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Re: ASCUS/ Positive HPV in elderly From: Joanne Bulley, MD (islesannie@gmail.com) Fri Mar 28 14:23:51 2008 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dean Huffman .: "Patient Arbitration Pacts Are Alarming Attorneys" Previous message: Joanne Bulley, MD: "Re: ASCUS/ Positive HPV in elderly" In reply to: Rafael Haciski: "Re: ASCUS/ Positive HPV in elderly" But at the same time - these folks don't always clear the virus. I have women on whom we have done 2 or 3 procedures. The gynonc supports holding back as long as it is CIN 1 : just like in the teens to early 20s when we are concerned about childbearing. And once you do the LEEP - the cervix stenoses. So I would encourage saving the LEEPs and Cones for when really needed. Otherwise you get yourself backed into the "should I do a hyst" because "I have been taking parts of this cervix off over the past 5 years and now there is no os to curette and is there any cervix left to take off but the pap is still abnormal" Needless to say I have a lot of these patients. Some are women who were widowed - and spend half the year in a sunny place and half up here - and get involved with a new partner ... and frequently that partner has been less than honest about his promiscuity. (Ok - sometimes she is less than honest about # of partners ...) One went back to the partner and said he had given it to her .... he tried to vehemently deny it - but then he did talk to his doctor who mentioned the number of partners he had had .. he had to admit to this woman that he was really a "ladies" man - for years he had a different woman for each season depending on who was in town when .... There is a lot of sexual activity still going on in the 70 & 80 yo group. I have never had much luck at convincing folks 40 & older to use condoms and especially not the 60 & older! Joanne At Fri, 28 Mar 2008, Rafael Haciski wrote: > >The older the pt, the less retrained I am about taking a generous bx >- and in an 80 yo the cx is probably very small and a small swipe >with the Loop (generous bx) will in essence do a cone, add the ECC >and you are good. Dx'ed and tx'ed. > >-- >Rafael Haciski MD FACOG >Anchor Health Centers GYN >800 Goodlette Rd #360 >239-643-8780 office >239-571-0292 cell >Naples, FL. > -- Joanne Bulley, MD solo gyn Keene, NH "enjoying" the results of epidural depomedrol for a bulging L4-5 disc. Ruins the end of the ski season and start of hiking. Bah Humbug Next message: Dean Huffman .: "Patient Arbitration Pacts Are Alarming Attorneys" Previous message: Joanne Bulley, MD: "Re: ASCUS/ Positive HPV in elderly" In reply to: Rafael Haciski: "Re: ASCUS/ Positive HPV in elderly"

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