Voted "Best OB-GYN" in Towne Lake, Woodstock and Canton Voted "Mom-Approved OBs" by Atlanta Parent magazine readers
November 3, 2017

liposuction candidate photoIs liposuction right for you? Certain requirements must be met in order to ascertain whether this surgery will be a potentially successful one for you. An appointment for a preliminary consultation with your physician should always be made so that you fully understand the benefits, risks, and exactly what the procedure entails. It is necessary to be completely honest and open with regards to the expectations you may have and the results you expect.

Many women assume that this procedure is the answer to all their prayers – that it will magically give them the firm, svelte body they’ve always dreamed of having. This is not the case.

Liposuction is not a quick fix for weight loss. Nor does it miraculously get rid of excessive cellulite or stretch marks. The purpose of liposuction is to remove resistant bundles of fat that stubbornly refuse to respond to regular diet and exercise, especially after you have reached and maintained a healthy weight. If you are in good enough physical condition to undergo this surgery, only strong determination, good eating habits and regular exercise will keep the weight from returning. Liposuction cannot do that for you. Its results are only permanent if your weight remains stable.

It needs to be mentioned that liposuction only removes what is referred to as ‘adipose tissue’. This is fatty connective tissue that consists of those lingering fat cells you want to banish from your body. That is liposuction’s sole purpose. It does not remove excess skin nor does it tighten or repair anything internally or externally the way a tummy tuck or breast lift might, though it is on occasion, used to extricate small, leftover fat deposits during a tummy tuck procedure. Generally, it simply removes bulges, lumps, and bumps via suction to give the trouble spots in question a more sculpted, smoother appearance. Liposuction is, however, often performed simultaneously with other cosmetic procedures like the ones mentioned.

Additionally, positive change will not show overnight. It can take up to three months to see the benefits, and to see optimum results, all precautionary instructions you are instructed to follow regarding your aftercare must be adhered to. This includes wearing a pressure garment for the specified amount of time. Some discomfort and swelling should be expected, along with leakage at the incision site for several days. The extra effort on your part should, in time, bring about a more pleasing appearance.

Who is an Ideal Candidate for Liposuction?

• Women who are within 15% to 30% of their ideal body weight according to body mass index (BMI) calculations.

• Women who have fat deposits confined in their necks, thighs, abdomens, arms, back and other areas that have proven to be unresponsive or genetically resistant to diet and exercise.

• Women in good physical health who have no critical illness or chronic condition that may hamper healing.

• Non-smokers.

• Women who no longer plan to get pregnant.

• Women with a positive mental and emotional outlook.

• Women with a strong determination to maintain their current health and weight long term.

• Women of any age who presently have strong, firm skin elasticity.

Are There Ever any Medical Reasons to Perform Liposuction?

Yes. Liposuction is usually considered an elective surgery, but there are exceptions where it is warranted for medical reasons. These include:

• Profuse armpit perspiration (axillary hyperhidrosis)

• Fatty benign tumors (lipomas)

• Fat metabolism problems (lipodystrophy)

• Enlargement of the dorsoscervical pads (buffalo hump) which can be caused by adrenal disease or certain medications such as anti-HIV drugs or steroids.

What Conditions or Issues Might Disqualify a Woman From Receiving Liposuction?

Since liposuction is a surgical procedure, certain medical or physical conditions may prove dangerous or even fatal depending on their severity. Sometimes general anesthesia is used, usually when the operation is coupled with another cosmetic procedure. These problems, depending on their severity, could prevent patients from withstanding the procedure safely. Therefore, the following disadvantages may preclude them from being prime subjects:

• Women who suffer from depression: Depression can be a possible after-effect of any surgery, including liposuction. Any pre-operative depression can worsen the condition. Furthermore, certain antidepressant or anti-anxiety medications can be extremely dangerous when combined with anesthesia.

• Significantly overweight or obese women: Typically, skin elasticity is lost with the stretching that occurs with considerable weight loss, making it less likely that the surgery will give the smooth, firm, desired appearance.

• Women who have been diagnosed with scarring/collagen or connective skin diseases such as collagen vascular disease, etc.

• Women with extreme stretch marks.

• Women with acne who have used Accutane up to 6 months prior to surgery.

• Women suffering from Lupus erythematous, endocrine problems, lung or heart disease, high blood pressure (hypertension), diabetes, vascular and circulation problems, healing complications, and blood clotting disorders.

Can I Continue to Take My Daily Medications?

It is mandatory that your doctor is aware of every single medication, herb, and supplement you take regularly or even occasionally. This includes all recreational drugs and alcohol. They are not there to judge, only to take every precaution to ensure absolute safety before, during, and after your procedure. Many of the above may have a detrimental effect on you physically and emotionally. You may be required to discontinue some of the products you are taking, and only your specialist knows how to advise you in this matter.

