Doctor's Orders

Think about the last time you went to the doctor. You probably showed up to the office, filled out some paperwork and flipped through old magazines (or maybe this magazine!) in the waiting room. When it was your time to be seen, you were likely taken to the back, and assessed by a nurse prior to the doctor making his or her arrival. Doctors and patients are busier than ever, committed to taxing schedules and what feels like a never-ending to do list. During your appointment, you ask the questions that are at the forefront of your mind, and then you and your doctor go your separate ways, only to meet again six months or a year later. 

But what about the questions that pop into your mind during that interim period? Alternatively, you may be hesitant to see a new doctor due to unanswered questions (and you’re simply not satisfied with what you’ve read on WebMD). Perhaps you’ve been considering acupuncture, a cosmetic procedure, or wondering why we’re gifted with a colonoscopy at the ripe age of 50. Maybe you’re unsure of why you’re suddenly experiencing joint pain after running long distances, or you’re wrestling with self-doubt that is preventing you from becoming a better athlete. These 10 Austin medical professionals have answered our questions about health, preventative care and advancements in the field. 

 Q+A: Orthopedic // Dr. Michael Burris

What do you do as an orthopedist?

I treat injuries to bones and joints. That includes any broken bones, joint injuries, ligament tears. For the knee, cartilage injuries, like meniscus tears. For the shoulder labral tears, rotator cuff tears and then also general joint pain occurring in the knees, shoulder, ankle pain. I see lots of runners, lots of athletes of all type. But as far as generalized knee pain goes, I think runners have been taken over by the explosion of minor injuries occurring in CrossFit.

What is it about running that causes so many ailments?

What it comes down to is that it’s a repetitive high-load weight bearing activity. In cycling, for example, it’s a repetitive but low-impact activity. But in that high-load weight bearing activity is where most of the injuries are and luckily most of them are not serious injuries—it’s not usually how you’re going to tear anything; it’s just how you’re going to develop pain. Everyone’s mechanics of running are different, and that causes different injuries for different people. 

There are better shoes for certain people and that depends on how they run and the anatomy in their foot and leg. My advice is: play around with different shoes and find what’s perfect for you. There is some trial and error in that, and it might be costly, but once you find what works you’ll be less likely to develop injuries. Where most people get injured are either when they’re starting out running or they’re trying to make a jump like increasing distance or speed. 

What is it about CrossFit that causes minor injuries?

CrossFit is a much more dynamic activity, so it’s more strenuous on the body. It differs from traditional weightlifting where you’re just sitting in one position and lifting weight in a certain way that you can really be in good control. Before CrossFit was even developed, it was known that type of dynamic movement had a higher risk of injury, especially if they don’t have someone that has taught them proper mechanics.  

What are the most common injuries you treat?

I see and treat ACL tears commonly, but I see general knee and shoulder pain the most. But for more specific injuries, ACL and meniscus tears are the most common. That’s not really from running or CrossFit. I see those injuries from soccer.

Is there anything preventative that can be done to avoid injuries?

Staying in good overall condition protects you. Many people look at core balance and strengthening programs, and those are great for injury prevention, especially in the legs. Even if you’re just a runner, if you have better developed muscle groups, you’re going to have better control and stability. If your muscles are weak and you don’t have dynamic control, when you start moving, cutting and pivoting, you’ll be at higher risk for acute injuries. If someone is just a runner or just a weightlifter, you’re going to be more prone to injury because they aren’t using their bodies in different ways.

Q+A: Psychology // Dr. Alice Lottes

What do you do as a mental health doctor?

I’m a general psychologist with a Ph.D. from the University of Texas working in private practice. I see patients from the age of 4 all the way through adulthood. I work with children and their families. I also work with young adults in college and then later in adulthood as well.

Do you see a difference in what kids need versus what teenagers need versus adults?

The people that come to my office are self-selected, so they want to be here because they’re ready to have help. The children with their parents that come in may be dealing with developmental issues, developmental delays such as autism, Asperger’s, or they might have attention deficit hyperactivity disorder, anxiety or depression. The way that I work and the modalities I use with children and their families involve a lot of parent coaching. In teens there tends to be anxiety and depression, which can lead to self-harm-type issues. If they let the families in, I see a lot of progress in that, but sometimes they really need their privacy. With adults there’s all types of modalities. Some people are on a life journey, trying to figure out what’s next in their life. Some people really have clinical anxiety and depression, and others have serious mental illness.

