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February 17, 2016

Dr. Gandhi delivering babyWhat are some of your favorite parts about your job?
I really enjoy talking to my patients and caring for women. Especially as a woman. I feel like I can relate to a lot of the same worries and concerns they have.

Also, the spontaneity. This specialty incorporates surgical skills as well as quick-thinking on your feet. It is a moment-to-moment kind of thing, especially when it comes to delivering babies. I always feel totally humbled because when I get to work, my schedule may say one thing, but when I get done, I could have done a C-section at lunchtime or an emergency surgery that afternoon. All in the same day.

Dr. Gandhi graduation photoHave your studies and sub-specializing in FPMRS changed the way you think about patients or how you approach their problems?

The pelvis is such an interesting cavity, containing organs that play a crucial role in muscle support, reproduction and sexual function. After becoming board certified in this subspecialty, I realize that I play a unique role in helping women resolve issues of pelvic organ prolapse, leakage and sexual dysfunction. In fact, I realize how much women think about these embarrassing topics, especially the sexual dysfunction symptoms, and how much their needs change as they get older.

For both menopausal patients and younger patients, it’s becoming a lot more acceptable to talk about sexual dysfunction. There’s a cultural shift going on that is allowing and encouraging women to feel more comfortable talking to their doctors about it. I’ve learned how to talk to patients better about sex, too. And why they’re not enjoying it, and how to improve it. We even do ThermiVa in the office which is a procedure that helps tighten the vaginal canal and improves lubrication. This is cutting-edge technology that provides patients non-surgical options without having to even take hormones.

Another unique piece is the degree in which doctors are challenged to restore the anatomy without using synthetic materials (such as mesh). Patients are looking for surgical options that give them a quick recovery and yet, are successful. Surgical management of prolapse is more tailored to each patient, rather than using synthetic products to augment repair. I think I’m a better surgeon because of it.

What has been your biggest challenge?
I’m very sensitive. I really have to displace myself from taking things to heart. I worry about my patients all the time. How they’re doing; how I can help them. But it can be emotionally draining. I’m trying not to be such a worrywart all the time, and trying to be more objective.

What is your biggest success up until now?
Building up a medical practice that I am proud of – I can think of no other success than being a trusted provider. I think most of my referrals come from other patients. It’s been a slow process for me, but I see the difference in the number of patients after joining Cherokee Women’s eight years ago. I continue to grow and try to improve the care I deliver.

Patients have said to me, “I want to see you because I know you’ll take care of me.” It’s so flattering, it’s such a high. I can’t believe somebody would feel that way about me, especially if they don’t even know me. That’s what I wanted, when I was in medical school and residency, to have a situation where the patient could tell that their doctor loves what they do.

When you were young, how did you picture being a doctor? How is your work the same as that, and how is it different?Dr. Gandhi with mom photo
When you’re young, you don’t live in reality. You live in this foggy, idealistic world. I had a really good mentor, though. I went to high school in a very small town called Amanda, Ohio. Everybody kind of knew each other. My parents owned a grocery store, and we lived on top of the grocery store. I knew I wanted to go to medical school, and I surrounded myself with other people who believed in me and thought I could do it. I always pictured myself looking old (around 30 or so, because when you’re 15, 30 seems so old!), and saying, “Man, I knew I could do it.”

I realize now how naïve I was. The practice of medicine is on-going and fluid. One can never master it. But every great doctor aims high. This is what benefits patients in the long-run, a physician who never stops learning and is never “done.”

What words of wisdom would you give your younger self?

I think I would’ve told myself to have more fun. Trying to get everything done is an accomplishment, but sometimes it can compromise your ability to really grow as a person. If I could tell my fifteen-year-old self anything, I would say take moments to spend time with your family and friends. Every summer, all I did was study or go on some internship or work. And this is the first time in private practice that I’ve actually started taking vacations and making myself a priority.

My dad passed away in November and it’s really impacted my life and how I will live it in the future.

Dr. Gandhi with dad photoWho is one person who has had a tremendous impact on your life, personally or professionally? Why and how did this person impact your life?

