What Happens to Your Vagina After You Have a Baby
Dr. Litrel discusses what happens to your vagina after giving birth and explains pelvic organ prolapse. Watch more Urogynecology videos below.
Dr. Litrel – Food, Books and Mastery
An Interview With Michael Litrel, MD, FACOG, FPMRS What was your first job? I was a waiter at Kennedy Airport, at the international arrivals building. I was seventeen years old, and had to wear a bow tie. It was great preparation for being a doctor. I met people from around the world, served people with their basic needs, and I had to utilize my time efficiently. I shuttled between tables just like I do between exam rooms – and I tried not to drop anything. What is your legacy? How do you want to be remembered?As the longest living person alive? (He laughs.) I want to have always done my best, and to have always been honest, and to accomplish what God had put me on the planet for. What book has influenced you most? In 1984 I read The Road Less Traveled by Scott Peck. That really influenced me a lot. I also really like Richard Bach’s book, Illusions. Other books include Mere Christianity, by C S. Lewis, and The Prophet, by Kahlil Gibran, which has influenced me a lot again this year. One of my all time favorites that I’ve reread for several years is The Holy Man, by Susan Trott. It’s short, funny and quite profound. A book that’s influenced me this year is The Life-Changing Magic of Tidying Up by Marie Kondo. I especially recommend it to young mothers. Handling stress by “Tidying Up” What words of wisdom would you pass on to your childhood self? I think believe in yourself and know that the dreams in your heart are gifts from God to pursue. And I would say that I think there’s so much bad stuff – and it’s so easy to believe the bad stuff – but what’s most important is to believe the good stuff, and to then pursue. Never give up. Keep endeavoring despite the pain and the sadness. If you could master one skill right now, what would it be? Surgery. That’s the skill I’m most endeavoring to master. You don’t cut into the human body willy-nilly. During each and every individual operation, I try to master the surgery. I think the pursuit of mastery is the purpose of life. You have to seek mastery. You can master the ability the walk at two years old, but that doesn’t mean you don’t trip sometimes. When performing surgery, I think that I serve, not that I’ve mastered. In every surgery, my goal is to serve each patient and God at the same time. Okay, a question just for fun – If you could only eat one meal for the rest of your life, what would it be? Chinese food. I really like Szechuan beef, but now I’m a vegetarian. I’m an aspiring vegan so I’ve given up a lot of my favorite foods. Cookies, a personal favorite, are sadly not on the list. FUN FACTS Unexpected Twin Dr. Litrel is an identical twin. Born before the technology of ultrasound, he was unexpected until the very day he and his brother Chris were delivered. His first birth certificate named him “Baby B” Chinese-Italian Culinary Mutt Dr. Litrel grew up eating custom ravioli from his Italian father’s pasta shop on Long Island, and authentic Chinese dishes homemade by his Chinese grandmother in the Bronx Healer With a Black Belt Dr. Litrel is a lifelong martial arts student. He has studied karate, chi gong, bando, tai chi, and has a black belt in tae kwon do. He has also studied the Japanese healing art of Reiki. POP QUIZ: How well do you know Dr. Litrel? Which of these jobs has Dr. Litrel NOT had? A. EMT (Emergency Medical Technician) on ambulanceB. High School Chemistry TeacherC. Forensic Intern (assist with autopsies)D. Waiter ANSWER:Sorry – trick question! Dr. Litrel has worked in ALL these jobs.
