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September 17, 2013

The month of September is Ovarian Cancer Awareness Month and this week on our blog, the team of Cherokee Women’s Health felt it important to remind women how important it is to maintain a good relationship with your doctor and to spread awareness about this disease. Approximately 1.5% or 1 in 71 women will be diagnosed with ovarian cancer in her lifetime. Most women do not experience any symptoms of ovarian cancer, so it’s important to be in tune with your body and be comfortable talking to your doctor about any changes.

Symptoms of Cancer of the Ovary

While ovarian cancer is harder to detect than other cancers, there are some symptoms women can watch out for, especially if they persist for two weeks or longer:

  • Bloating
  • Pelvic or abdominal pain
  • Back pain
  • Enlargement or swelling of the abdomen
  • Inability to eat normally
  • Unexplained weight loss
  • Urinary frequency or incontinence
  • Constipation
  • Feeling tired
  • Indigestion

Diagnosis and Treatment Patient consulting doctor

A malignant cyst on the ovaries may be found during a routine yearly pelvic exam with your OB/GYN. Other diagnosis options are vaginal ultrasound, laparoscopy or blood tests.

Vaginal Ultrasound – This procedure uses sound waves to create pictures of your internal organs that allow your doctor to view the images on a screen. The ultrasound will show shape, size, location and makeup of the cyst.

Laparoscopy – In this type of surgery, a laparoscope is inserted into the abdomen to view the pelvic organs. Laparoscopy can also be used to treat cysts.

Blood tests – For women past menopause age, in addition to an ultrasound, your doctor may recommend a blood test that measures the amount of CA 125 in your blood. An increased CA 125 level may be a sign of ovarian cancer in women past menopause.

Treatment for ovarian cancer is based on the stage of the cancer and how much the cancer has spread outside the ovary. Epithelial ovarian cancer has four stages, ranging from the least to most advanced stage. Usually, surgery to remove the uterus and ovaries is performed, and sometimes the lymph nodes and tissue from the abdomen may be removed as well. Surgery may be followed by chemotherapy, depending on the stage of the cancer.

It’s important for women treated for ovarian cancer to schedule routine checkups with their health care provider so he or she can monitor your body’s progress after treatment and make sure you stay as healthy as possible.


September 12, 2013

Last week we received a great question from a potential patient about different types of protein alternatives for vegetarians and vegans. This topic is especially pertinent for a handful of our OB/GYNs,  as Dr. Gandhi and Dr. Crigler are vegans and Dr. Litrel is striving to maintain a vegan diet. If you are looking for alternatives to animal-based proteins, whether it’s due to health reasons, personal beliefs or because you’re looking for alternatives due to pregnancy food aversions, never fear. There are plenty of great options to help keep your body healthy and strong. Here are a few of our favorites: woman-eating-fruit-salad

  • Whole grains – Surprise! Certain whole grains can also be a good source of protein. These include whole wheat, brown rice, whole-grain cereals, wild and brown rice, barley, bulgar, millet, couscous and quinoa. Here’s a little tip about quinoa: it contains more than 8 grams of protein per cup, including all nine essential amino acids that the body needs. For an added protein punch, add wheat germ or rolled oats to your recipes when baking,
  • Soy – Whether it comes in the form of soy milk, edamame (soybeans), or tofu, soy is an excellent source of protein. Foods made from soy contain some of the highest amounts of vegetarian protein.
  • Legumes –  Chock-full of protein legumes offer a variety of options in the form of split or green peas, soybeans, chickpeas, black beans, navy beans, kidney and pinto beans. Two cups of kidney beans, for example, contain about 26 grams of protein! And don’t forget the old standbys of peanuts and peanut butter.
  • Seeds – Sunflower seeds, poppy seeds and sesame seeds all contain protein. Sunflower seeds contain the most at 7.3 grams per quarter cup. Try topping a salad with sunflower or sesame seeds, or adding poppy seeds to a vinaigrette.

Whatever the reason for your diet preferences, the physicians at Cherokee Women’s Health are dedicated to help you find ways to get healthy and stay healthy. Don’t hesitate to let us know if you have questions about diet and healthy food options when you’re in our office for your next appointment.

September 3, 2013

For the month of September, Cherokee Women’s Health Specialists wanted to have a contest to celebrate how amazing and inspirational women can be. What better way to do that than to have a contest titled the Most Inspirational Woman Contest?

Starting Tuesday, September 3rd, we will be accepting a photo and up to 25 words explaining how the woman you’ve chosen (It can be anyone; Mom, daughter, aunt, grandmother, sister, friend, or any female of your choosing) has inspired you in some way. Entries will be accepted through Tuesday, September 17th, and the winners will be determined by the number of likes each entry receives.

