Issue 7 - Mobile Ob

Mobile Ob-Gyn, P.C.
Center for Women’s Health
A Woman’s View
Women’s Health News and Updates from Mobile Ob-Gyn, P.C.
Fall 2004
Volume Six, Number Two
UNDERSTANDING THE EMOTIONAL
STAGES OF A WOMAN’S LIFE
FEATURING
DOCTORS JULIE GRINSTEAD, KIRBY PLESSALA, PHILLIP MADONIA AND CHARLES HANES, II
A
woman will go through many passages during her lifetime. She often begins her search for identity
during adolescence. During middle adulthood, her main focus is typically on marriage, family and
work. Throughout the mature years, she reflects - and she will either accept or change her destiny.
ADOLESCENCE
– Bridging the Gap Between
Childhood and Womanhood
Many changes occur in the bodies of adolescents as they mature into young adults,
capable of reproduction. Chemicals in the
body called hormones produce these
changes. Signs of physical development in
girls include:
• rapid gains in height and weight,
• breast development,
• growth of pubic hair,
• menarche (first menstrual period),
• growth of underarm hair,
• increased production of oil,
• increased sweat gland activity, and
• the beginning of acne.
Hormones are also responsible for emotional changes. Teens may feel confused,
have emotional outbursts, feel sad, or experience strong emotions or moods that change
quickly. Common behavioral concerns
include risk-taking behavior, rebelliousness,
wasting time, mood swings, drug experimentation, school problems, psychosomatic complaints and sexual activity.
It is important to learn how to openly
communicate about the physical and emotional changes that occur during puberty.
Questions concerning adolescent sexuality
were addressed in a special program entitled
“Can We Talk”, co-sponsored annually by
Mobile Ob-Gyn and Providence Hospital.
During the March, 2004 seminar, adolescent
girls were given an opportunity to ask Dr.
Julie Grinstead questions about their changing bodies and budding sexuality.
Simultaneously, their mothers were talking
with clinical psychologists, Drs. Cay and Kent
Welsh. Dr. Grinstead received such questions as, "Do you get twins by having sex
when you're already pregnant?" proving that
there are a lot of myths and misinformation
circulating among young girls today.
In the correlating Q&A session with the
mothers, the Welshes explained that children
are constantly pushing their boundaries,
beginning as early as the uterus. As they
enter adolescence, the need to become independent is normal, healthy behavior. It is the
parents' job to provide resistance; something
good to push against.
October is National Breast Cancer Awareness Month
During this period of
emotional and physical
growth, Dr. Grinstead
states that it is vitally
important for teens to
get enough sleep (up to
10-11 hours), exercise
and eat nutritious meals
Julie Grinstead, M.D.
to help build strong
bones and stamina. Ensuring that a teenager
gets these things is a way that parents can
exercise and provide that good resistance the
Welshes recommend.
(Continued on 2)
Inside This Issue:
“Understanding the Emotional
Stages, cont.” . . . . . . . . . . . . . . . 2
Postpartum Depression
Menopausal Transition
The Older Woman
“In Their Spare Time” . . . . . . . . . 3
Spotlight on Dr. Robert Wood
“Calender of Events” . . . . . . . . . . 3
“About Breast Cancer” . . . . . . . . 3
“What’s New?”. . . . . . . . . . . . . . . . 4
(Continued from p.1)
POSTPARTUM DEPRESSION
MENOPAUSAL TRANSITION
– Beyond the Blues
– Making Sense of The Change
Both postpartum depression and postpartum blues,
have been reported in
greater than 80 percent of
mothers. The problem, usually indicated by depression
and crying during the hospital stay or soon after going
Kirby Plessala, M.D.
home, is generally limited to
a few days and goes away spontaneously.
Dramatic hormone changes can contribute
to a new mother's feelings of depression. Just
before delivery there are amazingly high levels
of estrogen, progesterone and other hormones
in the mother's body. Immediately after
delivery these levels fall dramatically and the
mother's hormones sometimes do not return to
normal for two to three months. Dr. Kirby
Plessala says that other key factors in postpartum depression include fatigue, genetics, and
the environment.
When Dr. Plessala counsels a
new mother who is experiencing
the blues, the conversation might
go something like this: "She'll tell
me that she's tired, emotional,
moody, and crying frequently.
