Single Site Robotic Surgery

New technology is available to assist surgeons to treat patients in the least invasive way possible.  Surgeries that used to be completed with large incisions or multiple incisions, can now be completed with the assistance of the Da Vinci Robotic Surgical System and one single incision.

This system is powered by advancements in robotic technology that allow the hand movements of the surgeon to be translated into small, very precise movements of tiny instruments used inside of the patient’s body.  One of these instruments, a laparoscope (a thin tube with a tiny camera and light attached), sends images to a video monitor in the operating room to guide the doctor during the procedure.  The surgeon has total control of the Da Vinci Robotic Surgical System at all times (source: www.davincisurgery.com).

There are many benefits to the patient when using the Da Vinci Robotic Surgical System and the SINGLE SITE approach.  Performing procedures using this approach is virtually scarless for the patient.  Having a smaller incision reduces recovery time for the patient.  The reduction in recovery time means that the patient is back to performing normal activities of daily life, like caring for family members or working, more quickly than if a large, more invasive approach was used.  Less time away from work and family reduces costs for the patient.  The risk for complications is greatly reduced with a less invasive surgical approach.  The risk for pain, infection, and bleeding is reduced with a single incision surgery, as the robotic system allows for very precise surgical movements by the surgeon.

Many gynecologic issues can be addressed using robotic surgery, including severe pelvic pain, abnormal or very heavy vaginal bleeding, uterine fibroids and pelvic prolapse (falling/slipping of a pelvic organ).  Some procedures that can be completed with the assistance of the Da Vinci Robotic Surgical System include hysterectomy, endometriosis resection, and myomectomy.

Dr. Avelino Garcia, who is certified for use of the Da Vinci Robotic Surgical System, is the only gynecologist in the Permian Basin who is performing SINGLE SITE gynecological surgery.  If you are interested in addressing gynecological problems using the robotic approach, call the Women’s Clinic at MCH ProCare for an appointment today at (432) 640-2491.

Dysmenorrhea/Painful Periods

By: Sanchita P. Yadalla, M.D., FACOG

Do you suffer from painful periods? You’re not alone. According to American College of Obstetricians and Gynecologists (ACOG), “more than one half of women who menstruate have some pain for 1-2 days each month.”

There are two different types of painful periods, or dysmenorrhea. The first type, Primary Dysmenorrhea, is caused by natural chemicals in the lining of the uterus called prostaglandins. At the beginning of the menstrual cycle, prostaglandins increase, thus increasing menstrual pain. During a period, the lining of the uterus is shed. As the lining sheds, the pain decreases. Many times, primary dysmenorrhea occurs in young girls who have just started having menstrual cycles. As these young women grow and mature, their periods become less painful, and sometimes improve after childbirth.

The second type of painful periods, or Secondary Dysmenorrhea, can be caused by issues in the reproductive system, including Endometriosis, Adenomyosis, and uterine fibroids. The pain associated with secondary dysmenorrhea usually gets worse over time, instead of improving. It also usually lasts longer than normal menstrual cramping.

There are multiple treatments that can be used to help with dysmenorrhea. Certain types of pain relievers, like ibuprofen or naproxen, help reduce prostaglandins, thus helping to control pain caused by Primary Dysmenorrhea. Certain hormonal birth control methods can also be used to treat the underlying causes of Secondary Dysmenorrhea, thus reducing pain associated with periods.  Healthy diet, regular exercise, and a daily multivitamin (especially containing Vitamin B and Magnesium) can also help reduce pain associated with periods.

If you are suffering with painful periods, please call ProCare Women’s Clinic
for an appointment at 432-640-2491.

Cervical Cancer Screening copy

The Importance of Cervical Cancer Screenings

By: Christopher Petr, M.D.

