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Re: GYN: ASC-US papFrom: Betsy Hyde (elishyde@mindspring.com)Fri Jul 30 20:28:23 2004
On Friday, July 30, 2004, at 09:01 PM, Garry E. Siegel, M.D. wrote:
> She had cryo years ago, unclear diagnosis (abnormal paps is all she
not to appear uninformed, but what is LTL? I'm guessing tubal ligation,
but don't get the initials.
> When Mirenas first hit the market, I was the only provider in our md/cnm group trained in insertion. One of my OB colleagues referred a post menopausal nulligravida with severe menopausal sx responsive to estrogen and unable to tolerate progestin due to psych side effects. She also had significant psych issues....aka Black Hole People. (this is a term used in certain midwife circles to describe those women whose extreme neediness will suck you into their gravity pits/black holes and you will shrivel up and die and will never be seen again. They also come in pregnant varieties.)
She came in with a cervical os like this . I gave her a
paracervical block and inserted the Mirena like butter off a hot knife.
> I'm not impressed by the pap. Shows the natural history of HPV...and that is that it usually goes away. Repeating the pap in 6 months should be more than sufficient. Insert the Mirena if this is what she wants. Use a paracervical block. If it doesn't work, go on to plan B.
-- Betsy Hyde CNM Branford, CT
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