182. Pardon me for asking

Randy has scheduled a vasectomy 3 days before his wife's scheduled cesarean delivery.  When a prior provider suggested that the time may be not be optimal, Randy, a trial lawyer, said he had a six week trial starting in January and just couldn't take time off.

But I'll have to give him credit: in the same setting, most dudes would tell their wives, you're having surgery anyway, you do it.  Which attitude aside, does have it's point, a cesarean tubal ligation has fewer complications than a vasectomy, and does not make the cesarean recovery any more difficult.

181. Proactive

52 year old Lisa, on the other hand, has decided to learn from history, so as not to repeat it, as they say. During a recent exam, I thought I felt an abdominal mass, until I realized I was just feeling her abs.  I noted my observations and she said, yeah, I do core exercises all the time.  My mother had ovarian cancer, and she broke her hips just getting out of her chair. She just sat in the chair all the time. Go Lisa.

180. Fate

Theresa is 38 years old, never pregnant and not sexually active.  She is overweight, hypertensive, and pre-diabetic, without much evidence from the clinical records of much progress in managing these issues, but she did come in for cervical cancer screening ("Pap smear"), which was abnormal, prompting an office procedure called colposcopy--that's where I come in.

Pap smears screen; colposcopies confirm. 

The colposcopy begins with application of acetic acid (aka vinegar), which causes proteins to denature/precipitate, forming small particles that reflect light straight back to its source instead of scattering the light.  The examiner thus sees white, which is biopsied (a small--about 1/16th inch--sample is removed for microscopic evaluation). This contains more cells than the brushings of a Pap smear.  More cells = more information = more accurate diagnosis.

Theresa's biopsy showed cancer, early enough for successful treatment--she will do well. I was struck by her attitude with the news; as if she totally expected cancer; just one more health problem that fate has decreed for her.