After 25 years as an academic consultation-liaison psychiatrist, my professional life changed dramatically in 1994 when I was selected to lead a new multidisciplinary women's health initiative at the University of Toronto's largest teaching hospital. A typical day starts with a patient at 8 AM, and today I see a 34-year-old woman with bipolar affective disorder who has recently discovered that she is 8 weeks pregnant. Her attending psychiatrist is concerned about continuing to prescribe lithium and has referred her for consultation. Based on her past unstable illness history, I recommend that lithium be continued throughout the pregnancy and that she undergo a level 2 ultrasound in the second trimester to rule out congenital anomalies. I recommend that her lithium dose be carefully monitored during pregnancy to avoid suboptimal levels and after delivery to prevent toxicity. I advise the patient of the risk of postpartum bipolar relapse and encourage follow-up with her psychiatrist. I conclude by writing a consultation letter to her psychiatrist, and with the patient's permission, copy her obstetrician. At 9, I meet briefly with my administrative assistant to discuss the day's events and sign various forms, requisitions, and payment authorizations. At 9:30, I grab my
A Day in the Professional Life of a Chair in Women's Health
Abstract
After 25 years as an academic consultation-liaison psychiatrist, my professional life changed dramatically in 1994 when I was selected to lead a new multidisciplinary women's health initiative at the University of Toronto's largest teaching hospital. A typical day starts with a patient at 8 AM, and today I see a 34-year-old woman with bipolar affective disorder who has recently discovered that she is 8 weeks pregnant. Her attending psychiatrist is concerned about continuing to prescribe lithium and has referred her for consultation. Based on her past unstable illness history, I recommend that lithium be continued throughout the pregnancy and that she undergo a level 2 ultrasound in the second trimester to rule out congenital anomalies. I recommend that her lithium dose be carefully monitored during pregnancy to avoid suboptimal levels and after delivery to prevent toxicity. I advise the patient of the risk of postpartum bipolar relapse and encourage follow-up with her psychiatrist. I conclude by writing a consultation letter to her psychiatrist, and with the patient's permission, copy her obstetrician. At 9, I meet briefly with my administrative assistant to discuss the day's events and sign various forms, requisitions, and payment authorizations. At 9:30, I grab myPreview Only. This article cannot be rented because we do not currently have permission from the publisher.
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A Day in the Professional Life of a Chair in Women's Health
Stewart, Donna E.
Follow Academic Psychiatry
, Volume 27 (3): 221
American Psychiatric Publishing, Inc (Journal) – Sep 1, 2003
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