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Category: Moms

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.

December 6, 2016

Perineoplasty, also referred to as perineorrhaphy, is plastic surgery that focuses on the deformities, imperfections, damages and defects of a woman’s anus and vagina. The surgery specifically removes scar tissue, unsightly bulges and unwanted skin, and then tightening or loosening the perineal muscles and vagina. An added benefit of perineoplasty is that, by making these adjustments, the surgery also serves to restore a woman’s confidence, and physically increase her levels of sexual pleasure.

What is the Perineum?
The perineum is the area located between the anus and the vagina. Small as it is, the perineum has the important job of being a structural support for several surrounding organs, and it encapsulates muscles that play a large part in vaginal tightening and loosening.

What Can Cause Damage to the Perineum?
Childbirth: Giving birth vaginally, especially during a difficult delivery, is the most common cause of perineal damage. Even an uncomplicated delivery can cause physical trauma to the vaginal and perineal muscles. Sometimes, an incision is made (episiotomy) in the perineum to ease baby out more easily. Sloppy stitching by a less experienced physician to mend either the natural tearing or planned cut may result in improper healing of the tissue, muscles and perineum. This may leave heavy scarring, pain and discomfort. Multiple births, of course, may worsen these problems. Perineoplasty can rectify them by opening the stitched area again and re-suturing it correctly, enabling proper healing.

Obesity: Excess weight can put strain on the entire body, including the perineum and the structures that it supports. It can also stretch the muscles, causing them to lose elasticity, much the way a mattress becomes concave in places as it conforms to the weight of your body sleeping on it night after night, providing less support as time goes on.

Extreme weight loss: We’ve all seen the ravages of sagging, flaccid, excess skin on someone who has thinned rapidly due to illness or binge dieting. Just as these unsightly effects are visible outside of the body, they can also happen internally, causing the perineal and other muscles to droop permanently even though the pressure of weight is gone. Think of that mattress again. It may regain its shape again during the day for a while, but eventually, after several years, the indentations and depressions become permanent.

What Other Conditions Does Perineoplasty Treat?

  • Vaginal itching
  • Vaginal laxity: (looseness of the vaginal opening that can cause decreased sexual sensation)
  • Vaginismus: (involuntary contractions of the vagina during attempted intercourse)
  • Vulvar vestibulitis: (severe pain during attempted penile or tampon entry)
  • Genital wart removal
  • Incontinence: (involuntary loss of urine)
  • Intraoital vaginal stenosis: (narrowing of the vagina, often caused by cancer treatment)
  • Dyspareunia: (painful intercourse due to a small vaginal opening)
  • Cystocele: (protrusion of the bladder into the vagina)
  • Rectocele: (protrusion of the rectum into the bowel)
  • Aesthetic enhancement: (tightening of loose or flaccid tissue or bulges to give the area a more attractive visual appearance).

What to Expect
Perineoplasty is an out-patient procedure that usually takes about an hour under general or local anesthetic. Rarely is hospitalization required.

A ‘V’ shaped incision is made to the posterior vaginal wall. Scar tissue, bulges and other damages are removed. Depending on the reason for the surgery, the muscles are then either tightened or loosened to correct the problem, then stitched carefully. After a brief recovery time, the patient is permitted to go home.

Recovery
Patients are cautioned to refrain from having sex for six weeks. It is recommended that any strenuous activity such a bicycling, horseback riding, heavy lifting, or stretching be avoided during this time as well. Tampons should not be used. Most patients should be able to return to work after several days.

Pain and discomfort is usually minimal to moderate and can be treated with over the counter pain medication, or a prescription supplied by the doctor. Minor bleeding and some discharge can occur, and this is normal.

There may be some dizziness or nausea for a day or two as a result of the anesthesia, but this should disappear after forty-eight hours.
The incision must be kept clean and dry. Stitches will dissolve by themselves in about two weeks. It is important to drink lots of water and increase fiber intake during this time to avoid constipation.

Complications
Generally, there are few risks associated with perineoplasty. However, the doctor should be contacted if any of the following occur:

  • Excessive bleeding
  • Signs of infection
  • Constipation not relieved through fiber intake
  • Vaginal discharge accompanied by a foul odor.

Childbirth can cause a great deal of trauma and physical change to the body, and women have accepted this as part of the reproductive process since the beginning of time. Today, however, there are procedures that can virtually restore your body to its pre-pregnancy state.

There is no need to suffer quietly and resign yourself into assuming that nothing can be done to ease the pain or embarrassment associated with any of the conditions mentioned above, or to dread intimacy because of possible discomfort or lack of sensation. We can help you. To make an appointment with one of our specialists, please call 770.720.7733.

