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ThermiVa is performed without the use of lasers, offering patients no recovery time or delay in sexual activity. The procedure only takes 15-30 minutes and requires no preparation time, so it offers flexibility for patients looking to receive treatment without hassle.

How Does ThermiVa Treat Mild Urinary Incontinence

Pregnancy, childbirth and menopause are all contributing factors to urinary incontinence in women. ThermiVa is best for mild stress urinary incontinence, which includes leakage with certain activities, including coughing, sneezing, laughing and during exercise. For these factors, ThermiVa can be an excellent treatment option. Benefits of the ThermiVa include:

• Reduction in leaking during everyday activities
• Reduction in the “gotta-go” feeling, or sense of urgency
• Improvement of muscular coordination and strength of squeeze

ThermiVa and Vaginal Dryness

Another common issue that many women face, particularly after menopause, is vaginal dryness. Vaginal dryness occurs during menopause as a result of the body’s decrease in the production of estrogen. ThermiVa treatments promote internal and external vaginal moisture by encouraging new collagen growth and circulation of the blood. Thus, this treatment is useful for menopausal patients who do not want or are unable to use estrogen replacement. ThermiVa can also offer relief for women who are on estrogen-reducing prescriptions such as Tamoxifen, which can cause vaginal dryness.

Are You a Good Candidate?

If you’re interested in receiving the ThermiVa procedure, consider these questions:

• Are you currently menstruating?
• Do you have signs of vaginal or bladder infection or severe vaginal pain or pelvic pain?
• Are you pregnant or could you become pregnant?
• Do you experience difficulty with tampons staying in, vaginal flatulence, or have you noticed a difference in penetration during intercourse or foreplay?

All physicians at Cherokee Women’s Health are trained and qualified to administer ThermiVa treatments. Our practice also offers patients three physicians (Dr. Litrel, Dr. Gandhi and Dr. Haley) who are board certified in Female Pelvic Medicine and Reconstructive Surgery (FPMRS). This certification allows them to provide exceptional care in regards to complications related to pelvic floor disorders.

To schedule an appointment to speak to one of our physicians about ThermiVa, contact our office at 770.720.7733 or request an appointment online.

An Interview With Michael Litrel, MD, FACOG, FPMRS – Part 2 of a 3 Part Series

Read Part 1 of Dr. Litrel’s interview. The link to Part 3 is below.

Of all the specialties you could have chosen, why did you choose obstetrics and gynecology?
I was quite surprised myself that I chose OB/GYN. I really hadn’t thought of it as a specialty before I attended medical school because I was more inclined towards surgery. However, when I delivered my first baby, it was such a miraculous moment in my life. It was 3:00 in the morning, and I remember it distinctly. I was in awe that this child actually came from a woman’s body. Ten seconds later, as I was placing that baby into that little infant warmer, I realized that I wanted to participate in this miracle; that I was going to be an obstetrician. It was a profound moment for me, and I can’t begin to express how much great personal satisfaction and enjoyment I’ve received over the years by taking care of women and women’s issues.

Your wife Ann also works at Cherokee Women’s. Do you find it difficult to separate work-related issues from home life, or do you find it can strengthen a relationship?
Ann works on public relations for the clinic and I have my medical practice so yes, we work under the same roof and our paths do cross but we each tend to our own professions. I’m a doctor, something I’ve wanted to be since the age of seven and Ann is, first and foremost, an artist.

In answer to the second part of your question regarding separating work-related issues from home life, I think it’s very important to be married to your best friend and someone you trust implicitly. Ann is both of those to me.

We have a strong, healthy relationship and have been married for 28 years. Like any normal couple, we have our ups and downs, but we know how to apologize and go on from there. We’ve grown together and share similar interests. We agree on many things, including our relationship with God, and about becoming better people. As we advance through life, we continue to support, encourage and help each other. We’ve known each other half our lives so I wouldn’t say being a doctor and discussing work-related issues makes either my job or my marriage harder, any more than Ann being an artist and sharing her passion for it impacts either of those things.

You have an identical twin brother named Chris. When growing up, did you find that you and he shared that proverbial ‘brain’.
As identical twins, he and I understood each other so well that we didn’t learn to speak early or verbalize our thoughts to other people.

However, we’re very different. My brother is a lawyer by trade, and a lawyer’s thought process is entirely different from a doctor’s. Physicians focus more on immediate problems, whereas attorneys think three years ahead of time. Still, we’re very close and I rely on his counsel a great deal.

If you decided to retire tomorrow, what would you do?
Do you mean if I stopped practicing medicine? Well, I love what I do so as long as I’m healthy enough to keep doing it, I don’t really want to retire unless I absolutely have to. If anything, as I get older, I’ve become a better surgeon so I’d like to continue for as long as possible.

My other passion would be writing and speaking about the relationship between health and spirituality, something that’s very important to me. That’s one of the reasons I was drawn to the care of women and their health—because what life event could possibly be more spiritual and meaningful than the birth of a child?

I chose to specialize in surgical gynecology because human beings grow inside of a woman’s body, and sometimes you need a surgeon that can bring them safely into the world. I enjoy it, not only for the concrete aspects of surgery, but also for the deep spiritual meaning of this process known as the creation of a life.

We can clinically describe how a single cell turns into a newborn baby over 280 days, but the process itself is miraculous. It’s a testimony to the fact that our lives have deep purpose and deep meaning, and that God grants us life.

If you were to write another book, what topic would you choose?
As it happens, I’m currently working on a book on pelvic reconstructive surgery, but I’m also tying it in with the correlation between health and spirituality. Women not only endure suffering and damage to their bodies, but also to their souls. We all do. So the book I’m writing expands on that subject.