Honestly, there is never just one person. My father obviously was my biggest supporter. He never doubted my ability and was so insistent that I could achieve ANYTHING as long as I worked hard. He and my mother and brother have been so crucial in getting me to this point. The sacrifices they made for me through the years, I could never repay. But I strive to make my father proud, every day. I miss talking to him during my lunch breaks. But I know he is with me. I am so lucky to have had HIM as my father, mentor and spiritual role model.

You’ve mentioned that you like Shakti Gawain’s quote, “Our bodies communicate to us clearly and specifically, if we are willing to listen to them.” What are some ways patients can be more in tune with their bodies? What kinds of things should they pay attention to?

I think one thing is to not ignore symptoms. Day to day, you want to think about what you’re putting into your body, and what your body is saying in return. If it’s time for an oil change in your car, and the little light in your dashboard comes on, you’ll probably get your oil changed. Symptoms are the dashboard warning lights. Our bodies communicate to us using these sometimes subtle signs or symptoms. We just have to make sure we heed the warning.

On the flip side, as a doctor, you’ve gotta pay attention too. The answers are there when the patient walks through the door. But they may not have the answers to explain what the patient is feeling. Most of the time, patients don’t want to complain about their symptoms. I ask them if they have any concerns or if they’re having any pain, and sometimes I get, “Not really.” Not really? Who knows what “not really” means in medicine? You have to really explore further.

Ideally, if patients are able to listen to their bodies, they shouldn’t prolong seeking care. A delay in getting care, whether financial, or for some other reason, can lead to disease or other issues that ultimately either require invasive intervention or make an issue untreatable.

February 16, 2016

 

pregnant-woman-saying-no-to-alcohol picThe Centers for Disease Control made headlines this week when they announced that sexually active women of childbearing age should never drink alcohol unless they’re on birth control. The recommendation met with both support and backlash: many women agree that it’s not worth the risk, while others argue that telling 3.3 million women not to drink isn’t feasible. What do you think?

Are You Expecting?
You probably know that consuming alcohol during pregnancy can negatively impact a baby’s mental, physical, and behavioral development. What you may not know is whether or not you’re expecting. Some moms-to-be take 4 to 6 weeks to realize they’re pregnant. And as many moms of lovable broods know, about half the pregnancies in the United States are unplanned. Even women actively trying to get pregnant might continue drinking. According to the CDC, only 1 in 4 women stops drinking alcohol when they go off birth control. Exposure to even minimal alcohol during pregnancy may affect the baby’s health. So is the risk worth it?

The Effect of Alcohol on Developing Babies
Whether you’re happily expecting or simply trying, we know your baby’s health is your #1 consideration. But you may not realize just how much damage drinking during pregnancy can cause. Even small amounts of alcohol can cause:

  • Miscarriage
  • Stillbirth
  • Prematurity
  • Fetal Alcohol Spectrum Disorders (FASDs)
  • Sudden Infant Death Syndrome (SIDS)

FASDs can affect a child’s development both before and after birth. Symptoms can include anything from abnormal facial features and underdeveloped growth to poor memory, attention or hyperactivity disorders, learning disabilities, speech and language problems, and low IQ. Many people suffering from FASDs also have impaired hearing or vision and problems with their hearts, kidneys, or bones.

Make the Healthy Choice
At Cherokee Women’s Health, we advocate for the health of mothers and their babies. According to the CDC recommendation, all expectant mothers should refrain from drinking alcohol during pregnancy. If you’re trying to get pregnant, we recommend that you stop drinking alcohol until you go back on birth control. If you discover you’re pregnant unexpectedly, stop drinking immediately.

Cherokee Women’s Health has an experienced team of obstetricians, dedicated nurse-midwives, and board certified FPMRS surgeons on staff. We specialize in normal and high risk pregnancies, with expert care providers trained in both natural and standard births. To learn more about how to ensure a healthy pregnancy, call today to make an appointment with one of our providers.

patient talking to doctors picWhen you’re diagnosed with Pelvic Organ Prolapse, you’re faced with a challenging and emotionally painful question: Should I continue adding children to my family?  Whether you’ve always wanted a big family, or just two children, you know that your health is in a precarious and delicate state. You’re afraid of worsening your prolapse, but even more afraid that you will regret not choosing to become pregnant again.