Dr. Christopher Petr
Dr. Christopher Petr

Cervical cancer screenings are used to determine if a woman has cell changes that could progress to cancer. According to The American College of Obstetricians and Gynecologists (ACOG), “Healthy cells grow, divide, and are replaced as needed. Cancer of the cervix occurs when these cells change.” It can take many years for cancer of the cervix to develop. Early cell changes, also known as dysplasia, occur prior to the development of cancer. The most common cause of cervical cancer is HPV (Human Papillomavirus) infection. HPV can be shared during sexual intercourse, and is often not associated with any symptoms. HPV is very common, and most infections resolve on their own. 

Many women are unaware that a cervical cancer screening is recommended starting as early as 21 years of age, using a test called a Pap smear. Current ACOG recommendations for cervical cancer screening include completing a pap smear every three years if between the ages of 21 through 29. For women over the age of 30, pap smears every 3 to 5 years with co-testing for HPV is recommended. If there is abnormal results obtained, additional testing with your doctor is required.  An abnormal result does not mean cancer. Yearly gynecological examinations are also recommended, regardless of whether or not a pap smear is due.

Measures can be taken to prevent cervical cancer. It is important to live a healthy lifestyle. This includes regular exercise, healthy diet and a daily multivitamin. It has also been proven that monogamous relationships reduce the risk for sexually transmitted diseases, including HPV. As the most common cause of cervical cancer is HPV, the HPV vaccine is recommended. The HPV vaccine can be given to males or females, as early as age 9. The HPV vaccine consists of three doses, given in a six month time frame. 

To schedule your yearly gynecological exam or begin your HPV vaccination series, call ProCare Women’s Clinic at 432-640-2491.

Changes that the body experiences during pregnancy

As seen in the Odessa American’s Medical Matters:

https://www.oaoa.com/people/health/medical_matters/article_7029ea62-15eb-11e9-8f32-a3289c4ca12c.html

by Sanchita P. Yadalla, M.D.

Dr. Yadalla is Board Certified in Obstetrics and Gynecology and is a Fellow of The American Congress of Obstetricians and Gynecologists (FACOG). She offers a full range of OBGyn services at the MCH ProCare Women’s Clinic and can be reached at (432) 640-2491.

Body changes during early pregnancy

Pregnancy causes many body changes in women. In early pregnancy, most symptoms begin at about six weeks. Every pregnancy, and every woman, is different … so some women can experience symptoms sooner than six weeks and some will experience symptoms later than six weeks. Some women do not experience symptoms of early pregnancy at all!

Body changes in the first trimester

  • Very early in the first trimester (one to two weeks after conception), some women notice vaginal spotting or light bleeding when the fertilized egg implants in the uterus. This is also known as “Implantation Bleeding.”
  • Due to softening of the cervix, it is common to spot or bleed after intercourse, especially in early pregnancy.
  • Light abdominal cramping that comes and goes may also occur, due to growth of the uterus. Bleeding like a period or painful abdominal cramping is not normal and should be evaluated by your physician.
  • Most women experience breast changes during pregnancy. The breasts feel heavier and become much fuller. The color of the areola may change to a darker hue.
  • Most women complain of breast tenderness, but this eases through the pregnancy. It is recommended that pregnant women wear comfortable, supportive bras. It is important to be sure it is sized correctly, especially as the breasts grow during pregnancy.

The body experiences many changes as progesterone, a pregnancy hormone, levels increase:

  • A small amount of white discharge is normal in pregnancy, as long as it is not associated with vaginal pain, itching or odor.
  • Many women experience lack of energy or fatigue. Pregnant women require a healthy sleep routine and are encouraged to get plenty of rest. Your body is growing a human, after all!
  • The increase in progesterone can also cause nausea and vomiting. Due to the nausea, increased sensitivity to smells is not uncommon. Nausea/vomiting in pregnancy can sometimes lead to dehydration. Symptoms of dehydration include abdominal cramping and headaches. It is encouraged to continue proper hydration, as tolerated. Nausea and vomiting usually improves near the end of the first trimester and the appetite returns.

