Friday, August 29, 2014

Heavy Periods or Abnormal Bleeding?  Novasure Endometrial Ablation may be the answer.

What is NovaSure Endometrial Ablation?

NovaSure® endometrial ablation is a quick, safe, and simple procedure to lighten or stop your periods, without the side effects of hormones or the risks of hysterectomy.

Why choose the NovaSure procedure for your heavy period?

  • The NovaSure procedure is safe: No pills. No hormonal side effects.
  • The NovaSure procedure is effective: For 90% of women, menstrual bleeding is dramatically reduced or stopped.
  • The NovaSure procedure is quick: NovaSure endometrial ablation is a one-time, five-minute procedure that can be done in your doctor’s office, usually for the cost of a copay.

How does NovaSure endometrial ablation procedure work to treat heavy periods?

NovaSure endometrial ablation, is a one-time, 5-minute in-office procedure trusted by over 2 million 1 women.  NovaSure® is an endometrial ablation (EA) procedure that can reduce or stop menstrual bleeding. It works by removing the endometrium, or the lining of the uterus (the part that causes the bleeding), with a quick delivery of radiofrequency energy.

NovaSure endometrial ablation procedure steps and how it works:

NovaSure: Heavy Period Treatment Step 1  Your doctor slightly opens your cervix (the opening to the uterus), inserts a slender wand, and extends a triangular mesh device into the uterus
NovaSure: Heavy Period Treatment Step 2 The mesh gently expands, fitting to the size and shape of your uterus
NovaSure: Heavy Period Treatment Step 3  Precisely measured radio frequency energy is delivered through the mesh for about 90 seconds
NovaSure: Heavy Period Treatment Step 4  The mesh device is pulled back into the wand, and both are removed from the uterus.


No part of the NovaSure endometrial ablation device remains inside your body after the NovaSure procedure.

Benefits and considerations of NovaSure procedure for heavy periods

NovaSure is Safe
No pills. No hormonal side effects.

NovaSure is Effective
For 90% of women, menstrual bleeding is dramatically reduced or stopped.

NovaSure is Quick
NovaSure endometrial ablation is a one-time, five-minute procedure that can be done in your doctor's office, usually for the cost of a copay.

NovaSure endometrial ablation can do more than just stop the menstrual bleeding. Many women who've had the NovaSure endometrial ablation procedure say they are now able to spend more time at work and daily activities, participating in more social and athletic outings now that they no longer suffer from heavy menstural bleeding. They also report improved energy levels, better moods, and a boost in self-confidence. And many also had a significant reduction in painful periods and PMS symptoms like irritability.*

Not all women are candidates for NovaSure Endometrial Ablation.

Your doctor will explain the risks of all treatment options. NovaSure endometrial ablation is for premenopausal women with heavy periods due to benign causes who are finished childbearing. Pregnancy following NovaSure can be dangerous. NovaSure endometrial ablation is not for those who have or suspect uterine cancer, have an active genital, urinary or pelvic infection or an IUD. NovaSure is not a sterilization procedure. Rare but serious risks include but are not limited to thermal injury, perforation and infection. Temporary side effects may include cramping, nausea, vomiting, discharge and spotting.

1.Hologic Inc., Data on file, 2014.
*Cooper J, et al. A randomized, multicenter trial of safety and efficacy of the NovaSure system in the treatment of menorrhagia. J Am Assoc Gynecol Laparosc. 2002; 9:418-428.