Women have unique human problems because of the nature of creating new life inside their bodies, and there’s suffering that comes from that process. So from that perspective, I’m writing about the nature of surgery in terms of when to have it and when not to have it. I’m also writing about the nature of health since health is not only about the physical but about the sexual and spiritual aspects as well.

I’d like to educate patients on the fact that we’re not human beings having spiritual problems, but that we’re spiritual beings having human problems. These human problems we all sometimes have call for the attention of a surgeon.

Do you like to travel? If so, where was your favorite place?
One of the things I like about practicing medicine is that I don’t have to travel anywhere. People from all over the world come to see me. I guess I’m more of a homebody than I am a traveler. I like keeping my life pretty simple. I have traveled and visited many different countries, but it’s not my favorite thing to do. I’ll go, but I prefer to stay home.

As a busy OB/GYN surgeon, I’m sure the demands can be overwhelming. How do you deal with those demands – both at work and at home?
I try to manage my schedule in such a way that I can always be in top form whenever I have patient duties. When I see my patients, I remain completely focused and concentrate on them. I also make sure I leave openings in my schedule to allow for free personal time. That way, I know that I can continue to do what I do indefinitely to prevent burn out.

Instead of allowing myself to get overwhelmed, I try to set up my calendar in a manner that guarantees I can be in peak mental condition all the time, thus insuring that I give the best care I possibly can. I’m 50 years old so I know myself well enough to know what works for me.

To unwind after work hour, Ann and I will often go for a walk around the neighborhood for about 40 minutes. We may go to the gym for some exercise, or out to have something to eat. Our favorite date is going out for a glass of wine, an appetizer, some dessert, and maybe catch a movie. That’s probably been our favorite type of date for the last thirty years.

I think we all need to give ourselves personal time to build up a relaxed, spiritual reservoir so that we can make good choices. To me, good choices are eating right, exercising, taking my wife out, having friends over, laughing and enjoying life—that’s MY relaxation.

Coming from an Asian-Italian background, how did you combine the two worlds when it came to traditional customs, beliefs and holidays?
Since I have a mixed ethnicity, I always had a few problems in the sense of fitting in. I was born in 1965 and there weren’t that many Chinese-Italian people out there back then. Although we’ve come a long way as a society in the sense that people are much more tolerant of interracial marriages today than they used to be, it was a bit difficult for me at times when I was growing up.

I probably chose my profession, because as a kid, I didn’t fit in too well with the world around me. I think that’s one of the reasons I was so drawn to medicine. In medicine, it’s not about skin color, ethnicity, wealth, or socioeconomics. It’s about helping and healing people.

As for holidays and customs, my mom’s father and stepmother lived in New York City. They were vegetarian Buddhists. For Chinese New Year, my step-grandmother would make a traditional Chinese meal, after which we would go into the city and celebrate. When fireworks were still legal, we would light them and throw them at the dragon. I remember how much fun that was.

As for the other side of my family, my dad had a lot of Italian friends—in fact his business was Italian food manufacturing. He worked with a lot of Italians, so we spent most of our time in their environment. New York is very rich in Italian flavor and community, so we got a lot that particular ethnic exposure too.

I still have Italian friends in New York. My grandparents have since passed away, so I’m not as in touch with my Chinese roots these days as I am with my Italian ones.

What is your very first childhood memory?
I remember when I was 3 years old we were moving to the house that would become my childhood home. I remember driving down that block and coming to the house that I would grow up in.

Ok, I just have to ask: When you watch medical movies or TV shows, do you find yourself mentally correcting the inconsistencies?
When I was younger, I used to think about all the things they were doing wrong. Now I simply sit back and enjoy what I see on the screen. I’ve come to understand that they’re just trying to create drama, and I recognize that movies and TV are all about the story.

When I was training to be a resident I used to watch ER—and that was actually a very good show. Michael Crichton was asked to be a consultant on that show because he was a Harvard trained doctor. It was a good series but sometimes it was just too much. To draw viewers, they would try to condense all these improbable situations into a one-hour episode of heightened drama and sensationalism. A lot of it was very real but it was just too intense. I DID enjoy it though. I also used to like M*A*S*H*. I still watch medical shows today because it made people aware of what it’s like to be a doctor, or a doctor in training.

What inspires you to continuously educate yourself and want to learn more? Did you have a mentor?
I think I became a doctor because I wanted to matter to other people. I also think that perhaps childhood pain is the root of my deep desire for my life and my actions to matter.

For me, life is about evolving, learning and constantly getting better and better. I don’t think my motivation to learn can be attributed to any one person. I’ve had excellent teachers and mentors throughout my life, and I feel blessed to have had them, but I don’t think that I can ascribe sole mentorship to any one person.

I think the best way to live is to always improve one’s self. I’m hoping my children have learned that from Ann and me. I pray they will always strive for self-improvement in their lives. I think that the people who don’t try, who don’t aspire to progress, who choose to remain stagnant in their viewpoints—these people become trapped in the belief that they are always right, when in fact, they can be tragically wrong.

Read Part 3 of Dr. Litrel’s interview.

Vaginal health is a crucial aspect of a woman’s overall well-being throughout her life. However, it’s a topic that often goes undiscussed due to cultural taboos and discomfort. As women age, the vagina undergoes significant changes, and understanding these changes is essential for maintaining optimal health and quality of life. In this article, we will explore the impact of age on vaginal health, discussing common issues, preventive measures, and ways to promote a healthy vaginal environment at every stage of life.