A Ritz Cracker Kind of Guy
by Michael Litrel, MD, FACOG, FPMRS My doctor partners and I take turns being on call for the holidays. Two years ago, my turn fell on Thanksgiving, and as I looked across the table at my loved ones and listened to their loud and animated conversation, I remember noticing they all seemed to be in various states of inebriation. I began to wish the hospital would call me. Nothing is more annoying than being the only sober one at the dinner table. Especially when you paid for all the wine. I realized there were three ways to handle my unhappiness. One, I could make sure I wasn’t on call the following year so I could join in the frivolity. Two, I could cultivate new friends and family who were less inclined to intoxicate themselves at holiday meals. Or three, I could view this moment of unhappiness as a spiritual lesson and walk more strongly the path of Love. The decision was easy. I decided not to be on call again. Holidays are stressful, but particularly so for women. Women are more aware of the subtleties of celebration. They put effort into aesthetic touches that would never dawn on a man. The intention, I believe, is to manifest beauty. But sometimes the result is marital conflict. Every Thanksgiving, Ann makes six dozen homemade crackers called “Cheddar Crisps” that come in three flavors: cracked blacked pepper, caraway seed, and something called nigella seed. Ann carefully sequesters her crackers in a tin box to be doled out at the right moment. Every guest is given three crackers just after saying grace, one of each flavor – and a bowl of butternut squash soup. It’s such a big deal to Ann that you handle each cracker like Grandma’s antique tea cup. Unfortunately, I am more a Ritz cracker kind of guy, accustomed to shoveling large quantities into my mouth until I am full. So for me this homemade cracker stuff is holiday stress. How do I express genuine appreciation for the work my wife has put into this pre-Thanksgiving snack, without conveying my true thoughts? Stop wasting so much time already – they’re just crackers! Instead, I channel Effete Cracker Connoisseur, solemnly critiquing the subtleties of each flavor and commenting about how the steam from the soup opens up the palate so one can fully appreciate the differences. But truthfully, I just wanted Ann to stop making them. Last year I got my wish. I was not on call, and no homemade crackers were to be found! But I noticed a few things. Free to imbibe a glass of wine, I found I did not want any, but instead chose sparkling water. And the sodden idiots inclined to boorish conversation I remembered from the year before were actually beautiful people I am so very blessed to have in my life. But what surprised me most was that I actually missed Ann’s homemade crackers. It’s not always easy for a man to appreciate the attention to detail an effortful woman brings into her family’s life. Sometimes what she does seems frivolous – and God knows, sometimes it’s expensive. But there is a reason for a woman’s efforts, and this I understand – as a father, as a husband of twenty-eight years, and also as a physician who has listened to women carefully over the years. A woman gives life to her children, brings beauty to her home, and creates ties in her community. A woman makes life more beautiful for us men – Whether we want her to or not.
The Great Mesh Debate: Unraveling the Basics
by Peahen Gandhi, MD, FACOG, FPMRS Since the 2008 FDA Public Health Notification regarding use of transvaginal mesh for use in pelvic organ prolapse repair, there has been much controversy. Pelvic organ prolapse (POP) is a gynecologic condition that affects nearly a third of middle-aged women. POP is essentially weakness of the muscles that hold the pelvic organs in place, causing a bulge to be felt by the patient. I often describe it to patients as a sort of “vaginal hernia.” Symptoms include pelvic pressure, incontinence, and may affect sexual activity. The reason why the use of synthetic mesh or biologic grafts came about is that in some women, their own tissue was not strong enough to uphold the repair. Pelvic Floor Surgeons are Specially Trained to Treat and Diagnose Pelvic Organ Prolapse I discuss with my patients both non-surgical and surgical options. When discussing the surgical options, I often hear patients say, “you are not going to use that ‘mesh’ in me, are you? I see it all over the TV, these lawyers say it’s dangerous.” As a surgeon specializing in female pelvic medicine and reconstructive surgery (FPMRS), it is paramount that my communication includes a discussion of the indications, risks and potential benefits of any POP procedure. As FPMRS board-certified physicians, Dr. Litrel, Dr. Haley and I have specialized training and education regarding POP repair with use of mesh. Pelvic floor surgeons trained in the use of these devices and that have properly counseled their patient on potential risks, have low complication rates. Patients need to know this important fact. Individualized Treatment Plans Tailored To You Individualized patient-centered treatment plans are the key to limiting potential complications. When patients come for a consultation, there are three key elements to the visit: Detailing the symptoms most distressing to the patient is important in tailoring a plan of care to meet her expectations. A complete physical exam helps to delineate the source of the pelvic floor weaknesses. Lastly, the treatment plan should include not only the correct surgical procedure for the patient, but also an outline of how to avoid future recurrence of the prolapse. This includes discussing pursuing an overall healthy lifestyle (i.e. healthy diet, smoking cessation, routine exercise). We’re Here to Help I want patients to know that their specific prolapse needs can be met by a variety of surgical techniques, including mesh as one of them. When properly placed by a board-certified urogynecologist and pelvic reconstructive surgeon, the complication rates are low. Empowering my patients with knowledge assures their eventual satisfaction with their final decision. To schedule your GYN appointment or surgical consult, call 770.720.7733 or schedule an appointment online.
What is ThermiVa?
ThermiVa is a technology that helps women reverse the effects of childbirth and aging. Learn more in this video by Dr. Litrel. Watch more Vaginal Rejuvenation videos below.