Liposuction has evolved considerably since its introduction into the world of cosmetic surgery. Though it is much less invasive than ever before, it is still surgery and should only be performed by a qualified, board-certified specialist experienced in the procedure.

To schedule a confidential consultation or for more information, please call our private number at 770-721-6060.

liposuction photoLiposuction may be right for you if you’ve been struggling with excess weight in certain areas that just won’t budge, even after trying every exercise and diet known to man.

What is Liposuction?

Liposuction is a procedure that removes fatty deposits from the body using a suction method. The process is quite simple to understand. A thin tube called a cannula is inserted under the skin into a small incision near that troublesome mass you want gone – and just like that vacuum you use at home to inhale the dust bunny from under your couch, that cannula sucks out the fat.

What is the Purpose of Liposuction?

Many women are under the false assumption that liposuction is a quick fix for weight loss and can eliminate cellulite or stretch marks. This is not the case at all, and the procedure is never recommended for these reasons. In fact, even the most intense liposuction procedures only result in a difference of under five pounds, which is hardly enough to warrant undergoing any surgery.

Liposuction is recommended as a final effort to correct, reshape and sculpt those trouble spots that have been resistant to diet or exercise. Stubborn fat deposits tend to become squatters in the abdomen, buttocks, outer thighs, face, neck, hips, legs, upper arms, back, and waist. Liposuction eliminates these clusters, leaving your skin with a smoother, shapelier appearance.

What are the Benefits?

Your self-confidence and mental outlook are just as important as your physical health. Liposuction can offer you the opportunity to walk into a room poised and self-assured, instead of agonizing over whether anyone notices that unwanted bulge you’re trying to conceal with tight, torturous undergarments. Self-esteem rises with positive self-body image, and though beauty is, indeed, only skin deep, it’s your skin and only you can decide when you’re comfortable in it.

Is it Painful?

New techniques have made liposuction much safer, less painful, faster and easier. Depending on the particular process being used, and the amount of fat to be removed, you may only need local anesthesia and a sedative to keep you calm throughout the process. If larger amounts need to be extracted, or if you are undergoing additional surgery such as a tummy tuck (abdominoplasty), facelift, breast reduction or other cosmetic surgery, general anesthesia may be required. If necessary, your doctor will prescribe pain medication.

What is the Recovery Time?

Typically, depending on the amount of fat removed, any major discomfort eases within 2 to 4 days and normal activity can be resumed within a few days. Swelling and bruising at the entry site can be expected to last 7 to 10 days and you may be required to wear a compression garment for a specified amount of time. Some fluid drainage is to be expected and an antibiotic might be prescribed before and after to ward off infection. You may not see the complete effects for quite some time, especially if a significant amount of fat was drawn out. You will, of course, be advised about aftercare and what to watch out for, such as swelling, numbness etc., before being discharged, either from the clinic or hospital where your process takes place. In many cases, you will be allowed to leave within a few hours following your procedure.

As with any surgery, there are always risks, and liposuction is indeed surgery. Therefore, it should always be performed by an experienced, board-certified specialist who will brief you thoroughly and take the time to answer any and all questions you may have.

For more information or for a confidential consultation, please call our private number at 770-721-6060.


October 12, 2017


std signSexually transmitted diseases and infections (STDs/STIs) have accelerated to alarming levels. Disturbing statistics show that, in the United States alone, 20 million cases are reported annually. Half of these are found in millennials, which are younger people between the ages of 15 to24. Syphilis, chlamydia and gonorrhea are the three top STDs affecting the younger population today. 820,000 cases of sexually transmitted infections are attributed to gonorrhea alone.

What is the Difference Between an STD and an STI?

Though used interchangeably, there is a difference, albeit a slight one.  An STD is a catch-all term for all sexually transmitted diseases. An STI is an infection that has not yet become a disease. Since most STIs can be treated with the proper medications when caught in time, they do not always evolve into a disease. For example, if you are unaware you have the STI, chlamydia, or are staying quiet hoping it will go away, it can blossom into an STD called pelvic inflammatory disease.

The term STI is used more often now to counteract the stigma that was once associated with STDs. It’s a gentler and more optimistic acronym, since people associate the word ‘infection’ with ‘cure’, thus implying the condition has a hopeful outcome.

Other than Intercourse, How Does One Get an STI or STD?

Bacterial and viral STIs are typically transmitted sexually via oral, vaginal or anal sex. Exposure to infected blood, skin, mucous membranes, seminal or vaginal fluids, bodily secretions, and open sores place you at high risk for STIs. Unclean shared needles used for tattooing, piercing and drug injection render you highly susceptible as well. Other STIs, such as pubic lice and scabies can be spread via physical personal proximity or infested fabrics.

