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Re: Gyn: Cervical DysplasiaFrom: Andrew Folley (agfolley@hotmail.com)Fri Mar 14 16:21:41 2008
Dan I agree. At this rate we will be advocating a radical hysterectomy for her treatment. Date: Fri, 14 Mar 2008 17:12:31 -0500From: rd.braun@gmail.comTo: ob-gyn-l@mail.obgyn.netSubject: Re: Gyn: Cervical DysplasiaWhy is everyone getting so excited about CIN 2?????????Dan On Fri, Mar 14, 2008 at 5:37 PM, Joanne Bulley, MD <islesannie@gmail.com> wrote: My thoughts exactly.I told her by phone that I needed to see her in the office (to at leastget her warm body where I could talk to her face to face)I will look with the colpo - but expect to find nothing.I briefly mentioned hyst in the phone call ...If she is reluctant then I will insist she see one of the gyn oncs atDartmouth so that that person can tell her she really has to have thathyst.When I look with the colpo I will reflect on VH / LAVH.JoannePS - our hospital is finally willing to get the morcellator and startthe LSH etc. I have 2 scheduled with a new (but seasoned - not just outof residency) gynecolgist who is willing to have me work with him on mypatients so I can get the supervised experience. Monday I do a workshopin Providence RI with the harmonic scapel At Fri, 14 Mar 2008, Gordon Goldman wrote:>>Offer hysterectomy. If she declines, send her to your worst enemy.>>-->Gordon M. Goldman, M.D., FACOG>Private Practice, St. Louis, Mo.>>On Mar 14, 2008, at 2:04 PM, Joanne Bulley, MD wrote:>>> What would you do next?>>>> 53yo G4P3013 S/P SVD x 3 (but very narrow pelvis) LMP 7/02>>>> Pap 12/06 LSIL "possible CIN 1">>>> Colpo 1/07 no lesion, ECC scant>>>> Pap 7/07 LSIL "possible CIN 2">>>> Colpo 7/07 no lesion, can't visualize SCJ>>>> Recommend LEEP (surgery rescheduled due to the death of her mom)>> 9/07 LEEP: CIN 2-3, resection margins clear>> ECC: superfical atypical cells, no definitive dysplasia>> Endometrial curettage: (vigorous curettage) : detached glands &>> bstroma,>> no intact endometrium; one fragment squamous epithelium with mildly>> atypical parakeratosis>>>> Pap 3/2008 HSIL c/w CIN 2>>>> Patient very into the "complementary and alternative" therapy - opting>> for homeopathic treatment of hypothyroidism (with elevated TSH and>> positive thyroid antibodies) and of osteoporosis (BMD T scores started>> out at -4.0 for spine and -3.2 for hip and are now -4.5 and -3.1)>>>> -->> Joanne Bulley, MD, FACOG>> Solo gyn>> Keene, NH USA>--Joanne Bulley, MD, FACOGSolo gynKeene, NH USA-- R. Daniel Braun, MD FACOG(L) ABMP CMThProfessor EmeritusDept. of Obstetrics and GynecologyIndiana U. School of MedicineR. Daniel Braun"Science without Religion is LAME; Religion without Science is BLIND"Einstein 1941 _________________________________________________________________ Helping your favorite cause is as easy as instant messaging.=A0You IM, we g= _________________________________________________________________ ive. http://im.live.com/Messenger/IM/Home/?source=text_hotmail_join
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