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Pregnancy Question: “How is my weight?”

“Dr. Petersen, how is my weight?”

Frequent, I get asked “How is my weight?” at prenatal
visits.

I, in turn, respond with a question of my own:   “How do YOU feel about your weight”?

I ask this because weight gain, in a lot of ways is up to the individual patient.  Why?  Because, in truth, the weight that you gain is the weight you will have to lose after the pregnancy.   It is recommended that we gain SOME weight in pregnancy.  How much or how little is necessary, however, is still unclear.  Most obstetricians and experts in the field agree that 20-30 pounds is an acceptable weight gain during pregnancy.

When I had my first child, I was in college.  I wasn’t a doctor, I was barely even pre-med.  I didn’t know ANYTHING about OB/GYN!

I thought that I could eat whatever I wanted because the baby would use up all the calories.  My friends and family pushed food at me all the time!  My grandmother told me that the fat would just “melt” away after the baby was born.  The sad truth is that when my first child was born I went home 40 pounds heavier than I had ever been in my life.  Trying to lose that much weight with a newborn to care for was awful. Boy, did I feel lied to when that baby was born.  Now I had all the stress of being a new parent, along with having nothing that I could wear but maternity clothes.  I was devastated.
Back in the day…

Centuries ago when food was scarce, the practice of encouraging women to “eat for two” made sense.  Most women began pregnancy underweight and they worked and cared for children during pregnancy the same as they would before pregnancy in order to survive.  Consuming extra calories was difficult in these times.

Unfortunately, centuries later, friends and relatives still push this out-dated advice.  Pregnant women are encouraged to eat “for the baby” at parties and family gatherings.  People seem to think that they are helping by constantly offering “the baby” food.  Nobody tells you that most American women are already eating enough calories to support a growing fetus before they are even pregnant.

They also don’t tell you that every pound that you gain in pregnancy is not devoted towards the baby. In general only a total of 10 pounds can be attributed to the weight of the baby, the amniotic fluid, and the extra blood volume of pregnancy.  Early in the pregnancy this number may only
be 5 pounds.  Some patients do gain a fair amount of weight from fluid (swelling), but this is not usually until later in the pregnancy and therefore not a likely reason for being overweight before the last months.

We really only need 200-400 more calories a day for the baby’s nutrition over a baseline healthy diet.  That’s only 1 blueberry muffin, a small cheeseburger, or 2-3 Coca Cola’s.  Without consuming many more calories than many of us already are, you can still have a healthy pregnancy.  If you look at how many calories Americans are already eating, many women really don’t need to increase their calories at all. We recommend a minimum of 1500 calories a day in pregnancy.  Most women are eating well over that when they are not pregnant. So, the problem is not trying to gain weight for mostwomen anymore.  The problem is trying not too gain too much.

It is extremely easy to gain weight when you arepregnant.  A few of us will have enough nausea in the first trimester to lose a little weight, or maintain our pre-pregnancy weight in the first few weeks, but that is the exception rather than the rule.    Lost weight is almost always well replaced by the second trimester. This is because in pregnancy one of the goals of the metabolism is to elevate blood sugar and fats in the circulation for the baby to take out of the bloodstream through the placenta.  This high blood sugar and nutrient rich blood is great for the baby, but the hormones associated with this change are what you could call “storage hormones.”   They promote storage of calories as fat.  This may be an evolutionary necessity, or it may just be a side effect that plagues women with unnecessary
weight gain during pregnancy.

But Baby needs to eat!  Right?

One of the reasons that we gain so much weight is because we tend to think that if we eat a lot in pregnancy, it will all get used by the baby to grow.  The opposite is actually true- what the baby doesn’t take your body avidly stores.  The baby needs good, consistent nutrition, but he or she does not consume a large amount of calories.  Cortisol, insulin, and growth hormone allserve to try and store nutrients rather than increase metabolism or “burn calories”.  So, you can gain weight faster when you are pregnant even if you eat the same number of calories as a non-pregnant woman!

Merry go Round Metabolism

Unfortunately, for a number of women, obesity often begins in their first pregnancy.   After the baby is born, many women will fail to lose that last 10 pounds of baby weight before they get pregnant again.  If they keep 10 pounds after each pregnancy, that’s 20 pounds after 2 and 30 after 3
pregnancies. This is not to mention any weight gained between pregnancies.  Given that our metabolism slows down as we get older we already have to work hard to stay in our appropriate weight range.  Without serious effort , that 10-20 pounds stays for a lifetime.  If you think about most of us that are not pregnant right now, most of us are already struggling to maintain our weight.  It is not easier after pregnancy.   Friends and relatives always made it seem to me like the fat just melts off of you after the baby is born because you have some epic increase in metabolism.  Yes, there are women that seem to drop it like nothing after they have the baby, but the majority of us are stuck with it without some serious work.  Whether we breastfeed or not, it’s hard to do that kind of work when you have a newborn.  Seems like all you can do is sit around and eat!   Lack of sleep also is shown to decrease your metabolism and we all know that you don’t get any sleep when you have a newborn!

