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January 21, 2016

Your feedback is very important to us. The doctors and staff at Cherokee Women’s Health care about what you want from your doctor visits, which is why we regularly survey our patients. Your feedback tells us that you want doctors who listen, spend time with you and have a great bedside manner. And of course, you want an educated physician who can clearly explain your symptoms and treatment options.

Dr. Litrel wants every patient of Cherokee Women’s Health to feel seen, heard and compassionately cared for so he has hand-picked an amazing team of caring, compassionate and highly educated doctors. All our providers pride themselves on engaging with their patients while making sure the patient feels accepted and heard while discussing symptoms or treatment.

Following are a few testimonials from our patients:

Dr Litrel is always very caring and considerate. He listens to your symptoms without making you feel like he’s in a hurry to move on to the next patient. He has offered alternative help with my Sjogren’s Syn. Disorder. He treats you with respect.” Sue H.

“Dr. Gandhi serviced my prenatal appointments, and I thoroughly appreciated how she listened to me and my body. Nothing unnatural was forced, which I believe helped in a very smooth delivery. She was always very upbeat and her excitement bubbled over. By the end of each visit, I was always smiling. Susan delivered my baby, and she did a wonderful job. She was very comforting and soothing. Again, I appreciate how she let my body naturally deliver the baby it its own time. This was a wonderful pregnancy and birthing experience.””Billi R.

“Doctors actually listen to me and do what’s best for me. They care more than another other doctor I’ve been to.” Emilee Z.

“In June of 2011, I was rushed to Northside Hospital in Canton in severe pain only to find I had a ruptured tubal pregnancy. My family and I were so devastated. Dr. Litrel came to my bedside and prayed with us, and then I was rushed to the operating room for surgery. He was so wonderful, kind and had the best bedside manner. It’s February of 2012, and we are expecting again. Everyone in the office is so kind and respectful. I wouldn’t have any other group of doctors take care of me in our situation, and couldn’t imagine any other doctor bringing our miracle baby into this world.” Kimberly L.

“Dr. Gandhi is an extremely professional and caring doctor. She always makes sure that I am completely informed of what is going on with me. She also explains everything in a manner that is easily understood. I am so thankful for her hard work, dedication, and concern for my well-being. I cannot imagine trusting anyone else with my health than Dr. Gandhi and Cherokee Women’s.” Lyn B.

Cherokee Women’s Health wants to be your OB/GYN healthcare provider. With a diverse group of five doctors – male and female – a seasoned midwife and a nurse practitioner, we believe you will find the care, compassion and excellent care that you are seeking. Please call 770-720-7733 or visit cherokeewomenshealth.com to schedule an appointment today at our Canton or Woodstock locations.

December 17, 2015

pregnant-woman photoYou just had a baby, but something feels “off “down there. You’re not quite sure what to expect because you’re new to the whole postpartum process, but you’re certain that a bulge in your vagina is not normal. When the vaginal pressure does not ease up, you decide to check in with your doctor, only to find out that you have a type of Pelvic Organ Prolapse called Uterine Prolapse.

As scary as this diagnosis may sound to you, there are options available to relieve symptoms, or repair the prolapse.


Uterine Prolapse: Causes and Treatments

You wonder how this prolapse happened. One day your uterus is snugly in place, and the next, you are suffering the unpleasant symptoms of pain, pressure and an aching lower back. A prolapsed uterus is a common occurrence after a vaginal birth, but even women who have never given birth can also develop a prolapse. When damage to the fascia, ligaments and muscles of the pelvic floor occurs, it can cause the uterus to sag into the vaginal canal – leading to incontinence, and a feeling that something is “stuck” or “falling out.” These problems may worsen with age, as decreased estrogen causes the pelvic floor to relax even more.

Fortunately, you don’t have to deal with these meddling symptoms. There are options, depending on the severity of your symptoms.

