Tips for Summer Family Travel
In a COVID-19 world, prepare for your summer vacations wisely. Summer is upon us, and with it brings the urge to travel. As more people are vaccinated against COVID-19 and restrictions are loosening, many families are celebrating with post-pandemic summer vacations. Here are some tips for traveling with your kids this summer: Road Trip Pit Stops for Kids If you’re taking a road trip, this typically means many hours in the car. Take the time to schedule some kid-friendly pit stops rather than just the gas stations. On long car rides, kids often have a lot of built-up energy, and a quick trip to the restroom while mom or dad fills the car won’t be enough to get their wiggles out. Along with your fuel and meal stops, look for unique and fun places to stop that will allow the whole family to stretch their legs and burn some of that pent-up energy. If it’s hard to find a park or other fun spot, spend some time at a play zone inside a fast food restaurant. You Can’t Have Too Many Snacks on Trips with Kids It’s human nature to become grumpy when you’re hungry. A grumpy child can make a car ride seem much longer than it needs to be. Whether you’re in the car, at the beach, or camping, it’s a good idea to have plenty of healthy snacks on hand, like cheese sticks, fruit, whole grain crackers, beef jerky and granola bars. Research has shown that high amounts of sugar can make kids hyper. But if you’re a parent, you probably already know that! Road Trip Car Activities Before you leave, stock the car with as many activities as possible. Try hanging an organizer on the back of the driver and passenger seats that you can fill with activities like Play-Doh, drawing pads and colored pencils or markers, puzzles and books. Some organizers even come with a fold down tray that becomes a table for each child. If you’re flying to your destination, fill a backpack with games and activities to keep everyone occupied. Let Your Kids Set the Pace Often, a vacation can become stressful as we rush to see every sight and do every activity. This is also stressful for your child. Try taking some days to let your child’s pace dictate how much you do. Even if you don’t get to see and do everything, your children won’t burn out or throw tantrums. Summer Travel During COVID Continue to follow CDC guidelines while you’re traveling this summer. Remember that each state has different requirements regarding masks and distancing. If you’re traveling with children who have not been vaccinated, it’s a good idea for them to continue wearing masks. It’s better to be outside than inside if you’re traveling to areas with large groups of people.
Your Breech Baby
Our Southlake, Fort Worth ObGyns explain what happens when you carry a breech baby You’re ready to give birth, and you feel like you’re prepared — until your ObGyn tells you that you have a breech baby. For a vaginal birth, the baby is ideally positioned head down, but 3 to 4 percent of pregnancies involve a breech baby. During the last weeks of pregnancy, if the baby is positioned buttocks, feet or both first instead of head down, we call it a breech presentation. Breech Positions Defined Every breech baby doesn’t present in the same position. Your breech baby may be in one of three breech positions. Our Southlake and Fort Worth ObGyns may refer to your breech baby in these ways. When the baby presents bottom down first and has bent knees, this is a complete breech. If the baby stretches his or her legs out toward the head, we call it a frank breech. When the baby is positioned with one leg hanging down, we call it a footling or incomplete breech. Our Southlake and Fort Worth ObGyns may discover your breech presentation during a pelvic examination or when they are feeling your belly. If so, they will order an ultrasound to confirm their suspicions. Can My Breech Baby Be Repositioned? We might be able to turn a breech baby using external cephalic version, or turning the baby. According to the American Congress of Obstetricians and Gynecologists, more than 50 percent of the time, turning a breech baby baby works; however, some babies may turn back into the breech position after the procedure. If you still have a breech position after week 36, we may try to turn the baby. This procedure should be done where a delivery room is easily accessible in the rare case that any problems occur. During the procedure, your ObGyn will use her hands to apply firm pressure to the abdomen to get the baby to rotate to a head-down position. During this process, we use an ultrasound to guide us, and we monitor the baby’s heart. Not every mother with a breech baby will qualify to have an external cephalic version. We do not attempt this with a mother carrying multiples. What Are My Delivery Options for a Breech Baby? If your baby has not turned head down, you will probably need a C-section. This is usually the safest way to deliver a breech baby for the sake of both mother and baby. Talk to our Southlake and Fort Worth ObGyns if you have concerns about a C-section. We are highly experienced in performing the procedure. For more information about pregnancy and birth, contact us for an appointment.
