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Re: Gyn: Fibroids/endometriosis/adenomyosis From: Efrain Ramirez (eramirezt@coqui.net) Wed Apr 6 21:32:59 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DoctorJoe@aol.com: "Re: Lawsuit-Minded Doctors, Hospitals Restrict Delivery-Room Videos" Previous message: Robert J. Carpenter, Jr. MD: "Re: Lawsuit-Minded Doctors, Hospitals Restrict Delivery-Room Videos" In reply to: Garry E. Siegel, M.D.: "Gyn: Fibroids/endometriosis/adenomyosis" Next in thread: Richard Chudacoff, MD: "Re: Fibroids/endometriosis/adenomyosis" Thrombophilia w/u (liability concerns) then add Micronor - BTW- hard to stay away from the surgical solution.. good luck..Ef >At Wed, 6 Apr 2005, Garry E. Siegel, M.D. wrote: > >49 YO P2102 with: > >known fibroids--4 cm intramural/subserosal one seen at lapscope a few >years ago, still seen on scan and felt on exam > >Stage 2 endometriosis from same lapscope, excised totally > >S/P endometrial ablation for menorrhagia, done concurrently with >lapscope. No fibroids in the cavity > >Also germane is that she has had a LEEP subsequent to the above for CIN2 >(clear margins) with adenomyosis. > >Lastly, in college, she had a traumatic DVT and never has been on the >pill. > >She was seen in December with worsening menometrorrhagia and pelvic >pain, and placed on Lupron. She has become amenorrheic, has no pain, >and says her abdomen is smaller (clinically she is around 8 weeks size >today, no real change). > >She is very troubled by hot flashes. > >Options I've kicked around: > >1. Increasing her Zoloft dose (already on 100 mg/day). >2. Adding a progestin (which one? dose?). >3. Add low dose combination estrogen/progestin therapy (remember the >DVT); if this is considered, might thrombophilia testing be in order? >4. Of course, LAVH-BSO, but for the sake of discussion, let's stick to >non-surgical options for now. > >Garry > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > -- I think I will do nothing for a long time but listen, And accrue what I hear into myself...and let sounds contribute toward me. ~walt whitman~ Next message: DoctorJoe@aol.com: "Re: Lawsuit-Minded Doctors, Hospitals Restrict Delivery-Room Videos" Previous message: Robert J. Carpenter, Jr. MD: "Re: Lawsuit-Minded Doctors, Hospitals Restrict Delivery-Room Videos" In reply to: Garry E. Siegel, M.D.: "Gyn: Fibroids/endometriosis/adenomyosis" Next in thread: Richard Chudacoff, MD: "Re: Fibroids/endometriosis/adenomyosis"

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