Another way that we get sabotaged with excessive pregnancy weight gain is with lack of activity.  People encourage pregnant women to rest, sit, and sleep.   Our friends and relatives discourage activity in pregnancy.  On top of that we are tired, our feet hurt after working all day and we don’t feel very cute in workout clothes.

Getting active

The truth is, however, unlike friends and relatives, doctors now encourage pregnant women to exercise.

You should try to maintain an active lifestyle when you are pregnant.  Women that are used to exercising can continue their level of activity unless they feel pain or contractions.  There is no maximum heart rate that pregnant women should avoid during exercise (another myth) and there is no reason to discourage pregnant women from exercising because they might “get too hot”.  Pregnant women SHOULD
avoid activities that they could fall during, however, even if they are used to doing them.  Rollerblading, snow skiing, and bike riding are not good activities because we tend to be more “clumsy” when we are pregnant and a fall can be devastating to a pregnant woman and her
baby.  While some women can maintain high impact activities like running all the way to delivery, some choose to decrease to a lower impact activity due to fatigue or discomfort.  Regardless, maintaining aerobic exercise of some type is not only OK, it is RECOMMENDED.  I recommend 20 or more minutes a day at least 3 days a week.  Ideally, however, pregnant women should get some type of aerobic exercise EVERY day.

In order for us to maintain that activity, however, there has to be a dedication to it from the beginning.  It is very hard to get motivated to exercise when you are pregnant as you are already tired a lot of the time.  You are more likely to do well with this if you are committed to it from the beginning of the pregnancy.  As you get further along you get more fatigue and aches and pains.  The third trimester is NO TIME to try to start an exercise regimen!

Dr. P’s Blog Pregnancy Weight Points:

  • 20-30 pounds is an appropriate weight gain for
    most patients.  (Obese patients are
    encouraged not to gain more than 15 pounds.)
  • Pregnancy
    weight gain should be viewed as maternal weight
    gain.  The baby only requires a 2-400
    kcal/day increase in women that are not already overeating.
  • Metabolism in pregnancy is not faster, in
    contrast, gaining weight occurs faster in pregnancy than in the non-pregnant
    state.
  • Be more active.
    A sedentary lifestyle is not recommended for pregnant patients, and
    contrary to popular belief fat does not “melt off” of the majority of women in
    the post-partum period, even if they breastfeed.
  • Having a healthy weight gain in pregnancy is
    also very important for avoiding obesity later in life.

If I had had this information when I was pregnant with my first child it would have saved me a lot of heartache and stretch marks.  That is why I pass it along to you!

I’m interested in your comments!

Dr. P

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Know your treatment options for Pelvic Pain

Category: Pelvic Pain

I Have Pelvic Pain. What Treatment Options Are There for Correcting This Problem?

Pelvic pain itself is not a syndrome but instead a symptom of an underlying cause. It will be important to try and determine why you are having pelvic pain in order to properly treat it. However, diagnosing the root cause can often involve a trial and error process. Your doctor may need to spend some time using various tests to determine your diagnosis. In the meantime, pelvic pain from an unknown cause can be treated through different manners. Below, you will find information on how your doctor could treat pelvic pain.

Treatment for General Pelvic Pain

Dealing with pelvic pain will begin in a more generalized approach. For your comfort, your doctor will want to treat the pain itself while determining its exact cause. A few of the medication-based treatments that may be used include the following:

  • NSAIDs. These nonsteroidal anti-inflammatory drugs are usually the first stop in treating chronic pain. These medications can be found in over-the-counter and prescription strengths. You will need to discuss with your doctor which would be best for your pain therapy.
  • Narcotics. If you have more severe pelvic pain, then your doctor may suggest the short-term use of narcotic pain medications. However, these medications are highly addictive and dangerous so they cannot be used for long-term pain management.

In addition to the medications, some research has recently found that certain antidepressants called TCAs (tricyclic antidepressant medicines) can reduce the amount of chronic pelvic pain in some women. This is a fairly new method of treatment, so it may not be the avenue that your doctor will choose to recommend.

