|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: GYN: Pelvic Mass (long--good case)From: Garry E. Siegel, M.D. (garrys@mindspring.com)Tue Mar 31 20:32:57 1998
>Garry, >Way to take control, brother! You are going to win this one. Ignore the >pathologist and heme/onc for now. Watch fluid balance, lytes, and chf >which you can prevent. Watch out for florid DIC. Let pulmonology do >the vent settings for her ARDS but you call the shots on fluids, >blood/components, (I still think she needs a few units of whole blood) >Your original question -- what's causing the pancytopenia--still gets >the same answer: it's the overwhelming sepsis; but NOW you have control >of that. It's all in the details now. Press on. Cal Well, Cal, she's about the same tonight, and the path on the uterus and remaining ovary were remarkable for chronic endometritis and inflammation on the serosal surfaces. However, had I left her uterus and ovary in, and if she doesn't recover, better to have a path report than an autopsy one showing a TOA (my partner's wise comment!). With respect to fluids, ventilator, etc., I hope that you will not diss me for not being the primary MD in charge of fluids, etc. I was very comfortable with critically ill ICU patients postop when a resident (U of Alabama, 82 to 86), as we did lots of pelvic exents and sick people rad hysts, as well as big ovarian cases. However, I have one really sick patient a year, and I'm not up to snuff on it, althought my gut feeling is that I know the basics well enough to fly. It is reasonably politically incorrect for me to manage her totally, and, actually, I've enjoyed letting the internists hover around and tinker! I'll keep you updated. Garry
-- Garry E. Siegel, M.D., FACOG Private Practice Roswell, Ga.
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Mon Nov 2 05:27:25 2009 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.