Take a tour of our facilities!

 

 

 

 


General

Q. What should I do if I have a concern after the office is closed?
If you have a medical emergency or are in labor, you may call our office.  This will direct you to our answering service who will then page the doctor on call.  The doctor will return your call and advise you. If you do not receive a call back from the doctor in a timely fashion, please contact the answering service again.

Q. What should I do if I need a medication refill?
If you have seen us within the past year, call your pharmacy to let them know you would like your prescription refilled.  They will fax us a request; we will then review your chart and should be able to approve that request.  If you have not seen us within the past year, call the office.  You need to schedule an appointment and then we may be able to refill your prescription until you are able to see us.

Q. With what hospital are the doctors affiliated?
Our doctors are affiliated with Northwest Community Hospital which is located down the street from our main office and attached to our second office.www.nch.org

Q. How can I get a copy of my medical records?
Please fax or send us medical records release form.  The cost for copying your entire chart is 50 cents per page (maximum fee of $30).


Obstetrics

Q. What over-the-counter medications are safe to take during pregnancy?

PROBLEM

MEDICATION

Allergies

Benedryl, Claritin, Zyrtec

Cold/flu/sinus

Tylenol, saline nasal spray, Neti Pot *see below

Cough

Robitussin, Robitussin DM, cough drops

Constipation

Colace, any fiber containing supplement (Fibercon, Metamucil, etc.) or cereal (FiberOne, All Bran)

Diarrhea

Imodium, Kaopectate (**Call doctor if diarrhea lasts more than 24 hours)

Headache

Tylenol (extra strength OK)
DO NOT TAKE Advil, Ibuprofen, Motrin, Aleve, aspirin (unless instructed by your doctor)

Heartburn

Tums, Maalox, Pepcid, Pepcid AC, Zantac

Hemorrhoids

Preparation H, Tucks pads, Anusol

Rashes

Hydrocortisone cream, benedryl cream
**if not resolving/improving over 24 hours, call   your doctor

Yeast infection

Monistat

*Most cold medications are generally regarded as safe in pregnancy if used for a short period (24-48 hours) of time. Here is some information about some of the components of common cold medications:

  • Pseudoephedrine (Sudafed): This decongestant is OK to use on a short term basis after the first trimester. There have been some rare reports of birth defects with this medication if used in the first trimester.
  • Phenylephrine (found in Tylenol Cold): This decongestant should not be used in patients experiencing any high blood pressure issues during their pregnancy.
  • If using Nyquil or other nighttime cold medications, you may want to purchase the formulation that is alcohol-free.

Q. When should I make my first prenatal appointment?
Call us after you have a positive home pregnancy test.  We will make an appointment for you at approximately 6 ½ weeks of pregnancy.  We perform an ultrasound at your first visit to confirm your due date.

Q. What if I’ve had a miscarriage in the past?
Call us with your positive home pregnancy test.  We will schedule you to come in for lab work to check your HCG level (pregnancy hormone) and your progesterone (hormone that supports early pregnancy).  We follow the HCG level to make sure it rises correctly and then schedule an ultrasound for you at the appropriate time.

Q. What hospital will I deliver at?
Our doctors deliver at Northwest Community Hospital.  This hospital has an obstetrician and pediatrician present 24 hours a day, seven days a week.

Maternity services info: Nchbaby.org

Q. Are there any foods I should avoid?
It is recommended that pregnant women do not eat lunch meats or hot dogs unless reheated till steaming hot.  They also should not eat soft cheeses (goat, feta, blue, gorgonzola, brie, queso fresco) unless the package label indicates that the cheese is pasteurized.

Pregnant women can (and should!) eat fish—in moderation (no more than 12 ounces per week).  Avoid tilefish, shark, and mackerel as these have higher mercury content.  Albacore tuna has a higher mercury content than canned light tuna.  Therefore, it is recommended that pregnant women only eat 6 ounces of albacore tuna per week.
Pregnant women should avoid raw or undercooked foods (sorry, no raw sushi!).

Please see the FDA website for further information:http://www.cfsan.fda.gov/~pregnant/pregnant.html

Q. I have a cat---should I be worried?
Toxoplasmosis is a parasite that can be found in cat feces.  If a woman is exposed to this in pregnancy, her baby could be affected by hearing loss, mental retardation, and blindness.  Therefore, we recommend that you have someone else change your kitty litter during pregnancy.  If this is not possible, you should wear gloves when handling kitty litter and wash your hands thoroughly immediately following contact.  You may still pet and love your cat!!

