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Category: General

November 29, 2016

woman with low sex drive photoEvery week women ask me why their sex drive is so low. “Fix me so I can enjoy sex more and want it more often,” they say. Then they ask me to check their hormones and to give them a physical examination.

This is a popular topic among women and it’s everywhere in the media. Patients ask me about the latest fads they’d seen touted as the latest, greatest best thing. They ask about bioidentical hormones. Vaginal rejuvenation. Sexual vitamins. Gspot enhancement. clitoral hood reduction. The list goes on. Treatments of all sorts are advertised to women of all ages to solve a low sex drive. And it’s true that some solutions, when chosen for the right person, can transform a woman’s sexual responsiveness.

However, most of the time treatment is unnecessary or unhelpful.

Sometimes a woman’s sex drive is low for a good reason. But something that’s not broken can’t be fixed. Other times there is something that can be done. Asking the right questions is the key to understanding how to help them.

Five Key Questions for Women With a Low Sex Drive

1) Has your sex drive dropped or has it stayed more or less the same?
Many women are convinced they have a low sex drive because they compare their desire for sexual contact with their male partner’s. However, men and women typically have vastly different desires for sexual intercourse. The typical woman’s sexual desire usually ranges from once or twice a week to once or twice a month. The typical man’s is once or twice a day. This discrepancy accounts for the feeling many women have that there is something wrong with them.

That said, if a woman’s sex drive has suddenly dropped, a woman should consult with her doctor to determine the reason. If it’s always been low, then chances are that’s the way you are.

2) What is your childbearing history?
There is a myth that women reach their sexual peak in their forties. This is the idea that women in this age range finally becoming sexually liberated from natural inhibitions. The idea is that the forty year old woman now has a sexual desire and ability to orgasm that has reached new heights. There are specific circumstances in which this occurs but it is the exception rather than the rule.

Women in their forties who have not yet had children can have a very high sex drive. But oftentimes, there’s a reason for this. Women who have small children will often see their sex drive plummet. When toddlers and grade school children require constant mothering, there is often little left for the woman’s partner.

And women who are breastfeeding often have the lowest sex drive of all women. After all, she has a baby feeding off her body all day long and when she puts her head on her pillow at night, the last thing she wants is for more physical contact. Men will often say, “You used to want to have sex, I think there is something wrong with you.” It’s at this point that she’ll seek my help. Or, her partner will send her in to see me.

3) Does sex hurt or do you have pain with your cycles?
There are two main reasons why sex hurts. One has to do with vaginal dryness. This is pain with entry, which commonly occurs with menopause. The ovaries stop producing estrogen which leads to thinning of the vaginal lining, which exposes nerves and decreases lubrication. There is more pain and less pleasure and a reduced desire for sex. This can be treated with topical estrogen cream or even more advanced office procedures such as ThermiVa.

Other women commonly hurt with sex because they experience pelvic pain with their cycles. This is painful sex from the actual thrusting motion. If a woman missed school during her adolescence because of discomfort during her cycle or if her mother needed a hysterectomy for pelvic pain, it’s very likely she has endometriosis or internal scarring of her internal reproductive anatomy. This patient needs a gynecological evaluation, particularly if she has not had children, is experiencing infertility or if she experiences pain more than a couple of days a month.
Women with back pain during their cycles often have a tilted uterus that can be corrected by an experienced surgeon during an outpatient laparoscopy.

4) How is your general health?
In the same way that a person’s appetite for food drops when they’re not feeling well so does their appetite for sex. When you are in bed with the flu you don’t want to eat and you don’t want to be sexually active. But if you are chronically unhealthy, your desire for sex will be low as well.

The most common reason for poor health in America is lifestyle. As a society, we are sedentary and we eat addictive, poorly nutritious food. Patients with cancer and heart disease don’t come to my office complaining of low sex drives. But overweight patients who munch on pizza and don’t exercise often complain of a lack of sexual desire. Exercise and nutritious plant based diets raise testosterone levels and other important hormones responsible for not only sex drive but also an overall sense of youth and vigor.

5) Do you have orgasms?
Many women cannot have orgasms with sexual intercourse. Clitoral stimulation is the main way for a woman to achieve sexual climax. Unlike a man’s sex drive that ends with ejaculation, many women don’t focus on the biological climax but rather the emotional and physical intimacy. But a woman who does not orgasm can see her sex drive eventually plummet. It’s important to understand your body and to know how you achieve physical gratification from sexual activity.