Tuesday, August 26, 2014

Make Way for Baby: 8 Tips for a More Comfortable Labor & Birth

People often track a woman’s labor progress by how much her cervix is dilating (opening), but much more is happening during labor.
With each contraction, a woman’s uterus pushes her baby down into her pelvis, and the baby tucks and turns to find its way through. A woman feels intense pressure and stretching as her baby moves down. Ligaments – loosened during pregnancy –allow the pelvic bones to move and make more room for the baby.
Most women worry about labor being long or difficult. Small minorities of babies become stuck in a tough position during labor, or have heads bigger than their mother’s pelvis, and are eventually born by cesarean. A majority of babies can and will fit through the pelvis, given enough time and support. If we look at labor from the baby’s perspective – as a challenging journey through a woman’s curvy, tunnel-like pelvis – there are several things women can do to enhance comfort and encourage their baby’s progress toward birth.
During pregnancy
Be active
Aim for at least thirty minutes ofmoderate activity daily – it doesn’t have to be all at once.  Walk, jog, or swim. Try yoga, which combines stretching and strengthening with breath awareness, a great a mind-body preparation for labor. Staying fit will give you the strength and flexibility to move around during labor to help your baby move through your pelvis.
Eat well
Healthy eating will help you grow a healthy-sized baby. Choose plenty of vegetables and whole grains, and beans, nuts, lean meat, dairy, eggs for protein. Try to eat smaller meals at meal times and snacks with protein in between. Ask your provider about recommended weight gain for the full pregnancy, and try to stick to your goal. If money is tight you may qualify for the Women, Infants and Children (WIC), a government program offering financial assistance for buying food.
Sit smart
Watch posture during long hours at your desk or in the car. When a woman sits lying back or hunched over with her pelvis tilted back, her lower back forms a comfy hammock for her baby and the baby is more likely to lie with its back against her back, looking up toward the ceiling. A baby who stays in this “posterior” position during labor has a harder time squeezing through the pelvis. You can encourage your baby to settle in an “anterior” position, facing down toward your tailbone, by sitting upright with hips above knee level and your pelvis and belly tilted forward. Tuck one pillow behind your lower back, and if necessary, another pillow under your buttocks.
Take a birthing class
Childbirth classes teach pain-coping practices, labor positions, and helpful comfort measures. This knowledge may help minimize stress and fear and provide you with tools for coping with pain and unexpected events during labor.
During labor
Walk, move around, and change positions
If you listen to your body, you will often choose the best position for your baby’s labor progress.  Sway back and forth leaning on a partner “slow dancing,” try hands and knees position, or bounce, or do figure eight circles on a birthing ball. Change positions every few contractions to create more space for the baby to navigate through the pelvis.
Rest, reenergize and hydrate between contractions
After each contraction take a deep breath, and on the exhale release tension and let the body soften. Sip a drink or some ice chips to stay hydrated. If you’re hungry ask your provider if you may have light snacks. When fatigued, try positions that allow for maximum rest during breaks. Relaxation allows the baby to settle lower into the pelvis as labor progresses.
Ask your provider about your baby’s position
A baby who is face down in the “anterior” position usually has an easier time fitting through the pelvis than a baby who faces “sunny side up” in the “posterior” position. Contractions push the back of a posterior baby’s head against the back of its mother’s pelvis (sacrum), rather than straight down through the pelvis and into her cervix. The baby takes longer to engage in the pelvis, the cervix takes longer to dilate, and the mother experiences more back pain. If a baby is “posterior,” nurses, midwives, and doctors can suggest positions that will help encourage rotation. Sometimes a provider can turn the baby by gently rotating its head during an internal exam.
As you are pushing
Keep changing positions and resting between contractions
Just like earlier in labor, try to change positions every fifteen minutes during pushing. Sitting on the toilet, squatting, hands and knees, lying on each side, or lying on your back with knees pulled wide and back can all be helpful positions to push your baby down and out.  Use your breaks between pushes to rest – some women even fall asleep for a moment!
A baby makes its final twists and turns with the final pushes, and at last emerges into the world.  Labor is hard work, it hurts, but women and babies are strong, and we know that with time, support and encouragement they can do it.
Author:  Cory Simon-Nobes, APRN, CNM, is a certified nurse midwife at Champlain OB/GYN and Fletcher Allen Health Care.

Monday, August 4, 2014

From the Midwife: What is Healthy Weight Gain in Pregnancy?


