Hysterectomy or homeopathy for fibroids... Why waste the money?

in #life7 years ago (edited)

By the age of 60, one in five UK women will have had a hysterectomy (one in three in the USA), with around 60,000 women yearly having the procedure performed on the NHS. If you add up the cost to the country, at an average price of £4500 per op, it comes to a £270 million annual bill for the NHS. And that's without all the lost work days, sick pay and disruption to family life (and bedroom action).

Please hang on to that figure of £270 million while I digress a little. Back in 2015, Patient C, a woman in her early forties from Scotland, contacted me about a fibroid that had set up shop in her womb and was now running, and ruining, her life. She already had an NHS hysterectomy booked for six months time, and merely wanted help from me to manage her symptoms in the meanwhile. 

She was a stoic sort, as so many of us Brits are, but I could tell she was suffering - stabbing pains in the lower abdomen, severe pain during intercourse, a protruding lower tummy like she'd just finished a three course meal, a menstrual cycle of 21 days with two week long bleeds in between leaving her menses free for a pitiful one week a month. The periods themselves were so painful, and more importantly so heavy, she couldn't leave the house without taking an industrial quantity of sanitary supplies and a change of clothing. 

With such clear and strong symptoms it didn't take me long to find the right remedy, Sepia, in this case. I gave her 200c and then 1m repeated over the next few months. She responded extremely well with a visible shrinkage of the fibroid, so much so that she couldn't even feel it most days. Her heavy periods also disappeared. As her NHS op deadline drew near, she decided to postpone it for a while. 

Six months after that her gynae consultant refused to give her another scan because she was no longer showing symptoms 'worth' surgery. In 2018 she's still postponing the op, in fact to be precise, she's signed herself off the waiting list altogether. My services for the entire course of treatment? Less than a first class return train ticket from London to Edinburgh, Patient C's childhood home. 

Now back to that £270 million. Firstly, £270 million is approximately £265 million more than the entire NHS annual budget for homeopathy. Secondly, Patient C is just one of four such patients with fibroids who I have seen in the last few years and to date, none of them have taken up that offer of an op because, after homeopathic treatment, none felt the need. I calculate I've saved the NHS £18,000, and the ladies in question a considerable degree of discomfort and distress. 

Now multiply my work by the number of homeopaths in the UK (about 6000). Let us all treat just one or two women with fibroids per year and already we have an annual NHS saving of £54 million. Even if only half of them respond to treatment, that's still £27 million (enough for about another 1000 nurses a year, FYI). 

Whether you believe in the power of placebo or the power of homeopathy or neither, or both, offering women with gynaecological problems a stop off visit with a homeopath after the scan and before the hysterectomy might just be a cost saving experiment for the NHS that really pays off. 

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Well I'm glad you mentioned "the power of the placebo" because that is the only effect possible with a 200C treatment. It is water, plain and simple.

Of course you do miss the possibility that fibroids can go away by themselves entirely untreated especially as a woman starts menopause. While the average age for menopause is around 50 the is a great deal of variation and some women start before even reaching 40. Therefore in your sample of one single person it is entirely believable this had nothing at all to do with even the placebo effect. Without medical history no one could say anything for sure on this one case.

If you go read the literature on treatment for fibroids you see efficacy numbers for the placebo in the 10-20% range. So really it shouldn't be surprising that any treatment emulating a placebo, such as homeopathy could claim to have success. But that doesn't mean it is a great treatment especially when remedies to control bleeding can be 80% or more effective.

http://www.nejm.org/doi/full/10.1056/NEJMoa1103182
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5155051/

Thank you for your engagement @o1o1o1o.

I completely agree, fibroids can and do go away by themselves at menopause, but usually this in the case of small fibroids only. Large fibroids very rarely go away by themselves, hence the number of fibroid related hysterectomies.

Moreover, please do not assume that the other three cases I mention were peri-menopausal or menopausal women.

I note your statistic about the effect of an iron supplement (effective in just 19% of the placebo test subject group) in the paper you cited, as well as the common reported side effects of headache, nausea, abdominal pain and hot flushes in using the drug Ulipristal for fibroid reduction (around 25% of women). Luckily 100% of my patients showed a reduction in symptoms from the treatment I offered, and 0% of my albeit small sample of patients complained of side effects or any 'serious adverse events'.

Your blanket disdain of the power of homeopathy aside (I encourage other readers to test the validity of your statement by a quick read of the many papers published by the Homeopathic Research Institute: https://www.hri-research.org/), it is clear that placebo does work for at least 19% of fibroid patients (around 12,000 women per annum in the UK) and this in itself is worth further investigation.

Whether the options offered to fibroid patients are iron supplements, homeopathy or another 'placebo', all are likely to be cheaper and less distressing to the patient than the looming threat of a hysterectomy.

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Amazing figures .... what a saving ... wow, imagine what we could do with a few more examples!

Hi @marygreensmith. I think we could all take an area we work on most and calculate the NHS savings and write it up here. It might make for interesting reading!

Hell’s teeth Laula! When you put it that way ... what’s not to love?
I’m guessing you didn’t count hospital infections, anaesthetic and pain killer side effects and accidental deaths during surgery in your calculations too.
😄

Or the prolapses post hysterectomy surgery that need more surgery! It's about 5% of all those women. 5% is 3000 women. Gulp. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562278/).

Sepia is pretty handy for prolapses too!

Love your post, so true! I see you 'tagged' me here but I didn't get any notification of it, just saw it by chance... what am I missing?!

I have no idea how this works. Ask @alanfreestone. He knows everything.

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