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Recognizing National Infertility Awareness Week

Recognizing National Infertility Awareness Week

This month we’re standing with the N.I.A. to recognize infertility awareness with a focus on preconception counseling, because that’s where education begins.  With preconception counseling at W.H.O.C., Dr. Cothran follows your journey from planning to your first positive pregnancy test or, if needed, referral to a specialist after 12 months of trying without success. Whether you anticipate fertility may be an issue or not, you’ll want an experienced women’s health expert on your team as you consider your first or next pregnancy.

Why Preconception Counseling Is Important in Infertility

Preconception counseling is an important step in your overall health and wellness. It begins about 3 to 4 months before you’re hoping to become pregnant, or when you decide to stop contraception, and it includes evaluation of the following:

  • Overall family plan and emotional well being
  • Medical history and current medications
  • Update of important immunizations
  • Fitness and body mass index
  • Diabetes mellitus and hypoglycemia before conception
  • High blood pressure and borderline H.B.P.
  • Folic acid and other supplements
  • Nutritional guidelines before pregnancy
  • Screening for genetic counseling if needed
  • Vocational issues and ergonomic considerations
  • Optimizing the likelihood of pregnancy

As more women decide to put off starting a family until they’re established in their careers, preconception counseling can help you sort through a range of lifestyle-impacting changes. It can help you avoid preventable complications and prepare for smooth transition through the trimesters of pregnancy. Dr. Judy counsels with compassion and non-judgement, and patients often comment on the ease of discussing sensitive issues after their visits.

Clinical infertility is diagnosed after 12 months of trying to conceive without success. It can be a stressful experience with impact to your relationships. Dr. Cothran guides you through the referral process and counsels you on what to expect.

The goal of preconception counseling is to ensure you’re as healthy as possible before you become pregnant. Partner with Dr. Cothran for women’s health in a caring atmosphere.

Diet Preparation for 3-Hr Glucose Tolerance Test

Diet Preparation for 3-Hr Glucose Tolerance Test

If you are prescribed a glucose tolerance test by Women’s Health of Chicago, it’s important to use this diet in preparation for the test.  If you have any questions, feel free to call us.

Important Note: This diet, sample menu and substitution, is only for preparation for the Glucose Tolerance Test, and should not be confused with substitution lists in any Diabetic Diet.

Follow directions as precisely as possible:

  • Follow this diet for 3 full days before the test. This is important so test results will be reliable.
  • You will not gain a significant amount of weight after only three days of the diet.
  • Any additional food you desire may be eaten, but please do not delete any portions.
  • For the final 12 hours before the test, no food, no liquids, no tea, no coffee, no smoking and no gum. Water is allowed. Do not fast for more than 16 hours.

You should take any medications on the same schedule prescribed by you physician, such as blood pressure or heart medication. Do not take any over-the-counter medications for 12 hours before the test, such as cough or cold preparations, vitamins, aspirin, etc. All testing begins the morning after a night’s sleep (i.e. no working the night before).

About the Sample Diet

Be sure to eat 150-200 grams of carbohydrate for 3 full days before the test. The approximate grams of carbohydrate are in parentheses following each menu item. You may feel
free to substitute from the table below.

Breakfast

  • 8 oz. orange juice (20)
    1 slice toast (15)
    1 tbsp. jam or jelly (15)
    One cup dry cereal (20)
    8 oz. milk (10)

Mid-morning Snack

  • 20 grams of carbohydrate from list below

Lunch

  • 1 sandwich (30)
    8 oz. Wheat Thin crackers (10)
    8 oz. milk (10)

Mid-afternoon Snack

  • 20 grams of carbohydrate from list below

Evening Meal

  • Meat (your choice)
    1 medium potato
    One serving vegetables or salad (10)
    1 pear (20)
    8 oz. milk (10)

Evening Snack, if desired (day 1-2 only)

