Angry in the Great White North

Cindy Sheehan had a much publicized trip to the hospital last week:

Peace mom Cindy Sheehan spent the night in a hospital for a gynecological procedure and treatment of dehydration but said Saturday that wouldn't stop her protest against the Iraq war on land she bought near President Bush (website - news - bio) 's Crawford ranch. Sheehan was listed in stable condition at Providence Health Center in Waco, about 20 miles east of Crawford.

Sheehan returned to Texas on Friday after a few days in Seattle at the Veterans for Peace convention. She planned to resume the war protest she started Aug. 6, the first anniversary of the beginning of her 26-day peace vigil that drew thousands of anti-war demonstrators and spurred counter demonstrations by Bush supporters.

Instead, friends took her from the airport to the hospital. After being on a liquid diet as part of the nationwide "Troops Home Fast" hunger strike, Sheehan had been treated at a Seattle emergency room Thursday, and ate for the first time in about 37 days, said her spokeswoman Tiffany Burns.

Doctors in Waco stopped uterine bleeding, gave her a blood transfusion and planned a biopsy, she said. Sheehan was dehydrated again Friday, but said it was probably from the bleeding.

Clearly this was an emergency, and related to blood loss. Well, probably related to blood loss according to this media report. Keep that phrase in your head as you read on.

I want to lay some groundwork here. The body of an average sized woman contains about 9 pints of blood. Blood loss can, of course, be fatal:

The body can normally lose 1 pint of blood (usual amount given by donors) without harmful effects. A loss of 2 pints may cause shock, a loss of 5 to 6 pints usually results in death.

So what can we make of this by Missy Comley Beattie, one of Cindy Sheehan's associates in Gold Star Families for Peace?

Blood is the fluid of life, coursing through our veins and providing oxygen to the body.

Cindy Sheehan has just been released from a Waco hospital where she was treated for exhaustion and dehydration and was transfused after losing almost five pints of blood. This ordeal is nothing compared to the heart-shattering agony of hearing the words, "We regret to inform you," a message delivered over and over as more blood seeps into the Iraq sand each day. [emphasis added]

Yeah, yeah, Iraq. Five pints?! Over half her blood supply?! Until I read this, the assumption has been, based on the bland news reports like the one I quoted, that Cindy Sheehan suffered from a bit of excessive bleeding not uncommon in women her age, and that the effect of the bleeding was magnified by her fast, thus requiring the unusual step of a transfusion:

In the evaluation of the woman with AUB [abnormal uterine bleeding], obtaining a thorough history is of paramount importance. Emphasis should be placed on learning the pattern and quantity of bleeding. Because most women are poor at estimating blood loss and recalling exactly when they bled, all patients should be asked to keep a prospective menstrual calendar in which they record days and severity of bleeding. Menses lasting for more than 8 days or in which more than 80 ml of blood is lost are probably abnormal (i.e., menorrhagia). It has been estimated that up to 20% of women have excessive menstrual blood loss and that the incidence is similar for African-American and white U.S. women.

For people not familiar with the metric system, 80ml might be a lot of blood to lose via menstruation, but it represents less than 0.2 pints. According to Missy Comley Beattie, who is clearly no doctor, that is less than 25 times the blood loss Cindy Sheehan suffered.

Beattie goes on:

The dangerous amount of blood that Cindy Sheehan lost has been replenished. But medical experts can do nothing to ease the grief Casey's death has brought. There is no transfusion for the heart. Over 2,600 families in this country feel the never-ending pain that bonds Sheehan to the despair and suffering of the Iraqis whose lives and culture have been destroyed. [emphasis added]

Yeah, yeah, war is bad. Dangerous amount? You think?

Hey, I'm not a doctor either, but to lose five pints, you have to have suffered some sort of dramatic uterine trauma. It can happen as a result of childbirth:

After the baby is delivered, excessive bleeding (postpartum hemorrhage) from the uterus is a major concern. Ordinarily, the woman loses about 1 pint of blood after delivery. Blood is lost because some blood vessels are opened when the placenta detaches from the uterus. The contractions of the uterus help close these vessels until the vessels can heal.

Loss of more than 1 pint of blood during or after the third stage of labor (when the placenta is delivered) is considered excessive. Severe blood loss usually occurs soon after delivery but may occur even as late as 1 month afterward.