 Baby weight – it’s a topic that has worried expectant mothers and fueled celebrity magazines for years. How much weight is normal to gain? Let’s change the question. What expectant moms really need to be asking is: how much weight gain is enough for a healthy baby?It’s normal for all women to gain weight during pregnancy. Typically, you will put on 2-4 pounds in the first trimester. Weight gain picks up after this. You will want to aim to gain ¾ to 1 pound weekly from the second trimester on.
How much weight you gain depends on you. Every woman is unique and so too is every pregnancy. Taller women, for example, may be advised to gain more weight. Ask your midwife what is right for you.
Here are some general guidelines from the American College of Obstetricians and Gynecologists:
If you are…
  • Normal weight before conceiving, gain 25-35 pounds.
  • Overweight before conceiving, gain 15-25 pounds.
  • Underweight before conceiving, gain 28-40 pounds.
  • Carrying twins, gain 35-45 pounds.
Where does all that weight go?
It will ease your mind to know that weight gain is caused by the following:
  • Baby (approximate weight gain is 7-8 pounds)
  • Placenta (approximate weight gain is 1-2 pounds)
  • Amniotic fluid (approximate weight gain is 2 pounds)
  • Breasts (approximate weight gain is 1 pound)
  • Uterus (approximate weight gain is 2 pounds)
  • Increase in blood volume (approximate weight gain is 3 pounds)
  • Body fat (approximate weight gain is 5 pounds)
  • Increased muscle tissue and fluid (approximate weight gain is 4-7 pounds)
That adds up to 25 pounds!
Does that mean it’s OK to give in to food cravings?
Yes and no. Estrogen, an appetite stimulant, will rise in your blood stream around your 13th week of pregnancy. You will be hungry. Be sure to indulge your cravings, but keep it in balance so as not to crowd out more nutritious foods. You do not want to contribute to excessive weight gain.
How many calories should I consume?
A full-term pregnancy (forty weeks) requires about 80,000 calories, which comes out to an extra 300 calories per day. This may differ from woman to woman depending on age, activity level, and pre-pregnancy weight. Eating extra protein is also recommended way to get the extra calories in. Shoot for 70-80 grams of protein per day.
Author: Marti Churchill, CNM,  is a certified nurse midwife at Champlain OB/GYN and Fletcher Allen Health Care. 



Wednesday, July 9, 2014


We are excited to announce that Champlain OB/GYN has added Certified Nurse Midwifery to the practice. 

Our goal, as always, is to provide comprehensive services, and appropriate and effective care.  We are confident that the FAHC Midwives are the perfect addition to our practice because we are all committed to offering you the most advanced and complete care that is personalized to your needs.  The FAHC midwives are the longest standing midwifery group in Chittenden County with many years of experience and they are well known for their individualized family-oriented prenatal care.   The physician and midwifery collaborative care model at Champlain OB/GYN will give you a balance of natural and medical perspectives during your pre and postnatal care in a convenient, comfortable and relaxed practice.  You will have the same or similar testing and treatment options available to you and you will still deliver your baby in the hospital setting.  
Your care will be primarily with the Midwives.  They will see you for your monthly, bi-monthly, weekly, and bi-weekly visits.  Champlain OB/GYN physicians will see you for any ultrasounds, problem visits, or consults that the Midwives recommend.  The on-call schedule for delivery will consist only of Midwifery call and the FAHC physicians will offer assistance if needed.  Your 6 week post-partum visit will be performed by a physician at Champlain OB/GYN.
We value the relationships that we have created with you and we understand that with any change there are many questions and concerns.  We would greatly appreciate you allowing us to answer your questions about this transition, please ask any questions or voice any concerns at your next visit, or call the office.
 Sincerely,
Champlain OB/GYN Physicians and Staff