Maintaining Your Mental Health During Winter Months
Seasonal affective disorder mixed with a pandemic create extra challenges during “winter blues” months. For many of us, with the winter months can come “the winter blues.” Days are shorter, weather is colder. And with the addition of COVID-19, this winter is like no other. Many have been working from home, isolated due to travel restrictions and case counts. And sadly some have lost family members and friends to the pandemic. We’re all adjusting to a changing world as the headlines continue to scroll in. “The winter blues” might be more intense this year. And knowing the difference between sadness and depression can be difficult. Am I Sad Or Depressed? It’s completely normal to feel sad now and then. It’s also normal to feel a bit more sad during the winter months. But depression and sadness aren’t the same thing. And in some cases the depression leads to seasonal affective disorder (SAD). Seasonal affective disorder is estimated to affect 10 million Americans. Another 10 percent to 20 percent may have mild SAD. SAD is four times more common in women than in men. — Psychology Today Symptoms of SAD Symptoms of seasonal affective disorder can include intense issues with sleeping and eating, increased use of drugs and alcohol, and general trouble functioning. These symptoms feel more intense and severe during the long winter months and may be exacerbated by social isolation and life changes. Tips For Getting Through The Winter in Good Mental Health Here are some things to try if you’re feeling depressed by this particularly difficult season. Take a “news break.” With the pandemic sending many of us into our homes, it’s undoubtedly increased our screen time. While it’s important to stay informed, the constant barrage of the 24-hour news cycle takes a toll. While it may sound challenging, try to work toward only one hour of news a day. Keep up a healthy sleep routine. This includes going to bed and waking up on a consistent schedule and avoiding electronics in the bedroom. Experimenting with temperature and other strategies will help you find what works best for you. Get active. Even with lockdowns and restrictions, you can still get outside. Even if it’s just for an hour a day it will provide you with necessary Vitamin D and boost your mood. Use your support system. 2020 and 2021 have taught us that human interaction is vital to mental health. As isolation has kept us from the people we love, it’s become challenging to maintain those connections. Reach out to your support system: Friends, family, co-workers. Anyone you trust. If you still find yourself unable to cope with dark thoughts and feelings, or unable to function in the way you know you’re capable of, it may be time for professional help. This could include medication. Talking to your doctor about where to begin is the best way to start. Contact us today, and we can help point you in the right direction for your best mental health.
To Mask or Not to Mask During COVID-19 Pandemic
During the COVID-19 Pandemic, We Discuss The CDC Face Mask Guidelines There has been a lot of confusion and outright debate about the use of masks in public as all states with stay-at-home orders are now either open or slowly opening amid the ongoing coronavirus pandemic. On April 16, 2020, The Dallas Morning News reported that Dallas County was requiring the use of masks at essential businesses and on public transportation. Then, on May 12, WFFA Channel 8 reported that the Texas Attorney General argued that the city of Dallas couldn’t make masks a requirement as it was in conflict with Governor Greg Abbott’s executive orders in responding to the pandemic. The long and short of it: Some businesses are requiring masks, and some aren’t. Therefore, as we go out into public, we see a mix of mask wearers and non wearers. We hear many heated opinions in our social media feeds. The information has become confusing and at times overwhelming. So, what should we do? Should We Wear Masks During COVID-19? According to the Centers for Disease Control and Prevention, covering the face does help slow the spread of the virus and may help stop transmission from those who have it and don’t know it. They recommend the use of a cloth face covering or mask in public settings when social distancing isn’t easy to maintain. This would include places like grocery stores or pharmacies. If you’re taking a walk in the park, there’s no need for a mask. Enjoy the air on your face! The CDC gives the following recommendations for how your mask should be worn and maintained. Cloth face coverings should: Fit securely to the side of the face Be tied snugly or looped around ears Have multiple layers of fabric Not restrict breathing Be able to be laundered and dried without losing shape It’s important to note that a mask is not a substitute for any of the other precautions we should all still be taking (social distancing, limiting crowds, frequently washing hands, etc,). As the debates continue from a policy perspective, we must continue to do our part from a public health perspective. We all want life to return to normal as soon as possible. We want our economy to be as functional and as strong as possible. We want our kids and elderly to be safe and protected. We want our schools and churches and sports arenas open. So, let’s do our part and follow the guidelines laid out by the CDC and our health experts. Stay abreast of local mandates for the latest information that applies to you and your city/county. Visit the CDC website for more guidelines and tips on making face coverings.
