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Conspiracy of silence on women’s pain must end | Letters

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I was an interventional radiologist for 35 years, placing needles and catheters into conscious patients every day. I had three different intensely painful procedures before I qualified in medicine and as a result have had a needle phobia all my life – ironic considering my career. I discovered early in training that hurting anyone was avoidable with conscious sedation and intravenous pain relief, supplemented with generous local anaesthetic administered with long needles as thin as a hair applied to the nerves of the region.

None of my colleagues in the three countries in which I worked did this consistently, if at all. I am aware that it was largely my own experiences that alerted me to the need for adequate pain relief. The medical injunction to do no harm should also mean cause no pain, as this is not difficult to achieve. Some surgeons and radiologists should never be let near a conscious patient. I knew an orthopaedic surgeon who retired at 58 due to cancer. He told me later that he realised he had never given enough pain relief throughout his career. What a sad epitaph for an otherwise decent man and able surgeon.
Mark J Towers
Navan, County Meath, Ireland

A few years ago, I experienced a post-menopausal bleed and was referred for an ultrasound scan. The female radiographer who did the scan said all was well. She was pleased that I would not now have to go into “the next room”, where a doctor was waiting to carry out further investigations on women whose scan showed potential abnormalities. She said that she often held the hands of these women and could hardly bear the sound of their “ whimpering”. That word will stick with me for ever. A year or so later I mentioned this on a routine visit to a gynaecologist. His response: “She should never have said that. It’s not that bad.” What a conspiracy of silence.
Stella Acton
Cambridge

I was recently admitted to A&E with excruciating abdominal pain. I was denied effective pain relief for three days before being given “patient controlled analgesia”. During the three days prior to this, I requested pain relief for the removal of my coil and was reluctantly given gas and air. I later requested extra pain relief for the removal of an abdominal drain, which I was denied. The devastation of the NHS seems to be affecting clinical practice to the point of illegality.
Name and address supplied

Hospital gynaecology departments seem to be coercing women into endoscopies of the womb with no sedation or anaesthesia, just done with over-the-counter medicines to be taken at home. NHS audits show that one in three experience severe pain during a hysteroscopy, biopsy or polyp removal, which can take more than half an hour. “I was tortured by lovely people” – the Campaign Against Painful Hysteroscopy hears this almost daily.

Hospital clinics are pretending that uterine endoscopy causes only “mild discomfort”, when in fact it causes significant pain for most patients. The Campaign Against Painful Hysteroscopy has an ongoing survey of more than 2,500 stories of gynaecological violence. It’s time that the Department of Health offered all hysteroscopy patients anaesthesia or safely-monitored intravenous sedation with analgesia.
Katharine Tylko
Campaign Against Painful Hysteroscopy

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Solar storms may cause up to 5500 heart-related deaths in a given year

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In an approximate 11-year cycle, the sun blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field, which may disrupt our body clock and ultimately affect our heart



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17 June 2022

A solar storm

Jurik Peter/Shutterstock

Solar storms that disrupt Earth’s magnetic field may cause up to 5500 heart-related deaths in the US in a given year.

The sun goes through cycles of high and low activity that repeat approximately every 11 years. During periods of high activity, it blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field.

These so-called solar storms can cause glitches in our power grids and bring down Earth-orbiting satellites. A handful of studies have also hinted that they increase the risk of …

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UK Covid infection rate rising, with more than a million cases in England | Coronavirus

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Coronavirus infections are rising in the UK, figures have revealed, with experts noting the increase is probably down to the more transmissible BA.4 and BA.5 Omicron variants.

The figures from the Office for National Statistics (ONS), based on swabs collected from randomly selected households, reveal that in the week ending 11 June an estimated one in 50 people in the community in England are thought to have had Covid – around 1.13 million people.

The figure is even higher, at one in 45, in both Wales and Northern Ireland, while it was highest in Scotland where, in the week ending 10 June, one in 30 people are thought to have been infected.

