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Dr. Pfeiffer
Dr. Pfeiffer, Doctor
Category: OB GYN
Satisfied Customers: 5986
Experience:  Ob/Gyn Doctor
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I just had my second silver nitrate treatment after a davinci

Customer Question

I just had my second silver nitrate treatment after a davinci hysterectomy..is this common It has been 12 weeks will it ever heal?? It has caused me much anxiety
Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr. Pfeiffer replied 1 year ago.

Dr. Pfeiffer :

hello

Dr. Pfeiffer :

let me just make sure I understand..

Dr. Pfeiffer :

you had a hysterectomy where the cervix was removed...done with the robot

Dr. Pfeiffer :

you started having pain/bleeding or both and are now having silver nitrate placed vaginally at the cuff

Dr. Pfeiffer :

sound right?

Customer:

yes I was fine for 6 weeks then started spotting I had a silver nitrate treatment and continued to spot for another 10 days and went in again for another treatment today..no pain

Dr. Pfeiffer :

ok..

Customer:

any side effects with silver nitrate

Dr. Pfeiffer :

I can't say it's common because to me that means it happens more than half of the time.

Dr. Pfeiffer :

that said, it isn't unusual

Customer:

is my immune system poor

Dr. Pfeiffer :

no..not at all

Dr. Pfeiffer :

this is called grandulation tissue

Dr. Pfeiffer :

it happens to some women at the vaginal cuff during the healing process.

Dr. Pfeiffer :

typically we use the silver nitrate to chemically burn the tissue until it goest away.

Dr. Pfeiffer :

I have seen this happen in patients several months after surgery.

Dr. Pfeiffer :

and..in severe cases where the silver nitrate doesn't work..sometimes whe have to revise the vaginal cuff and let it heal again...hopefully without the grandulation tissue formation.

Customer:

i am still having discharge tonight..does that seem right? to revise the cuff do you have to have surgery again

Dr. Pfeiffer :

No real side effects with the silver nitrate...except you might have an increase in vaginal discharge, possibly an odor, and the discharge may look gray/black/orange..

Customer:

she said it was a pea size area that had not healed

Dr. Pfeiffer :

Yes...revision of the cuff is another surgery because usually the bladder will attach itself to the top of the cuff so you need to be able to see the top of the cuff to prevent cutting the bladder.

Dr. Pfeiffer :

ok...that sounds pretty minor and should respond to the silver nitrate.

Dr. Pfeiffer :

it may take several treatments though.

Dr. Pfeiffer :

and the discharge you are having is due to the silver nitrate and normal.

Customer:

Thanku so much!! I had anxiety about this so i finally took a xanax..are they real addicting

Dr. Pfeiffer :

yes..

Dr. Pfeiffer :

very much so.

Dr. Pfeiffer :

use sparingly and only if you need them.

Dr. Pfeiffer :

they are hard to get off of

Customer:

any other way to deal with anxiety without taking xanax..my dad also just passed this week..usually i do not deal with stress well so my bp shot up and i have been having headaches..most of the time my bp is low..i have also been having some short of breath they did a ekg and it was normal but gave me xanax

Customer:

my headaches are on top of my head

Dr. Pfeiffer :

Don't get me wrong...that's what the medication is for.

Dr. Pfeiffer :

So use it if you need to.

Customer:

anything else i can use

Dr. Pfeiffer :

What I'm saying is...use it when you are having problems with your anxiety..and not simply because you like the way they make you feel...that's when you might get in trouble.

Dr. Pfeiffer :

all of the medications in that class are equally important.

Dr. Pfeiffer :

the non benzodiazapines...

Dr. Pfeiffer :

buspar

Dr. Pfeiffer :

SSRI - such as Zoloft

Dr. Pfeiffer :

equally addictive..not important.

Dr. Pfeiffer :

sorry...typo

Customer:

is it dangerous to have spikes in bp due to anxiety..can i exercise with the bleeding and bp problem

Dr. Pfeiffer :

well we all have spikes in blood pressure under certain circumstances.

Dr. Pfeiffer :

exercising with the bleeding really isn't an issue

Dr. Pfeiffer :

the bp..that is something that should be cleared with your local doctor who knows your history and also how high these spikes are.

Customer:

i had bled out to 7.5 hemoglobin before the hysterectomy and had to have a transfusion..did this cause damage to my heart..or cause this anxiety feeling..it has caused anxiety bc i am freaked out about the dangers of tranfusion

Dr. Pfeiffer :

I don't think so...

Dr. Pfeiffer :

we see women get down to that level commonly..usually after delivery, but occasionally in women your age with abnormal bleeding.

Dr. Pfeiffer :

usually if there is damage to the heart as a result of the bleeding it manifest itself as a heart attack.

Dr. Pfeiffer :

transfusion are pretty safe nowadays.

Dr. Pfeiffer :

I typically tell my patients..about the same odds of winning the lottery as far as getting something from a transfusion.

Customer:

that would show on the ekg right

Dr. Pfeiffer :

yes

Customer:

would you transfuse at 7.5

Dr. Pfeiffer :

that's always subjective.

Dr. Pfeiffer :

in a woman your age yes.

Dr. Pfeiffer :

in younger women I wait until 7

Customer:

so if i can get by without xanax..taking asprin for headaches that would be better..does xanax really help with the spikes of bp

Dr. Pfeiffer :

if the anxiety is the cause of the spikes in BP the xanax will help that.

Dr. Pfeiffer :

if it's due to something else the xanax will not help.

Customer:

do you recommend testing for hiv etc after a transfusion

Dr. Pfeiffer :

if you have headaches from elevated blood pressure you might need a BP pill.

Dr. Pfeiffer :

No..to the HIV question

Customer:

what bp meds causes the least side effects..last time i tried my bp went down to 85/55..and i felt awful

Dr. Pfeiffer :

well..now you're getting to an internal medicine question.

Dr. Pfeiffer :

most of the elevated blood pressures we treat is in pregnancy

Dr. Pfeiffer :

remember...we started with a surgical question

Customer:

Thanks so much You were wonderful!!!

Dr. Pfeiffer :

you're welcome.

Dr. Pfeiffer :

take care and have a good evening.

Dr. Pfeiffer, Doctor
Category: OB GYN
Satisfied Customers: 5986
Experience: Ob/Gyn Doctor
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