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 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 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.

Our doctors have decades of combined experience and expertise in the field of women’s health and fertility assistance. We understand your frustration, sadness, and heartache over your efforts to conceive, and we want you to know that there is hope for your situation. Thanks to constant medical breakthroughs, that hope grows larger every day.

sad-woman-inferilityOur priorities are twofold. The first is to treat every woman that walks into our clinic with the same counsel, focused care, and individual attention that we would treat a beloved member of our own family.

The second priority, equally important to us, is to make sure that we are constantly abreast of the most up-to-the-minute technology and knowledge in all facets of women’s health. This includes reproductive assistance. Our technology is equally cutting edge, allowing us to correct many previously irreparable infertility issues.

What Causes Infertility?
Sometimes the causes are unknown, but the more common ones are:

  • Ovulation problems
  • Blocked fallopian tubes
  • Endometriosis
  • Inferior egg quality
  • Hormonal problems
  • Past infections
  • Uterine fibroids
  • Ovarian issues such as cysts (polycystic ovary syndrome)
  • Past miscarriages
  • Irregular periods
  • Low or ineffective male sperm.

If My Cause is Unknown, Can Cherokee Women’s Reproductive Assistance Specialists Still Help Me?
Yes. Even though your tests may come back completely normal, we can still help you. Though every reproductive system functions the same way, there are also differences. Just as you have a unique fingerprint, your body may have variations that can affect the process of fertilization. Simple lifestyle factors can affect your ability to conceive, and these can be as simple as:

  • Caffeine consumption
  • Diet
  • Overweight or underweight
  • Smoking
  • Medication, either prescribed or social drug use
  • Lack of exercise or excessive exercise
  • Alcohol intake
  • Stress.

Our staff of reproductive assistance experts is persistent in finding the reason for your infertility, and once we do, we will recommended different modifications to help you through your dilemma.

What Can You Do For Me?
Not only do we offer the most in-depth testing to pinpoint your specific reason for infertility, our diet and nutrition experts can help adjust or change your diet, and recommend vitamins and supplements to help with any deficiencies that might be contributing to your difficulties with conception.

If you are suffering from any weakness in your pelvic area that might be preventing you from carrying a baby full term, our doctors can customize an exercise regimen to strengthen those frailties.
Our OB-GYNs and FPMRS surgeons (Female Pelvic Medicine and Reconstructive Surgery) hold the highest certifications and are qualified to perform the surgeries necessary to correct any physical impairment or disorder that may be interfering with your successful reproduction, including:

  • Laparoscopic surgery to correct ovarian disorders and restore ovulation.
  • Tubal cannulation, salpingectomy, salpingectomy, or fimbrioplasty to eliminate scar tissue or remove or rebuild damaged sections of blocked fallopian tubes
  • Tubal reanastomosis to reverse tubal ligation
  • Myomectomy to remove uterine fibroids
  • Laparotomy to remove larger fibroids.

What if I Still Can’t Get Pregnant?
There are still reproductive assistance options available. Once we’ve looked at and corrected any possible physical, nutritional or lifestyle detriments that may be hampering your ability to conceive, there are still alternatives available. These include:

  • Fertility medications and hormonal therapy to boost ovulation and egg production.
  • Gamete Intrafallopian Transfer (GIFT): Eggs and sperm are extracted, mixed and placed in the fallopian tubes to fertilize.
  • Zygote Intrafallopian Transfer (ZIFT): An option in cases of low sperm count, or where at least one fallopian tube is unscarred. A scientifically fertilized embryo is injected into the healthy tube.
  • Intracytoplasmic Sperm Injection (ICSI): A healthy sperm is injected directly into your egg.
  • Artificial or Intrauterine insemination: ‘Washed’ sperm is introduced into the uterus, bypassing any sluggish sperm issues or hostile environment, such as thick or acidic mucous preventing the sperm from reaching the egg to make conception possible.
  • In vitro fertilization (IVF): A common approach today in cases where age, internal pelvic scarring, or low sperm count contribute to infertility. A lab developed embryo grown from egg and sperm is implanted into the uterus. Donor eggs from volunteers or previous IVF patients who no longer wish to have more children can be used if your partner’s sperm or your eggs are compromised and cannot achieve conception.