Talking with a Urogynecologist who specializes in Female Pelvic Medicine and Reconstructive Surgery may help to make this decision easier for you to make. Since there are surgical and non-surgical treatment options for any stage of prolapse, your doctor can offer insight that may alleviate your fears and concerns. Once you’ve settled on an additional pregnancy, it is important to take care of yourself physically in order to optimize a birth and post-partum period that will accommodate your body and your prolapse. Pelvic Organ Prolapse doesn’t have to rule your decisions. Don’t let your limitations hold you back from living the life you want!

During and After Pregnancy Prolapse Care:

Pelvic Floor Physical Therapy- The exercises and touch therapy included in PT can help to keep your symptoms to a minimum throughout your pregnancy. Ask your Urogynecologist or OB/GYN for a referral to a Physical Therapist who specializes in Women’s Health. After you deliver, check with your Urogynecologist and OB/GYN to be cleared to begin the healing process of post-partum physical therapy.

Prenatal and Post-Partum Support- When worn correctly, a maternity belt can ease pressure on the pelvic floor and lower back, allowing you to move easier and prevent straining. Different from a waist-trainer or girdle, effective post-partum support can be therapeutic for a healing pelvic floor. Run these products by your doctor to see if they will work for you and your limitations.

Conscientious Movement- Remember that you are growing a baby, as well as nursing your prolapse. Move with purpose, and don’t push yourself to the point of pain. Lifting should be kept to a minimum, as well as bending over. When you do have to make larger movements, engage your Transverse abdominus and Kegel muscles. Keeping theses muscles strong will help support your pelvic floor, and help prevent any stress urinary incontinence. When recovering from birth, give yourself time to heal. Move slowly, and deliberately, and “baby” your pelvic floor. Ask your doctor how soon you can resume any pelvic floor exercises, and start slowly, working yourself up to your pre-pregnancy status. Simple life adjustments can have a big impact on a successful pregnancy and post-partum period.

 

pregnant-woman-with-pain picPain, pressure, and fullness are very common complaints during pregnancy. But when those pesky symptoms don’t subside after birth, you may be dealing with Pelvic Organ Prolapse.

Pelvic Organ Prolapse, or POP, occurs when your pelvic floor suffers damage from pregnancy and childbirth. The weight of carrying your baby for nine months, as well as a difficult or traumatic birth, can tear the ligaments and connective tissue of your pelvic floor. As a result, your injured pelvic floor may have difficulty holding your organs – such as your uterus, intestines, rectum, urethra, and bladder – in place, and they fall downward. If you have POP, you may experience: urinary issues such as incontinence or difficulty urinating, bowel movement issues such as constipation or straining to use the bathroom, painful sex or intercourse, and lower back pain.

POP is usually diagnosed after birth when the symptoms persist; the complications can range from mild to severe. Every prolapse is different and will require a specialist’s approach in both diagnosing and treating your prolapse. Though childbirth is the most common reason women develop POP, there are other risks that make a woman prone to the condition.

Listed below are some common causes of POP. Are you at risk for developing a prolapse?

  • Childbirth
  • Genetics
  • Smoking
  • Chronic coughing
  • Straining
  • Heavy lifting
  • Menopause
  • Obesity
  • Nerve or muscular damage

If you experience any symptoms related to Pelvic Organ Prolapse, or want to discuss risk factors, schedule an appointment with your doctor. If you do have POP, there are options available to you so that you don’t have to endure the effects of your prolapse long-term.

