Flu Shot 101

Welcome to the first article in my series on preventative health care for women.

With the fall settling in and winter right on its heels, the flu shot is the definitely a hot topic.

Every season as the weather cools, our patients heat up with urgent questions about the flu shot: “Should I get the flu shot?”; “Is the flu shot safe in pregnancy?”; “I am breastfeeding – do I still need the flu shot?”

Here, I answer your questions and explain why the flu shot is for you, dear Healthy Woman patients.

Pregnancy puts extra stress on your heart and lungs. Pregnancy can also affect your immune system. Protection is paramount during pregnancy because your immune system is suppressed, which puts you at a higher risk of catching every bug that’s making the rounds — especially the influenza virus. These factors increase the risk of not only getting the flu but of developing serious complications of the flu, such as pneumonia and respiratory distress. If your due date falls within the flu season (October to April), your baby runs the risk of getting sick, too, both because the baby’s immune system is not yet fully developed and there’s no safe flu vaccination for babies under six months old. There is an increased risk of not only getting the flu but of developing serious complications such as pneumonia and respiratory distress. In turn, flu complications increase the risk of premature labor, preterm birth and other pregnancy complications. A flu shot can help prevent these potential problems.

What’s more, there is evidence that getting a flu shot during pregnancy offers your baby some protection after birth. He may receive some antibodies from you during pregnancy. And if you are immune, your newborn is less likely to be exposed to flu. (For this reason, make sure other family members get vaccinated too.) Protecting your infant is important because young babies who catch the flu are at particular risk for serious illness, but they can’t be vaccinated themselves until they’re 6 months old.

In the June issue of the American Journal of Obstetrics & Gynecology, a new study sponsored by the Centers for Disease Control and Prevention suggests that getting your flu shot during pregnancy can protect your newborn and reduce the likelihood that your baby will catch the infectious disease. Babies in the study were 48 percent less likely to be hospitalized for flu if their mothers were vaccinated during pregnancy versus those who were not vaccinated.

You’ll need a flu shot even if you’ve had one in previous years because different strains of flu come around every year. Get the flu shot as soon as it’s available regardless of which trimester you’re in. If your doctor or midwife doesn’t have a supply, call your local health department and find out if it’s available elsewhere in your community. The American Lung Association offers an online flu vaccine clinic locator. Visit www.flucliniclocator.org, enter a zip code and a date (or dates), and receive information about clinics scheduled in your area. Or try the CDC’s flu vaccine finder. Since pregnant women are at such high risk for serious flu-related complications, they’re given priority to receive the vaccine.

There is also a nasal flu vaccine called FluMist that contains live but weakened viruses. The nasal flu vaccine is not recommended during pregnancy because it has not been tested in pregnant women. The FluMist nasal vaccine can be used in healthy people aged 2-49 years old.

It’s best to get the flu shot in September or October so you’re protected before the flu season begins. But if you miss getting the shot in the fall, it’s still worth getting vaccinated later because the flu season can last into May. The flu shot available during the 2011-2012 flu season offers protection from both H1N1 flu (swine flu) and seasonal flu.

Some precautions prior to taking the shot:

If you’re allergic to eggs, check with your doctor before receiving a flu shot or if you’re sick and have a fever, wait until your symptoms are gone to get your flu shot. Some moms-to-be are concerned about the preservative Thimerosal, used in some flu shots. The CDC has found no convincing evidence of harm resulting from exposure to this preservative in vaccines, and both the CDC and ACOG say the benefits of the flu shot far outweigh the theoretical risk, if any, from Thimerosal.

To protect yourself and your growing family from the flu, the CDC is also urging people to follow its three-step approach to prevention:

1. First, get a flu shot.

2. Second, make sure to wash your hands and cover your mouth when you cough. Your family and any child caregivers should do the same.

3. If you do get the flu, visit your doctor and follow his or her orders on medication to help reduce the risk of complications. Some of the other simple measures are also listed.

4. Avoid crowds.

5. Avoid contact with people who have a cold.

6. Do not touch your eyes, nose, or mouth. Germs are often spread when you touch a contaminated surface and then touch your eyes, nose, or mouth.

Please contact your doctor if you come down with any of the flu symptoms or before trying any of the over the counter medications. However, some of the home remedies that you can try risk-free are listed below.