Treating Pain When You Know the Cause

If your doctor has determined the cause for your ongoing pelvic pain, then the treatment can be focused on managing that cause, and therefore, managing the pain. Here are some of the treatments that would be used for certain conditions:

  • For pelvic pain caused by cyclic ovulation, a medication that stops the ovulation process itself may be used. Generally, this would include certain birth control medications.
  • For irritable bowel syndrome, antibiotics can be used to manage infection and inflammation.
  • For pelvic pain related to endometriosis, GnRH-As (gonadotropin-releasing hormone agonists) can be used to stop the production of certain hormones in the body.
  • For severe pain from fibroid cysts or endometriosis, your doctor may suggest surgery as the best option to relieve severe chronic pelvic pain. These procedures are now done using minimally invasive methods which means less pain, less bleeding and shorter recovery time. Generally, surgery is used as a last resort since it may include the removal of reproductive organs.

Pelvic pain can seriously disrupt your lifestyle whether it is chronic or cyclical. In order to resolve the pain, you will need to discuss with your doctor the proper diagnosis methods so that the root cause of the issue can be found. In any case, you will want to find pain treatments to give you relief immediately. After that, your doctor can help you determine which long-term treatment option is right for you.

 


Knowledge is POWER!

Category: Uncategorized

New Online Feature:  Women’s Health Tab

For those of you that haven’t stumbled across it, I’ve got a special tab marked “Women’s Health” near the upper right hand corner of the screen.  (Please see the screenshot below)

I highly recommend checking it out.  I am VERY EXCITED because it possesses a wealth of knowledge pertaining to many of the questions a number of patients typically have.

Click here and you’ll be directed to the tab where you can view additional info on:

  • Pregnancy and Childbirth
  • Medical Testing
  • Medications
  • Healthy Lifestyles

I also have some interactive tools that will allow you to determine:

  • If you are at risk for osteoporosis
  • The progress of a young embryo develop over 9 months
  • When you are most fertile
  • Your due date
  • Your need for certain health screenings
  • Your stress level
  • How well you “bounce” back

Take a look around and let me know what you think!

-Dr. P

 

 

 

 

 

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Yes, this inquiring mind would like to know…

Hello everyone!

Welcome to my first official “blog” post.  So glad you’re here!

First, I wanted to start by saying that for those of you that allow me to take care of you now, I am truly grateful.  Thank you SO MUCH for letting me have the chance to be your OB-GYN.  Working with you and getting to know you all  each and every day is a blessing.  For those of you that have found your way here that are not currently patients of mine, it’s my hope that you’ll consider me if you find yourself in need of the services I offer later in life.

With that being said, I’ll get on with my post!

I’ve been kicking around a number of topics to be my first, and I finally decided to choose one that’s very near and dear to my heart:  PATIENT SATISFACTION!

I’d like to think that my staff and I do a pretty good job at taking care of our patients.  I’ve had a number of my happy patients be kind enough to leave some positive comments in the recommendations area of my practice’s Facebook page (https://www.facebook.com/drrachelpetersen) regarding their experiences with me on my facebook page.  They made me feel so loved!

However, it got me to thinking:  I know that as a consumer of goods and services myself, that if I’m not pleased with a product or a service, or don’t feel like I’ve been treated well that I don’t usually choose to use the product or the service again.  And when I do that, I don’t usually let someone with the company know what they’ve done to disappoint me.

While my staff and I believe that we are getting things right a good bit of the time, it does make me wonder if there have been times that a patient feels like we have let them down.  Or, could there be certain things that my staff and I could do better that are reasonable and are within our control that we haven’t thought of that would mean a lot to our patients.

My husband mentioned to me that if  I really wanted to know, perhaps I should just “ask”.

I was like, “Really, dude???  Are you kidding me????  It’s not that simple!”

And he said, “No, I’m not.  And, yes, it is that simple”

(Ladies, he went on to say that if asked, he would say that my waiting room needs an XBOX 360 for the guys to play while they are waiting on their wives and girlfriends in the back.)

Frankly the thought of asking someone and then finding out that I’ve let that person down somehow no matter how big or small initially frightened me.

What if someone complained?  Yikes!

I realized later that if I wanted to make sure that my staff and I were doing the best we could for our patients, the only way I was going to find out for sure was to offer a way for my patients to let me know how my staff and I are doing.  After all, if something may be wrong, and I’m oblivious to it, then I can’t do anything about it.  I decided that it was time for me to be honest with myself by asking you all to be honest wiht me.

While I will always continue to love hearing how we’ve helped many of you out, I do care to know if you have any friendly suggestions or if your experience within my practice has been anything less than stellar.  And this inquring mind would like to know.

It’s my hope that I can encourage many of you to begin to complete a brief satisfaction survery that is now available on my website.

http://www.drpetersenobgynal.com/onlineserve/survey

A copy of each that is completed gets emailed to me.  They are anonymous, but if my patients are open to being contacted for follow up,  they can choose to enter their names and a phone number or an email address in the general comments area.  It’s my promise to all of you to  consider each and every suggestion as well look into any incident that may have rubbed you the wrong way.  Of course, I’ll be very obliged to receive the warm fuzzy things too.