  • 20 grams or carbohydrate from list below
10-15 Grams 20 Grams 30 Grams 50 Grams
1 apple 1 banana 8. oz apple juice 1 piece of iced cake
3 arrow roots 1 corn-on-cob 1 bagel 1 piece of pie
1/2 cup blueberries 1 cup dry cereal 6 dates 8 oz. prune juice
1 slice bread (not puffed) 6 oz. cranberry juice 3 Fig Newtons 1/2 cup raisins
2 med. carrots (raw) 3/4 cup cream of wheat 1 cup ice cream 1 cup fruit yogurt
1/2 cup cooked cereal 1 cup fruit cocktail 1 small potato
1/2 grapefruit 1 whole graham cracker 1 small sweet potato
12 grapes 4 oz. grapejuice 4 prunes
8 oz. milk (skim ok) 1 hamburger roll 1 cup spaghetti
1 medium peach 1 medium pear 2 toaster waffles (Eggos)
2 cups popcorn 8 oz. orange juice 1 slice of pizza
1 cup strawberries
8 oz. tomato juice
1 cup tomato soup
1 cup plain yogurt
4 vanilla wafers

Important Considerations & Reminders for Glucose Tolerance Test

  • On the third day of your diet, eat nothing (not even toast) and drink nothing, except sips of water after 10:00 p.m. and until your test is complete.
  • First a fasting blood sample will be drawn, then you will be given a sugary liquid to drink.
  • Each hour after the drink, blood will be drawn. This will be done three times.  It is important that the blood be drawn at exactly one-hour intervals, so please be available at the indicated times.
  • Please bring something to read or do while quietly sitting until the test is over.
  • Do not eat, smoke or drink anything except water during the test. Sips of water should be taken only if you are very thirsty.
  • After the last blood draw, you may leave the laboratory. At that time, you may have your lunch, and resume your normal diet.
  • If you are unable to eat your usual diet, please inform your health care provider.
  • Maintain your usual activity level on the days preceding the test.

Download the “Diet Preparation for the Glucose Tolerance Test”  from the Patients Welcome Page.

Sourced from www.gentlebirth.org/archives, and adapted with permission from the University of California, San Francisco, OB Clinic.

A Bouquet of Honors for Breast Cancer Awareness

A Bouquet of Honors for Breast Cancer Awareness

Breast Cancer Awareness Brings Autumn’s Bouquet

Among the multi-colors of Autumn this month is a beautiful streak of pink. For Breast Cancer Awareness Month, we honor victors in the battle against breast cancer, and cherish the memory of brave heroes we’ve lost. Women’s Health of Chicago supports survivors, many who’ve fought breast cancer multiple times, and now serve as activists, mentors, and tireless examples of how the battle might be won for all. While an update on the war against this disease is mixed with highs and lows, one thing remains constant: early detection is still our best weapon in the fight.

As an obstetrics and gynecology specialist, I’ve walked through diagnosis and treatment of this disease with close friends and patients.  Very few people I know remain untouched in some way by the fight for a cure. It’s a personal battle for me and many in my genetic family and patient family.

Rates of Detection and Survival in the Battle Against Breast Cancer

The survival rate for breast cancer has been growing since 1989. Survival rates among women under the age of fifty are even more encouraging than the national average. Treatment advances, earlier detection, and increased awareness are credited for this increase.

Float pink balloons for breast cancer awareness at women's healthThanks to awareness and screening, rates of detection have been on the rise.  Earlier detection uncovers more cases of breast cancer annually – about 307,000 this year or one in eight women.  Cures for Stage I Breast Cancer approach 95% nationally, and that’s great news.  Not only does early detection increase rates of survival, women who maintain a recommended mammography schedule undergo less invasive treatment at lower cost. Consult your gynecologist for advice on how regularly you schedule a mammogram based on your age, family history, and genetic risk factors.

Unfortunately, advances in detection and treatment haven’t impacted all women evenly.  Black women receive breast cancer diagnoses at younger ages and survival rates are lower than those for white women.  The data suggests that breast cancer may exact a greater economic and family toll on black women than even Asian or Latino women. The median age at diagnosis is 58 for black women and 62 for white women.

The data for the report was obtained from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute, a program that has been collecting information on cancer patients since 1973.

Feel Something, Say Something

In addition to mammograms, we stress the importance of patients trusting their own familiarity with their bodies. Whether it’s a lump or an inclination that something is wrong, follow through and get it checked. You may learn your concern is unfounded, or examination may lead in a totally different direction.  However, act on this instinct, because it’s a common trait among women who discover breast cancer early.

A Strong Network of Support

No one should battle this disease alone. Agencies and support groups are working to raise funds to increase breast cancer awareness and research.  Learn more about how you can donate, get involved, or find your own support group, by reaching out to the American Cancer Society, the National Breast Cancer Foundation, or Susan G. Koman for the Cure.