Vaginal Health in Adolescence and Young Adulthood

In adolescence and young adulthood, vaginal health often takes a backseat to other aspects of physical and emotional development. However, it is during this period that the foundation for lifelong vaginal health is established. Here are some key considerations:

• Menstrual Hygiene: Proper menstrual hygiene practices are essential to prevent infections and discomfort. Young women should be educated about using suitable menstrual products and changing them regularly.
• Sexual Health Education: Understanding sexual health, safe sex practices, and the importance of regular check-ups is vital to prevent sexually transmitted infections (STIs) and unplanned pregnancies.
• Avoiding Douching: Douching disrupts the natural pH balance of the vagina and can lead to infections. Encouraging young women to avoid this practice is crucial.
• Pelvic Floor Exercises: Young women can benefit from pelvic floor exercises (Kegels) to maintain vaginal muscle tone and support urinary and bowel functions.

Vaginal Health in Adulthood

As women enter their reproductive years and beyond, vaginal health becomes a more prominent concern. Here are some age-specific considerations:

• Pregnancy and Childbirth: Pregnancy and childbirth can cause temporary changes in vaginal health. Women should receive adequate prenatal care and postpartum support to address any issues that may arise.
• Menopause and Perimenopause: The hormonal changes associated with menopause and perimenopause can lead to various vaginal symptoms, including dryness, irritation, and decreased elasticity. Hormone replacement therapy (HRT) and over-the-counter lubricants can help alleviate these symptoms.
• Pelvic Organ Prolapse: As women age, the risk of pelvic organ prolapse increases. This condition can lead to discomfort and urinary incontinence. Pelvic floor exercises and, in some cases, surgical interventions can provide relief.
• Regular Gynecological Check-Ups: Regular check-ups with a gynecologist become even more crucial in adulthood to monitor and address any emerging issues promptly.

Vaginal Health in the Golden Years

In the later stages of life, maintaining vaginal health can significantly impact a woman’s quality of life and overall well-being. Here are some key considerations:

• Vaginal Atrophy: Vaginal atrophy, a common issue in postmenopausal women, can lead to thinning and drying of the vaginal tissues. Treatment options may include topical estrogen creams, non-hormonal moisturizers, and laser therapy.
• Sexual Health and Intimacy: Open communication with a partner and healthcare provider can help address any sexual health concerns that may arise due to age-related changes.
• Continual Pelvic Floor Exercises: Continuing pelvic floor exercises throughout life can help prevent incontinence and maintain vaginal muscle tone.

A Lifelong Journey

Vaginal health is a lifelong journey, with each stage of life presenting its unique challenges and considerations. By understanding how age impacts vaginal health and taking proactive measures, women can enjoy healthier and more comfortable lives. Open communication with your OB/GYN, regular check-ups, and a commitment to practicing good vaginal hygiene are essential components of maintaining vaginal health at every age. Breaking down the societal taboos surrounding this topic is crucial to ensure that women receive the care and support they need throughout their lives.

Our OB/GYNs Are Here For You

If you have questions about your vaginal health, our OB/GYNs are happy to help you. To schedule an appointment, please contact us at 770.720.7733 or simply request an appointment online.

There are a lot of surprising postpartum facts that many women aren’t aware of so this article delves into the unexpected realities that women may face after having a baby.

Welcoming a new baby into the world is undoubtedly a life-altering experience for any woman. Amidst the joy and wonder of motherhood, there are numerous surprising and often unspoken aspects that women may encounter postpartum.

Changes That Can Occur After Giving Birth

1. The Fourth Trimester: Many women are familiar with the concept of the three trimesters of pregnancy, but the fourth trimester is a term gaining recognition. This period encompasses the first three months after childbirth, during which a woman’s body undergoes significant changes in recovery and adaptation. From hormonal shifts to physical recovery, the fourth trimester is a unique phase that demands attention and care.
2. Brain Changes: After childbirth, a woman’s brain undergoes structural changes, adapting to the demands of motherhood. Areas associated with empathy, caregiving, and multitasking expand, enhancing maternal instincts. This neuroplasticity reflects the brain’s remarkable ability to reorganize, reinforcing the profound impact of motherhood on cognitive architecture.
3. Organ Changes: During pregnancy, a woman’s organs undergo remarkable adaptations to accommodate the growing fetus. The uterus expands exponentially, displacing nearby organs. The heart pumps more blood to support both mother and baby, and hormonal changes affect the kidneys and lungs. These intricate adjustments ensure optimal conditions for fetal development and maternal well-being.
4. Hair Loss: A surprising yet common postpartum experience is hair loss. During pregnancy, hormonal changes often lead to thicker, healthier hair. However, after giving birth, hormonal levels shift again, causing a substantial number of women to experience hair shedding. While this can be alarming, it is typically temporary, and most women see their hair return to its normal state over time.
5. Postpartum Contractions: Contrary to expectations, contractions do not necessarily end after the baby is born. Postpartum contractions, also known as afterpains, occur as the uterus contracts and returns to its pre-pregnancy size. These contractions can be surprisingly intense, especially during breastfeeding, as the hormone oxytocin is released, triggering uterine contractions.
6. Body Changes Beyond Weight Loss: Postpartum body changes go beyond the focus on weight loss. Women may find themselves with a changed body shape, stretched skin, and lingering discomfort. Embracing and adjusting to these changes is an ongoing process that requires self-compassion and patience.
7. Postpartum Hormone Rollercoaster: The hormonal rollercoaster doesn’t end with childbirth. Postpartum hormonal fluctuations can contribute to mood swings, anxiety, and other emotional changes. Understanding and acknowledging these hormonal shifts is crucial for women as they navigate the emotional landscape of the postpartum period.

Our OB/GYNs Are Here For You

The postpartum period is a time of immense joy, challenges, and surprises. By shedding light on these unexpected facets of the postpartum journey, women can better navigate the transitions and changes that come with new motherhood. From physical transformations to emotional shifts, each woman’s postpartum experience is unique, emphasizing the importance of self-care, support, and open communication about the realities of life after childbirth.