How to Choose a VR Surgeon
Choosing a doctor is a highly personal decision. Patients must weigh credentials and experience alongside bedside manner and comfort levels. For a gynecological procedure, finding a surgeon who is skillful and amiable is paramount. Here are two helpful tips for how to choose the right vaginal rejuvenation surgeon. c Choose an Experience Surgeon Before considering anything else, find a board-certified surgeon with the right experience. Many plastic surgeons don’t specialize in gynecological surgery. Because of this, vaginal rejuvenation is often misconstrued as a purely cosmetic procedure. Not only are the surgeons at Cherokee Women’s Health board certified in OB/GYN procedures, they have decades of experience in specialized surgeries. Because of their extensive knowledge about the sensitivity of vaginal rejuvenation, they’re able to provide each patient with better results and faster recoveries. Be Comfortable with Your Doctor Finding a board-certified gynecologic surgeon should be the first step when choosing vaginal rejuvenation, but the doctor-patient relationship is just as crucial. Schedule a consultation with your surgeon. You should feel comfortable asking questions and discussing desired outcomes with your GYN. Write down a list of questions prior to your consultation. 4 Important Questions to Ask Your VR Surgeon: What training do you have in gynecology surgery? How many vaginaplasties or labiaplasties have you performed? What tools do you use? How long is the procedure, and what can I expect during recovery? Always weigh both practical and personal concerns when choosing a vaginal rejuvenation doctor. Find a surgeon with training and experience who puts you at ease. If a physician has training but no bedside manner (or vice versa), keep looking. You want to feel completely comfortable during the procedure and recovery. Our Vaginal Rejuvenation Experts are Here for You For more information on choosing a qualified surgeon, call us at 770.720.7733 or schedule an appointment online.
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Troubleshooting Common Breastfeeding Problems
Breastfeeding provides countless benefits to both mother and child. It creates a bond between a mother and her baby, giving the two newfound intimacy outside of the womb. Breast milk also provides infants with nutritional benefits they won’t receive anywhere else, ensuring the fast physical and mental development of newborns. Breastfeeding is the most natural thing in the world, but that doesn’t mean it’s without its difficulties. Common Breastfeeding Problems Milk production. Many mothers worry that they’re not producing enough breast milk to keep their babies fed. If you’re worried about milk supply, monitor your infant’s behaviors. If your child is not audibly swallowing, seems dissatisfied after breastfeeding, or produces fewer than 6-8 wet diapers and 3-4 soft, yellow stools per day, ask your OB about supplementing your baby’s diet. Mothers can also encourage breast milk production by drinking lots of water, ensuring easy latching, emptying both breasts at every feeding, using a pump between feedings, nursing at night, and eating OB recommended foods to encourage a healthy supply of milk. Latching pain. Latching pain is common in the weeks after birth, especially for first time mothers. Reposition your baby so his mouth covers more of the nipple below the areola than above. If you have dry or cracked nipples, wear loose clothing, apply lanolin cream between feedings, and let a little milk air dry on the nipple after each feeding (breast milk is a natural healer for you and your baby). Too much milk supply. Nurse more frequently to limit engorged breasts. Clogged ducts. If you aren’t draining your milk supply, you may notice clogged ducts or lumps on the breasts. Nurse more frequently and make sure your nursing bra isn’t too tight. If you experience redness, aching, or fever, you may have an infection. Ask your doctor to prescribe an antibiotic. At Cherokee Women’s Health, we dedicate ourselves to providing optimal care to moms and their babies. Call to schedule an appointment with one of our exceptional board-certified obstetricians or midwives.
