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Re: Hep C carrier & gyn surgeryFrom: John Perry (docjcp@hotmail.com)Wed Jan 28 23:28:23 2009
Check her Hep C RNA titer level. It should tell you better the status of her Hep C infection and whether it is active or not. If her levels are low, go ahead and do her surgery. If her levels are higher and she needs to be treated according to the Infectious Disease docter, then maybe consider an endometrial ablation to control her bleeding for now followed by a hysterectomy in the future for the fibroid uterus and pain. > Date: Wed, 28 Jan 2009 21:38:49 -0600> From: islesannie@gmail.com> To: ob-gyn-l@mail.obgyn.net> Subject: Hep C carrier & gyn surgery> > Hi folks,> > It has been ages since I had a Hep C carrier up for necessary but> elective surgery.> > Patient who had been treated with Interferon long ago. And tested> negative afterwards.> > Now in need of hyst - planned LSH BSO (sever menorrhagia, fibroids> apropriate to my level of LSAH) (47 yo - requested BSO rather than> keeping the ovaries). She called today to see about having the BSO> done. At the end of the conversation just before we hung up (so I could> go carve the eis und schnee from my driveway) she mentioned as a "by the> way" - "My Hep C seems to be positive again since starting Raptiva."> > Severe Psoriasis. Rheumatologist put her in immunosuppressant, Raptiva.> Now has a positive Hep C test (I don't have the results - this is verbal> from patient to me.)> > Should I postpone her hyst til she has been treated with the interferon?> For those that operate at some frequency on those who are Hep C positive> - what percautions do you advise?> > (hope this doesn't seem dumb)> > Thanks> > --> Joanne Bulley, MD> solo gyn> Keene, NH> > wonder how much more ice &/or snow before I go to work in the AM.
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