Do you think everyone can benefit from seeing a psychologist? 

We often look at the trifecta. With kids, teens and adults we look at three things: Is their home life being disrupted? Is their school/work life being disrupted? Is their social support network being disrupted? If a person has two or three of those, then that’s probably a good time to go in and examine what’s going on. That doesn’t have to be the case though. Some people are going through transitions and they want someone to talk to. Or they may be in grief and they’ve been in grief for a good while and they want someone to talk to outside of their friend group.

What would you tell someone who is on the fence about seeking mental help?

Every person is doing the very best that they can. When they arrive in this office, and when they’re asking for help, they’re in a brave and courageous place in their life. Accepting where they are, accepting who they have been, and all the events that have led up to where they are, and acknowledging that they’re brave to be here seeking help.

Where do you see the future of psychology going?

I think there will always be a place for private practice. I think there are many practitioners that are grouping together with other practices. For example, acupuncturists and psychologists working together. Or a family practitioner and pediatrician with a psychologist and collaborating in a medical group. We’ve all been able to communicate with each other in the past, but I think in the future doctors will start private practice groups that are more cohesive with the inclusion of multiple practitioners working together.

How does your mental health tie into your overall health?

It’s definitely an important piece! You have your financial health, your mental health, physical, and spiritual health. If you’re out of alignment in the area of mental health, the other pieces will eventually begin to shift. But if you focus on trying to improve those other pieces, it can bring your mental state up.

Part of the gold standard for treatment of depression is moderate movement three to four times a week. People that are severely depressed aren’t encouraged to run marathons or half marathons because it’s too much on their nervous system. Movement in general has been shown to affect mental health. 

Q+A: Sports Psychology // Dr. Tim Zeddies

What do you do as a sports psychologist?

Sports psychology is mainly about performance enhancement. So, generally stated, what I try to do is to help people make better what they are already doing that’s good or great and to improve the things that might not be so good or great as a way of improving their overall performance.

Do you treat mostly athletes at the college and professional level?

I was the main consulting psychologist for the University of Texas football team for about 10 years until Mack Brown left, and I also worked with a lot of other UT athletes. In addition, I’ve worked with Olympic athletes and professional athletes. But these days I do a lot of work with high schoolers, junior high, and believe it or not kids as young as 9 years old. Figure skaters, equestrians, tennis—individual sports, and a little bit of team sports.

What do the younger kids come in for?

 Generally it’s performance anxiety, but that can come out in a lot of different ways. What I typically see from younger kids is that their parents tell me that there is a difference in terms of how well they perform in practice versus how well they perform in a game or event. With slightly older kids – middle school and especially high school – because they’re developmentally at a different stage, they’re able to articulate things in a way that the younger kids simply can’t. Oftentimes there’s a level of emotional distress that can begin to not only impact their athleticism but also have an impairing effect on other aspects of their lives, primarily social or academic.

Do you primarily focus on what happens in training and competition, or do you also inquire about daily habits and non-athletic matters?

We don’t just talk about the time that they’re training; we discuss all aspects of life. One of the things I try to convey to my elite athletes or the athletes aspiring to be elite is that you have to live like a champion if you want to play like a champion. What that means is taking care of some of the basics. Sleeping, eating, socializing, managing stress in healthy ways—which in this day and age isn’t always something that athletes do especially at the high school and college level.

What are some of the more unique cases you’ve seen?

I like challenges. When an athlete comes in and reminds me of things I personally had difficulty with, it provides me an opportunity to address that again. One time I worked with a rock climber, who believe it or not, sometimes got freaked out by heights. They have these championships where the higher you go in the sport, the higher the climbs tend to be. When I was in high school, I fell from a 30-foot cliff and broke my arm, so when I was working with him, I felt my own anxiety coming up.

What is the most important piece of advice you can give to both athletes and nonathletes?

In sports psychology and general psychology, I emphasize the importance of belief in self. If I could pick one thing that I would want to help people improve, it would be belief in self. When the pressure is on, when there is adversity or difficulty, one of the first things that will waiver is belief in self. To get people to fight through that and believe in themselves, no matter what.

