Safety Lesson of the Day - Cosmetic Procedures

Just as a precaution, you may wish to avoid having unlicensed persons inject stuff into your @$$.

In case you’re asking yourself, “But why might I want to avoid having unlicensed persons inject stuff into my @$$? What could possibly go wrong?” you might want to check these bizarre reports from the CDC out of a facility in North Carolina.

From one of three cases, all of which are quite similar: “According to facility records, 300 mL of ‘dermal silicone/saline solution’ were injected into each buttock… The woman experienced headache and vomiting…and noted that her urine looked like purple blood. She went to an emergency department…and was found to be in acute renal failure.”

The CDC report notes that the person administering the shots was a radiology tech and yet “Signage and promotional materials available on the Internet and in facility A referred to the facility as a family medicine practice and used the name of a family medicine physician licensed in North Carolina. However, this physician had no recent affiliation with facility A and no involvement with the soft-tissue filler procedures.” The individual was eventually arrested and charged with practicing medicine without a license.

So, you know, get whatever you want injected into your butt, but you might want try to find out if the facility is a total fraud first. I’m going to personally just keep on avoiding shots in the butt as much as possible.

My Beautiful Mommy - Kids’ Book on Plastic Surgery

“My Beautiful Mommy” is a book to explain plastic surgery to kids. And by “kids,” I mean it’s targeted at 4-7 year olds, because some plastic surgeon was worried that the little ones wouldn’t understand that mommy wasn’t really “hurt or sick” when she came home from the hospital with bandages and bruises after her boob job or tummy tuck.

Look, do whatever you want, but I have a problem with a plastic surgeon working to normalize these procedures for little kids and including a message of always striving to be “prettier” for girls who haven’t even hit puberty yet. As Newsweek indicates, the book:

“…features a plastic surgeon named Dr. Michael (a musclebound superhero type) and a girl whose mother gets a tummy tuck, a nose job and breast implants. Before her surgery the mom explains that she is getting a smaller tummy: ‘You see, as I got older, my body stretched and I couldn’t fit into my clothes anymore. Dr. Michael is going to help fix that and make me feel better.’

 

Mom comes home looking like a slightly bruised Barbie doll with demure bandages on her nose and around her waist.. The book doesn’t explain exactly why the mother is redoing her nose post-pregnancy. Nonetheless, Mom reassures her little girl that the new nose won’t just look ‘different, my dear—prettier!’”

Argh. I’m not linking to the publisher for the book, but BoingBoing has an image of the cover. Apparently cosmetic surgery causes you to be surrounded by fairy dust and butterflies, and your kid will throw open her arms because she finally loves the new, not ugly you.

Vaginal Collagen Injections (File Under “Things I Will Not Be Doing”)

Via Margaret Cho’s blog I learned that collagen injections into the g-spot (such as the “G-Shot”) are now available that are supposed to enhance sensation. Margaret was less than impressed, noting that, “Now my vagina just feels like there is a gel insole in there. Like my cervix is wearing boot socks. I am totally asexual and I feel like I am sitting on a hemorrhoid donut all the time.”

One commenter smartly asks why the emphasis on the g-spot, asking, “I mean, I understand that there could be greater pleasure for women in that area, but why not just stimulate the areas that are NATURALLY pleasurable for them, even if that means that penetrative sex just doesn’t cut it?!” In other words, why get a shot to make doing things one specific way easier for someone else?

Apparently the shot was developed by one of those plastic surgeons with a “reality” television show, David Matlock. The San Francisco Chronicle did a piece on the topic last year, and noted the lack of real studies suggesting that the injection is helpful. While collagen injections have been FDA-approved for the treatment of some patients with urinary incontinence, the “G-shot” is an off-label use. From the piece:

Tiefer and Herbenick question the efficacy of the G-Shot, noting the lack of a double-blind study, which would inject some patients with collagen and others with a water solution. In sex research, Tiefer said, placebo effects are not uncommon. If a doctor tells a client she’s going to have great sex after taking a shot, without a double-blind study, it’s hard to tell if it’s true.

