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Re: Emergency ContraceptivesFrom: LCLEMOS@aol.comTue Mar 7 16:22:36 2006
In a message dated 3/7/2006 3:21:16 P.M. Eastern Standard Time, dahmd@cfl.rr.com writes: Laurie- First of all, as you can tell, this list is not for discussing actual medical issues :) True, it is for discussing obstetrically related issues...and increasing our contact and humanity and taking out our daily frustrations.. oh sorry, that must be another list ... I'll try to be coherent (I had a busy night with 9 deliveries). When prescribing combination birth control pills or the (rare) depo-Provera injection, I hand the patient a "prescription" for calcium twice a day. I also discuss breakthrough bleeding and when to discontinue the pill or call for questions or an appointment. You are very coherent, but I wonder how you can function at 3 PM if you were up all night? Red Bull for you too? When prescribing the progestin-only pill I discuss the need for same time administration and the higher failure rate when not breastfeeding. I discuss infection risks for non-monogamous behavior and the potential for both amenorrhea and abnormal bleeding with the Mirena LUS. Some prescribe estrogen to take if bleeding from a denuded endometrium occurs, but I prefer for patients to call first. I do discuss emergency contraception with barrier methods. We are on call in-house 24/7 so unless someone calls at 2am, it's not a big deal. We educate to call the next morning, which helps, but we don't get many calls because we spend a lot of time educating that patients should not depend on EC since it's failure rate is higher than most other forms of contraception. So you don't discuss EC with those on hormonal methods - your clients are generally reliable in taking BCP daily or nearly? Never come late for that depo shot? Not depending on EC as birth control seems like good advice certainly. It seems to work for your population to have access to docs in hospital then for EC as needed? Thanks for the thorough answer. Ashley (Sorry to tell you, Laurie, it's 75 degrees and I'm heading to the pool). Cruel, you are too cruel. Although my parents rub it in most days, they are about an hour north of you in one of those gated adult communities with golf course...places for adults to escape their children and grandchildren and then complain that "they never come to visit".. wish I were there. I'll bet it is light out there still too at 6 PM...argh.. LCL in ME
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