Re: HELP! Screening & advice for sex workers

[Guest guest]

True Lynette.  I started to post yesterday that my practice (and life) were boring after that story, but then I started thinking about some of the stuff I've heard from patients.  Now my life, that isn't too exciting, thank goodness.

Sharon 

 

I continue to maintain that primary care is enough of a dramatic story that watching drama on TV is a step down!

 

Lynette I Iles MD 301 South Iowa Ste 2Washington IA 52353 Flexible Family Care 'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee.  If you have received this email in error, please notify the sender immediately and delete it from your computer.

[Guest guest]

Pam: Don’t forget to keep screening for violence. It is very frequent in sex workers and it usually goes undetected because the workers hardly ever report it. It may not apply to your patient but I would keep that one in mind Izquierdo-Porrera MD PhDExecutive Director & Co-founderCare for Your Health, IncPhone " Don't ever let injustice go by unchallenged. " From: [mailto: ] On Behalf Of roxywibleSent: Friday, October 28, 2011 8:59 PMTo: Subject: HELP! Screening & advice for sex workers I have a friend who is a patient & came to me for a routinegyn exam today. When asked # of partners since last pap she told me she is now a sex worker. She showed meher website. . very interesting! Her partner is aware of her new profession has concerns about STDs & other risks.Anyone want to take a stab at this one?I reviewed the obvious, but feel her greatest risk is HPV risk of carcinoma not only cervix, but rectal, larynx. . .etc. . and she can spread this back to her partner I would assume.She uses condoms for vaginal intercourse but does not like the taste oflatex so she performs oral sex without any barrier method.Interestingly, mostly services men who are her father's age who are nowwidowed or just lonely and not getting their needs met in marriage.Of course, this is illegal in Oregon so we had to discuss whether to write allof this in her official chart. Uninsured at this point but wondering aboutdiscrimination in future for health/life insurance policies.Another fun day at the office!PamelaPamela Wible, MD3575 St. #220 Eugene, OR 97405www.idealmedicalcare.org

[Guest guest]

Thanks!!

Pamela

>

> > I have a friend who is a patient & came to me for a routine

> > gyn exam today. When asked # of partners since last pap

> > she told me she is now a sex worker. She showed me

> > her website. . very interesting! Her partner is aware of her

> > new profession has concerns about STDs & other risks.

> >

> > Anyone want to take a stab at this one?

> >

> > I reviewed the obvious, but feel her greatest risk is HPV

> > risk of carcinoma not only cervix, but rectal, larynx. . .etc. . and

> > she can spread this back to her partner I would assume.

> >

> > She uses condoms for vaginal intercourse but does not like the taste of

> > latex so she performs oral sex without any barrier method.

> >

> > Interestingly, mostly services men who are her father's age who are now

> > widowed or just lonely and not getting their needs met in marriage.

> >

> > Of course, this is illegal in Oregon so we had to discuss whether to write

all

> > of this in her official chart. Uninsured at this point but wondering about

> > discrimination in future for health/life insurance policies.

> >

> > Another fun day at the office!

> >

> > Pamela

> >

> > Pamela Wible, MD

> > 3575 St. #220

> > Eugene, OR 97405

> >

> > www.idealmedicalcare.org

> >

> >

>

[Guest guest]

Due to some changes to my travel plan, I will not be needing coverage right away. I will inform you as soon the start date is comfirmed. Thanks for your help. Frances Ilozue, MD Rapha Family Medicine, PC2200 Main StreetBuffalo NY 14214716 2004825 fax To: Sent: Thursday, November 3, 2011 4:08 PMSubject: Re: HELP! Screening & advice for sex workers

Thanks!!

Pamela

>

> > I have a friend who is a patient & came to me for a routine

> > gyn exam today. When asked # of partners since last pap

> > she told me she is now a sex worker. She showed me

> > her website. . very interesting! Her partner is aware of her

> > new profession has concerns about STDs & other risks.

> >

> > Anyone want to take a stab at this one?

> >

> > I reviewed the obvious, but feel her greatest risk is HPV

> > risk of carcinoma not only cervix, but rectal, larynx. . .etc. . and

> > she can spread this back to her partner I would assume.

> >

> > She uses condoms for vaginal intercourse but does not like the taste of

> > latex so she performs oral sex without any barrier method.

> >

> > Interestingly, mostly services men who are her father's age who are now

> > widowed or just lonely and not getting their needs met in marriage.

> >

> > Of course, this is illegal in Oregon so we had to discuss whether to write all

> > of this in her official chart. Uninsured at this point but wondering about

> > discrimination in future for health/life insurance policies.

> >

> > Another fun day at the office!

> >

> > Pamela

> >

> > Pamela Wible, MD

> > 3575 St. #220

> > Eugene, OR 97405

> >

> > www.idealmedicalcare.org

> >

> >

>