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Re: Hep C carrier & gyn surgery From: Joanne Bulley, MD (islesannie@gmail.com) Thu Jan 29 17:22:37 2009 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr. Ainsworth: "Re: epidural pumps" Previous message: vnellsch: "Re: OB-GYN-L digest 6782" In reply to: Allan Ho: "Re: Hep C carrier & gyn surgery" Next in thread: Allan Ho: "Re: Hep C carrier & gyn surgery" Reply: Allan Ho: "Re: Hep C carrier & gyn surgery" Her dermatologist checked the status: she has severe psoriasis and had been on immunosuppressives. So Derm A had stopped his therapy because of mildly elevated LFT (I did not know any of this) and then after she saw me - she went to Dermn B who said "before I change to another agent I need to know more" and after talking with him today, he sent me her labs. Hep C is at 26.5 (significant positive is anything over 8) LFTs (AST and ALT) are well above the norm and higher than in September when the last Derm had checked. I think I don't have enough info yet - this came to light in the last week. I think she needs more liver eval including coags before I take her to to the OR. I think we can be extra vigilant about our universal precautions and so forth. I just don't want her to have a complication that could be avoided by being sure all appropriate assessments have been done before going to the OR. She had a previous global ablation and was sent to me to have a re-ablation. I don't think that is a good idea. She is not anemic (hgb 16). As much as she has her heart set on getting this uterus out - I think it is likely in her best interest to wait. Joanne At Thu, 29 Jan 2009, Allan Ho wrote: > >Universal precautions is a given with any surgeries. This reminds me of the >days when HIV was new and we had to deliver all the HIV infected mother by >C/S. It's not a comfortable feeling no matter how many pairs of gloves you >wear... > >Could this patient be having bleeding problems because of her liver >disease? This makes me want to ask whether global endometrial ablation >would be appropriate on patients with intrinsic coagulopathy or who are >immunosuppressed. > >Allan > -- Joanne Bulley, MD solo gyn Keene, NH Next message: Dr. Ainsworth: "Re: epidural pumps" Previous message: vnellsch: "Re: OB-GYN-L digest 6782" In reply to: Allan Ho: "Re: Hep C carrier & gyn surgery" Next in thread: Allan Ho: "Re: Hep C carrier & gyn surgery" Reply: Allan Ho: "Re: Hep C carrier & gyn surgery"

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