Voted "Best OB-GYN" in Towne Lake, Woodstock and Canton Voted "Mom-Approved OBs" by Atlanta Parent magazine readers
September 18, 2018
Midwife Susan Griggs, APRN, CNM photoWe often receive questions from expectant mothers about the different members and roles of our team throughout the pregnancy and delivery process. If you are wondering what the differences are between a midwife and an OB-GYN, you are not alone. Let’s take a closer look and break down what distinguishes an OB-GYN from a certified nurse midwife.

What Type of Education Does a Midwife and OB-GYN Have?

Both OB-GYNs and certified nurse midwives have extensive training to support you throughout your birthing experience. No matter which option you choose, you’ll be in good hands.
  • OB-GYN: An OB-GYN is a doctor who has studied 4 years of medical school, plus 4 years of residency and 3 more years of specialization.
  • Certified Nurse Midwife: A certified nurse midwife is a Registered nurse with an advanced Master’s degree in nursing and a certification by the American Midwifery Certification Board. Typically they study for 2-4 years (Bachelor’s degree), plus another 2 years (Master’s degree).

What Types of Care do Midwives and OB-GYNs Provide?

The most important thing is that you do what makes you feel the most comfortable and safe. It does not necessarily need to be an either/or decision; it is perfectly acceptable to see both a midwife and an OB-GYN. Ultimately, we encourage you to consider what you feel is best for you and your baby.


  • Can assist with hospital births and any surgical procedures including cesarean sections
  • Able to prescribe medication
  • Able to prescribe contraception

Certified Nurse Midwife

  • Can assist with home births, birth center births, or hospital births
  • Able to prescribe medication
  • Able to prescribe contraception

What is the Focus of a Midwife Versus an OB-GYN?

These two types of care providers are separate but complementary professions. They may also work together on a team to provide effective patient-centered care. When choosing your main care provider, it really boils down to what you feel you need.


  • OB-GYNs work in teams at Cherokee Women’s regardless of if you’re expecting a child or are coming for a routine gynecology check-up.
  • Trained to manage high-risk pregnancies, complications and perform surgery if needed (for example cesarean sections), offer epidurals or use instruments such as forceps and vacuums to facilitate delivery.
  • OB-GYNs are not typically present for the entire labor, as they are attending to more than one patient at a time.
  • Focus on prenatal care, surgical prenatal care, childbirth, surgical childbirth, women’s health, postpartum care, menopause care.

Certified Nurse Midwife

  • Midwives rely on clinical experience to provide expert care in normal pregnancies. They see birth as a normal, natural process, intervening only when necessary and not routinely.
  • Certified nurse midwives are present for labor support, often using more natural approaches such as breathing techniques and hydrotherapy.
  • Focus on prenatal care, childbirth, women’s health, postpartum care, transitional counseling (ex. nutrition and exercise, breastfeeding, emotional changes post-partum)

Things to Consider Before Making Your Decision

You may want to speak with family, friends and other health care professionals. Ask them about their own experiences and recommendations. Next, ask yourself some of the following questions in order to help you decide:
  • Is vaginal birth your priority?
  • Would you like a natural or medicated birth? Do you think there is a good chance you will want an epidural?
  • Do you want your caregiver with you during labor?
  • What are your plans for pain management?
  • What are you hoping will happen at the hospital?
  • Do you wish for more support and advice for your transition to parenthood?
  • Are you considered high-risk or do you have any complications such as diabetes?
  • What does your instinct tell you?

Final Thoughts

At Cherokee Women’s we are pleased to be able to offer flexible labor and delivery options. Our practice has two certified nurse midwives on staff. If you wish to have a midwife as a caregiver we do our very best to work with you to offer this type of care. We cannot guarantee that a certified nurse midwife will be available at the exact time of your delivery, but we will ensure that you and your baby are provided with the most competent, compassionate and safe care possible.
If you have any further questions, please do not hesitate to contact us or make an appointment at 770.720.7733. We are happy to help you to be more informed and feel as comfortable as possible throughout your pregnancy.
September 5, 2018

Sherene Harati after the Teal Trot.If you go to our Canton office, there is a good chance you have met Sherene. Her bright smile and helpful attitude keeps her teammates and patients in high spirits.

What you may not know about Sherene is that she is an Ovarian Cancer Survivor. She was diagnosed in 2014 after getting a second opinion for her PCOS. She felt the doctor she was seeing at the time didn’t take her concerns about her symptoms seriously. When she saw a new doctor she mentioned her symptoms again. This time the doctor recommended an ultrasound.

During the ultrasound they identified a mass. Sherene had just graduated from college and didn’t fit the demographics of the women who usually develop Ovarian cancer, so her doctor wanted to keep an eye on the mass. It would have been easy for her to sweep it under the rug, but her doctor followed up, and Sherene kept all of her appointments.

Sherene lost one of her ovaries, but they caught the cancer early. After completing her treatment, including chemotherapy, Sherene is cancer free. It’s been almost three years and Sherene sticks to her follow-up appointments every few months to make sure she is still healthy.

Sherene’s Take Home Message

Sherene’s biggest message? Listen to your body! If you think something isn’t right, talk to your doctor. It’s okay to get a second opinion, especially if you think you aren’t being heard.

Now Sherene is dedicated to spreading the message about Ovarian cancer. Every year she participates in the Teal Trot 5k in Atlanta. She raises money and awareness and has fun in the park with her friends and family. Sounds like a great day!

Learn more or help Sherene on her mission to spread awareness by visiting the Georgia Ovarian Cancer Alliance site. The next Teal Trot will be September 15, 2018; to sponsor Sherene, visit her campaign page!

Sherene kept a positive attitude during treatment.

Sherene kept a positive attitude during treatment.

Still smiling! Sherene participates in her first Teal Trot.