Who Gets STDs?

From birth to death, no one is immune. There is no racial, economic, age or gender barrier. Sexually transmitted infections are impartial, in that they don’t discriminate.

What are the Symptoms?

Each STD/STI has its own list of multiple symptoms. You may have some or all of them. In many cases, there are no symptoms at all. If you are sexually active, especially with plural partners, or if you indulge in oral sex, pay attention to your body’s signals. Sudden pelvic, abdominal, back, tongue, mouth or throat abnormalities, should always be reported to your physician. Even your dentist can detect oral STI issues.

It is important to insist your partners use protection or provide proof of ‘cleanliness’. Use condoms and/or a dental dam regularly. Have yourself tested on a regular basis. Just as you can get an STI, you can also unknowingly transmit one.

What are the Risks of Untreated STIs?

Repercussions can be severe, even fatal. Untreated STIs can lead to STDs, affecting you physically and mentally, destroying your nervous system, organs, bones, joints, tissues—every part of you. Some may lie dormant for years. If you have an STI and are pregnant, your baby can be born with that same condition, or be stillborn. Even if you firmly believe you are in a completely monogamous relationship and are suddenly afflicted with some of the tell-tale symptom associated with STIs, see a physician. It’s always better to be safe than sorry.

What are the Treatments?

Treatments vary based on the individual infection you have. Only your physician can prescribe the correct regimen after proper diagnosis. Antibiotics are usually effective for bacterial, parasitic or yeast STIs. There are however, some resistant strains of gonorrhea emerging that have become immune to antibiotics. Early intervention is important. Viral STDs cannot usually be cured, but they can be managed with antiviral medications. Vaccinations can help prevent hepatitis and some HPV types. Remember, STIs can recur. Even if previous treatment cured your gonorrhea, you can still contract it again from another partner.

Why are so Many Young People Suddenly Getting STDs/STIs?

There are a number of reasons for the astronomical rise:

  • Multiple Partners: Risk rises in non-monogamous relationships.
  • Unprotected Sex: Misplaced trust, inhibitions lowered by drug or alcohol use, and other factors can make women less cautious, leaving them vulnerable to these infections.
  • Oral and Anal Sex: Many females opt for oral or anal sex, either because of homosexual preference, desire to preserve virginity, fear of pregnancy or other reasons. The human mouth is just as ideal a location for STIs as the vagina, and venereal disease plays no geographical favorites. It’s as enthusiastic growing north as it is south. Gonorrhea, chlamydia, herpes simplex 1&2, syphilis, human papillomavirus (HPV), and human immunodeficiency virus (HIV) can all be transmitted and contracted orally and anally.
  • Casual Sex: One night stands are becoming more frequent and acceptable, increasing the odds of infection.
  • Internet Dating: Wining and dining a woman for weeks, even months to eventually ‘get lucky’ has become less of a seduction ritual. Many social sites are devoted to individuals who aren’t interested in relationships or are too busy to devote time to them. They admittedly seek only physical encounters. The possibility of engaging in sex with one-or even more- sexual partners a week dramatically raises the chances of getting an STI.
  • Less fear of pregnancy and long term physical repercussions: Because there is now access to so many forms of birth control, fewer cautions are being taken. Where women once refrained from sex for fear of getting pregnant, those ‘accidents’ are preventable or easily ‘rectifiable’ now. Likewise, knowing that a few days of taking antibiotics can cure just about any infection has made people less cautious about protection.

I Heard That Mouthwash Can Cure Oral Gonorrhea. Is This True?

In a word, NO! Though research has shown that mouthwash does indeed kill some gonorrheal bacteria in the mouth and a little past the tonsils into the throat, there is no evidence to support that it has any healing qualities beyond that.

Believing a quick gargle will make you spit out all traces of gonorrhea is a dangerous assumption to make. This home remedy is as effective on oral STIs as covering an atomic bomb in bubble wrap to muffle the explosive sound. In fact, using mouthwash as a cure or preventative may actually mask some important symptoms that your physician needs to know about in order to identify and treat you effectively.

Statistic show that one in four Americans will contract an STD in their lifetime. Many won’t even know it. If you think you may have an STI or STD and wish to schedule an appointment for screening, call 770.720.7733.





October 4, 2017

The tofu in miso soup is a healthy source of probiotics.You may have heard friends, family, or co-workers talking about ‘probiotics’. If so, you likely thought that this was the next big trend in weight loss and nutrition.

Well, you may be happily surprised to learn that probiotics are gaining traction in the medical world as well. Numerous studies have been done on the benefits of introducing probiotics into your lifestyle.

It turns out, probiotics can help a number of conditions while aiding in weight loss management. In this article, we’ll dive into how you can use probiotics to achieve and maintain your health and nutrition goals.