MIW banner_use

Contest Prizes Available

For this contest, we have some great prizes available!

Grand Prize – A Spa Deluxe package – $250-250 value

Second Prize – Facial $70 value

Third – Mani-Pedi – $50 value

Contest Fine Print

  • The contest will run Tuesday, September 3rd – Tuesday, September 17th and can be accessed to enter through our Facebook page.
  • Please keep your entry under 25 words. Entries over 25 words will be disqualified.

We’re looking forward to seeing all the photos and inspirational women! Be sure to head on over to our Facebook page to submit your entry!

August 27, 2013

Last month on the Cherokee Women’s Health blog, we introduced you to Amanda, a domestic violence “thriver” who was able to get out of an abusive relationship and rebuild her life. This week, we wanted to share part two of our interview with Amanda chronicling her amazing journey.

In part two of her interview, Amanda discusses how domestic violence has affected her children, particularly her four-year-old daughter who witnessed her father run over Amanda with a car when she was pregnant with her second child. She also responds to how she felt after leaving her husband, if she was surprised by the amount of help she received once she had left, and how long it took her to recover, financially, physically and emotionally.

Amanda says that her advice to anyone in an abusive relationship would be to reach out to friends and family and the community for help. Have  a plan and know that you are not alone.

If you or someone you know is a victim of domestic violence, please seek help. Contact the Cherokee Family Violence Center hotline at 770-479-1703 (En Español: 770-720-7050).

August 20, 2013

A laparoscopy is a surgical technique using a thin, lighted tube that’s threaded through a small incision in the belly to look at abdominal organs, and in many cases, female pelvic organs. Laparoscopy is used to detect problems such as uterine fibroids, cysts, adhesions (scar tissue), and infection. Other common procedures include hysterectomy, removal of abnormal tissue, tissue biopsy, and tubal ligation (commonly referred to as getting your tubes tied).

Laparoscopic surgery has many benefits, including less pain after surgery, a lower risk of infection, a quicker recovery time, and generally, the procedure can be done as an outpatient surgery so you will be able to return home the same day. Additionally, because of the smaller incisions, your body heals faster and the scars will be smaller.

During Your Consultation questions-to-ask-your-doctor

If you want to learn more about a laparoscopic procedure, first make an appointment with your doctor to discuss surgery options. During your pre-op visit with your OB/GYN, it’s important to ask as many questions as you need so that you can feel comfortable about the procedure. Questions to ask include:

  • How long does the surgery typically take?
  • What can I expect the aftercare to be like?
  • What steps do I need to take to prepare for the surgery?
  • What can I take for pain relief after the surgery?

What to Expect After the Surgery

In most cases, you will be able to return home the same day of your surgery. The doctor will want to keep you for 2 to 4 hours after the surgery to monitor you and prepare for your trip home. For the first 24-48 hours, you might experience some of the following symptoms:

  • Pain at the site where the scope is passed through the wall of the abdomen.
  • Mild nausea from the medicine
  • Cramps similar to menstrual cramps
  • Discharge like a light menstrual flow for up to 7 days
  • Aching in your neck and shoulders from the gas put in your abdomen.
  • Swelling in your abdomen for a few days.
  • Bruising at the incision site.
  • Fatigue or muscle aches for a day or two.

If you can, try to enlist the help of a good friend or family member beforehand. You’ll want to make sure take it easy for a few days, so pre-schedule things like basic housecleaning, laundry, and a handful of easy-to-heat meals so that you’re off you’re feet as much as possible.

For more information about laparoscopic surgery techniques, you can visit our website or make an appointment to speak with one of our OB/GYN surgeons.


August 14, 2013

You may have heard about some women’s complications with vaginal mesh surgeries. This week on our blog, we wanted to take a deeper look at this procedure and quell any misunderstandings about vaginal mesh surgeries.

What is Vaginal Mesh, and What is it Used For?

Vaginal mesh is a piece of synthetic mesh that is inserted into the vagina to treat pelvic organ prolapse, a condition where a woman’s pelvic or reproductive organs fall into her vaginal opening, cystocele (anterior vaginal wall prolapse) and rectocele (posterior vaginal wall prolapse). Pelvic organ prolapse is often linked to strain during childbirth, when the muscles in a woman’s body can weaken or stretch out. If the muscles don’t recover, they are unable to support a woman’s pelvic organs. Women may also get pelvic organ prolapse after a hysterectomy, which can sometimes leave other organs in the pelvic area with little support. For many years, vaginal mesh was used to treat the above conditions and was considered standard care.