A Urogynecologist specializing in Female Pelvic Medicine and Reconstructive Surgery can assist you in choosing the right treatment plan for you. POP doesn’t have to rule your life. Take control and start the conversation with your doctor, today!

woman-with-stomach-pains pic…and other things you might say if you have Pelvic Floor Dysfunction:

  • My cervix hurts during sex.
  • Sex is painful.
  • It feels like something is stuck in my vagina.
  • I pee when I stand/sit/lean forward/exercise.
  • There is a bulge in my vagina.
  • I have to stick my finger in my vagina to have a bowel movement.
  • I always have the urge to pee.
  • I can’t empty my bladder completely.
  • I am always constipated.
  • There is intense pressure/pain in my pelvic area/lower back.

A strange, new sensation has taken over your body. Simply put into words: it feels like your bottom is falling out. You may be hesitant to share this information with just anyone, but you can’t help but wonder what could be causing this unsettling symptom. Women who suffer from Pelvic Floor Dysfunction have used this description and the others above to explain exactly what is happening down there.

Pelvic Floor Dysfunction, or PFD, is a set of conditions that cause women to experience unpleasant urinary and bowel disorders or Pelvic Organ Prolapse, also known as POP. Symptoms of these disorders include urinary or fecal incontinence, pain, pressure, or constipation.

So, how exactly did your bottom end up this way? Over time, your pelvic floor muscles have endured some damage or weakness that has caused your organs to sag into your vagina, or rectum, hence the feeling that something is “falling out”. Childbirth is a very big factor that plays into PFDs, but there are other causes as well including genetics, heavy exercise, straining, and other health impairments.

Every woman has a different experience with PFD and you should always keep this in mind when discussing treatment plans with your doctor. The effects of PFD can range from mild to severe, but there are treatment options that may work for you. Sometimes treatment includes simple lifestyle changes, physical therapy, an intravaginal device called a pessary, or surgery, including the placement of transvaginal mesh.

Take back your body! Make an appointment with one of our board certified Female Pelvic Medicine and Reconstructive Surgery specialists to start the conversation about PFD.

woman-doing-yoga picSometimes suffering with Pelvic Floor Dysfunction, or PFD, can make you feel like you are limited in what you can do. If you’ve been diagnosed with Pelvic Organ Prolapse, Urinary Incontinence, or Bowel Control Issues, it can be confusing or frustrating for you as you try resuming your normal daily routine without irritating your symptoms. Being able to lead a full, satisfying life with PFD is important, but engaging in activities which aggravate your disorder can cause your symptoms to worsen. Here are some things to keep in mind about PFD as you go about your daily life.

1. DO Exercise.
DON’T choose a workout that includes heavy-lifting such as crossfit, or will put intense pressure on your pelvic floor such as running, or plyometrics. The straining in those types of activities can cause your PFD to get worse over time. Choose exercises such as Restorative Yoga, walking, and other low impact exercise that will not put pressure on your pelvic floor. Looking for something specific? Check out Hab-It, or Pfilates™

2. DO Pelvic Brace
DON’T Sneeze Pee. Forgetting to engage your transverse abdominus (your lower abdomen) and your Kegel muscles when you sneeze, cough, or laugh can cause urine leakage to occur. Brace yourself and save a trip to the bathroom and a change of underwear. When you engage these muscles, your pelvic floor will not feel the downward pressure that results from these everyday movements.

3. DO Retrain your Bladder
DON’T head to the bathroom every time you feel the slightest urge to pee. Your bladder needs retraining to stop triggering frequent restroom breaks out of habit. To start retraining, avoid taking bathroom trips less than two hours apart. Over time, you will you find that you have the urge to urinate less frequently and you will be urinating larger amounts. Not sure if you’re releasing a full bladder? Count how long you urinate for. A full bladder should be a stream of at least ten seconds long. Don’t forget to count with a “Mississippi” in between each number! Tell your bladder who’s in control and retrain yours!

4. DO Seek Treatment
DON’T suffer from the interfering symptoms of PFD. There are treatment options available that will fit your lifestyle and diagnosis. The first step is finding a Urogynecologist who can assess your needs and suggest a treatment that will work for you. Some of those choices may include: Physical Therapy, Pessaries, Medicines, or Surgery.