Some pregnant women experience emotional changes early in pregnancy:

  • Sometimes, women report mood swings, being irrational or unexplained weeping.
  • Many women are anxious about being pregnant, which can also cause an emotional reaction.
  • As the pregnancy progresses, many women feel much more relaxed and calm. Many start getting excited in anticipation for the new arrival.

Body changes in the second trimester

With the start of the second trimester of pregnancy, many pregnancy symptoms may stay the same but there will be new changes as well:

  • For many women, morning sickness will improve or only occur sporadically and appetite seems to increase. Changes in appetite can cause constipation, gas or bloating. It is also common to experience heartburn or indigestion.
  • Although there will be a decrease in breast tenderness, the breasts will continue to grow. A supportive, well-fitting bra is still recommended for optimal comfort.
  • White vaginal discharge due to hormone changes is still common as long as it is not associated with other symptoms like vaginal burning, pain or odor.

There are many new changes that can occur during the second trimester of pregnancy:

  • The fatigue from the first trimester fades and the pregnant woman usually has increased energy. 
  • An increase in blood volume during pregnancy can cause some mild swelling of ankles or feet, especially when standing for an extended period of time. 
  • Some women experience sensitive gums that bleed when brushing. It is important to continue routine dental check-ups. 
  • Many pregnant women experience nasal congestion or nose bleeds. It helps to keep the nasal passages moist with saline spray and by using a humidifier at home.
  • The uterus is supported in place by a group of ligaments. As the uterus grows, these ligaments stretch or pull. It is not uncommon for this stretching or pulling to cause aches in the lower abdomen or on either side of the abdomen. As the uterus grows, it becomes heavier. It is encouraged for the expectant mother to use a maternity belt or support to help alleviate these pains. Extreme abdominal pain is never normal in pregnancy and should be evaluated by a physician.
  • During the second trimester, the uterus continues to grow out of the pelvic cavity. Many women see changes in the size and shape of the abdomen. As the uterus grows, posture may change due to the pregnant belly protruding. This change in posture can cause back pain in the pregnant woman.
  • The favorite change of the second trimester to many pregnant women is the ability to feel fetal movement. Feeling fetal movement is sporadic at first, as the fetus is so small. By the end of the second trimester, a pregnant woman should feel consistent fetal movement. Movements in the second trimester may feel “clunky” and as though they are big stretching movements.

Body changes during the third trimester

In the third trimester, most women become increasingly uncomfortable. As the baby becomes larger and settles in the pelvis, new physical discomforts can occur:

  • Due to increased fluid volume produced, there may be an increase in swelling of the ankles and feet, as well as hands and face.
  • Colostrum (or “Pre-Milk”) may start leaking from nipples as the breast prepare to begin producing milk.
  • Some women may alternate times of extra energy (nesting) and extra fatigue as time gets closer to delivery.
  • These discomforts may cause problems sleeping comfortably at night.

After the baby “drops”:

  • After the baby “drops” or settles in the pelvis, a pregnant woman may be able to breathe easier, as there is less pressure on her diaphragm and more room for her lungs to expand. But there will be more pressure placed on the bladder by the baby being lower in the pelvis which may cause more frequent urination.
  • Increased backache and heaviness, as well as buttock and pelvic discomfort are common. Some women even have a sensation of a sudden sharp pain or shock in the pelvic area if the baby settles on a nerve. While uncomfortable, all of these experiences are normal parts of the third trimester.

Contractions:

  • Pregnant women in the third trimester, may have more frequent and intense contractions, called “Braxton-Hicks Contractions”. These contractions are irregular and can be eased with rest, Tylenol administration and hydration.
  • Labor contractions become stronger over time and come at regular intervals. Labor can also be distinguished by vaginal bleeding or leakage of amniotic fluid. If these symptoms occur, a pregnant woman needs to be evaluated by her doctor.