What are Probiotics?

Probiotics are ‘good’ bacteria that can be found in within your body already. Adding these ‘good’ bacteria to your daily routine can improve your overall well-being in many ways. Probiotics support weight management and promote a healthy immune system.

Typically you can get enough probiotics through foods like:

  • Yogurt
  • Cheese
  • Saurkraut
  • Kimchi
  • Kombucha

However, those with an aversion to foods that contain healthy probiotics, or if you are lactose intolerant, you can easily get your health on track with dairy-free probiotic supplementation.

How do Probiotics Work?

When there are too many ‘bad’ bacteria in your gut and not enough ‘good’ (usually due to a poor diet), the imbalance can have adverse effects on your body.

Not having enough ‘good’ bacteria in your diet to counteract the bad can lead to weight gain, constipation, diarrhea, skin conditions, and other various health conditions.

There are several ways probiotics can be used to improve your overall health.

1)   Introduction of Good Bacteria

When you introduce friendly bacteria into your digestive tract, they instantly begin to work to improve your overall immune system by making short-chain fatty acids (SCFA).

The SCFA create a colonization microbiota that teaches the immune system to increase its tolerance to harmful bacteria. Secondly, microbiota that can help break down otherwise indigestible foods.

2) Enhance Existing Bacteria

Many probiotics are not only designed to introduce new bacteria into your system but also enhance the bacteria that is already there. Intensifying the prebiotic fiber keeps your body trained to produce more on its own.

 3) Encourage Nutrient Absorption

Probiotics allow you to get more out of your food. Introducing new bacteria into your stomach can break down the food you eat more easily. Ensuring you have a healthy digestive tract is the best way to increase the performance from the other foods you eat.

Taking probiotics alongside other supplements is also beneficial. Many dieticians recommend stacking these supplements to enhance the absorption of your vitamins.

Probiotics improve digestion which raises the bio-availability of the nutrients in the foods and other supplements you take.

Probiotics and Weight Loss

Obesity has been shown to be closely linked to your gut flora. Probiotics are helpful in supporting proper weight management and can even combat the weight gain typically associated with aging adults.

Maintaining a healthy balance of probiotics such as Lactobacillus helps the body reduce inflammation which helps keep metabolic diseases at bay.

One study showed that Lactobacillus amylovorus decreases the ‘bad’ gut bacteria Clostridium leptum. As a result, subjects were able to achieve and maintain a total fat loss of 4%.

Final Thoughts

Probiotics can aid in your battle against obesity by supporting the maintenance of a healthy well-balanced diet. Feel free to call our office if you have questions regarding nutrition or probiotics.

One of our trained staff members will be happy to help answer any questions you may have or schedule a consultation for our weight loss program. Our medical weight loss program can provide probiotics to help you achieve your health and nutrition goals.

romantic couple photoLoss of sexual desire after fifty does not have to be the norm. If you find yourself uttering “not tonight” excuses more and more lately, Cherokee Women’s Health Specialists can provide treatment options so you can say goodbye to your low libido and get back to feeling “alive” again.

Many women after fifty weren’t raised talking about sexual health so it may be an uncomfortable topic to bring up to your GYN. However, after over forty years of combined specialized experience in women’s health, our providers can assure you that, although you are a unique individual, your struggle with a lowered libido is not unique at all. Nor is it something you should be embarrassed about.

Declining sex drive is often something older women keep to themselves. They may feel isolated and abnormal in a world of uninhibited sexual openness. Additionally, new libido medications for men increase the pressure for women to perform when desire is nonexistent. They avoid bedtime until their partner is fast asleep. Some fear their unresponsiveness may cause their significant other to seek gratification elsewhere. Others, wanting to please the person they love, dutifully ‘fake it’, which results in eventual resentment and even feelings of being violated.

Without intervention, waning desire can lead to a sense of inadequacy, self-loathing, insecurity and depression. It can cause misunderstandings and hurt feelings, sometimes ultimately leading to shattered relationships. None of this has to happen. For menopausal and post- menopausal women looking to recapture lost desire, help for the following problems is available:

• Dryness and pain: Dryness after menopause is common. The vaginal walls grow thinner, the opening can get smaller, and the canal shorter. Causes include a drop in the hormone, estrogen, which previously kept your lady parts firm, plump and moist. These changes can make intercourse unpleasant enough to embrace celibacy. We can recommend different hormonal therapies, topical creams and water based lubricants that have come a long way from the petroleum products and creams recommended by your grandmother.

• Sagging and loss of sensitivity:  Just as your body shows signs of aging, time can impact your genitals. Vaginal childbirth delivery can stretch and displace internal organs and tissue. Estrogen loss can leave your vulva and labia loose and flaccid. This can affect sexual pleasure attained through friction. Orgasms become harder to achieve.