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James Haley, MD, FACOG, FPMRS: Becoming a Doctor is a Challenge and a Calling
Dr. Jim Haley has just finished a morning performing surgeries in the O.R., and is headed into a full afternoon schedule of patients. Chatting as the interview begins, he mentions that when the weekend comes, he’ll be participating in his first Obstacle Race – a run in which he will face mud pits, barb wire, and ice baths. “I guess I’ve always been drawn to action,” Dr. Haley smiles, “life and death drama. From the time I was 13 or 14, it seemed to me I was supposed to be a doctor. I figured maybe surgery or E.R. medicine. But when I got to medical school and delivered my first baby, I knew right then I wanted to be an obstetrician. “I don’t remember this, but after that first delivery, my wife Lisa tells the story of me coming home just laughing off and on all night – because it was SO COOL. I’d never experienced anything like that before! “I’m drawn to challenges. There’s a lot of challenges to being an obstetrician – the training, being on call, the long hours, and dealing with such an important part of peoples’ lives. But it seems like the challenges drive me in life – physical challenges, too. “Over the years I’ve been in 7 marathons, 1 ultra marathon, 15 triathlons, and 1 Iron Man. (An Iron Man is a Triathlon in which the participant swims 2.4 miles, runs 26, and bikes 112.) Recently, Dr. Haley also became one of the select number of Georgia OB/GYN’s to be board-certified in the subspecialty of FPMRS, Female Pelvic Medicine and Reconstructive Surgery. He says simply, “I like to go after things that are hard to do.” What experiences have shaped you as a doctor? “One great memory about being an OB was getting to deliver my two children. And it made me laugh, too. I’d delivered lots of babies and watched them being taken to the nursery afterward. But I noticed that this delivery was different: they weren’t taking this one away. They were leaving him in the room. And I had to laugh when I realized that was because he was mine. “But something that had a big impact on me was that Lisa and I had two miscarriages – I think this was God’s way of helping me be empathetic about the pain my patients feel when they lose a baby.” Do you have a philosophy about practicing medicine? Dr. Haley mentions his faith directly and without self-consciousness. “I think of being a doctor as my calling. I love the Lord, I love my family, I love my wife Lisa. As a Christian, we are called to serve and help others – this is the calling God has designated for me, and how I can do that.” Click here to learn more about Dr. Haley, and to watch his interview. FUN FACTS about Dr. Haley Top Doctor Dr. Haley was named “Patient’s Pick Top Doctor” for favorite Gynecologist in Cobb County by Atlanta Magazine in 2012. Iron Man Dr. Haley’s done 7 marathons, 1 ultra marathon, 15 triathlons, and 1 Iron Man. (Swim 2.4 miles, run 26 miles, bike 112 miles.) New Orleans Boy Dr. Haley lived in New Orleans for 22 years before becoming a Georgian, with two brothers still there. During Hurricane Katrina, Dr. Haley’s mother, age 91, came to live in Rome, Georgia – and is still there!
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How to Manage Pregnancy Cravings
All women experience cravings, but with the fluctuating hormones of pregnancy, food cravings reach an all time high. A nutritious diet helps the physical and cognitive development of the baby on board, so it should come as no surprise that eating too much junk food can negatively impact your pregnancy. Learn how to curb pregnancy cravings (and know when it’s okay to indulge). What Women Need to Know about Pregnancy Cravings Eating healthy foods boosts the wellbeing of a mom and her baby during pregnancy. Following a nutritious diet improves the child’s brain development, lowers the risk of pregnancy complications and birth defects, and helps keep both mom and baby at a healthy weight. Does that mean expectant mothers can never indulge? Of course not. Recent medical research suggests that it’s alright to indulge, even in items previously thought off limits, like limited amounts of caffeine. However, the idea that pregnancy cravings tell moms their body needs is unsubstantiated. Pregnancy cravings, though harder to ignore than regular cravings, are often nothing more than a hormone-hijacked thought that, “That sounds delicious right now.” How to Curb Pregnancy Cravings What’s a mom to do when the cravings strike? Before reaching for comfort foods, learn how to deal with pregnancy cravings. Know what your cravings mean. While a craving for chocolate may just be a craving for chocolate, cravings for nonfood items like ice, cornstarch, or charcoal may be a sign of pica. Always notify your doctor if you experience unusual (especially nonfood) cravings. Always resist eating raw seafood, meat, or eggs; unpasteurized milk; unpasteurized juice; and raw vegetable sprouts. Avoid drinking herbal teas or alcohol. Eat a balanced diet recommended by your obstetrician or midwife to reduce pregnancy cravings. Eat every few hours to avoid dips in blood sugar. Keep active as recommended by your doctor. When to Indulge Pregnancy isn’t nine months of self-denial. Try these healthy ways to indulge pregnancy cravings. Find the source of the craving. Are you really craving chips, or are you craving crunch? Choose a healthy snack that satisfies your base need. Eat healthy versions of your favorite snacks (like fresh fruit instead of sweet treats). Indulge in small doses. Instead of eating a king sized candy bar, try the fun-sized version. Don’t ignore the power of dark chocolate! Milk chocolate has few nutritional benefits, but dark chocolate is full of antioxidants. If you can’t curb your chocolate craving, trade that Hershey’s bar for something 60% cocoa or higher. Not sure what to eat during your pregnancy? Ask your obstetrician or midwife to create a nutritional meal plan to fit your needs. For more advice on prenatal health, call us at 770.720.7733.