Complications Associated with Vaginal Mesh

The primary cause of complications associated with vaginal mesh is how the body reacts to it and how it is placed within the body during a surgical procedure. However, in the fall of 2008, an FDA notification that stated patients should be aware of the complications that do potentially exist in relation to the vaginal mesh surgeries urged people to ensure that their surgeon had the proper training and experience required to perform the procedures. Because of this notification, an increase in surgical technique and mesh technology have decreased complications associated with the procedure, but it’s important to note that it should be done by a surgeon with the proper training and experience in vaginal reconstruction.

Cherokee Women’s Health’s Surgery Policy Dr. Litrel

Here at Cherokee Women’s Health Specialists, our doctors’ approach to surgery is the following:

  • We take seriously the Hippocratic Oath we swore in becoming physicians.
  • We constantly seek the best solutions available on the forefront of medical technology.
  • We offer our patients the healthiest and most effective solutions we know of.
  • We treat each patient as we would a family member.

This means no unnecessary surgeries, and looking for the best and easiest solutions to alleviate suffering for each and every patient. The Cherokee Women’s Health Specialists  are experts at removing surgical mesh. Our pelvic and urogynecologic surgeons have the experience and education required to offer our patients a solution to their complications involving vaginal mesh.

If you would like to schedule an appointment with one of our doctors to discuss vaginal reconstructive surgery options, please contact one of our offices conveniently located in Canton and Woodstock.


August 6, 2013

If you’re a patient of Cherokee Women’s Health, you have probably seen Dr. Litrel’s book that he co-wrote with his wife Ann called A MisMatch Made in Heaven: Surviving True Love, Children, and Other Blessings In Disguise. The book is a “he said, she said” account of stories about family, children, faith and marriage – 25 years to be exact. Published in April of 2013, the book is Dr. Litrel’s second published work, with The Eyes Don’t See: What Patients Can Teach Doctors About Medicine, published back in 2004. Cover of Dr. Litrel's Book

Originally, Ann started helping Dr. Litrel edit the book, but she quickly took on the important role of the woman’s point of view.

“We already knew the subject of the second book would be family and marriage. But after looking over Michael’s stories, I began to think the book would be more enlightening if it included the woman’s perspective, too,” said Ann.

Recently, we received a testimonial from a woman who picked up Dr. Litrel’s book while accompanying her sister to an appointment at our Canton office. She reached out to us about how much she enjoyed the book and we wanted to share her kind words here on our blog this week.

Hi, Dr. Litrel;

I picked up your book at your practice about a month ago when I accompanied my sister for her annual check up. The title of your book attracted me, and then when I flipped through the pages while waiting, it seemed an interesting book with all the fun illustrations.  I have to say that this is the first book I bought in a doctor’s office and it is one of the best books I’ve ever read!

Last night I finished the whole book at 1:45am.  When reading what Ann wrote on “Looking Back on 25 Years”, it made me cry, especially when she said on page 264 and page 265 about “burst of sobbing that seemed to come over me all on their own…”I felt a flood of regret. In trying to be the perfect wife and mother, how many fun, message moments had I missed…”

My husband and I have two children, 8 and 4.  Recently my sister confided with me that my son Ethan (8) had told her that I had too many rules and that he wished he had parents like my sister and her husband.  Now my sister hasn’t had any children yet now at her late 30’s.  Anyway, she just wants to communicate with me so I can perhaps adjust some of my ways.   I know my children love my husband and me but they do not get to do with us all the fun things they do with their aunt and uncle.  After all, they only visit their aunt and uncle 3 or 4 times a year (as during school semesters it is hard to drive 7 hours round trip just for one day’s time together.) They always come to the door to greet me and they always find excuses for me to spend more time with them, especially before bed time.

Your book is very encouraging, for both parenting and husband-wife relationships.  Your writing style is so humorous and oftentimes made me laugh like a college girl. I have to say that I haven’t had time to read a book so quickly being a mom, wife and a full-time employee for a demanding job.  During that weekend I was visiting with my sister in Canton, one of our friends invited us to the Braves Game (the kids and my husband went) and I only attended lunch with our friend. Due to the driving distance, I waited at the downtown Westin Hotel lobby reading your book so my husband didn’t have to drive me all the way back to Canton and go back to downtown again for the Braves Game. I heard my self giggling quite a lot; fortunately I found a closed waiting area, like a cave with one entrance.  I was all by myself.