Today, there are more options than ever to correct these problems. ThermiVa, a non-invasive, gentle warming laser treatment, can restore the youthful appearance and function of your vulva and vagina by tightening and treating their external and internal tissues.

Vaginal rejuvenation, which includes labiaplasty and vaginoplasty, reshapes, trims and alters the appearance of the vagina and labia. It not only offers aesthetic enhancement but can renew your self-confidence exponentially.Various reconstructive surgeries can secure genital organs back into their original position with a relatively short recovery period. We even have the technology now to transform your genitalia to a virginal state if you so choose.

• Incontinence: Fecal and bladder incontinence are usually a result of internal organ trauma from childbirth. If you’ve been avoiding sex because you’re worried about accidents or being seen in adult diapers, we offer solutions ranging from simple exercises to surgical repair.

• Post hysterectomy issues: Removal of reproductive parts does not mean the end of intimacy. In fact, a high percentage of women report that they enjoy sex even more after a hysterectomy so whether you’ve undergone a partial, total or radical procedure, sex doesn’t have to become a memory.

Your hormones may be out of whack for several weeks and depression, whether psychological or triggered by abrupt hormonal changes, may occur. The extent of your surgery will determine how your estrogen and testosterone levels will be affected. You may possibly enter menopause and experience hot flashes, insomnia, and other symptoms. These temporary after-effects should abate with time. If not, and you are still disinterested in sex, talk to us. Once we determine if hormonal levels, medication, scarring, or other problems are causing your low libido, our FPMRS urogynecologists can help determine treatment options.

If loss of sexual desire is a concern for you, call us to book an appointment at 770.720.7733.

September 29, 2017

What is Tubal Ligation?

Commonly referred to as “getting your tubes tied,” tubal ligation is a permanent surgical procedure that is performed to prevent pregnancy. More formally, it’s also known as female sterilization. In recent years, the term “tubal sterilization” is most accurate, since the technical definition of the word “ligation” refers to a specific surgical technique that is no longer used in most sterilization surgeries.

Whatever the term you prefer, the procedure involves closing off a woman’s fallopian tubes to prevent eggs from traveling down to the uterus, and prevents pregnancy.

When Can Tubal Ligation be Performed?

Tubal ligation can be done in conjunction with childbirth, since the advantage is that it can be performed at the same time as a C-section or within 48 hours of a vaginal delivery. Many surgeons prefer to do the surgery after birth because you’re already in the hospital, and your abdominal muscles are still relaxed from having just given birth.

If you decide later on that a tubal sterilization is the procedure for you, it can also be done as an outpatient procedure separate from childbirth via interval tubal ligation. This process uses a laparoscope, a thin tube with a camera lens and light on the end. The procedure involves general anesthesia to prevent any pain or discomfort.

What to Expect During the Procedure

If you have an interval tubal ligation as an outpatient procedure, either a needle is inserted or an incision is made through your navel so your abdomen can be inflated with gas (carbon dioxide or nitrous oxide). Then the laparoscope is inserted into your abdomen.

In most cases, your doctor will make a second small incision to insert special instruments. Using these instruments passed through the abdominal wall, your doctor seals the fallopian tubes by destroying segments of the tubes or blocking them with plastic rings or clips.

If you have a tubal ligation after vaginal childbirth, your doctor will likely make a small incision under your navel, providing easy access to your still-enlarged uterus and fallopian tubes. If you have a tubal ligation during a C-section, your healthcare provider will use the same incision that was made to deliver the baby.

What to Expect After the Procedure

If your abdomen was inflated with gas during the interval tubal procedure, the gas will be withdrawn. You may be allowed to go home several hours after the procedure. If you have the procedure in combination with childbirth, the tubal ligation isn’t likely to add to your hospital stay.

You may have some discomfort at the incision site afterwards. Other symptoms you may experience include:

  • Abdominal pain or cramping
  • Fatigue
  • Dizziness
  • Gassiness or bloating
  • Shoulder pain

You may take acetaminophen (e.g. Tylenol) or ibuprofen (Advil, Motrin IB, others) for pain relief, but avoid using aspirin, since it may increase bleeding. Your doctor will most likely permit you showering or bathing 48 hours after the procedure, but will advise against straining or rubbing the incision for a week.

You should also avoid strenuous lifting and sex for one to two weeks, but can resume your day-to-day activities gradually as you begin to feel better. Your stitches will dissolve and won’t require removal.