1. Use sugar, ginger or honey-based lozenges to relieve sore throats and cough.

2. Get plenty of bed rest.

3. Drink ample fluids, such as water, juice, and caffeine-free tea.

4. Put an air humidifier in your room to provide extra moisture, which can help reduce congestion

Many flu and cold medications have not been well studied in pregnancy, check labels carefully! Treatments for cold and flu symptoms during pregnancy include:

1. Acetaminophen

2. Saline nasal spray or nasal irrigation

3. Pseudoephedrine (decongestant and may be helpful for some people). Avoid pseudoephedrine in the first trimester, if you have hypertension or are hyperthyroid.

Since pregnant women with flu are at greater risk of serious illness and death from flu, the Centers for Disease Control and Prevention and the American College of Obstetrics and Gynecology recommend the use of Tamiflu (Oseltamivir) in pregnant women with suspected or test-proven flu.

Stay safe!

Cheers in health,

Neeti Misra MD FACOG

 

Sign Language: How to Spot Perimenopause

To everything—turn, turn, turn—there is a season. A time to be born, a time to die, a time to plant, a time to reap, a time to pause and contemplate: “How the heck do I know if I’m about to go through menopause?”

Okay, so maybe the lyrics don’t go quite like that, but for women of a certain age, it’s the burning question—and not just because of hot flashes. Wondering what to look for when it comes to perimenopause? Here are some of the telltale signs:

Hot flashes. This hallmark of perimenopause—a sudden feeling of warmth, usually around the face, neck and chest—got its reputation for good reason, as up to three-quarters of perimenopausal women will get them at some point.

Irregular periods. As your body prepares to stop menstruating completely, your periods could become more erratic. They may become shorter, longer, heavier, lighter, closer together, farther apart, or just completely unpredictable.

Breast tenderness. About a third of women in the early stages of perimenopause will experience tender breasts, but it often subsides later on.

Mood swings. Feeling sad, irritable or just plain blah could be a sign that menopause is on the horizon.

Decreased sex drive. A lack of libido can have many different causes, but the hormonal changes your body goes through as it prepares for menopause can zap some of your desire, as can other symptoms, such as vaginal dryness and fatigue from lack of sleep.

Bladder issues. Needing to urinate more often, leaking when you cough or sneeze, and urinary incontinence (leaking randomly) are three of the ways your bladder control might change with perimenopause.

Every woman is different and might experience all or none of the above signs. If any symptoms are interfering with your well-being or you have questions about perimenopause, contact your Healthy Woman doctor.

Whether it’s a time of love or a time of hate, a time of war or a time of peace, a time you may embrace or a time to refrain from embracing, it’s a time that—turn, turn, turn—comes for every woman, in every season.

Girl Talk

Gynecologist—even word is a bit intimidating, especially when you’ve never been to one.

Usually, it’s not until you’ve had your first visit with a gynecologist that you realize how seeing one is really no big deal. In fact, when you go to a gynecologist who you really trust, it’s like having a super knowledgeable friend who makes it his or her top priority to ensure that you blossom into a healthy woman.

Speaking of trusted and well-liked gynecologists, here, Healthy Woman’s own Dr. Susan Pacana answers the age-old question: “When do I need to bring my daughter to the gynecologist for her first visit?”

My patients with older children always ask about when they should bring their daughters in for their first gynecological check-up. The thought of having to go to the “gyno” often frightens teens and twenty-somethings. However, if approached in the right manner and at the right time, the gynecologist can be, along with the girl’s parents, a trusted source of information about safe sex, contraception, normal periods and sexually transmitted infections (STIs)—and certainly a better source than the Internet or her misinformed girlfriends. 

According to the American Congress of Obstetrics and Gynecology, adolescent girls should have their first visit with an obstetrician-gynecologist between the ages of 13 and 15; subsequent visits should occur at least annually. (Of course, there may be some reasons for parents to bring their daughters in earlier.) Most likely, this initial visit will not include a pelvic exam unless indicated by the patient’s medical history. If your daughter is sexually active by the time of her first visit, the doctor will recommend testing for STIs, but the first Pap smear can wait until she is 21.

Ideally, a young woman should see the gynecologist at a time when there are no pressing issues, so the doctor and patient can get to know each other. This allows the young patient to develop a trusted relationship with her physician, who she then can turn to when there may be an issue with birth control or STIs. An annual visit gives the doctor a chance to monitor the patient’s development and provide screening and care for physical, emotional and behavioral conditions. In turn, these visits can empower adolescent girls to assume more responsibility for their own health, safety and well-being.

