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Re: ACOG Antepartum Record - Pain Scale? From: Joanne Bulley, MD (islesannie@gmail.com) Sat Nov 24 14:27:41 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "Re: ACOG Antepartum Record - Pain Scale?" Previous message: Charlie Chambers: "Re: ACOG Antepartum Record - Pain Scale?" In reply to: FRANCES WREN: "Re: ACOG Antepartum Record - Pain Scale?" Reply: Garry E. Siegel, M.D.: "Re: ACOG Antepartum Record - Pain Scale?" Reply: R. Daniel Braun: "Re: ACOG Antepartum Record - Pain Scale?" About 6 months ago our hospital clinical monitoring committee reviewed the information about some people being "rapid metabolizers" of codeine (into morphine) and thus able to get much higher levels of morphine in the blood stream with the complications of excess narcotics and all that entails. So we reminded all docs about this and Anna's recommendations fit right into that issue. Joanne At Fri, 23 Nov 2007, Meenan, Anna wrote: > >A small percentage of moms (it varies by ethnicity) rapidly >metabolize codeine to morphine. I wouldn't say codeine is >contraindicated in breastfeeding moms, but needs to be given for only >a few days, and if pain continues, the situation needs to be >re-evaluated, which is why I have to keep reminding my residents not >to send more than 2 or 3 days worth of T3 home with breastfeeding >moms and to tell them to call if still having pain requiring >narcotics when that runs out. > >Anna Meenan, MD > >>In the UK a post Caesarean breast feeding patient kept complaining >>of pain (no apparant cause) and was given repeated doses of >>codeine.There was a neonatal death on day 15 suspected to be due to >>resp.depression.Therefore now is strictly contraindicated in breast >>feeding women >>Aditi >> >>>>----- Original Message ---- >>From: "art fougner, md" <evsono@pipeline.com> >>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> >>Sent: Wednesday, 21 November, 2007 5:47:57 PM >>Subject: Re: ACOG Antepartum Record - Pain Scale? >> >>She's Dead, Joe. >> >>Art >> >>At Wed, 21 Nov 2007, <mailto:DoctorJoe@aol.com>DoctorJoe@aol.com wrote: >> >>>You know, (1) you can't trust the patient not to be faking, and (2) you >>>don't want to be embarrassed by a lawyer ("Didn't you see, Nurse >>>Jones, that when >>>you recorded 'asleep' the patient wasn't breathing and his tongue was >>>lolling out to the side? The patient was DEAD, Nurse Jones, he was DEAD!!") >>> >>>Joe P. >> >>-- >>art fougner, md >>"May The Wings of Liberty Never Lose a Feather." - Jack Burton >> >>For ideas on reducing your carbon footprint visit >><http://uk.promotions.yahoo.com/forgood/environment.html>Yahoo! For >>Good this month. -- Joanne Bulley, MD, FACOG Solo gyn Keene, NH USA Next message: Garry E. Siegel, M.D.: "Re: ACOG Antepartum Record - Pain Scale?" Previous message: Charlie Chambers: "Re: ACOG Antepartum Record - Pain Scale?" In reply to: FRANCES WREN: "Re: ACOG Antepartum Record - Pain Scale?" Reply: Garry E. Siegel, M.D.: "Re: ACOG Antepartum Record - Pain Scale?" Reply: R. Daniel Braun: "Re: ACOG Antepartum Record - Pain Scale?"

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