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Health Related Questions and Answers

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Here you will find answers to frequently asked questions and information on obstetrical and gynecological topics that may concern you. This information is updated on a regular basis, so please check in periodically for new additions. Please keep in mind that the answers provided are generalizations and may or may not apply to your particular case.

General Obstetrical Questions

I have noticed that I am beginning to have swelling of my feet. My friends tell me to go home and put my feet up. Is this true?

If I try to get pregnant during the next several months, should I be taking some vitamin supplementation?

Is there an optimum weight gain that I should set as a goal during my pregnancy?

I am very early pregnant and I had a small amount of spotting. Should I be alarmed?

I'm not happy with my sex life. Is something wrong with my hormones?

Should I be taking extra calcium supplements along with my diet?

I keep hearing about HPV virus. What is it and why is it important?

What about the HPV vaccine? Should I get it?

How do I know if I am in premenopause?


Urinary Tract Infections Questions

What are UTI Symptoms?

How do I collect a Specimen?

What are UTI Treatments?

What are some ways to prevent UTI?




I have noticed that I am beginning to have swelling of my feet. My friends tell me to go home and put my feet up. Is this true?
While your friends are well meaning, a pregnant person should not sit with their legs elevated. That position could actually increase your swelling, as well as increase your chances for other problems.

The following is a discussion taken from your PRENATAL INSTRUCTION BOOKLET. If, after following these recommendations, you notice that the swelling is increasing, please call the office and bring that to the attention of your provider.

LYING ON YOUR SIDE: During pregnancy, as the uterus continues to grow, it places more weight upon the blood vessels which supply your kidneys. This is particularly noticeable when a pregnant woman is standing, sitting or when she is lying on her back. The increased compression of the blood vessels which supply your kidneys prevents the kidneys from removing excess water from the body. As a consequence, swelling of your fingers, your feet, and your face are usually noticeable. More importantly, an increase in your blood pressure may result.

The only way we can prevent this from happening is to ask patients to lie on their side. This increases the blood flow to the kidneys, allowing them to remove some of the water. In addition, lying on your side will increase blood flow to the uterus, thereby supplying the baby with more oxygen and nourishment. All pregnant women should get into the habit of lying on their side early in their pregnancies. It is assumed that you are in this position while you sleep. The extra time mentioned here refers to daylight hours.

If the doctor notices that you are beginning to retain water, or if your blood pressure is beginning to increase, he may very well suggest to you that you spend more time lying on your side. We suggest spending one hour at least three times during the day. You need not sleep. You may read, watch TV, watch the children play. It is only important that your position is flat and that you are either on your left or right side. Do not sit with your feet elevated!

If you awaken in the morning and notice that there is still swelling of your fingers or your feet, then you should try to spend more than the three hours that day lying on your side. Learn to increase the amount of time that you spend in this position yourself and adjust it accordingly.


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If I try to get pregnant during the next several months, should I be taking some vitamin supplementation?
It has been shown that if a woman takes a daily dose of .4 mg. of folic acid each day several months prior to becoming pregnant, it can lessen chance for neural tube defects in her baby. These defects result in malformation of either the brain or the spinal cord. It is not necessary to take a high priced vitamin supplement. Any nonprescription prenatal vitamin will usually suffice.


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Is there an optimum weight gain that I should set as a goal during my pregnancy?
The combined weight of the baby, increased size of the uterus, increase in blood and amniotic fluid, as well as the placenta usually totals about 26 pounds. Weight gain during pregnancy of more than this amount usually is accounted for by increased fat deposits in the patient, or fluid retention.

During the first 16 weeks of the pregnancy, we would encourage you not to focus too much concern on your weight. Some people will actually lose weight during these weeks, due to nausea, vomiting, or perhaps to even better eating habits than they had prior to getting pregnant. Others may gain more weight than they would like because they find that starchy foods help make their stomach feel better.

After 16 weeks of pregnancy, however, we encourage you to try to limit your weight gain to 2 1/2 to 3 pounds for each month remaining during your pregnancy. There are some exceptions to this guideline. For example, people who start their pregnancy very underweight and malnourished may benefit by a few added pounds of weight gain. It is important to remember that during the last few months of pregnancy, excessive weight gain in the patient will usually also be associated with increased weight of the baby at birth. What might have been a 7 1/2 lb. baby could easily result in a baby weighing 9 1/2 to 10 lbs. Obviously, this increase in the baby's weight will often be reflected in a more prolonged and possibly difficult delivery. A few hints in helping the patient to limit her monthly weight gain amounts are listed below:


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I am very early pregnant and I had a small amount of spotting. Should I be alarmed?
During the first 8-10 weeks of pregnancy, a small amount of spotting or brown discharge is exceedingly common. As the developing placenta attaches itself to the wall of the uterus, it will frequently generate a few drops of blood, which the patient will notice as a slight blood-tinged discharge, small spotting or a brownish discharge. This usually resolves spontaneously and does not affect the rest of the pregnancy.

Unfortunately, if the pregnancy, for whatever reason, was not developing normally or it was not continuing, this small amount of bleeding could signify that a miscarriage will be forthcoming. If the pregnancy is less than 7 weeks by dates, it frequently is impossible to tell which of the above outcomes will occur, even when we use ultrasound. When an early pregnant patient does experience bleeding in the early weeks of her gestation, we recommend the following:


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I'm not happy with my sex life. Is something wrong with my hormones?
Female sexuality is a hugely complex subject. In a recent pole, 43% of the women were dissatisfied in one form or another with their sexual life. I would strongly recommend the book, I'm Not In the Mood, by Judith Reichman, M.D. This is a very comprehensive book and goes into many types of sexual dysfunction and their possible causes and treatments in great detail. We have copies in our lending library and it can be obtained through any major bookstore or on-line.

There are several components to the female sexual response and they generally follow the pattern below. This was taken from the American College of Ob/Gyn patient education pamphlet on sexuality and sexual problems:

The Sexual Response Cycle

A woman's body follows a regular pattern when she has sex. There are four stages:

The possible cause, and therefore treatments, of your particular sexual unhappiness may very well depend upon which of the above categories that you think best reflects your situation. We would encourage you to discuss these issues with your provider. Hopefully you will be able to review the above mentioned book prior to your visit with your physician.

During his residency training in obstetrics and gynecology, Michael R. Mirwald, M.D. completed a three month elective rotation on human sexuality and sexual dysfunction. This was offered by the Psychiatric Department, Loyola University Stritch School of Medicine, in Chicago. It was headed by Domeena Renshaw, M.D. Dr. Renshaw maintains this program in Chicago and is a frequent guest on television programs and has been published extensively.


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Should I be taking extra calcium supplements along with my diet?
Unless you have a medical condition and your physician has told you to avoid increasing your calcium, it is generally felt that most people, particularly women, should take extra calcium supplementation in addition to their regular diet. Below is a chart of recommended doses of calcium that was produced by the National Academy of Sciences in 1997. For infants and children please consult your Pediatrician prior to adding any extra calcium to their daily diet. A woman's peak bone density mass should occur when she is approximately 30-35 years of age. If, because of her diet, other medications, or medical illnesses, she has not absorbed sufficient calcium during her early years of life, she will frequently not maximize her bone density by the time she is 30-35 years of age. When menopause occurs it is anticipated that there will be a rather dramatic decrease in bone loss for all women, particularly during the following 5-6 years. For those people who have not maximized their bone density when they were younger, this can put them at risk for osteoporosis.

It is important to remember a few facts about calcium supplementation:

CALCIUM

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