Author name: Diane

OB Patient Stories

HELLP Syndrome Diagnosis: A Life-Threatening Variant of Preeclampsia

HELLP Syndrome is a serious, rare condition that left undiagnosed can result in life threatening consequences. Cristie was diagnosed with HELLP in her 38th week of pregnancy. Dr. James Haley of Cherokee Women’s Health Specialists diagnosed her with HELLP when she was 38 weeks pregnant. A variant of preeclampsia, HELLP can be hard to diagnosis as symptoms are similar to preeclampsia. Thankfully, Dr. Haley recognized the symptoms and took immediate action, which resulted in Cristie delivering a healthy baby boy. If not for the early diagnosis, there may have been a much different outcome. It all started when Cristie began to feel a dull pain in her abdomen. She suspected it was just indigestion or heartburn. She had no idea that within just a few days, at 38 weeks pregnant, she would be diagnosed with HELLP Syndrome. Within days, Cristie would undergo two platelet transfusions, a plasma transfusion and deliver her baby boy Jack—with no epidural. This was Cristie’s second pregnancy, as she and her husband Jason had had a healthy baby girl named Charlotte just two years earlier, after enduring some fertility issues. Other than being diagnosed with gestational diabetes during both pregnancies — which she controlled with her diet and experienced no issues — this second pregnancy was going smoothly, just like her first one. When she began having upper abdominal pains, she assumed it was just heartburn or indigestion, as it first happened after dinner. However, the pain continued for the next few days, and she started experiencing nausea and fatigue as well. “Something’s Not Right” On day four, the pain got so severe, Cristie was reduced to tears. It was a Saturday night and she told her husband that she just knew something wasn’t right, so they called the after-hours number at Cherokee Women’s Health. When she explained the situation, the nurse told her to head to the hospital, as she may be going into labor. Admitted to the Hospital Once in Labor and Delivery, Cristie was given antacids and monitored for an hour. At this point, her cervix was only one centimeter dilated. Dr.  Haley was on call that night and after evaluating Cristie, decided to admit her. He told her he would give her some time to go into labor on her own, but if she hadn’t progressed by 5 a.m. he would start Pitocin to induce her labor. An Extremely Low Platelet Count Cristie had planned on an epidural when the time came, so Dr. Haley ran labs to prepare. One of the items checked were her platelet count. The primary role of platelets is to aid in clot formation to prevent bleeding. Although a woman’s platelet count may drop some during pregnancy, a normal platelet count in the third trimester would be approximately between 150,000 to 300,000. When they received the results, the nurse told Cristie that she thought there was a mistake because her platelet level was only 46,000. However, her records indicated that all were at normal levels just two weeks prior when she had the test done at the office. Cristie’s labs were repeated and this time the platelet count was even lower. The tests also revealed that her liver enzymes were very elevated. Diagnosed with HELLP, a Serious Variant of Preeclampsia Dr. Haley came in to discuss the results with Cristie and Jason and explained to them that she had developed a condition called HELLP syndrome. HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome is a life-threatening pregnancy complication that is a very uncommon variant of preeclampsia. Up until four days before she ended up in the hospital, Cristie had no symptoms. When she did develop symptoms, they were just abdominal pains and nausea. Throughout her pregnancy, she had no abnormal bloodwork either. Both HELLP and preeclampsia usually occur during the later stages of pregnancy or soon after childbirth. HELLP syndrome is rare, only occurring in approximately 1 to 2 out of 1,000 pregnancies. Early diagnosis is critical because serious illness and even death can occur in about 25% of cases. HELLP can be difficult to diagnose because of the already existing symptoms of preeclampsia, such as high blood pressure and loss of protein in the urine. HELLP Symptoms Symptoms of HELLP syndrome include: An Epidural Was Off the Table Dr. Haley told Cristie that she would need a platelet transfusion and that an epidural was off the table since her platelets were too low. Dr. Haley then assured her and her husband that he would call the blood bank and set everything up. Between midnight and 5 a.m., Cristie had two platelet transfusions. This brought her platelet level up to a safer level, but still not in the normal range. It’s Time! It was important that Cristie deliver soon so she was started on Pitocin later that morning. Dr. Haley had ended his shift, and now another OB/GYN from Cherokee Women’s Health was on call and came in to take over. At 9 a.m. things weren’t progressing enough, so her OB/GYN explained to Cristie that she needed to break her water to speed things along. Within 45 minutes baby Jack was born, on Father’s Day! It was a rough 45 minutes though, since Cristie had to deliver naturally. At one point, Cristie told her doctor she couldn’t do this and wanted to go home but she was assured she could. Cristie says she screamed so loud during the labor that the nurse from the room next door came over to tell them that her patient had planned to deliver naturally until she heard Cristie, she then changed her mind and requested an epidural! “Jason was there supporting me, holding my hand and doing what he could, but I couldn’t have done it without my OB/GYN. She was everything I needed. She was my birth coach, my doula, my mom figure and my doctor.” – Christie Cristie needed further transfusions, and also required continued monitoring of her blood pressure, platelets and assessment of her liver so

