Diane, Author at Cherokee Women's Health

A certified nurse midwife is a separate but complementary profession to an obstetrician. Physicians are experts in pathology (the study and diagnosis of disease) and should have primary responsibility for the care of pregnant women who have recognized complications or diseases. Midwives are experts in normal pregnancy and in meeting the needs of pregnant women that aren’t related to pathology. In many countries, midwives have the primary responsibility for women with uncomplicated pregnancies. Midwives Focus on the Natural Process With a focus on the normalcy of pregnancy and its potential for health, midwives view birth as a natural process that should be treated as such until there is evidence of a problem. Midwives are experts in supporting and enhancing the normal physiology of labor and delivery as well as breast-feeding. With our team of midwives, we are pleased to be able to give women more flexibility in regards to their labor and delivery options, ultimately offering them the best in prenatal care for each patient. Here is one of a handful of testimonials we have received about our midwives over the years: “Throughout my pregnancy I pretty much met all the doctors and the midwives. I love all of them and will never go to any other OB/GYN practice! All of you guys are AWESOME!” Pregnant or Soon to Be? We Can Help If you have more questions about the differences between an obstetrician and a certified nurse-midwife, don’t hesitate to call us at 770.720.7733 or schedule an appointment online with one of our midwives or one of our board-certified OB/GYNs.

How to Shop Pink for Breast Cancer Awareness

Diane /

Each October, the world begins to “think pink” when it comes to breast cancer awareness. With statistics such as “1 in 8 women will be diagnosed with breast cancer*”, it’s no surprise. But the good news? About 2.6 million female breast cancer survivors currently live in the United States*. And that number continues to grow thanks to research provided by the numerous foundations that make it possible. The “pink” campaign began in 1990 by the then-titled Susan G. Komen Breast Cancer Foundation but is now called Susan G. Komen for the Cure. Now it’s so much easier to purchase the items you regularly buy (or even splurge on a new one) and benefit breast cancer awareness and research at the same time. There are a lot of options for every type of personality and budget. When purchasing items to benefit breast cancer research, because of a phenomenon known as “pinkwashing,” be advised when you’re out and about and looking for items that truly do support breast cancer research. According to the Better Business Bureau, in order to make sure donations go to the right place, it’s best to research pink product claims before making a purchase. Ask questions, research the business, confirm the charity’s corporate sponsors, and lastly, consider a direct donation in lieu of purchasing an item. Choose your own favorite breast cancer outreach and research charity and donate to them directly, it’s tax-deductible that way.

Well Woman

Are You Getting Regular Mammograms?

Diane /

Each year, much of the world goes pink to help spread awareness for breast cancer. In an effort to do our part, Cherokee Women’s Health wanted to devote our first blog in the month of October to reminding women how important it is to get regular mammograms. According to the National Cancer Institute, women age 40 and older should have mammograms every 1-2 years, and women who are at higher than average risk of breast cancer (due to family history or women who carry the known mutation in either the BRCA1 or BRCA2 gene) should talk with their health care provider about whether to have mammograms before age 40 and how often to have them. What to Expect If you haven’t been to a doctor for a regular mammogram appointment yet, don’t worry – it’s a fairly painless process. Mammography is a fast procedure (about 20 minutes), and discomfort, if any, is minimal for most women.Mammograms require very small doses of radiation, however the risk of harm from this radiation exposure is extremely low. The benefits of mammography nearly always outweigh the potential harm from radiation exposure, but if you’re concerned about exposure to radiation (especially if you’re pregnant), it’s important to talk to your doctor about these concerns. Tips for a Successful Mammogram Here are a couple extra tips to help make sure your visit goes smoothly: Bring your past mammogram films/results with you. If you’ve been to the same facility before, make sure your past results are available to whoever is reading the study. Discuss your family history of breast and other cancers — maternal and paternal — with your doctor. Ask if your center has CAD — computer-aided detection — a tool that assists the radiologist in finding any areas of concern that need further attention. If you’ve been referred for a mammogram because of a suspicious lump or a finding on another test, get a detailed note from your doctor including the reason the mammogram has been ordered. Work with your doctor to compare your mammogram results with any other tests you may have had done, such as ultrasound or MRI. On the day of the exam, avoid wearing a dress, since you’ll need to remove your top for the test. Don’t wear deodorant or antiperspirant, since these can show up on the film and interfere with the test results. Schedule your mammogram to avoid the time when your breasts are swollen or tender, such as right before your period. In between your routine mammograms, it’s important to maintain self-checks each month. Women can do this in the shower, in front of a mirror or lying down, whatever they find most comfortable. If you have questions about routine self-exams or about mammograms, don’t hesitate to contact one of our offices conveniently located in Canton or Woodstock.