At Healthy Woman Ob/Gyn, we enjoy educating our teenage patients about reproductive health and giving them the insight and guidance they need to go from healthy girls to healthy woman.

Visit our website and call to schedule an appointment (732.431.1616) for you or your daughter today!

Healthy Woman Job Opportunities

Are you outgoing, organized, capable, confident, smart and looking for a fantastic new job in the healthcare industry?

Then reach out to Healthy Woman, NJ’s most beloved Ob/Gyn practice, today to see what we can do for you.

Great jobs, growth opportunities, supportive staff, happy environment and a chance to really help people.

We’re accepting applications for front desk/office staff and medical assistants, so if you’re up for it, email Stephanie at sserrentino @ healthywomanusa.com.

Don’t wait! Email now!

A Baby Fair to Fall For

Pregnant or thinking about getting pregnant?

Come see us at the CentraState Fall Baby Fair (CentraState’s Star and Barry Tobias Ambulatory Campus, 901 West Main Street in Freehold) on Tuesday, October 4th from 6 to 8 pm.

Meet our warm, friendly doctors and staff, learn about our exclusive Pregnancy Connect program and get the inside scoop on everything you need to know to have a happy, healthy pregnancy, birth and beyond including:

  • What to expect at your preconception visit with your Ob/Gyn
  • Exercise, immunizations and lifestyle changes before pregnancy
  • Nutrition, prenatal vitamins and supplements
  • Understanding about fertility, ovulation and conception
  • Identifying and managing risk factors
  • How to have a healthy pregnancy
  • How to have a great birth!

Register for free here or call 866-236-8727 for more information.

It’s sure to be a baby fair to remember!

The Secrets of a Healthy Pregnancy: A Girls’ Night Out

Grab your best gal pals and join us for this fun (and possibly life-changing) girls’ night out!

From proper nutrition and natural fertility tips to the latest scoop on egg freezing, IVF and how to ensure a healthy pregnancy, we’ll dish on exactly what you need to know!

Where: American Hotel 18-20 East Main Street in Freehold

When: Tuesday, October 25 from 7 to 9 pm

What: A mom-in-the-making mixer to get the inside scoop on trying-to-conceive, pregnancy, birth and beyond

Plus, cocktails/mocktails, hors d’oeuvres, giveaways, gift bags and good girl talk! And it’s all free! Don’t miss it!

TO RSVP by October 20th, please call 732.431.1616 or email events@healthywomanusa.com

For more info on Healthy Woman Ob/Gyn, go to www.HealthyWomanUSA.com.

For more info on A Better You Weight Loss, go to www.ABetterYouWeightLoss.com.

For more information on IVF NJ, go to www.IVFNJ.com.

 

 

Meet Dr. Misra

Meet Dr. Neeti Misra of Healthy Woman Ob/Gyn and get the latest tips on women’s health—everything you need to be a healthy woman.

Dr. Misra is Fluent in Hindi/Marathi

Find Out How to Live Your Best Life!

Part of Dr. Misra’s Community Connection Series

Find Out What You Need to do to be a Healthy Woman

 

What: A lecture, Q & A and brunch mixer with Dr. Neeti Misra of Healthy Woman Ob/Gyn

When: Sunday, October 16 at 11 am

Where: Sri Guruvaayoorappan Temple

Why: To meet Dr. and learn about women’s health issues and cutting-edge solutions

RSVP: Call 732.972.5552 by October 12

About Dr. Misra

Dr. Neeti Misra attended medical school and did her first residency in obstetrics and gynecology in her native India, after which she completed an internship and residency at the Long Island Jewish Medical Center, the Long Island campus for the Albert Einstein College of Medicine. A board-certified diplomate in obstetrics and gynecology, Dr. Misra is also a member of the American Congress of Obstetricians and Gynecologists.

Says Dr. Misra, “My goal is is to promote health awareness amongst women, especially minority women. During my five years in practice, I have noticed that most women do not consider themselves a priority when it comes to health care and I would like to change that by showing them simple preventitive healthcare measures that would solve any problems before they got out of hand. I like to counsel women in all age groups, from adolesence to menopause, and I customize the care that I administer to meet the needs of each and every woman I treat.”