Call us today to make an appointment with one of our OB/GYNs at either our Canton or Woodstock location or schedule an appointment online.

An Interview With Michael Litrel, MD, FACOG, FPMRS – Part 1 of a 3 Part Series

Links to Part 2 and Part 3 of Dr. Litrel’s interview below.

One of your areas of specialty is Cosmetic Gynecology, especially vaginal rejuvenation. Can you expand a little on the subject of vaginal rejuvenation?
Originally, as female reconstructive surgeons, we would operate on the vagina or internal and external genitalia. We took care of medical issues such as bulges or weakness that prevented the organs from working properly.

Vaginal rejuvenation is a more recent elective surgery to enhance the visual appearance of a woman’s genitalia. Over the past twenty years, the field of Cosmetic Gynecology – especially vaginal rejuvenation – has become the fastest growing niche in plastic surgery. As the popularity increased, we began to see patients who’d been encouraged to undergo plastic surgery – from surgeons who don’t specialize in women’s pelvic anatomy. We’d find ourselves called in to correct whatever mistakes had been made in those procedures – but the problems were not always ‘fixable.’ It became obvious that the best thing we could do was to offer Cosmetic Gynecology ourselves, and at least insure that the women who came under our care could avoid the irreversible damage from inexpert surgery, and receive the benefits of surgery from Pelvic Reconstruction Specialists.

Apart from esthetic merits for visual genital distortions, or internal adjustments that restore tautness and sexual pleasure, what other conditions can be corrected, with these procedures?
When it comes to external cosmesis, which is surgery performed outside the body, we mostly treat conditions like elongated genitals or labia which may interfere with clitoral stimulation. It’s mostly anatomical—things are too long, getting in the way, disrupting sexual pleasure or causing orgasmic inability.

Vaginal surgery consists mostly of correcting “bulges,” be they bladder, rectal or intestinal bulging. We increase the caliber of the vagina to allow for better sexual sensation. Since the vagina leads to the internal sexual reproductive organs, if there’s pain or bleeding or scar tissue, lots of times those things have to be corrected surgically as well.

Sexual interest and gratification often diminish over time, due to a number of reasons such as lack of lubrication, the loosening of vaginal tissue and muscle, etc. Can pelvic reconstruction or vaginal rejuvenation give women a renewed sense of sexuality and confidence—and if so – how?
I think it’s a very individual thing. I’ve taken care of thousands of women and sexuality issues can vary. They can come from anatomical differences between partners, hormonal issues– even lack of awareness of proper technique. The list is endless, so I’m not going to say “have surgery and it will fix everything.” I’ve seen the full range of what causes problems, and I deal with them all on an individual basis.

As an example, I saw a patient recently who came from a neighboring state. After asking questions about the pain she was experiencing, I examined her and found there was nothing physically wrong with her. After speaking with her, I was able to pinpoint that the real problem stemmed from sexual abuse. I’m able to treat the anatomical problems, but a lot of these complaints simply must be addressed through counselling. I certainly wouldn’t recommend surgery in her case, but would guide her to other venues of help. It’s a complicated subject and doesn’t really have one answer.

Are the benefits of pelvic reconstruction and vaginal rejuvenation permanent, or does time eventually cause the original problems to recur?
I’ve seen patients I’ve operated on 10 years ago, and they’re doing great. For a lot of anatomical problems, if we fix them and they don’t suffer damage, they stay fixed. For instance, if a woman has a normal sex life and doesn’t have a baby, she probably won’t need surgery, and then, if it’s a cosmetic thing, such as labial elongation (hypertrophy), then once you fix that, it’s not going to grow back. It’s not common to have to re-operate.

For the cosmetic parts, however, sometimes you have to perform a few nips and tucks six months or a year later. But typically, that’s not necessary either. As for the tightening operations, once you do it, you’re done.

Many people might describe the procedures we’ve covered as “frivolous,” “unnecessary,” “a waste of money,” etc. Their assumption might be that you need to accept yourself “the way you are.” Can you describe the positive physical and psychological impact these procedures have had on some of your patients during your extensive career?
Fifteen or twenty years ago, I probably would have said the same thing. I remember I was very much against breast implants at one time, but over years of practicing, I’ve noticed that it helps some women feel better about themselves, and we all want that.

Now, in the field of Cosmetic Gynecology, with procedures such as vaginoplasty or, labiaplasty, the reason we, as female reconstructive surgeons are in this field, is because we know we’re the best at fixing it and we know that it’s not just about cosmetic surgery. It’s functional as well. Unlike a breast implant, face lift, or even a tummy tuck, none of which really have a function, internal and external genitalia are functional. Whether it’s sex, urination or defecation, there’s a biological function that’s dependent on the correct anatomical restoration of a woman’s body. So in terms of ‘frivolous,’ well, if you’re fixing a bulge here or there because a woman’s bladder is dropping or leaking, or you’re fixing the rectum bulging out, you can also do a tightening operation because the patient desires it for their sex life. I don’t think a good sex life is frivolous. I think it’s an important part of a relationship and it’s an important part of the way a woman feels about herself.

The word ‘surgery’ can be frightening and intimidating. It usually sparks the fear of pain, long convalescence, operative and postoperative complications, etc. On average, what is the recovery period for most of your procedures?
Typically – because we do less invasive surgery with laparoscopes and robots – one to three weeks. Certainly some healing processes can go on for three months, but after one to two weeks, people generally feel pretty good.