While the figures remain below the peak levels of infection seen earlier this year, when around one in 13 people in England had Covid, the findings are a rise on the previous week where one in 70 people in England were thought to be infected. Furthermore, the data reveals increases in all regions of England, except the north-east, and across all age groups.

Experts say that a key factor in the increase is probably the rise of the Covid variants of concern BA.4 and BA.5.

“Infections have increased across all four UK nations, driven by rising numbers of people infected with the BA.4 and BA.5 Omicron variants,” said Kara Steel, senior statistician for the Covid-19 Infection Survey.

While Steel said it remained too early to say if this was the start of another wave, others have warned it may already have begun, with increased mixing and travelling among other factors fuelling a rise in cases.

Among concerns scientists have raised are that BA.4, BA.5 and another variant on the rise, BA.2.12.1, replicate more efficiently in human lung cells than BA.2.

Prof Azra Ghani, an epidemiologist at Imperial College London, said the latest figures were not surprising, and might rise further.

“This increase in infection prevalence is likely due to the growth of the BA.4 and BA.5 Omicron subvariants, which as we have seen elsewhere in Europe, appear to be able to escape immunity generated from previous Omicron subvariants,” she said.

“It is therefore possible that we will continue to see some growth in infection prevalence in the coming weeks and consequently an increase in hospitalisations, although these subvariants do not currently appear to result in any significantly changed severity profile. This does however serve as a reminder that the Covid-19 pandemic is not over.”

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NHS to offer women in England drug that cuts recurrence of breast cancer | Breast cancer

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Thousands of women in England with breast cancer are to benefit from a new pill on the NHS which reduces the risk of the disease coming back.

The National Institute for Health and Care Excellence (Nice) has given the green light to abemaciclib, which cuts the chance of breast cancer returning after a patient has had surgery to remove a tumour.

Trials showed that patients who had the drug with hormone therapy had a more than 30% improved chance of their cancer not coming back after surgery, compared with hormone therapy alone.

“It’s fantastic thousands of women with this type of primary breast cancer will now have an additional treatment option available on the NHS to help further reduce the risk of the disease coming back,” said Delyth Morgan, the chief executive of charity Breast Cancer Now.

“The fear of breast cancer returning or spreading to other parts of their body and becoming incurable can cause considerable anxiety for so many women and their loved ones.

“New effective treatments such as abemaciclib, which can offer more women the chance to further reduce the risk of the disease recurring, are therefore extremely welcome and this is an important step change in the drug options available for this group of patients.”

The twice-a-day pill is suitable for women with hormone receptor-positive, HER2-negative, node-positive early breast cancer at high risk of recurrence who have had surgery. About 4,000 women will benefit initially, Nice said.

Helen Knight, the interim director of medicines evaluation at Nice, said the draft recommendation came less than a month after abemaciclib received its licence.

“The fact that we have been able to produce draft recommendations so quickly is testament to the success of our ambition to support patient access to clinically and cost effective treatments as early as possible,” said Knight. “Until now there have been no targeted treatments for people with this type of breast cancer.

“Abemaciclib with hormone therapy represents a significant improvement in how it is treated because being able to have a targeted treatment earlier after surgery will increase the chance of curing the disease and reduce the likelihood of developing incurable advanced disease.”

Abemaciclib works by targeting and inhibiting proteins in cancer cells which allow the cancer to divide and grow. It normally costs £2,950 for a packet of 56 150mg-tablets, but the manufacturer, Eli Lilly, has agreed an undisclosed discounted price for NHS England.

“Thanks in part to this latest deal struck by NHS England, NHS patients will be able to access another new targeted drug for a common and aggressive form of breast cancer,” said Prof Peter Johnson, the cancer director of NHS England.

“Abemaciclib, when used alongside a hormone therapy, offers a new, doubly targeted, treatment option, helping to increase the chances of beating the cancer for good, as well as meeting the NHS’s commitment to delivering improved cancer care under our long-term plan.”

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