Relax – not every uterine prolapse will require surgical repair. You and your doctor can work together to decide the best course of action to fit your lifestyle and diagnosis. Many women with mild symptoms find that pelvic floor physical therapy is helpful in reducing symptoms. Those with more moderate symptoms might find reprieve by wearing a device known as a pessary, which is fitted to your vagina, and worn internally. A pessary can help to lift the uterus out of the vagina, and relieve many of the distressing symptoms. If your symptoms are more severe, Pelvic Reconstructive Surgery may be the best option to ensure that you are not living with the troublesome effects of uterine prolapse.

You are not alone! Many other women are dealing with the inconvenience and pain of a prolapsed uterus, and you don’t have to suffer in silence. Make a list of questions and concerns and contact your doctor today. A prolapsed uterus doesn’t have to rule your life.

Specialists in Female Pelvic Anatomy
Physicians who are board certified in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) understand complex female anatomy, and are able to offer a range of effective treatment options when problems occur. In fact, Cherokee Women’s is the only OB/GYN practice in the southeast with multiple OB’s who are also board certified in FPMRS.

You’re in good hands – during your pregnancy and after. Talk to your FPMRS physician about your options to find relief for your symptoms – and help that “bulge” disappear.

Many women spend weeks, months, or even years reaching the decision to have vaginal surgery. Each woman has her own reasons for the choice: discomfort, pain, embarrassment, or decreased sexual pleasure, to name a few. But once surgery day arrives, this transformative life experience becomes a waiting game. Even the most knowledgeable patient can succumb to fears while healing from a vaginoplasty. That’s why Cherokee Women’s Health gives you top care, expert follow-up, and direct access to your surgeon when you need it most.

Is My Post – Vaginoplasty Healing Process Normal?

  • How long does it take to recover after vaginoplasty surgery? Because every woman’s body is different, each patient recovers at a slightly different rate. Many patients can start to move around as soon as the anesthesia wears off. Ice the incision area in the 24-48 hours after surgery. Most patients can return to a normal behaviors (such as non-strenuous work) after 48-72 hours, but a full 6-8 week recovery period is necessary before engaging in sexual activity. Optimize your healing process by carefully following the post-op instructions of your physician. 
  • pelvic painI still feel vaginal pain a week post-op. Is that normal? Many women experience pain as the skin and muscles of their most sensitive areas knit back together. Vaginal pain is still expected one week after surgery. If you’re experiencing post-op pain, take your prescribed painkillers or ice the area as recommended by your doctor.
  • I’m not happy with my results. Can I schedule another surgery? A patient cannot appreciate the results of a vaginoplasty before she’s fully healed. Tenderness, swelling, and myriad other factors may influence a woman’s perspective of her post-op results. We recommend waiting 6 months to 1 year after surgery to allow the site to fully heal and the vaginal muscles to settle into their new permanent state. If you’re still not happy with the results of your vaginoplasty, ask your surgeon about a follow-up procedure or labiaplasty.

Do you want to learn more about vaginal rejuvenation and recovery? Schedule a consultation with one of our GYN surgeons board certified in FPMRS (Female Pelvic Medicine and Reconstructive Surgery).

December 16, 2015

dr-hale-sunburst-pngTalking Veggies with Dr. Hale
We recently sat down with Dr. Hale to chat with her about her nutrition journey. Always a proponent of healthy eating, Dr. Hale began eating a plant-based diet last fall. She was enthusiastic about the positive results from her new eating habits, and shared the surprising connections between diet and “classic” female health issues, ranging from polycystic ovaries to adult acne, and even heavy, painful periods.

Pegan Dish PhotoThe Unhealthy Vegan – Go “Pegan”
Specifically, Dr. Hale’s diet can be referred to as a whole food, plant-based diet with an emphasis on whole grains, fruits, vegetables and legumes. “This is an important clarification,” she said, “because it is often confused with a vegan diet.” Her diet is not vegan; as vegan diets can still consist of a lot of processed, unhealthy foods.

A “pegan” diet is low glycemic, still high in vegetables and fruits, but allows for a small amount of high quality organic meats or low mercury, low toxin fish. Here, meat is used more as a condiment rather than the main feature. This is Dr. Hale’s second choice as an ideal diet. Her preference is still a completely plant based diet.