At one time, the standard treatment for conditions related to pelvic prolapse was a hysterectomy. It’s now possible to treat Pelvic Floor Disorders with pelvic reconstructive surgery. How has the specialty of pelvic surgery changed since you began? What conditions are fixable that women forty years ago would just suffer with?
Nowadays, the biggest changes have been the minimally invasive laparoscopic surgeries. We can visualize things better. We can access things and also repair things less invasively. Additionally, surgery is less risky than it used to be—better antibiotics, smaller holes. Tumors and organs can be removed with much tinier incisions. We do a lot more uterine saving surgery as opposed to hysterectomies nowadays.

What diseases, conditions or illnesses prevent a person from being a suitable candidate for pelvic reconstruction or gynecology cosmetics?
We have office procedures so that we can make things look better and work better without doing any surgery. If someone is sick with underlying medical problems, I don’t think they’ll be presenting with issues of vaginal laxity or problems of cosmetic appearance. They have bigger issues such as being unable to breathe, walk, etc. Typically I don’t see patients whose medical problems prevent them from having surgery. We can do more minimally invasive things for patients today.

I had a patient recently from North Carolina who was convinced I would have to perform countless surgeries. As it happened, all I had to do was a ThermiVa, a procedure which is a low frequency energy treatment we deliver in the office. It requires (3) thirty minutes treatments over a period of three months. I also have an 82 year old patient suffering from diabetes, and I’m still able to do something to help her.

Other than natural processes in the body such as aging, giving birth, etc., can your procedures repair such things as birth defects, accidental injuries, or physical trauma—and can these things be corrected even years after the damage has occurred, or is time of the essence?
Birth defects occur during birth and we certainly have to perform reconstruction because of that. This is not done in childhood, but when the person is diagnosed as an adult. If you’re referring to something like an anatomical variance, for instance, something like size and shape, or a congenital problem such as not having a uterus, vaginal septums, having two uteruses, or a hymen that doesn’t allow blood flow, typically, we do not address these issues until a woman is older. In fact, we may not become aware of them much before 15 years of age.

Defects can also happen during such occurrences as miscarriages. Typically, injury is not common. Unlike breaking an arm or something like that, the uterus and a woman’s genitals are very well protected, because they’re in the midline of the body and the center of gravity. So if injury does occur, it’s usually quite easy to repair.

To prevent such problems as infections, flaccidity, sexual discomfort, or sexual disinterest, what can women do to maintain personal gynecological health, other than general cleanliness, yearly pap smears and Kegel exercises?
I think that probably the most important thing that women can do is limit their number of sexual partners and just be sexually active with people that are faithful to them, love them and want the best for them. I think multiple partners are the number one cause of the problems that women have. If you marry someone, and have a good sexual monogamous relationship with them, it would solve most of the problems we see.

I have a 22 year old patient who is beautiful. She’s had several sexual partners. I did cosmetic surgery on her and some tightening, but she hates herself because of things her partner said to her regarding her genital appearance. Had she waited for the right, committed partner, he most likely would not have said anything and accepted her the way she is.

Many physical issues also come with a related psychological issue such as fear, shame, religious inhibition, etc. As a women’s health specialist, how do you personally deal with the psychological deterrents to put your patients at ease?
I think we’re all a little inhibited. It’s just part of being a person. Inhibitions tend to disappear when you’re in the process of having a baby come out of your body. Nothing will stop you from pushing out that baby. My specialty is OB/GYN, and my subspecialty is reconstructive surgery, so I’ve delivered thousands of babies, and women are generally comfortable with that. Many of my patients have gone through a lot, and I’ve gotten very close to them, but I think that’s only due to good communication. People want someone to help them, and if you let them know it’s okay to feel a certain way, then it’s okay to feel and express the pain, etc. They just need to be nurtured in such a way that we can open up the lines of communication.

Read Part 2 and Part 3 of Dr. Litrel’s interview.

Part 6 of Queen’s journey to motherhood. Our patient, Queen, shares her journey to motherhood after a high-risk pregnancy.

For Sheila, the experience of giving birth vaginally was nothing short of extraordinary. Giving birth is a momentous occasion, filled with an array of emotions ranging from excitement to nervousness. As she shares, Sheila discovered the true essence of strength, love, and empowerment.

Preparing for Motherhood

Throughout her pregnancy, Sheila meticulously prepared for the arrival of her little one. She attended childbirth classes, read numerous books, and sought advice from experienced mothers. Armed with knowledge and support, she felt more confident about the impending delivery. Despite the preparations, nothing could entirely alleviate the butterflies in her stomach as the big day approached.

Riding the Waves of Emotion

Sheila’s labor began gradually, and she found solace in the loving presence of her partner, who offered unwavering support. As contractions intensified, Sheila’s determination surged forth, and she surrendered to the natural rhythm of her body. In the hands of her compassionate obstetrician, she felt secure and nurtured.

As the hours passed, Sheila experienced the ebb and flow of emotions that often accompany labor. Yet, with each surge of pain, she recognized it as a reminder of the beautiful life she was about to bring into the world. Through deep breaths and unwavering focus, Sheila harnessed her inner strength, drawing upon the love she held for her unborn child.

Vaginal birth is an intricate dance of body and mind. Sheila had to relinquish control and trust her body’s innate ability to deliver her baby safely.

Welcoming New Life

And then, after what felt like both an eternity and an instant, Sheila heard her baby’s first cry. The room filled with joy, relief, and an overwhelming sense of awe. Sheila’s heart swelled with love as she held her precious bundle for the first time, also known as the ‘Golden Hour’.

In the aftermath of childbirth, Sheila experienced an overwhelming mix of emotions. Amidst the exhaustion, she marveled at the newfound strength she discovered within herself. Giving birth vaginally had unlocked an immense well of power that she never knew she possessed. The experience had transformed her, leaving her feeling like a warrior, ready to conquer any challenge that came her way.