Monday, June 2, 2014

From the Midwife: How to Handle Sibling Adjustment

The addition of a new family member – whether it is your first child or your fifth – affects everyone. Understanding that the older siblings need time to adjust is crucial.  The ease of the sibling’s transition has more to do with their personality and ability to transition to any change in their life than it has to do with their gender or the number of years between them. Bringing a new baby into your older child’s life may be one of the most challenging things s/he has had to deal with up until now, but it eventually will also be one of the greatest gifts you can give them.
Take some time helping to prepare them ahead of time can help them set up appropriate expectations and allow for feelings to be shared.
  • Tell your child about your pregnancy when you tell your friends. They should hear about it from you directly and not ‘overhear’ it or learn about it from someone else.
  • Bring them to some prenatal visits to meet your birth provider, hear the heart beat, and be able to ask questions.
  • Describe what life will like in the early days with the baby: they will sleep a lot, cry, breastfeed, need to be held and have their diaper changed.  You will need to spend a lot of time with the baby. The baby won’t be able to play with them and they won’t need to share their toys – in the beginning.
  • Try spending some time around a new baby with your child – at daycare or with a friend or family member with a new baby.
  • Share pictures, videos and stories about the birth and babyhood of your older child. Tell them about their birth and what they were like as a baby. Express how excited you were when they were born and how everyone wanted to see them and hold them.
  • Talk about how much you love them and not matter what you will always love them.  This may seem obvious to you but stating it out loud, a few times in different ways is important for your older child to hear.  Losing your love is what they fear the most.
  • Teach them how to hold a baby and practice holding and gentle touching with a baby doll.
  • Include them in any preparations they can – giving them choices whenever possible: such as which outfit should you bring the baby home in (A or B), picking out a gift for them to give the baby, choosing the color of the new car seat, etc.
  • Read books together about pregnancy, birth, adoption and new baby siblings.
  • If you are considering having your older child present at the birth – talk with your midwife about this. Many families have found this to be a very positive experience but it is not necessarily right for every family. Extra preparation should happen around what to expect at the birth, watching videos of birth and the child will need their own support person who can take them out if they become over whelmed. Saving an age appropriate job for them is special such as cutting the cord or putting on the baby’s hat.
Once your new baby is here there are ways to help your older child adjust:
  • Plan a birthday party for the day you get home. Have a frozen ice cream cake in the freezer or have a family member or friend get one for that day, have balloons, and a “0” candle. Sing Happy Birthday to the baby and have the older sibling give the baby a gift AND have the baby give them one.  It brings home the meaning of what a BIRTH day really is while creating a celebration for the whole family.
  • “Love bomb” the older sibling. Have people special to the older child be around more in the first week or two to fill in for the attention that you would normally give him or her.
  • Set aside time each day (away from the baby) for each parent to give uninterrupted one-on-one time with the older child. Even 10 minutes of focused attention has an amazing effect of showing them how you still love them and they are important. Let them chose the activity and you follow their lead.
  • Listen – really listen  – to how your child feels about the new baby and the changes in your family. If they express negative emotions, acknowledge them.  Help your child put words to their feelings. Never deny or discount their feelings.
  • Create ways for them to express negative feelings – draw an angry picture, act out feelings towards a doll or roar like a lion – but hurting is not allowed!
  • “Baby” your older child if that is what they crave. This may help stave off regression in other areas that are less acceptable to you. You may think your older child will become more independent when the baby comes home but often it is not the case.  Expect less independence and you may get more.
  • Remind visitors to pay attention to the older child (and not just the baby)
  • Have a few extra treats/gifts in the closet in case friends bring gifts for the baby and the older child feels left out.
  • Find jobs and creative ways the older child can help you: baths, dressing, pushing the stroller, putting silverware away from the dishwasher, helping vacuum, running to get the book to read while you breastfeed, etc. Follow your child’s lead on this and be careful not to overdo it. Any chance you can give the older child choice and power in their life, the more they feel in control – and less likely to act out for attention and power.
  • Talk about the ways being older is beneficial – they can chose what to eat, can go to the park and play, having friends, etc.
  • Read books together about families in transition – any time you can talk about and acknowledge their mixed up feelings & that they are all normal and ‘ok’ the better they can negotiate the roller coaster of change.

Marti Churchill, CNM, is a certified nurse midwife at Fletcher Allen Health Care.
Marti Churchill, CNM, is a certified nurse midwife at Champlain OB/GYN  and Fletcher Allen Health

Tuesday, May 13, 2014


Frequently Asked Questions About Midwifery


Champlain OB/GYN is excited to add Certified Nurse Midwifery care to our practice. All changes bring questions, so we’ve asked the Fletcher Allen midwives to answer a few commonly asked questions.

 

I’m confused, I thought midwives delivered babies at home.  Do they deliver babies at Fletcher Allen?

 

Many people think “home birth” when they hear the word “midwife,” and are surprised to learn that midwives deliver babies in the hospital. In fact, Certified Nurse Midwives (CNMs) have practiced at Fletcher Allen for over forty years, and have delivered thousands of babies in Fletcher Allen’s Claire M. Lintilhac Birthing Center! The Fletcher Allen midwife team is available 24/7 and provides prenatal, postpartum and well-woman care in the office, and labor, birth and initial postpartum care in the hospital.

