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Breast Implant vs. Natural Breast


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Just started doing a GYN rotation. Today the doc asked me what I noticed about this mildly obese patient's breasts. I told her it felt and looked normal to me, no bumps, lesions, asymmetry etc. Then she told me the pt had breast implants. I asked her iif they suppose to be more firm since I guess it wasn't as soft as other patients. She said no and left it at that. So if surgical scars aren't apparent, how do you tell by touching?

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So if surgical scars aren't apparent, how do you tell by touching?

I'll take the bait...

 

 

There's this crazy, kind of outdated practice called "History Taking" where you ask the patient any past medical hx and past SURGICAL hx BEFORE you touch them. Or, you have an awesome staff that already did this and you review it in the chart.

 

Kinda archaic, but saves the guessing game...

 

 

Sent from my iPhone using Tapatalk

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I'll take the bait...

 

 

There's this crazy, kind of outdated practice called "History Taking" where you ask the patient any past medical hx and past SURGICAL hx BEFORE you touch them. Or, you have an awesome staff that already did this and you review it in the chart.

 

Kinda archaic, but saves the guessing game...

 

 

Sent from my iPhone using Tapatalk

Yeah because we know patients are awesome historians and always tell providers everything.

 

Sent from my Nexus 7 using Tapatalk

 

 

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Jasmine Tridevel, the Tampa woman who became an internet sensation when she announced she had cosmetic surgery to add a third breast moron.gif

The 21-year-old massage therapist claims she had to ask over 50 doctors to perform the surgery, which involved taking skin tissue from her abdomen and adding a silicon implant. She also got an areola tattooed on. The procedure cost $20,000, and Tridevil had to sign an NDA so [she] couldn't disclose what doctor performed it.  Read more at http://www.snopes.com/photos/bodymods/jasminetridevil.asp#acMMwGmZdRRAYGXP.99

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  • 3 weeks later...

My preceptor doesn't let me take their history or do any charting. Students are not allowed to be in with the patient by themselves- her rules. She already knows their medical/surgical history and only has her staff members take history. Charts are all on her computer which I don't get to go on. She only allows me to do physical exams, and only on "normal" patients. Whatever, I'll just wait until the next rotation when I'm allowed more freedom again.

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My preceptor doesn't let me take their history or do any charting. Students are not allowed to be in with the patient by themselves- her rules. She already knows their medical/surgical history and only has her staff members take history. Charts are all on her computer which I don't get to go on. She only allows me to do physical exams, and only on "normal" patients. Whatever, I'll just wait until the next rotation when I'm allowed more freedom again.

So... you're paying to shadow?  Talk to your clinical coordinator--you are not getting your money's worth.

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I agree, next time I'm trusting my instincts and will talk to the faculty about it if I'm in this kind of situation again. In my first rotation I was allowed a lot of autonomy and the preceptor was happy to teach and was receptive to all my questions. I may have got off to a wrong footing in this one, however. This gyn rotation is only my second. I was naive to think things would improve if I were more proactive and asked to help out with hx taking, exams, etc. However, I could tell by her tone she was irritated by this and that's when she told me her rules. Later a classmate informed me she rather students not ask and she will offer them opportunities as she sees fit. So I took a more passive stance, gave her the space she needed. She allowed me to do breast and pelvic exams by the 2nd week. Paps finally in the 3rd. I thought she'd let me do a little more each week, but it only went as far as that. Definitely did not learn the way I wanted to.  

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