Many women need vibrators applied directly to their clitoral region to achieve climax. The first step is masturbation alone when you can discover for yourself what gets you there. This can then be incorporated into sexual activity with your partner. Good communication is necessary to have a healthy sexual life. Some husbands will be uncomfortable with this kind of change. I tell my patients who indicate this to me to blame me (their doctor). “My doctor told me I have to do this so I can continue to be sexually active because having children and getting older has changed my body.” Hey, if it means a woman will have more intimacy and a better sex life, I’ll take one for the team!

Woman Healing From SurgeryThe length of time it takes to recover from surgery is different for everyone. In the same way that one person can run three miles and another has trouble walking up a flight of stairs, our bodies can heal at vastly different rates. But no matter who you are there are things you can do to increase your recovery time.

1) Adequate Rest – Most women are sleep deprived even without surgery because they typically take care of everyone around them. 12 to 14 hours of sleep each day is recommended the first week after surgery. For the next three weeks, an extra two hours of sleep a day is recommended.

2) Adequate Calories – After surgery is not the time for weight loss. Your body needs good nutrition to allow for healing of injured tissue. 15 to 20 calories per pound of current body weight is a good guideline.

3) Adequate Protein – Healing from surgery requires increased protein intake. Protein is required for your tissue to rebuild and for antibodies and white blood cells to fight off infection. This is sometimes difficult to do in the first week after surgery when you are more sedentary and may not be as hungry. But target one half to one gram of protein per pound of body weight a day. A hundred grams of protein a day is an excellent target. Consider supplementing your diet with protein shakes or protein bars.

4) Adequate Iron – If you had any blood loss during surgery, then you should take 15 to 30mg of iron a day for the first month after surgery. There are iron supplements available over the counter. These can cause constipation, particularly when taken with narcotics for pain relief. Iron rich foods include spinach, beans, whole grain oats, greens, lentils, shell fish like clams or oysters. Dietary iron is better than supplements if you can get enough this way. Eat a spinach salad with beans and drink a green smoothie to build up your iron and get rich healing nutrients every single day.

5) Water and Fluids – Water is necessary for carrying nutrients to your cells and to flush bacteria and waste from your body. The classic recommendation for water intake is eight 8 oz. glasses of water a day or about one half gallon. This is a fine target for most people. You want to drink about one half to one ounce of fluid per pound of body weight. Gatorade or a drink with electrolytes can help replace lost salts and minerals and help you get additional calories. You can tell you are getting enough fluids if you must urinate frequently.

6) Decreased Activity – After surgery everyone decreases their activity because of the pain. People have different abilities to tolerate physical discomfort so some increase activity faster than others. A good rule of thumb after a major surgery is to minimize your activity for at least two weeks. It’s fine to walk to the mailbox when you feel up to it but don’t go shopping or clean or vacuum. I took my wife to the movies four days after her c-section because she absolutely insisted, but I parked in the handicapped spot. After two weeks of relative inactivity, try increasing your activity to about 25% of your activity before surgery. After four weeks increase to 50%. After six weeks, 75%. Expect to get to 100 percent after 8 weeks. This will vary of course based upon the surgery and the individual. Bottom line: Get adequate rest and allow your body to heal.

7) Fresh Air and Sunshine – It is well known that sunlight helps with the synthesis of Vitamin D. This is certainly necessary for healing. But many holistic doctors also promote sunshine as necessary for the healing process in general. There are different theories about this but nothing definitive. From my experience as a clinician and at times in my life as a patient, I have noticed that people heal faster when they get sunshine and fresh air on a daily basis. This doesn’t mean you should lay out in the sun but an open window or sitting on the porch each day for twenty minutes or longer is a good idea. I suspect so much of the poor health that we see in the developed world is that too many of us are cooped up inside all day.

8) Inner Peace – We all weaken and become ill at times and this can be very frightening. As you heal from surgery, it’s important to focus on whatever it is that brings you peace and comfort. For some, it’s prayer. For others, it may be meditation. But at the core of these things, it’s the ability to feel gratitude for all the blessings we’ve been given. It’s a blessing to be able to walk around pain-free, to have plenty to eat and drink, to have a warm bed, to have people to love and laugh with – and yes, even to be able to go to work.

So while it’s easy to get down while your body heals, it helps to focus on the big picture and be grateful for all you have, including the surgery you just had. After all, there was a time not so long ago when that surgery may not have even been available.

November 10, 2016

A recent study has concluded that certain types of hormonal birth control can lead to depression. More than one million women were studied over a 13-year span and those who took combined progestin and estrogen pills had a 23% likelihood of developing depression. Those who were taking a progestin-only pill were 34% more likely to be diagnosed as depressed. For adolescents between the ages of 15-19 who used birth control pills, the instances of depression jumped to 80%.