More information: http://www.cfsan.fda.gov/~pregnant/whiltoxo.html

Q. What about caffeine?
The current recommendation is that women consume no more than 200 mg of caffeine per day during pregnancy.  This may be most important during your first trimester as there have been some studies that link high caffeine intake with an increased risk of miscarriage.

The caffeine content of certain beverages and foods is listed here:

  • Coffee (8 oz) brewed (drip)  137 mg
  • Caffeinated soft drink (12 oz) 25-45 mg
  • Tea (brewed)   48 mg
  • Hot chocolate (12 oz) 8-12 mg
  • Dark chocolate bar   30 mg
  • Milk chocolate bar   11 mg
  • Dunkin Donuts 16 oz coffee  143 mg
  • Starbucks tall coffee (12 oz) 260 mg
  • Starbucks Grande Caffe Latte  150 mg







Q. Can I dye my hair/get highlights?
Yes.

Q. Can I have an occasional glass of wine during pregnancy?
Alcohol consumption during pregnancy has been linked to birth defects and mental retardation.  No one knows exactly how much alcohol it takes to cause these problems.  Therefore, it is currently recommended that pregnant women avoid any alcohol intake during pregnancy.

Q. Can I travel during pregnancy?
The American College of Obstetrics and Gynecology state that in an uncomplicated pregnancy, a woman may travel by plane up to the 36th week of pregnancy within the United States.  The best time to travel is during your second trimester (14-28 weeks).  Generally, women feel better during this phase of pregnancy (less nausea, not too uncomfortable yet).  If you are taking a long trip, we recommend that you move around (flex and extend your legs, walk) in order to avoid blood clots.  If travelling by car, you should always wear your seat belt!

Q. Can I exercise during pregnancy?
If you currently exercise, you may continue to do so.  You may need to modify your work out somewhat to include more low impact activities.  In general, walking, elliptical machines, exercise bikes, prenatal exercise classes and light weight lifting are considered safe.  Activities that are high risk for falling or abdominal trauma (skiing, gymnastics, horseback riding) are not recommended.  If you have not previously exercised, please ask us for recommendations in the office.  If you experience any of these symptoms during exercise, you should stop immediately: vaginal bleeding, contractions, shortness of breath, dizziness, or chest pain.  You should always stay well hydrated during your work out.  After 20 weeks, we do not recommend exercises that require you to lay flat on your back like sit-ups.

Q. I’ve been exposed to Fifth’s disease—what should I do?
Please call the office and schedule a time to come in for bloodwork.  We will test to see if you’ve been infected by/exposed to Parvovirus, the virus that causes Fifth’s disease.  Most often, even if your bloodwork demonstrates a new infection, there will be no problems for your baby.  However, occasionally a fetus can develop anemia from parvovirus exposure, so we follow our exposed patients along with a high risk obstetrics physician to ensure the health of your baby.  For more information:
http://www.cdc.gov/ncidod/dvrd/revb/respiratory/B19&preg.htm

Q. I’ve been exposed to Shingles—what should I do?
If you had chicken pox in childhood, you are immune for life and shingles exposure will not affect you or your baby.  If you are not sure if you are immune to varicella (chicken pox), we can test for this and make further recommendations based on your results.

Q. I want to help paint the baby’s new nursery—is this OK?
Yes.  Paint fumes are not known to cause birth defects or harm to your baby.

Q. What do I do if I think I’m in labor?
We recommend you call us if:

  • You are not full term and are experiencing tightening/cramping/contractions more than 4-6 times in one hour.  If this does occur, please drink lots of fluids, lay down on your side and rest.  If the contractions do not resolve, please call.  You should also call if you feel you are leaking fluid.
  • In any trimester of pregnancy, if you have bleeding like a menstrual period or heavier, call us.  It can be normal to have some light spotting after intercourse or a vaginal exam in the office.
  • If you are full term and begin to have contractions, time them.  When they have been five minutes or less apart over one to two hours and seem to be getting stronger, call us.  If you feel your water has broken, call us.
  • If you are in your third trimester, and are not feeling your baby move as much as usual, we recommend you eat and drink something, lie down on your side and pay close attention for movements. The American College of Obstetricians and Gynecologists (ACOG) recommends that you note the time it takes to feel 10 kicks, twists, turns, swishes, or rolls. A healthy baby should have 10 movements in less than 2 hours.  If you do not get enough movements, please call us.

 

Q. Who will deliver my baby?
We currently have 6 physicians that care for our obstetric patients.  The doctor that is on call when you go into labor is usually the doctor that will deliver your baby.  We do our best to ensure that you meet all of our OB doctors prior to your due date so that you will feel comfortable with the doctor that ends up delivering your baby.