 

Most midwife-attended births in the United States take place with Certified Nurse Midwives in hospitals, just like at Fletcher Allen.  CNMs are healthcare professionals who specialize in assisting normal, uncomplicated births. They are Advanced Practice Registered Nurses with graduate education in midwifery. They have graduated from an accredited nurse-midwifery education program, which includes a university degree as well as hands-on clinical training by practicing CNMs. They also have passed the national certification exam of the American Midwifery Certification Board (AMCB).  In Vermont most home birth midwives are either Certified Professional Midwives or Naturopathic Doctors, who go through different education and certification processes. 

 

Why would a woman choose a midwife?

 

Many women choose to give birth with the help of midwives because of a desire for individualized care and a unique birthing experience. The word “Midwife” literally means “With Woman.”  The midwifery model of care is evidence-based, promotes listening to women and respecting their desires, and minimizes the use of medical interventions unless necessary or requested by a woman. Midwives believe a woman and her family deserve the knowledge they need to make good health choices for themselves. A midwife does not simply tell a woman what to do, since what is right for one person may not be right for the next. Instead, a midwife offers information and helps each woman decide what is best for her and her baby, building a healthcare relationship grounded in trust and respect.

 

Midwifery care also produces improved health outcomes. National research indicates that women who choose a Certified Nurse Midwife have lower rates of induction of labor, cesarean birth, and perineal trauma, and higher rates of breastfeeding.  CNMs can prescribe medications and order diagnostic procedures when appropriate and medically indicated. 

 

Midwives use the same schedule of prenatal appointments and routine testing in pregnancy, but they tend to spend more time with women during prenatal visits, and more time by a woman’s side in labor – supporting her and watching for any health concerns.  They provide exceptional, individualized care to women across the lifespan, through pregnancy, birth, postpartum and beyond.

 

What if I have a complication that requires an obstetrician?

 

As a practice based in an academic medical center, the Fletcher Allen Nurse Midwives collaborate seamlessly with Obstetricians, Maternal Fetal Medicine specialists, and Pediatricians when needed. If a woman has a complication during pregnancy, the midwives will consult with collaborative obstetricians at Champlain OB/GYN and Fletcher Allen. During labor or prenatal assessments in the birthing center, they may consult with Fletcher Allen Obstetricians, who are available in the hospital 24/7.  If need arises for a cesarean, vacuum or forceps-assisted birth, a midwife stays with the woman and her family in a supportive role, and a Fletcher Allen Obstetrician delivers the baby.

 



Do I have to have an un-medicated birth if I use a midwife? I think I might want an epidural.

 

Midwives offer a variety of pain relief options in labor, including massage, relaxation, use of a tub, and epidural anesthesia if desired. Using a midwife does not mean a woman must have un-medicated childbirth. Approximately 45% of Fletcher Allen midwifery patients desire or need some form of anesthesia during their births, and epidurals are readily available.

 

I’m hoping for a natural childbirth. Will a midwife stay with me in labor to help me get through it?

 

One of the hallmarks of midwifery is labor support. The Fletcher Allen midwives set up their call days in 24-hour shifts to help provide continuity of care during long labors, and have the next day off so they are able to stay up to provide support. Midwives are directly involved providing care during labor, encouraging movement and position changes to promote labor progress, and using hands-on support, hydrotherapy, and gentle words to guide pain coping. The Fletcher Allen midwives stay attuned to their staffing and their total number of patients so they can provide direct support as much as possible, when desired.

 

If you have additional concerns please talk with us at your prenatal visits!  The birth of your baby is also the birth of you as parents and the growth of your family.  Sometimes navigating this transition can feel overwhelming. The Doctors and Midwives want you to feel safe, supported and informed about your care.

Monday, May 5, 2014

Acupuncture at Champlain OB/GYN:

What to Expect

Many first-time patients are concerned that acupuncture needles will feel like hypodermic injections at the doctor’s office. They won't. Acupuncture uses sterile, single use, hair-thin, flexible needles that are hardly felt when inserted. Using gentle stimulation to move qi, a unique sensation called de qi is felt. Patients often describe de qi as a heavy, achy pressure, or spreading, traveling feeling. You may also feel an "electrical" sensation moving down the meridian pathways, though this is less common. Most patients find these acupuncture sensations deeply satisfying and leave the treatment feeling both mentally and physically relaxed, often with uplifted spirits. 