Does taking birth control cause depression?There may be outside factors involved in the diagnosis of depression, especially considering that women in the adolescent stage may be predisposed to depression due to other issues they encounter such as hormonal changes, or depression from a triggered immune system.

With depression associated as a symptom of some types of hormonal birth control, it is important for women to discuss all birth control options with their doctor as well as disclose any and all side effects, including depressive symptoms.

If a patient is prone to depression or has relatives who suffer from depression, it is worth mentioning to the doctor. However, these risks should not scare women away from birth control, in fact, an unplanned pregnancy can cause depression, too. There are many options available today. If one on method does not fit with a patient’s lifestyle, there are others to try. Being open with health care providers is key. Knowing a patient’s health history makes it possible for doctors to prescribe medications that will get the best results.

Do you experience side effects from your birth control? Tell us about it, we might be able to help!

November 4, 2016

ultrasound photo with brenda

Accredited ultrasound services require a highly educated and skilled expert to operate the ultrasound machine and perform diagnostic examinations. Ultrasound is used both for pregnancy and also for the diagnosis of GYN issues.  A physician interprets the resulting images. Based on one or multiple factors, he or she affirms that the anatomy is normal, or if an abnormality is suspected, recommends further testing or treatment.

How Ultrasound Changed Pregnancy

When the technology of ultrasound first emerged, pregnant women were excited to see their developing babies. A patient would lie on a cold table, bladder filled with the large quantity of water she was required to drink to yield a clear picture. The technician lubricated her stomach with cold gel, and proceeded to rub a transducer probe across her belly while the anxious future mom and dad looked on.

The pictures were often disappointing – blurred and grainy. Without the sonographer patiently tracing the image with a finger on the monitor, prospective pareents didn’t know if they were admiring their baby’s face or the uterus it was inside. As for gender, well, that was still a hit and miss thing – basically no different from the baby shower tradition of swinging a ring on a rope, and guessing the baby’s sex based on whether the ring twirled or swung like a pendulum.

Back then, only the sonographer’s experienced eye could differentiate the important information from the blips and blotches on the monitor to insure that all was well. But since then, the quality of ultrasound – and the training of technicians – have evolved a hundredfold.

Briefly, How Does Ultrasound Work?

The ultrasonographer sends harmless high frequency sounds, undetected by human ears, toward a ‘target,’ in this case, your growing baby. Those sound waves are directed via a probe called a transducer. The sound waves bounce back, creating an ‘echo’ when they encounter the bone or tissue of the baby. That echo creates an image on a monitor—a picture of your baby complete with all its parts, including internal bones, tissue, organs and even blood flow. You may recognize only larger parts of your baby, like face, limbs, heart, etc., but the technician knows what all the little pieces of the fetus are. He or she is trained to decipher and measure every part to verify due date, gender, and to detect if anything is out of the ordinary.

Does Our Practice Offer Ultrasound Services?

Yes, we offer ultrasound services at our practice and are accredited at both our Canton and Woodstock locations. Headed up by our chief ultrasonographer, Brenda Peters, our practice has earned a place on a limited list of practices fully accredited by the American Institute of Ultrasound in medicine for obstetric and gynecologic ultrasound. Brenda’s training includes a Bachelor of Science degree from the diagnostic medical sonography program of the Rochester Institute of Technology, where she graduated with high honors in 2000. She is also a registered OB-GYN Ultrasonographer by the American Registry for Diagnostic Medical Sonography, and is certified in nuchal translucency, a specific screening to determine the presence of Down syndrome.

What Does Ultrasound Accreditation Involve?

The ultrasonographers in our accredited offices update their skills and stay current by attending the obligatory programs available. Additionally, our physicians take ongoing ultrasound classes and pass a test every three years to meet AIUM guidelines for reading ultrasound studies.

What Skills Does a Registered Ultrasonographer Have?