What is Endometrial Ablation, and Who Is It Recommended For?
Women with heavy menstrual bleeding can consider this procedure with their doctor. An endometrial ablation is a procedure to remove the endometrium, which is the lining of the uterus. The procedure is considered for women with heavy menstrual bleeding between periods or periods that last a long time. There can be many causes for heavy bleeding, such as changing hormones or fibroids and polyps growing in the uterus. The endometrial ablation procedure not only makes everyday life easier for some women, but it also can address health problems caused by excessive bleeding such as anemia. In most cases, an endometrial ablation will stop periods altogether. If it doesn’t, a woman’s flow should return to normal or be very light. Endometrial Ablation: How It Works An endometrial ablation is not a surgical procedure. During an office visit, the doctor inserts very thin tools through the vagina to reach the uterus. The type of tool used depends on the type of ablation being done. The most common types endometrial ablation are: Hydrothermal: fluid is pumped into the uterus and heated for 10 minutes. This destroys the uterine lining. Balloon therapy: a balloon is inserted into the uterus through a tube, then filled with heated fluid. The uterine lining is destroyed as the balloon expands. High-energy radio waves: An electrical mesh is inserted into the uterus and expanded. Radio waves are passed through the mesh, causing it to heat up, which destroys the uterine lining. Freezing: a thin probe with a cold tip freezes and destroys the lining of the uterus. Microwave: Microwaves are passed through the uterus, destroying the uterine lining. Electrical: An uncommon procedure is to destroy the uterus lining by passing an electrical current through it. This procedure is not recommended for women who are pregnant or considering getting pregnant in the future, as it can make getting pregnant much more difficult. Endometrial ablation is also not recommended for women who have: Gone through menopause A vaginal or cervical infection A weak uterine wall An IUD Cancer of the uterus or cervix Pelvic inflammatory disease (PID) Side Effects of Endometrial Ablations Normally, it shouldn’t take long for a woman to heal and resume her normal routine following an ablation. It’s common to feel nausea and have an urge to urinate for the first 24 hours following the procedure. Some cramping and bleeding should be expected for a few days, and a watery or bloody discharge can occur for up to three weeks. The discharge comes out first as a watery pink fluid and may be heavy during the first three days after the procedure. Gradually, it changes to a brownish color and becomes lighter. Women can use pads to absorb the discharge and change them every time they go to the bathroom. Do not use a douche or tampons while recovering from an endometrial ablation. For the first few days after the procedure, women can have pain and swelling in their lower abdomen, which could feel like menstrual cramps. To help ease the pain, place a hot water bottle or heating pad on the belly for a half hour at a time. Don’t sleep with a heating pad on. Take any pain medication that the doctor directs. Typically, an over-the-counter pain medicine such ibuprofen is all that’s needed. Do not take aspirin, as it can exacerbate any bleeding. Women recovering from endometrial ablations can take showers as soon as they like, but shouldn’t soak in a bath or swimming pool. They should wait until vaginal discharge has stopped completely. Complications of Endometrial Ablation: When to Call Your Doctor Women experiencing any of the following symptoms should contact their doctor right away: A strong-smelling discharge from the vagina Fever of 100.4°F or higher Intense cramping, stomach pain or vomiting Heavy bleeding or bleeding that doesn’t stop two days after an ablation Difficulty urinating Periods that aren’t lighter after three menstrual cycles Visit with your healthcare provider if you’d like more information about endometrial ablation. Together, you can determine if this procedure is right for you.
An update on COVID-19 (Coronavirus) from The Providers of Women’s Integrated Healthcare, P.A.