Menopause and Hormone Therapy

Could it be Perimenopause?

Diane /

Hot flashes are one of the most common symptoms of perimenopause, the time in a woman’s life right before she experiences menopause, or permanent infertility. During perimenopause, your body’s production of estrogen and progesterone rise and fall, and many of the other symptoms are a result of decreasing estrogen. Other symptoms of perimenopause include menstrual irregularity, sleep problems such as night sweats, mood changes, vaginal and bladder problems, loss of bone density, changes in sexual function or desire, and changes in cholesterol levels. Treatment for Perimenopause If you’re experiencing any of the above symptoms, you can make an appointment with your doctor to discuss the various treatment options, the most popular of which is hormone therapy. Hormone therapy can help relieve the symptoms of menopause. For women who still have their uterus, estrogen is usually given in conjunction with progestin, a synthetic version of the hormone progesterone. This helps reduce the risk of cancer of the lining of the uterine that occurs when estrogen is used alone. Estrogen is used to treat hot flashes specifically, which is the main complaint of women experiencing perimenopause symptoms. Estrogen can also relieve vaginal dryness and can help to relieve some changes that can cause problems associated with urinary incontinence. It is recommended to maintain a healthy lifestyle by eating healthy, staying active and getting enough sleep during this time. Once you’ve gone through 12 consecutive months without a menstrual period, you’ve officially reached menopause, and the perimenopause period is over. We Can Help If you have questions about hormone therapy treatment for menopause or would like talk to one of our doctors about your perimenopause, don’t hesitate to schedule an appointment.

Cancer Screening, Well Woman

Ovarian Cancer Awareness

Diane /

Ovarian cancer will be diagnosed in approximately 1.5% — or 1 in 71 — women in her lifetime. Most women do not experience any symptoms of ovarian cancer, so it’s important to be in tune with your body and be comfortable talking to your doctor about any changes. Symptoms of Cancer of the Ovary While ovarian cancer is harder to detect than other cancers, there are some symptoms women can watch out for, especially if they persist for two weeks or longer: Bloating Pelvic or abdominal pain Back pain Enlargement or swelling of the abdomen Inability to eat normally Unexplained weight loss Urinary frequency or incontinence Constipation Feeling tired Indigestion. Diagnosing Ovarian Cancer A malignant cyst on the ovaries may be found during a routine yearly pelvic exam with your OB/GYN. Other diagnosis options are vaginal ultrasound, laparoscopy or blood tests. Vaginal Ultrasound – This procedure uses sound waves to create pictures of your internal organs that allow your doctor to view the images on a screen. The ultrasound will show shape, size, location and makeup of the cyst. Laparoscopy – In this type of surgery, a laparoscope is inserted into the abdomen to view the pelvic organs. Laparoscopy can also be used to treat cysts. Blood Tests – For women past menopause age, in addition to an ultrasound, your doctor may recommend a blood test that measures the amount of CA 125 in your blood. An increased CA 125 level may be a sign of ovarian cancer in women past menopause. Ovarian Cancer Treatment Treatment for ovarian cancer is based on the stage of the cancer and how much the cancer has spread outside the ovary. Epithelial ovarian cancer has four stages, ranging from the least to most advanced stage. Usually, surgery to remove the uterus and ovaries is performed, and sometimes the lymph nodes and tissue from the abdomen may be removed as well. Surgery may be followed by chemotherapy, depending on the stage of the cancer. It’s important for women treated for ovarian cancer to schedule routine checkups with their OB/GYN so he or she can monitor your body’s progress after treatment and make sure you stay as healthy as possible. Make an appointment today by calling 770.720.7733 or schedule an appointment online.

