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Mental Health Check

7/7/2020

COVID-19, Raise your hand if you’re done!


Well, it’s here and we don’t really know when it’s going to be over. We have talked about how to stay safe by washing your hands and wearing a mask, keeping your circle small and only taking essential trips. But what we haven’t talked about is mental health.

We need to make sure we are taking care of our minds and bodies as well. We all know that diet and exercise play a big role in how we feel mentally. But beyond that here are some great tips for coping with this quarantine;


Creating a routine-

It can be very simple; breakfast, make beds, play time, tv time, lunch, rest time, etc.. If you are stuck at home with kids look into your local Libraries. Some are doing story time via Zoom and even have curbside pickup options. A great account to follow if you have little's on Instagram is @Busytoddler click here for her website. She has wonderful, easy ideas of things to do with kids around the house.


*If creating a routine adds to your stress, don’t! You know your family and what helps and doesn’t help. Don’t compare your family to other families, just do what’s best for you. *


Stay active-

Another thing we need to be aware of is if we are getting outside. Even if it’s just for a quick walk, a stretch, or walking away from the computer to give your eyes a break. Try to get outside at least once a day if not more. You will start to notice some of that stress going away. Go on a drive and make a list of things to search for with your kids.


Changing up your environment is key.


Mental check-

Another way we can take care of our minds during this crazy quarantine time is meditation or yoga. There are so many great apps, YouTube videos and podcasts that you can listen to. Some will lead you through a breathing exercise to help you relax and take your mind off the stress of COVID-19. 

Here are some examples https://meditationminis.com/. These are quick and easy meditations you can do on your break from working while you walk, in your car after you get home but before you head in to greet your family, or while the kids are napping. If you have a little more time this YouTube channel https://www.youtube.com/user/yogawithadriene is great for yoga and even some breathing exercises that are quick and easy. Trust me, it’s great for beginners too!

Maybe consider taking a break from social media. There are so many ugly things out there right now and taking a break for a few hours or days can be great for your mind.


Communicate-

Communicating and staying in touch helps with us to not feel so isolated. Don’t forget to talk to your friends and family, Zoom a girl’s night or social distance in your backyard (BYOB!)


If you are feeling like the stress and anxiety are too much and you know it’s beyond just going on a walk, please talk to your provider. 2020 has thrown us all for a loop and it has hit us all differently. If you need professional help reach out. 

COVID- 19 Mask requirement 

6/23/2020

HERE is the link for the information on face covering requirements.

HERE is a link to a resource website with updates and resources for Oregon.


We are still open and seeing all of our wonderful patients


We wanted to update you on changes and what your visit will look like with us


As of Wednesday, June 24th everyone will be required to have a face covering (mask, shield or face covering, such as bandana or scarf) in businesses. Those with medical conditions that makes it hard to breathe when wearing a mask or disabilities that prevent you from wearing a mask are exempt.


We are still asking that you do not bring anyone with you to your appointment.


If you or anyone in your household has cold or flu like symptoms (unrelated to allergies), we are asking that you stay home and reschedule.


For your safety we will all be wearing masks and the rooms are thoroughly sanitized after each patient. Our lobby is regularly sanitized along with door handles and bathrooms.


We want everyone to stay safe and healthy and are excited to continue to care for you all


Pregnant during quarantine ​

3/30/20

As of yesterday the "shelter in place" mandate was extended until April 30th. One more month of social distancing and staying put. 


So many of you are wondering how this virus will impact you during your pregnancy. 


The two biggest questions we have received are;


1- Should I be doing anything different to protect myself? 

Dr. Miller-Davis found this great article from NPR and it will answer many of your questions. Click to read it HERE


2- Can I have a support person with me while I deliver?

The great news is YES you can have one support person with you at the hospital. You will be able to discuss the details at your next appointment with Dr. Miller-Davis.


As we mentioned before, these are very scary times. We are considered an essential service, and are still open regular business hours. 

We are asking that you reschedule if you or anyone in your household has cold or flu like symptoms (cough, fever, runny nose...)  

If you feel you have COVID-19, please call your primary care provider and they will advise you on the next steps to take.


