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Re: NorplantFrom: ainsron (ainsron@sbcglobal.net)Thu Feb 16 15:52:06 2006
I've removed numerous norplants, some placed by me, some placed by others and never had a problem with the removal or identifying the Norplant in situ. Is she obese? Is the insertion scar visible? It sounds like the insertion was not in the appropriate tissue plane, probably deeper into the sub-Q. Is there an Ob/Gyn in your area who has experience with Norplant? He would probably have in-office ultrasound that could assist in findings the rods. Is there really a reason that she needs to have them removed at this time. They should be biologically inert and could remain there forever, much as the buckshot in the lawyer shot by Cheney ;)- Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of fran wilson Sent: Thursday, February 16, 2006 2:17 PM To: Multiple recipients of list OB-GYN-L Subject: Norplant Hi, I need some advice from the group. I have a patient who has had a Norplant in place for 6 years. She wants to have it removed, but is uninsured. I would do it, but I can't palpate the rods, and could not localize them with x-ray. Doing a lit search (and calling Wyeth for advice) it seems that the way to remove these rods is under realtime US, or mammography, or a fluoroscope. I don't have access to these options, and I can't find a surgeon in the area who is willing to do this (due to Norplant Foundation restrictions and preauthorization requirements). I have obtained the records of the insertion, and it appears to have been uneventful. Does anyone have any great ideas for getting these rods out in the office without ultrasound? Would any of you try to remove them without realtime US, maybe in two different sessions? Fran Wilson, CNM Kennewick, WA
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