Each year, more than a million families in the United States experience a miscarriage, stillbirth or death of an infant. Yet because these events can be emotionally difficult to discuss, there is little public awareness, so families may not always get the support they need. October is Pregnancy and Infant Loss Awareness Month, a time to show support for these families, highlight available resources and build understanding of how family, friends and the community can help.

If you visit a MidMichigan Health facility during the month of October, you may notice staff wearing pink and blue ribbons to show their support. We will also participate in the International Wave of Light, a worldwide remembrance event on October 15, 7 to 8 p.m. During this time, candles will be lit at the entrances of MidMichigan’s Medical Centers in Alma, Alpena, Midland and West Branch (the sites of our four Maternity Centers) to honor babies gone too soon and their families. Patients, staff and community members are welcome to attend.

Whether you’re thinking about getting pregnant, or you’re currently pregnant, you might be wondering how to know which medications are safe to use during your pregnancy. This includes everything from prescription medications, to over-the-counter cold remedies to your daily multivitamin. How do you know what’s safe, and what you should
stop taking to protect yourself and your baby?

Nearly every pregnant woman will face a decision regarding medication at some point
during their pregnancy. However, there’s not detailed information on effects of many
medications when it comes to pregnant women, because they are not included in safety
studies.

What we do know, though, is that there are some cases in which it would be more harmful to stop taking a medication during pregnancy, if, for example, the medication helps control a health condition. On the flip side, there are also certain medications that increase the risk of birth defects, miscarriage or developmental disabilities. Certain things, such as the dose of the medication, during what trimester you take the medication and what health conditions you have, all play a role in this as well.

The best thing to do is to discuss any medications you are currently taking with your
health care provider. You can do this even before you are pregnant, as there are some
medications that are unsafe in early pregnancy. Your provider will help you create a
treatment plan so that you, and your baby, are as healthy and as safe as possible.

Throughout your pregnancy, you’ll want to check in with your doctor before starting or
stopping any new medication, and this includes prescriptions, vitamins, supplements or
over-the-counter remedies. Even after you deliver your baby, your doctor will be able to
work with you to determine if you should continue taking your medication or, when it’s
safe for you to resume taking medication you stopped taking during pregnancy.

Together, you and your doctor can work together to come up with a plan to keep you and your baby as healthy and safe as possible.

Obstetrician/Gynecologist Shawna Ruple, M.D., sees patients at MidMichigan Obstetrics & Gynecology in Midland. Dr. Ruple specializes in routine and problem gynecology care, gynecologic surgery, prevention of female reproductive cancers, birth control options, caring for women while pregnant and more. For more information on in-office treatments and procedures, contact her office at (989) 631-6730.

The average woman in the United States is 51 years old when she goes through menopause. Menopause marks the end of a woman’s menstrual cycle, and is diagnosed when 12 months have passed without a menstrual period.

There are several common side effects that can occur during menopause. Some are talked about often: hot flashes, night sweats, mood changes and a slow metabolism. But there are other side effects that aren’t discussed as often, perhaps because they’re uncomfortable to talk about. But the reality is, they are common for many women. Painful sexual intercourse and vaginal dryness are both likely to happen during menopause.

During menopause, estrogen levels decrease, and vaginal tissue becomes more sensitive and susceptible to injury, which can lead to pain, especially during sexual intercourse. It’s estimated that 20 to 30 percent of women experience this during menopause. In addition to fragile vaginal tissue, other factors can contribute to intercourse pain, such as injury or trauma from childbirth, pelvic surgery or any other type of accident.

Did you know that seeing a physical therapist can help with pregnancy-related pain? And, post-partum physical therapy can help a mom improve posture, core and pelvic strength, even if delivery was many years ago.

Pregnancy brings changes to a woman’s body, including weight gain, altered center of gravity and balance, laxity in her ligaments and increased blood volume. These changes play a huge role in her ability to maintain her same activity level without added stress and strain. In a study published in the American College of Obstetrics and Gynecology, it was estimated that more than 65 percent of pregnant women experience low back pain.

