Re: sidual dysplasia
From: Karen Lee (karen@karenlee.org)
Mon Jan 5 07:32:20 2004
She has an appt for LEEP in 4 weeks.
--- Charlie Chambers <cchamber@gorge.net> wrote:
> Karen
>
> Sorry but I misunderstood. I thought you would
> be doing the Aldara
> instead of the LEEP. How long till she gets the
> LEEP? If only a matter
> of a few weeks then I don't see the harm.
>
> On Jan 3, 2004, at 3:08 PM, Karen Lee wrote:
>
> > --- Charlie Chambers <cchamber@gorge.net>
> wrote:
> >> I think it's a dangerous proposition. One of
> >> the reasons to do the LEEP
> >> is for treatment, but the other is to insure
> >> that no contiguous areas
> >> of frank carcinoma are present.
> >
> > Help me to understand how Aldara use could
> > confound the pathology so as to obscure
> > continguous areas of frank carcinoma. And
> thank
> > you for taking the time with this. This is
> very
> > helpful as I know I'm sticking my toe into
> theicy
> > pond with great intentions, which often count
> for
> > naught.
> > Karen
> >
> > You are using
> >> an "experimental"
> >> treatment at best for someone with an
> increased
> >> risk of cervical
> >> carcinoma. The only way that I could see
> this
> >> happening is with
> >> informed consent and with IRB approval.
> >> Different story with someone
> >> with LGSIL who you are observing to allow
> >> spontaneous resolution, and
> >> then hoping to expedite with the Aldara.
> >> On Jan 3, 2004, at 9:42 AM, Karen Lee wrote:
> >>
> >>> So, this week I had a 22yo who had 2 N Paps
> >> in
> >>> the last 2 years. The recent one was LGSIL;
> >> colp
> >>> with 2 Bx, both HGSIL with glandular
> >> involvement!
> >>> So, of course she will have LEEP. I
> discussed
> >>> this with the Doc I refer these to and
> >> wondered
> >>> how he felt about my Tx her with Aldara
> while
> >>> awaiting the LEEP. He wasn't troubled by
> it,
> >> so
> >>> yesterday she had her first Tx. What do you
> >> all
> >>> think?
> >>>
> >>> Karen Lee, ARNP
> >>>
> >>> --- "art fougner, md" <evsono@pipeline.com>
> >>> wrote:
> >>>> I don't believe MgSO4 was approved for
> >>>> eclampsia. and ASA antedates the
> >>>> FDA. OTH off label indications put the
> onus
> >>>> totally on the practitioner
> >>>> so ...
> >>>>
> >>>> art
> >>>>
> >>>> At Fri, 2 Jan 2004, RModugno@aol.com
> wrote:
> >>>>>
> >>>>> Content-Type: multipart/alternative;
> >>>>
> >>>
> >>
> >
>
boundary="-----------------------------1073081945"
> >>>>>
> >>>>> -------------------------------1073081945
> >>>>> Content-Type: text/plain;
> >> charset="US-ASCII"
> >>>>> -------------------------------1073081945
> >>>>> Content-Transfer-Encoding: 7bit
> >>>>> In a message dated 1/2/2004 1:58:24 PM
> >> Eastern
> >>>> Standard Time,
> >>>>> cchamber@gorge.net writes:
> >>>>> I was then chastised
> >>>>>> by a physician because I was using this
> >> off
> >>>> label
> >>>>>> and was very liable for lawsuit. I
> >> discussed
> >>>> it
> >>>>>> with the Aldara rep who, of course,
> could
> >>>> not
> >>>>>> recommend that usage.
> >>>>>
> >>>>> Once a drug is apporved by the FDA - you
> >> can
> >>>> use it for "off-label" uses
> >>>>> provided there is medical literature to
> >> back
> >>>> up this use.
> >>>>> e.g.terbutaline is not approved for the
> >>>> treatment of premature labor.
> >>>>>
> >>>>> Robert Modugno MD MBA FACOG
> >>>>> Marietta, GA
> >>>>> http://www.novaobgyn.yourmd.com
> >>>>>
> >>>>> -------------------------------1073081945
> >>>>> Content-Type: text/html;
> charset="US-ASCII"
> >>>>> -------------------------------1073081945
> >>>>> Content-Transfer-Encoding:
> quoted-printable
> >>>>>
> >>>>> In a message dated 1/2/2004 1:58:24 PM
> >> Eastern
> >>>> Standard Time, cchamber gorge.net writes:
> >>>>> I was then chastised> by a physician b
> >> cause I
> >>>> was using this off label> and was very
> >> liable
> >>>> for lawsuit. I discussed it> with the
> >> Aldara
> >>>> rep who, of course, could not> ecommend
> >> that
> >>>> usage.
> >>>>> Once a drug is apporved by the FDA - you
> >> can
> >>>> use it for "off-label" us s provided there
> >> is
> >>>> medical literature to back up this use.
> >>>>> e.g.terbutaline is not approved for the
> >>>> treatment of premature labor.
> >>>>>
> >>>>> Robert Modugno MD MBA FACOG
> >>>>> Marietta, GA
> >>>>> http://www.novaobgyn.yourmd.com
> >>>>>
> -------------------------------1073081945--
> >>>>>
> -------------------------------1073081945--
> >>>>
> >>>> --
> >>>> art fougner, md
> >>>> ich bin ein New Yorker
> >>>
> >>
> >
>