Matlock said he conducted a pilot study based on a 20-person sample. He asked patients, “Did it work or did it not?” and of those who responded, he reported 85 percent said the G-Shot was successful.

But Matlock refused to share the study or make the names of participants available. He also said a double-blind study would be ineffective for the G-Shot, as the client can feel the collagen bump, while a water-based injection would merely dissolve.

To date, Matlock has not published a peer-reviewed study of any kind. He said he’s gathering data to offer to medical peers and will release the findings on his Web site in coming months.

Can I just say that there is no way I’m getting shots in my vagina unless it’s medically necessary? Yes, multiple shots, because there is an anesthetic injection prior to the collagen. If you want to, fine, but count me out.

Locker Room Diaries - An Initial, and Unpleasant, Review

I picked up “Locker Room Diaries: The Naked Truth about Women, Body Image, and Re-Imagining the ‘Perfect’ Body” by Leslie Goldman in a recent browsing of the library, and I have to be honest - I haven’t finished the second chapter, and I’m not sure I can finish this book. I am a compulsive finisher of books and films, always pushing forward in anticipation that the next page or chapter or scene will reveal something worthwhile. I’ve read the complete Wheel of Time series more than once, including those draggy middle books. In this case, however, I don’t think I can bear the obsessive weighing and measuring of women’s bodies in what, one would assume from the title, would be a work precisely about refusing to let numbers rule women’s lives.

In the first chapter, Goldman describes the obsessive scale-related rituals of perpetually gym-going women, and pats herself on the back for no longer being ruled by this particular number. However, the text quickly devolves into a measurement festival, with characters introduced as “an avid Ashtanga yoga practitioner who stands five foot ten and wears a size 8,” “standing six feet and weighing 155 pounds of mostly muscle,” or a “twenty-nine-year old petite (we’re talking size 5 1/2 shoe), multihued blonde…Her exact bra size is 32A…” Continuing the breast measurments, one woman is described as “respectable 36C,” one’s size is described as “perfect,” another “a modest, natural-looking 36B” (on a woman who had implants). Respectable, perfect, and modest are all judgments about these women’s breasts, and their appropriateness - exactly the opposite of what this book purports to tackle.

Making further judgments with regards to breasts (the focus of the second chapter), she describes breasts that stand at attention” as “signify[ing] youth and the promise of a long future” while assuming that “those that swing low bear the signs of infusing life into children, of fighting gravity for decades,” ignoring the real differences between women that begin long before decades and childbirth have passed. Women’s natural breasts are simply shaped differently, and perky vs. pendulous may simply be genetics or size rather than a false dichotomy between the young and full of potential and the old who have “lost the battle.” The author insists that from “barely A to DD,” breasts tell a story, but she seems not have learned how to read and interpret that story with factual accuracy.

While the author is trying to convince us that numbers don’t matter, she introduces us to women first through those very numbers. While insisting that we not be slaves to the scale, she makes it clear that these numbers are fair game for public consumption and judgment, and perhaps even the identification of women, through their prominence in her descriptions of these women. As the title implies, the women profiled in the book tend to be those with the access, resources, and time to spend long hours at local gyms. The effect is not to inspire regular women to be healthy rather than obsessed, but to remind women who don’t spend 5-6 days a week at the gym (as the author lets you know she does) that they could be doing more. After all, if women more dedicated and athletic than they remain unsatisfied with their body image, what hope do they have of being personally satisfied while they are not devoting nearly so much time to calorie calculations and yoga and elliptical machines?