Vaginal Rejuvenation Surgery: Three Common Questions
by Dr. Michael Litrel, FACOG, FPMRS Our vaginal rejuvenation patients continue to be extremely happy with their results, whether they’ve received their surgery in the hospital or as an in-office procedure. “Dr. Litrel performed my vaginoplasty and he’s simply amazing! I feel absolutely wonderful and have done nothing but brag about him and his staff. I highly recommend your office. I was expecting more pain and downtime but I feel great! I sit at a desk all day and I’m going to work today. No pain meds for 24 hours. I had contacted another doctor’s office in your area prior to contacting you. I received your email response right away and it just felt right! From the time I first got in contact with your office, things fell into place and went so smoothly! I’ve never experienced this kind of excellent service at any doctor’s office I’ve ever been to. I was treated with such amazing courtesy and respect. I could not be happier with the care I received.” – Testimonial of patient Juana L. With all the discussions surrounding vaginal rejuvenation, many women considering the procedure may still find themselves with questions about it. This is completely normal, as vaginal rejuvenation is surgery, and should be treated as such. Here’s a look at three of the most common questions patients ask about the vaginal rejuvenation procedure. Am I a Good Candidate? Following vaginal births, women lose the strength and elasticity in the vaginal and perinatal area. These post-delivery complications can include urinary incontinence, pelvic or rectal prolapse, or loosened elasticity of the labia (the inner and outer vaginal lips) that may cause discomfort during physical activities. All of the above complications can benefit from the repairing and tightening of the vaginal tissue. Learn more! Download our FREE Vaginal Rejuvenation eBook. How Should I Prepare? If you’ve made the decision that vaginal rejuvenation surgery is something you want to have done, the most important thing you can do for yourself is to do your research. Find a specialist who is trained in Female Pelvic Reconstructive surgery, not just a plastic surgeon who claims they can perform the procedure to make sex more enjoyable. At your pre-surgery consultation, be ready with questions. Ask your surgeon about how long the surgery will last, what types of incisions will be performed, and if your surgery is considered a medically necessary procedure, find out about what insurance will and won’t cover. What Can I Expect After Surgery? The first 24-48 hours, patients can use ice packs to reduce the swelling. Routine everyday activity is permitted, and wearing loose clothing is highly recommended. You will be able to resume showering after the surgery, but use a soft washcloth and be careful not to scrub the incision areas. You will also need to avoid baths, pools, and hot tubs for four weeks post-surgery. Most patients can return to work after about a week, unless the nature of your work involves strenuous activity. For most women, the $10,000 question after having vaginal rejuvenation surgery is, “When can I have intercourse again?” This, of course, is dependent on the procedure and how well you take care of yourself afterwards. Most patients can resume intercourse within 8 weeks depending upon the complexity of their surgery. Want to Learn More About Vaginal Rejuvenation? To schedule a consultation about vaginal rejuvenation surgery, please call our female representative on her private and confidential line at 770.721.6060.
How VR Helps Women Reclaim Sexual Confidence
Increased sexual pleasure is one major reason women choose vaginal rejuvenation surgery. After childbirth takes its toll, bedroom activities often become less pleasurable for couples. Vaginal rejuvenation tightens lax vaginal muscles and smooths excess outer skin, giving women and their partners increased friction during intercourse. But the benefits of rejuvenative surgery go beyond merely the physical. Couples report that VR surgery improves the way they relate to each other during intimacy. Improving Confidence for Women after Childbirth During pregnancy and childbirth, a woman’s body goes through countless changes. New moms don’t simply face physical changes after childbirth, they experience emotional ones as well. Nothing can tarnish the amazing experience of motherhood, but in the months postpartum, it’s easy feel more like a mom than a person. Emotional exhaustion, combined with often unexpected changes to the look and feel of their most intimate places, makes many mothers lose sexual confidence. Intimacy becomes a chore instead of an emotional and physical connection with someone they love. Vaginal rejuvenation changes all that. It doesn’t simply improve the physical sensations of intercourse, but also boosts patients’ confidence by visibly smoothing and reshaping the vagina. This renewed self-confidence drives women to be more vocal about their sexual needs, more motivated to fulfill their partner’s desires, and more able to fully enjoy the improved sensations that result from vaginal rejuvenation. Our Vaginal Rejuvenation Experts Can Help Don’t let a dip in confidence derail your sex life. Learn how vaginal rejuvenation can improve physical sensations and emotional self-confidence in the bedroom. Schedule a consultation with one of Cherokee Women’s Health’s experienced, board-certified surgeons, or call us today at 770.720.7733.
A Patient’s Pelvic Prolapse Story
Dr. Gandhi talks with her patient Theresa, who shares her story of pelvic prolapse, hysterectomy and bladder sling surgeries. Watch more Urogynecology videos below.