Stay safe everyone! We can all do our part to flatten the curve.

Wash your hands

Stay home

Check in on your elderly friends and family members

COVID -19 Update

We here at Women’s Health of Oregon wanted to share an update with you all. As we are all asked to stay home and stay away from others, that doesn’t apply to “essential services” like banks, grocery stores and healthcare facilities. Dr. Miller-Davis and her staff will still be working and the office will be open regular hours. ⁣

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We are asking a few things of our patients;⁣

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•If you or anyone in your household has a fever or cold/flu like symptoms (cough, runny nose, body aches...) to please call and reschedule your appointment.⁣

•If you have traveled outside the US in the last two weeks, we ask that you reschedule. ⁣

•If you believe you have been exposed to someone who has COVID-19, please call and reschedule. ⁣

•Please only bring one other person with you to your appointment if you need a support person. ⁣

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We want to keep you and our staff safe and protected. ⁣

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We also understand that some of you may want to cancel and reschedule if you feel your appointment can wait, there will not be a cancellation fee. ⁣

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This time of uncertainty is unsettling. We are still here to care for our patients, call if you have questions. ⁣

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Remember to stay home when you can and stay safe.

Statement on Coronavirus

3/10/2020

The current projections for it’s expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely going to be widespread in the US by mid to late March and April.


Here is what our office is doing to take precautions. 

 THESE ARE THE SAME PRECAUTIONS WE USE DURING OUR INFLUENZA SEASONS.


1) NO HANDSHAKING!! Use a fist bump.


2) Use your knuckle to touch light switches or elevator buttons.


3) Open doors with your closed fist or hip when possible. Especially important on bathroom and post office/commercial doors.


4) Use disinfectant wipes at the stores to wipe down carts and child seats.


5) Wash your hands for 20-30 seconds and/or use a greater than 60% alcohol based sanitizer. Make this a habit as the first thing you do when you arrive home.


6) Keep a bottle of sanitizer by every entrance in your home, and in your car.


7) If possible, cough into a tissue or napkin and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!


WHAT TO STOCK UP ON:


1) Latex or nitrile gloves.


Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs). The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth. 


2) Hand sanitizers that are greater than 60% alcohol based.


3) Zinc lozenges and use at the first onset of “cold or flu symptoms” These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY "cold-like" symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.


4) DO NOT stock up on masks. The masks will not prevent the virus in a direct sneeze getting into your nose or mouth, but will help you not to touch your nose or mouth.


MOST IMPORTANTLY: If you are feeling ill please STAY AT HOME

Cervical Cancer Awareness

1/28/2020

This month is cervical cancer awareness month. Let’s talk about what we know about it, how we look for it and how we might prevent it.


Here at Women’s Health of Oregon we recommend that our patients come in for their wellness exam yearly. At your visit we perform a pelvic exam, breast exam, and if needed a pap smear. Most insurance companies will cover a yearly visit.


The great thing about women taking control of their health is that the incidence of cervical cancer in the United States has decreased by more than 50% in the past 30 years because of widespread screening with cervical cytology, including the pap smear. New technologies, including human papillomavirus testing, continue to evolve, as do guidelines for managing abnormal results.


How do we find cervical cancer and what is it?


Your provider will perform a pap smear (a test in which cells are taken from the cervix and/or vagina and examined under a microscope.) Cervical cancer begins when healthy cells in the cervix develop changes (mutations) in their DNA.


Are you ready for a mini science class? Don’t worry there won’t be a test.


Healthy cells grow and multiply at a set rate, eventually dying at a set time. The mutations tell the cells to grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can break off from a tumor to spread (metastasize) elsewhere in the body. Various strains of HPV, a sexually transmitted infection, play a role in causing most cervical cancer.

When exposed to HPV, the body's immune system typically prevents the virus from doing harm. In a small percentage of people, however, the virus survives for years, contributing to the process that causes some cervical cells to become cancer cells.

You can reduce your risk of developing cervical cancer by having screening tests and receiving a vaccine that prevents infection by certain types of HPV. Having an HPV vaccination does not change screening recommendations. Women who have been vaccinated against HPV still need to follow the screening recommendations for their age group.


