OB-GYN-L Messages for February, 2004: Re: chronic pelvic pain patient

Re: chronic pelvic pain patient
From: Robert Radnich (rhradnich@hotmail.com)
Mon Feb 23 12:36:48 2004

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Urology eval sound include hydrodistention to look for IC
> ----- Original Message -----
From: Richard Chudacoff, MD To: Multiple recipients of list OB-GYN-L Sent: Monday, February 23, 2004 10:41 AM Subject: RE: chronic pelvic pain patient
I wish we had someone like that here in Houston. I've been following her for 6 years. She has seen every discipline in medicine I can think of. She has not been sexually molested nor assaulted, does have some psychiatric history, although nothing to suggest Munchhausen's syndrome or other pain related psychopathology.
Richard Chudacoff, MD
A government that robs Peter to pay Paul can always depend on
the support of Paul.
George Bernard Shaw
Democracy is a device that insures we shall be governed no
better than we deserve.
George Bernard Shaw
-----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Charlie Chambers Sent: Friday, February 20, 2004 12:54 PM To: Multiple recipients of list OB-GYN-L Subject: Re: chronic pelvic pain patient
Richard
Has she been evaluated by a PT with specific training in women's health, and chronic pain? On Feb 20, 2004, at 10:20 AM, Richard Chudacoff, MD wrote:
I have a 22 year old, gravida zero, chronic pelvic pain patient who has had a left salpingoophorectomy for a dermoid cyst at the age of 14. Subsequently she has persistent pain which has required three laparoscopies for lysis of adhesions. Her right ovary on laparoscopy appears to be normal, as is her right fallopian tube. She has also undergone a laparoscopic presacral neurectomy. Currently she is on Depo-Provera and Nuvaring continuously which has decreased dysmenorrhea, but has not removed for chronic pelvic pain. She is amenorrheic. She would like her right ovary removed, because her pain is constantly right lower quadrant/pelvic in nature. For workup has included evaluation by psychiatry, neurology, pain medicine and gastroenterology.
The only thing that I could think of would be to super ovulate her, capture her ova, and then performed a right salpingo oophorectomy, with the understanding that she could use her captured ova for future fertility.
I would be eager for a discussion regarding this type of patient and options of therapy.
Richard Chudacoff, MD, FACOG
Chudacoff Obstetrics & Gynecology, PA
15200 Southwest Freeway, #270
Sugar Land, TX 77478
Tel: 281-277-3900
Fax: 281-277-3901
rchudacoff@mylinuxisp.com
Richard.Chudacoff@obgyn.net
http://www.mdhub.com/281-277-3900
http://www.chudacoffobgyn.yourmd.com
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************************************************************************* Charlie Chambers
Hood River, OR cchamber@alumni.rice.edu
"No matter where you go... there you are." Dr. Buckaroo Banzai ************************************************************************
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> <DIV style="FONT: 10pt arial">----- Original Message ----- </DIV>
<DIV style="BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: black">From: <A title=rchudacoff@mylinuxisp.com href="mailto:rchudacoff@mylinuxisp.com">Richard Chudacoff, MD</A> </DIV> <DIV style="FONT: 10pt arial">To: <A title=ob-gyn-l@dns.obgyn.net href="mailto:ob-gyn-l@dns.obgyn.net">Multiple recipients of list OB-GYN-L</A> </DIV> <DIV style="FONT: 10pt arial">Sent: Monday, February 23, 2004 10:41 AM</DIV> <DIV style="FONT: 10pt arial">Subject: RE: chronic pelvic pain patient</DIV> <DIV> </DIV> <DIV class=Section1> I wish we had someone like that here in Houston. I’ve been following her for 6 years. She has seen every discipline in medicine I can think of. She has not been sexually molested nor assaulted, does have some psychiatric history, although nothing to suggest Munchhausen’s syndrome or other pain related psychopathology. <o:p></o:p> <![if !supportEmptyParas]><![endif]> <o:p></o:p> Richard Chudacoff, MD<o:p></o:p> <![if !supportEmptyParas]><![endif]> <o:p></o:p> <![if !supportEmptyParas]><![endif]> <o:p></o:p> A government that robs Peter to pay Paul can always depend on <o:p></o:p> the support of Paul. <o:p></o:p> George Bernard Shaw<o:p></o:p> <![if !supportEmptyParas]><![endif]> <o:p></o:p> Democracy is a device that insures we shall be governed no <o:p></o:p> better than we deserve. <o:p></o:p> George Bernard Shaw<o:p></o:p> <![if !supportEmptyParas]><![endif]> <o:p></o:p> -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Charlie Chambers Sent: Friday, February 20, 2004 12:54 PM To: Multiple recipients of list OB-GYN-L Subject: Re: chronic pelvic pain patient <![if !supportEmptyParas]><![endif]> <o:p></o:p> Richard Has she been evaluated by a PT with specific training in women's health, and chronic pain? On Feb 20, 2004, at 10:20 AM, Richard Chudacoff, MD wrote:<o:p></o:p> <?fontfamily><?param Arial><?x-tad-smaller>I have a 22 year old, gravida zero, chronic pelvic pain patient who has had a left salpingoophorectomy for a dermoid cyst at the age of 14.  Subsequently she has persistent pain which has required three laparoscopies for lysis of adhesions.  Her right ovary on laparoscopy appears to be normal, as is her right fallopian tube. She has also undergone a laparoscopic presacral neurectomy.  Currently she is on Depo-Provera and Nuvaring continuously which has decreased dysmenorrhea, but has not removed for chronic pelvic pain.  She is amenorrheic. She would like her right ovary removed, because her pain is constantly right lower quadrant/pelvic in nature.  For workup has included evaluation by psychiatry, neurology, pain medicine and gastroenterology.<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller> <?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>The only thing that I could think of would be to super ovulate her, capture her ova, and then performed a right salpingo oophorectomy, with the understanding that she could use her captured ova for future fertility.<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller> <?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>I would be eager for a discussion regarding this type of patient and options of therapy.<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller> <?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>Richard Chudacoff, MD, FACOG<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>Chudacoff Obstetrics & Gynecology, PA<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>15200 Southwest Freeway, #270<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>Sugar Land, TX 77478<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller> <?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>Tel: 281-277-3900<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>Fax: 281-277-3901<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller> <?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>rchudacoff@mylinuxisp.com<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>Richard.Chudacoff@obgyn.net<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller> <?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>http://www.mdhub.com/281-277-3900<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>http://www.chudacoffobgyn.yourmd.com<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller> <?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>*****HIPAA Confidentiality Notice*****<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller> <?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>The documents inside this electronic transmission contain confidential information belonging to the sender that is legally privileged.  This information is intended only for the use of the individual or entity named above.  The authorized recipient of this information is prohibited from disclosing this information to any other party and is required to destroy the information after its stated need has been fulfilled, unless otherwise required by law.<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller> <?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Arial><?x-tad-smaller>If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of these documents is strictly prohibited.  If you received this electronic transmission in error, please notify the sender immediately to arrange for return.<?/x-tad-smaller><?/fontfamily> <?fontfamily><?param Times New Roman><?bigger> <?/bigger><?/fontfamily><o:p></o:p> ************************************************************************* Charlie=20 Chambers Hood River, OR cchamber@alumni.rice.edu "No =
matter where you go... there you are." Dr. Buckaroo Banzai ************************************************************************<FONT=20 color=3Dblack><SPAN=20
style="COLOR: black; mso-color-alt: windowtext"><o:p></o:p></DIV></BLOCKQUOTE></BODY></HTML>

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