The book feels as though it were written by two separate people, or at least one person who hasn’t truly resolved her body image issues to the extent one would expect from the author of a book described as a “wake-up call.” On one page, she writes, “The scale should not be the enemy. Ben and Jerry’s New York Triple Fudge Chunk isn’t even the enemy.” Yet later she describes a character as “work[ing] out regularly but admittedly ha[ving] a weakness for sub sandwiches and desserts of any kind…” A weakness. Something to be conquered. A flaw. This appears just twenty-one pages after the insistence that desert (in the form of ice cream) is not the enemy. It is this inconsistency that leads me to believe I may not be able to finish reading the book, because I’m not convinced the author believes what she’s saying, or even recognizes the contradictory messages in play in this work. At this moment, I certainly would not recommend it to women who are honestly seeking to overcome their addiction to measurements and perceptions of the “perfect” body.

Feminists and Body Image

A new study in the journal Body Image examines self-identified feminists’ and non-feminists’ perceptions of women’s attractiveness by body mass index (a ratio of weight to height). The authors interviewed 261 women in the UK who were largely white, educated, and unmarried and answered either “yes” or “no” to the question “Would you describe yourself as a feminist?” Those who were unsure were excluded.

The women were presented with 10 photographs of real women, viewed from the front, with two images each from the BMI categories of emaciated, underweight, normal, overweight, and obese. This is a little bit different from the categories we normally see in the U.S., as we don’t normally see an “emaciated” category separate from “underweight”, although the ranges are the same. For non-metric reference, a person who is 5′9″ would have to weight 124 lbs or less to be considered underweight, and would be considered “normal” weight up to 168 pounds. Someone my height (5′2″) can only get up to about 130 lbs before being considered overweight.

The participants then rated the images (whose faces were obscured and were dressed identically) from 1 (not at all physically attractive) to 9 (extremely physically attractive), identified the smallest and largest figures they considered attractive, and selected the figure they thought was “maximally physically attractive.”

The authors note that of the demographics such as age, education, and income, only feminist status predicted attractiveness rating. Feminists in general gave higher attractiveness ratings across the board, being more accepting of both thinner and heavier women. The figure with the highest approval rating from both groups, however, had a BMI of 18.45, which is slightly less than “normal” and into the underweight range.

This does not mean, unfortunately, that anyone was particularly accepting of varying body types, feminist or not - click the above graph to see details adapted from the study. If you plot the mean attractiveness ratings for each BMI, there is pretty close agreement on the most attractive, slightly underweight BMI, and attractiveness falls off on either side, with feminists simply falling less far in their ratings. The authors note several limitations of their study (such as “feminist” meaning different things to different people), but conclude, “although feminists do not appear to be buffered from preferring thin figures, their belief system nevertheless allows them to interpret physical attractiveness as encompassing a wider range of body weights. In this sense, attempting to more thoroughly understand the influence of feminism on thin-ideal internalisation may prove fruitful in the search for protective factors against negative body image.”

Swami V, Salem N, Furnham A, Tovée MJ. The influence of feminist ascription on judgements of women’s physical attractiveness. Body Image. 2008 Feb 13; [Epub ahead of print] PMID: 18280228

Feminists and Attractiveness, and Comprehensive Sex Ed and Teen Pregnancy

There are two new studies out that I want to talk about here, but I want to do them justice and will write more tonight. The first examines women’s perceptions of other women’s attractiveness by the judged woman’s BMI and the rater’s self-identification as a feminist (or lack thereof). The second looks at abstinence-only vs. comprehensive sex ed and initiation of sexual activity and teen pregnancy. Both of these are probably going to fall into the “things we were pretty sure about already” category, but from a quick glance there are some interesting tidbits there that deserve more examination than I can give them at the moment (such as that both feminists and non-feminists rated the “underweight” woman as most attractive). Suffice it to say that they’re being reported as “feminists are less judgy about weight” and “comprehensive sex ed is probably more effective.”

