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Two interesting casesFrom: John Robertson (jgmr@unixg.ubc.ca)Thu Aug 7 09:45:51 1997
Earlier this week I has two interesting cases in my office and was wondering if I could get some input. 1st Case: Woman comes in for Tubal ligation with a large book - something like "Guide to women's health" or something similar. Says she has read that a Tubal only takes 10 minutes and that the majority are done under local anaesthetic. Although Tubal ligations are quick I can't think of anythin in the OR that takes 10 minutes from getting in to the room to getting out, however I am more interested in peoples experiences with regional techniques. I have done some of these uner spinal and have found that although some women tollerate this well, others feel short of breath with the pneumoperitomeum, and if you have to use trendellenburg they really get anxious. I have never sone or seen one where the only anaesthetic was local. Any comments? 2nd Case: Woman on HRT comes in with her daughter. Her daughter has done a lot of "research" and wants me to perscribe a cream that contains natural E & P. Gives me a graph of average blood levels taken from 6 premenopausal women after application of the cream. The company is called "Women's International Pharmacy" - natural Hormone Therapy - By Perscription Only 2 addresses 5708 Monona Dr. Madison, WI 53716 Phone (608) 221-7880 and 13925 W. Meeker BLVD., STe #13 Sun City West, AZ 85357 Phone (602) 214-7700 Evidently she is supposed to put a tablespoon on her skin every day and it works like HRT. I ended up putting her on estrace and prometrium (micronized E & P both made from yams) and her daughter seemed happy that she was getting "natural " hormones because they came from yams. Questions - anyone heard of these guys? Do they have reliable dosages? how do others feel about use of creams for HRT? Hopefully these will be interesting topics for our readers in Copenhagen. John J.G.M. Robertson MD, 109-9181 Main St. Chilliwack, B.C., Canada, V2P 4M9 (604) 793-9988, Fax 793-9987 e-mail jgmr@unixg.ubc.ca
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