Still smiling! Sherene participates in her first Teal Trot.

Sherene gets the word out about Ovarian Cancer Awareness with teal hair.

Sherene gets the word out about Ovarian Cancer Awareness with teal hair.

August 23, 2018

Hysteroscopy diagramWhat is a Hysteroscopy?

A hysteroscopy is used to diagnose and treat problems of the uterus. A hysteroscopy is performed by inserting a speculum to open the walls of the vagina. The hysteroscope is gently placed into the uterus through the cervix and sterile salt water is used to dilate the uterus so the surgeon can visualize your anatomy. Small instruments are used to take biopsies when indicated.

Why is it Used?

A hysteroscopy is used to find the cause of abnormal uterine bleeding, changes in bleeding or an abnormal ultrasound finding. A hysteroscopy is performed to determine the best treatment plan.
Hysteroscopy are also used to:

  • remove scarring in the uterus
  • diagnose the cause of repeated miscarriages
  • locate an intrauterine device (IUD)
  • perform a method of permanent birth control

What Can I Expect?

Hysteroscopy is performed in our Canton office under IV sedation. You will not experience discomfort during the procedure, but you will need someone to drive you from our office.

You will go home shortly after the procedure. It is normal to have some mild cramping or a little bloody discharge for a few days. You can take Ibuprofen or Tylenol for any discomfort. If you have a fever, chills, or heavy bleeding, call your healthcare provider right away.

If you have any additional questions, please contact Cherokee Women’s Health Specialists at 770.720.7733.

hysterectomy diagramWhat is a Hysterectomy?

A hysterectomy is the surgical removal of a woman’s uterus, the womb. After hysterectomy, you will not be able to have children. Your hormones are generally not affected unless your ovaries are also removed.

Why Should I Have a Hysterectomy?

A woman may have a hysterectomy to treat common conditions, such as: pelvic pain, bleeding, prolapse, endometriosis, fibroids, painful periods, and pain with sex.

How is a Hysterectomy Performed?

A hysterectomy can be performed in different ways depending on the reason for the hysterectomy and other factors. You and your doctor can discuss the different ways of performing a hysterectomy to decide which route is safest and most appropriate for your specific situation. The three main hysterectomy procedures are laparoscopic, vaginal, and abdominal.

lap hysterectomy diagram

  • Laparoscopic Hysterectomy – A thin, lighted tube attached to a camera is inserted into the abdomen through a small incision. Additional small incisions are made to insert surgical instruments. A laparoscopic hysterectomy results in shorter hospital stays, an easier recovery and a decreased risk for infection than an abdominal hysterectomy.
  • Vaginal Hysterectomy – The uterus is removed through the vagina. The only incision is inside the vagina. However, your internal anatomy cannot be visualized by the surgeon.
  • Abdominal Hysterectomy – A larger incision is made on the abdomen to remove the uterus. An abdominal hysterectomy may be suggested if a patient has a large uterus, adhesions or other anatomical challenges. This kind of hysterectomy requires a longer hospital stay and healing time.

What are the Risks?

A hysterectomy is a commonly performed surgery. However, there are always some risks associated with having a surgical procedure. Your surgeon will discuss the risks and benefits so you can be informed to make the best decision.

What to expect after the surgery.

If you have any additional questions, please contact Cherokee Women’s Health Specialists at 770.720.7733.

It’s estimated that 20% of women suffer from depression during the time leading up to menopause (perimenopause) and throughout menopause itself. That means for every five women aged approximately 40 to 65, one may be suffering from menopausal depression.

What are the Signs of Menopausal Depression?

Everyone goes through extended periods of stress, which can often lead to temporary mild depression. When those emotions continue past a reasonable time frame, however, intervention may be necessary.

If you find some of the following signs have remained for prolonged periods during menopause, they may indicate depression. These are:

  • Absence of motivation
  • Fatigue
  • Low energy
  • Memory lapses
  • Excessive sadness
  • Aggressive behavior
  • Restlessness
  • Irritability over minor occurrences
  • Frustration
  • Sudden outbursts of anger
  • Irrational paranoia
  • Anxiety
  • Difficulty focusing or concentrating on everyday tasks
  • Unpredictable mood swings
  • Feelings of low self-esteem
  • Unwarranted feelings of guilt
  • Constant tension
  • Agitation
  • Apathy towards previously enjoyed activities
  • Difficulty making decisions
  • Crying jags or exaggerated emotional reactions
  • Difficulty sleeping or sleeping too much
  • Appetite changes (over-eating or not eating enough – possibly leading to eating disorders)
  • Experiencing unusual pain without medical basis
  • Feelings of deep despair

Sometimes I Feel Like I’m Going Insane! Why is This Happening?

Rest assured that you’re not alone. Menopausal depression is only partially, but not completely linked to hormonal changes within the body. As your ovaries age, they get tired and stop producing estrogen and progesterone, which are responsible for enabling fertility, menstruation and good reproductive health. Other parts of the body go into overdrive to try and make up for the loss. Fat cells, adrenal glands, and the hypothalamus struggle to make up the difference, but aren’t very efficient, causing internal balance disruptions.

The situation is similar to a substitute teacher taking over a class for a week while the regular one is off sick. She does her best but lacks familiarity with both the students and their curriculum. Though the class survives the temporary disruption, it does not function at an optimal level.

In your body’s case, the hypothalamus and pituitary glands produce more luteinizing hormone (LH) and follicle stimulating hormone (FSH) than normal to nudge additional estrogen production, but can’t quite pump out enough to maintain normal levels. Thus, serotonin and norepinephrine, which affect mood don’t get their regular dose of estrogen. Additionally, plummeting progesterone can cause sleep disturbances and erratic mood swings.