March 12, 2020 COVID-19 Screening Information First and foremost we wish to keep everyone as safe as possible, this includes patients and staff. We will be asking all patients the following questions in an effort to help determine whether you should be seen in our office. We ask that if you answer yes to any of the questions that you contact your PCP to be evaluated, if you do not have a PCP then you should visit an urgent care. Should you arrive to our office and be found to meet any of these criteria, you will be immediately rescheduled so that we do not expose other patients and staff. Please remember that our pregnant patients are at increased risk of developing infections. 1. Are you having flu-like symptoms; fever, or respiratory symptoms such as cough, or shortness of breath? 2. Have you traveled to an affected geographic area within 14 days of symptom onset? 3. Have you been in close contact with someone confirmed or being evaluated for COVID-19? If you have answered yes to any of these questions, you will need to be rescheduled 14 days out from the date of symptoms or from your return home from travel. You can call our office at 817-416-2229 to have your appointment rescheduled. Thank you for your understanding, The Providers of Women’s Integrated Healthcare, P.A.
Combating Stress in Young Adults
Stress Coping Mechanisms for Teens and Young Adults. This time of the year brings the last stretch of school into view for many young adults. With only one more semester to go, students can’t help but think about a fun summer ahead, maybe going off to college and being on their own for the first time, or maybe they’re finishing college and about to face the “real world.” What students sometimes fail to realize is that with lifestyle changes and new responsibilities come a whole mess of stress. What is Stress? Known as the fight or flight response, stress is a physical, emotional and mental reaction to change. Stress can often be good for us, pushing us to get work done and stay motivated. However, too much stress can lead to wear and tear on the body. It’s important that parents and their teenagers/young adults understand stress and how to control it. Stress is caused by many things, such as poor time management and pressures such as housework, roommates, homework, school or work. Many of these stressors will only get worse as students go off to college. Most will have to deal with multiple causes of stress in a day leading to an overwhelmed feeling and overall taking a toll on their health. 9 Side Effects of Stress Headaches Upset stomach Elevated blood pressure Sexual dysfunction Worsening premenstrual syndrome Problems sleeping Depression Panic attacks Anxiety For young adults specifically, stress creates detrimental side effects. For one, stress and sleep often create a snowball effect. The more stressed you are, the less you tend to sleep. The less you sleep, the more stressed you get. It’s recommended that teens get eight to 10 hours of sleep a night, yet only 15 percent say they get eight hours on school nights. A lack of sleep will make you tired, moody and more likely to fall asleep in class or, dreadfully, behind the wheel of a car. Additionally, stress tends to change eating habits for the worse. Students refer to weight gain as the dreaded Freshman 15, but stress can show itself in overeating and under-eating. A concerning 25 percent of students admit to skipping meals due to stress, while 13 percent report skipping a meal at least once a week. According to an American Physiological Association study, teens’ stress levels are reported at a 5.8 on a 10 point scale. That is 1.9 points higher than that of recommended levels and 0.9 points more than adults. “When I’m stressed, I tend to not eat as much,” said current college student Angela. “Also, I tend to spiral when I get stressed out. Usually, it’s panic mode for a little bit until I focus and breathe.” What to do About Stress The first step to tackling stress is to teach children coping mechanisms early on. Signs that your child is stressed include irritability, moodiness and feeling sick. By teaching children stress management early on, they will be better prepared for life in the long run. Not surprisingly, students who developed time management skills in high school are more likely to succeed in college. During stressful situations, it’s important that young adults avoid overeating, shopping, binge-watching, spending too much time on social media and alcohol consumption. Instead, young adults should focus on healthy coping mechanisms against stress, include basic self-care: 9 Methods for Coping With Stress Good sleep Healthy foods Regular meals Physical exercise Spending time with friends and family Breathing exercises/meditation/yoga/stretching Staying organized and planning ahead for tests and project due dates Supplements, such as hemp oil extract, L-theanine and complex B vitamin (talk with your physician) Prescription medicine if prescribed by a physician to combat depression and anxiety If stress is too much and symptoms get worse, talk to your physician. Our physicians can help young adults figure out treatment options and the best ways to cope with stress. Make an appointment today.