Then I will usually ask, Can you
function? Is this something that is
inhibiting your daily activities
where you can't care for your baby
or yourself? Is it incapacitating
you? If the answer is yes, then we're
getting more into depression. Then
I'll usually make the recommendation for a
treatment. If the answer is no, then the next
question is, are you getting the help you need
from your family? Do I need to help you by prescribing a medication?"
He continues by saying, "It may not be medication that you need. Help may come from the
pediatrician – he may say you need to do something different with your feeding or something
different with the baby to help alleviate some
of the stressors that you're feeling with your
baby. The help may come from the obstetrician
in providing reassurances that you're normal
and fine. There may be some emphasis on
accepting help when it's offered to you."
Dr. Plessala also stresses that women who
have been depressed or hyper-emotional
during their pregnancy may want to consider
taking an anti-depressant about 4-5 weeks
prior to delivery in anticipation of postpartum
depression. After three months of experiencing
the positive effects of the medication, he said
some women discover that they have been
depressed for years. “When that is the case, we
recommend that they stay on the medication
and come back to see us in a year,” he
concludes.
The transitional stage
of menopause has been
described as “adolescence in
reverse” with fluctuating
hormones and emotions.
Many women enjoy this
time of no worries about
Phillip Madonia, M.D.
pregnancy and menstruation; yet other women
mourn the loss of their fertility and youth.
Physical changes during the menopausal
transition may include:
• irregular and unpredictable menstrual
periods
• night sweats
• hot flushes
• vaginal dryness
• depression
• fatigue
• memory and concentration loss.
Hormone Replacement
Therapy can help alleviate
some of these symptoms. Dr.
Phillip Madonia suggests that
estrogen can get you through
the transitional period with
mood swings; however, he
does not recommend that it
be used as an anti-depressant.
Women have an innate
wisdom about their own
bodies. Dr. Madonia states,
“If I tell a patient that I
believe she doesn't need to take hormones anymore because she's transitioned, and she says,
‘but I feel miserable when I don't take them,'
then that means that we should give her an
anti-depressant medication.” Unfortunately,
many of the SSRI drugs, like Prozac, Zoloft,
and Paxil have adverse sexual side effects.
Dr. Madonia has seen an epidemic number
of women who are voicing concerns about the
loss of their sex drive. He said, “The first thing
we do is sit down and try to analyze their stage
of life - are you working 60 hours a week? Do
you have a good relationship with your
husband? Do you still have a young child or
teenager at home who's getting on your last nerve?"
While there are no
simple solutions, there are
some things women can do
to improve their sex lives.
Dr. Madonia often prescribes
testosterone for his patients
with good results. Some of
his patients have also
tried Avlimil, an over-thecounter herbal supplement,
with a few promising
testimonials regarding its effectiveness.
When asked if he recommended that
women sign up for educational seminars on
menopause, he enthusiastically replied,
“Absolutely! The seminars are free and we
present a lot of fabulous information about
understanding menopause, hormone replacement therapy, management and treatment
options, and hysterectomy alternatives. I think
the more you know, the better off you are.
Information and knowledge are very
liberating."
THE OLDER WOMAN
– Aging Gracefully
The average woman will
live a third of her life after
menopause. Taking good
care of your heart; evaluating your cholesterol, calcium
and magnesium levels; and
assessing your bone density
are important. Osteoporosis
Charles Hanes, II, M.D.
and heart disease become
serious potential health concerns, as well.
Postmenopausal women may also experience vaginal dryness, which can lead to painful
intercourse. Women who have had a hysterectomy and undergone surgical menopause may
experience incontinence and decreased libido.
Women who began hormone replacement
(HRT) during perimenopause may decide to
continue it through the postmenopausal years.
Those with cancer, osteoporosis, and heart
concerns will want to research their options
and discuss these with their doctor. Dr. Charles
Hanes says that local forms of estrogen like
vaginal creams, suppositories, and vaginal rings
are sources of estrogen that can be safely used
without systemic effects.
According to Dr. Hanes, “Exercise has
tremendous physiological and emotional
benefits. It is vital for both sleep and energy,
and helps with weight management and bone
protection. We have more energy when we're
in good shape.”
"I think it's really helpful for women to find
an outlet, something with which to involve
themselves,” says Dr. Hanes. "So many have
spent their whole lives giving their life-blood to
their children and their family. It's a
great time for introspection. It's meeting
the challenge of finding your purpose in
life."