Here are the citations, if you have access and want to get a jump on reading the articles:
-Swami V, Salem N, Furnham A, Tovée MJ. The influence of feminist ascription on judgements of women’s physical attractiveness. Body Image. 2008 Feb 13; [Epub ahead of print] PMID: 18280228
-Kohler PK, Manhart LE, Lafferty WE. Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy. J Adolesc Health. 2008 Apr;42(4):344-51. Epub 2008 Jan 31. PMID: 18346659

Events for Boston Readers on Breast Implants and Maternal-Fetal Conflicts in Pregnancy

Thursday, March 13, 6:00 pm - Free lecture by David Haig, Maternal-Fetal Conflicts in Human Pregnancy
Harvard Museum of Natural History
24 Oxford Street in the Geological Lecture Hall
http://www.hmnh.harvard.edu/lectures_and_special_events/index.php

Pregnancy is the most intimate of human relationships and, just like any other relationship, there is potential for both cooperation and conflict. In this lecture, Dr. Haig, Professor of Biology at Harvard, will discuss the various genetic conflicts that transpire within the human womb, and visit the assumption that what’s good for the mother is also good for the fetus. Haig will consider evolutionary conflicts over the amount of maternal blood flowing to the placenta, and use this perspective to consider the causes of preeclampsia.

Friday, March 28, 6:30 pm - Free screening of the film Absolutely Safe and Q&A with the director
Boston University: Sargent College, Room 101
635 Commonwealth Avenue

Excerpts from the press release:

Millions of women around the world have breast implants. In the United States alone, hundreds of thousands of women get breast implants every year. Today, breast augmentation surgery is the number one cosmetic procedure in the U.S. and a multi-billion dollar industry. But, at a time when more women than ever are getting breast implants, fewer voices than ever seem to be asking “Why?” And, fewer still are asking “Are they safe?” The new 83 minute documentary ABSOLUTELY SAFE asks serious questions about this popular cosmetic surgery.

ABSOLUTEY SAFE is directed and produced by Carol Ciancutti-Leyva, executive produced by acclaimed filmmaker
Jennifer Fox, edited by Emmy-Award winning Editor Vincent Stenerson, and features the music of renowned composer Miriam Cutler. For more information on the screening contact: info at absolutelysafe dot com or (212)868-9780. Visit the film’s website www.absolutelysafe.com

New Study on “Diabulimia” Outcomes

A new study in the March issue of the journal Diabetes Care examines that gets at the outcomes women might experience from “diabulimia,” because looks at what happens when women with Type 1 diabetes take less insulin than they should. The researchers looked at women (following up with a group they first studied in the early 1990s) who said they ever restricted their insulin (from “rarely” to “always” doing so), compared with those who never did so. They also looked at the women’s self-care tasks (such as blood glucose monitoring), their feelings about living with diabetes and fear of hypoglycemia, psychological symptoms, attitudes related to eating disorders, and their A1C values. They then also looked at the complications the women had experienced.

The researchers found the following things:

• Those who restricted their insulin use (as in “diabulimia”) reported worse self-care behavior, higher distress about having diabetes, greater fear of hypoglycemia, and more general psychological and bulimia and other eating disorder symptoms.
• Women who were “insulin restrictors” at the time of the initial study were more likely to have experienced neuropathy and foot problems by the time of follow-up. Self-reported rates of retinopathy, neuropathy, and cardiovascular complications at follow-up did not differ between insulin restrictors and appropriate insulin users.
• Those who restricted their insulin were 3.2 times more likely to have died during the study period than those who didn’t, even after controlling for BMI, age, and A1C.
• When they looked at women who had died during the study period, those who restricted insulin died younger, at 44 vs. 58 years.

The authors do note that some of the participants may have restricted their insulin intake for other reasons aside from weight-related concerns, but their work seems to demonstrate some unappealing outcomes for those practicing this behavior. They also point out that the kind of specialized care needed by these women is often unavailable, something that has been discussed in our previous thread on this topic, and that more research should be done.

Related Posts: Diabulimia - New “Eating” Disorder Among Diabetics?, Diabulimia Discussion

Citation: Goebel-Fabbri AE, Fikkan J, Franko DL, Pearson K, Anderson BJ, Weinger K. Insulin Restriction and Associated Morbidity and Mortality in Women with Type 1 Diabetes. Diabetes Care. 2007 Dec 10; 31(3): 415-19.