I want to wrap this post up by saying that this patient satisfaction survey is only my first step in making a few improvements.  Be on the look out for more!

In the meantime, hope to hear from you!

-Dr Petersen

 

 

 

 

 

 

 

 

 

 

 

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Minimally Invasive Surgery Solution to Uterine Fibroids

Uterine Cutaway FibroidsThe conventional approach to uterine fibroid treatment involves an open surgery through a large abdominal incision. After cutting around and removing each uterine fibroid, the surgeon must carefully repair the uterine wall to minimize potential uterine bleeding, infection and scarring. Proper repair is also critical to reducing the risk of uterine rupture during future pregnancies.

da Vinci ® Myomectomy

Da Vinci ® Myomectomy, combines the best of open and laparoscopic surgery. With the assistance of the da Vinci ® Surgical System, surgeons may remove uterine fibroids through small incisions with unmatched precision and control. Among the potential benefits of da Vinci Myomectomy as compared to traditional open abdominal surgery are:

  • Opportunity for future pregnancy
  • Significantly less pain
  • A shorter hospital stay
  • A faster return to normal daily activities

To learn more, check out our section on [da Vinci ® Myomectomy].


Essure Creates Natural Barrier to Prevent Pregnancy

Category: Essure

Once your family is complete, Essure offers a 10 minute procedure for permanent contraception. Essure is a permanent birth control procedure that works with your body to create a natural barrier to prevent pregnancy. The Essure procedure offers women benefits that no other permanent birth control can.

  • Surgery-free—A simple procedure performed in your doctor’s office in less than 10 minutes
  • Hormone-free—A more natural birth control method
  • Anesthesia-free—There’s no slowing down to recover, and most women return to normal activities in less than a day
  • Worry-free—Since 2002 over half a million women and their doctors have trusted Essure as the most effective* permanent birth control

The Procedure

An Essure-certified doctor places soft, flexible inserts into each of your fallopian tubes through the natural pathways of your vagina and cervix. There is no incision necessary. The tip of each insert remains visible, so your doctor can confirm that placement is accurate.

THE PROCEDURE

Over the next three months, your body works with the Essure inserts to form a natural barrier within your fallopian tubes that prevents sperm from reaching your eggs. Your ovaries will continue to release eggs, but they will be absorbed naturally into your body. You must continue to use another form of birth control during these three months.

THE BARRIER

After three months you’ll take the Essure Confirmation Test to confirm you can no longer get pregnant. A special dye is introduced into your uterus, then viewed on an x-ray to confirm that the inserts are in place and your fallopian tubes are fully blocked. Once you receive verification from your doctor, you can start relying on Essure for permanent birth control.

THE CONFIRMATION

 

To learn more, check out our section on [Essure].

 


5-Minute Procedure to Reduce Heavy Periods With NovaSure

Category: NovaSure

1 in 5 women suffer from heavy menstrual bleeding. More than just a hassle, they take physical, emotional, and social toll as well.

NovaSure®, a one-time, five-minute procedure lightens or ends your heavy period. With no pills or hormonal side effects, menstrual bleeding is dramatically reduced or stopped.

NovaSure Works in Four Simple Steps:

NovaSure first stepYour doctor slightly opens your cervix (the opening to the uterus), inserts a slender wand, and extends a triangular mesh device into the uterus

 

 

NovaSure first stepThe mesh gently expands, fitting to the size and shape of your uterus

 

 

 

NovaSure first stepPrecisely measured radio frequency energy is delivered through the mesh for about 90 seconds, gently removing the lining of the uterus

 

 

NovaSure first stepThe mesh device is pulled back into the wand and both are removed from the uterus

 

 

 

To learn more check out our section on [NovaSure].

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Da Vinci Hysterectomy Gets You Back To Daily Activities Quickly

Conventional surgery for most gynecologic conditions are typically done through large abdominal incisions.  A new option is now available using state-of-the-art technology through a da Vinci® Hysterectomy. The minimally invasive surgery only uses a few tiny incisions to perform the procedure.

incision coparison

The da Vinci® surgical platform uses 3D, high-definition vision and miniaturized, wristed surgical instruments which allow for enhanced vision, precision, dexterity and control. There are numerous benefits to da Vinci® Surgeries when compared to conventional surgeries such as:

  • Less pain
  • Fewer complications
  • Less blood loss
  • Shorter hospital stay
  • Low risk of wound infections
  • Quicker recovery and return to normal activities

To learn more check out our section on [da Vinci Hysterectomy].

 


ABC News Profile on da Vinci Surgery

Category: Uncategorized

New research suggest doctors will perform better with robotic assistance.

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Data shows clinical advantages to robotic surgery

Category: Uncategorized

With a 3-D view and greater dexterity, the da Vinci surgical robot offers many advantages

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