Knowing about changes the pregnant body can experience helps an expecting woman feel calmer about what she is experiencing. If you have any questions or need additional information, reach out to your OBGyn provider. If you do not yet have a provider, the OBGyns at MCH ProCare Women’s Clinic are available to become your provider for your pregnancy and upcoming arrival of your bundle of joy.  

Why your baby needs you to breastfeed

by Candy Powell BSN, RN, IBCLC, RLC, CCE, Lactation Consultant and Certified Childbirth Educator at the Medical Center Hospital Center for Women and Infants.

As seen in the Odessa American’s Medical Matters at:

https://www.oaoa.com/people/health/medical_matters/article_65628f18-9cc3-11e8-b26b-437cd1d03725.html

Breastfeeding is a vital part of healthy child development and provides the best start to life for any baby. According to the American Academy of Pediatrics, breastfeeding is the standard for infant feeding.

The World Health Organization recommends:

  • early initiation of breastfeeding within one hour of birth
  • exclusive breastfeeding for the first six months of life
  • introduction of nutritionally adequate and safe complementary (solid) foods at six months together with continued breastfeeding up to two years of age or beyond

Why is breastfeeding important for your baby?  

Breastfeeding provides essential nutrients and antibodies that boost an infant’s immune system, providing protection from childhood illnesses. Benefits for breastfed infants include:

  • reduced risks for diarrhea and respiratory infections
  • protection against childhood obesity
  • protection against non-communicable diseases later in life, including cardiovascular diseases and diabetes mellitus
  • higher intelligence quotient
  • reduced risk for allergies.

Is there any benefit for the mother? 

Yes, breastfeeding is important for mothers too. Women who breastfeed have a reduced risk of breast cancer, ovarian cancer, obesity and osteoporosis.

World Breastfeeding Week

World Breastfeeding Week occurs annually the first week of August and is celebrated in more than 170 countries worldwide. During the week, the World Health Organization promotes the benefits of breastfeeding and raises awareness about this essential part of every person’s life course.

The 2018 theme, “Breastfeeding: Foundation of Life”, encourages breastfeeding as a way to promote mother-child bonding and to provide vital long-term health benefits to both mother and child. According to the Lancet 2016 Breastfeeding Series, “Improved breastfeeding practices have the potential to save the lives of 823,000 children and 20,000 women a year.”

World Breastfeeding Week also calls attention to local efforts that support breastfeeding.

Available local breastfeeding assistance and information

Medical Center Hospital’s Center for Women and Infants (CWI) Infants is designated as a Texas Ten Step Hospital which means policies and practices promote breastfeeding. CWI staff encourages and supports new mothers to breastfeed by giving them information and support throughout their pregnancy, in the hospital and after they are home.

Baby Café (FREE Drop-in Breastfeeding Center)

The MCH Baby Café is a free, drop-in breastfeeding center for mothers seeking more information or help with breastfeeding. Baby Café is free and open to breastfeeding mothers every Wednesday from 10 a.m. to noon in the CWI fourth floor classroom.

Oh Baby! Breastfeeding Basics (FREE CLASS)

Learn about the basics of breastfeeding and how to start off breastfeeding with tips on positioning, latching, how to recognize a good latch and how milk is produced.

Date and Time:  Saturday, August 4, 2018, 10:00 a.m. to noon

Location: MCH Center for Women and Infants, Fourth Floor Classroom

Sustaining Breastfeeding and Returning to Work (FREE CLASS)

Learn about accommodation laws and your rights in the workplace, child care, pumping to maintain and enhance milk supply and how to smoothen transitions from home to work and back.

Date and time:  Wednesday, August 8, 2018, 11:00 a.m. to noon

Location: MCH Center for Women and Infants, Fourth Floor Classroom

For more information on these free local resources, contact:

Candy Powell BSN, RN, IBCLC, RLC @ cpowell@echd.org  or 432-640-1714

Ashley Harry BSN, RN, IBCLC, RLC @ aharry@echd.org  or 432-640-1784

Gynecological Needs After Hysterectomy

by Dr. Avelino Garcia, MCH ProCare Women’s Clinic

Many women assume that once a hysterectomy (removal of the uterus) is completed, they no longer have need for a gynecologist. This, in fact, is not true! There are many health care needs for women, even after hysterectomy.