What advice would you give to others for transitioning to a plant-based diet?
The big thing is to consider food as medicine. (There’s lots of emerging evidence on this topic.) So if health is a priority, you need to be more attentive to what you’re putting into your body. If you try to have a more plant-forward diet (having more of your meals and more of your plate consist of vegetables), you are likelier to get a healthy dose of antioxidants and other things that help your body naturally detox.

Pegan Dish PhotoWhen I’m counseling patients about making a lifestyle change, I get them to look at lifestyle changes that will improve their health in the long-term.

When I was younger I had very heavy, painful periods. One of my main goals for transitioning to a plant based diet was to improve my periods as well as my overall health.

What are the benefits for women who choose to eat a plant-based diet?
While not everyone is guaranteed to have the same results, women with endometriosis can benefit from avoiding red meat and dairy as a means to reduce inflammation in their body. Many women with PCOS (polycystic ovarian syndrome) can improve their hormone balance through a low glycemic, plant based diet. A plant based diet is also a great strategy for achieving and maintaining a healthy weight. It also can reduce their risk for heart disease, which is the leading cause of death for women in the United States.

Are there any downsides to not eating meat?
I personally don’t think so. Contrary to what many people think, pregnant women can be completely meat-free and get sufficient protein to support a healthy pregnancy. They should, however, supplement with B12 and DHEA since these nutrients are harder to get naturally on a completely plant based diet.

dr-hale-running-picWhat are the first things you noticed happening to your body/mind after you changed your diet?
An increase in energy was the most noticeable change. Excess sugar sucks my mental clarity. Also, my menstrual flow wasn’t as heavy with hardly any cramps. As an added bonus I
also lost about 20-25 pounds.

How soon did you notice a difference after you switched up your diet?
In terms of my cycle, I noticed changes within a few months. A lot of people do notice that their skin clears up because you’re removing those inflammatory foods. That aspect for me has been a slower process since I’m working through multiple food sensitivities which I’ve learned also affects acne in adults.

How do you view your role for patients looking to make a dietary change?
I see my role as trying to help patients attain and maintain long-term health. Improving your nutrition is a way to be proactive about your health and do more than just depending on pills. I encourage patients to focus on the things they can add to make positive lifestyle changes rather than focusing on what they can’t have or do. Making small changes over time can help produce more sustainable change in the long term. This also helps fight an all-too-common diet “crash-and-burn.”

Do you have any suggestions on how to make the changes easier?

Having a buddy makes it easier. I have a certificate in Plant Based Nutrition through the T. Colin Campbell Center of Nutrition Studies that I feel equips me to support patients wanting to make positive changes in their diet. Dr. Crigler has many years of experience with a plant based diet so is also a good resource. There are also numerous resources available including websites, books, movies and more. While the New Year is a common time to make lifestyle changes, there is never a bad time to improve your health.

Below are a handful of resources that Dr. Hale recommends:

21daykickstart.org – free meal plans by the Physician Committee for Responsible Medicine in addition to numerous informative articles
Yum Universe – the blog that got Dr. Hale started with tasty plant based recipes
T. Colin Campbell Center for Nutrition Studies – articles, inspirational stories and recipes
The China Study – a book based on a landmark study in nutrition and disease.
Happy Herbivore encouraging blog and low-cost meal plans
Forks Over Knives – inspirational film, app and meal plans
Food Matters TV – hungry for change movie
Mark Hyman, MD – a proponent of the pegan diet
Plant Pure Nation – movie released earlier this year. You can join a “pod” in your area for support for your healthy lifestyle.

Dr. Hale on Vacation! Staying Healthy – Mind, Body and Soul
With all that hiking and fresh air, it’s clear to see that Dr. Hale not only talks the talk, she walks the walk!

Dr. Hale Vacation Photos

 

 

December 4, 2015

Essure photoEssure is a permanent birth control method that is over 99% effective preventing pregnancy. Approximately 750,000 women and their doctors have chosen Essure for permanent, non-hormonal birth control without surgery.

Recently, the safety of Essure has come into question, and the FDA has received thousands of complaints about the device from women and doctors. The FDA held a committee hearing on September 24th to review Essure’s safety and efficiency, but no recommendations have yet been made to the agency.