Physical therapy can help pregnant women reduce pain through stretching and soft tissue release techniques, strengthening exercises and teaching proper mechanics for all activities to reduce the risk of pain, especially low back and pelvic pain.

Following delivery, a new mother is faced with juggling car seats, diaper bags and feeding positions, and often has a desire to get back into a regular exercise routine. Labor and delivery of the baby affects the mother’s pelvic floor (muscles required to prevent unwanted leakage of urine, stool or gas), abdominal muscles and low back, just to name a few. A qualified physical therapist will complete a thorough evaluation to determine what the best method of recovery will be for you to improve unwanted leakage, pelvic or back pain, lifting mechanics and posture.

Seeing a physical therapist during this joyous time of a woman’s life can simply help a mom or mom-to-be ease into her new role and alleviate some common unwanted symptoms.

Jerilyn Strong, D.P.T., is part of MidMichigan Health’s Rehabilitation Services team in Ithaca. She provides physical therapy in her hometown community, and specializes in pelvic floor therapy. To make an appointment, contact her office at (989) 875-4193.

What is lymphedema? It’s a buildup of lymph fluid in the fatty tissues just under your skin most commonly caused by the removal of or damage to your lymph nodes as part of cancer treatment. It results in a blockage in your lymphatic system which causes swelling, most often in the arms and legs but it can affect the face, neck, abdomen and genitals, depending upon what area of the body was treated.

Early detection of the onset of lymphedema increases the likelihood of successful treatment. Changes are usually subtle and progress slowly. Swelling may not be the first noticeable symptom. Sometimes, it is a sensory change such as a tingling feeling that will come and go, a feeling of heaviness or tightness in the limbs, or other subtle signs like jewelry feeling a little snug or a Continue reading. →

Preparing for breast cancer surgery can bring a lot of stress and anxiety. You may be experiencing many different emotions and have a list of unanswered questions. The breast cancer team at MidMichigan Medical Center – Midland is available to offer information and support to help you prepare for your surgical experience.

A monthly “Healing After Breast Surgery” class is held at the Center for Women’s Health on the campus of MidMichigan Medical Center – Midland. This free class is offered the third Friday of every month and is hosted by a certified lymphedema physical therapist and a certified breast cancer nurse navigator. Both individuals are also certified in the rehabilitation of cancer patients.

Common topics reviewed and explained at the class include lymphedema, normal post-operative changes, how to care for your drain tubes and incisions, signs and symptoms of infection to watch for, nutrition for breast cancer and when therapy may be needed.

Patients are taught effective stretching exercises to perform after breast surgery that can preserve arm function and mobility and reduce the chance of lymphedema.

By educating you on these topics either prior to or shortly after your surgery, the goal is to provide you with the tools and knowledge necessary for a positive recovery experience. Small group sessions are held monthly to foster an inviting, laid-back atmosphere where patients feel comfortable discussing their fears or concerns.

Family members and caregivers are welcome to attend to support their loved one preparing for surgery. Educational booklets and references are provided free of charge.

MidMichigan Medical Center – Midland’s Breast Health Program is certified through the National Accreditation Program for Breast Centers and has been recognized as the region’s only Certified Quality Breast Center of Excellence from the National Quality Measures for Breast Centers Program. Those who would like more information or to register for an upcoming Healing After Breast Surgery class may call (989) 837-9045.

Jada Pinkett Smith made headlines recently when she spoke about undergoing a vaginal rejuvenation treatment to resolve bladder issues on an episode of her Facebook series, Red Table Talk. It led to many people questioning what, exactly, vaginal rejuvenation treatment is, whether or not it’s safe, how it works and which treatment is best for them.