Pelvic Pain or Pain with Intercourse

A yearly pelvic examination is encouraged for all women, even after child bearing years. During a pelvic exam, the gynecologist assesses the vaginal anatomy, looking for any skin abnormalities or lesions. During a bi-manual examination, the gynecologist feels internally and externally for any masses or abnormalities. These examinations also help to assess women who suffer from pelvic pain or pain with intercourse.

Bladder or Bowel Issues

Some women have problems with pelvic support, or a relaxation of the muscles that support the bladder and rectum. These women may suffer from urinary leakage, difficulty completely emptying the bladder or issues moving the bowels. These are issues that can be diagnosed and assessed by an annual pelvic examination by a gynecologist.

Menopausal Symptoms

As women age, menopausal symptoms can occur, even long after a hysterectomy. Some women suffer from hot flashes, especially at night. Many women complain of problems falling or staying asleep. After menopause, vaginal dryness and recurrent infections in the urinary tract (bladder infections) are very common, which can also lead to painful intercourse or pelvic pain.  These are also important issues that are addressed by a gynecologist during your annual examination.

Bone Changes

Bone changes occur as women age. According to The American College of Obstetricians and Gynecologists (www.acog.org), “A small amount of bone loss after age 35 years is normal for both men and women. But during the first four to eight years after menopause, women lose bone more rapidly.” This increases the risk for osteopenia or osteoporosis. This is addressed by Bone Density Screenings (DEXA Scans) that are ordered every other year after the age of 65.

Breast Health

Breast health is also an important issue addressed yearly by the gynecologist. During an annual examination, a breast exam is completed by the provider. Yearly mammograms are ordered to screen for breast cancer.

Yearly examinations by a gynecologist are still important, even if you do not have uterus. Make your health a priority! Call MCH ProCare Women’s Clinic for an appointment today at (432) 640-2491.

Urinary Incontinence

by Dr. Avelino Garcia

As seen in the Odessa American Medical Matters: http://www.oaoa.com/people/health/medical_matters/article_5e237dea-dd36-11e7-b864-efb69ed2f589.html

Though many are embarrassed to discuss it, urinary incontinence is very common among women. Urinary incontinence is leakage of urine. It can range from leaking just a few drops of urine to complete bladder emptying. Other accompanying symptoms include having the strong urge to urinate, urinating frequently, waking up several times during the night to urinate, burning with urination or leaking urine while sleeping.

There are three main types of urinary incontinence in women.

  • Stress Urinary Incontinence (SUI) is leakage of urine when laughing, coughing, sneezing or exercising.
  • Urgency Urinary Incontinence (UUI) is a sudden urge to urinate that cannot be stopped. Many women leak urine before they can make it to the restroom.
  • Mixed incontinence combines the symptoms of both SUI and UUI.

Several things can cause or worsen urinary incontinence. Urinary tract infections can cause leakage of urine. Certain types of medications, like diuretics, caffeine and alcohol, can contribute to urinary incontinence, as these are substances that cause your body to create more urine and/or are bladder irritants. Different disorders caused by weakening of the muscles of the pelvic floor can cause problems controlling urination. Long term constipation is often a trigger for urinary incontinence, especially in older women. Neuromuscular or anatomical problems can also cause problems controlling urinary leakage.

Urinary incontinence is diagnosed by medical history and a physical exam. A pelvic exam is necessary to determine if there is pelvic organ prolapse. Certain tests may be done during the physical examination to see if there is complete emptying of the bladder after urination. In some cases, imaging and bladder function tests can be ordered for further information.

