Abortion, health care, HPV, chronic pain: what I’ve learned from my most popular posts of 2012

I published 97 posts in 2012 and during the year my blog was viewed approximately 970,000 times.  I’m humbled that anyone took the time to read anything that I wrote. Some posts were read by a couple of hundred people and some posts by a couple of hundred thousand. I don’t think the writing on the posts that drew exponentially more readers was spectacularly better, but these posts somehow stuck a cord and people graciously passed on what they read.

As I plan for 2013, I want to reflect on my top 5 posts from 2012 to see what I can learn:

1) Anatomy Of An Unsafe Abortion 287,827 views. This went viral very quickly, thanks to FreeThoughtBlogs, Michael Moore, and the thousands of people who reblogged, tweeted, and posted to Facebook. It even made it to the front page of Reddit, albeit briefly. I think it touched so many people because it’s true, but even worse, it’s a compilation. I have been knee-deep in the blood of a young woman more than once because she didn’t know how to distinguish between a safe, skilled provider and a hack looking to profit off of the disadvantaged. Medicine is ripe with purveyors of snake oil, some sell colonics, others homeopathy, and some procedures they have no business performing. But homeopathy, unlike a sharp curette, is unlikely to puncture the uterine artery. This post makes me especially sad given the recent news from Texas banning Planned Parenthood from participating in the state Women’s Health Program (reproductive health care for low-income women who do not qualify for Medicaid). There will be fewer Planned Parenthood offices, no doubt the purpose of the law the Governor likes to call Texas a “pro-life state.”  Fewer safe places for women in Texas to get abortions won’t affect the abortion rate, just the health consequences for the women who need those services.

2) Did Irish Catholic Law or Malpractice Kill Savita Halappanavar? 41,770 views. The world was aghast that a woman in a 1st World Country could die in a hospital while a needed medical procedure was denied, but that’s what happens when the government interferes at the bedside. Many large news organizations covered this tragic case, but few OB/GYNs spoke out, at least in a public way. I think that’s why my post was so popular. Be wary America, encroachment on your right to have the correct medical procedure could be coming to your state. For example, in Georgia at 22 weeks a woman in Ms. Halapannavar’s position could find herself needing to have her uterus cut open (a hysterotomy) to save her life instead of an induction of labor. Why? Because the Government of Georgia wants to spare a 22 week fetus pain (the pain it can’t feel using known embryological principles and neuroanatomy), a fetus that has a 1% chance of survival. I’ll post on this in a day or two.

3) Cancer vs. The Constitution 41,224 views. This is what happens when a woman never gets a Pap smear and happens to have the type of persistent HPV that causes cancer. And it’s true. Again, it’s a compilation as I’ve seen more than one woman in the ER dying for want of a Pap smear. Probably 10 in 10 years. Hopefully, it will happen less with more insured, but not if we don’t bring down the cost of health care. Obesity, inactivity, smoking, the propensity for surgical cures, over imaging, and the lopsided medical reimbursement system of favoring invasive procedures over talking (just to name a few) are conspiring to make the American model of health care unsustainable. I fear I may soon writing a post entitled The Food Lobby Defeats American Health Care System.

4) How Common is HPV in the Mouth and Can You Get It By Kissing? 41,045 views. The top 3 posts amassed thousands of views in a day. This is a little post that has reliably received 150-300 views/day since I posted it in Feb. 2012. Not surprisingly “HPV in mouth” is the top search term for my blog.  This tells me that people crave information about STDs that they just can’t get anywhere else except, well, Google. That’s sad. The fact that we have trouble talking about STDs and safe sex is part of the problem.

5) Persistent Pain After a C-section: when is it nerve pain and what can you do? 40,675 views. I wrote this post in 2011 when a twitter follower asked a question about post c-section pain (it’s a post, not direct medical advice). On days that I don’t post it is often my most viewed. This tells me (along with the comments, some that break my heart) that so few doctors understand pelvic pain (or chronic pain, for that matter). It’s so sad, because  it is pretty rare that in my practice we are unable to improve this kind of pain. We don’t always cure it, but we can almost always ease suffering and improve quality of life.

So what do I take from all this?

People like when a doctor speaks out passionately (and hopefully constructively) about health care injustice. Really, more of us need to do this.

People crave accurate medical information, especially about STDs and chronic pain. Expect more of these posts. Going to the doctor armed with good information is what makes an empowered patient.

I’m also going to post more on reducing the cost of health care. This is something that affects us all. We are stewards of our own health care system, just as we are stewards of the environment. We all need oxygen and we all need medical care.

I’m also going to bring back the Sex Position Posts. Hey, a girl needs to have a little fun now and then.

Thank you everyone for your support in 2012 and hopefully for your continued support in 2013.

What would you like me to post about?