Most women can get through menopause with minimal discomfort, but for others whose side effects are much more dramatic, menopausal depression can have a psychological ripple effect when combined with the following occurrences:

  • Empty nest syndrome
  • Fear of aging and facing one’s mortality
  • Death of family members or friends
  • Hot flashes, palpitations, headaches and night sweats causing interrupted rest, full-blown insomnia, exhaustion, irritability and/or loss of focus and memory
  • Declining physical health
  • Negative body changes from aging, resulting in lowered self-esteem
  • Lowered libido resulting from vaginal dryness and sexual pain
  • Caretaking responsibilities of elderly relatives
  • Lack of emotional support from friends and family leading to feelings of isolation and aloneness
  • Divorce or job loss
  • Exposure to environmental pollutants, or sensitivity to chemicals or synthetic hormones found in foods

Who is More Likely to Suffer From Menopausal Depression

Any woman can experience depression during menopause, but some are more predisposed. Extreme menopausal depression can lead to social isolation, relationship breakdowns, and even thoughts or attempts of suicide, especially for women who:

  • Have a family history, or they themselves suffered from depression, Premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), or postpartum depression
  • Have undergone surgical menopause (oophorectomy) or a hysterectomy
  • Feel devalued or non-essential due to their age
  • Regret never having children, whether by choice or circumstance
  • Resent impending infertility and losing their childbearing abilities
  • Are alone, or lack moral and emotional support from family and friends
  • Are unemployed, are of low income, or are experiencing financial stresses
  • Dread aging, menopause, or have low self-confidence
  • Have poor overall health, or have family members suffering from poor health, especially if they are caretakers of the latter
  • Have received minimal education
  • Have multiple regrets regarding past life choices
  • Smoke
  • Do little or no exercise
  • Are unhappy in their relationships
  • Have a sexual abuse history
  • Have extremely stressful lifestyles
  • Have taken antidepressants in the past
  • Suffer from significantly more hot flashes than average

What Can I do to Feel Better?

There are many lifestyle changes you can make to find relief. Some are:

  • Get at least a half hour of regular exercise five days a week
  • Try to get at least 8 hours of sleep.
  • Try relaxation methods such as Tai Chi, massage, yoga, meditation, etc.
  • If you smoke, quit
  • Join or create a support group for women with similar menopausal complaints
  • Avoid alcohol, tranquilizers, recreational drugs, and caffeine-especially near bedtime
  • Find a calming hobby such as painting, gardening, coloring, etc.
  • Find short-term projects that can give you a sense of satisfaction and achievement
  • Avoid isolation. Reach out regularly to family, community, and friends
  • Volunteer to help those less fortunate than yourself
  • Don’t sweat the small stuff: Prioritize and concentrate on what needs your attention now. Break up chores into smaller manageable time frames and declutter your environment
  • While you’re feeling this way, don’t make any life-changing decisions, you may regret later

Are There Any Natural Remedies That Can Help?

Eastern cultures rely heavily on diet and herbal and holistic medicine for many ailments, including menopausal depression. In China, for instance, only 10% of women suffer from different menopausal discomforts compared to 85% of American women. Western medicine recognizes the value of many of these time-honored and effective remedies. Today, many doctors work in tandem with these ideas, incorporating them into their modern day treatments, and recommending different formula combinations which may contain the following:

  • Ginseng
  • Dang kui
  • Sichuan lovage (chuan xiong)
  • Cordyceps (dong chong xia cao)
  • Red sage root (dan shen)
  • Angelica Sinensis (dang gui)
  • San-Qi ginseng (shen-san-qi)
  • Safflower flower (hong hua)
  • Trifoliate orange (zhi-ke)
  • Achyranthes (huai-niu-xi)

A healthy diet rich in protein, vegetables, fiber, and whole carbohydrates is also essential in warding off depression during menopause.

Other natural herbs and supplements include:

  • St. John’s wort (Hypericum perforatum)
  • B complex vitamins
  • Chromium
  • Omega 3 containing EPA and DHA
  • Magnesium
  • Vitamin D
  • Herbal teas containing hops
  • 5 HTP

What if Nothing I Do Helps?

If your depression continues despite all your attempts, you may need medical intervention in the form of short or long-term antidepressants, estrogen replacement therapy, or the additional help of a therapist to discuss your problems.

How Can Cherokee Women’s Health Specialists Help Me?

Cherokee Women’s Health Specialists is a broad-based OB practice consisting first and foremost of three doubly accredited urogynecologists holding certification in OB-GYN and Female Pelvic Medicine and Reconstructive Surgery (FPMRS), a highly coveted credential approved only under the most stringent criteria set forth by the American Board of Medicine (ABM).

Along with these specialists, additional gynecologists, urogynecologists, obstetricians, nutritionists, and experts in holistic medicine and diet, are available for any and all female health-related disorders, concerns, and problems, providing you with the best possible care.

Your depression could be menopause-related, but there can also be other reasons for your symptom. As stated earlier, menopause itself does not cause depression, but it can contribute to it hormonally. You should always discuss your issues with your doctor to rule out any other physical or psychiatric disorders.

Depression is treatable. It is also encouraging to note that, though many women suffer from depression before and during menopause, once the transition is complete, with proper care, the depressive symptoms decrease and often disappear.

For a consult with one of our gynecologists to discuss depression during menopause, call 770-720-7733.

July 25, 2018

Vaginal dryness is a common problem that affects millions of women. Thankfully, lubricants are available to help provide relief from painful sex and irritation. To help you make an informed decision on which lubricant is right for you, it’s first important to learn why you’re experiencing vaginal dryness.

What Causes Vaginal Dryness?

Woman with lubricantsThe most common reason for vaginal dryness is perimenopause, menopause, and post-menopause. Hormones, such as progesterone, estrogen, DHEA (dehydroepiandrosterone) and testosterone begin to plummet with age and can result in dryness.