The first line of treatment for urinary incontinence is nonsurgical. This may include lifestyle changes, like discontinuing caffeine and alcohol, and managing fluid intake during the day. Weight loss in overweight patients is beneficial for reducing leakage of urine. Bladder training may be discussed by your provider. According to the American College of Obstetricians and Gynecologists (ACOG), “the goal of bladder training is the learn how to control the urge to empty the bladder and increase the time span between urinating to normal intervals (every three to four hours during the day and every four to eight hours at night).”

Performing Kegel exercises helps strengthen pelvic muscles and can improve all types of urinary incontinence. There are many medications that help improve UUI by controlling bladder spasms, manage to relieve the urge to urinate and urinary frequency.

A pessary may be recommended for nonsurgical management of SUI and to improve pelvic support. A pessary is a small device that helps to support the walls of the vagina, thereby lifting the bladder and urethra. These devices come in many shapes and sizes and can be fitted by the provider during the pelvic exam. Pessaries can easily be removed for cleaning and re-inserted by the patient at home, making them a very convenient alternative to surgery for many women.

There are several surgeries that can be completed by the provider in a hospital setting to improve SUI. There are many different slings are available for the treatment of urinary leakage. A sling is a narrow strap made of synthetic materials that is placed under the urethra to lift and provide extra support. Other surgical procedures include lifting and securing the bladder neck to nearby supporting structures using stitches.

If you are suffering from urinary incontinence, call ProCare Women’s Clinic today and make an appointment at (432) 640-2491.

Mammography: Frequently Asked Questions

by Dr. Mason “Gage” Hicks, Radiologist
As seen in the Odessa American Medical Matters at: http://www.oaoa.com/people/health/medical_matters/article_6a3aea48-b692-11e7-9190-137b296bd2ab.html

Why do women need to have yearly screening mammograms?

It reduces a woman’s risk of dying from breast cancer. Studies have shown that mammography screening cuts the risk of dying from breast cancer nearly in half.

When should a woman start having mammograms?

There are conflicting recommendations from different societies. We follow the American College of Radiology and Society of Breast Imaging guidelines which recommend yearly screening mammograms beginning at age 40 for women at average risk for breast cancer (most women). Studies have shown that this is how we will save the most lives.

Why yearly and not every other year?

It’s simple … yearly screening results in more lives saved than screening every other year.

Should a woman ever start having screening mammograms before age 40?

There are certain situations where a woman should start mammography screening before age 40 … women who are considered high risk. If you are unsure, then talk to your doctor. The American College of Radiology and Society of Breast Imaging never recommend screening mammograms before age 25.

What are some reasons a woman would be considered high risk for breast cancer?

Women with certain genetic mutations (BRCA1 or BRCA2), family history, women who received radiation to the chest at a young age (usually for treatment of Hodgkin’s disease) and women with a personal history of breast or ovarian cancer.

What is 3D mammography?

3D mammography, or breast tomosynthesis, is a breakthrough technology in breast imaging that allows a clearer, more accurate view of the breast (as opposed to the traditional 2D mammogram). It allows the breast radiologist to see through the different layers of tissue in the breast. This improves breast cancer detection.

What are the benefits of 3D mammography?

Earlier detection of small breast cancers

Clearer images of the breast tissue

Fewer additional tests or unnecessary biopsies

Greater accuracy

Greater likelihood of detecting multiple cancers

What does it mean if my doctor says I have dense breasts?

It has to do with the way you are made. It doesn’t mean that anything is wrong with you, though it can increase your breast cancer risk. Every breast has different amounts of fatty tissue versus glandular and connective tissue. When you look at a mammogram, the black/darker parts of the breast are the fatty tissues and the white/lighter parts of the breast are the glandular and connective tissues. When you have dense breasts, it means that there is more of the white/lighter tissues relative to the black/darker tissues.

What is the significance of having dense breasts when it comes to mammograms?