Embracing Motherhood

The postpartum period brought its own set of trials, but the bond between Sheila and her baby strengthened each day, and she reveled in the joy of motherhood. In the toughest moments, she reminded herself of the incredible journey she had undertaken to bring her child into the world.

In conclusion, Sheila’s experience of giving birth vaginally was a transformative and empowering journey. From the initial trepidation to the overwhelming joy, the memory of that day will forever be etched in her heart, reminding her of the extraordinary strength and beauty that lie within the act of bringing new life into the world.

Here For You

Our OB/GYNs and certified nurse midwives are here for you. Call us today at 770.720.7733 to schedule an appointment or request an appointment online at either our Canton or Woodstock location.

As a 27-year-old woman, I had envisioned a natural delivery, but circumstances led me down a different path. For me, that meant getting a C-section. In sharing my personal experience, I hope to provide insights and reassurance to others who may find themselves on a similar journey.

The Unexpected Turn

As my due date approached, I eagerly prepared for the anticipated arrival of my baby. However, during labor, complications arose, and it became clear that a C-section was necessary for the safety of both my child and me. While I initially felt a mix of disappointment and worry, my healthcare team at Cherokee Women’s Health explained the situation with care and helped me understand that a C-section was the best course of action.

I’m Actually Getting a C-Section

Heading into the operating room, a mix of nerves and excitement filled my heart. The medical team made me feel at ease as they prepared me for the procedure. I was given anesthesia, and soon after, I felt a gentle tugging sensation as the doctors began their work. Though I couldn’t see what was happening, the support and encouragement from the medical staff helped me feel connected and reassured.

Meeting My Miracle Baby

As the surgical team worked efficiently, the anticipation grew. And then, a cry pierced the air—a sound that instantly melted my heart. I caught a glimpse of my beautiful baby as they were held up for me to see. Despite the different path my journey took, the overwhelming joy and love I felt at that moment erased any doubts or concerns I had about the C-section.

Recovery Challenges and Triumphs

C-Section recovery presented its own set of challenges, both physically and emotionally. The first few days were marked by discomfort and soreness around the incision site. However, with the guidance of my healthcare team, I found ways to manage the pain effectively. Walking slowly and gradually increasing my activity level played a significant role in my recovery. Along with rest, proper nutrition, and the support of my loved ones, I gradually regained my strength.

Embracing the C-Section Journey

Though my birth experience may not have followed the path I initially imagined, I’ve come to realize that it is not the mode of delivery that defines my journey into motherhood. It is the love, devotion, and bond I share with my child that truly matters. The C-section became a part of my story, and it doesn’t diminish the joy and fulfillment I experience as a mother.

A Message of Support

To any woman who finds herself facing a C-section, remember that your journey is unique and valid. Embrace the unpredictability of childbirth, and don’t be afraid to lean on the support of your healthcare team, family, and friends. The bond you create with your child transcends the method of delivery.

My journey into motherhood through a C-section taught me valuable lessons about resilience, adaptability, and the unconditional love that accompanies motherhood. By sharing my story, I hope to empower and uplift others who may find themselves on a similar path. Remember, the birth of your child is a remarkable and awe-inspiring experience, regardless of how it unfolds.

Our Compassionate OB/GYNs Are Here For You

If you’d like to make an appointment with our diverse team of OB/GYNs at either our Woodstock and Canton location, please call 770.720.7733 or simply request an appointment online.

The physicians at Cherokee Women’s Health Specialists are committed to ensuring that your experience after surgery is as comfortable as possible. The following information will help answer frequently asked questions and will help you understand some of the common experiences that may occur after your surgery. Please do not hesitate to call the office with any additional questions about your recovery.

• Call the office to schedule a post-operative appointment two to four weeks after your surgery.
• If an ER visit is necessary post-operatively, go to Northside Hospital Cherokee if possible, but if you are an out of town patient or live in another state, then your closest hospital is appropriate.

Call the office at 770.720.7733 right away if you experience:

• Fever higher than 100.4 degrees
• Shortness of breath
• Dizziness
• Heavy vaginal bleeding
• Severe pain not relieved with your pain medication
• Persistent nausea or vomiting
• Increased pain, redness, or swelling at the incision

IF THE SYMPTOMS ARE SEVERE, GO TO THE EMERGENCY ROOM OR CALL 911 FOR AN AMBULANCE IF NECESSARY.

How Much Activity Can I Do After Surgery?

General – There are no standard limitations with regards to activity after gynecological surgery except for driving and sexual activity (see below). If you stayed in the hospital overnight, you should plan to rest with minimal activity for at least a week. If you were sent home the same day you should plan to rest with minimal activity for three days. If you had a procedure with no incisions (such as a D and C or endometrial ablation) then you probably only need to rest for a day. Use common sense and listen to your body. Every patient is different, and different patients will have differing degrees of recovery. Gradually advance your activity. If the activity you are doing increases your discomfort, then STOP. If you are feeling well during increased activity but have increased pain the next day you need to decrease your activity.

Adequate rest and nutrition is required to heal from surgery. LISTEN TO YOUR BODY.

Stairs – Apprehension about stairs or weakness in mobility may require help when climbing up and down stairs. You are allowed to use the stairs if you feel you are able. It’s a good idea to put both feet on each step to not lessen the strain on your body for a week or longer after surgery.

Exercise – If you had incisions on your body wait until you get clearance from your surgeon. Use common sense when starting an exercise routine after surgery. Start out slowly and gradually increase time, distance and speed. Once you are cleared to exercise a general recommendation is to start out at 25% of what you were doing before surgery for a week or two and increase by 25% at each one or two week interval.

Driving – Driving should only begin only after you have stopped taking narcotics, and if you feel strong enough to be able to stop the vehicle in an emergency. At this point you should be able to walk up and down stairs comfortably and sit down and stand up without experiencing discomfort. Have someone drive you if you are still experiencing discomfort.

