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Hello. I am looking for as many professional opinions as I can get right now. Work in an office with other doctors? Ask them too.... Please! Patient comes in for IUD (Mirena) implant. Medication in given to soften cervix, IUD inserted, the end..... Patient is 32 and unknowingly conceived 10 days prior. Medication and IUD SHOULD (statistically) terminated unknown pregnancy. Patient goes to ER thinking she has a cyst causing pain on left ovary, only to discover she is pregnant, with a boy (17w3d). Seen at OB for ultrasound. RNP thinks she sees IUD, but unsure. It is never looked for again. Doctor seen through rest of pregnancy says there is "no evidence" of it being there, assumes it came out soon after going in. What steps would you take during a suspected IUD pregnancy or following delivery to ensure the IUD was out of patient's body? (Not in uterus or somewhere else in abdomen) 1 year since birth of child, no return of menses, and IUD was recently found in uterus on ultrasound. How would you proceed? Bayer was ZERO help when called for guidance.
So this morning I bumped into my nurse manager that wrote one my letters of recommendation this cycle and she ended up printing out for me the detailed letter of recommendation she submitted on my behalf. I was awed by how vast and detailed the letter she wrote was but I was also left surprised at the many and I mean MANY "physician's assistant" (in lower case letters) there were throughout the entire recommendation. I was at a complete loss for words after reading. I mean she works along side so many on our floor I didn't think this was possible. The last sentence ended with: I implore you to consider him for you physician's assistant program" I don't even know what to say to that. I mean, I absolute love the fact that she wrote such a detailed letter for me describing my many interactions with patients, nurses, PAs and Physicians but I cant help to feel MORTIFIED at what Adcoms will think! I am already nervous about this process it became amplified after reading this letter. Any advice on what I should do?? Should i call my schools? Should i call CASPA to see if i can have her removed from my app? Am i overreacting? Please help!