woman with low sex drive
Pelvic Organ Prolapse Education, Pelvic Reconstruction Education, Sexual Health, Shallow Vagina Education, Vaginal Lengthening Education

19 Reasons for a Low Sex Drive

If you find yourself asking, ‘What happened to my sex drive?’ you’re not alone. It’s a common problem for women, especially after giving birth or as they age. But there are many other reasons for a low sex drive, ranging from hormonal imbalances to lack of self esteem. That said, there is help available. 19 Reasons for a Low Sex Drive 1. Hormonal imbalances: The three hormones that impact a woman’s sex drive and reproductive organs are estrogen, progesterone and testosterone. 2. Menstrual cycle: Irregular periods or a lack of a menstrual cycle can wreak havoc on natural hormonal processes, causing a reduced sexual desire. 3. Age: Testosterone, progesterone and estrogen levels diminish as women age and enter menopause, causing lowered sexual interest, loss of muscle mass, compromised bone health and vaginal dryness that can lead to painful intercourse. As these hormone levels decrease, so does libido. 4. Antidepressants or other medications: Prescription drugs have side effects, and often includes a reduced sexual desire. Sexual dysfunction and even genital numbness may be attributed to some currently prescribed antidepressants. Blood pressure medications, antihistamines and sleep aids are just a few that can interfere with sexual desire. Always give your doctor a complete list of medications you are taking. 5. Lack of quality sleep: Fatigue and irritability can cause drowsiness, irritability and fatigue, which can cause a lack of sexual desire. 6. Birth control: Some oral contraceptives fool the body into believing it is pregnant by neutralizing the very hormones that enhance libido. If you notice a sudden disinterest in sex after starting birth control, speak to your doctor. 7. Alcohol, smoking or drug abuse: Smoking restricts blood flow to the body. The clitoris, labia and vagina become engorged with blood during sexual arousal, just like a man’s penis, so restricting this flow also restricts sensation and response to physical stimulation. Alcohol is a depressant. It dehydrates the body, dulls sensitivity and causes loss of vaginal lubrication. 8. Giving birth: Immediately after giving birth, a woman’s hormones cause an uproar in her body. Physical trauma to the vaginal area, possible postpartum syndrome and the exhaustion and stress of caring for a newborn amplify a lack of interest in sex. These issues may only last a few weeks or months, but if sexual desire remains low or nonexistent for longer, consult your doctor. 9. Genital conditions: Pelvic organ prolapse, tissue deterioration, fecal incontinence, urinary problems, atrophy and a small vaginal opening are only a few of the physical problems that can decrease sexual desire. If you experience pain with intercourse, or prolapse or incontinence is disruptive, seek treatment from a urogynecologist, a specialist in advanced female pelvic reconstruction.  10. Vaginal dryness: Many physical conditions — including giving birth, hormone imbalances or aging — can cause vaginal dryness. It often can cause painful intercourse, which in turn leads to a lack of desire. 11. Surgery: A hysterectomy with or without removal of the ovaries decreases the hormones necessary for sexual gratification. 12. Major health conditions: Cancer, high blood pressure, neurological disorders, hypothyroidism, diabetes, arthritis, infertility and coronary artery disease — along with the medications and procedures necessary to correct these issues — are just a few disorders that can lessen sexual desire. 13. Anemia: Low iron levels caused by heavy periods can result in anemia. Anemia reduces red blood cells and compromises a protein called hemoglobin whose job is to push oxygen from your lungs to all your body parts, including the pelvic area. Since blood is vital to the labia, clitoris and vagina to enhance erotic sensitivity, anemia can greatly subdue bedroom pleasure and cause fatigue, weakness and sexual apathy. 14. Depression or low self-esteem: Either of these emotional conditions can affect performance or pleasure by causing disinterest, especially if medication is being used to control the issue. If a woman lacks confidence,  she may shy away from physical contact, robbing herself of the gratification of a healthy sex life. 15. History of sexual abuse: Rape, assault and molestation can have a devastating effect on the psyche. Without counseling, the aftermath of these experiences can leave lifelong psychological scars, and it is understandable that a woman may avoid any future sexual encounters. 16. Trauma: Psychological trauma such as post-traumatic stress disorder (PTSD) can follow any highly disturbing event. Just as with sexual abuse, the repercussive emotions following the death of a loved one, a divorce, violence, being the victim of a crime, etc. may lead to sexual dysfunction and a lower sex drive. 17. Relationship problems: Constant tension and conflict with a loved one can slowly chip away at even the strongest of relationships. Anger and unresolved issues ultimately make their way into the bedroom, negatively impacting any activity that is still, or no longer, going on there. 18. Stress: Worries about health, finances or other everyday problems cause physical and mental tension. If a woman is unable to relax and enjoy sex, orgasm is impossible and frustration is inevitable, causing her to lose interest altogether. 19. Poor communication: Optimal sexual performance does not come naturally. It’s a learning process for both partners. Many couples avoid telling each other what pleases them in the bedroom. Whether it is due to shyness, fear of shock or ridicule, women sometimes avoid telling their mates what they prefer and, in time, come to dread intimacy altogether. How Can I Get Help? In order to get to the root of the problem, an honest discussion with your OB/GYN is necessary, as well as a list of any medications you are currently taking. Your doctor will ask relevant questions to find out whether the problem is physical or emotional. After an examination of the genital area, blood tests may be required to determine hormonal levels. Once a diagnosis is made, your doctor will move forward to correct the problem. It may be as simple as a change or alteration in medication or a new prescription. If surgery is indicated, most physical corrections are minimally invasive, can be done in our office and the recovery time is usually short. Get Your Sex Life Back So if you find yourself asking yourself,

