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June 1, 2015

Dr. Crigler photo

Dr. Britton Crigler writes about the importance of cervical cancer screening:

I ran my fourth half marathon in January of this year in Atlanta in preparation for eventually completing my first full marathon. My wife Lauren and I were running together, racing to the finish line, and we noticed a young man face down on the side of the road with one other person kneeling beside him. At first I thought he had just tripped or was dehydrated. We stopped and eventually were joined by a flight nurse, ER physician, and EMT who were all running the marathon as well. After inspection, we realized this athlete was in his mid-20’s and had a laceration on his head. He was not breathing and did not have a pulse. We started CPR and after about five minutes –which felt like an eternity–his pulse returned and color started returning to his face. My wife and I felt lucky to be a part of helping this man survive. Watching him reminded me how delicate life can be, and I was reminded that there is a limit to the things we can plan, prepare for and control.

A Passion for Preventative Medicine

My passion for preventative women’s health was one of the reasons I chose to be an OB/GYN.  During medical school, we are trained to look, listen and examine to diagnose a problem. This is the most challenging part of medicine. (Google can only get you so far.) Once a diagnosis is made, a medication, lifestyle change, or surgery will usually fix the problem.  If the diagnosis is cancer, especially when diagnosed in the later stages, treatment plans are not so simple. There is no quick easy fix, no simple cure, and no easy way out. Some cancers like ovarian cancer are typically diagnosed in the later stages because there are few early symptoms.  Treatment with chemotherapy and surgery can prolong life but rarely result in a complete cure.

Breakthroughs in Medicine Provide Prevention for Cervical Cancer

Cervical cancer is completely different from other cancers, as it’s preventable. First, the cervix can be seen directly by your OB/GYN or primary care physician without invasive testing using a Pap smear. Pap smears are very effective at evaluating abnormal cells that may develop into cancer. This is why it’s so important to schedule a regular exam with your OB/GYN. (Over 60% of patients with cervical cancer have never had a Pap smear.) Known risk factors for cervical cancer include persistent infection by HPV. In fact, HPV is the most common sexually transmitted disease in the United States.

In the past several years, a breakthrough in medicine has provided a way to fight back and prevent cervical cancer. High-risk HPV strains including 16 and 18 have been associated with the majority of cervical cancers. Other HPV strains including 6 and 11 are associated with genital warts or growths on the vulva, cervix or penis. The Guardisil vaccine provides patients a way to actively protect themselves from these four strains of viruses. Additionally, the Cervarix vaccine will protect against the two strains that cause cervical cancer. It is recommended for male and female individuals between the ages of 9 and 26. These vaccinations protect young men and women before there are exposed during sexual activity. Most insurance companies, including Medicaid, will pay for the vaccine. (If you don’t have medical insurance, there are still ways to pay for the vaccine. Talk to your healthcare provider about your options.)

The HPV vaccine offers promise and protection from a known direct cause of cervical cancer. With it, we can fight and prevent a cancer that has taken the lives of too many women. Please don’t hesitate to contact your OB/GYN, pediatrician, primary care physician, or local health department with questions or concerns about these vaccines. There are also plenty of online resources available for parents and caregivers. We have included some helpful resources below:

National Cervical Cancer Coalition
World Health Organization – HPV and Cervical Cancer Facts
The HPV Connection – The Oral Cancer Foundation

May 12, 2015

I received this wonderful handwritten card from my patient Steffanie. She also gives thanks to our great staff. It is humbling when our patients take time out of their busy days to let us know that we made a difference.

dr-litrel-testimonial

 

May 6, 2015

Mother’s Day is this weekend and no one deserves more praise than mom. From the moment we’re born, they’re there to nurture, love and guide us through life. It’s a job that often goes unnoticed so on this day (and every day), we want to honor these special women who give so much of themselves to make this world a better place. Thank you from the bottom of our hearts, moms!

Our providers also wanted to pay tribute to their beautiful moms by sharing these photos with you. Enjoy! 🙂

docs-with-moms-collage-final

March 10, 2015

March 5, 2015

Endometriosis affects about 5 million American women. It’s an often painful disorder in which tissue that normally lines the inside your uterus — the endometrium — grows outside your uterus (endometrial implant). Endometriosis most commonly involves your ovaries, bowel or the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond your pelvic region.