  • They are required to have basic knowledge of pathophysiology (knowledge of disorders and syndromes), anatomy, and physiology (knowledge of the function of living matter such as cells, tissues and organs)
  • They must be able to differentiate between normal and abnormal sonographic findings, recognizing particular conditions and diseases.
  • They must be able to recognize ultrasound patterns and imaging.
  • Sonographers do not simply diagnose findings, but must also know how to efficiently operate the equipment to acquire all the necessary data for diagnosis.
  • They must possess excellent clinical and communication skills
  • They must be able to assess and care for their patients, be adept at problem solving, and apply unbiased, logical, critical thinking to all findings.
  • They must adhere to all sanitary guidelines to prevent infection, and be mindful of all safety and health issues.
  • They are required to have knowledge of ultrasound physics
  • They keep image copies, accurate records, precise charts and detailed information, sharing their diagnosis with their medical colleagues in order to insure optimum patient care.
  • They often communicate findings to patients in real time, taking however long is necessary to explain all procedures, thus instilling trust, confidence and calmness in the person under their care.
  • They need strong verbal and written skills, in both medical and layman terminology to be able to communicate their findings to their colleagues.
  • In many cases, they may be required to move patients and be able to stand for long hours, requiring them to be in peak physical condition.Ultrasound Registry takes years of study, dedication and experience to achieve.
  • Reaccreditation is done every three years for our office.

Our staff of professionals in this field are available to care for you, the patient, with their knowledge and expertise at all times.

For more information, visit Northside Hospital Cherokee.For an appointment, call our office at 770.720.7733.

October 26, 2016

Bring your birth control questions to the providers at Cherokee Women's Health.The responsibility of Family Planning has never been easier with all of the options available to meet a patient’s health and lifestyle needs.  While the choices may seem overwhelming, a doctor can help to find the right contraception method to meet each patient’s needs. Below are some things to consider before scheduling an appointment with a care provider:

  • Disclose Complete Health History- It is especially important to be honest and thorough when disclosing health history because of any risks associated with contraception methods. This is a critical step in finding a birth control that will work for any health conditions a patient may have. Furthermore, there are certain birth control types that are contraindicated for those with genetic conditions or predispositions such as breast, uterine, or ovarian cancers.
  • Ask about options-it is best to make an informed decision about birth control, so start by asking what types are available. Choices range from pills, implants, and injections to more permanent options such as sterilization for women or men. While considering all of the options, it is important to plan for the future. For patients looking for long-term or permanent birth control, it is advantageous to ask about the reversibility of the method. Plans change, and patients should know if their birth control can be easily reversed.
  • Inquire about the Efficacy of Birth Control-Different methods hold different rates of effectiveness and a doctor can help compare methods that will work best for each patient’s needs. Find out what types of back-up or emergency birth control can be used to bolster effectiveness, prevent failure, and protect against sexually transmitted diseases. Additionally, ask if any supplements or antibiotics will interfere with the effectiveness of birth control and if there are back-up birth control options that should be used.
  • Evaluate the Cost-Some birth controls will cost more out-of-pocket than other types. Doctors can assist in finding a solution that fits into the budget. Contacting insurance is another suggestion to see what options are covered under a patient’s health plan.
  • Compare the Side-Effects and Benefits-Ask for a run-down on the types of side effects that can occur on birth control. Some patients may want to adjust their method based on their level of comfort with the side effects they experience. A doctor can answer any questions about switching methods or reducing symptoms or side effects.
  • Lifestyle Considerations-Depending on a patient’s lifestyle and individual menstrual cycle, there are contraceptive methods that may be the most optimal choice. For patients who travel often, they may find that they need a method that does not require weekly updating, or monthly prescription renewals. Those with irregular periods may want to consider something that regulates their cycle, such as birth control pills. Doctors can help pinpoint a method that accommodates lifestyle needs.

More than Protection– Proven benefits of taking contraceptives include regulating periods, reducing heavy bleeding, and clearing up skin conditions such as acne. Endometriosis is another condition that can be helped with the right birth control method, eliminating pain associated with the disorder. Women suffering from PMS, or PMDD should ask their doctor about a birth control method that can also help eliminate or lessen these irritable symptoms. Mention any symptoms experienced prior or during a menstrual cycle such as:

  • Mood changes or Anxiety and Depression
  • Severe pain
  • Sleepiness or Insomnia
  • Social Dysfunction
  • Weight gain and water retention

Birth control is not a one-size-fits-all method. If a particular type of birth control does not meet a patient’s needs, they should discuss any issues with their doctor and find other suitable options. Cherokee Women’s Health want to help take the guess work out of choosing a birth control. The first step in finding a contraception method is making an appointment with one of our health professionals, today!

October 19, 2016

Routine prenatal care is not a luxury or indulgence. It’s something both you and your baby deserve, and it’s a service that we excel at and are happy to provide.

Just as a gardener waters, nurtures, and cares for the seeds that he planted in rich, fertile soil, your baby, who is even smaller at conception than those seeds, needs the same dedication and attention to insure its prenatal growth and development in the womb. We help make that happen.