Several other causes include:

  • Medications that have an overall dehydrating effect
  • Minimal moisture due to inadequate foreplay
  • Certain autoimmune diseases
  • Allergies
  • Stress and prolonged periods of anxiety
  • Alcohol
  • Smoking
  • Cancer treatments
  • Breastfeeding
  • Childbirth
  • Ovarian surgery
  • Hysterectomy
  • Beauty products such as soaps, bath products, scented hygiene products and douches
  • Foods that contain hormones

What Other Conditions Can Accompany Vaginal Dryness?

Lack of vaginal lubrication can affect you in many different ways, resulting in:

  • Pain: When genitals lack sufficient moisture, penetration and other everyday activities can become unbearable.
  • Weakened vaginal elasticity and tissue lining: As vital hormones deplete, skin and tissue thin, sag and lose their ability to stretch. This is why we become reliant on oils, creams, moisturizers, hormonal therapy and lubricants.
  • Psychological issues: Vaginal dryness and the many conditions that cause or accompany it can lead to depression, anxiety and even relationship deterioration.
  • Skin and internal problems: Without vital lubrication, irritation, itching, foul odor, urinary tract infections, and many other pelvic problems can occur. You can even suffer from prolapse, bladder deficiencies, leakage, pressure, chronic pain (vulvodynia) and inflammation (vestibulitis).

Choosing the Right Lubricant for You

Now let’s look at how to select the correct lubricant. There are many types and they range from pleasure-enhancing, non-staining, odorless, perfumed, and even flavored options. And many contain a myriad of unpronounceable ingredients so choosing the right one can be a challenge. Before deciding on the best one for you, you should consider the following:

  •  Safety: You want something that’s natural and safe as certain ingredients contained in over-the-counter lubricants can be unnecessary or harmful. As such, you’ll want to avoid the following:
  1. Chlorhexidine gluconate
  2. Parabens
  3. Benzocaine
  4. Petroleum-based
  5. Propylene glycol
  6. Glycerin
  7. Nonoxynol-9
  8. Phenoxyethanol
  9. Aspartame
  • Multi-purpose usage: Consider buying a lubricant that addresses additional problems such as thinning, skin sensitivity, urine leakage, etc.
  • Compatibility: Will you be using the product in combination with adult pleasure items or condoms?
  • Sensory enhancers: Are taste, smell and texture important? You may prefer something more neutral. Today’s lubricants may also contain menthol or capsaicin, a compound of chili peppers, which tout additional stimulation. While they might enhance your sexual experience, they can also cause uncomfortable stinging or burning to more sensitive skin and tissue.
  • Can any of the ingredients clash with medications you are presently using or any disorder you might currently have?
  • Do you plan to use the lubricant on a daily basis for general dryness, or only when considering intercourse?

Once you have established all safety factors and your personal needs, deciding if you actually need a lubricant, moisturizer, or more aggressive therapies is your next step. Knowing their function and the results they provide will enable you to make the right selection.

What is a Lubricant and What Does it Do?

Most lubricants are designed for mild to moderate dryness and immediate use. They alleviate uncomfortable friction during intercourse and provide short-term relief.

They come in gel or liquid form and the following types are available:

  • Water-based lubricants: These are topical and are not absorbed by the skin. They can be used safely for self-gratification, foreplay stimulation and intercourse. Easy to wash off, they pose no damaging danger to condoms. If you are currently suffering from a yeast infection, make sure your product does not contain glycerin, as it may further aggravate the situation. Water-based lubricants are applied immediately before sex. They do not provide long-term relief for dryness, require no prescription, and are available over the counter.
  • Oil-based lubricants: These may contain petroleum jelly and other harmful additives, so read the labels carefully. Vaginal tissue is highly absorbent, and these lubricants can disrupt your already delicate hormonal balance. Their greasy texture makes them difficult to wash off, exposing you to infectious bacteria and skin disorders. Oil-based lubricants can disintegrate latex condoms that protect you from pregnancy or sexually transmitted diseases (STDs). Polyurethane condoms are recommended. Oil-based lubricants are not intended for long-term relief and available over the counter.
  • Silicone-based lubricants: Silicone lubricants consist of safe, non-toxic ingredients and fall somewhere between the oil- and water- based lubricants. They cannot be absorbed through skin, can be used in water, and pose no danger to latex condoms. Their downside is their disagreeable taste and difficulty to rinse off. Residue can invite bacteria. They should never be used with silicone adult toys because they can stick and cause discomfort. Not everyone feels comfortable with their unusual slipperiness. They are available over the counter and are usually hypoallergenic.
  • Moisturizers: Vaginal moisturizers have been found to be beneficial for women’s menopausal dryness issues. They don’t only soothe friction discomfort, but can be used regularly to minimize daily dryness. Moisturizers continue to work up to four days by adhering to the vaginal walls in the same manner as your natural secretions do. They often come with an applicator for internal use. You may still have to rely on a lubricant for additional help. Moisturizers can be bought without a prescription.
  • Natural, homemade lubricants: Many women make chemical-free lubricants from home ingredients with their own preferred scent and flavor. Some safe ingredients include organic coconut oil, sea buckthorn oil, ghee (purified butter), olive oil or aloe vera. Herbal extracts and essential oils may also be added. Always research if these can be used in tandem with your partner’s condom type to avoid breakage.