If you have any concerns that you aren’t healing properly, it’s important to call your doctor to see if you need a follow-up appointment. Additionally, contact your health care provider immediately if you experience:

  • A temperature of 100.4 F (38 C) or greater
  • Fainting spells
  • Severe abdominal pain that’s persistent or gets worse after 12 hours
  • Bleeding from your incision that’s persistent or gets worse after 12 hours, despite use of pressure and bandages
  • Discharge from your incision that’s persistent or gets worse

Who is the Ideal Candidate for the Procedure

Tubal sterilization is considered a permanent surgery, so it’s a good option only if you’re completely sure you don’t want any more children.

If you’re not entirely sure if you’re done having children, you might consider other less permanent forms of birth control. While you may have heard of women who successfully get their tubal sterilizations reversed, it isn’t guaranteed to be effective, and involves a second invasive surgery.

Additionally, because tubal sterilization is a surgery, your doctor may advise against the surgery if you’re obese, have chronic health conditions such as heart disease, or if you’ve had complicated abdominal surgeries in the past.

Complications from Tubal Ligation Procedures

If you think you may be pregnant after your tubal ligation procedure, you should contact your health care provider immediately. While tubal ligation is highly effective in preventing most pregnancies, it isn’t an absolute in preventing pregnancy. An estimated 1 out of every 200 women will become pregnant after tubal ligation.

Complications related to tubal ligation include an increased risk of an ectopic pregnancy, which happens when a fertilized egg implants in the fallopian tubes instead of traveling to the uterus. An ectopic pregnancy can be dangerous, and can cause a rupture in the fallopian tube, resulting in internal bleeding.

Considering Tubal Ligation? Start a Conversation

In 95% of cases, tubal ligation is an effective permanent form of birth control. Before deciding if this procedure is the best fit for you, it’s important to consider all the possibilities and know your options. If you think tubal ligation might be the right permanent birth control option for you, we invite you to contact your doctor to start a conversation.

September 28, 2017

Imagine this: You’re pregnant and wake up with a horrible backache, or have lingering pain from a previous injury. You think, “I may still have some hydrocodone that my doctor prescribed for me, that might do the trick.” Stop–before you take any medicine, it’s imperative that you learn the dangers of opioid use during pregnancy or if you’re considering starting a family. Why? Opioid Use Disorder is on the rise in pregnant women, and many have no idea of the potential dangers.

Opioid use during pregnancy has increased dramatically over the past ten years. In fact, according to a recent United Nations report, Americans use more than 99% of the world’s hydrocodone. These startling facts are the reason more and more OB-GYNs are alerting patients to the serious complications associated with opioid misuse and opioid disorder.

While many people are familiar with hydrocodone, there are lot of different drugs that fall under the category of opioid. Many of them are prescription medications used for pain relief, often prescribed after surgery, dental work, or an injury. In addition to hydrocodone, other opioids include oxycodone, hydromorphone, codeine, methadone, propoxyphene, and buprenorphine. You may be surprised to learn that heroin is also an opioid.

The Dangers of Opioid Use During Pregnancy

Opioid Use Disorder is another name for opioid addiction. Symptoms of opioid addiction include using more than the amount of the drug that is prescribed for you; having work, school, or family problems caused by your opioid use; and feeling a strong urge or desire to use the drug.

Taking opioids during pregnancy can cause serious complications for the baby, including a drug withdrawal known as neonatal abstinence syndrome after the delivery. NAS occurs when your newborn baby, who is no longer receiving the drug from your bloodstream, may have withdrawal symptoms for days to weeks after being born. Symptoms of the syndrome include: shaking/tremors, crying, fever, poor feeding, diarrhea, vomiting, and sleep problems.

Other complications for babies related to opioid use during pregnancy may include:

  • Spina bifida
  • Hydrocephaly (excessive fluid in the baby’s brain)
  • Glaucoma
  • Gastroschisis (a hole in the abdominal wall from which the baby’s intestines stick out)
  • Congenital heart defects
  • Placental abruption, growth problems, preterm birth, and stillbirth

Opioids: If You’re Pregnant

It’s very common for women to experience pain during pregnancy, such as pelvic pain, low back pain, or migraines. At your first pregnancy well-check visit, your doctor will provide you with a list of approved medications that are safe to take during pregnancy.

If you’re experiencing pain during pregnancy, it’s very important to have an honest and thorough discussion with your doctor, especially before deciding on a pain management option.

This is because there are many unknowns surrounding safe opioid doses for pregnant women. Because of these unknowns, even if you use an opioid per the exact instructions from your healthcare provider, it still may cause NAS in your baby.

Additionally, if you’re pregnant and are on opioids, it is not recommended to stop taking them without talking to your healthcare provider first. Attempting to quit “cold turkey” or without any warning can cause severe problems for your baby, including preterm labor or death. The most important step is to talk to your doctor about your opioid use, and together, come up with a plan to keep you and your baby as healthy as possible.

