Re: GYN: RV fistula
From: R. Daniel Braun (rd.braun@gmail.com)
Wed Aug 31 13:06:19 2005
Mac,
You are turning cynical in your old age.
Cynic Term devised by optimists to describe realists.
I think it was Mark Twain. but I could be wrong.
Dan
On 8/31/05, William D. McIntosh, M.D <wmcintosh@premiermed.com> wrote:
>
> I don't think he was talking about the lack of an exam table in a
> nursing home, but rather in the hospital itself. My hospital does not
> have a single exam table for inpatient exams. The ER has a couple, but
> you can't use them for inpatients. I actually had to give a patient a 6
> hour pass to leave the hospital to come to my office so that I could do
> a reasonable exam. We did have an exam room years ago, but the hospital
> filled it with the dreaded "nurses with clipboards" long ago. After
> all, yet another cohort of administrative nurses is much more useful
> that actually performing patient care.
>
> WD McIntosh, MD FACOG
> Clarksville, TN
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Dr.
> Ainsworth
> Sent: Wednesday, August 31, 2005 10:19 AM
> To: Multiple recipients of list OB-GYN-L
> Subject: Re: GYN: RV fistula
>
> Love those nursing home consults with not equipment available. You
> described my experiences to a "T." I think you are exactly right, she
> needs a colonoscopy, exam under anesthesia and would probably benefit
> from a diversion, which could be temporary if you find a repairable RV
> fistula and no malignancy. Inflammatory bowel disease is also a
> possible cause. At her age with poor surgical risks, she would more
> likely be a candidate for a permanent diverting colostomy.
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--
R. Daniel Braun
Kinky for Governor