5. DO Live your Life
DON’T let your PFD slow you down or dampen your spirits. Modify your activities, but not your life to adjust to your diagnosis. Consider joining an online support group to help you cope with the struggles of PFD. Visit Voicesforpfd.org for more information about how you can reach out to others who are suffering from PFD, as well.

pregnant woman with heart

This February, Cherokee Women’s Health celebrates American Heart Health Month. After all, moms-to-be aren’t just keeping one heart healthy. From the first time you hear your baby’s heartbeat, your own is racing with anticipation, joy, and more than a few nerves. Keep your heart strong during pregnancy by taking care of your body and your health.

Nutrition During Pregnancy
Every pregnancy is different, and as a mom-to-be, you need your own, doctor-recommended diet to ensure you and your baby get all the nutrients you need. But refocusing on diet and exercise helps you maintain your weight, limit the effects of post-partum, and keep your baby growing strong.

Eat high fiber grains and nuts
Get plenty of omega-3 fatty acids from olive oil and pregnancy-safe fish like salmon
Avoid salt, which can increase blood pressure
Do several low-to-moderate intensity workouts each week, unless your doctor recommends rest
Avoid eating or drinking caffeine, which can cause irregular heartbeats

Avoid Consuming Caffeine
Caffeine increases your blood pressure and heart rate — bad news for both your pregnancy and your heart health. Not only can it lead to dehydration, caffeine crosses the placenta to your baby, who can’t yet metabolize it . Most women know to avoid major sources of caffeine like coffee during pregnancy, but you may not realize how many of your favorite craving snacks sneak caffeine into the mix.

Caffeine is found in:

  • Tea
  • Soda
  • Coffee (even decaf!)
  • Chocolate
  • Energy-enhancing foods and drinks (such as energy water or fortified foods)
  • Coffee or chocolate flavored ice cream
  • Some over-the-counter pain relievers like Excedrin

While it’s considered safe to consume small amounts of caffeine during pregnancy, it’s easy to lose track. Talk to your doctor about how much caffeine is safe for you and your baby during your pregnancy.

Heart Disease and Pregnancy
If you’ve ever been diagnosed with heart disease, high blood pressure, or have had cardiac symptoms such as chest pain, shortness of breath or palpitations, alert both your cardiologist and your OB-GYN. List all medications you’re taking, and make sure none of them will have adverse side effects on your baby’s development.

For more information on health during pregnancy, contact Cherokee Women’s Health.
 

Pregnancy Image

February 4, 2016

RED-HEARTDid you know heart disease is the No. 1 killer of women, causing 1 in 3 deaths each year? That’s approximately one woman every minute so it’s important to know the symptoms and how you can take control of your risk factors.

Following are the most common heart attack symptoms in women:
Shortness of breath
Uncomfortable pressure, squeezing, fullness or pain in the center of your chest.
Nausea, vomiting, cold sweat or lightheadedness
Pain or discomfort in any of the following: jaw, neck, stomach, arms (one or both).

How can you help prevent it?
There are many things you can do to control heart disease and with the right information and care, heart disease in women can be treated, prevented and even ended. Studies show that healthy choices have resulted in 330 fewer women dying from heart disease per day.

Here are a few lifestyle changes you should make:
Don’t smoke
Manage your blood sugar
Get your blood pressure under control
Lower your cholesterol
Know your family history
Stay active
Lose weight
Eat healthy

Trust your gut
Women are less likely to call 9-1-1 when experiencing symptoms of a heart attack themselves so trust your gut. If you aren’t feeling normal or are experiencing any of the symptoms above, call 911 or head to your local emergency room.

Northside Hospital-CherokeeSince 1993, Cherokee Women’s Health has delivered more babies at Northside Hospital-Cherokee than all other OB practices combined. Readers of AroundAbout magazines and Family Life Publications have voted Cherokee Women’s Health “Best OB-GYN” in both Canton and Woodstock.

Most recently in 2017, the practice was voted #1 “Reader’s Choice” in all three locations of Towne Lake, Woodstock, and Canton.