Photo by sullyt64 and used under a Creative Commons license.

Dear Horizon Blue Cross Blue Shield of New Jersey: This is Incredibly Bad PR

Via Junkfood Science, I learned that Horizon Blue Cross Blue Shield of New Jersey, in response to a lawsuit from parents over the insurer’s refusal to cover their children’s anorexia or bulimia, is demanding access to the children’s emails and MySpace and Facebook accounts. According to this news item:

Horizon claims that the children’s online writings, as well as journal and diary entries, could shed light on the causes of the disorders, which determines the insurer’s responsibility for payment. New Jersey law requires coverage of mental illness only if it is biologically based.

 

Horizon claims the eating problems are not biologically based and that the writings could point to emotional causes. It contends that access to the writings is especially important because the court has barred taking the minors’ depositions.

Essentially, the insurer is claiming that the eating disorders are simply an emotional problem, and want to root around in children’s communications to try to demonstrate that nothing is physically wrong - it’s all in their heads. And mental health concerns never have a biological basis, right? That must be why psychiatrists never prescribe drugs to help with mental health. Or not.

I wonder how BCBS plans to separate normal teenage angst from writings demonstrating a direct cause of their eating disorders? Somehow I doubt that’s even possible, because, let’s be frank - if someone dug up all of your teenage missives, would it seem like you were a mature, mentally stable person? Probably not. Also, teens never exaggerate their mental suffering, right? Way to try to humiliate them in the process of trying to get their serious (sometimes fatal) disorders covered so they can have access to treatment. Ugh.

Saturday News Round-Up, 2/2/08

February has many health observances worth noting:
-It’s American Heart Month, and yesterday was “Wear Red for Women” day as part of the Heart Truth campaign focused on women’s heart health.
-February 2-11 is National Condom Week. Buy one, give one, y’all.
-February 7 is National Black HIV/AIDS Awareness Day.
-February 24-March 1 is National Eating Disorders Awareness Week.

-The CDC reports on unexplained neurologic illnesses among workers in a pig slaughterhouse in Minnesota, calling it “Progressive Inflammatory Neuropathy” and releasing a preliminary case definition.

-The FDA released a public health advisory on the smoking cessation drug Chantix after reviewing reports of “changes in behavior, agitation, depressed mood, suicidal ideation, and actual suicidal behavior.”

-According to the Washington Post, “When the Consumer Product Safety Commission returns to work on Monday, it will not have the authority to adopt safety rules, order mandatory recalls of dangerous products, or impose civil penalties on companies that do not report product hazards immediately,” because it has a vacancy it has to fill.

-Some jerk writes, “she changes her mind and says drunkenly ‘actually…’ But being so caught up in the moment, he disregards this as momentary insanity on her part and enters her anyway. Who is really to blame in this situation? ? Yes, the guy should have stopped when she said no, but didn’t she vehemently send the message that sex was what she wanted? I mean, she even showed up to the party looking like pure sex, so who is really at fault?” And the jerk is a woman (a student at BU). And she uses this scenario as an example of “The Blurry Line between Sex and Rape.” Oh, honey.

-RH Reality Check has a piece by Susan Wood praising Sen. Clinton for her Plan B advocacy. Good discussion going on in the comments.

-Jezebel is talking female ejaculation. If you Google that, you’re going to get some unsavory results (well, depending on whether you’re at work or not). You might start with Scarleteen’s Sexual Response and Orgasm: A User’s Guide.

-Scarleteen is also talking embarrassing period moments. Margaret Cho has something to say about this as well, like, “I am the worst when it comes to period stains. That is why I never move because my mattress is so so so so stained that whenever I change the sheets it just looks like a murder scene.” I love Margaret Cho.

Finally, a couple of OBOS posts I haven’t linked to yet: Pregnancy Weight Gain Guidelines May be Revised, and Gearing Up for Super Tuesday.