bich le

Dear Bleeding At Grand round the Professors and Residents all agee the following: 1) A thorough Gynecology Exam must be done 2) The Pregnancy Test Must be done: Both Urine and Blood Test 3) Good Bleeding History must be answered: The Amount of Blood ( how many pads or tampons used per day), How frequent this abnormal type of bleeding occurs? Any pain associated with this bleeding? 4)Keep in mind: Any Bleeding out of routine is Abnormal (and You are Concerned) Sincerely Yours, Bich Le, M.D.

Dear Bleeding At Grand rounds, the professors and residents all agree:

1) A good history and physical exam ( including a thorough Gynecology exam ) required
2) The Pregnancy Tests( urine and blood test) must be done
3) A visit to the Family Physician ( or A free Medical Clinic) As Soon As Possible.

Sincerely Yours, Doctor Bich Le

Dear Abnormal Vaginal Bleeding : At Grand Round, The Professors and the Residents agreed the following: 1) A thorough Gynecology Examination Is needed 2) Pregnancy tests must be done: both Urine and Blood Tests 3) If the pregnancy tests are Negative, the additional therapeutic hormonal treatment might be required . Thank you very much Sincerely Yours, Bich Le, M.D.

Dear Strong Signal At The Medical Conference , the Attendings and The Residents recommend the following: 1) Visit a Gynecology clinic . 2) Have a Pregnancy Blood Test. 3) Further Tests per Gynecology Clinic Sincerely Yours, Bich Le, M.D.

At Grand Rounds, the professors and the Residents agree upon the following:
1) A thorough Gynecology Examination, pregnancy test urine (+ blood test) should be in order.
2) The Medical Lab work -up including the hormonal profile.
3) Your medication could be the source of the abnormal hormonal variation and the weight control goal.
4) If the pregnancy test is negative, a short course of hormonal therapy can be very helpful to resolve the problem
Thank you very much.
Sincerely Yours,
Bich Le, M.D.

Dear spotting problem Patient
At Grand Rounds, The doctors and residents would recommend:
1) Blood pregnancy test, abdominal ultrasound, and pelvic ultrasound ( if needed)
2) Gentle, thorough gynecology exam.
3) Your medical history should include the age of Menarche, duration of menstruation, amount of vaginal pads /tampons used each day, and last normal menstrual period.
4) Keeping a Good Record of the monthly period would be part of your routine.

Dear Ms Concern:
If your Case was presented at The Medical Conference , The Staff
Physicians Would Recommend The Following:
1)Visit your Gynecology Doctor
2) Have a Blood Pregnancy test (Beta HCG)
3) Follow your gynecology doctor 's Recommendation regarding your
contraception and /or Lab Tests with Respect to Other possible Issues.
Sincerely Yours,
Doctor Bich Le

Dear Mrs.,

Let us start like when I teach my residents, we need few more info: why did you have a hysterectomy (fibroid or bleeding or cancer...)? Abdominal surgery or vaginal surgery? Partial or total hysterectomy? Any blood transfusion? Any family history of cancer or bleeding? Your current medications? And are you allergic to anything? Post-surgery, any lab work: CBC, BUN, Creatinine, SGOT, SGPT, any scan: pelvic ultrasound, CT? After reporting your problem, did you have a gentle, thorough pelvic exam, vaginal cuff culture? Once it is confirmed SSI, have you had any antibiotics? I would tell my residents to start on ciprofloxacin and cefazolin while waiting for the culture result. Lastly, I would obtain a second opinion from my local colleague.
In Conclusion, I wish you Happy Holidays.

Dear Ms.,

You can go to the nearby Planned Parenthood or a local clinic for a gentle pelvic exam, wet mount, and culture. Make sure the discharge is not from the allergy of the new soap or lubricant. I usually tell my residents: if it looks like a yeast infection, vinegar douche or plain yogurt can restore normal vaginal flora and generating a soothing feeling.
I wish you Happy Holidays.