The simple answer is: it depends. There are several different treatment options available to fit a wide variety of symptoms, ranging from non-invasive to surgical, radiofrequency to laser and more. Continue reading. →

The American College of Radiology (ACR) and Society of Breast Imaging (SBI) have released a new set of guidelines, recommending that every woman take a risk assessment starting at the age of 30 to see if screening earlier than the age of 40 is needed. This is particularly true for the African-American population as they recognize that these women are at an increased risk for breast cancer. The ACR and SBI instituted these recommendations in order to help save more African-American women and others (which also include the Ashkenazi Jewish population) who are at high risk.

Below are a few facts on which the ACR and SBI based their recommendations:

• African-American women are 42 percent more likely to die from breast cancer than non-Hispanic white women despite roughly equal incidence rates.
• African-American women have a two-fold higher risk of aggressive – “triple negative” – breast tumors.
• African-American women are less likely to be diagnosed with stage I breast cancer, but twice as likely to die of early breast cancers.
• African-American women have a higher risk of BRCA1 and BRCA2 genetic mutations than those of Western European ancestry. Carriers of either mutation are at a much higher risk for breast cancer.
• Since 1990, breast cancer death rates have decreased by 23 percent in African-American women, compared to 43 percent in Caucasian women.

Continue reading. →

Many benign gynecologic conditions can have a significant impact on a woman’s quality of life and interfere with work, school and even her relationship with her partner. Conditions such as uterine fibroids, endometriosis, chronic pelvic pain, heavy and painful periods and pelvic floor prolapse can often be treated with non-surgical interventions. However, if surgery becomes necessary, a minimally invasive surgical approach may be an effective option.

The da Vinci single site surgical approach offers the patient many benefits. This type of minimally invasive surgery only requires a single one and a half inch incision at the belly button. A small camera and instruments placed through a special port are then used to perform the surgery. Because this approach requires only a single small incision, and uses small delicate instruments for tissue handling and dissection, patients experience minimal blood loss, greatly decreased post-operative pain, less risk of infection and a much shorter post-operative recovery. For most patients, these procedures can be done as an outpatient surgery requiring no overnight hospital stay. Because the incision is incorporated into the natural irregularities of the belly button, this is a virtually scarless approach to surgery.

Types of gynecologic surgery that can be performed with the single site approach include hysterectomy, treatment of pelvic floor relaxation, sterilization procedures, diagnosis and treatment of pelvic pain and endometriosis and treatment of ovarian and Fallopian tube cysts and masses.

If you have been struggling with pelvic pain, heavy bleeding or other gynecologic problems, contact Gynecologist John Lieberman, D.O., for an appointment. Dr. Lieberman will review your treatment options and discuss whether da Vinci single site surgery is possible for you.

Skin rashes, shoulder and back pain, ill-fitting clothing and constantly trying to minimize your breasts shouldn’t be a lifestyle – and there is a solution.

Women with large breasts and musculoskeletal symptoms of the neck and back may see improvement with a breast reduction procedure. Chronic rashes beneath your breasts and grooving in your shoulders from your bra strap may make you a candidate for the surgery. Most insurers provide coverage at age 18 but make exceptions on a case by case situation.

Each insurer has a set of requirements that need to be met to be considered for surgery, including a recent mammogram. These will be discussed at the time of your consultation. Your physician and their staff will guide you through the process from the first visit to obtaining the authorization. Surgery can be scheduled within two weeks of receiving the authorization.

The surgery is designed to reduce the size of the breast and then reposition the breast on the chest wall so the remaining weight is better distributed. This procedure is performed in an operating room under general anesthesia and takes approximately three hours. Patients go home the same day and are seen for follow up and drain removal four days later. Wearing a sports bra 24/7 is recommended, except for showering, which is allowed once the drains are removed.

Upper extremity exercise is not recommended for one month, as well as being fitted for a new bra. Patients are amazed at how little pain they experience, and often remark that they wonder why they waited so long.

Plastic and Reconstructive Surgeon Mark Komorowski, M.D., sees patients at his office in Bay City and performs procedures at MidMichigan Medical Center – Midland. To learn more or to inquire about becoming a patient, contact Dr. Komorowski’s office at (989) 893-9393.