Symptoms That May Not be Helped by Lubricants

Store-bought lubricants or other dryness aids may not help some of your symptoms. In that case, you may need to talk to your gynecologist about trying something more effective, such as:

  • Estrogen therapy: Low-dose estrogen therapy requires a prescription. It comes in cream form, tablets with applicators to insert them, or as vaginal rings that must be replaced every three months. The cream should never be used immediately before sex, as hormonal transference is possible. Vaginal estrogen therapy is never recommended for women with breast cancer.
  • Androgen therapy: If you are also experiencing low libido, prolapse, vaginal thinning, or incontinence issues, androgen therapy may be right for you. Available over the counter, this topical vulvar cream contains the hormones testosterone and DHEA (dehydroepiandrosterone). This combination has proven to work wonders for dryness, vaginal irritation, sexual disinterest, urinary leakage, incontinence, thinning and failure to achieve orgasm.

We’re Here to Help You

Dr. Litrel addresses menopause in this informative video as he explains the effects of hormones in various areas of a woman’s life. If you have any questions about vaginal lubricants, moisturizers, or related therapies, our experts at Cherokee Women’s Health Specialists are here to help you. Their skill and training in the most up-to-date technology enable them to diagnose and treat all of your unique feminine issues.

To book an appointment, call 770.720.7733.

June 19, 2018

Recently, one of our patients made the decision to have the liposuction procedure here at our office. She has chronicled her journey, and we had the pleasure of sitting down with her and learning more about why she made the decision, what reservations she may have had, and what life is like 3 weeks post-op.

Why did you want to seek out Liposuction? 

“I should preface my entire story by saying that I’m not overweight, I’ve never been overweight, but I have always had fat in very unwelcome places. A common misconception is that liposuction is for weight loss—it isn’t! It’s more for when you’re at your ideal weight, but you need to sculpt out the shape you want to be.

My trouble area has always been the “love handle” region. To add insult to injury, I have really high hip bones, so I’ve always felt like next to my long skinny legs and my long slender arms, my stomach had always looked like a tire.

When I heard that my trusted providers of Cherokee Women’s Health were going to start offering this procedure, I was very excited. I haven’t seen Dr. Litrel as my physician in all my years of annuals and during my pregnancy, he is very particular about who he surrounds himself with and the employees he hires, so I knew I could put my full trust in him in regard to my body sculpting goals.”

Were you scared about going through the procedure? What were your reservations?

“Truth be told, the pre-op appointment was, for me, slightly embarrassing. I planned for this though. I haven’t worn a bikini since the birth of my son, who is now two years old. Even before pregnancy, I was never fully confident wearing one, so having my stomach visible for someone to see, judge, and doodle on had me a little uneasy.

All of that aside, Dr. Litrel and his medical assistant Kami put me to ease quickly, even though to me, it looked like he was looking at my stomach as though he was solving the world’s most difficult puzzle. I watched him as he drew out a map and game plan on my stomach as though he could see clearly what my issues were and exactly how to solve them.

During the same appointment, Dr Litrel explained everything that would happen step by step during the procedure and what to expect for recovery. He also carefully laid out that, due to some of the more difficult to reach pockets of fat that I have on my body, I will likely need a follow-up procedure in about 12 weeks. When you have a physician that is completely honest like that, there’s truly nothing like it. I wasn’t expecting perfection from this procedure, more just improvement. I was even more impressed that Dr. Litrel seemed confident that after a second procedure, we could create the silhouette and curves that I both desired and deserved.”

Can you describe the procedure for us? What was it like?

“Since my procedure, the most common question that I get asked by family and friends is, “Did it hurt?”

There are plenty of liposuction resources online, and I believe that many resources can be overwhelming for people to think about in terms of pain and how the procedure is done. For me, the step was to inject a numbing solution into my stomach so that I wouldn’t feel any pain. The doctors waited about thirty minutes for the solution to fully kick in, and while I felt a little pressure, I didn’t feel pain. I was awake for the procedure, but the medicine that was moving through my IV made me loopy, and I was in and out for most of it. One moment that I do recall quite vividly, is having an itch on my nose and not being able to scratch it. I also remember trying to see what was going on throughout the procedure, and each time, the staff in the room would say, “Close your eyes and go back to sleep” in perfect unison.

After my nap, the next thing I knew, the nurses were assisting me in getting my new accessories for the first time. These girdles are necessary for me to wear during my recovery for the next few weeks, and they were explaining the steps of taking them on and off. One full body girdle sits just under my breasts down to just above my knee. It has a convenient hole in the bottom to make bathroom breaks easier. The other girdle is a binder similar to the one you receive after getting a c-section.”

Before and after shots of patient. After shots are 3 weeks post-op.

What does the recovery process look like?

“From the procedure room, the staff escorted me into a separate room to help me “Wake up” from the anesthesia. I was able to have my first few sips of water (something I’d been looking forward to since 7:00am!), and shortly after, my fiancé and son came back to check on me and then take me home.

Dr. Litrel came in to talk to me while I was waiting for my anesthesia to wear off, but I was told I kept giggling at him and then falling asleep, so he updated my fiancé on my after care and medication. The waiting for recovery felt like less than 10 minutes, but I was told it was closer to 45 minutes to an hour. The light anesthesia administered during the procedure makes the procedure an outpatient procedure, however I was having a little bit of difficulty staying awake in the recovery room.

Knowing that I am very sensitive to medication and anesthesia, I was given Phenergan in my IV during the procedure to settle my stomach (and also knock me out for the rest of the day so I could get some sleep afterwards).

On the way home, we stopped at the pharmacy and picked up my antibiotics and extra nausea medications, and I was homeward bound!”

What can someone expect from post-op?

“I slept the rest of the afternoon after the procedure and didn’t wake up from my Phenergan-induced nap until around midnight. I was amazed at how little pain I was in. Most of my discomfort was caused by the girdle and being unsure about moving around in it successfully. Standing up and sitting down in the girdle for the first few days gave he third trimester pregnancy flashbacks! 😊 I assumed that maybe the numbing solution hadn’t completely worn off yet, so I kept my guard up waiting for the pain to hit. I took extra strength Tylenol every six hours or so for the next 48 hours, not necessarily because I needed them for pain management, but more as a “just-in-case.”