What Should I Eat After Surgery?

After surgery, your body needs enough calories and nutrients to fully recover from the procedure. Eating the right foods after surgery can decrease risk of infection, speed healing of the incision and increase strength and energy. The best post-surgery foods to eat are packed full of vitamins and minerals.

Here are some foods and nutrients you should focus on in your post-surgery diet:

Fiber – A common complaint after surgery is constipation. To avoid this uncomfortable post-surgery complication, eat plenty of fiber. Some high-fiber foods include fresh fruit and vegetables. Whole grain breads and oatmeal are other great sources of fiber. To prevent constipation, avoid foods like dried or dehydrated foods, processed foods, cheese and dairy products, red meats and sweets.

Protein – The amino acids in protein help with wound healing and tissue regeneration. Protein can also help with strength and energy following surgery. Lean meats such as chicken, turkey, pork and seafood are excellent sources of protein. You can also get protein from eggs, nuts, beans and tofu. Dairy also contains protein, but if you’re struggling with constipation, go for the other sources of protein instead of dairy options. If you have trouble getting enough protein in your diet after surgery, try adding protein powder to drinks or smoothies. Several Physicians at Cherokee Women’s recommend a Vegan diet which is absence of animal products including meat, dairy and eggs. Eat to Live by Joel Furman MD gives excellent recipes and recommendations for those inclined.

Carbohydrates – Fatigue is common following any surgical procedure, but eating the right kinds of carbs can help restore your energy levels. Get carbs from high-fiber foods like whole grains, fruits and veggies, and beans and legumes. These foods will boost energy levels without causing constipation.

Fat – Healthy fats from olive oil, avocados, coconut oil, nuts and seeds will improve immune response and aid the body’s absorption of vitamins. Fat will also help increase energy levels after surgery.

Vitamins and Minerals – Perhaps the most important nutrients in your post-surgery diet are vitamins and minerals. Vitamin A (found in orange and dark green veggies like carrots, sweet potatoes, kale and spinach) and vitamin C (found in citrus fruits, berries, potatoes, tomatoes, melons, and sweet bell peppers) help with wound healing. Vitamin D (found in milk, fish, eggs, and fortified cereals) promotes bone health. Vitamin E (found in vegetable oils, nuts, beef liver, milk and eggs) protects the body from free radicals. Vitamin K (found in green leafy veggies, fish, liver and vegetable oils) is necessary for blood clotting.

Zinc – (found in meat, seafood, dairy and beans) and Iron (found in meat and poultry, beans, apricots, eggs, whole grains and iron-fortified cereals) are also helpful for wound healing and energy following surgery.

Water – In addition to eating foods that are rich in fiber, protein, healthy fats, carbohydrates, vitamins and minerals, you must stay hydrated after surgery. Proper hydration isn’t only necessary for healing, but may also be necessary to help your body absorb medications following surgery. Be sure to drink at least eight glasses of water every day after surgery to stay hydrated.

The foods you should and shouldn’t eat can vary depending on the type of surgery and any medications you may be on so speak with your surgeon about your specific post-surgery dietary questions.

When Can I Take a Shower?

You may take a shower the day after surgery. Baths are typically fine the day after surgery if you desire. Make sure you have someone around to help you should you need assistance. If you are experiencing discomfort a sponge bath is a fine substitute.

How Should I Care For My Incisions?

Keep your abdominal incisions clean and dry. No special creams or ointments are needed. Your incisions are closed with a suture underneath your skin, which will dissolve on its own. It is then covered with a surgical-grade liquid band-aid. This protects the incision and will stay in place for up to two weeks or longer. The glue can be removed after two weeks by applying some Vaseline to the glue for several minutes and then using soap and water and gentle scrubbing with a washcloth after two weeks. A small amount of bleeding at the incision sites is not uncommon. If it persists, call your doctor. Once the glue is removed it is OK to apply Neosporin to the incisions if they are red or inflamed. If you notice sutures poking through the skin you can trim them with nail clippers and/or see your surgeon.

How Long Will I Have Bleeding After Surgery?

Vaginal spotting may last for several weeks after gynecological surgery. Call the office if you have heavy bleeding, increasing bleeding, a foul odor, or if you have urinary or rectal bleeding. Removal of ovarian cysts or other gynecological procedures may cause your period to come within a few days after surgery.

I Have Large Bruise Near My Incision, Is That Normal?

Some patients will develop bruises at the incision sites. The incision sites are made by “trocars”, a plastic sleeve that is used for access during the surgery for the camera and for instruments. Sometimes these trocars cut tiny vessels just beneath the skin that cause limited bleeding. Even under the best of circumstances, it is sometimes impossible to see these small vessels. A bruise will develop that will resolve. Those patients with very large masses or fibroids may also develop bleeding at the incisions that can be more extensive due to longer manipulation of the trocar sites. Rarely, this bleeding can be very extensive, leading to a large bruise that tracts to the groin area. Please note that this type of bleeding almost always resolves. Pain or warmth may develop from the blood under the skin. Use Motrin 600 mg every six hours or 800 mg every eight hours to relieve the pain.

How Much Pain Will I Have After Surgery?

Incision – Pain around the incision sites is not uncommon, and will resolve over several days. Most patients describe pain as minimal or moderate, and will improve daily.

Pelvic and Rectal – Some patients describe pressure and pain with urination or with bowel movements. These symptoms resolve and are due to irritation to the rectum and bladder from the surgical procedure, and will resolve with time.