Nutrition and Weight Loss

Healthy Food Options for Vegetarians and Vegans

Diane /

Last week we received a great question from a potential patient about different types of protein alternatives for vegetarians and vegans. If you are looking for alternatives to animal-based proteins, whether it’s due to health reasons, personal beliefs or because you’re looking for alternatives due to pregnancy food aversions, never fear. There are plenty of great options to help keep your body healthy and strong. Here are a few of our favorites: Whole grains – Surprise! Certain whole grains can also be a good source of protein. These include whole wheat, brown rice, whole-grain cereals, wild and brown rice, barley, bulgar, millet, couscous and quinoa. Here’s a little tip about quinoa: it contains more than 8 grams of protein per cup, including all nine essential amino acids that the body needs. For an added protein punch, add wheat germ or rolled oats to your recipes when baking, Soy – Whether it comes in the form of soy milk, edamame (soybeans), or tofu, soy is an excellent source of protein. Foods made from soy contain some of the highest amounts of vegetarian protein. Legumes – Chock-full of protein legumes offer a variety of options in the form of split or green peas, soybeans, chickpeas, black beans, navy beans, kidney and pinto beans. Two cups of kidney beans, for example, contain about 26 grams of protein! And don’t forget the old standbys of peanuts and peanut butter. Seeds – Sunflower seeds, poppy seeds and sesame seeds all contain protein. Sunflower seeds contain the most at 7.3 grams per quarter cup. Try topping a salad with sunflower or sesame seeds, or adding poppy seeds to a vinaigrette. Whatever the reason for your diet preferences, the physicians at Cherokee Women’s Health are dedicated to help you find ways to get healthy and stay healthy. Don’t hesitate to let us know if you have questions about diet and healthy food options when you’re in our office for your next appointment.

GYN Problems, Laparoscopic Surgery Education

What to Know About Laparoscopic Surgery

Diane /

A laparoscopy is a surgical technique using a thin, lighted tube that’s threaded through a small incision in the belly to look at abdominal organs, and in many cases, female pelvic organs. Laparoscopy is used to detect problems such as uterine fibroids, cysts, adhesions (scar tissue), and infection. Other common procedures include hysterectomy, removal of abnormal tissue, tissue biopsy, and tubal ligation (commonly referred to as getting your tubes tied). Laparoscopic surgery has many benefits, including less pain after surgery, a lower risk of infection, a quicker recovery time, and generally, the procedure can be done as an outpatient surgery so you will be able to return home the same day. Additionally, because of the smaller incisions, your body heals faster and the scars will be smaller. Questions to Ask Your Doctor If you want to learn more about a laparoscopic procedure, first make an appointment with your doctor to discuss surgery options. During your pre-op visit with your OB/GYN, it’s important to ask as many questions as you need so that you can feel comfortable about the procedure. Questions to ask include: How long does the surgery typically take? What can I expect the aftercare to be like? What steps do I need to take to prepare for the surgery? What can I take for pain relief after the surgery? What to Expect After Laparoscopic Surgery In most cases, you will be able to return home the same day of your surgery. The doctor will want to keep you for 2 to 4 hours after the surgery to monitor you and prepare for your trip home. For the first 24-48 hours, you might experience some of the following symptoms: Pain at the site where the scope is passed through the wall of the abdomen. Mild nausea from the medicine Cramps similar to menstrual cramps Discharge like a light menstrual flow for up to 7 days Aching in your neck and shoulders from the gas put in your abdomen. Swelling in your abdomen for a few days. Bruising at the incision site. Fatigue or muscle aches for a day or two. If you can, try to enlist the help of a good friend or family member beforehand. You’ll want to make sure take it easy for a few days, so pre-schedule things like basic housecleaning, laundry, and a handful of easy-to-heat meals so that you’re off you’re feet as much as possible. We’re Here to Help For more information about laparoscopic surgery techniques, call us at 770.720.7733 or schedule an appointment online with one of our highly skilled OB/GYN surgeons.

