commented on SL Letter of the Day: Do It, Sissy
The worst thing you can do with a foreign object stuck in your rectum is try to dig it out yourself or "drink a lot of coffee" or follow some other horrendous home remedy. These are situations that get a lot of laughs but they are serious and the consequences can be devastating if it is not handled properly. It's not just the risk of infection or muscular perforation - there is also pressure ischemia, where the mass effect of an object left in for HOURS can impede blood flow to the rectum, resulting in issue death and ulceration.
If something is stuck in your ass and you can't get it out, get medical help. Do not wait a few days, do not try to pry it out with a grapefruit spoon (seen that with a vagina - terrible result), do not ask your friend who's "really in touch with her body" for advice. GO TO THE HOSPITAL.
commented on SL Letter of the Day: Do It, Sissy
Terrible advice. If you look up contraindications for the use of ExLax (senna), you will see "gastrointestinal obstruction" and "fecal impaction" on the list.
Senna is a stimulant laxative, which means it encourages the intestines to contract more vigorously. If that tampon is firmly lodged and your intestines begin contracting against a fixed obstruction, there's always a risk of perforation. At that point, you'll be on the fast track to colostomy which you will probably dress up with lipstick and a wig.
Furthermore, an anus usually has a lot more muscular tone than the introitus of a vagina. Therefore, pulling out a swollen mass with a string is less likely to be successful when you're pulling it out of someone's asshole. If the string breaks off, then you're stuck with a wad of fiber soaking up bacteria and whatever other foolishness you've happened to cram up your ass that day, cooking away at 98.6 degrees. You might as well allow a piece of pork to fester up there.
Instead of making this mistake and having to come to the ER with this problem, try using a little FORESIGHT instead. We would appreciate it.
Aug 28, 2012
commented on Newly Married Straight Couple Invites Gay Couples to Have First Dance at Wedding Reception to Protest Marriage Inequality
You cannot ethically deprive someone of rights they deserve because of what other people MIGHT do.
- You can't keep women from voting because you are afraid women might decide they could live on their own and abandon their families (some women did)
- You can't keep schools segregated because you are concerned about violence and disruption if you integrate (all these things happened).
- You can't keep a same-sex couple from marrying because you are afraid heterosexual people might decide to stop procreating (a few probably will).
There is a reason that statues of Justice are blindfolded: Justice does NOT CARE how the rest of society will react if someone is treated fairly. Justice has always been about what individuals deserve, never about what the majority fears or wants.
Jun 1, 2012
commented on SL Letter of the Day: John Shore's Advice to a Young Christian
Terribly wordy, overcomplex advice.
The best response is:
"If God feels this way, I just don't love him anymore. I could fake it, but that would be wrong. Jesus commanded us to love God with all our heart and mind and soul, and that's not something I can do anymore."
This takes away the argument about 'what God says' (which you will never win), it takes away arguments about the bible, it takes away arguments about whether God exists. You will completely take the wind out of his sails by saying you believe everything he says, you just can't force yourself to feel love for a being that feels this way.
May 31, 2012
commented on Oklahoma Hospital Refuses Services, Emergency Contraception to Rape Victim
I am an ER physician and have done sexual assault exams, though I am not SANE/SAFE trained. This was a few years ago when there were very few SAFE examiners at all and there was no other option. In more recent years, trained assault examiners actually get furious with us if we even talk with the patient first, much less do the exam. Much of this anger is due to their concern about compromising a legal case in case there is even a small difference in charting (e.g. "patient states she was attacked at approximately 6 PM" and "patient says she was raped 1 hour prior to arrival"). They don't want us to do a piecemeal treatment before sending the patient to them - they want to be involved from start to finish.
A second issue is that sexual assault exams take a LONG TIME. Often an hour and a half or more. Most often, this exam is forensic in nature - you're trying to gather evidence for a legal case, not save the patient from imminent death. If a rape victim isn't in immediate danger of death, and you're a single-coverage doctor in an ER full of patients who may have acutely life-threatening conditions...well, the patients who could die take precedence. It's very hard to justify blowing off the elderly chest-pain patient or the seizing infant to perform a SANE exam when there's a dedicated examiner at a hospital only a few miles away. The ER doc has to consider their obligation to every patient in that emergency room, not just the one who's the most devastated.
Since you have 72 hours for both emergency contraception and post-exposure HIV prophylaxis, I can see how in some situations a physician might decide that the best approach considering the needs of all the patients would be to divert the rape victim to a hospital with a dedicated examiner instead of performing the exam themselves and (a) messing up the patient's legal case while (b) abandoning their ethical obligation to patients who were sicker.
If this physician threw the patient out without any follow-up or recourse, then that's wrong and unethical. If she sent the patient to another facility that could reasonably see and treat her within 24 hours, then it's possible that a tough decision was made - but not a cruel one. We have no idea what the situation was in that ER that night.
May 22, 2012
commented on SL Letter of the Day: Anti-Gay Sister-In-Law Getting Her Kink On
Revenge is a dish best served cold. Wait, and let her behavior lead to her own punishment.
But, if you can, GET EVIDENCE and just hold onto it. It's a nice feeling to have, and you'll see that it actually decreases your desire to use it. And, if she ever really menaces either of you, you've got an ace in the hole.