What You Should Do During Breast Cancer Awareness Month

Breast cancer awareness inspires and motivates women to action. No matter your age, if it’s been longer than 12 months since your last mammogram, schedule your physical examination and mammogram as soon as possible. If you’ve had your mammogram, encourage a loved one or co-worker to schedule their annual exam. You could be the difference in another life saved.

Back to College? Don’t Forget Your Physical

Back to College? Don’t Forget Your Physical

Why it’s important to schedule back-to-college physicals

The last few weeks before young women head to college for the first time can be frenzied. It’s easy to forget to schedule a physical examination before you go. However, among back-to-school priorities, getting a physical before arriving on campus gives students a significant advantage.

It’s always helpful to have an idea of what to do in an emergency, whether extreme weather preparation, minor auto accidents, or an unexpected medical issue. It’s great to have a first-aid kit in a dorm room or car. Students can avoid harmful drug interactions by reviewing food and drug labels, and making appropriate diet choices.

Getting to know the college campus can take months

Many students, away from home for the first time, aren’t experienced at making a doctor’s appointment. When illness strikes, they often don’t know what to say when they call. Even if they are comfortable making the appointment, they may not know to bring along personal identification, and a list of allergies and medications. Anne Welch, Clinical Administrator of the University Health Service at the University of Kentucky, urges parents to arm their children with this information. “Student health fees and tuition cover basic health services.  She’ll have a bigger head start, however, if she arrives with a health baseline.” Baseline lab results help identify causes for concern in the event of an health emergency.

Most college preparatory packages include directions for accessing campus services. These include office visits, allergy shots and counseling. Health educators are also available on some campuses to promote preventive medicine programs. A few colleges have even added dietitians on the watch for eating disorders and dietary recommendations. “It’s a big part of what we want parents to know that these kids have access to coming into college,” Welch says.

Teenagers headed to college should get a physicalImmunizations and Basic Protection

Students should also check to see which immunizations their college requires and ensure they get those taken care of before heading off to school. While each state has different requirements, most colleges require prior vaccination for measles, mumps, rubella and varicella (chickenpox), along with TDAP vaccine to protect against tetanus, diphtheria and pertussis (also known as whooping-cough).

Due to the increased risks of living in residential housing, we also recommend vaccinations for meningitis and hepatitis B. Bacterial meningitis is more easily spread through close quarters with other students. Hepatitis B virus is transmitted through blood, semen or other body fluids and can cause a serious liver infection without a vaccination. Plan to protect your student against these risks by reviewing vaccination records before they depart for campus.

Sensitive Discussion

With the information obtained through health history, physical exam, and lab tests, we counsel how to safeguard students’ health. We discuss sex, date rape, drug and alcohol use, smoking, seat belt use, nutrition, exercise, and stress management. Because of the sensitive nature of these topics, we offer students their choice of whether to have parents present.

Most important, we provide a safe zone where young women can ask any and all questions they have before college. No question is dumb or too silly to ask.  It can be the talk that makes the difference, especially freshman year.

The Best Mother’s Day Gift

The Best Mother’s Day Gift

Happy Mother’s Day!

It’s the time of year we all pause to give thanks and express our love and appreciation for our mothers. We honor those mothers we’re fortunate to have close by and the moms we appreciate across the miles.  We cherish memories of mothers to whom we’ve had to say good-bye, at least on this side of life.  And for too many of us, Mother’s Day’s day is a painful holiday, reminders of unfulfilled desires to experience motherhood ourselves, or punctuated by lingering grief and loss.

There are many reasons Mother’s Day is a meaningful season for us at Women’s Health of Chicago.  We’ve devoted to helping women plan motherhood through preconception counseling, and supporting patients tackling the toughest fertility challenges . We’ve counseled mothers on the sensitivity of a teen’s first visit to a women’s health specialist, and educated thousands of young women on the risks of sexually transmitted diseases.  I’ve had the pleasure and gratification of caring for generations of mothers in the same family. Truly, I’ve been sincerely moved by the depth of the bond shared between mother and daughter.

Mother’s Day Health Alert

However, it’s important during this season to remind all women that while you’re selecting greeting cards and making plans for Mother’s Day dinner, please take time to make sure your mom and all the important mothers in your life have had an annual physical exam and mammogram in the past 12 months.  Sure, load up on beautiful flowers, delicious treats, picnic fun and the gathering of family to honor the matriarch who’s made it all possible.  We’ve traded a few ideas in our office for handmade gifts designed for lasting memories, all in additionHappy Mother's Day from Women's Health of Chicago to the best gift of all.