There are almost as many solutions as there are reasons for infertility, and our women’s health specialists are here to help you with your situation. To make an appointment for fertility assistance, please 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 4, 2016

Pregnant woman photoThe second trimester takes place from the 14th to the 27th week of a woman’s pregnancy. This is usually the most comfortable and pleasant time. Mercurial Jekyll/Hyde moods begin to balance out. You no longer sob uncontrollably over a run in your hose, or laugh maniacally when someone passes gas. Morning sickness is becoming a distant memory, and you can now start showing off that baby bump in all those maternity tops you’ve carefully selected. Even that sex drive that may have waned somewhat during the nausea, exhaustion and general malaise of your first trimester may return.

What Happens Next?
The egg (zygote) evolved from being the size of a pinhead into a recognizable little human being, first called an embryo and, after 8 weeks of gestation, a full-fledged fetus. New symptoms may occur, but generally, they are more tolerable than the previous three months. These may include:

  • Nightmares: Stress, hormonal change and anxiety can affect sleep, causing you to dream about outrageous, even horrible scenarios. Waking up in a cold sweat may happen more often.
  • Abdominal discomfort: Aches and pains caused by a stretching uterus and ligaments is normal. Excruciating pain, however, is not. Call your doctor if you experience anything other than moderate discomfort.
  • Quickening: This is the term given to feeling the fetus stir inside you. At about 16 to 20 weeks, you will feel a slight flutter. As the baby grows and takes up more room, movement is felt more distinctly.
  • Blips: An odd bubbling sensation that turns into a stronger methodical twitch as pregnancy continues is simply the fetus experiencing hiccups. Don’t worry. He or she is not having seizures. Your dinner probably just didn’t agree with it.
  • Breathlessness: The uterus can crowd the lungs as the fetus grows, disrupting smooth air flow. Unless you are gasping for air, some breathlessness is normal.
  • Body shape changes: The waist thickens, hips expand, your derriere can widen, and even your face may produce an extra temporary chin if you gain too much weight too quickly. By the end of the second trimester, you will have probably gained 16 to 22 pounds. Only two can be attributed to the baby. The rest is placenta, uterus, amniotic fluid, body fluid and blood. Your body also stores about 7 pounds of fat throughout pregnancy to prepare you for breastfeeding.
  • Stretch marks: Your tummy and thigh skin, elastic as it is, can only stretch so much at a rapid pace before the middle layer of skin (dermis) tears, exposing the deeper layers. Most of these marks diminish or disappear after birth.
  • Bleeding gums: Many women experience sensitive, bleeding gums due to hormonal changes. Use floss gently and get a softer toothbrush, but don’t skimp on your dental hygiene habits.
  • Heartburn, constipation and hemorrhoids: All are common. Smaller meals are recommended, along with more fiber and fluids. Try Sitz baths and speak to your doctor about an ointment or cream to relieve irritation.

What Precautions Can I Take During This Time?

  • Keep in shape with moderate, low impact exercise.
  • Eat healthy and keep junk food to a minimum. The more weight you gain, the harder your labor can be, and losing excess pounds afterwards may be difficult.
  • Avoid unnecessary medical procedures such as Botox injections, chemical peels etc. Even whitening your teeth or coloring your hair can be harmful.
  • Take no medications without speaking to your obstetrician.
  • Keep all your prenatal appointments. You will probably be seen once a month during this time, more often if problems are detected. It’s important to monitor your progress.

What Tests Are Performed During the Second Trimester?

  • Urine tests: These will be requested at every visit to monitor protein levels.
  • Maternal serum alpha-fetoprotein (MSAFP) and multiple marker screening (MMS): One or the other are offered for genetic screening and are optional. They are used to measure specific fetal protein output to determine if there is a possibility of Down syndrome or spina bifida. If positive, an ultrasound or amniocentesis is done for confirmation.
  • Sonogram: This non-invasive procedure can be done at any time during pregnancy, but is typically conducted at the end of the first trimester or during the second to confirm gender and due date. It can also reveal such conditions as placenta previa, cleft palate, and many other developmental or growth problems.
  • Glucose screening: This checks blood sugar levels for gestational diabetes. If readings are elevated, a glucose tolerance test may be ordered.
  • Fetal Doppler ultrasound: Sound waves determine if fetal blood flow is normal.

How Big is My Baby Now?
The fetus is about 14.5 inches long and weighs a little less than 2 pounds. It is about the size of a cantaloupe and is able to blink, sleep and wake up. The brain is very active and developing rapidly. Its maturing taste buds can now taste what you eat. Experts even believe dreaming is possible. Hearing is becoming more acute and sensitive eyes may react to light.

Each trimester has its own unique milestones, and our doctors have the knowledge and expertise to make sure that your pregnancy is progressing safely and well. For more information, visit Northside Hospital Cherokee. For an appointment, call our clinic at 770.720.7733.

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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