Treatment for Opioid addiction during pregnancy involves medication-assisted therapy, or opioid-assisted therapy. Long-acting opioids are given to reduce the “cravings”, but they do not cause the pleasant feelings that other opioids cause. Examples of these medications are methadone and buprenorphine. Treatment for opioid addiction also includes drug counseling, which helps people avoid and cope with situations that might lead them to relapse.

Opioids: Trying to Conceive

If you’re trying to conceive or are considering getting pregnant and are currently using an opioid medication, use effective birth control until you’re no longer taking the medicine. Let your doctor know all of the medications you take to make sure you are as healthy as possible before getting pregnant.

At Cherokee Women’s, it’s important to each of our physicians to have open, honest communication with our patients. If you’re concerned about opioid use during pregnancy, contact our office to schedule an appointment to discuss your concerns with one of our physicians.

September 27, 2017

You think you may have an ovarian cyst. Or, could it be a uterine fibroid?

Ovarian cysts and fibroids have many of the same symptoms and can be difficult to self-diagnose. You may experience pelvic pain during certain activities, dull or sharp pain in your abdomen, or no symptoms at all.

Unless you’re a trained professional, you probably don’t know the differences between the two. In fact, many women often don’t know they’ve got either until their OB-GYN does a routine pelvic exam.

Ovarian cysts are very common and typically go away on their own. While uterine fibroids are not an issue for some women, others experience problems such as changes in their menstrual cycle and even infertility.

In this article, we’ll discuss the most obvious ways to tell which of the two you have. We’ll also cover several treatment options to consider for both.

Overview: Ovarian Cysts

An ovarian cyst is a sac or pouch filled with fluid or other tissue and is caused by your menstrual cycle. As you’ve probably guessed it forms directly on your ovary.

Each month your body grow normal follicles (a cyst-like structure). These follicles produce hormones such as estrogen and regulate the timing of releasing an egg during ovulation. Cysts occur when a normal follicle continues to grow.

Because of this, ovarian cysts are most common for women who are at the childbearing age or going through menopause. You are also at a higher risk of getting ovarian cysts if:

  • You’re taking fertility drugs
  • During pregnancy
  • You’ve had a severe pelvic infection
  • You’ve had ovarian cysts in the past

Most ovarian cysts go away on their own within 1-2 menstrual cycles.

You may experience little to no symptoms when you have an ovarian cyst. However, they can also cause dull or sharp pain in your abdomen during certain activities.

Treating an Ovarian Cyst

When your doctor diagnoses you with an ovarian cyst they will typically suggest treatment if your cyst becomes large, is causing problems such as pain, or if cancer is suspected.

There are two types of treatments for ovarian cysts.

  • Watchful Waiting. This is a process of monitoring your cyst for changes in size or appearance through scheduled ultrasounds.
  • Minimal Invasive Surgery. Typically, your OB-GYN won’t suggest surgery unless the cyst continues to grow or doesn’t go away on its own.

Uterine fibroids can cause discomfort and impact a woman's fertility.Overview: Uterine Fibroids

A uterine fibroid is a growth from muscle tissue. Fibroids can appear as single growths or clusters. They vary in size, shape, and location. Some grow rapidly, while others take years to form.

Unlike ovarian cysts, fibroids can form anywhere throughout the uterus. Fibroids can be found within the uterine walls, on the outer surface, or even attached to the stem-like structure.

Doctors still aren’t exactly sure what the cause of uterine fibroids is. However, research has led to several factors being involved such as genetic changes and hormonal changes.

Women of childbearing age are most affected by uterine fibroids. Often, fibroids will decrease in size after menopause due to reduced hormone production.

Although most women have had at least one uterine fibroid throughout their life, many aren’t aware because often symptoms don’t occur. Other women aren’t as lucky. Fibroids can have numerous adverse health effects including:

  • Abdominal pain or cramps
  • Difficult or frequent urination
  • Bleeding between periods
  • Pelvic Pain
  • Infertility

You may experience one, all, or none of the above symptoms if you have a uterine fibroid. It’s important to have regular visits to your doctor including routine pelvic exams.

Treatment for Uterine Fibroids

Your healthcare provider will suggest seeking treatment for your fibroid if you’re noticing symptoms. Rarely are uterine fibroids found to be cancerous.

There are a few treatment options available to you. Talk to your doctor about which of the following is the best approach.

  • Drug Therapy. Often your doctor will suggest birth control pills or other hormone altering drugs.
  • Myomectomy. This is the surgical removal of the fibroid. During this procedure, your uterus is left in place.