Best Mother’s Day Gift

There is no better Mother’s Day gift than gently reminding, and harassing if necessary, your beloved mothers to schedule their annual physicals and mammograms.  Remember, early detection is the best weapon we have in the fight against breast cancer, and a host of other diseases that are nearly 100% curable if detected in early stages.  The rate of Type II Diabetes is at epidemic proportions in the U.S. and there’s so much we can do if it is detected early.  There are too many reasons to list here to remain vigilant about maintaining and supporting the maintenance of good health in our mothers, but perhaps LOVE is the only reason you need.

Say Happy Mother’s Day in a way that can really count. Make an appointment today for someone you love at Women’s Health of Chicago.

The Fight Against Pelvic Pain

The Fight Against Pelvic Pain

Pelvic pain, and related painful syndromes, which can be more difficult to describe, require thorough diagnostic protocols to determine the cause in each specific case. Therefore, it’s important that your primary care physician have a good relationship with a women’s health specialist who is following your overall health as well as your OB-GYN needs. That’s why I make a point to know the primary care physician and other related specialists treating my patients. Holistic, collaborative care is the best way to keep you living a vital and healthy lifestyle.

Managing pelvic pain with non-surgical options

When diagnosed with pelvic organ prolapse, you’ll have a number of surgical and non-surgical options to consider. To select the best option for you, we’ll consider a number of elements in your medical history, current physical condition and immediate support system. Either way, it’s is important to understand all options before deciding which treatment is best. Many women do very well with nonsurgical treatments for prolapse. Here is a quick synopsis of some of them.

First, We Advise Close Observation

A first option for pelvic organ prolapse might be observation or expectant management, which simply means periodic checkups and no active treatment at all. There is no evidence that this is likely to cause more problems than treating prolapse, until organ prolapse becomes severe enough to cause poor bladder elimination, bowel evacuation or irritation around the prolapsing tissues.
Although data show that prolapse is likely to worsen over time for most women, there is no current method to accurately predict who is likely to develop worsening prolapse, so treatment may simply not be necessary for women with lesser degrees of prolapse. The key is to diagnose it early and follow it closely.

Physical Therapy for Pelvic Pain

Another early treatment option includes pelvic floor physical therapy. In this instance, treatment is designed to reduce pelvic pain by improving the muscular support of and blood flow to the pelvis. Many women find this treatment eliminates their symptoms all together. Many times this will improve bladder and bowel symptoms as well. Working with a trained pelvic floor physical therapist is more likely to result in improvement than observation or home “Kegel” exercises alone. In the event you choose this route, I’ll follow-up closely to support your commitment to a regular schedule of therapy, and to track how effectively it relieves your pain.

What Is a Pessary?

Pessary Device from WebMDFinally, the oldest and best known non-surgical treatment of prolapse is a device called a pessary. A pessary is a device worn inside the vagina which supports the bladder, vagina or uterine apex, and rectum. There are many types of pessaries available, the most commonly used is a “Ring with Support”, which somewhat resembles a diaphragm used for birth control, except that it is a bit stiffer and flat rather than dome-shaped, and has perforations in the support membrane to allow for circulation of vaginal fluids and let the tissue “breathe.” Another common pessary includes a dome with ballast type called a Gellhorn. The appropriate type of pessary is best determined by the physician or healthcare provider trained in the proper assessment and fitting of the pessary. Once this is done, instructions regarding self-care and/or intermittent visits with office care of the pessary will be given.

Effectiveness of Pessaries

Many women achieve satisfactory treatment of prolapse with a pessary, and choose to continue this course of therapy indefinitely to relieve pelvic pain. While it is natural to develop some increase in vaginal discharge, as long as it is not disagreeable and manageable, this is usually acceptable. Sometimes, the pessary can cause irritation or erosion of vaginal tissues due to rubbing against the vaginal tissues. Often this can be corrected by increasing the amount of lubricant, or occasionally leaving the pessary out for a short period of time. A small number of women will develop a vaginal infection and become unable or unwilling to use a pessary. Normally, however, when properly fitted a pessary should be a “silent passenger”, and a woman wearing a pessary should be totally unaware of it.

You can learn more about pessaries at WebMD.

There’s much more to learn, and at Women’s Health of Chicago, WebMD we’ll make sure you’re thoroughly educated and well prepared to manage your pessary, or any other non-surgical treatment you elect.