Anterior and Posterior Repair Education, GYN Problems, Mesh Education

Cherokee Women’s Offers Treatment for Vaginal Mesh Complications

Diane /

Vaginal mesh is a piece of synthetic mesh that is inserted into the vagina to treat pelvic organ prolapse, a condition where a woman’s pelvic or reproductive organs fall into her vaginal opening, cystocele (anterior vaginal wall prolapse) and rectocele (posterior vaginal wall prolapse). Pelvic organ prolapse is often linked to strain during childbirth, when the muscles in a woman’s body can weaken or stretch out. If the muscles don’t recover, they are unable to support a woman’s pelvic organs. Women may also get pelvic organ prolapse after a hysterectomy, which can sometimes leave other organs in the pelvic area with little support. There are some misunderstandings surrounding vaginal mesh surgeries. For many years, vaginal mesh was used to treat the above conditions and was considered standard care. We want to take a deeper look at this procedure and quell any misunderstandings about vaginal mesh surgeries. Complications Associated with Vaginal Mesh The primary cause of complications associated with vaginal mesh is how the body reacts to it and how it is placed within the body during a surgical procedure. However, in the fall of 2008, an FDA notification that stated patients should be aware of the complications that do potentially exist in relation to the vaginal mesh surgeries urged people to ensure that their surgeon had the proper training and experience required to perform the procedures. Because of this notification, an increase in surgical technique and mesh technology have decreased complications associated with the procedure, but it’s important to note that it should be done by a surgeon with the proper training and experience in vaginal reconstruction. Cherokee Women’s Health’s Surgery Policy Here at Cherokee Women’s Health Specialists, our doctors’ approach to surgery is the following: This means no unnecessary surgeries, and looking for the best and easiest solutions to alleviate suffering for each and every patient. The Cherokee Women’s Health Specialists are experts at removing surgical mesh. Our pelvic and urogynecologic surgeons have the experience and education required to offer our patients a solution to their complications involving vaginal mesh. Schedule an appointment online or call us today at 770.720.7733 if you would like to discuss vaginal reconstructive surgery options.

Have a Healthy Pregnancy: Best Foods for Pregnant Women

Diane /

So you’ve just discovered that you’re pregnant! Congratulations from the team at Cherokee Women’s Health! One of the most important things you can do to get ready for your new baby is, well, eat! Best Foods for Pregnant Women If you’re already out of your first trimester and/or are fortunate enough to not have morning sickness as a symptom of your pregnancy, try to eat a healthy balance of the following food groups: Protein – If the idea of lean chicken or fish turns your stomach, try eggs, nuts, beans, or legumes, which are all great sources of protein during pregnancy. High-protein foods also contain amino acids, are the building blocks of every cell in your (and now your baby’s) body. Low-fat dairy – Calcium will help your bones grow strong during pregnancy, and will also help your baby’s growing bones. Try a creamy yogurt smoothie or a quick snack of string cheese to help get you through the day. Colorful fruits and veggies – Load up on any kind of green, yellow, orange, or red fruits and veggies you like (smoothies and juices count). Pinterest has a wealth of healthy food options for pregnant women, and there’s a recipe for just about everyone. Water – Ok, so water’s not a food, but it’s especially important to drink plenty of water during pregnancy because it provides benefits like building new cells, delivering nutrients, and flushing toxins. Fighting Food Aversion and Nausea If you’ve been relegated to crackers and ginger ale, don’t worry – here are a couple good options for your growing baby that are bland and easy to keep down. Lemons – Citrus fruits are packed with Vitamin C, an important nutrient during pregnancy. Try adding lemon juice to your water for an added punch. Other citrus fruits to try are oranges, tangerines and grapefruit. Pretzels – Had enough crackers? Pretzels are also a bland choice that add a little variety. Dry cereal Brown rice Applesauce (try to look for an organic option, if possible) Have a question about a food that’s a do or a don’t during pregnancy? Don’t hesitate to ask your doctor when you’re at one of our offices for your next prenatal appointment.