Whether this is your first pregnancy, or you’re already familiar with the whole process of giving birth, the importance of prenatal care can’t be emphasized enough. No matter how typical your pregnancy is, or how little risk your baby is exposed to health-wise and genetically, proper vigilance from conception to safe delivery is vital.

routine prenatal care exam photoOur specialists are trained in every facet of women’s health. We excel in the fields of fertility, obstetrics, gynecology and pelvic surgery. Not only do we offer optimum prenatal care, but we treat you, the patient, the same way we would treat our own mothers, sisters, daughters and all other females in our lives. Having successfully delivered over 10,000 babies, our priority is to safeguard not only your continuing well-being, but that of your baby. We offer every advantage currently known to women’s medicine, all with a compassionate and dedicated approach.

What Can You Expect From Us?
From your very first prenatal care visit, we treat you with the utmost care and respect, beginning with the initial pleasant greeting you receive the moment you walk through our doors. We’re professionals, but first and foremost, we’re human, just like you. We want you to feel as comfortable as possible so that you can establish a trusting relationship with your physician, and with his or her assisting staff.

How Can You Prepare For Your First Visit?
Bring your medical history and background. They’re important. That information gives us an idea of how closely we need to scrutinize your progress. It can help us decide what tests we should run during your first few prenatal care appointments. Your information and subsequent test results, if merited, determine whether your pregnancy should be considered high risk, moderate risk or risk free. No matter what the results, we are qualified to treat all levels.

What Happens During Routine Prenatal Care Appointments?
Our standard examinations during each visit include the following:

  • Blood tests
  • Blood pressure monitoring
  • Listening to your baby’s heartbeat
  • Urinalysis
  • Abdominal measurement to verify normal fetal growth
  • Pelvic examinations when necessary
  • Addressing any patient concerns.

When you’re ready for your first ultrasound, our prenatal care physicians are among the few who are fully accredited in the use of the most modern up-to-date 4D ultrasound. This procedure allows you to see your growing baby in full detail. It also lets our trained specialists evaluate your baby’s progress, detecting any potential problems that might occur as it matures from embryo to fetus, and finally to the infant you’ll cradle in your arms.

What Other Routine Prenatal Care Services Are Available?
We check for gestational diabetes, anemia and any genetic abnormalities. By conscientiously monitoring both your baby’s development along with your own, we want to relieve you of any stress or worry. When you leave after an appointment with us, we want you to do so with complete peace of mind.
We also offer the following prenatal care services:

    • Nutrition and diet: Our experts will help you maintain a healthy weight throughout your pregnancy, insuring a less complicated delivery. We provide information on regular, vegetarian, gluten free, vegan, and holistic nutrition. We take every precaution to insure that you and your baby receive the proper nourishment you need to sustain a trouble-free pregnancy.
    • Physical therapy: On-staff professionals will guide you in preparing your body for labor. Their recommended prenatal exercises and fitness regimens will minimize any possible trauma your body might experience during delivery, such as perineum damage, pelvic organ prolapse, or urinary incontinence. Their expertise has been proven invaluable, reducing previously unavoidable pelvic injury while giving birth.
    • Midwifery: You may be more comfortable with a nurse-midwife to assist you during delivery. We will partner you with a highly skilled nurse midwife, who has decades of experience. As long as your pregnancy is uncomplicated and progressing within normal guidelines, this practitioner is available to you.
    • Counsel and advice: No topic or concern you wish to broach regarding your pregnancy is trivial to us. We’re happy to address any subject, including such topics as breastfeeding, natural childbirth, having participants in the delivery room, umbilical cord blood banking, signs of postpartum depression, or circumcision if you are having a boy. You might be strongly opposed to routine afterbirth procedures, like a nurse washing your baby instead of leaving that first bath to you, or allowing it to have a pacifier in your absence. If it’s important to you, it’s important to us. We’ll answer your questions, dispense guidance as you need it and accommodate you to the best of our ability.

Getting you through your pregnancy with as little stress and complication as possible is our primary focus. We accomplish this goal successfully during every routine prenatal exam by treating you as the important and unique individual you are.

To schedule an appointment, please call us at 770.720.7733. For more information on prenatal care, visit Northside Hospital Cherokee.

Midwife-attended births have doubled in the United States since 1990, and the numbers continue to rise every year. In fact, the demand for them is beginning to far outweigh their availability. We are proud that our staff of these professional caregivers is among the very best, and prouder still that they manage to find the time in their busy schedules to help ensure that their numbers continue to grow by mentoring, educating and indoctrinating future midwives to fill the fast growing gap of need.

