Emergency-nurses/ob/gyns

C

CathydsRNA

Cathlete
Please if anyone can help, I need it ASAP. My cousins daughter 24 is pregnant and will be ready to deliver anyday. She was just diagnosed with a serious liver condition,ICP, related to impaired bile flow and toxic buildup of bile. It is associated with hemorrhaging during delivery and still birth of infant. If it was picked up earlier (and it should have been) in could have been managed. Also recommened is delivery of the baby at 36-37 weeks. It is too late for that.She is at a small community hospital and I am trying to find someone to help, who knows what they are doing..even if it means having her come to Philly but I don't know if anyone would take her so late. Any advice greatly appreciated.
 
Hi Cathy. I'm not a nurse or a doctor, and I wish I could have more specific advice or a name to give you. You might try calling the university hospitals in the Philadelphia area and asking to speak to their ob/gyn departments, trying to find someone that way. Better yet--check their web sites (U of Pa? also, Hahnemann, however it's spelled??) Again, so sorry this is vague--I wish you all the best on this.
 
This doesnt sound like your job to be honest. If the community hospital cant deliver the baby they should take steps to transport her to a hospital that can. That being said you definitely need to find a doctor/hospital with a "high risk" department. Your best bet is to find a large university hospital b/c they usually have a high risk OB on staff and to also make sure it has a neonatal ICU equipped for very premature baby.
 
Remember the serenity prayer? I agree that, however well meaning your intentions, this isn't your battle.
This woman is an adult, able to make her own decisions. As to another doc not wanting to take on the liability at this point, there's always the option of showing up in the ER of a hospital that has the proper facilities.
Because of the new privacy laws (HIPPAA), most care givers won't discuss someone else's medical issues w/ you. She'd have to explore this on her own.
Good luck to her,
Valerie
 
It is my battle as I am in the position to help and find help and so I have taken it up after being beseeched by the mother to be and her mom. I am in the biomedical profession(started a biotech to focus on HepB and C using RNAi technology and ahve a adjunct position at a local teaching hospital) and have many medical contacts (albeit not in ob/gyn...that is why I have asked for advice here.) It is my experience that doctors from small community hospitals often aren't nearly as skilled or up to date as physicians from bigger centers or teaching hospitals. I have experienced this personally through the awful care my Dad received after he was diagnosed with HCV and then liver cancer. I work in the area of viral hepatitis and hepatology and had many physician contacts who knew of appropriate clinical trials and were aware of and practiced newer treatments. If I let my Dad stay entrusted to the local docs who recommended that he be put in hospice and gave him a prognosis of 4-6 months, he wouldn't have been given the gift of an extra 4 years of quality life. His story as written by me and a physician I found through my contacts and has been published in the Spring 2003 newsletter from the HepB foundation. The story was written to give others hope and let them know that they are in power to find other treatment options if they just look. I think the link is www.hepb.org and then you can go to resources and then newsletters . The article is in the Spring 2003 letter and is called one man's story. In any event through discussions I had yesterday, I was referred to a maternal/fetal expert who has been in contact with my cousin. We found out that she was not being given the standard of care prescribed for this condition, nor was the baby being monitored appropriately nor did it dawn on them that they weren't treating this appropritaely and so they weren't making arrangements to have her moved to a more appropriate place. I am glad I stepped in. I don't beleive one should ever walk away. I shall keep you updated.
 
Cathy,

Thanks for posting a link to the article you co-wrote about your dad. It's really fascinating and inspiring. I'd say your folks hit the jackpot with a daughter like you!! Also, it gives people a chance to see the role scientists play in medicine. My husband is an MD but is also involved in research and clinical trials--it's hard work. I can only guess at the countless lives that have been saved because of your dedication. Thank you.

Michele
 
Cathy,

I am so happy you found a physician who can care for your cousin's daughter. I applaud you for your efforts!!! I really think she should demand a referral from her doctor, it ticks me off when doctors do not make necessary referrals. I see it often in my local community and very few people, including those who have the knowledge, are willing to advocate for others.

Please update us!

Autumn
 
Thanks for the link to the article. I know someone with HCC and a poor prognosis and have sent her the article. By the way, I also hope you cousin fares well.
 
Cathy, I am so glad your cousin's daughter and her baby are doing well. I missed this thread when it was originally posted and while I could not have offered any advice, I definitely would have shown support. I am glad I saw it this time. Take care. Thanks for the information and help you also gave me Cathy.
 
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