Are there symptoms?

Early-stage cervical cancer generally produces no signs or symptoms. That is why it is important to schedule your yearly exams with your gynecologist.


Signs and symptoms of more-advanced cervical cancer can include:

  • Vaginal bleeding after intercourse, between periods or after menopause
  • Watery, bloody vaginal discharge that may be heavy and have a foul odor
  • Pelvic pain or pain during intercourse
The type of cervical cancer that you have helps determine your prognosis and treatment.


The main types of cervical cancer are:

  • Squamous cell carcinoma. This type of cervical cancer begins in the thin, flat cells (squamous cells) lining the outer part of the cervix, which projects into the vagina. Most cervical cancers are squamous cell carcinomas.
  •  Adenocarcinoma. This type of cervical cancer begins in the column-shaped glandular cells that line the cervical canal.


Risk factors for cervical cancer include:

  • Many sexual partners. The greater your number of sexual partners, and the greater your partner's number of sexual partners, the greater your chance of acquiring HPV. That being said, you can contract HPV the very first time you have sexual contact.
  • Unprotected Sex- HPV is spread by skin to skin contact of the genital area with someone who has HPV.
  • A weakened immune system. You may be more likely to develop cervical cancer if your immune system is weakened by another health condition and you have HPV.
  • Smoking. Smoking is associated with squamous cell cervical cancer and you can make HPV more difficult to clear.


To reduce your risk of cervical cancer:

  • Ask your doctor about the HPV vaccine. Receiving a vaccination to prevent HPV infection may reduce your risk of cervical cancer and other HPV-related cancers. Ask your doctor whether an HPV vaccine is appropriate for you.
  • Have routine Pap tests. Pap tests can detect precancerous conditions of the cervix, so they can be monitored or treated in order to prevent cervical cancer.
  • Practice safe sex. Reduce your risk of cervical cancer by taking measures to prevent sexually transmitted infections, such as using a condom every time you have sex and limiting the number of sexual partners you have.
  • Don't smoke. If you don't smoke, don't start. If you do smoke, talk to your doctor about strategies to help you quit.

Exercise in pregnancy

1/14/2020

  As we jump into the new year and start our resolutions, typically working out or a healthier diet is first on the list. If that's you, we have some tips for our pregnant patients as you begin your exercise journey with baby in tow. It is so important to maintain a healthy diet and along with that getting up/out and get moving! It can be so hard to motivate yourself and let's be honest being tired, sick and in pain, exercise is the last thing on your mind.


Exercise during pregnancy can help:

  • Reduce backaches, bloating, swelling, and constipation
  • Increase energy
  • Improve mood
  • Improve posture
  • Improve sleep quality
  • Promote muscle tone, strength and endurance

Pregnancy causes many changes in your body. The hormones in pregnancy causes joints to become more mobile and relaxed. It is important to avoid motions that could increase your risk of injury. It is also important to try and not overdo it and keep your heart rate at an acceptable lever. Our recommendation is a heart rate of less than 150.


As your body shifts and you carry more weight in your front, be careful to maintain your balance to avoid falls and injury.


Exercises that are considered safe in moderation are:

  • Walking
  • Swimming 
  • Cycling on a stationary bike 
  • Running
  • Strength training 
  • Yoga


**Of course, with all of these you want to make sure and check with your provider to make sure they are safe for your specific needs.


Start a routine slowly to see how your body reacts, you can increase your workout by 5 minutes a day once a week. Remember to listen to your body, stop if you need to.


Warning signs to stop exercising and call the clinic are:

  • Vaginal bleeding
  • Dizziness
  • Feeling faint
  • Shortness of breath or chest pain
  • Headache
  • Muscle weakness
  • Calf pain or swelling
  • Uterine contractions
  • Decreased fetal movement 
  • Leakage of fluid 


Some guidelines for exercising during pregnancy:

  • After your first trimester, avoid exercising on your back
  • Avoid exercise in hot humid weather
  • Wear comfortable, cool clothing
  • Drink plenty of water
  • Take it slow 

Gestational Diabetes

11/26/2019


This month is Diabetes Awareness Month so we thought we would take an opportunity to share a little about gestational diabetes.


