Bowel cancer screening pain bias

[BuckingFrolics]

Toddled along to the hospital last week for bowel cancer screening test as now 55 and it's free.

Not unduly concerned about pain as leaflet and all online stuff said "may be uncomfortable" in which case pain relief will be provided.

Meet first nurse who says before I have sat down, "we'll give you gas and air before the procedure starts". What? No I'm fine, I say, if it's uncomfortable I'll grit my teeth.

Meet the nurse doing the procedure who again offers gas and air before we start.

What? I thought this was "uncomfortable" - what's with the gas and air?

She says - of fucking course -"oh men find it uncomfortable but because of the womb and bladder position it's more painful for women and we offer gas and air - particularly if you've had a cesarian as there may be adhesions."

Yet another example of men being taken as the norm.

(And yes it fucking hurt like a bastard.)

Was this a colonosopy ? Gosh, I had a GA for that ! No wonder it hurt you, it's very invasive . And gas / air , wow that doesn't do anything. It's just nitous oxide, ie laughing gas , so the colonoscopy hurts but you ( supposedly ) don't care. I think you got short-changed OP.

These information leaflets have to be written with people other than relatively healthy men as the default demographics.

Presumably you might have driven yourself to the test and G&A wouldn’t be ideal in that situation. Others hate G&A, particularly if they’ve had a bad experience with it in labour. Having no warning that it’s routinely offered for this procedure is quite shit.

No not a colonoscopy but a "bowel screen" so lower bowel only.

Eh? Are they offering routine colonoscopy for bowel screening in the UK/NHS ?

I wasn't aware of that. Did you have bowel prep (clear you out laxatives) the day before?
I was sedated with Midazolam when I had one, definitely not allowed to drive. It was great though. Didn't feel a thing.

I'm not clear what your complaint is. You were advised pain relief was available and you turned it down.

come on Lass, you're not normally obtuse.

the OP is quite clear. the medics she saw advised her that men and women experience different levels of pain from the procedure. the leaflet was written as if only men would read it

If women routinely experience enough pain that G&A is pre-emptively offered, then the leaflet should say something like ‘many people find this procedure painful and patients will therefore be offered pain relief in advance’. It’s a very different scenario.

I woke in the middle of a colonoscopy the other week.. .which surprised everyone. I've had it done with only a couple of valium before. It was v. Unpleasant. Just tried to stay calm but want offered any pain relief or was it discussed

You can drive after G and A I believe - it only stays in the body for 3-5 minutes I thought?

In my area a sedative injection is routinely offered for a colonoscopy- G and A is the ‘brave’ option. But that may be for whole bowel only.

come onLass, you're not normally obtuse

Oh I'm been told I'm obtuse several times on here so guess I must be. OP was offered pain relief but turned it down and is now making a fuss about goodness knows what. She was warned she might need pain relief but that isn't good enough apparently- it has to be offered because she is a woman.

Lass
Come on keep up. Men and women have different experiences. Leaflet for men not women.
She says - of fucking course -"oh men find it uncomfortable but because of the womb and bladder position it's more painful for women and we offer gas and air - particularly if you've had a cesarian as there may be adhesions."

That was the verbal advice of the nurses at your local unit though, that women typically find it more painful. Staff at another unit may think differently. If it's a widespread opinion the leaflet should be more detailed, but there's no evidence this is the case from this one experience.

yeah, it could be that the nurses at OPs local unit were wrong

or it could be, as extensively documented in Invisible Women, that what with men being the default humans, the leaflet was written for what they were likely to experience. and what with this being Feminism Chat, the OP thought she'd like to have a chat about it

sheesh

I think the nurse was wrong, or misspoke.

Pain levels are based on the individual (varies individually, not by sex) and by the degree of inflammation (the biggest single factor).

Some say that more patients arrive at A&E when it's the full moon, really believe it, and state it as fact to third parties. But actual analysis shows it not to be the case.

OT, I know, but - superstition aside - I’d expect fewer A&E incidents during a full moon as you are less likely to bump into something.

Margaret McCartney did a piece in one of her books about bowel screening.

The really fascinating bit was that there was a study about the level of promotion which encouraged take up, but if they were then given more information to help make a properly informed decision about the effectiveness of it and the potential harms of screening, take up of screening actively dropped. Thus there was a dilemma over how much you should tell the patient to enable informed decision making and whether that was more important than getting the 'correct behaviour' from a patient and higher take up rates of screening.

Certainly I find it interesting that references to pain are anecdotal from the nurses rather than stuck on a leaflet for everyone to consider before getting to the screening. Especially if indeed women are more likely to feel pain...

If women DO indeed feel more pain then that is depriving women the opportunity to consider their opinions first and prioritising 'correct behaviour' over informed choice.

And if women DONT feel more pain then that's pure straight down the line sexism from staff rather than an evidence based piece of information.

Either way, it strikes me as troubling in terms of women's health.

There is so much feminist analysis of medicine.
Here is an excellent blog and I'll give you the link to the author's analysis of medical diagnoses. She calls it The Diagnostics Racket.

cannabisrefugeeesq.wordpress.com/2019/06/29/the-diagnostics-racket-ft-scooby-doo/

I don't go for smear tests for various reasons which I won't go into here

A paragraph from there

After 100 years of feminist activating in the West, American women are still fucked and being fucked (and fucked over) in every way imaginable and it’s not primarily about voting and husbands and money anymore if it ever was but about men having wrecked our entire country by now with male-made nuclear contamination > makes everyone sick > Western medicine is 100% under male and patriarchal control.*

I had a colonoscopy whe i was 22, no pain reief, sedative had no impact, maybe worn off due to wait? I remember snivelling due to the ain and looking at the nurse's por arm which had bad scarring and thinking i was being pathetic.
Hope you are ok now.

Where I live, it’s hard to find a provider to do the screening without sedation. I was reading up on not needing it and kept coming across the statement that it is rarely actually painful as long as they take their time. Then in fine print the caveat that women often find the test painful, especially if they have had any previous abdominal surgery. At the time, it struck me that I had never seen a more blatant example that men are considered the default.

Pain levels are based on the individual (varies individually, not by sex) and by the degree of inflammation (the biggest single factor).

Presumably though women are much more likely than men to have birth injuries, other conditions or previous interventions in that part of the body than men, which affects pain.

We are currently caught in a battle with doctors over my mum's heart condition, they are insisting, despite evidence, that sex plays no role in the presentation and diagnosis of heart attacks. It makes you doubt your sanity. I am also being told there is"no evidence" about the effects of the menopause on a condition that disproportionately affects women during and after the menopause. They just don't care.

The nurse was wrong, it's very individual, one persons manageable pain is another's excruciating, male or female is irrelevant. Yes our biology may make it more likely to be painful but we all know women are better with pain! I've had two procedures (not this one) where sedation is offered but I had just local anaesthetic because I wanted to drive- my friend then had the same procedure which I accompanied her to and they had to stop and administer sedatives.

Yes our biology may make it more likely to be painful but we all know women are better with pain!

FFS.