How Many Treatments Will I Need?

The benefits of acupuncture are cumulative, so more then one treatment is necessary. For acute conditions you can expect to have 5 to 10 treatments, but you will usually begin to feel relief after the first few. Chronic conditions may take longer to respond, depending on the type, severity, and duration of the condition. Preventive treatments, treatments for general well-being, or seasonal "tune ups" may also be scheduled on an as-needed basis.

Is Acupuncture Safe?

Yes. Acupuncture is safer than taking Tylenol and is used by millions of Americans every year. Acupuncturists are required to undergo extensive education, including detailed study of human anatomy and training in Clean Needle Technique. Nieve is certified by the National Certification Commission for Acupuncture and Oriental Medicine and is licensed by New York and Vermont state. As required by law, Nieve uses pre-sterilized, disposable, single-use needles to ensure your complete safety.

Acupuncture for Menstruation

For many women, their menstrual cycles can be irregular, painful, and even debilitating.  Pain, of any kind, is your body's way of telling you there is an imbalance. Acupuncture, herbs, and dietary changes, can help you return your cycles back to health as well as provide pain relief. The following are some of the conditions/symptoms that acupuncture effectively treats:
  • Dysmenorrhea (pain during period)
  • PCOS
  • Amenorrhea
  • Bloating, gas
  • Painful breast swelling
  • irritability, emotional instability

Acupuncture for Fertility

Many women have spent most of their adult lives trying to avoid pregnancy, now when they want to get pregnant, they are finding it more difficult than they ever imagined. Acupuncture, combined with herbs, nutrition and lifestyle guidance can balance conditions that may impede conception. Clinical studies show that Acupuncture enhances fertility by more than 50% and can increase the efficacy of assisted reproductive therapies such as IUI and IVF by 40-60%.
Below are a number of ways Chinese Medicine can help to enhance fertility and increase the efficacy of IUI/IVF:
• Improve the function of the ovaries to produce better quality eggs
• Regulate hormones to produce a larger number of follicles
• Increase blood flow to the uterus and increase the thickness of the lining of the uterus
• Enhance relaxation and decrease stress
• Prevent the uterus from contracting (this is a holding treatment typically done post-transfer)
• Lessen the side effects of drugs used in IVF
• Strengthen the immune system
• Improve quality and quantity of semen to create stronger embryos
• Decrease chances of miscarriage

Acupuncture for Pregnancy

Pregnancy is a time filled with magic and wonderment and when we are less inclined to take medication.  Acupuncture during pregnancy is an extremely safe therapy throughout all stages of pregnancy and an effective natural method to treat a range of symptoms, including the following:
  • Nausea/vomiting
  • Heartburn
  • Sciatica
  • Pain
  • Insomnia
  • Anxiety/restlessness
  • Headaches

Acupuncture for Birth

Acupuncture is a powerful yet safe way to assist the birthing process. By stimulating and regulating hormones, such as oxytocin, acupuncture can be used to:
  • encourage labor
  • dilate the cervix
  • stimulate,  strengthen and regulate contractions
  • increase blood flow to the uterus 
  • encourage baby to descend
  • turn breech or malpositions
  • ease pain

Acupuncture for Postpartum  

Postpartum is often overlooked and under appreciated. Plenty of time should be given for rest and recovery. Birth is exhausting and can leave a new mother blood deficient. Acupuncture, herbs, proper dietary changes, and of course plenty of rest can restore lost nutrients and blood.


Other Conditions Commonly Treated with Acupuncture also available at Champlain OB/GYN

  • Pain and Athletic Injuries
  • Facial pain - TMJ, trigeminal neuralgia
  • Low back pain
  • Neck pain
  • Migraines
  • Headaches
  • Sciatica
  • Old injuries and Painful scars
  • Stress, Fatigue, and emotional Disorders
  • Panic Attacks
  • Anxiety
  • Chronic Fatigue
  • Stress-lines on the face
  • Early signs of aging
  • Insomnia
  • Fibromyalgia
  • Pregnancy related conditions
  • Gynecological Disorders
  • Fertility Support
  • Menstrual Cramps/PMS
  • Menopausal Symptoms
  • Digestive Issues
  • IBS
  • Crohn's Disease
  • Reflux Esophagitis
  • Chronic constipation
  • Ulcerative Colitis
  • Respiratory Illnesses
  • Allergies
  • Asthma
  • Sinusitis
  • Common Cold
  • Tinnitus
  • Vertigo
  • Addiction
  • Nicotine
  • Substance Abuse Support
Author:  Nieve Shere M.S. LAc. ;  Shere Family Acupuncture at Champlain OB/GYN

