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Re: Volume From: Garry E. Siegel, M.D. (garrys@mindspring.com) Wed Jun 21 20:44:39 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Stmidwife@aol.com: "Third stage, how long?" Previous message: Russ Fawcett: "Re: Volume" In reply to: Efrain Ramirez: "Re: Volume" Next in thread: Ina May Gaskin: "Re: Volume" First BP 160/80 on admission, attributed to advanced labor. She delivered 20 minutes later. PP Recovery BPs 160/80, then 152/79, then about the same 15 minutes later, then "refused cuff." BTW, the patient and husband basically refused about anything. She had a headache and apparently didn't feel right, and the CNM had a feeling that something seemed odd. She seized around 4 hours later--labs then--Hct 32, platelets 89K, SGOT 1000, creatinine 1.1. Stabilized, CT negative, on Mag, and around 12 hours later platelets to 25K and oozing/nosebleed such that ICU MD called, moved to ICU (no beds were available after the seizure)--oh, and husband talking for her (she wasn't yet fully coherent) REFUSED Labetolol, and argued with my partner. Slick good ICU MD said, "Do you want me to call her mother and tell her that her daughter died because you refused proper treatment?" I'll remember that line and use it. This AM platelets up after time and transfusion, Hct. 25, SGOT 750, but creatinine 1.8. She is undergoing diuresis this PM, BP ok and waking up. On top of all of this, there was controversy regarding breast feeding and circumcision best discussed off list. Physicians feel free to email privately for more detail. Garry At Wed, 21 Jun 2006, Efrain Ramirez wrote: > >What were the initial labs, BP? > >Ef > >At Tue, 20 Jun 2006, Garry E. Siegel, M.D. wrote: >> >>That's the same mantra I heard about bailing out the GP. >> >>Had a CNM patient who delivered last night 15 minutes after arrival, and >>she had an eclamptic seizure 4 hours PP. I've not seen one of those in >>a while. >> >>While his wife was lying there post-ictal after Magnesium, Ativan and a >>CT, the husband asked about breast feeding. I suggested stabilizing the >>mother and having her wake up first. >> >>Garry > >-- >“ The greatest obstacle to knowledge is not ignorance, >it is the illusion of knowledge.” Daniel J. Boorstin - Historian > -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: Stmidwife@aol.com: "Third stage, how long?" Previous message: Russ Fawcett: "Re: Volume" In reply to: Efrain Ramirez: "Re: Volume" Next in thread: Ina May Gaskin: "Re: Volume"

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