It’s like being a baseball player: If somebody hits .350 for the season, chances are, 99 out of 100 seasons they will be the batting champion. If they hit .350 for their career, chances are, they’re going to be in the hall of fame! What does that mean? Almost seven times out of every 10 times they come to the plate, they fail. Life’s a little bit like that. You don’t want to let your failures define who you are. You want to maintain enough belief in yourself that you use those experiences to learn and grow from in a way that makes you better.

Q+A: Gastroenterology // Dr. John Ziebert

What do you do as a gastroenterologist?

I diagnose and treat digestive diseases. The brunt of the business is gastroesophageal reflux disease, ulcer disease, irritable bowel syndrome, and colon cancer screenings.

Why did you decide to go into this field?

I lost a bet.

Really!?

No, I chose to do it primarily because it’s one of those subspecialties where you can do clinical work and talk to patients, and have a clientele that you grow old with. Some of my patients I’ve seen for 20 years, and it’s neat to see how their disease is handled—what makes it better, or worse, or what can make it manageable. I also get to do procedural work, so I don’t have to be in the clinic all day. I get to use these instruments that have incredible definition when looking at the GI tract. There are so many impressive tools that show the GI tract like you wouldn’t believe. 

With all the instruments we pass into the stomach and then into the colon, it’s amazing to be able to see that area of the GI tract. Whereas in the ’70s we weren’t doing that; we didn’t have all those flexible scopes to let you see that much. Nowadays when you have a gallstone, we can go in with a scope and retrieve it. Before, you had to have open surgery and walk away with a big scar. It’s getting less invasive, and it’s an exciting field to be in when you get to do things with scopes rather than open surgery.

Why does most colon cancer develop after the age of 50?

The thought is, to go from a normal colon to cancer, there are a few steps that lead up to it. You start with a normal colon, and then you acquire some kind of genetic mutation which causes you to form a polyp. That polyp, over time, acquires more mutations, and then it turns into a cancer. The polyp sits there, it gets another genetic hit where it forms another mutation, and then another mutation, and then turns into a cancer. It takes about 10 to 15 years for that to happen. But, about 10 percent of colon cancers occur in younger people, around the age of 40.

There seems to be some overlap with symptoms of irritable bowel syndrome, celiac, and food allergies/intolerances. How can you differentiate?

There’s a huge overlap between IBS (which is probably the most common thing we see) and then different subsets of illnesses that mimic irritable bowel syndrome. The problem is, when we talk to patients and they say, “I have cramping pain, I have diarrhea that’s been going on for 10 years, I don’t have any blood in my stool and I don’t have any weight loss.” We’d say that sounds like IBS, and then give them medication for it and stop there. But now, we are seeing that celiac disease and lactose intolerance are more common than we thought. If you don’t look for those alternative causes, you’re not going to find it. You have to keep your mind open and think about the other possibilities.

What causes runner’s trots?

One of the theories is that, when you’re running and vigorously exercising, over time you’re shunting a lot of blood to your large muscle groups of your butt and your thighs. You have a metabolic demand in your big muscle groups. You get relatively less profusion of your GI tract, so your GI tract sees a little less blood. When that happens, the thought is that the GI tract doesn’t absorb as well, and then you get excessive water in the colon. 

Q+A: Dentistry // Dr. Grant Glauser

What do you do as a dentist?

As a dentist I like to focus on the patient as a whole. It’s not about just getting you in and then seeing you out. I like getting to know the patients as a friend, basically, and then trying to make them healthier and happier. It stems from my grandfather, who was a dentist, and his patients have been his patients and friends for life. It’s trust to let someone into your mouth. If you don’t have that, then it makes everything more difficult.

There’s the old saying that “the mouth is the mirror to the body”—do you see truth in that in your practice?

Oh definitely. Typically athletes have really healthy mouths, sometimes even on the obsessive side, and I have to tell them that they’re brushing too hard and need to tone it down. Usually if someone is healthy and they take care of their body, they’re also going to take care of their mouth. The same applies to the opposite; if someone doesn’t take care of their body, we’ll find that they don’t take care of their mouth. The cool thing about dentistry is that we can detect cancer or systemic diseases in the mouth, prior to them being diagnosed.