More abrasive approaches include:

  • Hysteroscopy. This is an outpatient procedure that destroys fibroids within the uterine walls through electricity or a laser.
  • Endometrial Ablation. This procedure is intended to destroy the lining of the uterus and in turn, the fibroids.
  • Hysterectomy. This is the surgical removal of the uterus. Sometimes doctors will leave ovaries in place for hormonal reasons. Speak to your doctor about this possibility.

Final Thoughts

Women experiencing pain or other symptoms from either ovarian cysts or uterine fibroids should seek medical advice. Once you get an official diagnosis, your healthcare provider can help you decide on a plan for treatment.

Still have questions? Don’t hesitate to contact us with questions regarding your symptoms or to schedule an appointment. A member of our trained staff will be happy to help you in any way possible.

September 26, 2017

Can post pregnancy exercise help a woman get back to her post-pregnancy weight.If you’re like many new moms, you’re ready to shed that extra baby weight… and now! It’s a perfectly natural feeling but if you’re not careful it can lead to a never-ending cycle of harmful weight loss that doesn’t last.

There is hope, however.

A healthy combination of nutrition and exercise can get you back to pre-baby weight in a matter of mere months. Be sure not to rush it though. Remember, it took 9-months to get to where you are now. Don’t expect lasting weight loss to happen overnight.

Incorporate Exercise into Your Daily Routine

Exercise can be a wonderful tool for new moms for many reasons. Physical activity can help reduce stress and help you sleep while keeping your muscles and bones strong.

Before starting a new routine, take care to get proper guidance on what to you can expect from your post-baby body. Heading to the gym for a workout right away can be harmful to your body, especially if you’ve had a c-section.

So what can you do?

  • Start slow. Having a newborn doesn’t leave you much time for anything, much less exercise. Try incorporating 30 minutes of walking into your daily routine broken into short 10 minute breaks as you can.
  • Incorporate strength training into your routine. Strength training with medium to light weights can help increase bone density as well as building muscle.
  • Don’t go it alone. You’re more likely to stick to an exercise program if you’ve got support from friends, family, or other new moms. Try joining a gym that has classes dedicated to new mothers.
  • Avoid jumping into old routines. Instead of worrying about what you could do before your pregnancy, focus on what your body can handle now. While you’re pregnant your body releases hormones that loosen your ligaments, making giving birth easier. It can take time for them to get back to normal.

Remember, don’t start any exercise until you feel ready. Women that have had c-sections or complicated births should consult a medical professional before starting any exercise programs.

Create A Healthy Diet Plan

Although exercise plays a strong role in meeting your weight loss goals, healthy nutrition is a primary factor for lasting weight loss. No matter how much you workout, exercise does not counteract an unhealthy diet.

It’s often hard to eat right when balancing life with a newborn. But it doesn’t have to be.

Try some of the following tips to get on the right track for reclaiming your body through healthy eating.

  • Eat at least 1,800 calories a day, especially if breastfeeding. Avoid crash diets. Pushing yourself to the max can leave you stressed which actually promotes weight gain.
  • Stock up on healthy snacks. Noshing on foods like sliced fruits, veggies or wheat crackers throughout the day is a healthy way to keep cravings at bay.
  • Choose a well-balanced variety of foods. Stick to foods high in the nutrients you need while low in calories and fats. Try a variety of lean meat, chicken, and fish as your primary source of protein to keep your energy levels up.
  • Drink lots of water. Not only does water keep you feeling full but some studies have shown that water can also aid in speeding up your metabolism.

When you were pregnant you likely changed your eating habits to support your baby’s growth and development. Making the change back to your old routine can seem daunting. Seek support from friends, family, or other new moms when necessary.

Final Thoughts

Don’t be afraid to ask for help with your post-baby weight loss. Every woman and every situation are unique. Here at Cherokee Women’s Health, we have a medically supervised weight loss program designed especially for women.

We can help nursing moms like you find a sustainable diet plan. Feel free to give us a call to learn more about our weight loss programs tailored just for you.

September 20, 2017

“When I started the program at Cherokee Women’s Health I had already lost 16 pounds but it had taken me over 5 months and then I plateaued in my weight loss journey.”

This part of Wendy’s story is not uncommon. Many people begin diet and weight loss programs and see early successes but have a difficult time reaching their goal. At Cherokee Women’s Health Specialists our doctors have formulated a plan specifically for women and their unique needs. The program includes personalized meal plans and nutritional education.

“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!”

Each patient gets a personalized plan that can include supplements along with the nutritional counseling, and regular check-ins giving women the skills they need for long term success.

 Goal for the Bridesmaid: Pounds and Dress Size… Going Down!

“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.”

Our medical weight loss program is designed to be an effective life style change that puts the power in our patients’ hands. With nutrition counseling, exercise plans and accountability, the medical weight loss plan gets results for women.

Call 770-720-7733 to schedule your free consultation today.

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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.”
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