For more information about Healthy Woman Ob/Gyn, please call 732.431.1616.

 

Period Piece: The Causes of and Cures for Heavy Menstrual Bleeding

With an average of about 500 periods in a lifetime, a woman’s monthly cycle is no small part of her days. As if that weren’t enough, add in menorrhagia—aka heavy menstrual bleeding—and those 500 periods might feel more like 5,000.

Menorrhagia, when your period is so heavy that it interferes with your normal routine (this might involve changing your pad or tampon every hour or two for days, or a period that lasts longer than a week), has numerous causes, which include:

Ovulation issues. If your ovaries aren’t functioning properly and releasing an egg, your hormones are thrown off balance and menorrhagia can result. This is most common in girls first getting their periods and women approaching menopause, but it can happen anytime.

IUDs. Although intrauterine devices (IUDs) are one of the most effective forms of birth control, the nonhormonal (copper) variety can come with the side effect of heavy bleeding.

Fibroids and polyps. Small growths like fibroids on your uterus or polyps on your uterine wall can affect the flow and length of your period.

Bleeding disorders. Having a condition that impacts your blood’s ability to clot could lead to excessively heavy periods.

Medications. Different types of medicines can make your period heavier or longer than it normally would be, particularly anticoagulants (which stop blood from clotting) and anti-inflammatory medications.

Miscarriage. A one-time occurrence of menorrhagia in which your period comes later than expected could be due to miscarriage.

There are plenty of other causes, too—such as cancer, thyroid problems, a hormone imbalance, and endometriosis—and sometimes, there’s no explanation that can be found.

And now for the cures:

If you experience unusually heavy periods, see your Healthy Woman doctor to discuss treatment options. Birth control pills and Mirena, a hormonal IUD, are two therapies that not only prevent pregnancy but can also help with heavy periods. Also, NSAIDs (non-steroidal anti-inflammatory drugs like Advil, Motrin and Aleve) relieve cramps and can lessen blood loss. If you’re looking for an easy and lasting solution (not just a temporary quick-fix), we offer a safe, effective, in-office procedure called cryoablation that can help to eliminate heavy periods altogether. Performed under local anesthetic, it only takes 10 to 15 minutes in the comfort of our office. Most patients can leave the office within one hour and experience little to no pain after the procedure.

Five hundred periods is enough as it is—keep them from taking over your life by getting heavy menstrual bleeding checked out.

What To Really Expect When You’re Expecting

So you’re pregnant. Now what?

A journey of 40 weeks of pregnancy begins with one doctor’s visit—one that will be indelibly etched in your memory and part of the fabric of your family’s folklore forever.

Here, Healthy Woman Dr. Borislava Burt gives us the inside scoop on the many medical milestones of pregnancy from verifying that you are indeed pregnant to the ultrasound that can show you the sex of the baby to the not-so-beloved glucose test (gulp!) and beyond.

Pregnancy is an amazing event that culminates in the most wondrous gift of all: the birth of your child. Being pregnant is indeed amazing, but it can also be confusing especially for a first time mom-to-be. Besides the myriad of questions that continually pop up into your head (What type of food should I eat; What are the best vitamins to take?; Can I drink coffee or color my hair?), many women wonder about how soon they should see their doctor and what to expect from visit to visit.

Here’s what to really expect when you are expecting:

The Dating Scene

Accurate dating is of the essence in managing pregnancy. There’s a lot more to it than just knowing your due date. For a doctor, a patient’s estimated due date is very important for monitoring fetal development and knowing when to interfere if something is worrisome. Most patients may not realize that the earlier the due date is established, the more accurate it is. The best time to see your doctor is at approximately six to seven  weeks after the first day of your last menstrual period. Dating is done based on your cycle as well as an ultrasound.

First Things First

Once your pregnancy and due date are confirmed, your first visit will involve you and your doctor discussing your medical history along with a full physical examination. Your doctor will try to identify any factors in your health that may pose certain risks during your pregnancy, such as a history of preexisting elevated blood pressures or diabetes. The first visit will also incude baseline pregnancy blood testing as well as referrals for ultrasounds. Blood work will assess your level of immunity and/or exposure to certain infections, such as hepatitis and rubella, as well as establish your blood type and check whether you have anemia.

Testing! Testing!