o-shot woman
Sexual Health

Low Sex Drive

Do you have a low sex drive? If so, you’re not alone. About half of all women report having a low sex drive at one time or another in their lifetime. Lack of sexual desire, reduced sensation or pleasure and painful sex are common sexual problems that women routinely face. Women are quite capable of accomplishing anything, so if you’re experiencing a low sex drive or if your sex life isn’t exactly where you’d like it to be, you should know that help is available. If there is a decline or change in sexual desire and it is bothersome – or if you’re experiencing painful sex – it is necessary to seek treatment from an OB/GYN. With today’s resources and modern medicine, we are usually able to identify and treat the source of a lower sexual desire. What is a Normal Sex Drive? There is no “normal” when it comes to libido or sex drive. It is whatever you and your partner enjoy, and all couples are different. Sometimes couples are mismatched in their sexual desire but it doesn’t necessarily mean one is normal and the other is not. They just have different sexual appetites. However, if there is a decline or change in your sexual desire and it is causing a problem or troubling you, talk to your OB/GYN. There are different levels of libido and each woman is unique. The levels can rise and fall monthly, yearly and throughout a woman’s lifetime depending on physical and psychological factors. What are the Different Levels of Sexual Desire? Sexual desire is different for each woman and intensity can vary. It may range from heightened desire, where a woman may want sex one or more times a day (hypersexuality), to several times a week, once a month, once every few months or year, (hyposexuality) or not at all (asexuality). Doctors who specialize in sexual health explain that there are two different kinds of sexual desire: spontaneous and responsive. Usually while in a relationship, spontaneous sexual desire fades after several months or a couple of years. That is a completely normal phase of most relationships. Usually, as spontaneous desire fades, most women still react to responsive desire. Learn more about sex and relationships by downloading our VR eBook, written by our own Dr. Michael Litrel. Lists for $15.95 on Amazon but you can get it FREE by clicking the button below. While sex drives vary from woman to woman, there is no reason you shouldn’t have a satisfying sex life. Our OB/GYNs can help. Call us today at 770.720.7733 or schedule an appointment online.