Dr. Litrel's Blog

A Holy Place

Diane /

Eight years ago my wife Ann was hospitalized for a life-threatening bleed in her brain. I sat in vigil at her bedside for many hours through the days and nights as she lay there in pain, unable to move, barely able to whisper. I was afraid that I would lose my wife – and my young boys their mother. But early one morning Ann spoke one sentence to me, and the heavy feeling of worry that had filled my chest suddenly evaporated. In its place was a wonderful certainty my wife would be okay. A shunt had been placed by the neurosurgeon to alleviate the pressure on Ann’s brain. The shunt slowly dripped out blood-tinged cerebral spinal fluid the entire week. I watched from my chair next to Ann’s bed as, drop by drop, the fluid fell into the collecting system. The fluid had a reddish color at first. As the days passed, the fluid gradually clarified to a pinkish tinge. Finally one morning the fluid had the healthy hue of fine champagne. Ann was still in such pain she could hardly open her eyes. She squeezed my hand as she woke up and whispered good morning. I tried to cheer her up. “Your cerebral spinal fluid looks so good this morning, I’m tempted to take a sip,” I said wryly. A few moments later Ann responded. “If you swallow….a mouthful,” she croaked, “it will raise your IQ…fifty points.” I was stunned. Immobilized in Intensive care for over a week, my wife had just made a joke. A funny one to boot! I knew then that Ann was going to be alright. Our son Tyler inherited his mother’s courage and sense of humor. Several years ago he was injured in a skiing accident. It was a two-hour ambulance ride to the nearest city hospital. With a fractured bone almost sticking through the skin, Tyler suffered the bumpy ride along the mountain road in agony. Just before Tyler’s surgery, his doctor told him he would need a strong narcotic for the pain. He recommended Vicodin. “Oh, that’s my favorite one,” my twelve-year-old offspring quipped. The surgeon looked shocked. “That’s the one that Dr. House takes.” Tyler grinned as he referenced a family TV favorite about an E.R. doc, “House.” Last week Tyler required another major reconstructive operation, casting a shadow of fear and worry over our household. As a surgeon, I find it far easier to be the one providing care than the one worrying about my loved one. Both roles come with moments of fear. But no matter on which side of the medical relationship I find myself, I know this to be true: The hospital is a holy place. Here in this holy place, we seek help when we or our loved ones are injured or ill. Here in this holy place, gathered together, are people who have dedicated their lives to helping strangers in need. Here in this holy place, Love manifests itself through us in the most concrete of ways – all of us helping one another when we are in desperate need. And here in this holy place, God grants healing and relief. Nevertheless, as a Dad sitting next to my son’s bed before major surgery, I was a bit anxious. Tyler grabbed my hand moments before he was to be wheeled back to the operating room. “Dad, I need you to remember something for me,” Tyler said in a low, intense voice. Unsettled, I leaned forward to listen. “971-32-2745-1994. Write it down.” I fumbled for a pen and wrote the number down, repeating it back to Tyler at his request. Confused, I waited. “If I die, you will be contacted. Give them that code number,” Tyler said. “Within a week, you will receive ten million dollars cash – in untraceable bills.” His face still wore the trace of a smirk as the nurses wheeled him back to surgery. Later, as I sat for hours in the waiting room during the operation, I found myself again worrying. Life can be frightening and painful. We suffer so much, and over the course of a long life, lose what matters to us most – our bodies, and our loved ones. It’s so easy to forget the truth: despite our being biologically mortal, we are spiritually eternal. I remembered Tyler’s last minute joke. It was going to be okay. And so it was. -Dr. Mike Litrel

