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Re: Ob:  staples at C/S From: DoctorJoe@aol.com Sat Jul 29 10:54:06 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Lynn Montgomery, MD: "Re: staples at C/S" Previous message: Garry E. Siegel, M.D.: "Gyn: Elongated cervix" Next in thread: Kim E. Goldman: "Re: Ob:  staples at C/S" Reply: Kim E. Goldman: "Re: Ob:  staples at C/S" Reply: Garry E. Siegel, M.D.: "Re: Ob:  staples at C/S" In a message dated 7/29/06 10:11:03 AM, garrys@mindspring.com writes: > Over the last 3 years since being in a collaborative practice, many of > our CNM patients who seem to be a bit more "natural" (maybe many of them > have taken Bradley classes) are insistent to a fault about having > subcuticular sutures, not staples, for their unplanned C/S closure. > Honestly, it is almost as predictable as the sun rising in the east! > When I tell them that I prefer staples, and haven't sutured skin in > years (and thus am a bit out of practice), well, many seem taken aback. > > I have found that I don't want to tell the > mechanic/gardener/plumber/electrician etc.  how to do his job, yet this > seems the opposite to me. > > What's up with that? > Well, in parsing your post, the first thing I'd think is - what are the CNMs TELLING their patients about staples versus subcuticular stitches? Sounds like educational variation to me. You can always "brainwash" a patient given enough time. Is that what's going on? As for me, I always liked staples better. They give IMHO a straighter scar. They come out, hence, do not tend to stay in situ and cause (in some cases) more inflammation and sometimes a thicker scar. And I always took them out and places steristrips on Day 2 or 3, and I did it myself. So that meant I actually TOUCHED the patient and rubbed on her belly, so to speak. I think that 'bonding' is worth more than the actual technical question itself. And oohing and ahhing over how nice the incision looks is a positive thing, esp. in a patient with an unplanned C/S (i.e. in a patient who has "failed" in her birthing plan). And no, you wouldn't argue with a "professional" about his job, e.g. the plumber or electrician. You WOULD argue with the waiter about the way your food was prepared. So does that make you feel like more of a "server" than a "professional?" It should. And therein lies one of the major problems with medicine today. Patient and doctor? No. Server and consumer? Yep. We've gone beyond the intermediary stage of "client." Joe P. Next message: Lynn Montgomery, MD: "Re: staples at C/S" Previous message: Garry E. Siegel, M.D.: "Gyn: Elongated cervix" Next in thread: Kim E. Goldman: "Re: Ob:  staples at C/S" Reply: Kim E. Goldman: "Re: Ob:  staples at C/S" Reply: Garry E. Siegel, M.D.: "Re: Ob:  staples at C/S"

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