 Q. Should I make a “birth plan”?
A birth plan is a statement of expectations and desires for the birth experience of parents-to-be.  It is completely optional.  As a group, it is our goal to help you achieve an exceptional delivery experience while doing what’s best to keep both you and your baby healthy.  We try to work with you and your family to meet your expectations and desires during the birthing process whether you’ve actually put those in writing or not.  Below is a short list of things that have mentioned in past birth plans and our philosophy regarding such:

  • I would like to move around during my labor.This is perfectly acceptable.  We have “telemetry” available at our hospital which allows for fetal monitoring while the patient is out of bed (walking, in rocking chair, etc.).
  • I would like a natural birth experience without pain medications. Whatever your wishes regarding pain control—they are OK with us.  If you do want an epidural, generally that is given during the beginning of the active phase of your labor and can be redosed if necessary.  If you do not want an epidural, our staff and nurses are happy to work with you to find comfortable positions and also can work with a doula if you so choose.
  • I would prefer not to receive Pitocin.  Pitocin is a medication used to bring on stronger and more frequent contractions.  It is the brand name for the hormone “oxytocin”, which is what your body produces naturally to cause contractions and labor.  It is most often used if we need to induce someone’s labor.  Many patients are able to go through labor without Pitocin.  However, sometimes labor “arrests”, meaning a patient’s cervix stops dilating.  Often it is due to the fact that contractions have slowed or are not strong enough.  In these cases, Pitocin can be used to augment your labor.  Before starting any such medications, we would always review that with you and decide together if that is the best thing for your labor.
  • I do not want a vacuum or forceps used for my delivery. These instruments are only used if medically necessary.  We will have a discussion with you if that time comes so that we can make the decision together.
  • I would like my husband with me during my entire labor and delivery.We are happy to have your husband with you during your delivery.  Our patients also sometimes request that their mother and/or mother-in-law also be present and this is usually possible as well.  If you require a c-section, only one family member is allowed with you in the operating room, however.
  • I do not want an IV. Although you do not need to be continuously hooked up to intravenous (IV) fluids, we recommend at least “saline lock”.  This means the IV is in your vein but not hooked up to any machines, bags, or pumps, thereby allowing you mobility.  We like to have the IV in place in case an emergency arises which requires IV access.
  • I do not want an episiotomy. An episiotomy is a surgical incision made in the perineum to enlarge the vaginal opening before the birth of the baby's head.  We do not perform “routine” episiotomies.  Most often, they are performed if there is concern about the baby’s well being and cutting an episiotomy might help expedite your baby’s delivery. 
  • I want to hold my baby as soon as possible.As long as your baby is crying and vigorous at delivery time, we are happy to place the baby on your belly so you can begin bonding as soon as possible.  We are also happy to have the father cut the baby’s cord as long as the delivery has proceeded normally.  Occasionally, a baby may have a harder time in this transition period and need some extra stimulation and care.  In a case like that, we would bring the baby to the warmer first for evaluation, and then bring the baby back to you as soon as possible.  We’d also like you to breast feed when/if you feel ready.  There are a few things the nurses will need to do with the baby right after delivery (weight, length, warming, swaddling, etc.) and then she can help you with starting to breast feed.

Gynecology

Q. I missed one or two of my birth control pills.  What should I do?
If you’ve missed one pill, go ahead and take 2 pills that day (the pill you missed plus the pill for that day).  If you’ve missed two pills, take 2 pills the next 2 days.  If you have missed two or more pills, you MUST use a back-up birth control method (i.e. condoms) for the remainder of the month.  Missing birth control pills may cause breakthrough bleeding or spotting.  If you are late for your period after missing pills, you should check a pregnancy test.

Q. I have my period…can I still come in for my pap smear?
If you are bleeding heavily, we recommend that you reschedule.  If your bleeding is light or just spotting, you should keep your scheduled appointment.

Q. I think I might have a yeast infection, what should I do?
If you have had a yeast infection diagnosed by a doctor in the past, and your symptoms are the same, you may try an over the counter yeast infection medicine, such as Monistat.  If your symptoms do not improve within a week taking the medication, please make an appointment to see us.

If you have never had a yeast infection before, it is best to call our office for an appointment so that we can make sure you have the correct diagnosis and are treated with the correct medicine. 
Our nurses are also available to answer your questions regarding vaginal infections.

