Re: neonatal methadone withdrawal
From: Charlie Chambers (ricechaz@me.com)
Wed Jan 28 23:31:46 2009
--Boundary_(ID_3whlAtYg4mtUXXOMzLoZew)
Content-type: text/plain; charset=WINDOWS-1252; format=flowed; delsp=yes
Content-transfer-encoding: quoted-printable
Thanks for the reply Ron.
So do I take it from others that no one is aware of any "guidelines"
that mandate the care of these kids? All of this comes as a surprise
to me and searching has not found these "guidelines".
Thanks.
=
**************************************************************************
Charlie Chambers
Hood River, OR USA
cchamber@alumni. rice. edu
"I'm a goin fishin.
Yeah, I'm goin fishin
And my baby's goin fishin too!"
Taj Mahal
************************************************************************
On Jan 28, 2009, at 7:45 PM, Dr. Ainsworth wrote:
--
> I would like to see those “guidelines” too. We care for one or two
> methadone patients monthly at our community hospital, level 1. The
> pediatricians seem quite comfortable detoxing them. They often stay
> for a week or longer, but I don’t remember any that have stayed for
> 3-6 weeks. If the last baby was taken by CPS, there must have been
> other issues besides methadone.
>
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
> Charlie Chambers
> Sent: Wednesday, January 28, 2009 6:20 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: neonatal methadone withdrawal
>
> We have a patient who delivered about 3 years ago at our level
> facility who remained on methadone. Baby was cared for by a local
> FP, and did remarkably well though eventually taken by child
> protective services. Patient is now back in our practice at 35 weeks
> again on methadone. We discussed with local peds MD who is agreeable
> to care for the baby. However, behind the scenes, nursing
> supervisors were concerned with caring for this patient at our
> facility. Without prompting from ob or peds, they contact neonatal
> doc at tertiary care center regarding appropriateness of this plan.
> Opinion was given that there are new guidelines which mandate in
> patient management of these kids for 3-6 weeks. The local peds
> doesn't want to go against these "guidelines" and I can't seem to
> find the source. Are other aware of this ? Would you agree that
> delivery at level one facility is inappropriate? Opinions please.
>
> ****************************************************************************
> Charlie Chambers
> Hood River, OR
> cchamber@alumni.rice.edu
>
> "Almost anything you do will seem insignificant but it is very
> important
> that you do it....You must be the change you wish to see in the world"
> -- Mahatma Ghandi.
> *******************************************************************************
>
--Boundary_(ID_3whlAtYg4mtUXXOMzLoZew)
Content-type: text/html; charset=WINDOWS-1252
Content-transfer-encoding: quoted-printable
Thanks for the reply Ron.
So do I take it from others that no one is aware of any "guidelines" that mandate the care of these kids? All of this comes as a surprise to me and searching has not found these "guidelines".
Thanks.
**************************************************************************
Charlie Chambers
Hood River, OR USA
cchamber@alumni. rice. edu
"I'm a goin fishin.
Yeah, I'm goin fishin
And my baby's goin fishin too!"
Taj Mahal
************************************************************************
On Jan 28, 2009, at 7:45 =
PM, Dr. Ainsworth wrote:
I would like to see those “guidelines” too. We care for one or two methadone patients monthly at our community hospital, level 1. The pediatricians seem quite comfortable detoxing them. They often stay for a week or longer, but I don’t remember any that have stayed for 3-6 weeks. If the last baby was taken by CPS, there must have been other issues besides methadone.
We have a patient who delivered about 3 years ago at our level facility who remained on methadone. Baby was cared for by a local FP, and did remarkably well though eventually taken by child protective services. Patient is now back in our practice at 35 weeks again on methadone. We discussed with local peds MD who is agreeable to care for the baby. However, behind the scenes, nursing supervisors were concerned with caring for this patient at our facility. Without prompting from ob or peds, they contact neonatal doc at tertiary care center regarding appropriateness of this plan. Opinion was given that there are new guidelines which mandate in patient management of these kids for 3-6 weeks. The local peds doesn't want to go against these "guidelines" and I can't seem to find the source. Are other aware of this ? Would you agree that delivery at level one facility is inappropriate? Opinions please.
****************************************************************************
Charlie Chambers
Hood River, OR
"Almost anything you do will seem insignificant but it is very important
that you do it....You must be the change you wish to see in the world"
-- Mahatma Ghandi.
*******************************************************************************