What Exactly Do Midwives Do?
Our midwives have accumulated years of learning, experience and training in women’s health in order to receive their certification. They hold the highest degree possible in their field CNM (Certified Nurse Midwife). Their primary focus, however, is on providing care to women and their families during their pregnancy, delivery, and the following postpartum period. They are also qualified to:

  • Provide prenatal care
  • Dispense medication
  • Recognize any potential problems that may arise during pregnancy or delivery
  • Conduct annual women’s examinations
  • Administer birth control
  • Give pre-pregnancy counseling
  • Diagnose infections
  • Provide postnatal care to mothers and newborns
  • Advise on nutrition and diet
  • Arrange for all routine prenatal testing
  • Make limited medical decisions within their scope of training and expertise
  • Deliver routine pregnancy babies
  • Prepare women for delivery with relaxation and breathing techniques
  • Discuss breastfeeding and its options
  • Provide parenting education.

Why Would I Choose a Midwife Instead Of a Doctor?
Many women prefer to opt for natural childbirth in a more subdued, comfortable setting. Midwives approach childbirth as a holistic, rather than medicinal, experience. They concentrate on alternative drug-free methods to bring your child into the world, such as breathing and relaxation techniques, massage, comfortable positioning, and advice to help you cope with contractions as they become more intense.

midwife-photoAlthough our midwives encourage non-anesthesia delivery, you will not be refused medication if you should happen to change your mind during labor. In fact, if your midwife recognizes that you are in too much painful distress, she will urge you to accept relief so that the birthing process does not become a traumatic memory.

Our midwives also develop a more intimate bond with their patients, something physicians and surgeons are not always able to provide due to time constraints. Though all our doctors strive to answer all your questions and concerns, taking whatever time is necessary to put your mind at rest during your prenatal appointments, midwives offer more availability. Since they usually have less patients at one time than an OB-GYN, this allows them to concentrate more fully on each individual pregnancy.

By questioning and getting to know you better, our midwives will learn exactly what your preferences are during your natural birth process and will do their best to accommodate those wishes.

I’ve Already Had a Caesarean but Would Really Like to Give Birth Naturally This Time. Can I Still Ask for a Midwife or Natural Birth?
In many cases, absolutely! You’ll have to be evaluated by one of our OB-GYNs to make sure there is no risk to you or your child, of course. Your health and safety, along with your baby’s, are our primary concern at all times, but once we’re confident that a natural vaginal birth is possible, one of our staff nurse-midwives can take over your prenatal care, and often your labor and delivery.

Should any problems arise at any given time, our midwives are trained to immediately notify a physician for help and support.

Midwives are our respected colleagues, and we rely heavily on their knowledge and sound medical training to alert us to step in at any time we are needed to assist if they encounter a problem outside their scope of expertise.

Childbirth is one of the most memorable experiences in a woman’s life. A midwife is proficient in extracting the inner strength and determination you may not even be aware you have to give birth naturally and still revel in the whole process.

For more information on midwifery, visit Northside Hospital -Cherokee. To make an appointment with us, call us at 770.720.7733.

October 12, 2016

If your pregnancy has been defined as high risk, there is no need to panic. The truth is, all pregnancies on some level are high risk; to grow another human being inside your body is a significant event! A high risk pregnancy status is a precautionary determination to make sure that any pre-existing risk factors you have, along with any you may develop during your pregnancy, are monitored closely to ensure both your baby’s safety and yours.

Our obstetrics team has successfully delivered over 10,000 babies, many of those deemed high risk. We’re trained to detect and evaluate situations hazardous throughout gestation, and equipped with the technology to do so.

Most of all, our tenet is to treat every pregnant patient the way we would want our loved ones treated.

What Is Considered a High Risk Pregnancy?
There are many factors that can designate a pregnancy as high risk. Some medical, physical or genetic influences may predispose you to being susceptible to certain problems. These are:

    • High blood pressure
    • Being overweight or underweight
    • Diabetes
    • Cancer
    • High blood pressure
    • Heart, lung, or kidney disease
    • Epilepsy
    • Alcohol or illegal drug usage
    • Age (under 17 or over 35)
    • Multiple births
    • History of miscarriage
    • Family member or previous child with Down syndrome
    • Infections such as HIV, chicken pox, rubella, toxoplasmosis, hepatitis C, syphilis
    • Certain medications
    • Chronic health issues such a lupus, asthma, rheumatoid arthritis, heart valve abnormalities or sickle cell disease
    • History of preterm labor or preeclampsia.