According to the FDA’s website about Essure, they are currently reviewing information from the September 24th meeting, the public docket, and additional medical literature and adverse event reports which have been published or received since the panel meeting.

They anticipate communicating the next steps publicly at the end of February 2016.

The Essure Procedure
Essure is an in-office procedure in which a qualified physician inserts a soft, flexible coil into your fallopian tubes. The inserts work with your body to form a natural barrier that keeps sperm from reaching the eggs, preventing pregnancy. Once the Essure inserts are in place, you must continue to use another form of birth control until you have your Essure Confirmation Test, which is usually performed three months following the procedure.

Essure is only to be used as a method for birth control and does not protect against HIV or other sexually transmitted diseases.

What are the Risks of Essure? 
As with any procedure or other birth control method that alters a woman’s fertility, there are risks involved with the Essure procedure. Talk to your doctor about any questions or concerns you may have before starting any birth control method.

Short-term risks for Essure include:

– Mild to moderate pain during the procedure
– Your body may absorb a large amount of the salt water solution used during the procedure
– Mild to moderate pain and/or cramping, vaginal bleeding, and pelvic or back discomfort for a few days following the procedure. Some women experience nausea and/or vomiting or fainting, so you should arrange for transportation after the procedure.

Long-term risks for Essure include:

– Essure is made of materials that include a nick-titanium alloy. Once placed inside the body, small amounts of nickel are released from the inserts. Patients with a nickel allergy may have an allergic reaction to the inserts.
– Some reports of chronic pelvic pain related to the Essure procedure have been documented.
– Having the NovaSure procedure after the Essure procedure may affect the blockage in your tubes, and a risk of pregnancy may increase.

Putting It In Perspective

For patients who are considering forms of birth control, we asked Dr. Litrel to comment on the Essure controversy. “Pregnancy is a natural process, but it’s important for people to remember that unplanned pregnancy may be riskier than contraception. It’s important to discuss your specific health goals with your doctor.”

Schedule an Appointment

If you’re finished adding to your family and are looking for birth control solutions, schedule an appointment at 770.720.7733 to speak with your doctor to determine a good option for you.

December 3, 2015

dr-litrel-round-pic
An Interview With Michael Litrel, MD, FACOG, FPMRS

What was your first job?
I was a waiter at Kennedy Airport, at the international arrivals building. I was seventeen years old, and had to wear a bow tie. It was great preparation for being a doctor. I met people from around the world, served people with their basic needs, and I had to utilize my time efficiently. I shuttled between tables just like I do between exam rooms – and I tried not to drop anything.

What is your legacy? How do you want to be remembered?
As the longest living person alive? (He laughs.)

I want to have always done my best, and to have always been honest, and to accomplish what God had put me on the planet for.

What book has influenced you most?
In 1984 I read The Road Less Traveled by Scott Peck – that really influenced me a lot. I also really like Richard Bach’s book, Illusions.

Other books include Mere Christianity, by C S. Lewis, and The Prophet, by Kahlil Gibran, which has influenced me a lot again this year. One of my all-time favorites that I’ve re-read for several years is The Holy Man, by Susan Trott. It’s short, funny, and quite profound.

A book that’s influenced me this year is The Life-Changing Magic of Tidying Up by Marie Kondo. I especially recommend it to young mothers.

Dr. Litrel study photoWhat words of wisdom would you pass on to your childhood self?
I think believe in yourself and know that the dreams in your heart are gifts from God to pursue. And I would say that I think there’s so much bad stuff – and it’s so easy to believe the bad stuff – but what’s most important is to believe the good stuff, and to then pursue. Never give up. Keep endeavoring despite the pain and the sadness.

If you could master one skill right now, what would it be?
Surgery. That’s the skill I’m most endeavoring to master. You don’t cut into the human body willy-nilly. During each and every individual operation, I try to master the surgery.

I think the pursuit of mastery is the purpose of life. You have to seek mastery. You can master the ability the walk at two years old, but that doesn’t mean you don’t trip sometimes. When performing surgery, I think that I serve, not that I’ve mastered. In every surgery, my goal is to serve each patient and God at the same time.