Most cancers also look white on the mammogram. So when you have dense breasts (more of the white/lighter tissues), it sometimes makes it harder for the radiologist to detect cancers. The dense breast tissue can sometimes obscure cancers (particularly smaller cancers) and make them difficult, or even impossible, to see.

What should I do if I have dense breasts?

It’s something to talk to your doctor about. DON’T stop having mammograms. Certain types of cancers, particularly those that present as tiny calcifications in the breast, can easily be detected on mammograms … even in dense breasts. Your doctor may recommend additional screening depending on your overall breast cancer risk. Additional screening with breast MRI can be a valuable tool in certain patients.

Do I need a “screening mammogram” or a “diagnostic mammogram”? What’s the difference?

Generally speaking, if you are not having any breast problems and it’s time for your yearly mammogram, a screening mammogram is recommended. Diagnostic mammograms are generally performed on patients that either had an abnormality detected on their screening mammogram, or are having some kind of breast problem (lump, pain, discharge, etc.)

If the patient had a potential abnormality on a screening mammogram, a diagnostic mammogram is performed for further evaluation. This usually involves specialized mammogram views and possible ultrasound of the area to determine the nature of the abnormality and determine if a biopsy is needed.

The diagnostic mammogram is not better pictures or better image quality than the screening mammogram. It is just performed in a way that allows the problem or potential abnormality to be fully evaluated with the necessary imaging while the patient is in the department. Personally, I like to talk to every patient that has a diagnostic mammogram so that they leave our department with peace of mind and understanding of what my recommendations are.

October is Breast Cancer Awareness Month. Please make your mammogram a priority in your life and encourage your loved ones to do the same. Early detection saves lives.

Breastfeeding benefits both mom and baby

As seen in the Odessa American “Medical Matters”.
by Dr. Avelino Garcia

Breastfeeding is a fantastic bonding experience that benefits both mom and baby. There are many reasons that breastfeeding is so beneficial. If it is possible, it is encouraged to breastfeed for at least the first six months of life.

Most healthy infants are ready to breastfeed within the first hour of life. It is encouraged to breastfeed a young infant every two to three hours, according to hunger and need. Hunger signs include nuzzling the breast, sucking on hands or fingers and clenching fists. Crying is a late sign of hunger in a baby. Many women are concerned about the baby getting enough to eat. According to the American College of Obstetricians and Gynecologists (ACOG), “once your breast milk transitions from colostrum to mature milk, your baby will soak at least six diapers a day with urine and will have at least three bowel movements a day. [The baby may lose weight, but] After 10 days, your baby will be back up to birth weight.”

Breastfeeding in the postpartum period releases a hormone called oxytocin, which causes the uterus to contract. This helps the uterus return down to its normal size, and reduces the amount of bleeding that might occur after delivery. Breastfeeding helps burn extra calories, which helps return to pre-pregnancy weight sooner than if strictly formula feeding an infant. Women who breastfeed their infants have proven to have lower rates breast cancer and ovarian cancer. Breastfeeding women also have shown to have reduced rates of Type 2 diabetes, hypertension and heart disease.

Breast milk contains maternal antibodies that help protect infants from infections, illnesses and some allergies. Breast milk is easy for babies to digest and has the perfect amount of fat, sugar, water, protein and minerals needed for appropriate growth and development. Breast milk supply adapts and changes according to the infant’s growing and changing nutritional needs. Even short term breastfeeding has been proven to decrease an infant’s risk for Sudden Infant Death Syndrome (SIDS).

Although breastfeeding is a natural thing and works for most women, many women have trouble and need assistance. If you decide that breastfeeding is what your infant needs, there are many ways you can get assistance. Directly after delivery, hospital nurses can help you find a comfortable position and monitor correct infant latch. Certified Lactation Consultants can help teach you what you need to know to get started with breastfeeding your infant and help you with common problems many women face. Peer counselors, such as people who work with La Leche League or Women, Infants and Children (WIC) can provide support and answer non-medical questions regarding breastfeeding. Your OB/GYN can discuss breastfeeding during pregnancy and can help in the hospital and postpartum period. Your baby’s pediatrician can help answer questions regarding infant nutrition and infant weight gain to keep your baby in optimal health.