What is gestational diabetes?

Gestational diabetes develops during pregnancy. Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes elevated blood sugar that can affect your pregnancy and your baby's health.


Gestational diabetes puts your baby at risk for:

- excessive birth weight

- early birth and it’s related complications

- low blood sugar

- type 2 diabetes as an adult


For most women, having gestational diabetes does not always come along with signs or symptoms so we will test you for this during pregnancy. Expectant women can help control blood sugars by eating foods low in sugar and exercising. However, in some cases medication is needed.


What does the test involve?

It is recommended to test your glucose tolerance around 28 weeks gestation. Our providers will discuss this test during your 24 week visit and we will send you home with a glucola drink. At your 28 week visit you will drink it before you come in for your appointment and you will have your blood drawn.


Should your test come back elevated, we may send you to do a 3 hour glucose tolerance test at your delivering hospital lab. We may also send you to diabetes education where you will learn about testing your blood sugars and what healthy diet would work best for you and baby.


Of course, at your appointments we will go more in depth about the process and be able to answer any questions you may have. 

Nutrition in pregnancy

11/5/2019

Congratulations, you're going to be having a baby! There are so many things to think about, to do and not do, it can be overwhelming. One of the things you will need to think about is nutrition. You're not just eating for two, you're being healthy for two.

Healthy eating is a key component to meeting the demands of pregnancy and your developing baby.

The website www.choosemyplate.gov can help you plan a healthy diet for you and your family during pregnancy. Food suggestions and amounts that you need to eat during pregnancy are included in this diet tracker. The amounts are based on pre-pregnancy weight, due date, and exercise schedule. My plate includes a table of daily food choices broken down into the five food groups. For example, It is recommended that a pregnant woman of normal weight eat 8 ounces of grains peer day in the third trimester.

Vitamins and minerals also play an important role during pregnancy. Dietary guidelines recommend that pregnant women also get at least 600 micrograms of folic acid daily from all sources. This helps to prevent brain and spinal birth defects. More iron is needed in pregnancy to make blood that supplies oxygen to the baby. The recommended dose is 27mg daily, which is found in most prenatal vitamins. Calcium and vitamins D are both used during pregnancy to aid in baby’s bone and teeth development. Women 19 years and older need 1000mg of calcium per day, including pregnancy. Those aged 14-18 need 1,300 mg daily. Milk and other dairy products like cheese and yogurt are the best sources of calcium.

All women including those that are pregnant need 600 IU (international unit) vitamin D per day. Good sources are milk and salmon.

How much weight should you gain in pregnancy?

Pre-PregnancyWeight         BMI                Weight Gain

Underweight                     less than 18.5           28-40lbs

Normal Weight                   18.5-24.9                25-35lbs

Overweight                        25.0-29.9                15-25lbs

Obese                              30 or more              11-20lbs


Overweight and obese women are at risk of several pregnancy problems, including birth defects, macrosomia (a baby born significantly larger than average) and childhood obesity.

Food Safety

It is extremely important to avoid food borne illness during pregnancy. Pregnant women are 13 times more likely to get listeriosis than the general population. This can cause mild, flu-like symptoms in the mother but can lead to serious complications for the baby, including miscarriage, still birth, and premature delivery.

To help prevent listeriosis, avoid the following foods: unpasteurized milk and soft cheeses, including feta, queso fresco, queso blanco, brie, Camembert, blue cheese, hot dogs and lunch meats (unless steaming hot when served). Refrigerated pate and meat spreads. Refrigerated smoked seafood. Make sure all foods are washed thoroughly. Avoid raw or under cooked meats, seafood, and eggs.

Always make sure you wash all of your fruits and vegetables under running water for about 30 seconds before eating. Wash them right before you are going to eat, as bacteria can grow if you wash and then wait to eat.

There are so many things to think about when you get pregnant, we hope that is information will answer some of the nutritional questions.

If you ever have any questions or concerns feel free to call us or ask at your next OB appointment. We are happy to help!



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