Okay, a question just for fun – If you could only eat one meal for the rest of your life, what would it be?Dr. Litrel Santa hat photo

Chinese food. I really like Szechuan beef, but now I’m a vegetarian. I’m an aspiring vegan, following in the footsteps of Dr. Hale and Dr. Crigler, so I’ve given up a lot of my favorite foods.

Cookies, a personal favorite, are sadly not on the list.

FUN FACTS

chris-and-dr-litrel-twin-pic2Unexpected Twin
Dr. Litrel is an identical twin. Born before the technology of ultrasound, he was unexpected until the very day he and his brother Chris were delivered. His first birth certificate named him “Baby B”

Chinese-Italian Culinary Mutt
Dr. Litrel grew up eating custom ravioli from his Italian father’s pasta shop on Long Island, and authentic Chinese dishes homemade by his Chinese grandmother in the Bronx

Healer With a Black BeltDr. Litrel Karate photo
Dr. Litrel is a lifelong martial arts student. He has studied karate, chi gong, bando, tai chi, and has a black belt in tae kwon do. He has also studied the Japanese healing art of Reiki.

POP QUIZ:  How well do you know Dr. Litrel?

Which of these jobs has Dr. Litrel NOT had?

A. EMT (Emergency Medical Technician) on ambulance
B. High School Chemistry Teacher
C. Forensic Intern (assist with autopsies)
D. Waiter

ANSWER:
Sorry – trick question! Dr. Litrel has worked in ALL these jobs.

November 10, 2015

By Kathryn A. Hale, MD, MPH, FACOG

Dr. Hale photoI was blessed to have a unique training opportunity as a medical student at St. George’s University School of Medicine: I was given the option to complete certain clinical training blocks in the United Kingdom (UK).

In the UK at that time, labor and delivery was largely run by nurse midwives. I chose to complete my rotation in Obstetrics & Gynecology at Poole General Hospital in the south of England. The OB/GYN only became involved if there was a medical complication, fetal distress or the rare major perineal laceration. This meant that I spent the majority of my time working with and under the supervision of midwives, even though I was training to become a medical doctor.

Learning To Support a Natural Process
Midwifery approaches pregnancy and birth as a natural process. There is a focus on empowering the mother to harness her own strength to achieve the beauty of birth, and a shift away from medical interventions. In my training at Poole, patients were assigned one midwife who followed that patient throughout her entire shift. I was often assigned to a patient who may not have had a doula or family member present. I became her support. I spend much of my time listening to and encouraging the patient, and less time examining her.

When the time for delivery came, there was no sterile draping or gowns as if preparing for a surgical procedure. We simply donned a simple plastic apron and gloves. The bed wasn’t broken down. We just supported the mom in whichever position felt right to her body for birthing her child.

Healthy and Holistic Pregnancy Options
That experience helped lay the foundation of my transition to a more holistic approach to OB/GYN in general. It gave me a more compassionate and patient approach to coaching women through their pregnancy and birth, and strengthened my belief in supporting the mother in doing what she was made to do. This includes being attentive to a patient’s unique emotional needs and desires – so that she feels empowered rather than helpless during this critical period.

The midwifery experience during my training opened me up to patients who desire more natural options as they approach pregnancy and birth. I’ve also felt led to pursue more education in the application of options such as chiropractic care, herbal medicine and essential oils in pregnancy.

In our practice, my colleagues and I are fortunate to have the skills and experience of our Certified Nurse Midwife Susan Griggs as part of our OB team. Empowering our patients with knowledge and healthy options is what makes caring for women the amazing experience that it is, every day.

November 4, 2015

Susan Griggs, RN, CNM photoHow do you see your role as a midwife at a baby’s birth?
The term ‘midwife’ means “with woman,” so the main objective of a midwife is that they really support women during this task they have at hand. I like to make it the best experience I can, because I always think of every birth as if this is the only birth this woman will ever experience, or it’s their last one. I want it to be the best experience possible, while empowering the woman, allowing her to get what she needs to make the best it can be, because each birth is so special.