But as traumatic as this is, the panic button is hit after a mere pint is lost. But bleeding on this scale, especially since there is no evidence that Cindy Sheehan was in the hospital in recent weeks or months for any procedure, is a known side-effect of RU486:

An emergency room doctor, Mark Louviere, M.D., treated a woman from Waterloo, Iowa two weeks after she had taken RU-486 at the local Planned Parenthood clinic. When she arrived at the ER, according to Dr. Louviere's testimony, she was "in obvious shock" having "lost between one-half to two-thirds of her blood volume. ... It was my clinical opinion that she would die soon. ... Without even doing the routine preparation we normally do for surgery, I realized that I had to take her immediately to surgery to save her life."

Nine percent of women in U.S. trials bled for over 30 days, and one percent of women were still bleeding 60 days after taking RU-486.

Two women describe bleeding. Two patients in Des Moines, Iowa RU-486 trials told a TIME magazine journalist that their bleeding was "like turning a jug of water upside down" and "like a faucet was turned on. There was a steady stream of blood. I passed a golf ball size blood clot that scared me."

And this from a pro-abortion site:

Side effects, such as pain, cramping and vaginal bleeding, result from the abortion process itself, and are therefore expected with a medical abortion. Other side effects may include nausea, vomiting, diarrhea, chills, or fever. Complications are rare, but may include infection, excessive vaginal bleeding requiring transfusion (occurs in approximately 1 in 500 cases), incomplete abortion or ongoing pregnancy which requires a suction abortion (see above).

Recall that Cindy Sheehan was in hospital in Seattle immediately prior to coming to Waco, but not for surgery. The reports implied it was for exhaustion and dehydration from her liquid diet:

Sheehan has been on a liquid diet as part of the nationwide "Troops Home Fast" hunger strike. She was treated and released from a Seattle emergency room Thursday night. On doctors orders, she ate for the first time in about 37 days, Burns said.

No indication of bleeding, nor any hint of surgery. In fact, the problems started later. Perhaps she was misdiagnosed in Seattle. Perhaps she hadn't been forthcoming about something significant in her recent medical history. Perhaps the bleeding hadn't manifested yet, and the doctors didn't look for any explanation for her palour beyond dehydration:

When she arrived in Texas, Sheehan, 49, was pale and tired, Burns said.

Sheehan's sister, Dede Miller, said Sheehan also had been experiencing heavy bleeding so doctors in Waco performed a dilation and curettage, in which the lining of the uterus is scraped, and were doing a biopsy.

Heavy bleeding? According to Beattie, it was catastophic, life-threatening bleeding.

A follow-up D&C can be necessary, by the way, when things go wrong:

In a study reported by Silvestre et al. (1990), the overall efficacy rate [of RU486] was 96 percent, with 1 percent continuing pregnancies, 2.1 percent incomplete expulsions, and 0.9 percent required dilation and curettage (D&C). Only one woman required blood transfusion. The procedure is not only highly efficient, but it is generally acceptable to women.

Five pints of blood! There is nothing routine about losing five pints of blood. "Heavy" does not come close to characterizing it.

Maybe Beattie got her numbers wrong, or maybe the bleeding started after a botched surgical procedure in Seattle that was never reported, or maybe the news reports got it wrong and she was driven to the hospital for some other reason and the blood loss happened after treatment, or maybe there are reasons for that sort of dramatic bloodloss that I haven't been able to find.

Addendum: Have I gone too far? Stepped over a boundary? I don't think so. I did not go out looking for this information. I saw the reports about Cindy Sheehan's hospitalization, and like a few of you, I wondered how someone could become dehydrated on a liquid diet. She had a gynecological procedure, but then at her age, these things happen. I asked some discreet questions to be sure, but just to dispel my male ignorance of what could be the cause based on the sketchy details provided.

But like everything else that should be private, Cindy Sheehan and her people make it public. Missy Comley Beattie subtitles her piece "Open Wounds" with the line "Cindy Sheehan's medical condition is a metaphor for the state of our country." Really? Then why is she did she suffer near fatal bleeding? I want to understand the metaphor better. Cindy Sheehan's campaign has been based on what Maureen Dowd called the "absolute morality" of motherhood, with a heavy dose of Catholicism mixed in. Remember Cindy Sheehan and Martin Sheen leading the Sheehanites in saying the Rosary last summer? For a lot of people, these questions are legitimate because they strike at the moral core of her campaign.

Don't get mad at me. She brought it up. All she had to do was keep quiet, and I wouldn't have said anything. But if she wants to turn her medical woes into political theatre, then she's going to have to expect some questions to be asked.