Brushing, flossing, rinsing: is one more important or more effective than the other?

If you asked five different dentists, you’d get five different answers. You can’t just brush because then you’ll get bone loss between the teeth. You can’t just floss because you’re only getting in between the teeth and nowhere else. We typically see good brushers and bad flossers. Sometimes you can get by with that, but for the most part brushing and flossing go hand-in-hand. I like anything with fluoride. It’s safe and effective, and what we see with natural toothpaste is that it’s missing fluoride.

Why do you advocate for fluoride?

There’s research going on right now to find a way to provide a pill or antibiotic that gets rid of the bacteria. When the tooth starts to break down, fluoride comes in and replaces the mineral and strengthens the tooth. Let’s say you have an area where you weren’t brushing or flossing very well, when the fluoride gets there it can actually replace a cavity.

How does diet play a part in the development of cavities?

Diet plays a big part. If you’re trying to eat six meals a day, that’s actually worse for your teeth. Every time you eat, the environment in your mouth becomes really acidic and that favors the bacteria. When the Ph level drops, that’s when your teeth become susceptible to cavities. If you’re snacking throughout the day, or sipping on coffee, juice or Gatorade, it continuously feeds the bacteria that causes cavities.

What do you see in the future of dentistry?

I think the future of dentistry is going to be pretty cool. They’re always saying they’re looking at ways to attack the bugs in your mouth. Maybe someday they’ll create a gum where you chew it and it gets rid of the bacteria in your mouth—I think that’s somewhere in the future. There are possible advancements in regrowing teeth; right now we do implants and in the future maybe we can implant an actual tooth to grow in your mouth. There’s always going to be a need for the traditional stuff, like braces, but the technology now is making it easier for patients—it’s quicker, less painful. Dentistry is going through a digital revolution, so we’re no longer just taking impressions. We’re scanning and using 3-D technology to create crowns. Things that used to take a month now take a couple of days.

Q+A: Cosmetic // Dr. Lawrence Broder

What do you do as a cosmetic surgeon?

I spend my time interacting with patients who are seeking assistance with issues regarding their physical appearance. I have access to an array of both surgical and nonsurgical procedures that can be used to make significant cosmetic improvements.

What is a medical spa?

A medical spa or “medspa,” is a unique marriage of a medical office and a day spa. The goal is to offer cosmetic medical procedures in a more comfortable and inviting setting than a traditional medical office. A medical spa also employs other professionals like nurses and aestheticians who complement the physician in patient care.

Why did you decide to become a cosmetic surgeon?

Cosmetic surgery involves a great mix of procedures and patient care. The patients seeking these procedures are motivated to look better and be healthier. They come to us because they want to, not because of their insurance. They are spending their own money, and they demand a higher level of customer service. As a result, we must be transparent with our pricing, and our reviews are there for the world to see. This business aspect of cosmetic surgery also attracted me to the field.

What kind of treatments do you notice athletes often seek out?

Healthy people like athletes invest a lot of time and effort into looking good. Unfortunately, many athletes have areas of resistant fat and loose skin that will not respond to exercise. This is where body-contouring surgery can have a great impact. Athletes also spend a lot of time outside and tend to have more sun damage. This makes them look older than they actually are, and they can be helped by many cosmetic dermatology procedures.

What major changes have you seen in your industry? What changes or trends do you foresee/predict?

Patients are more savvy and busier than ever. They have read everything about the procedure on the Web before they even come in. They have less tolerance for downtime, discomfort, high prices and risk than ever. As a result, the trend is leaning towards less invasive procedures that are performed in-office. Patients are also demanding a much higher level of customer service and access to the latest procedures and products.

Do you offer any services to educate and promote healthy living? 

We try to look at the patient as a whole person. The patient that comes to us for liposuction or Botox usually has several other health concerns to address. Do they have a healthy diet? Do they smoke? Do they exercise? Do they wear sunscreen? Are they having hormonal problems? Without addressing some of these issues, we risk making the results of our procedures less effective and short lived. A comprehensive approach to patient care is the future in all fields of medicine.

How can cosmetic procedures help a person’s well being?