The First Signs Of Pregnancy
How to Know When You’re Pregnant What happens when your period doesn’t show up? From the first period to menopause, women are considered in their childbearing years. It’s important that women know the signs of pregnancy so they can know when they may be pregnant. To understand why we experience symptoms of pregnancy, it may help to understand where the symptoms come from. Signs of Pregnancy: What’s Happening In The Body? During ovulation, an egg is released into the fallopian tube. If the egg becomes fertilized, it will move out of the fallopian tube and start reproducing cells for 2-3 days. Then it will try to attach to the uterine wall, which can take 3-4 days. This is the beginning of pregnancy, also known as the gestational period. By this point, the woman’s body is already experiencing an increase in hormone levels. The most well-known sign of pregnancy is a late/missed menstrual cycle. The most common first sign is spotting and light cramps as implantation occurs. According to an American Pregnancy Association study, only 3% recognized spotting as their first sign, while 29% said it was a late/missed menstrual cycle. Another common sign of pregnancy is morning sickness. Morning sickness, or nausea, can happen during the day and night, and doesn’t always include vomiting. Twenty five percent of women reported nausea as the first sign they were pregnant. Another common symptom is breast tenderness or changes. Seventeen percent of women reported changes in their breasts within the first week of pregnancy. Other changes include size and darkening around the areolas as hormones increase. Additional Possible Signs and Symptoms of Pregnancy Moodiness Bloating Increased urination Food aversion or cravings Fatigue Lower backaches Headaches Heartburn High blood pressure Constipation Nasal congestion It is important to note that many signs of pregnancy depend on a woman’s own body. Some women report experiencing multiple signs within the first week while others say they didn’t experience any for the first few weeks. Also, it’s obvious that these possible symptoms are common side effects of other health situations, so taking a pregnancy test is key to knowing the truth. When to Take a Pregnancy Test If you find yourself experiencing these signs of pregnancy and believe you’re pregnant, take a pregnancy test. Tests are available at local drug stores. The recommended time to take a pregnancy test is 1-2 weeks after your missed period. It’s typical to go to the doctor eight weeks after your last menstrual cycle, but if you think you’re pregnant, contact your physician right away to make an appointment. We look forward to sharing this journey with you!
Pregnancy Hospital Bag Checklist
Pack the essentials for your hospital stay as you welcome baby. The big day is almost here. You’ve been waiting many months to meet your baby. The rollercoaster of emotions, the discomfort, the anticipation and all the preparations have led you here. Your baby is days away from coming. But, do you have everything you need during your hospital stay? Pack a Hospital Go Bag The thought of a comprehensive, everything-you-could-possibly-need hospital bag can sound overwhelming. But take comfort in the knowledge of many women who’ve gone before you and conquered the hospital go bag. We’ve compiled a list of necessities and nice-to-haves for your pregnancy hospital bag. Before the big day comes, be prepared by spending time packing your bag. Clothing Slippers and socks Robe, nightgowns or pajamas that can unbutton easily for breastfeeding Nursing bras Inexpensive or old underwear that you don’t mind getting ruined Loose, comfy clothes to wear home Flip-flops for the shower Toiletries Lip balm and body moisturizer Travel shampoo/conditioner Travel hair dryer Hair elastics Nursing pads, nipple cream, maxi pads Eye mask and earplugs for much-deserved relaxation Make-up and skincare products Glasses and/or contacts Medications from home if directed by physician Paperwork Contact list for sharing your big news Phone numbers for anyone helping with the house/pets while you’re gone Your birth plan and any paperwork you’ve been asked to complete by the hospital and/or for insurance Gear Camera/video camera, phone and chargers Pillows Music, books, magazines, games and playing cards Notebook and pen Watch or smartphone with an app to time contractions Movies Water bottle Baby Items A going-home outfit for baby Approved infant car seat with the base properly installed in your vehicle A few onesies, socks and a hat Cozy blanket Package of newborn/size small diapers Package of unscented baby wipes Partner Items Warm clothing in case hospital room is cold Pillows/blankets Money for meals at the cafeteria Laptop Snacks and drinks Change for vending machines We know this is a long list, and you’re going to need a big bag. But it’s better to be prepared and have the most peaceful experience possible while delivering your baby. Back at Home: Preparations For Being Gone Before the big day nears, create a plan that ensures things around the house are taken care of when you’re welcoming a new member to the family. If you have other children or pets, make sure to set up plans for where they can stay in any scenario. Have contacts on hand for this that can respond at a moment’s notice (grandparents, aunts, uncles, etc.). Ask someone you trust to collect your mail and water your plants. If possible, pay bills in advance for peace of mind. With the chaos of delivery day, consider creating a phone tree that engages family members to help spread the good news. Checklist for the House: Do You Have These Items Covered While You’re Gone? Pets Plants Mail Lawn care/Sprinklers Security system Thermostat Conclusion Delivery day can be a swarm of emotions and craziness, but being prepared ahead of time is a big help for mom, her partner and loved ones. Enjoy the big day, and relax in the peace of knowing what you need is in your bag.