What Can You Do For Me If I Have Any of These High Risk Pregnancy Markers?
The first step is to establish a trusting relationship with you, taking the time to answer all your questions and concerns.

In many cases, just a few lifestyle modifications can ensure a safe, healthy pregnancy. Some of these changes can be as simple as speaking to our diet and nutrition experts, who will counsel you on a food and supplement regimen appropriate for your specific needs. We may schedule more frequent prenatal visits so that we can carefully monitor your progress, taking immediate steps to treat whatever problems might occur.

high risk pregnancy photoYour blood pressure will be watched closely. Blood and urine tests will be taken during every prenatal visit, along with any physical examinations or scans that may be indicated.

Our high risk obstetric specialists will evaluate any medications you might be taking, making adjustments as necessary to protect you and your child. If you suffer from pre-existing chronic conditions, we will work with you to minimize any arising difficulties.

We may monitor your pregnancy more frequently with ultrasounds and fetal monitoring.

Finally, we screen for genetic abnormalities, providing information, counsel, and advice if required.

If My Pregnancy is Normal, With No Pre-Existing Conditions, Will it Stay That Way?
Usually, but not always. This is why prenatal care appointments are so important for both you and your baby. You can develop complications at any time, placing you into a high risk pregnancy category. Again, don’t become alarmed. Our specialists have combined decades of experience and training to deal with that if it happens, and the earlier we detect something, the better. Here are some of the things we look for:

  • Gestational diabetes mellitus (GDM or gestational diabetes): High blood sugar sometimes develops during pregnancy, causing headaches, depression, high blood pressure, hydramnios (increased amniotic sac fluid), and birth defects. It can also increase the danger of preeclampsia and premature labor. Babies can grow too large, resulting in a need for a caesarean, and they may suffer from jaundice and low blood sugar after birth. We screen for this between your 24th and 28th week- earlier if your history warrants it.
  • Preeclampsia: Preeclampsia causes persistent high blood pressure which can lead to organ damage and seizures, possibly requiring medication and/or early delivery. Routine urine testing at every prenatal visit can detect this, alerting us to rigidly monitor your progress.
  • Rh factor: Rh is an inherited protein found in some blood. If yours differs from your baby’s, difficulties may arise. We routinely test for this incompatibility to safeguard the well-being of the fetus.
  • Bleeding: Though not all bleeding is dangerous, if you’re deemed a high risk pregnancy, we follow up to make sure there is no jeopardy to you or your baby.
  • hCG: (human chorionic gonadotropin): This substance not only confirms pregnancy, but analyzing levels regularly can indicate if you are at high risk for ectopic pregnancy, possible miscarriage, or a Down syndrome baby.
  • Placenta previa: Sometimes the placenta covers the cervix, causing bleeding during delivery. Transvaginal ultrasound tests warn us beforehand if a caesarian is necessary.
  • Fetal problems: Our 4D ultrasound and other equipment can detect complications or abnormalities before they become a problem.
  • Premature labor: We can’t always predict if your baby will thumb its little nose at our calculated due date, but a previous history of early labor, a shortened cervix, or certain infections alert us to be vigilant of that possibility.
  • Placental abruption: When the placenta separates or peels away from the uterine wall, the situation may become detrimental to both mother and baby. We always look out for this and other potential dangers.

Our hospital partner, Northside Hospital Cherokee, opens its new facility in early 2017, continuing to handle a full range of services for our patients with high risk pregnancies. Since 1993, Cherokee Women’s Health has delivered more babies at Northside Hospital Cherokee than all other OB practices combined.

Whether yours is a routine or high risk pregnancy, our highly qualified, expert providers pride themselves on giving you the best individual prenatal care necessary to ensure a safe and healthy pregnancy.

For an appointment, call us at 770.720.7733.

October 10, 2016

An annual gynecological visit is critical to preventative care. Depending on age and medical history, part of the annual well-woman visit may include a procedure known as a Pap smear. A Pap smear tests for abnormal cervical cells which may be due to inflammation or a precancerous condition of the cervix.

DySIS graphic

Who Needs a Colposcopy?
If a woman receives an abnormal pap smear, the next step may be a colposcopy. A colposcopy is a procedure that allows the doctor to biopsy suspicious tissue.

Receiving an abnormal test result can be a scary experience. Cherokee Women’s Health can ease any woman’s mind with the new, state-of-the-art colposcopy exam. The DySISmap Advanced Cervical Imaging System is a revolutionary technology that measures abnormal areas of the cervix.