Susan Griggs photoWhat drew you to a career in midwifery and what do you enjoy most about your job?
I started my career as a nurse, including working in the ICU at Emory Hospital. Then, I began working at an outpatient facility in Atlanta, and we started to get more and more obstetrical patients. During my time there, I met a woman named Ellen Martin, who was a midwife. During my first pregnancy, Ellen was my midwife. I also started helping with obstetrical education and history for the group for that same office, and had another baby. After the second pregnancy that Ellen helped me with, she suggested I go into the midwifery profession. I looked at her like, “You gotta be kidding me.”

But Ellen had an insight into me because she knew me so well. After all, we had been working together and she also helped me through both of my pregnancies. So, I applied and was terrified when I was accepted to Emory’s graduate program. This made it real. But I had a fabulous program at Emory, and I remained working alongside Ellen for five years after I graduated. That group of doctors I worked with was a wonderful bunch. We really bonded, and still see each other every year.

What I really love about my job is when I see patients for their annual check-ups. They pull out their phones and I get to see pictures of their children. I get to see how the babies have grown and I feel really bonded with them.

How many babies have you delivered during your time at Cherokee Women’s? Susan Griggs, RN, CNM
I’ve delivered over 800 babies with Cherokee Women’s as of October 22, 2015 and have assisted with about 300 C-sections. Of the C-section births, Susan said, “This is an opportunity to see what the doctors are all about. I have such respect for the doctors I work with, they’re just awesome. They value me and my opinion, which I think is great, and of course, I value them. That’s why our relationship works so well.”

One of the questions I am often asked by patients is, “Do you do home births?” The easy is answer no.

Susan Griggs, RN, CNMDo you have a philosophy about life or medicine?
Midwives are committed to providing ethical, individualized, evidence-based care that focuses on the normalcy of events like pregnancy and childbirth. My goal is to educate patients and to help them understand what’s happening to their bodies while providing them with everything they need with the least amount of intervention as possible. I want every birth to be the best it can be.

Anything else we should know about you?

Susan and her husband have two beautiful daughters. One daughter is single and lives here in Atlanta, and the other is married in Denver and is an environmental scientist for Denver Water. Susan also has a beagle-hound mix named Fiona who loves to walk with her on their four acres at home. Susan Griggs, RN, CNM photo

Fun Facts

• Susan’s been a volunteer usher at The Fox Theater for over 12 years. She’s volunteered for all kinds of shows. Susan says it’s time-consuming but fun, because she really enjoys music and theater. She also goes to the symphony every year.

• At Cherokee Women’s, Susan serves as a clinical preceptor for students from the Midwifery and Family Nurse Practitioner graduate programs of Emory University, Frontier Nursing University, The University of Alabama and Kennesaw State University.

• Susan likes to travel. She plays piano and she says it’s a good release for her, although she claims she’s no expert. Susan also does pottery on the wheel and is a seamstress.

by Michael Litrel, MD, FACOG, FPMRS

My doctor partners and I take turns being on call for the holidays.  Two years ago, my turn fell on Thanksgiving, and as I looked across the table at my loved ones and listened to their loud and animated conversation, I remember noticing they all seemed to be in various states of inebriation. I began to wish the hospital would call me.

Nothing is more annoying than being the only sober one at the dinner table.

Especially when you paid for all the wine.

I realized there were three ways to handle my unhappiness.

One, I could make sure I wasn’t on call the following year so I could join in the frivolity.

Two, I could cultivate new friends and family who were less inclined to intoxicate themselves at holiday meals.

Or three, I could view this moment of unhappiness as a spiritual lesson and walk more strongly the path of Love.

The decision was easy. I decided not to be on call again.

Holidays are stressful, but particularly so for women. Women are more aware of the subtleties of celebration. They put effort into aesthetic touches that would never dawn on a man. The intention, I believe, is to manifest beauty.

But sometimes the result is marital conflict.

Every Thanksgiving, Ann makes six dozen homemade crackers called “Cheddar Crisps” that come in three flavors: cracked blacked pepper, caraway seed, and something called nigella seed.  Ann carefully sequesters her crackers in a tin box to be doled out at the right moment.