brooke's ob patient story
OB Patient Stories

Quick and Unexpected Labor and Delivery

Brooke’s journey to motherhood seemed to happen quickly — from having baby fever to rushing to the hospital to giving birth! As a first-time mom, Brooke wasn’t exactly sure what to expect when she and her husband began trying to have a baby. Figuring it would take some time and special planning to get pregnant, she downloaded an app on her phone to track her cycle and bought a pack of pregnancy tests. However, very shortly after, her baby fever turned into a reality! One day, Brooke’s cycle tracking app notified her that it might be time to take a pregnancy test. She took the test and to her surprise, two pink lines appeared! “I took the first one and thought, ‘this can’t be right!’, so naturally I took two more. Sure enough, she was pregnant! I went from feeling really excited to really overwhelmed within the span of a few seconds. It was good excitement, I just needed my husband’s reassurance.” – Brooke recalling the moment of surprise Brooke felt great at the beginning of her pregnancy, with her only early symptom being morning nausea, which was relieved by over-the-counter remedies recommended by the physicians of Cherokee Women’s Health. Her pregnancy was relatively uncomplicated until halfway through her second trimester, when her lower legs and feet started to swell. “The swelling never went away. I’d wear compression socks all day long, every day, and I still swelled. It wasn’t a medical concern, just very uncomfortable! The care I received from everyone at Cherokee Women’s Health was great, especially the sonographer, Rachel. Every ultrasound was so fun and exciting with her.” Braxton Hicks or the Real Thing? As a nurse at Northside Hospital Cherokee, Brooke was still active and walking a lot before she went into labor. She felt cramps the day before delivery, but they weren’t consistent and were at least ten minutes apart. She figured they were Braxton Hicks contractions. “I wasn’t even willing to call them contractions because they weren’t nearly as bad as I’d expected. I even met my husband at Olive Garden for dinner that night!” – Brooke recalls of her contractions That same night, at 38 weeks pregnant, Brooke was up every other hour with slight pains. Since she had been experiencing similar feelings the prior two weeks, she wasn’t alarmed. “I wasn’t waking up and thinking, ‘Oh, I’m having contractions’, I was just waking up and thinking, ‘I must have to pee because I’m nine months pregnant,’” Brooke said. It was around 5 a.m. when the pains became stronger and closer together, although they were still 10 minutes apart. She still wasn’t too concerned and knew she didn’t want to go to the hospital until she absolutely needed to. Then suddenly, her pain started to feel like contractions and went from 10 minutes apart to four minutes apart in the span of an hour. “It was around 7:30 a.m. when I woke my husband up. To this day, he still laughs when he recalls that I had no urgency in my voice. He told me I just woke him up and said, ‘Hey, you might want to throw some stuff in the bag for the hospital,’ giving him the impression we’d have the baby in the next 24 hours.” As Brooke’s contractions intensified, she leaned against the bathroom countertops for support. The day before, she explained the 4-1-1 rule to her husband Brice, which is that you should go to the hospital when contractions are regularly coming four minutes apart, each one lasts at least one minute, and they have been following this pattern for at least one hour. With this in mind, Brooke’s husband looked at the app she was using to time the contractions and noticed they were much closer together and lasting longer than she thought. It was time to go to the hospital! Time to go to the Hospital Around 8:30 a.m., Brooke and Brice threw everything they needed into the car and headed to Northside Hospital Cherokee. They arrived 15 minutes later and Brooke was already in so much pain, she was unable to walk so her husband brought her a wheelchair, and they rushed into registration. Brooke’s contractions were two to four minutes apart at that point. “I was gripping the arm of the wheelchair at registration and told her my contractions might actually be closer than two to four minutes. Then I told her I thought my water had just broken. She said since it was my first baby, my water most likely didn’t break yet and then asked me to stand up on the scale to check my weight. After I stood on the scale, I saw a puddle of water in the wheelchair and on the scale. They quickly moved me to a delivery room.” – Mom-to-be Brooke, moments before giving birth On the way to delivery, Brooke was asked if she wanted an epidural. She answered that she wasn’t sure just yet. When they arrived in the room, the option for an epidural was taken off the table because Brooke was already nine and a half centimeters dilated! Midwife Susan Fischels Delivers Baby Carolyn Certified Nurse Midwife, Susan Fischels of Cherokee Women’s, was there to deliver Brooke’s precious baby girl. Brooke felt like her body kept wanting to go her left side, which she didn’t anticipate. Susan assured Brooke that moving positions was okay and to do what her body felt like it needed to do. With no pain medication and with Susan’s support, Brooke welcomed her baby girl, Carolyn, into the world at 9:52 a.m., exactly 55 minutes after arriving at the hospital. Carolyn weighed 6 lbs. 6 oz., which was ironically Brooke’s birth weight as well. “Susan was so fantastic. Her voice just cut through the chaos in the room. When she gave me directions, I locked in on them and followed her direction. As a first-time mom so far into labor and not having anything for pain, I was

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