For some of us, no end of things to worry about

ABCDE
HEALTH&SCIENCE
tuesday , january
5, 2016
E
EZ
NATURE
GENETICS
ANYBODY
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they are, genetically speaking. E2
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right now, but does it work? E4
Nutritionists’ support grows for fasting
a few days a week to lose weight. E5
Prolapse: No
longer an ill
that women
don’t discuss
Pelvic flaw, often tied to
childbirth, affects millions
T ARA B AHRAMPOUR
BY
When Carmel Price’s mother had an
operation six years ago, Price helped
her in the hospital but never really
knew what the procedure was for. “I
heard that she was having ‘reconstructive surgery,’ like that her organs had
moved around and they were putting
them back where they belonged,” said
Price, a sociology professor at the
University of Michigan in Dearborn.
Then Price had two babies of her
own, and she understood — and
unlike many women in the past, she is
talking about it.
“My bladder was bulging outside of
my body, and if I was on my feet for any
significant length of time, like if I was
giving a three-hour lecture, or running
or jumping, it would fall out even
further.” Her mother confirmed that
this was the same problem she’d had.
Pelvic organ prolapse — in which a
woman’s bladder, uterus or rectum
falls down through the vaginal canal
— affects millions of women in America and becomes more likely the older
they get. The average age when women start to notice pelvic floor disorders, which include prolapse as well as
urinary and fecal incontinence, is 56;
by 80, half of all women have one or
more symptoms. One in 10 ends up in
surgery, and associated costs are soaring as the population ages, from an
estimated $66 billion a year in 2007 to
a projected $83 billion in 2020.
And yet for years, few women
talked about it. Gynecologists often
do not notice it in routine exams, and
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For some of
us, no end
of things to
worry about
S ARAH M ARANISS
V ANDER S CHAAFF
BY
It didn’t matter what we officially
called it, my psychiatrist said as he
looked up from his notepad. What I
had was “worry in search of a mission.”
Within 40 minutes of speaking
with me, he’d learned enough to
accurately describe the private struggle that had defined my life. Technically, there were names for what I
had, at least according to the Diagnostic and Statistical Manual of Mental Disorders: obsessive-compulsive
disorder and generalized anxiety disorder. But, as my psychiatrist told me,
these labels were most helpful for
research purposes. You could, he said,
drive a truck through psychiatric
diagnoses. And, throughout the stages of an individual’s life, the diagnosis
can change.
My anxiety started when I was in
third grade. I stood alone at the bus
stop with a battery-powered travel
alarm and two watches. I checked them
frequently as I looked for the yellow bus
to appear, fearing that it never would.
My teacher called me a worrywart and
my parents thought I was eccentric. No
one thought I needed help.
When I was older, AIDS snatched
the life of a beloved teacher, and I
privately feared that disease and
death could jump out from the dark.
Instead, it was two men with a gun on
a lonely subway, a mugging that made
me susceptible to panic attacks in
tunnels and dark theaters.
There were other moments that
convinced me that life could suddenly go from safe to dangerous. That
sunny day at work in September 2001,
for one, when I watched the planes
hit the towers and thought about the
split-second decision I made earlier
to not head downtown and vote.
But I didn’t need the prospect of
large-scale terrorism to drive me into
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KAI TI HSU FOR THE WASHINGTON POST
Zapped!
BY
J
S ANDRA G . B OODMAN
ean Hanvik decided that enough
was enough. When a painful intestinal inflammation flared in 2014, the
55-year-old benefits communications consultant balked at her doctor’s recommendation that she undergo another abdominal CT scan — her
fourth in eight years.
“I’d just read about how abdominal
CTs are one of the highest-risk tests [in
terms of radiation exposure] and should
not be repeated unless there was a major
change,” said Hanvik, who lives in Minneapolis. In the past, antibiotics and a
bland diet had quelled her recurrent
CT scans can help save
lives, but some experts
see radiation risks
in repeated testing
diverticulitis. Hanvik said she wanted to
follow that approach again but avoid a
scan, which contains about 10 millisieverts (mSv) of radiation, the rough
equivalent of 200 chest X-rays or 1,500
dental X-rays.
“I don’t think she appreciated my
uncharacteristic behavior,” said Hanvik,
adding that her primary care doctor
reluctantly agreed, but made her prom-
ise to return within 48 hours if she did
not improve. Hanvik got better, as she
had previously.
Hanvik’s newfound assertiveness and
her questions about the necessity of a CT
scan reflect a growing awareness of the
potential pitfalls of diagnostic imaging,
which in the past two decades has exploded into a $100 billion a year business.
Imaging has aided diagnosis and
helped many patients avoid exploratory
surgery, but it has also spawned concerns
about misuse. Experts cite ballooning
costs, including from duplicate procedures, potential harm from the tests
themselves and the overtreatment of
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