Re: Prolapsed cord-->language
From: Jamie (ajfields@pine-net.com)
Thu Feb 23 12:08:33 2006
A somewhat related question: At what gestational age can placenta previa
be diagnosed? I was taught that until late in pregnancy or until it can
clearly be confirmed to be over the os the correct term is low lying
placenta, but a local radiologist diagnoses previa in first trimester
u/s. Which might actually not be such a problem if he didn't also
advise the women that they will need a c/s.
At Thu, 23 Feb 2006, doctorjoe@aol.com wrote:
>
> Yeah, thinking back over my medical education:
>
>"neoplasm" = "new growth" (NOT necessarily cancer, or "malignant neoplasm")
>
>"tumor" = "swelling" (NOT necessarily cancer, or "malignant tumor")
>
>The same misunderstanding/misinformation abounds, e.g., in discussions of "dysplasia" and CIN/CIS. Patients AND doctors get confused. What exactly is "pre-cancer of the mouth of the womb" supposed to mean? I see patients all the time who claim to have had "cervical cancer" which was (successfully) treated with LEEP or conization or LASER. Gotta have a good LASER or a big LEEP loop to get all the metastases, don't you?
>
>The lawyers, on the other hand, understand that certain words mean certain things, using the true definition of "certain". They tend to be very repetitious (to normal people) because the words and phrases they use are "defined" in the law cases and codes to actually mean something specific. So you express the same idea in exactly the same way every time, so everyone is "on the same page," so to speak.
>
>By analogy, CIS may be defined by us to indicate depth of invasion less than 3mm or 5mm or whatever the definition is du jour, but it's very specific. So when someone says CIS, the numbers of millimeters are associated with the word in your mind and you understand what is being said. However, "tumor" has manifold associations, both lay and medical, and even within the same conversation. So understanding is difficult to attain when someone tosses out the word "tumor".
>
>The radiologist's reading of "prolapsed cord" in the situation described only underscores how inaccurate terminology is almost malum in se because of the confusion (and bad feelings) which results. And in some cases, it can lead to bad medicine, ultimately. And boy would the lawyers love that!
>
>Joe P.
>
>-----Original Message-----
>From: D. Ashley Hill <language">dahmd@cfl.rr.com>
>To: Multiple recipients of list OB-GYN-L <language">ob-gyn-l@dns.obgyn.net>
>Sent: Thu, 23 Feb 2006 12:00:40 -0600
>Subject: Re: Prolapsed cord
>
>Same problem in our area. Radiologists use "viable" to mean presence of
>a fetal heart rate, whereas MFM and neonatology and OB folks use
>"viable" to mean that baby has the chance to sustain itself outside the
>uterus with or without medical assistance. Also, many rads people use
>the term "neoplasm" to mean cancer, whereas gyn's use it to mean
>"abnormal growth."
>
>Ashley
>
>At Thu, 23 Feb 2006, language">rmodugno@aol.com wrote:
>>
>>The radiologist says "viable" and the perinatologist says "pre-viable" - who's
>correct?
>>
>>Robert Modugno MD MBA FACOG
>>Marietta, GA
>
>--
>D. Ashley Hill, MD
>Associate Director
>Department of Obstetrics and Gynecology
>Florida Hospital Family Practice Residency
> and Loch Haven Ob/Gyn Group
>Orlando, Florida
>
--
JFields, RN, BSN
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