Chest and Shoulder – If you had laparoscopic surgery, the carbon dioxide gas used to insufflate the abdomen during the procedure (so the surgeon can see) will irritate the phrenic nerve in some patients, leading to mild to severe pain. This nerve tracks pain impulses from the lining of the chest cavity. The pain can occur during deep breaths. This resolves within two to three days, and is not worrisome. If the pain is extreme or does not resolve, a visit to the local ER is important to rule out other causes of chest pain, such as heart or lung issues.

Sore Throat – Some patients will have a sore throat from the tube that is placed during anesthesia. Throat lozenges or warm tea will help soothe the discomfort, and this will resolve within a few days.

General – Pain should resolve over time, and will get better every day. If pain persists or becomes worse, a visit to the ER at the hospital where the procedure was performed is recommended.

How Should I Manage My Pain After Surgery?

You will be given a prescription for Motrin and a narcotic (Percocet, Norco or Dilaudid) at the hospital prior to your discharge. To be effective, Motrin should be used in doses of 600 mg every six hours, or 800 mg every eight hours. Narcotics should be used sparingly since they will cause constipation. The first several days following surgery, most patients use mainly Motrin during the day, with use of a narcotic sometimes at night to help with sleep. Using a heating pad on the lower abdomen is safe. Coughing can be uncomfortable initially because of abdominal discomfort. Placing a pillow on the abdomen to support your abdomen while coughing can be helpful.

Is It Normal to Have Swelling?

Abdominal – Some degree of abdominal distension (swelling) is to be expected after surgery. This is due to distension of the intestines, and resolves over time. It is usually mild to moderate only.

Extremities – Swelling of the legs and sometimes arms is not uncommon after surgery. This is due to increased fluid given during the procedure. This will resolve over several days. If you notice persistent or increasing swelling, tenderness to the calf or calf pain, please call the office immediately. If one leg is more swollen and red than the other you should be evaluated by your surgeon or in the emergency room because of the risk of a blood clot in your leg (DVT) that can be life threatening.

I Have Constipation, What Should I Do?

Constipation is common after surgery and usually resolves with time and/or treatment. Constipation means that you do not have a bowel movement regularly or that stools are hard or difficult to pass. Constipation can be made worse by narcotic pain medications or decreased activity or decreased fluid intake.

If you are having vomiting in addition to constipation, or if your surgery involved the stomach or intestines, call your surgeon before using medications to treat constipation.

A common approach to constipation after surgery is to take a laxative (eg, magnesium hydroxide [milk of magnesia]) or fiber supplement (eg, psyllium [Metamucil, Hydrocil] or methylcellulose [Citrucel]); this can be taken with a stool softener (eg, docusate [Colace]).

If the initial treatment does not produce a bowel movement within 24 to 48 hours, the next step is to take a stimulant laxative that contains senna (e.g,, Black Draught, Ex-lax, Fletcher’s Castoria, Senokot) or bisacodyl (e.g,, Correctol, Doxidan, Dulcolax). Read the directions and precautions on the package before using these treatments.

If these treatments do not produce a bowel movement within 24 hours, you should call your healthcare provider for further advice.

Once the bowels begin to move, you may want to continue using a stool softener (e.g., docusate (Colace) or a non-stimulant laxative (e.g., MiraLAX/GlycoLax) on a daily basis to keep the stools soft. This treatment may be taken for as long as needed.

I Have Diarrhea, What Should I Do?

Diarrhea sometimes is caused by antibiotics and will resolve once the antibiotics are stopped. A probiotic such as lactobacillus can help with this process. Rarely, severe diarrhea can develop. Call your doctor if you have severe diarrhea, bloody diarrhea, or if your diarrhea is accompanied by fever or worsening pain.

I’m Nauseated, What Can I Do?

Anesthesia is the main cause for nausea immediately after surgery. After the first 24 hours, nausea is more likely caused by either your narcotic pain medication or your antibiotics. You will be sent home with nausea medication such as Phenergan or Zofran. If you are experiencing severe nausea, please call your doctor.

Will I Have Problems With My Bladder?

If you have had vaginal surgery, you may feel a pulling sensation during urination or you may feel sore if the urine falls on vaginal stitches. It can be normal to urinate frequently after surgery. Call your surgeon if you have any of the following:

• Burning with urination
• Needing to urinate frequently or urgently and then urinating only a few drops
• Temperature greater than 101ºF or 38ºC (measure with a thermometer)
• Pain on one side of your upper back that continues for more than one hour or keeps coming back
• Blood in your urine (you can check to see if this is just vaginal blood falling into the toilet by holding toilet tissue over your vagina)

What Should I Do if it is Difficult to Urinate?

Most women urinate at least every four to six hours, and sometimes more frequently. If you have not urinated for six or more hours (while you are awake) or if you feel the need to urinate and it will not come out, you should call your healthcare provider. Urinary retention is the inability to pass urine through the bladder.

A very small number of patients will develop this problem due to the anesthetic used for the surgery or if they had incontinence surgery. If you are sent home and are not able to pass urine, please go to a local emergency room. A catheter may be placed to allow the bladder to “rest” after the surgery, and will be removed several days later in the office. It is important to have this catheter placed to avoid injury to the bladder. If you have a self-cath kit and instructions how to use it, you may do this instead of seeking medical care.

When Can I Resume Sex?

Intercourse should be avoided until cleared by your surgeon. If your surgery did not involve the vagina or cervix, intercourse can typically resume in two to three weeks. If you had a hysterectomy or surgery in the vagina, you should avoid intercourse for a minimum of eight weeks to allow the top of the vagina to fully heal. Make sure you are examined by your surgeon and cleared. Avoid deep penetration initially until you are completely comfortable. Clitoral orgasm (stimulating the clitoris without vaginal penetration) is typically fine after gynecological surgery, unless you had surgery on your labia minora or majora, in which case you need to get clearance from your surgeon.