In endometriosis, displaced endometrial tissue continues to act as it normally would — it thickens, breaks down and bleeds with each menstrual cycle. Because this displaced tissue has no way to exit your body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions — abnormal tissue that binds organs together.

Endometriosis can cause pain — sometimes severe — especially during your period. Fertility problems also may develop. Fortunately, effective treatments are available.

Causes of Endometriosis
The exact cause of endometriosis is not known. However, possible causes include the following:

  • Your immune system may not be getting rid of endometrial cells outside of the uterus like it should.
  • Heavy bleeding or an abnormal structure of the uterus, cervix, or vagina causes too many endometrial cells to go up through the fallopian tubes and then into the belly. (This is called retrograde menstruation).
  • Blood or lymph fluid may carry endometrial cells to other parts of the body. Or the cells may be moved during a surgery, such as an episiotomy or a cesarean delivery.
  • Cells in the belly and pelvis may change into endometrial cells.
  • Endometrial cells may have formed outside the uterus when you were a fetus.
  • It may be passed down through families.

When to Call Your Doctor
If you develop sudden, severe pelvic pain, call your doctor immediately. Call a doctor to schedule an appointment if:

  • Your periods have changed from relatively pain-free to painful.
  • Pain interferes with your daily activities.
  • You begin to have pain during intercourse.
  • You have painful urination, blood in your urine, or an inability to control the flow of urine.
  • You have blood in your stool, you develop pain, or you have a significant, unexplained change in your bowel movements.
  • You are not able to become pregnant after trying for 12 months.

Treatment Options
There is no cure for endometriosis, but treatment can help with pain and infertility. Treatment depends on how severe your symptoms are and whether you want to get pregnant. If you have pain only, hormone therapy to lower your body’s estrogen levels will shrink the implants and may reduce pain. If you want to become pregnant, having surgery, infertility treatment, or both may help.

Not all women with endometriosis have pain. And endometriosis doesn’t always get worse over time. During pregnancy, it usually improves, as it does after menopause. If you have mild pain, have no plans for a future pregnancy, or are near menopause (around age 50), you may not feel a need for treatment. The decision is up to you.

Medicines
If you have pain or bleeding but aren’t planning to get pregnant soon, birth control hormones (patch, pills, or ring) or anti-inflammatories (NSAIDs) may be all that you need to control pain. Birth control hormones are likely to keep endometriosis from getting worse. If you have severe symptoms or if birth control hormones and NSAIDs don’t work, you might try a stronger hormone therapy. Besides medicine, you can try other things at home to help with the pain. For example, you can apply heat to your belly, or you can exercise regularly.

Surgery
If hormone therapy doesn’t work or if growths are affecting other organs, surgery is the next step. It removes endometrial growths and scar tissue. This can usually be done through one or more small incisions, using laparoscopy. Laparoscopy can improve pain and your chance for pregnancy.

In severe cases, removing the uterus and ovaries (hysterectomy and oophorectomy) is an option. This surgery causes early menopause. It is only used when you have no pregnancy plans and have had little relief from other treatments.

As OB/GYNs, we specialize in protecting your fertility and providing treatment to relieve physical suffering. Please contact us today to schedule your appointment by calling 770.720.7733.

January 20, 2015

 

FLYER_printed

Bring your girlfriends for a night of fun, laughter and learning with Dr. Kathryn Hale and Sara Bolden of Women’s First Rehabilitation for this WOMEN-ONLY EVENT.

This is the place to ask those “embarrassing” questions and find out what’s normal, what’s not and how you can improve your sexual health.

Limited seating. Pre-registration required. Reserve your seats today by calling  770.720.7733 to pre-register!

Our Facebook Winter Baby Contest is ON! Enter your baby photos (ages 0-24 months) for a chance to win some great prizes and perhaps more importantly, bragging rights!

To enter from your computer, simply go to our Facebook page.
To enter from a mobile device such as your phone or tablet, click here!

Contest runs from January 15th through January 29th!

