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Re: ankylosing spondylitis and ... From: Peter V. Weston, M.D. (weston@riverwalk-obgyn.com) Sat Apr 27 17:17:32 1996 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: mark decker: "Re: clomid and single shot pergonal for first line obgyn's" Previous message: Mark Perloe: "Re: clomid and single shot pergonal for first line obgyn's" Maybe in reply to: Douglas Krell: "ankylosing spondylitis and ..." Next in thread: Arthurfree@aol.com: "Re: ankylosing spondylitis and ..." At 03:02 AM 4/27/96 -0500, you wrote: >Anyone interested in tackling this case? > >61yo WF with ankylosing spondylitis and hypertension >smokes 2ppday X20 years. trying to quit. Has tried "everything" > >Meds: >Plendil >Zoloft >Prednisone 40mg/day >cytotec (for ulcers) >various NSAIDS >S/P 2 NSCVD > TAH/BSO 10 yrs ago > >Pt concerned about Estrogen and smoking > Osteoporosis > >My plan: quit smoking, quit smoking, quit smoking. > Start Estrogen > check bone density > adequate Ca++ and Vit D > other options: > quit smoking > Fosamax > check bone density > > keep smoking > eat filet mignon > live it up for the short time left. > >I'm just assuming pt. has osteoporosis, though I don't know specifically >about effect the fosamax may have on Ankylosing spondylitits. > >Any rheumatologists in the group? There are certain times when we have to accept that patients are autonomous beings and are not going to give up smoking. No, I am not a smoker and I cannot stand to be in the same room as someone who has recently had a cigarette. After we have counselled patients on the folly of their ways we have to treat them despite thier self destructive habits. I would start her on appropriate Estrogen therapy and give her Fosamax. I would contact Merck and ask them whether they have any info on AK and Fosamax. If you want to be academic you can order Bone Mineral Density studies but I would put money on her having significant demineraliztion. I would consider the test an unnecessary expense. Regards Peter -- Peter V. Weston, M.D. Private Practice, Gynecology, San Antonio. weston@riverwalk-obgyn.com Visit the Home Page of our great PC Organization (Alamo PC) <http://www.alamopc.org> "More harm is done because you do not look Than from not knowing what is in the book" Zachary Cope Next message: mark decker: "Re: clomid and single shot pergonal for first line obgyn's" Previous message: Mark Perloe: "Re: clomid and single shot pergonal for first line obgyn's" Maybe in reply to: Douglas Krell: "ankylosing spondylitis and ..." Next in thread: Arthurfree@aol.com: "Re: ankylosing spondylitis and ..."

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