NOTE:   THIS IS MORE ABOUT GALLBLADDER THAN BF
In a message dated 95-10-07 08:45:21 EDT, Kellie Richardson wrote:
>Several weeks ago, I wrote asking about breastfeeding with Telepaque.  Well,
>she had the xray and they could not find a gallbladder much less gall
>stones!!  Now her liver enzymes are sky high and her bili is elevated and
her
>thyroid is low.  They want to do a CT with "Oral Scan C Barium Swallow " and
>"Omnipaque 300" IV.  She will not consent to this until I hear from ya'll
how
>it will effect the milk.  She is having about 3 gallbladder attacks per week
>so she is in pain. ............

My comments:
WHY ARE THEY EVEN DOING MORE TESTS????????
Doctors need to ask themselves  on every test that they do:How will these
results influence my care for this patient?
Lets review the data:
1.Patient has symptoms of GB(gall bladder) disease.
2.Patient has signs of disease in the hepato-biliary system( elevated liver
tests)
3.Patient's GB xray shows a non functioning gall bladder.
4.Patient's GB ultrasound was not helpful.
What would the doctors do in a third world country where they didn't have
access to a super-duper-hyper-techno-$$$$$-scan?  They would operate on the
patient and remove the GB!!!!  Lets look for a moment at how the results of
the proposed test could influence this lactating patient:
1: Test is bad, GB is "sick". End result>>>>>>>Removal of GB!!!!!!!
2: Test is normal or inconclusive.
    The Drs. need to make a decision on the other data at hand. The patient
has signs, symptoms and lab evidence of a "sick" GB.  what is the most likely
end result???
>>>>>>>>>>>>>>>>>>>>>>>>>>>>Removal of GB!!!!!!!!!!!!!!!!
This test in my opinion will not help the patient get better or the doctor
make a better diagnosis.  "Just because you CAN do something (the test),
doesn't mean that you SHOULD do it."
I predict that she will end up with a GBectomy and then will feel better.
I hope that she will not have to have a big hassle in the hospital when she
tries to BF/pump. She can BF/pump as soon as she is awake enough to do this
herself with out help.

*
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*  Jon Ahrendsen, M.D. FAAFP, LLLI Medical Associate   *
*  215 13th Ave SW                                                        *
*  Clarion, Iowa 50525  USA                                            *
*  515-532-2836, FAX 532-2523, Email [log in to unmask]   *
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