Every guest is given three crackers just after saying grace, one of each flavor – and a bowl of butternut squash soup.  It’s such a big deal to Ann that you handle each cracker like Grandma’s antique tea cup.  Unfortunately, I am more a Ritz cracker kind of guy, accustomed to shoveling large quantities into my mouth until I am full. So for me this homemade cracker stuff is holiday stress.

How do I express genuine appreciation for the work my wife has put into this pre-Thanksgiving snack, without conveying my true thoughts?

Stop wasting so much time already – they’re just crackers!

Instead, I channel Effete Cracker Connoisseur, solemnly critiquing the subtleties of each flavor and commenting about how the steam from the soup opens up the palate so one can fully appreciate the differences. But truthfully, I just wanted Ann to stop making them.

Last year I got my wish. I was not on call, and no homemade crackers were to be found!

But I noticed a few things.

Free to imbibe a glass of wine, I found I did not want any, but instead chose sparkling water.

And the sodden idiots inclined to boorish conversation I remembered from the year before were actually beautiful people I am so very blessed to have in my life.

But what surprised me most was that I actually missed Ann’s homemade crackers.

It’s not always easy for a man to appreciate the attention to detail an effortful woman brings into her family’s life. Sometimes what she does seems frivolous – and God knows, sometimes it’s expensive. But there is a reason for a woman’s efforts, and this I understand – as a father, as a husband of twenty-eight years, and also as a physician who has listened to women carefully over the years.

A woman gives life to her children, brings beauty to her home, and creates ties in her community.  A woman makes life more beautiful for us men –

Whether we want her to or not.

November 2, 2015
Dr. Gandhi photo

Dr. Gandhi

Since the 2008 FDA Public Health Notification regarding use of transvaginal mesh for use in pelvic organ prolapse repair, there has been much controversy. Pelvic organ prolapse (POP) is a gynecologic condition that affects nearly a third of middle-aged women. POP is essentially weakness of the muscles that hold the pelvic organs in place, causing a bulge to be felt by the patient. I often describe it to patients as a sort of “vaginal hernia.” Symptoms include pelvic pressure, incontinence, and may affect sexual activity.  The reason why the use of synthetic mesh or biologic grafts came about is that in some women, their own tissue was not strong enough to uphold the repair.

Addressing Patient Concerns – Specialized Training Makes a Difference
I discuss with my patients both non-surgical and surgical options. When discussing the surgical options, I often hear patients say, “you are not going to use that ‘mesh’ in me, are you? I see it all over the TV, these lawyers say it’s dangerous.”

As a surgeon specializing in female pelvic medicine and reconstructive surgery (FPMRS), it is paramount that my communication includes a discussion of the indications, risks and potential benefits of any POP procedure. As FPMRS board certified physicians, Drs. Litrel, Haley and I have specialized training and education regarding POP repair with use of mesh. Pelvic floor surgeons trained in the use of these devices and that have properly counseled their patient on potential risks, have low complication rates. Patients need to know this important fact.

Individualized Treatment Plans Tailored To You
Individualized patient-centered  treatment plans are the key to limiting potential complications. When patients come for a consultation, there are three key elements to the visit: 1) discussion of the symptoms, 2) complete physical exam, and the 3) comprehensive treatment plan. Detailing the symptoms most distressing to the patient is important in tailoring a plan of care to meet her expectations. A complete physical exam helps to delineate the source of the pelvic floor weaknesses.  Lastly, the treatment plan should include not only the correct surgical procedure for the patient, but also an outline of how to avoid future recurrence of the prolapse. This includes discussing pursuing an overall healthy lifestyle (i.e. healthy diet, smoking cessation, routine exercise).

So the verdict?
I want patients to know that their specific prolapse needs can be met by a variety of surgical techniques, including mesh as one of them. When properly placed by a board certified urogynecologist and pelvic reconstructive surgeon, the complication rates are low. Empowering my patients with knowledge assures their eventual satisfaction with their final decision.

To schedule your GYN appointment or surgical consult, call 770.720.7733.

 

 

 

 

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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