR in the middle, from a 3 to a 5. I was a little surprised that the Modelo performed relatively well, earning two first places and a second.

But of course this exercise largely was academic; generally I’m going to drink a real beer, such as a Guinness or a Rock Bottom Molly’s Brown.

Happy Exuberant Friday

The Objective Standard has published my latest article, “Call It Exuberant Friday, Not ‘Black Friday.'” I write about the day:

What’s so black about it? Stores and city streets glitter with holiday lights. Shoppers, often in bright-colored clothing, chatter with excitement among family and friends. … We should call it “Exuberant Friday,” a day for celebrating prosperity, shopping for gifts, and enjoying friends.

Read the entire piece!

Harry Potter, Distinguished Toastmaster?

I’ve just published a new article over at the web page for my book, Values of Harry Potter, titled, “Harry Potter’s Magical Communication.” Invoking examples from the Potter novels, I show how the stories offer several lessons for public speakers.

I write, “Tellingly, the final confrontation between Harry and Voldemort involves the two of them arguing, alone, in the midst of hundreds of their compatriots. Harry addresses Voldemort, but he speaks to inform the crowd of the truth of Voldemort’s evil and the virtues of Harry’s allies.” Read the whole piece!

This is relevant here: I’d like to congratulate Brad Beck and the other leaders of Liberty Toastmasters for creating a robust and amazingly valuable club. You can meet the future of Colorado’s liberty movement at these meetings.

Incidentally, I’m declaring this Friday “Sirius Black Friday,” in honor of Harry’s godfather. It’s the perfect day to buy my book!

Using the iPod Touch for Speech Notes

Earlier this evening I used my iPod Touch to help deliver a talk about religion in Harry Potter. (I’ll release a video and article about this soon.) I scrolled through my prepared notes on the Touch screen, and that worked very well.

I couldn’t find a good application for the purpose. So I just emailed myself the notes for the talk (a friend helped me sync my mail for the Touch), then cut-and-pasted the notes into the built-in Notes program. The only mistake I made was to leave some hotlinks in the text; Notes annoyingly opens up the web browser if you accidentally touch a link (which I did once, causing a brief pause in my presentation).

I liked the Touch much more than paper. You don’t have to shuffle papers or change pages, and the Touch is very small and easy to hold without interfering with gestures. It’s easy to change hands, too.

But there are a few things I don’t like about using the Notes program for this purpose. As noted, the possibility of hitting a hotlink creates a problem. In addition, if you touch the screen just wrong, the software thinks you want to select a block of text, which is disruptive when trying to deliver a talk. If you tip the Touch, it converts the text to the horizontal format, which I did not want. Finally, while Notes displays a clock at top, far better would be a timer. It’s hard to remember the start time and figure the total elapsed time when you’re concentrating on the material of the talk.

Obviously this opens up the possibility of some clever programmer developing and selling me the type of application I’m describing. To summarize, such an app would offer the following features:

* A timer prominently displayed on part of the screen.

* The rest of the screen devoted to the notes for the talk.

* Easy thumb-tapping to change pages or scrolling (user’s choice).

* The ability to import pdf files or cut-and-paste straight text.

* No disruptions involving hotlinks, text selection, or screen reformatting with the gravity sensor.

Let me know when you’re ready to sell this to me, and I’ll gladly buy it (for a reasonable price). Until then, Notes works adequately for the purpose.

***

Robin E. commented August 22, 2011 at 4:36 PM
I want this app too. I would use it for teaching, for workshops, for agendas for meetings, and other stuff too (yeah, I’m kind of busy…). I was just googling if such an app already exists and hit this blog. For now I’m sticking with emailing myself my notes in pdf format, but what you describe would work much better.

The only think I would add would be a check box for every point or paragraph or whatever, so I could check each thing as I cover it and then can easily find my place again when I’ve rambled off on a tangent.

Ari commented August 22, 2011 at 4:44 PM
Keynote seems to do much of this; however, it is too beefy for my preferences, plus I’m not sure it does at good job at the basics I describe. But I haven’t tried it.