The physicians of Mobile Ob-Gyn, P.C. are
committed to informing patients about women’s
healthcare issues through regular educational
seminars that cover each stage of a woman’s
life: adolescence to childbearing years,
menopause to the golden years.
We strongly encourage women to take
charge of their health by staying informed.
In Their Spare Time...
with Dr. Robert Wood
Mark Your Calendar
Surgical Interventions in
Women’s Healthcare
Mobile Ob-Gyn, P.C. Lobby
Providence Hospital Physician Buildings
Suite B-321
Light refreshments will be served. RSVP at 633-0793.
“Dropped Bladder? Successful Surgical
Solutions & Prevention of Recurrence”
with Charles Hanes II, M.D.
Thursday, November 4th • 6:00 p.m.
29-40% of all prolapse surgery are re-operations due
to failurewithin three years of the original surgery
Join Dr. Hanes as he discusses technical advances
that minimize failure.
wo pictures are prominently displayed on his office desk. One is
of Dr. Robert Wood and his beautiful wife, Kristina. The other is
of his three equally beautiful daughters, Taylor, 9; Peyton, 6; and
Ryan, 4. He said that at the end of a typical workday, before he can even
get in the back door, he is met with, "Daddy, Daddy, Daddy!" The girls
can't wait to tell him about their current extracurricular activities, like
ballet practice, gymnastics, piano, soccer, cheerleading, or basketball.
The sixth member of the family, Katie, is a 5-year-old chocolate lab.
Her picture is also affectionately displayed in his office. Dr. Wood
personally trained her, beginning as a puppy, to retrieve ducks. She
accompanies him when he goes duck hunting in Louisiana.
During the summer months, the entire family likes to fish. Dr. and
Mrs. Wood take their three fishing ballerinas and a picnic lunch to
Dauphin Island. There they spend time fishing, building sandcastles,
and swimming off Sand Island.
Going to Auburn during football season is a big deal for the entire
Wood family. Dr. Wood states, "We go to every home game unless our
schedule just prohibits it. We have a great family and friend reunion with
my parents, my brother and his kids, Kristina's parents and her brothers.
My parents park a motor home in the same spot for every game, so
everybody knows where to find the Woods. We put on a huge tailgate
party, with up to 50 people coming by to eat and visit.”
Disney World has also become an annual trip for the family. “Right
after Fat Tuesday, we drive to Orlando. We meet Taylor’s godparents and
hit the parks. Combined, we have four adults and five kids there and
ride everything from ‘It’s a Small World’ to ‘Space Mountain’,” says
Dr. Wood.
It is important to Dr. Wood to get home in time to have family
dinners and to join Kristina in reading to their girls before they go to
sleep at night. His own personal reading preferences include fiction by
authors such as Stewart Woods and John Grisham, along with Sports
Illustrated and Newsweek.
Dr. Wood usually runs the 10K in the Azalea Trail Run and also
enjoyed doing the one-mile Fun Run with Taylor and Peyton this year.
Ryan “ran” the race on Mom’s shoulders. He has now started doing
triathlons (longer races where you swim, bike, and run) and is really
enjoying those. Training usually occurs early in the morning or late at
night, so watch out for him!
Dr. Wood's eyes light up when he talks about his wife, Kristina. He
said, "Kristina is the glue, she's just fabulous. After 13 years of marriage,
we are still becoming better friends every day. We'll talk on the phone
T
2 and 3 times a day doing what I call ‘weather checks’: How are you?
What are you doing?"
When asked why he chose the field of Ob-Gyn as a specialty, Dr.
Wood responded: "I like delivering babies and I like doing
technically interesting types of surgery, especially laparoscopy. But I
think more than that, it probably goes back to the whole family
thing. I feel that the woman holds the family together. There is
something about having a bond with that patient; watching her
through her pregnancy and adding to someone's family that really drew
me into it.”
“Laparoscopic Supracervical
Hysterectomy (LSH) First Choice for Today’s Active Woman”
with Robert Wood, M.D.
The physicians
& staff of
Mobile Ob-Gyn,
P.C. are pleased
to support the
American Cancer
Society's
Paint the Town
Pink Event
set for
Saturday,
October 30th
at Springhill
College.
Registration for
the walk starts
at 8:30 a.m.
For more
information,
call the American
Cancer Society at
800-225-2345.
Tuesday, November 9th • 6:00 p.m.