Q. If the condom breaks or I have unprotected intercourse, is there any way to prevent pregnancy?
Yes.  Emergency contraception is now available over the counter.  It is called Plan B.  You must take this within 72 hours of the unprotected intercourse.  It works by interrupting or delaying ovulation (release of an egg) so that fertilization and pregnancy cannot occur.  This should not be used as a long term birth control method and cannot work once a fertilized egg has implanted into the uterus (i.e. when someone is already pregnant).  Plan B will come with extensive instructions.  You are welcome to call our office if you have questions.

Q. What is HPV?
Human papilloma virus is a very common infection that can be transmitted from person to person.  The type of HPV that we worry about is the kind that is sexually transmitted.  There are many strains of the virus that are sexually transmitted.   Some cause genital warts and some cause abnormal pap smears and even cervical cancer.  Studies show that at least 3 out of 4 sexually active people will contract HPV at some time in their lives.  The Pap smear is a test used to screen for cervical cancer and any lesions that could someday lead to cervical cancer.

 Q. Is there a medicine I can take to get rid of my HPV?
Unfortunately, there is no cure for HPV.  Your body’s immune system can sometimes fight the virus with time; and your pap smear can return to normal on its own in some cases.  There are things you can do to decrease your risk of getting HPV:

  • Limit your sexual partners.  The higher your number of sexual partners the greater your risk of being exposed to HPV.
  • Get vaccinated.  Gardasil is currently available in our office for patients 9-26 years old.  It protects women against the 2 most common strains of HPV that cause genital warts and the 2 most common strains that cause abnormal pap smears and cervical cancer.    http://www.gardasil.com/  
  • Use condoms.  This can decrease your risk of contracting HPV (although not 100%).
  • Quit smoking—smoking can worsen the effects of the HPV virus.

Q. Do I get an HPV (human papilloma virus) test with my pap smear?
In all our patients aged 30-64, an HPV test is done with your pap smear.  We do this test because it has been shown that an HPV test is more sensitive than a pap alone in detecting pre-cancerous lesions of the cervix.  If both your pap and HPV test are negative, you can have peace of mind that you do not have a high grade (pre-cancerous) cervical lesion or cervical cancer.

Q. What if I have a positive HPV test?

  • The current recommendation for a normal pap smear but positive HPV test is a repeat pap and HPV test in 6-12 months.  If your HPV is still positive at your repeat exam, it will be recommended that you have a colposcopy (microscope exam of cervix with biopsies).
  • If your HPV test is positive, you should not blame your partner.  There is no way to tell when or where you were exposed to the virus.  Exposure could have been many years ago.
  • If you have atypical cells on your pap smear and a positive HPV test, the recommendation will be for you to have a colposcopy.

Q. What is a colposcopy?

  • This is a test which allows us to view the cervix with a microscope.  Usually biopsies of the cervix are done with this test.
  • The test only takes about 15-20 minutes.  You may have some slight discomfort or cramping with the test but should be able to return to work or school the next day.
  • You should not have sex for at least 1-2 weeks following the test.
  • This test is for patients with abnormal pap smears or 2 positive HPV tests in a row.
  • You may have spotting, light bleeding, or dark colored discharge after the test.
  • Your doctor will have results within 1-2 weeks.

Q. I’ve been told I need a LEEP…what should I expect?

  • A LEEP (loop electrosurgical excisions procedure) uses a loop connected to an electrical current to remove a thin cone-shaped area of your cervix where abnormal cells are located.
  • A speculum is used like when you have a Pap smear.  We then inject numbing medicine into the cervix.  Once the loop is used to remove the abnormal area, we will control the bleeding with an instrument connected to the electrical current (cautery) or a special paste (“liquid band-aid).
  • Bleeding after the procedure can be normal but call us if you are soaking through a large pad in one hour for 2 consecutive hours.

Risks:

  • Infection—call us if fever >101.
  • A LEEP will NOT affect your ability to become pregnant in the future.
  • You may return to work/school after the procedure.  You may not have sex for at least 2 weeks after the procedure.
  • There is a very small risk that after having a LEEP that in the future, when you decide to have children, that your cervix may start to dilate too early (cervical incompetence).  We carefully monitor our patients for this complication, which happens VERY RARELY.  There is also a risk that scar tissue may form in your cervix making it difficult for your cervix to dilate during labor.

Q. I’m thinking of trying to get pregnant…what recommendations do you have?
If you have not already talked to your doctor about this, we would be happy to see you for a “pre-conceptual consult” to discuss recommendations and order any necessary lab work.  One thing that is very important is to make sure you are taking a vitamin containing folic acid.  The current recommendation is at least 400 micrograms (mcg) of folic acid daily for all women of reproductive age.  This will decrease your chance of having a baby with a neural tube defect (i.e. spina bifida).