Wednesday, April 30, 2014

Exercise the Heart in Pregnancy

April 30, 2014 by:
Marti Churchill, CNM, is a certified nurse midwife at Fletcher Allen Health Care.
Marti Churchill, CNM, a Fletcher Allen Healthcare certified nurse midwife offering prenatal care at Champlain OB/GYN.







Pregnancy brings out our strongest desire to stay healthy — for ourselves and for the baby growing inside.  Yet, many women have questions about what exercise is safe and how much and for how long?
Exercise is good for the pregnant body. Even if you haven’t been an avid exerciser before the pregnancy it is safe to begin to move your body and begin an exercise regime after you become pregnant. You just need to start slowly and gradually increase the length and frequency and intensity of your exercise over several weeks.  If you are already an athlete or actively exercise on a regular basis – then continuing to exercise at that same level is almost always a good thing.  Talk to your midwife about any limitations that may apply to your specific situation.
Things to consider while you exercise:
  • Stay hydrated – drink water before and after you exercise.
  • Stay cool – exercise indoors or in the morning or evening and not in the heat of the day.
  • Elevate your heart rate – but be able to maintain a conversation with someone during the exercise.
  • Move your body for at least 30-60 min 5-6 times per week.
  • Avoid any exercise where you might fall after the first trimester– waterskiing, mountain biking, downhill skiing, contact sports, etc.
  • Listen to your body – if something doesn’t feel right or is causing discomfort or pain, stop.
  • It is OK to do core exercises or strength training with weights in pregnancy. You just may need to modify the amounts of weight used and not do core work on your back.
Did you know?
  • Exercise actually gives you energy.
  • Exercise helps you sleep better.
  • Exercise reduces stress by creating a physical outlet for it.
  • Exercise helps you maintain healthy glucose levels.
  • Exercise promotes strong muscles which facilitates a healthy labor and recovery after the birth.
  • Exercise helps you to gain the right amount of weight for a healthy pregnancy.
Some good exercise for the pregnant woman:
  • Yoga (not Bikram)
  • Walking
  • Swimming, Water Aerobics
  • Aerobics, Pilates, Spinning, Zumba
  • Running
  • Nordic skiing or snow shoeing
  • Biking on paved bike trails or on a stationary bike
Before you start exercising or continue to exercise please contact your midwife or obstetrician to discuss your own situation.


Marti Churchill, CNM, is a Fletcher Allen Health Care certified nurse midwife offering prenatal care at Champlain OB/GYN .

Friday, April 25, 2014






We are excited to announce that Champlain OB/GYN has added Certified Nurse Midwifery to the practice. 


Our goal, as always, is to provide comprehensive services, and appropriate and effective care.  We are confident that the FAHC Midwives are the perfect addition to our practice because we are all committed to offering you the most advanced and complete care that is personalized to your needs.  The FAHC midwives are the longest standing midwifery group in Chittenden County with many years of experience and they are well known for their individualized family-oriented prenatal care.   The physician and midwifery collaborative care model at Champlain OB/GYN will give you a balance of natural and medical perspectives during your pre and postnatal care in a convenient, comfortable and relaxed practice.  You will have the same or similar testing and treatment options available to you and you will still deliver your baby in the hospital setting.  
This is how the transition will work for you during your pregnancy:
If you had your first obstetrical visit before 4/1/14, your care will be shared.  You will see both the midwives and the physicians of Champlain OB/GYN throughout your pregnancy.  The weekly on-call schedule for delivery will consist of 5 nights of Champlain OB/GYN physician call and 2 nights of Midwifery call. 
If your first obstetrical visit was on 4/1/14 or after, your care will be primarily with the Midwives.  They will see you for your monthly, bi-monthly, weekly, and bi-weekly visits.  Champlain OB/GYN physicians will see you for any ultrasounds, problem visits, or consults that the Midwives recommend.  The on-call schedule for delivery will consist only of Midwifery call and the FAHC physicians will offer assistance if needed.
For all patients the 6 week post-partum visit will be performed by a physician at Champlain OB/GYN.
We value the relationships that we have created with you and we understand that with any change there are many questions and concerns.  We would greatly appreciate you allowing us to answer your questions about this transition, please ask any questions or voice any concerns at your next visit, or call the office.
 Sincerely,
Champlain OB/GYN Physicians and Staff





Tuesday, April 22, 2014

Acne


ACNE


 

Question:  I’m not a teenager anymore, why do I still have acne?