MCH Center for Women & Infants has a free drop-in breastfeeding center called the Baby Café that is staffed with Certified Lactation Consultants. Baby Café is every Wednesday from 10 a.m. to 12 pm in the Center for Women & Infants Classroom. The Baby Café offers free breastfeeding education in a friendly, private environment. For more information, call (432) 640-1714 or (432) 640-1784.

 

PERIMENOPAUSE

by Dr. Krystal Murphy

Perimenopause and Menopause are natural events. However, the body undergoes some major changes during this time. Menopause is the time in a woman’s life when she naturally stops having menstrual cycles. This signals the end of her reproductive years. The time leading up to menopause is called perimenopause. These changes may cause some bothersome symptoms, although many women only have a few symptoms.

Many women wonder what causes the body to undergo such a drastic change. During childbearing years, monthly changes in estrogen and progesterone control the menstrual cycle. These hormones are created by the ovaries. As a woman ages, the ovaries make less estrogen. The decrease in estrogen causes perimenopausal symptoms, typically starting with a change in the menstrual cycle. Cycle length and heaviness may vary from the norm. Some women have shorter cycles or skip them altogether. Although these cycle changes are normal as menopause approaches, these symptoms should still be discussed with a healthcare provider because abnormal vaginal bleeding could indicate a problem. Call a provider to discuss bleeding between menstrual cycles, bleeding after intercourse, intermittent spotting, heavy or prolonged vaginal bleeding or bleeding after menopause. It is important to note that even if a woman no longer has a uterus, but still has ovaries, she may show signs and symptoms of perimenopause.

Some women suffer from more bothersome signs and symptoms of perimenopause. Some women have hot flashes and night sweats. A hot flash is a sudden feeling of overwhelming heat that rushes to the upper body and face. It can cause the skin to turn red or may cause sweating. While some hot flashes only last a few seconds, others may last several minutes. Hot flashes may cause sleep disturbances in perimenopausal women.

Other women may suffer from recurrent vaginal and urinary tract infections. As estrogen levels in the body decrease, vaginal tissue gets thinner and dryer. This may cause recurrent vaginal infections or pain with intercourse. Hormonal changes in the body also affect the urethra. The urethra can become dry and irritated. Some women have urinary frequency or recurrent urinary tract infections because of these changes.

To relieve these symptoms, many women see a gynecologist for treatment of perimenopause. Some providers recommend hormone therapy. Hormone therapy helps treat bothersome symptoms like hot flashes, vaginal dryness or pain with intercourse. Some hormone therapy helps prevent hip and spine fractures, as well as reduces the risk of some cancers. Your provider will discuss these benefits, but also the risks associated with hormone therapy. These risks include possible cancer risks, slightly increased risk for heart attack and possible risk of stroke, deep vein thrombosis (DVT) or other blood clot formation.

Other treatment options are available to treat perimenopausal symptoms. Certain medications, like antidepressants and blood pressure medications, can be used to reduce hot flashes and sleep disturbances. Vaginal moisturizers and water based lubricants are over-the-counter products that can help improve vaginal dryness and pain with intercourse.

Estrogen produced by a woman’s ovaries helps prevent bone loss, heart attacks and stroke. When these estrogen levels decrease, the risk for bone loss, heart attacks and stroke increases. Taking Vitamin D and Calcium supplementation is important to prevent bone loss and maintain bone health. Healthy lifestyle choices, like healthy eating and exercise, reduce heart attack and stroke risk. Routine annual exams give you a chance to sit down with your provider and discuss any changes or problems you may be facing. If you are showing signs of perimenopause or have questions about treatment for hormone changes, call ProCare Women’s Clinic at (432) 640-2491 to schedule an appointment.