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Nepene t1_ivkrosz wrote

He was looking for a birth control scar from an implant. He presumably guessed she was pregnant from her appearance, confirming it with an ultrasound. He was ambiguous because he likes having an air of mystery to his patient examinations.

So, the relationship is that in your arm medical professionals often implant a small plastic tube called a Nexplanon or Implanon containing etonogestrel which blocks pregnancy normally, and failed in her case.

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RainingRabbits t1_ivlekt2 wrote

To add on to this - these implants are typically close to the skin and can often be seen when thin people raise their arms. If it's implanted deeper or the person is larger, you can tell if someone has one by looking for a small round scar.

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[deleted] t1_ivml55n wrote

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[deleted] t1_ivmyolw wrote

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winningjenny t1_ivna6ox wrote

There's a warning on the paperwork to see a Dr if you can't find it, please do and take care!

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BioEdge t1_ivncark wrote

I'm a paramedic and my skin is crawling just thinking about it. I can take seeing inside a skull, but things embedded under skin is where I lose it

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Vlinder_88 t1_ivookxv wrote

Yeah well no, I used to have one and the scar doesn't magically disappear once they take it out :') You should just feel for it when you can't see it, not look for scars.

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DJHellduck t1_ivo421a wrote

How does your size impact the visibility of the implant? It’s not like those extra 10 centimetres makes your skin thicker…

Edit: apparently he meant fat people.

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heteromer t1_ivo6h54 wrote

Because the implants aren't in your skin. They're subcutaneous, which lies underneath the dermal layers. People who are overweight have greater subcutaneous fat content, so it might not be as visible.

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[deleted] t1_ivma96g wrote

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mcnabcam t1_ivmydyv wrote

The idea being that someone on implanted birth control is more likely to be sexually active and less likely to have a secondary birth control method like condoms. She would presumably have noticed a condom failing and would not be as oblivious to her pregnancy

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EmilyU1F984 t1_ivnp8iz wrote

It‘s insane to me that people on continuous Bc are not recommended to do monthly pregnancy tests. Those tests are less than 50 cents when bought in bulk.

And you will most likely miss the pregnancy on an implant or IUD far past legal limits for abortion.

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unofficialShadeDueli t1_ivnzao7 wrote

They are.

Technically I should take a pregnancy test every 6 months. But I don't have enough sex to warrant that...

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finishedlurking t1_ivnwljn wrote

you speak rationally but many 'working class' don't have the know how or time to do that

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EmilyU1F984 t1_ivnwuwi wrote

That‘s why I complained about this not being a standard recommendation by prescribing physicians. Not about laypeople not knowing everything.

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finishedlurking t1_ivnxgyg wrote

well it may be recommenced but the outcome is the same; due to limited time, distrust and resources of many people

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EmilyU1F984 t1_ivny2ds wrote

Nah it‘s not recommended in the first place. That‘s the major problem.

Otherwise: 50 cents a month is cheaper than the eventual late term abortion or full term pregnancy.

The problem is people not being given adequate information to make informed healthcare choices. Not poverty itself. In this case specifically.

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Ruca705 t1_iw2c2qp wrote

Have you considered the huge amount of plastic production and chemical waste that would take place if every user of a Bc implant started testing monthly? We are talking a very large amount of pregnancy tests here. Millions upon millions of people around the world have these implants, you want to multiply that by 36 for the duration of the implant, can’t you see how astronomically wasteful and damaging to the planet that would be?

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[deleted] t1_ivnydqf wrote

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EmilyU1F984 t1_ivo0t6p wrote

Mate I’m saying that‘s how it is, because it’s not standard practice. Individual physicians going above and beyond official guidelines is commendable but not standard practice.

Just like painkillers and anesthesia isn‘t standard.

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Tricky_Violinist_906 t1_ivo00zs wrote

Actually I remember this episode mentioning that. Something along the lines of “and do you test regularly as you’re supposed to?” And she of course says no because plot haha

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Alpacaofvengeance t1_ivo7q18 wrote

Implant (if inserted correctly) is crazy effective though, it'd be a waste of money to be doing the tests.

Might be worthwhile for Mirena/IUD.

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Ruca705 t1_ivo9vvq wrote

It’s almost impossible to get pregnant on the implant, testing monthly is a waste of resources

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snpods t1_ivoem03 wrote

The counter-argument to that is that an implant like Nexplanon is highly effective. More effective than condoms or the pill based on actual usage by a decent margin.

1 in 1,000 people using Nexplanon over three years will become pregnant. There’s no such thing as user error once the device has been in place for several weeks.

For condoms, the practical efficacy rate is about 87% per year. For the pill, it’s about 93%.

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EmilyU1F984 t1_ivopyzh wrote

It‘s 6 USD per year to test monthly, a non medical abortion runs you at least 300USD, having to birth the child risks you half a million or death and permanent disfigurement plus the psychological trauma of being forced to carry a baby to term.

Seems like with the 1 in 1000 rate per 3 years, it’s advisable to just test.

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ArbitraryBaker t1_ivoirua wrote

Fewer than eight out of 1,000 women (0.8 percent) become pregnant over five years using Mirena. Why should I do more pregnancy tests than someone who uses condoms? My daily activities wouldn’t change much based on whether I got a pregnancy diagnosis or not.

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Voctus t1_ivol4a8 wrote

Presumably someone using only condoms would have a missed period as a hint that they need to take a test, while many women on continuous birth control have infrequent or no periods so wouldn’t otherwise notice something was different.

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dbossman70 t1_ivo2bsz wrote

the more important difference is the show ran from ‘04-‘12 so nexplanon probably didn’t exist yet.

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DeltaBlack t1_ivo7p4b wrote

Nexplanon? Yeah, probably not. These types of birth control implants however are older than Nexplanon and date back to the late 1980's to the late 1990's.

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PaulClarkLoadletter t1_ivojysl wrote

He likely looked at her medical records like most doctors. A normal doctor would ask about it and request a pregnancy test and/or ultrasound. House likes to look amazing.

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snpods t1_ivovmoj wrote

Based on your username, I’m guessing you’re a gynecologist? If so … is it also true that the manufacturer improved the insertion device when transitioning from Implanon to Nexplanon?

My doc was mentioning something during the insertion procedure for my first Nexplanon (after I had already had Implanon), but I get squeamish and wasn’t paying attention. Lol. I’ve been curious for years, but never asked again!

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Thekinglotr t1_ivnfvf0 wrote

It doesn't contain progesterone. It contains etonogestrel, they are not the same.

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Matthew_C1314 t1_ivmj0bk wrote

This happens in a few episodes, but is this not the one where she raises her arms and he determines that the clothes are smaller on her since she gained weight. Like lifting the arm lifted the shirt?

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