The Truth About Breast Cancer
Dr. Henry Koch Addresses Common Myths & Misconceptions
• I do not have a family history; therefore,
my risk of breast cancer is insignificant.
In fact, most women diagnosed with breast cancer
have no family history. While a positive family history
does increase an individual’s risk of getting breast cancer,
a negative history is, by no means, a reason to be less
vigilant. Currently 80% of the women with breast cancer
have none of the known risk factors.
• My mammogram was normal so I do not have anything
to worry about.
Though a normal or negative mammogram is reassuring, it is not an
infallible test. 10% of palpable (can be felt) breast cancers are not visible on
mammograms. For this reason self-breast exams monthly and annual exams by
your doctor are essential in the early detection of breast cancer.
• If I find a breast lump it will almost certainly be cancer.
Most breast lumps are benign fibroadenomas, cysts or other nonmalignant
conditions. It is imperative to evaluate these immediately. This will both
ensure that they are not cancerous or for early diagnosis if the results indeed
are positive. Diagnostic tests might include mammography, ultrasound, needle
aspiration, biopsy or even watchful waiting through a menstrual cycle.
• I am too young to get
breast cancer.
While age is the biggest risk
factor, breast cancers may occur in
the teens. Overall, the lifetime
risk of breast cancer is one out of
every eight women in the U.S. A
50-year old female has a risk of one
in forty, increasing to one in
twenty-four at age 60 and one in
fourteen by age seventy.
Every year the physicians and staff
of Mobile Ob-Gyn, P.C. recognize
October as Breast Cancer Awareness
Month. Throughout the month,
we will offer a special gift to each
patient who schedules a mamogram.
We encourage you to make an
appointment for your annual clinical
breast examination (CBE)
and mammogram now.
;
What’s New!!
Congratulations!
We would like to welcome our new Director
of Clinical Research, Pamela J. Angerholzer.
Julie and Andrew
Grinstead
introduce
Milligan and
McGowin -- born
June 22, 2004
Pam is an R.N. with 30 years of nursing and four and a half years
of research experience. She also has a certification in Women’s
Health and Clinical Research. Pam has worked with Mobile
Ob-Gyn off and on since 1977!
Clinical Trials are research studies performed by physicians and
healthcare professionals to help determine if a medication is safe
and effective. All medications, even over-the-counter ones,
originate through research trials.
Our patients will be offered the opportunity to participate in
clinical trials on-site. Voluntary participation is at no cost. Trials
may include medication, examinations, and diagnostic and
laboratory tests. Possible travel-related reimbursements may also
be offered.
Clinical Research enables the physicians of Mobile Ob-Gyn to
offer our patients an improved quality of life, extra hands-on care
and cutting-edge treatments. We hope these trials will greatly
benefit, not only our patients, but also the population at large.
A Woman’s View
is a bi-annual women’s health newsletter from
the physicians of Mobile Ob-Gyn, P.C. for our
patients & the women of our community.
Our Mission
is our commitment, as a fully integrated team of
physicians & staff, to provide consistent, high
quality care for each patient in an environment
that is both professional & compassionate.
Our Vision
is to respond actively to the changing needs of
each patient as she advances through the stages
of her life. We will fulfill this endeavor by
expanding our practice through diversified
services; specialized care; and a progressive,
integrated approach to healthcare.
We will seek to earn the trust and respect of each
patient. Then, in partnership with the patient, we
will strive to maintain the privilege to provide her
with the best possible healthcare over the course of
her lifetime.
-
Do you, or someone you care about, currently suffer
from female urinary incontinence? If so, we encourage
you to ask your doctor about an educational video,
“Understanding Female Urinary Incontinence:
Treatment, Management & Surgical Intervention”
Developed by
The Continence Center of Mobile at Mobile Ob-Gyn, P.C.
Call Cheryl Perry, R.N. at 633-0793
to request your complimentary video today!
Mobile Ob-Gyn, P.C.
Center for Women’s Health
Phillip Madonia, M.D. • Henry J. Koch, M.D.
Charles R. Hanes II, M.D. • Kirby J. Plessala, M.D.
Shawn J. Kleinpeter, M.D. • Robert A. Wood, M.D.
Julie G. Grinstead, M.D.
6701 Airport Blvd.
Suite B-321
Mobile, Alabama 36608-6703
(251) 633-0793
www.mobileobgyn.com
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