I can thankfully say that I never got the pain I was expecting to feel afterward. I was sore, but unless my toddler crawled around on me, I never really hurt.

“By Sunday morning, my tiny incisions were done draining and had pretty much healed. I had minimal bruising, something I’m very thankful for. I didn’t have many post-op restrictions, so by the end of the weekend I was feeling well enough to clean my house.”

What have the first three weeks of post-op been like?

“I spent the first week with a little soreness. I was slightly uncomfortable, but mostly annoyed with the full body girdle. The opening at the bottom that I first found so funny suddenly was more frustrating than funny. Trying to find clothes that fit over the girdle was a little difficult, as it’s hard to hide a knee-length girdle under pants. (And I had the weirdest panty lines all the time!)”

What about the second and third weeks?

“By the second and third week, I had all but forgotten I’d even had the procedure done. Dr. Litrel approved for me to remove the body girdle but recommended that I continue wearing the other girdle for a while. By the end of the second week, I was starting to notice subtle changes in my stomach. It was visibly smoother, although I was still swollen. Dr. Litrel assured me that the swelling would go down but reminded me that the full results of the Lipo take up to twelve weeks.

Currently, I’m in my third week post-op and it feels like my procedure was performed months before. I am so excited to watch my body continue to change, and I am already feeling more confident thanks to Dr. Litrel and his amazing surgical team.”

This interview was completed three weeks post-op. We invite you to stay tuned as we continue to chronicle her journey after having the liposuction procedure done. If you’re interested in scheduling an appointment for liposuction, please contact our office to speak with our cosmetic services scheduling division at 770-720-7733.


June 6, 2018

Today, June 6th, 2018, marks one year since we launched our Medical Weight Loss Program here at Cherokee Women’s Health. We have been privileged to help women reach their goals by providing the motivation and resources needed with an understanding of how weight loss is approached specifically for women.

Our Medical Weight Loss Program Has Over 350 Participants

Our providers saw a need for a female-only Medical Weight Loss Program. It became obvious to them as obstetricians and gynecologists that a woman’s body gains and loses weight differently than a man’s. We, as women, have specific challenges—from hormones and child birth to elevated stress levels. We created a program that incorporates:
  • Weekly Fat Fighting Injections
  • Natural appetite suppressants or FDA approved appetite suppressant
  • Pharmaceutical Grade Dietary Supplements
  • HCG therapy
  • Body Fat Analysis
  • Dietary and Exercise Support and Counseling

Thanks to these methods, many women have been able to meet their weight loss goals and keep it off too!

Here are a few of our Medical Weight Loss Program success stories:

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Erica D.
“I have lost 27 pounds since April 24, 2017 on the Medical Weight Loss Program!! I have s
o much more energy and have started working out again. I’ve learned that tracking calories is very important and that when you do, you will make healthier food choices. This has been one of the easiest programs I have ever done!”
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Christy W.
“I’ve lost 41 pounds and only have 9 pounds to go before I reach my goal weight! My energy has soared, I sleep better and have less inflammation. I’m better able to care for my kids and my self-confidence has increased. On the Cherokee Women’s Health Weight Loss Program, I’ve learned portion control, how to believe in myself again, that sugar is not my friend and to not be afraid to use doctor-approved medication to help achieve my goals. This program gives you the tools you need to succeed through an amazing, medically-trained staff that supports you 100% of the way. To anyone who’s struggled to lose the weight, I would say to them, ‘One Day or Day One? You decide!’”

Wendy has lost 38 pounds!
“The program gave me a huge boost in my weight loss journey.”

“When I started the program at Cherokee Women’s Health I had already lost 16 pounds but it had taken me over 5 months to lose it and then I plateaued in my weight loss journey.  In the last 4 ½ months I have lost an additional 38 pounds with Cherokee Women’s Health Specialists.  

When I began the program, I was shopping for and being fitted for a dress for my sister’s wedding and initially I was going to be in a size 18-20 dress.  By the time the wedding came around I had a size 14-16 and still had to have the dress taken in some before the wedding.  The program gave me a huge boost in my weight loss journey.  I now have more confidence, I’m happier, I feel better, and best of all I have more energy to run around and play with my kids without feeling so tired.    

One big thing that I learned from the program is the relation of calories in food to how many calories my body actually burns and that every calorie counts. I used to let food control me but now I control the food.  It really puts calories into perspective and this program has given me the tools I need to not only lose the weight but to keep it off!”

Angie Has Lost 27 Pounds!
“I have been able to go buy a smaller size!”

“I have been able to go buy a smaller size than I was wearing and have a ton more energy! The Medical weight loss program at Cherokee Women’s Health Specialists has helped me to learn to make better choices in the foods I eat.  The beginning of my weight loss journey was not easy to start but it has been so worth it and has gotten so much easier as I have learned the relation to foods and how my body uses food for fuel.  I would recommend this program to anyone wanting to make a lifestyle change and learning how to lose weight for good!”

Call Today to Schedule Your Free Medical Weight Loss Consultation! 770-720-7733

May 21, 2018

An interview with Air Force veteran Dianna Hornes, third-time mom and our OB “Cover model” for this spring’s AroundAbout magazines.


“I joined the Air Force after high school to get as far away from home as possible,” Dianna opens her story. “And they sent me from Phoenix to Las Vegas!” She laughs. “My friend and I joined at the same time. She wanted to be as close to home as possible – and they sent her to Guam! Go figure.”

Dianna’s new baby Matthew is the first child of her second marriage to Dennis, a Woodstock policeman. As she already had two daughters from her first, we suspect that her journey from military through family life may not have been smooth.