 

Answer:  Acne is a skin problem that starts when dead skin cells and oil clog up pores, then get infected by bacteria, and cause pimples and cysts which can be unsightly, painful or permanently scar the skin.

 

Symptoms of acne include whiteheads, blackheads or pimples.  It can occur on the face, neck, shoulders, back or chest.


Acne can start in the pre-teenage years but continue throughout adult life, and actually get worse in our 30s-50s.

To control acne, look for products that say “noncomedogenic” on the label.  Wash your face with a gentle soap.  You can also use over the counter cream with benzoyl peroxide or salicylic acid.

For acne that does not respond to these treatments, stronger prescription medicines, both hormonal and non-hormonal, can be used.


**To discuss treatment of acne, call Champlain OB-GYN for an appointment.  Most medical insurances cover these visits.  In addition, Dr. Maria Carracino is now prescribing Isotretinoin (also known as Accutane), a strong vitamin-based medication that completely and permanently cures acne.  For more information, schedule an appointment today at 879-1802.

Tuesday, February 18, 2014

Flu shots for winter

Should I get the flu shot or not?  This is a question that MANY people ask themselves every year.  As the winter marches on in Vermont, you may find yourself asking this very question.  We are here to provide information to help you make a decision if the flu shot is right for you.

The flu is a highly-contagious respiratory illness that is caused by the flu virus.  The flu virus infects the respiratory track, and results in symptoms ranging from mild to severe.  The symptoms can include: fever, chills, cough, sore throat, nasal congestion, headaches, muscle or body aches, fatigue, extreme tiredness (rarely people have nausea, vomiting, and/or diarrhea). For most people, the flu is self-limiting (the body will fight it on it's own) and people will recover fully without significant complications.  However, there are special populations that may have severe illness with complications from the flu virus, including hospitalization and possible death.  These "at risk" populations typically include: older adults and elderly, infants and young children, pregnant women, and people with ongoing health issues such as diabetes, cancer, heart failure, or asthma.

The very best way to prevent the flu is by getting a flu shot in the fall.  The flu shot we offer at Champlain OB/GYN is an inactivated trivalent (three viruses) vaccine.  Medical researchers make a prediction (based on data from last year, the flu season in the southern hemisphere, and medical models) to determine which three virus strains to put in the flu vaccine, which will hopefully protect us the best.  The flu vaccine is recommended for all people over 6 months of age - it is the best way to protect yourself, your family and friends, and your community from the flu.  The more people get vaccinated, the better our community is protected.  There is something called "herd immunity" which is that if most people get vaccinated, the virus does not have enough hosts to survive in and rates of illness are reduced.
Hospitalization rates by age

- Pregnant women:
All pregnant women who will be pregnant during the flu season (October through April) will be offered the flu shot.  Pregnancy represents a very high-risk time - pregnant women are more likely to have a complication, including respiratory compromise that may result in difficulty breathing.  It is important to protect yourself when you are pregnant from the flu, and the best way to do so is by getting a flu shot.


There are a lot of misconceptions about the flu out there.  Just to clear up come common rumors...
- You can NOT get the flu from the flu vaccine.  The vaccine that is given is a DEAD virus, and you cannot get sick from a dead virus.
- You can get the vaccine even if you don't like eggs, or vomit when you eat eggs.  Only those people who have an anaphylactic reaction to eggs should not get the vaccine (if you've ever eaten a cookie, then you don't have an allergy to eggs).
- The flu-vaccine does not cause autism or any other developmental delays.  There have been many research studies done that show there is no correlation between vaccines and autism.

You can check the Vermont Surveillance website to see if there is any flu activity in the state, which it is updated continuously as the flu is diagnosed and reported.