The way we look to others and ourselves has a critical role in our well being. A positive self-image propagates a pattern of healthy living. Cosmetic procedures can have a role in improving body image and promoting healthy behavior. It is not a cure-all or magic bullet, but it can make a huge difference to many patients.

Q+A: Cardiology // Dr. David Zientek

What do you do as a cardiologist?

As a general and interventional cardiologist at the Seton Heart Institute, I am primarily involved in diagnosing and treating patients with suspected or known coronary and peripheral arterial disease, congenital heart disease, abnormal heart rhythms, and congestive heart failure.

Should you only see a cardiologist if there’s an imminent problem or if you have a family history of heart disease? Or is there a certain age at which everyone should check in with a cardiologist?

The majority of people are referred to a cardiologist for diagnosis if they have symptoms that could be related to a heart problem or if they have known cardiac problems that require ongoing treatment or follow-up. For patients at risk for heart disease such as those with a family history, a primary care physician will usually do an excellent job of managing risk factors for coronary disease such as high blood pressure, diabetes, high cholesterol, and smoking. We occasionally become involved with patients in whom the usual measures to control high blood pressure or cholesterol are not adequately reducing risk.

The ketogenic diet is becoming more popular, and many athletes are embracing fat in their diets. This includes consuming butter—even in coffee—on a regular basis. Is the ketogenic diet helpful in maintaining heart health?

The ketogenic diet has traditionally been used for some rare conditions such as childhood seizures. It has normally been used for a limited time of two years under close supervision of a dietitian. Recently there has been some evidence that a modified version of the ketogenic diet (with 30 grams of carbohydrate, and high amounts of protein and fat) may be helpful for those who need significant weight loss and are trying to reduce the severity of, or even correct hypertension, diabetes and high cholesterol. In general, reducing processed carbohydrates is recommended. However, most cardiologists are still nervous about recommending this diet because of the lack of studies on long-term effects.

From a cardiac standpoint we really encourage the Mediterranean diet as the best for maintaining a healthy weight and having a positive impact on cholesterol, diabetes and overall heart health. A recent study suggested that people who closely adhere to this type of regimen have an almost 50 percent lower risk of developing heart disease over 10 years than those who do not eat significant amounts of these foods.

Year after year, heart disease tops the charts for leading cause of death in America. Why do you think so many people are affected by heart disease?

A diet high in processed food, often high in sodium and sugars, and low levels of physical activity increase three of the major risk factors for coronary artery disease: diabetes, hypertension and high cholesterol. 

We have made great strides in reducing cigarette use, but there are still a significant number of people who have this risk factor. There is some concern that the new e-cigarettes may still have a significant cardiac impact and put previous nonsmokers at risk for taking up the use of regular tobacco.

Is there anything in particular you’d like Austinites to know about heart health?

I would say that for the majority of people the biggest thing you can do to maintain a healthy cardiovascular system is regular exercise. Any activity reduces your risk. On days when you may not be able to get in a full exercise session, do things like walk the stairs up to your office, park at the far end of the parking lot, or work in 5–10 minutes of walking at lunch.

The second factor is diet. Minimizing eating out and reducing your intake of processed food by preparing your own food can have a large impact. If you smoke and cannot quit on your own, consult your physician about possible aids to stop. 

Finally, regular checkups to monitor risk factors such as blood pressure, cholesterol and diabetes will significantly decrease the chances of heart disease in the future. 

Q+A: Oncology // Dr. Matt McCurdy

What do you do as an oncologist?

As a radiation oncologist, everything is treatment. No prevention, just treatment. About 30 to 40 percent of what I do is palliative treatment so I work to relieve pain from cancer that has spread to the bone or the brain, and improve quality of life. The rest of it is going for cure. There are certain conditions where we treat radiation alone, but usually it’s chemotherapy or in addition to surgery. For example, with early stage breast cancer, the surgeon will perform a lumpectomy and then we give full-press radiation after that to prevent the tumor from coming back. Surgery and radiation have equal curate, they just have different side effects.

Why did you choose radiation oncology over medical or surgical oncology?

I feel like I’ve won the lottery. With radiation oncology you get to see the patient every week on treatment. You get to know them well and form a bond. I like that personal interaction.