 

A Powerhouse OB Team: High-risk Pregnancy Management, Holistic Nutrition and Midwives

Pregnant women who come to Cherokee Women’s Health Specialists find a truly holistic practice, combining a significant depth of knowledge with technological advances. All the physicians have the expertise to manage high-risk obstetrics as needed. Ultrasound services are nationally accredited by the American Institute of Ultrasound in Medicine and headed up by our Chief Ultrasonographer Brenda Peters. Four-dimensional ultrasounds are available when needed for diagnostic purposes, and healthy pregnancies are confirmed with advanced technologies for noninvasive testing including Nuchal Translucency or Cell Free DNA testing.

Dr. Gandhi part of the Best OB-GYN team in Canton and Woodstock.

Dr. Gandhi with a baby delivered at Northside Hospital-Cherokee

Additionally, Drs. Hale and Crigler are experts at noninvasive muscle floor pelvic strengthening options, including Apex and Intensity devices. Both vegans, they build on the mind-body-spirit approach of the practice, with Dr. Hale recently achieving certification in plant-based nutrition from T. Colin Campbell Center for Nutrition Studies. Her election to the National Medical Honor Society Alpha Omega Alpha is a distinction shared by Drs. Litrel and Gandhi.

Our Midwife Team Teaches Other Midwives at Multiple University Programs

Certified Nurse Midwife Susan Griggs and Ruth Roser round out this team of providers to complete the picture of a practice with total dedication to the health of their patients, before and after childbirth. Susan earned her Masters of Nursing with a specialty in Midwifery at Emory University and has served as a clinical preceptor for midwife students at multiple university programs, including Emory University and Kennesaw State.

The Center for Disease Control made headlines this week when they announced that sexually active women of childbearing age should never drink alcohol unless they’re on birth control. The recommendation met with both support and backlash: many women agree that it’s not worth the risk, while others argue that telling 3.3 million women not to drink isn’t feasible. What do you think?

Are You Expecting?

pregnant woman with wineYou probably know that consuming alcohol during pregnancy can negatively impact a baby’s mental, physical, and behavioral development. What you may not know is whether or not you’re expecting. Some moms-to-be take 4 to 6 weeks to realize they’re pregnant. And as many moms of lovable broods know, about half the pregnancies in the United States are unplanned. Even women actively trying to get pregnant might continue drinking. According to the CDC, only 1 in 4 women stops drinking alcohol when they go off birth control. Exposure to even minimal alcohol during pregnancy may affect the baby’s health. So is the risk worth it?

The Effect of Alcohol on Developing Babies

Whether you’re happily expecting or simply trying, we know your baby’s health is your #1 consideration. But you may not realize just how much damage drinking during pregnancy can cause. Even small amounts of alcohol can cause:

FASDs can affect a child’s development both before and after birth. Symptoms can include anything from abnormal facial features and underdeveloped growth to poor memory, attention or hyperactivity disorders, learning disabilities, speech and language problems, and low IQ. Many people suffering from FASDs also have impaired hearing or vision and problems with their hearts, kidneys, or bones.

Make the Healthy Choice

At Cherokee Women’s Health, we advocate for the health of mothers and their babies. All expectant mothers should refrain from drinking alcohol during pregnancy. If you’re trying to get pregnant, we recommend that you stop drinking alcohol until you go back on birth control. If you discover you’re pregnant unexpectedly, stop drinking immediately. Inform your doctor about any alcohol you may have consumed in the early stages of your pregnancy.

Cherokee Women’s Health has a team of obstetricians, certified nurse-midwives, and board certified surgeons on staff. We specialize in normal and high risk pregnancies, with expert care providers trained in both natural and standard births. To learn more about how to ensure a healthy pregnancy, call today to make an appointment with one of our providers.

Wine and Pregnancy Image

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“Dr. Litrel was a fantastic doctor. I had my first exam with him, although at first I was skeptical about a male doctor for my GYN. But after I met him I’m glad I kept an open mind, and I couldn’t have dreamed up a better doctor. He cares about you as a person and not just a patient. The front desk ladies and nurses were very friendly and it’s a great office, very clean and not intimidating. I highly recommend Cherokee Women’s Health.”
– Vicki