Prizes include:

  • Grand Prize (TWO WINNERS): 16″x20″ Print on Canvas (to display those beautiful photos!) 
  • 2nd place: $25 Johnny’s Pizza gift certificate
  • 3rd place: $25 Johnny’s Pizza gift certificate
  • 4th place: Bojangle’s Picnic Pack
  • 5th place: Chick-Fil-A basket with gift cards

Can’t wait to see your most adorable winter baby photos! 🙂

December 9, 2014

woman with headache

Does thinking about upcoming holiday parties have you stressed out? Do you spend too much time thinking about how you’ll handle the inevitable question of when you’re going to have kids? Sure, you’ve been looking forward to the holidays for months now but it can also be stressful for anyone struggling with infertility. You’ll be visiting with extended relatives that you haven’t seen in years or friends from school that you only keep in touch with through Facebook. You’re going to be seeing a lot of people who will ask you how your life is going and of course, the inevitable question…when you are going to have kids?

This seemingly innocent question can turn a joyous occasion into a disaster in a split second. Suddenly, you’re stammering and looking at your husband for help. You want to respond in a way that doesn’t illicit pity but also in a way that doesn’t encourage more questions.

So how do you handle baby questions when you’ve been struggling with infertility?

Have an answer ready. Talk with your husband beforehand about how you’re going to handle these sensitive questions. Having a plan will make you feel much more at ease when it happens.

Skip the details. There’s no reason you have to tell anyone you’re struggling to have a baby. Keep it vague so when you’re asked when you’re going to have kids, just reply, “Well, we hope to someday.” Then quickly ask them a follow up question that has nothing to do with babies.

Use humor. There’s a reason some of the most tragic people in history have been so funny. They learned to use humor to deflect their real feelings so doing this when you’re asked uncomfortable questions can work wonders. So when they ask you when you’re going to have a baby, you can respond with, “Baby? Baby what? Baby dog? Baby cat?” Then just laugh it off. They’ll likely get the hint and change the subject.

Believe in good intentions. Most people have good intentions and are genuinely interested in your life and they’re really not trying to make you uncomfortable. The thing is, most people who haven’t struggled with infertility have no idea what a sensitive subject it can be. Try to keep that in perspective.

Conversations about when you’re going to have a baby can either make or break a gathering. But by taking some of these steps, you’ll feel more comfortable and be better able to enjoy everything this wonderful season has to offer.

Our OB/GYNs have years of experience in dealing with sensitive female issues. Please call 770.720.7722 to make an appointment today in either our Woodstock or Canton locations.

November 26, 2014

pregnant woman standing and holding on to her stomach

You’re having a baby! Yipee!! Oh but wait, that means doctor’s appointments. But after that initial joy, reality sets in and you realize you’re in store for a lot of appointments. And exams. And blood being drawn. Ugh. But fear not, we’re here to help you with real issues expectant moms face when visiting the OB.

The Wait! Oh, the Wait!
You booked your appointment and what happens? You sit in the waiting room for what seems like days. No one likes waiting but thank goodness, most of us now have smart phones to help distract us. So to help pass time, whip it out and play a game of Words with Friends, check your friends’ status updates or get caught up on your work emails. Whatever it is, these distractions can be a huge help in passing the time.

Book Early
Sure, an extra hour of sleep is awesome but if you book your appointment early in the day, you’re more apt to be seen quicker than if you booked a later appointment. Why? Because an early appointment means the office is less likely to be running behind. But what happens if an early appointment isn’t available? Call ahead to see if things are running on time. The receptionist may just tell you it’s okay to show up a little later. Just be sure to triple check how late you can show up as you’d hate to lose your spot altogether!

Go to Your Happy Place
The dreaded exam. Nobody likes it. After all, you’re showing your most intimate parts to a near stranger and you can’t help but wonder if you’re “normal” or if you groomed well enough, etc., etc. Oh, the things that run through our minds when we’re on that exam table! Some of us joke to the point of embarrassing ourselves (yours truly), while others think of anything other than the task at hand. But just remember this, while it’s the first time in months that your legs have been in stirrups, it’s the umpeteenth time your doctor has seen the same parts just that week. And as any OB will tell you, they’ve seen every size, shape and form and they certainly aren’t passing judgment. They’re simply there to help you with your health concerns.