With Emory and Grady Memorial Hospital, Fourth in the State of Georgia
Cherokee Women’s Health is the first practice in north Georgia, and only the fourth in the state, to offer this highly sensitive colposcopy technology to women in the community.  We’re proud to bring our patients access to this ground-breaking technology, currently available only in powerhouse healthcare systems including Emory Hospital and Grady Memorial Hospital in Atlanta.

What is the DySISmap?
Unlike a standard colposcopy, the DySISmap offers a color-coded digital map of the acetowhitening process which details abnormal areas of the cervix. The color-coding highlights any cervical abnormality from weak to strong areas of concern, and tells the doctor exactly where to biopsy to test for cancer or precancerous cells.

This precision in detecting any inflammation or precancerous conditions early allows doctors to treat the cervix before the cancer spreads to other areas of the body.

Woman worried about pap smear results

With the DySIS system, patients may choose to watch the scan as the doctor performs it, and the DySIS allows the doctor to store images captured from the scan. By storing these images, later scans can compare cervical changes over time.

Contact Cherokee Women’s Health with any questions related to cervical health or to learn more about the DySIS Advanced Cervical Imaging System, a new technology which can put your mind at ease.

October 4, 2016

Vegans can have healthy pregnancy without adding animal products to their diets.A healthy pregnancy requires that mothers-to-be eat foods rich in vitamins and minerals to help support their growing baby. One of the first prenatal appointments with an obstetrician will include a discussion about what foods to eat or avoid in order to provide optimal nutrition for fetal growth. The American Congress of Obstetricians and Gynecologists suggests that pregnant women eat a well-rounded diet which should consist of fruits and vegetables, whole grains, dairy, and meat. However, for those whose diets stray from the five food groups, such as vegans, or vegetarians, they simply need to find other foods or supplements that will provide adequate nutrition for themselves and their babies.

Veganism is a dietary lifestyle which completely abstains from the consumption of animal products. A vegan’s diet eliminates: eggs, meat, dairy, honey, etc. It is not imperative for a vegan mother-to-be to include these food items in her diet because a 100% plant-based diet can include all the required nutrition a mom and baby need. A fundamental step is making sure to find alternative sources for the all-important vitamins and minerals needed to foster healthy development and less pregnancy complications.

Iodine:

No matter her dietary lifestyle, iodine is one of the essential minerals that a pregnant woman must consume. Iodine is important for proper thyroid function, and critical during pregnancy for fetal neurological development. The recommendation for pregnant women is 220 micrograms of iodine a day. Even a small deficiency can have a major impact on fetal development, which is why sources of iodine need to be included in consumption. Due to its use in the milking process, dairy can often be a main source of iodine intake for women. Instead of dairy, a vegan mother can add iodine to her diet by taking iodine supplements, eating fortified foods, or using iodized table salt.

Iron:

Iron is a mineral often found in red meat. Iron deficiency anemia is a concern for pregnant vegans, unless they can find alternative sources for the mineral. The body requires at least 30 milligrams of iron daily during pregnancy to increase blood supply and foster a healthy fetus. In addition to possibly adding in iron supplements, pregnant vegans should be eating green leafy vegetables, whole grains, and dried beans daily to ensure necessary iron levels.

Calcium:

For vegans, sufficient calcium intake will be more tedious to acquire than simply drinking milk. 1,000 mg. are needed during pregnancy to help build healthy fetal bones and teeth. Vegans can turn to kale as a large source of calcium to add to their diet. Other top vegan calcium sources include: almonds, bok choy, turnip greens, or fortified foods such as soy milk, cereal or orange juice.

Vitamin B12:

When it comes to vitamins, one vitamin vital to pregnancy is Vitamin B12. Vegans do not naturally consume as much B12, because they abstain from eating animal products which are rich sources of the vitamin. Plant products do not contain a considerable amount of B12, but foods such as cereal are often fortified with the vitamin. Pregnant women are recommended to take 2.6 mcg. of B12 a day, and even slightly more when breastfeeding. B12 deficiency is life-threatening, so pregnant and breastfeeding vegans need to ensure that their levels are appropriate for pregnancy.

Vegan mothers should bring up any questions or concerns to their doctor when it comes to meeting the crucial vitamin and mineral intake during both pregnancy and breastfeeding. It is always recommended to not begin taking any additional vitamins or supplements without consulting a physician first. If a mom-to-be is struggling to reach these nutritional values, she may be put in touch with a nutritionist, who can assist in planning a suitable diet for the duration of pregnancy and breastfeeding. Having a baby changes everything; but moms don’t have to completely adjust their dietary lifestyles to keep themselves and their baby healthy.

 

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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