The Pap Test: What is It, and Who Needs It?
January is Cervical Health Awareness Month, and we’re committed to keeping you as healthy and informed as possible. As women, many of us get pap tests as part of our annual well-women exams. But, do we know why? We at Women’s Integrated Health believe it’s important to be aware of and understand what’s going on with your body. Here’s what you need to know about the pap test: The pap test is an important part of an annual well-woman visit for many women, because it can detect cervical cancer. Cervical cancer was once Nearly 13,000 women in the United States are diagnosed with cervical cancer each year, but the disease is preventable with vaccination and appropriate screening. According to the Centers for Disease Control and Prevention, “Cervical cancer used to be the leading cause of cancer death for women in the United States. However, in the past 40 years, the number of cases of cervical cancer and the number of deaths from cervical cancer have decreased significantly. This decline largely is the result of many women getting regular Pap tests, which can find cervical precancer before it turns into cancer.” January is Cervical Health Awareness Month, and at Women’s Integrated Health, we’re committed to keeping you as healthy and informed as possible. What is a Pap Test So, exactly what is a pap test? A gynecologist, a doctor who specializes in women’s reproductive organs, performs a pap test during a regular well-woman exam. The physician takes samples of cervical cells and tests them for any precancerous symptoms. Cervical cancer is usually caused by human papillomavirus (HPV), so it’s common to get both tests at once. The process includes: The patient lies on the exam table and places her feet in the stirrups. The health care provider gently places an instrument called a speculum into the vagina to open it slightly. This allows the provider to see inside the vagina and cervix. Cells are gently taken from the cervix area with a brush. This process shouldn’t hurt, but it may pinch and be uncomfortable. The cells are sealed in a liquid container. The sample of cells is sent to a lab for examination. The patient receives her results in a few weeks, and, if the results are abnormal, she is notified about a follow-up visit. What if the Pap Test Results are Abnormal? An abnormal pap test means that the lab detected abnormally shaped cervical cells in the sample that was sent for testing. Most of the abnormal cells are not cancerous but instead are the result of a cervical or vaginal infection. Abnormal pap tests are common. If a pap test comes back abnormal, a woman’s provider will probably order additional testing, often HPV DNA testing. Some abnormal test results call for a colposcopy, a procedure to look closely at the cervix with a colopscope, a microscope-like device. If the coloposcopy brings back abnormal results, a biopsy is called for to determine presence of cervical cancer or precancerous conditions. If cervical cancer is detected during the biopsy, treatment options include surgery, radiation and chemotherapy, depending on the stage of the cancer. How to Prepare for a Pap Test It is recommended to avoid having sex, using tampons and being on your period three to four days before having a pap test. Women on their periods should call their provider to see if the provider prefers she reschedule. Who Needs a Pap Test? At Women’s Integrated Healthcare, all women receive individualized care. Every woman is encouraged to get her annual well-woman exam, but our individualized care recommendations will determine the procedures and tests performed during these visits. In general, it’s recommended that women should start screening at 21 and have a pap test every three years between the ages of 21 and 29, usually without HPV screening. At age 30, it’s recommended to get a pap test every five years with HPV screening. If abnormal results are detected, it’s usually recommended that women rescreen in sixth months to a year, as needed. Women at a higher risk for cervical cancer should get tested every three years. Who Doesn’t Need a Pap Test? If a patient has had a complete hysterectomy, there is no reason to continue pap screening. However, it’s important to note that all women should continue their yearly well-woman visits. Conclusion Cervical cancer was once one of the most common causes of death for American women, so pap smear tests can be life saving. We encourage women to be proactive, take control of their health and schedule their well-woman visits to stay on top of their overall wellness.