Dr. Litrel's Blog

Cocaine or Prayer? How Best to Feel Better

Diane /

Sixteen years ago, when I first started my private practice, the complaints of some of my patients confused me. Despite normal exams and lab results, a number of women told me they just weren’t feeling well. They didn’t have energy and felt overwhelmed by life. I couldn’t figure out what was going on. The visiting pharmaceutical salesmen, however, came to the rescue. The diagnosis, I learned, was depression. The solution to my patients’ complaints was the pharmaceutical company’s product, taken once a day, every day — forever. In my first year of practice, I selectively began prescribing antidepressants. I was pleased to see that many patients experienced a lifting of their sadness. I continued prescribing depression medication judiciously. Still, the diagnosis and treatment troubled me. Early in my medical training, I had anticipated that psychiatry would be my specialty. The word “psychiatry,” literally translated from the Greek, means “treatment of the soul.” I had entertained the idea of a joint degree at Emory in both medicine and the ministry, so the idea of practicing in the field of medicine that handles the human soul called to me. But I soon learned that the reality of the practice of psychiatry was not what I had imagined. Psychiatric patients were placed on powerful medications with little real understanding of the diagnoses or the mechanism and side effects of the drugs. Now, twenty years later, my work hours and job duties can be demanding and emotionally draining. There are desperate moments in the dead of night when a life is at stake and I am rushing into the operating room. But no matter the hour, I find the cries of a healthy newborn baby a joyful reminder that God is always present in our lives. Obstetrics and Gynecology has proven to be the spiritual field of medicine I was seeking as a young man. I stopped prescribing antidepressants years ago, after a patient who had been on Zoloft came to my office in a desperate state. I found her curled up on the floor of the exam room. Having quit her medication three days earlier, she said she felt like she was going out of her mind. She quickly felt better after resuming the medication. But her withdrawal symptoms were too similar to those I’d seen experienced by addicts. People abuse drugs to be happier, to alleviate their suffering. Antidepressants affect the neurotransmitters in the brain with a mechanism similar to that of cocaine. We all experience sadness in our lives, a sense of confusion about what we are doing, and, at times, an overwhelming feeling of despair. These are normal human emotions that all too often have a spiritual purpose. Drugs supply relief; but are they the solution? Health is not just about vital signs, laboratory findings and medical diagnoses. Part of health is understanding our purpose in life and following that path in our daily actions. When we stray, we are designed to experience unhappiness. After all these years in practice, seeing thousands of patients, it’s been my observation that depression is not a true diagnosis of the body like cancer or pregnancy. It’s a spiritual discomfort to remind us to look deeper at our lives — and to make a change. -Dr. Mike Litrel

Well Woman

Cherokee Women’s on Faith and Health

Diane /

Dr. Litrel is known for making a priority out of praying with his patients before surgery. This is something that many patients appreciate and see as a way of connecting with their doctor on a more personal level. Cherokee Women’s Health on Faith and Health One of our patients had this to say about Dr. Litrel and his strong connection between faith and health: “Dr. Litrel, I am so grateful to have you as my doctor. I wanted to write you this thank you note to tell you how thankful I am that God brought me to you and your practice. I have prayed for a kind, caring, get-to-the-issue doctor for years and my prayer was finally answered. Not only have you made me feel comfortable you have shown and demonstrated to me the love of Christ. I never in a million years would have thought my doctor would pray with me before surgery. And when you did, I knew for a fact that God had His hand over me that day and it brought me complete peace. I could never say thank you enough. Praying that God blesses you, your family and your practice always. That He will continue to give you wisdom and favor in all you do. 1 Corinthians 1:4-9 In His Love.” – Allie S. We invite you to view more videos on our Youtube channel, and be sure to check back often for additions to the page. You can also follow along with us on Facebook, Twitter and Instagram as well.

Author name: Diane

What are the Differences Between a Certified Nurse Midwife and an Obstetrician?

How to Shop Pink for Breast Cancer Awareness

Are You Getting Regular Mammograms?

Could it be Perimenopause?

Ovarian Cancer Awareness

Healthy Food Options for Vegetarians and Vegans

What to Know About Laparoscopic Surgery

Cherokee Women’s Offers Treatment for Vaginal Mesh Complications

Have a Healthy Pregnancy: Best Foods for Pregnant Women

A Holy Place

Cocaine or Prayer? How Best to Feel Better

Cherokee Women’s on Faith and Health

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WARNING: Mature Content