Ouch!
Being probed and having your blood drawn isn’t exactly on anyone’s bucket list. But there are a few things you can do to help alleviate the discomfort. Start by talking to your doctor before the exam. Ask them what you can expect to feel before they start. Just knowing what to expect can take a lot of the fear and surprise out of it. And the less tense you are, the less discomfort you will feel. Another great tip is listening to music on your iPod, taking deep breaths or visualizing a favorite vacation.

When you’re having your blood drawn, look away and don’t be afraid to turn into a Chatty Cathy. These tricks will definitely help take your mind off of things.

Ask Those Questions
If you ever feel like your doc breezes in and out before you even have a chance to ask one question much less the list of questions you had in mind, you will definitely leave your appointment frustrated and worse than that, without the information you need. To help ensure you get what you need out of your appointment, have a list of your questions in hand when the doctor enters the room and just start asking! And please know, it’s highly likely that your doctor isn’t even aware that you’re feeling rushed. She just knows that she has a lot more patients to see and is doing her best to keep on schedule. To get more time next time, ask if you can schedule a longer appointment. Just be sure to ask if you’ll be billed extra and if insurance will cover it.

Birth Plan, Shmirth Plan
You’ve put a ton of time into creating the perfect birth plan and you’re so excited to show your doctor how invested you are and what happens? She barely glances at it. What?! Before you get upset, try looking at it from the doc’s point of view. If everyone handed her a novel of a birth plan, she’d never get around to seeing her patients. So what to do? Make a list of bullet point items and discuss them with her. And make sure you prioritize and touch on the deal breakers without focusing so much on your “wish list”. This will help ensure that you’ll be heard and your doc is more apt to take your preferences seriously.

Hopefully these tips will make your next OB visit a little more pleasant. To schedule your appointment, please call us at 770.720.7733 or visit us online at cherokeewomenshealth.com.

 

October 15, 2014
Dr. Gandhi photo

Dr. Gandhi

It was so annoying. I could not sleep. Drip, drip, drip sang the faucet all night long. I created excuses for myself so I wouldn’t have to fix it. My excuses ranged from, “I don’t have time,” “I don’t have the money to spend on a plumber,” or the classic “it really isn’t that bad.” But every morning when I looked in the mirror, I realized I was suffering. I was sleep deprived and cranky.

Reluctantly, I went to the local home improvement store to get some advice.

“It’s probably the washer,” said the man behind the counter, while his thumbs snapped his suspenders. “Over time the washer is forced against the valve seat which causes it to wear out. As a result, you’ll notice dripping around the spout.” I thanked him kindly and proceeded to the cash register to make my purchase.

It made sense. It took just an hour to replace and voila! No more annoying drips.

You know what I realized from this experience? We women put up with a lot!

I see so many women come to my office with debilitating urinary leakage. They cannot enjoy Zumba for fear of an accident. Some cross their legs and hope for the best every time cold season comes around for fear that a sneeze will cause leakage. Others are embarrassed by leakage during intercourse.

So women endure the drip, drip, drip. They try to convince themselves that “they don’t have time to go to the doctor,” or they worry that “insurance won’t pay to fix it anyway” and of course, they tell themselves “it really isn’t that bad.”

Sound familiar? Of course it does. More than a third of women suffer from bladder control problems. The most common risk factor is childbirth. The muscles around the bladder and pelvis become weakened, which makes it harder for you to control when your urine starts flowing. Hormonal changes, such as diminished estrogen at the level of the urethra, also affect your ability to withstand increased pressure on your bladder such as exercise or even an unexpected sneeze.

Women are surprised when I counsel them on the treatment options available, most of which are lifestyle changes. However, surgical advances in the past ten years have given skilled surgeons the tools in order to fix urine leakage with simple thirty minute outpatient procedures that leave no visible scars. It is a readily treatable condition with minimal side effects or long-term risks.

Empowering women with clinical knowledge is rewarding. That is my suspender-snapping moment.

If you have issues with urinary incontinence, help is available. Call us today to schedule an appointment at 770.720.7733 or schedule an appointment online.

Dr. Gandhi authored this article and is a board-certified urogynecologist with Cherokee Women’s Health Specialists in Canton and Woodstock. Urogynecology is a subspecialty within Obstetrics and Gynecology that focuses on disorders of the female pelvic floor such as pelvic organ prolapse (bulging out of the uterus and/or vagina), urinary incontinence, fecal incontinence and constipation.

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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