tag:blogger.com,1999:blog-16638275.post8080310590679549885..comments2024-01-05T19:30:12.040+00:00Comments on Dr Jest's Caseblog: Emergency Service?Doctor Jesthttp://www.blogger.com/profile/14446967855995345815noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-16638275.post-43783854115259272202008-04-30T16:46:00.000+01:002008-04-30T16:46:00.000+01:00input of a consultant? Oh, okay.You've a good mem...<I>input of a consultant</I>? Oh, okay.<BR/><BR/>You've a good memory (so have I), I remember reading about that case too, some years ago - it was in Africa, I think, and the girl concerned had no opening to her cervix, so it should have been impossible for her to become pregnant. It was an angry husband or brother who stabbed her, not the boyfriend who had impregnated her. It could be a shaggy dog story, of course - all seems highly unlikely.Zhttps://www.blogger.com/profile/00822383355869390919noreply@blogger.comtag:blogger.com,1999:blog-16638275.post-54097286144099951672008-04-30T15:53:00.000+01:002008-04-30T15:53:00.000+01:00z- wise words as ever, though I seem to recall rea...z- wise words as ever, though I seem to recall reading a report of a pregnancy resulting after an abdominal stab wound following oral sex...<BR/><BR/>Dr A- always happy to be of service doc ;-)<BR/><BR/>orchidea- in this young lady's case yes she prefers the latter aproach and I would certainly not argue with her. I hope the extra strong or large fit condoms I supplied to her for him will do the trick, and yes, perhaps he ought to be the one to consult, but since it is she that would have to bear the consequences if we don't get it right I'm happy to try to "treat" him through her as it were.<BR/><BR/>bendy girl- thanks for a fascinatin insight. perhaps there is some unusual shear force at work here. I'll be sure to pass your advice on if I can.<BR/><BR/>elaine- indeed. A point well made in the interests of public health. <BR/><BR/>becks- welcome. as you say some family planners and GPs are ok with the idea of IUCDs for nulliparas, but fitting can be a tad trickier, and there are still some hangups about the small increase in risk of pelvic infections and their effect on future fertility, though I accept this is probably overplayed and based on experience now 3-4 decades out of date.Doctor Jesthttps://www.blogger.com/profile/14446967855995345815noreply@blogger.comtag:blogger.com,1999:blog-16638275.post-50655632497311783612008-04-29T23:44:00.000+01:002008-04-29T23:44:00.000+01:00I am a nullipara who regards her coil as the best ...I am a nullipara who regards her coil as the best thing since sliced bread. I'm not sure if there is any official guidance on this, but clearly some doctors are willing to fit them and surely in this case it would be better than "handfuls" of morning after pills!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-16638275.post-43446175634307203692008-04-29T19:16:00.000+01:002008-04-29T19:16:00.000+01:00... and you don't require penetration to result in...... and you don't require penetration to result in impregnation...Elainehttps://www.blogger.com/profile/06847149482684623481noreply@blogger.comtag:blogger.com,1999:blog-16638275.post-54419981834075766682008-04-29T13:16:00.000+01:002008-04-29T13:16:00.000+01:00Bendy Girl - I'm a petite woman with an... erm... ...Bendy Girl - I'm a petite woman with an... erm... tall man. We've used condoms in the past with no problems at all (except being out of condoms). One thing I know for <I>sure</I> is that if withdrawal worked, I'd have 50% less children than I have now!<BR/><BR/>:)Unknownhttps://www.blogger.com/profile/01053418339912201502noreply@blogger.comtag:blogger.com,1999:blog-16638275.post-6794338832311480372008-04-29T12:59:00.000+01:002008-04-29T12:59:00.000+01:00I'm amazed no-one else has mentioned this, but her...I'm amazed no-one else has mentioned this, but here goes....<BR/><BR/>The combination of petite woman and well endowed man (actually doesn't have to be much more than average now I think about it), in my experience has led to condoms breaking so frequently I would always check they're intact after initial penetration. It seems to be something about the forces applied to the condom and that they become too great causing the breakage, typically on initial penetration. <BR/><BR/>I'm in a similar position to the lady you describe so was offered a coil by a fam planning consultant. It wouldn't hold and had to be removed in A&E a day later as it was 'stuck'. A consultant might be willing to offer your patient a trial of a coil considering the circumstances. Mine was done under colposcopy (sp?) to improve the chances of accuracy. Ironically.<BR/><BR/>The best thing I can suggest is huge amounts of ky jelly (or similar) Enough lube seems to go some way counteract the the different forces, but were I desperate not to get pregnant I wouldn't be relying on it without checking the condom every time. <BR/><BR/>Having been through the process with the input of a consultant I can't come up with any real answers. Withdrawl seems to work best as a method of contraception and is probably no more risky than their current situation. <BR/><BR/>I wish them luck, and if you come up with any better suggestions, please do let me know! <BR/>Bendy GirlBenefitScroungingScumhttps://www.blogger.com/profile/08939136229593231935noreply@blogger.comtag:blogger.com,1999:blog-16638275.post-64203293740397092842008-04-29T09:13:00.000+01:002008-04-29T09:13:00.000+01:00Do the adverse effects of taking the contraceptive...Do the adverse effects of taking the contraceptive pill really outweigh those of taking the morning after pill (too) frequently?<BR/><BR/>Perhaps it's her boyfriend who should be consulting you.Unknownhttps://www.blogger.com/profile/01053418339912201502noreply@blogger.comtag:blogger.com,1999:blog-16638275.post-66464630945128799362008-04-28T23:50:00.000+01:002008-04-28T23:50:00.000+01:00The pun is most satisfactorily dreadful! Thanks, D...The pun is most satisfactorily dreadful! Thanks, Dr J. :-)Dr Andrew Brownhttps://www.blogger.com/profile/13858213625632400403noreply@blogger.comtag:blogger.com,1999:blog-16638275.post-51222467299527631872008-04-28T21:27:00.000+01:002008-04-28T21:27:00.000+01:00I don't think they're putting it on properly. May...I don't think they're putting it on properly. Maybe one of them has very long or jagged nails?<BR/><BR/>I understand that, among those for whom artificial contraceptive devices are not acceptable, mutual oral sex is an enjoyable substitute that gives no risk of pregnancy. Maybe the suggestion from a family doctor is a touch intrusive, however. I can't help thinking that she might as well go ahead and have a baby - nine months with no need for contraception, after which she could use a coil if she wanted to.Zhttps://www.blogger.com/profile/00822383355869390919noreply@blogger.com