It touched me to tears when I read the following on page 14;
“I walked for miles in the dark, listening to the sounds of waves crashing, looking at the starts, and wondering why I was there.
Finally I prayed.
God answered me. ….
If Ann died, I would celebrate the short time I had known her with an increased spiritual awareness of the fragility of life, dedicating myself to becoming the person that God meant me to become…”

I told my husband the story in your book when Ann was sick for a month and the illustration was so funny “still accepting hot meals”.  I remembered that our church brought us hot meals when I was on bed rest for 6 weeks before my 2nd baby Kathleen was born. The meals stopped on the day I gave birth.  You comment made me smile as I had some sort of the same thought 🙂 The so many examples of your children are inspiring.  I wonder too, how did Tyler get his teacher to call you on the cell the very next day after he is grounded.

Anyway, I could go on and on…but I am sure you don’t have time to read many words from a reader. I also have to pack up for our vacation at the beach tomorrow, something we’ve promised the kids before school starts.

I just want to thank you and Ann for writing this book.  It is fun, humble and genuine which makes it so unique and attractive. I have to confess I don’t read as much. My husband, on the other hand, always have a book to read.

I’d love to meet you and your wife in the future.  I have this sense that maybe our path will cross sometimes doing something meaningful.  How you decided your focus as a medical doctor was a true miracle.  I love the picture of you and Ann at the back of the book.  You have a kind and relaxed smile and your wife’s is so radiant and beautiful! – Lucie

To purchase your own copy of Family – A MisMatch Made in Heaven, you can order online or pick up a copy at your next appointment.

July 31, 2013

Here at Cherokee Women’s Health Specialists, our mission as OB’s is to ensure that all babies are born well. Part of that mission is a healthy birth, and the other part is that the babies go home to safe homes. To us, well-born means more than just a birth, it’s a way of life. Unfortunately, heartbreaking stories of babies who are born into abusive homes and the existence of domestic violence is far too prevalent. In an effort to help save lives, we felt it important to bring the severity of this issue to our blog this week.

Domestic Violence Statistics

Domestic violence is an issue that doesn’t discriminate on race or status. The root of why men (and sometimes women) beat their partners and children is due to power and control. The abuser’s need for absolute power and control drives them to violence. Often, a man feels powerless in the event of a new pregnancy due to stressors of a new baby on the way, such as finances, the amount of attention the woman and baby are getting, and other reasons.

According to local organization Cherokee Family Violence Center‘s website:

Battering is the single largest cause of injury to women in the United States – over mugging, automobile accidents and rape, combined.  (NCADV 2003).  In 2009, Georgia was rated the 10th highest in the nation for the rate at which men kill women.  In 2010, Georgia mourned at least 130 domestic violence related deaths.

Other frightening domestic violence statistics include:

  • The No. 1 and No. 2 causes of women’s deaths during pregnancy in the United States: Domestic homicide and suicide, often tied to abuse.
  • Georgia is currently ranked 6th in the nation for rate of men killing women, seeing increasing numbers of Domestic Violence fatalities since 2008.
  • In 2012, there were 3,635 Domestic Violence related calls to law enforcement in Cherokee County.

Children are also effected by domestic violence. Children brought up in a home with domestic violence are more likely to develop social, emotional and psychological behavior problems. For the staff at Cherokee Women’s, our commitment to well-born babies is more than just helping women during their pregnancies, it’s a commitment to helping women, children and babies in the long term against the threat of domestic violence.

Domestic Violence Healing

The Cherokee Family Violence Center has had many successful stories of women who have graduated from their program. You can read some of their stories of healing here. One of the stories in particular that touched us so was that of Amanda Fleming, a 25-year-old with three small girls who came to live with Cherokee Family Violence Center in 2005.

Amanda’s story begins after her now ex-husband began verbally abusing her during her first pregnancy. She was without a strong support system and fully dependent on him and his family, who were also abusive. During her second pregnancy, the physical abuse began, in front of her then 2-year-old. At 8 months pregnant, her ex-husband backed into her with his car while she was sitting in the driveway with her other daughter and she went into early labor. He took her to the hospital and the staff were able to stop the labor. It was at this time that she decided to leave him and began working on a plan to do so. The week she planned to leave and move in with family, she not only found out he’d had past substance abuse issues with marijuana and cocaine, but she found out she was pregnant for a third time. Unable to handle the stress of the situation, she broke down and confided in her OB/GYN and by law, he had to report her situation to an agency, which forced them to take in-home parenting classes and family counseling. Her ex-husband rarely attended. Her counselor told her something that impacted her to finally leave: “Do you want your daughters to be married to a man that treats them this way, ’cause staying with him is teaching them that it is OK.” Her counselor helped her get her GED and driver’s license, neither of which she’d had before.

