Letter to the Editor

Abstract

To the Editor:Having experienced a fatal pulmonary embolus after arthroscopy in a morbidly obese woman, Eugene E. Berg suggested that “the obese patient be considered for anticoagulation prophylaxis.” ( Arthroscopy 1998;14:321-324.)However, that patient was on birth control pills which were apparently not stopped, contrary to the recommendation of the Physician's Desk Reference (1997;pp 1908, 1912, 1915, 1919, 1929, 1933.) I learned of this recommendation after a thin young woman suffered the only pulmonary embolism I have seen after arthroscopy.Rather than beginning a regimen that itself has a considerable, and occasionally fatal complication rate, it would be prudent to stop a drug perioperatively that is known to increase the risk of thrombosis and fatal pulmonary embolism, especially if the patient is a smoker.Sincerely, To the Editor:Having experienced a fatal pulmonary embolus after arthroscopy in a morbidly obese woman, Eugene E. Berg suggested that “the obese patient be considered for anticoagulation prophylaxis.” ( Arthroscopy 1998;14:321-324.)However, that patient was on birth control pills which were apparently not stopped, contrary to the recommendation of the Physician's Desk Reference (1997;pp 1908, 1912, 1915, 1919, 1929, 1933.) I learned of this recommendation after a thin young woman suffered the only pulmonary embolism I have seen after arthroscopy.Rather than beginning a regimen that itself has a considerable, and occasionally fatal complication rate, it would be prudent to stop a drug perioperatively that is known to increase the risk of thrombosis and fatal pulmonary embolism, especially if the patient is a smoker.Sincerely, Having experienced a fatal pulmonary embolus after arthroscopy in a morbidly obese woman, Eugene E. Berg suggested that “the obese patient be considered for anticoagulation prophylaxis.” ( Arthroscopy 1998;14:321-324.) However, that patient was on birth control pills which were apparently not stopped, contrary to the recommendation of the Physician's Desk Reference (1997;pp 1908, 1912, 1915, 1919, 1929, 1933.) I learned of this recommendation after a thin young woman suffered the only pulmonary embolism I have seen after arthroscopy. Rather than beginning a regimen that itself has a considerable, and occasionally fatal complication rate, it would be prudent to stop a drug perioperatively that is known to increase the risk of thrombosis and fatal pulmonary embolism, especially if the patient is a smoker. Sincerely,