Thanks to modern science, you will also be offered testing for some of the more common chromosomal anomalies, such as Down syndrome. This can be done via blood tests and/or ultrasound or more invasive testing, such as amniocentesis or CVS (chorionic villous sampling). Predictability of these tests ranges anywhere between 76 to 100 percent, depending on the method chosen.

Ultra Cool

At roughly 20 weeks into your pregnancy, you will be scheduled for a very detailed ultrasound, which, besides giving you a glimpse of your little miracle, will check to make sure that all fingers and toes are there as well as assess the rest of his or her anatomy. This is also the most common time to find out whether the stork will be dropping off a little boy or a little girl on your doorstep.

Oh, Sugar!

Several weeks later, more blood work will be done, including the dreaded glucose testing. But have no fear ladies, it’s really not that bad – drink it cold and fast and it will be over before you know it.

The Heart of the Matter

Then soon to follow are more frequent physical examinations in order to assess whether your body is getting ready for delivery. And as for the rest—all those questions and concerns—your doctor will be sure to address them all and give you the guidance you seek. From the first visit to the last, your doctor will be there with you every step of the way—through the nausea, through the weight gain, through the heartburn, through the uncomfortable and sometimes incessant nudging underneath your ribcage. But despite all that, you will forever remain in wonder of this beautiful, indeed amazing process of pregnancy—and you will never tire of hearing the galloping, thumping sound of another human being’s heart inside your beautifully growing belly.

 

About Borislava Burt-Libo, D.O.

Dr. Borislava Burt-Libo grew up in Brooklyn, N.Y. She graduated magna cum laude from New York University with a major in psychology and a minor in biology. She then received her medical degree from New York College of Osteopathic Medicine, where her medical education emphasized administering to each patient as a whole individual and caring for one’s health and well-being comprehensively and thoroughly, rather than treating just one symptom at a time. Dr. Burt then completed her residency training in obstetrics and gynecology at Lutheran Medical Center in Brooklyn and went on to practice in a private setting in Brooklyn and Manhattan for two years. Dr. Burt now lives in New Jersey with her husband and two children. She is fluent in Russian.

 

 

 

 

Sleeping Beauty: The Science of Sleep and Why You Need the Right Amount to Look and Feel Your Best

When the day gets busy—whether it’s filled with work, carting kids to and from activities, looking after aging parents, taking the dog for a walk, cooking dinner, hanging out with friends (or all of the above)—oftentimes the last thing on the priority list is sleep. That may not seem like a big deal when you have so many other things going on, but getting seven to nine hours of sleep should be one of your top focuses all the time. Why?

Sleep is a complicated subject that scientists and researchers are still working to understand. What we do know is that sleep affects so much more than how tired we feel—lack of it can lead to a decreased ability to pay attention or remember new information, an increased chance of getting into a car accident, and a greater risk for conditions like depression and drug abuse.

For those working on becoming healthier and losing weight, getting the right amount of sleep is vitally important. Without it, you’re more likely to suffer from obesity and diabetes. Many studies have noted a connection between sleep and weight, including the six-year Quebec Family Study, which found that those who slept less than seven hours a night were 35 percent more likely to gain 12 pounds by the end of the six years than those getting an average of seven to eight hours of sleep a night. Those who snoozed more than nine hours were 25 percent more likely to gain the weight.

There are a few different reasons for this. For starters, when you’re sleep-deprived, you tend to make bad choices. Ever reach for a high-calorie latte or cookies to help you wake up? And if you’re tired, you might skip the gym—or if you do make it, not have enough energy to put the full effort into your workout. You may be too zonked to figure out what to eat for lunch or dinner, turning to convenient fast food to get you through the day.

Even beyond that, your metabolism needs sleep to function correctly. If you’re running on a big deficit, your body’s hormones will tell you to eat more, and your metabolism will slow down—both of which can add up to weight gain.

Want to improve your sleep hygiene? Try these five tips from the American Academy of Sleep Medicine:

• Don’t go to bed unless you are sleepy.

• Get up at the same time every morning.

• Avoid taking naps if you can.

• Don’t have caffeine after lunch.

• Don’t have alcohol within six hours of bedtime.

So turn a proper night’s sleep from pipe dream to reality—because if you snooze, you lose…weight, that is.

For more weight loss tips or helping losing weight, go to www.ABetterYouWeightLoss.com.

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