Just a week after the delivery of her third child, Amanda began to have complications with her heart. When her youngest was only 3 months old, she suffered from a TIA, or mini stroke. Her plan to leave was put on hold due to her health. A couple months later, she received a call from family that her grandfather was not doing well, so the entire family came up to Georgia for a visit. The night they arrived, he passed away. The next night her ex-husband started going into withdrawals and took off from her mom’s house to a local bar, only to return drunk and screaming. He left for their own home shortly after. Amanda and her children came home and immediately started packing up the house, locking it down so he couldn’t come inside. The police were called and her parents called a U-Haul truck to bring her things back their house. She lived with her mother for 3 months until December 2005, when she came to live with CFVC. CFVC Survivor

Amanda worked 2 jobs and attended school all while taking care of her 3 children. Eventually, she was able to drop one job and focus on finishing her schooling. Amanda graduated from Appalachian Technical College as Valedictorian with her LPN. She has been working in hospitals ever since, and is now fully independent and working at Northside Hospital in Atlanta. Amanda is now an advocate for victims and speaks on their behalf. She is no longer a victim nor a survivor, but a thriver. Amanda is pictured here with her three girls.


If you or someone you know is suffering from domestic violence, please seek help. Their crisis hotline is 770-479-1703 (En Español: 770-720-7050).

Together, we can help save lives.
July 26, 2013

So you’ve just discovered that you’re pregnant! Congratulations from the team at Cherokee Women’s Health! One of the most important things you can do to get ready for your new baby is, well, eat!

Best Foods for Pregnant Women

If you’re already out of your first trimester and/or are fortunate enough to not have morning sickness as a symptom of your pregnancy, try to eat a healthy balance of the following food groups:

  • Protein – If the idea of lean chicken or fish turns your stomach, try eggs, nuts, beans, or legumes, which are all great sources of protein during pregnancy. High-protein foods also contain amino acids, are the building blocks of every cell in your (and now your baby’s) body.
  • Low-fat dairy – Calcium will help your bones grow strong during pregnancy, and will also help your baby’s growing bones. Try a creamy yogurt smoothie or a quick snack of string cheese to help get you through the day.
  • Colorful fruits and veggies – Load up on any kind of green, yellow, orange, or red fruits and veggies you like (smoothies and juices count). Pinterest has a wealth of healthy food options for pregnant women, and there’s a recipe for just about everyone.
  • Water – Ok, so water’s not a food, but it’s especially important to drink plenty of water during pregnancy because it provides benefits like building new cells, delivering nutrients, and flushing toxins. Woman eating healthy foods

Fighting Food Aversion and Nausea

If you’ve been relegated to crackers and ginger ale, don’t worry – here are a couple good options for your growing baby that are bland and easy to keep down.

  • Lemons – Citrus fruits are packed with Vitamin C, an important nutrient during pregnancy. Try adding lemon juice to your water for an added punch. Other citrus fruits to try are oranges, tangerines and grapefruit.
  • Pretzels – Had enough crackers? Pretzels are also a bland choice that add a little variety.
  • Dry cereal
  • Brown rice
  • Applesauce (try to look for an organic option, if possible)

Have a question about a food that’s a do or a don’t during pregnancy? Don’t hesitate to ask your doctor when you’re at one of our offices for your next prenatal appointment.

July 16, 2013

A few months back, we shared a video of Dr. Gandhi’s medical assistant Sammy sharing about Cherokee Women’s connection to faith and health, miracles in the exam room, and a more personal side of Dr. Gandhi herself. We wanted to revisit the video about Dr. Gandhi here on our blog in case you missed it.

Dr. Gandhi of Cherokee Women’s Health Specialists

Sammy describes Dr. Gandhi as a down-to-earth doctor who really takes the time to get to know her patients when they come in for an appointment. Her kind sense of humor makes patients feel more comfortable when they may be feeling anxious about an OB/GYN appointment. Her patience and thoroughness make her a favorite here at the Cherokee Women’s offices, and even our older patients feel that she has a “thoughtful maternal instinct” when shes’ in the exam rooms.

Dr. Gandhi joined Cherokee Women’s in 2007, and recently celebrated her ACOG Board Certification, a ten-year process that starts when doctors enter medical school. About the experience, she shares, “There is no one more important to me than my family,” says Dr. Gandhi. “We all share our successes, and I feel really fortunate to have had their support through all the years of my medical training. I really found my calling in OB/GYN, and I so much enjoy practicing here at Cherokee Women’s Health – thank you to everyone!”

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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