Q: So, first off – you’re married to a Woodstock policeman and fellow veteran, you have two little girls from your first marriage and now a newborn, Matthew. Would you mind just telling us a little bit about your story?

I was born and raised in Phoenix, AZ. I am the oldest and have 4 sisters and 2 brothers. As I said, I joined the Air Force after high school to get as far away from home as possible…

But the military experience was wonderful, in fact, one of the best experiences ever! I got to travel the world and see everything. I experienced life on a different level, and it made me more appreciative. From my first marriage I have Madison and Kayla … and now with Dennis I have little Matthew, as you know.

Q: How did you meet Dennis?

We are one of those Match.com success stories. It’s funny too, because I reached out to him first. After I divorced, I waited a year before I considered dating again. I had two daughters, Kayla and Madison, from my first marriage. At around a year, I created a Match.com profile. One day I was scrolling through all the profiles, specifically looking for matches who were interested in someone with kids. I came to Dennis’ profile, and his just happened to say “no”. 

But I was looking at pictures and I thought, “He’s a good-looking dude, you know what, screw it. I’m just going to send the message.” I’m very straightforward, and I believe you don’t need to sugar coat things or hide things from folks.

If you change your mind, message me. If not, have a nice life.”

So, I sent him a message saying, “Hey, you seem like a good-looking, nice guy. I have two daughters, I know you said you’re not interested in someone with kids, but if you change your mind, message me. If not, have a nice life.” And it took a couple of weeks, but he responded, and we went on our first date to Starbucks. Starbucks seemed like a safe bet in case things didn’t work out. Surprisingly, our first date was nine hours long. We met for coffee and stayed there for a few hours. Then we went to a restaurant, and we closed the restaurant down. After that, we drove home and continued to talk on the phone for like, 2 hours. We had a lot in common—he was in the Army, I was in the Air Force, and we connected and teased each other about which branch was better. The Air Force, of course! 

Q: What made you decide to marry Dennis?

He makes me want to be a better person for me and for everybody else. I couldn’t believe people when they said they met their true love or that they were in love with their best friend. It just didn’t seem real to me. I suppose I was a bit jaded from my divorce. Then I met Dennis. He makes me laugh, he’s someone who appreciates me, loves me and makes me feel good, and I realized, this is how it’s supposed to feel. I’m very much in love with him. He’s my best friend.

“I couldn’t believe people when they said they met their true love… It just didn’t seem real to me.”

Q: Did you have any concerns about starting over or creating a blended family?

Yes, I was very much against starting over and starting another family. My husband was also married before, but he didn’t have children with his ex.  It took me dating him for 4 months before I introduced him to the girls. I didn’t want them to meet this random person, and I didn’t know how dating would be for me. 

When we first started dating, and the first few months after being married, I wasn’t sure if I wanted more children. He was okay with that. He loves them very much, and he is very much their parent. People find it hard to believe that they aren’t his biological girls. He’s a natural with them.

Though, I could see how happy he was with being a father to the girls I knew he wanted to have a baby of his own. And that’s when I realized that when you love someone, their wants and needs become your wants and needs. I wrapped my head around that and am very much in love with him. I realized I wanted to have that connection with him forever, so that’s when we started trying to have a baby.

“When you love someone, their wants and needs become your wants and needs.”

I had a Mirena and decided, “it’s time we took this bad boy out.” When I told him that I was ready to start a family with him, the look on his face was just love and excitement and joy. And then when we were pregnant the first time it was, oh my gosh, it was the most amazing feeling in the world to have created a life with him. But the last two pregnancies (and miscarriages) were just horrible to go through.

But they made us stronger as a couple, and we also appreciate every moment that we have with Matthew. 

I want my husband to experience every little moment with his son and have all the input he wants on what we do day-to-day. I have already experienced caring for the girls, making a big deal about decorating their rooms, etc. So, every chance I get, I’ve put my husband’s wants and input into things. My husband is a huge Star Wars fan. To the point that we even had a Star Wars themed wedding. So, Matthew’s room is a Star Wars theme. We even had infant pictures taken with a little Yoda hat.  

Q: How are things with a newborn?

Things are great. Exhausting, but great. We’re supposed to take it easy for the first six week, but after Matthew’s birth, I just couldn’t. I’m a real estate agent and the market is insane right now. I was out going on appointments and showing houses with Matthew in tow. I think by the third week I had shown around 75 houses. Since we couldn’t take him to daycare because he was still so young, it has been quite the struggle. 

But my husband is very supportive and helps out any way he can. He works nights with the City of Woodstock Police, so our schedule has been challenging to say the least. Juggling a newborn, a 10y/o & 6y/o with both of our careers and life has its stresses, but it’s very rewarding at the same time. I am just thankful I have a really good support group surrounding me. 

Q: How was your pregnancy this go around?

This pregnancy was very good. I have practically been pregnant for two years. We had two previous miscarriages, so Matthew is our rainbow baby. During this pregnancy I took a lot of things very slow and very easy because the two times before were very hard, gut-wrenching and emotional. I didn’t want to go through that again. Each time we made it to the end of the first trimester then lost our babies. It was just a very, very sad experience. So, for this pregnancy it was tough in the beginning. You want to fall in love once you see that you’re pregnant with the positive pregnancy test, but you’re scared to let your emotions go. It’s hard to believe that it’s actually happening; that the baby is gonna stay. 

We had two previous miscarriages…you’re scared to let your emotions go.”

After the first trimester it was starting to feel real. I was able to wrap my head around the fact that this pregnancy was going to be successful. I was very fortunate to only have mild aches and mild nausea. The third trimester was great. I felt huge and as you can tell I had a big’ole moon belly! 

Q: How are the girls reacting to the new baby?

They love him. They absolutely adore him, and even fight over him. They want to hold him constantly. Since he is being breastfed I started pumping to give them an opportunity to help feed him with a bottle. They’re so wonderful with him. Kayla, the youngest, she calls him Moo-Moo. He eats a lot of milk and the “M” is for Matthew, so, yeah—Moo-Moo.

Yeah, the girls love to play with him and show him off. They love being big sisters. 

Q: What are you most looking forward to in your new relationship and family?

I’m looking forward to creating memories and just taking it all in. It’s weird, when I had the girls I was in a different place mentally and emotionally, and I don’t think I quite took in as much as I should have. I would say just being more in the moment and appreciating the moment.

Q: If you could give advice to other women based on your experiences, what would you tell them?

I would tell them that life is too short to not be happy. If your gut tells you you’re not happy, if something inside of you says, “There might be something else for me,” then there is something else for you. Life is too short to be unhappy. There will always be someone to love you. There will always be someone who will have their heart open, and if you have kids from a previous marriage, there will always be somebody out there for you who will welcome you and your family in and love them just like their own. Don’t settle; never settle. You are stronger than you realize.

“If your gut tells you you’re not happy…never settle!”

Q: What life lessons would you hope to instill in your children?

Always respect yourself and respect the person that you’re with. Also, never settle. Know your self-worth and know that you’re capable of… and this is going to sound so cliché… so much, and I know that if they were to apply themselves, they can do anything that they set their minds to. It’s a mental game, and they’re really strong. They can do whatever they want to do.

Q: Anything else you’d like to add to the interview?

I also want to say that Dr Gandhi and Jordan and both offices and all the women at Cherokee Women’s: I freaking love them. They’re awesome. You know, I can’t say enough about how pleased I am with everything. The emotional part; just being there for us and being silly with us, meant so much. Even when we were delivering via c-section, Dr. Gandhi was amazing and funny! I wasn’t excited about having to have a c-section, I really wanted a VBAC, but Dr. Gandhi is a doctor for a reason… She knows best!

My husband and I always feel comfortable enough to be able to joke around with her and with Jordan – they made our experience better. I’d would jokingly say, “I’m going to have a VBAC.” And Dr. Gandhi would reply, “Sooo, when we’re having the c- section…”. 

We did asked for a “gentle c-section”. It’s where we were able to have the blue tarp removed and replaced with a clear one to see pretty much everything. I’m weird like that. When we were taking pictures at the end, Dr. Gandhi was being silly and fun, and it made the entire experience very lighthearted and not so stressful or scary.

Dr. Gandhi is so funny and so amazing. I love that I can joke with her, then turn around and ask serious questions. Jordan is also hilarious, and easy to talk to.

So definitely, yes, it’s been a blessing to be with this practice and I’m just so thankful that I was able to use my VA benefits here.

Lots of medical practices do not like working with the VA as their payments can take a while to be sent. After researching doctors and practices, Cherokee Women’s was up on the list. I talked to the billing department and they were able to accept the VA’s payment. I was able to get great care and fell in love with Dr. Gandhi and nurse Jordan. They’re both great women, and I couldn’t have been happier with all of this.

“Everything happens for a reason!”

– We’re so happy that you ended up here and that you had an amazing experience with Dr. Gandhi.

I’m so blessed. I am beyond blessed. I must have done something right in another life because I don’t know what I did to deserve a wonderful husband and healthy daughters, a healthy son and great doctors to look after me. I truly am, and I believe it from inside my soul that I am very blessed with everyone that in my life right now.

May 1, 2018

By Dr. Kawami Clay, MD FACOG

Popular diets have two things in common: they tout rapid, dramatic results and they accommodate the masses with an ironic ‘one size fits all concept’. Many participants even experience significant weight loss in a short time–initially. Inevitably, however, that dreaded ‘plateau’ occurs. Then, despite all efforts, those last stubborn, morale-shattering pounds remain. Medical Weight Loss Program at Cherokee Women's

Women come to us regularly, discouraged because yet another diet did not yield the desired, optimistic results it promised. Their frustration is understandable-even warranted- because most are simply unaware of the complexities involved in safe weight loss management.

Fad diets usually fail because they are not individually customized. A myriad of factors can hinder successful weight loss. Medical history, genetics, hormonal issues, body mass index (BMI), basal metabolic rate (BMR), lifestyle, general health, medications-even state of mind must be considered.

For instance, a sedentary lifestyle, diabetes, depression, or a sluggish thyroid can greatly impact the rate at which one sheds unwanted weight. So can lack of support and negativity from apathetic family and friends who are hearing optimistic, unrealistic blather about yet another quick loss trend for the umpteenth time.

Additionally, some patients may require prescriptive intervention through safe and approved supplements, appetite suppressants and even injections if necessary.

All of these influences and more are important considerations and contribute to dietary outcomes. So do regular weekly follow-ups, one-on-one consultations, and ongoing moral support-even long after the desired goal is reached.

As specialists in female health, we realize that a woman’s chemistry and anatomy differ greatly from a man’s- and even from that of other females. This knowledge guides us to focus solely on each woman and her individual dietary needs. By combining our expertise, patient data, and continuing encouragement, all these elements help us create a customized medical weight loss program tailored for each woman and her unique requirements.

Correct nutrition fuels the body and mind like curative medicine, providing more pronounced energy, lifelong physical health benefits, and cognitive clarity, the same way the proper additives keep a car running at peak performance.

Adhering to a healthy diet and exercise regimen is never easy, but it doesn’t have to be an excruciating experience. With time, perseverance, nutritional insight, and safe medical intervention when necessary, any women can overcome the setbacks that would normally prevent her from reaching her dietary goals. With proper guidance, a harmonious balance between a comfortable self-image and a permanent, healthy lifestyle is achievable.

This article originally appeared in the May 2018 issue of Townelaker Magazine. To view it online, please click here

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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

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