What is the most common type of cancer people get?

Prostate cancer and breast cancer are the most diagnosed. Lung cancer is the most common cause death (so don’t smoke!).

How often do you see athletes or very healthy people get cancer?

Breast, prostate, ovarian, and endometrial cancer are a few that come to mind. There’s no real lifestyle practice that’s to blame. There’s a recent study that just came out, though, where they randomized woman to the mediterranean diet versus a normal diet. They found that the mediterranean diet prevented breast cancer in a couple women out of a thousand. It was only a handful of women but it prevented it. A little bit of exercise and limiting alcohol—that helps a little bit. It’s nothing like lung cancer and smoking, or pancreatic cancer and drinking.

Do you think more doctors will incorporate integrative medicine into oncology treatments in the future?

I certainly hope that integrative medicine works its way into all of medicine, but especially oncology. It’s not widely accepted yet, even in Austin! I’ll go to multidisciplinary conferences and others will say, “Oh here’s another hippie.” I’m not saying that’s the only treatment, but it’s beneficial to incorporate it. Patients will realize, “I need chemotherapy, even though it’s toxic for my body, but I can take milk thistle to protect my liver.” There’s no drug we can prescribe that protects the liver, but there’s milk thistle. We don’t know what’s in it but it works. 

I also recommend meditation to my patients, even just mind/body awareness—it doesn’t even have to be about love, kindness, Buddhist tradition—there’s all kinds of integrative medicine and meditation.

What are some of the most exciting new developments in the field of oncology?

Surgical techniques are improving. We have biological agents which always promise big but don’t quite come through because they have different side effects from chemotherapy. They’re not necessarily better, they’re just different. For example, Jimmy Carter (who has melanoma) is on the drug Keytruda. It feels like you have the flu 24 hours a day. You’re not vomiting or losing your hair, but it does feel like you have the flu—that’s an exciting area.

Q+A: Acupuncture // Jennifer Stang

What do you do as an acupuncturist?

Acupuncture, like other forms of manual work, is about trying to treat the whole person and get the person better as quickly as possible. So, with acupuncture we’re inserting needles into the body to get a response, and we want the blood flow to be aerated to try to heal tissue and effectively change hormones levels as well. I treat things from pain conditions to hormonal imbalances, fertility problems, digestive issues, and sleep problems. It really runs the gamut, but we are trying to get the body to heal itself through the needle work.

What kind of training do you go through to become an acupuncturist?

In the state of Texas, we have to have an undergraduate degree. We go back to graduate school for four years, and then we take four national exams to get licensed by the medical board. It’s over 3,000 hours of coursework.

Do you treat muscular conditions more than other areas of work?

Very commonly we are treating muscular conditions, but also neurological/nervous system with acupuncture. When dealing with pain, it can be a combination usually. You’re really working on the nervous system, muscular system and mysofascial system with acupuncture.  

Why would someone choose to see an acupuncturist over a massage therapist or a chiropractor?

The goal is to get somebody better as quickly as possible. Sometimes it’s good to have mutliple treatments going at the same time because while we’re trying to accomplish the same thing, we have different techniques in treating it. Some people respond to one treatment over another, so this is just another option that might work better for somebody.

The nice part about acupuncture is that even though we are usually trying to accomplish the same results, especially with pain-related conditions, with acupuncture we are actually inserting a point into the body. We get a different type of sensory response from the body, and we can get a stronger, quicker effect because we can touch the muscle with the needle rather than be superficial on the skin’s surface.

You treat more pain and fertility conditions, but what else can acupuncture treat?

There’s a limit to what can be treated, but there are specialists for one thing versus another. I really can’t emphasize enough the effect it has on anything stress related. This includes hair loss, digestive problems and skin conditions, to name a few. Usually we’re the last resort, but if somebody gets better, then we might be one of their first choices for treatment. We also treat nausea from chemotherapy and pregnancy. We treat a lot of pregnant women because they sometimes can’t take medication, and acupuncture is a really safe alternative.

Is there anyone who doesn’t respond to acupuncture?

Of course! I always look at it as: you can paint a canvas or you can paint a piece of wood or you could change the actual paint. When you change the medium, it changes the outcome, and your body is the medium. Two people could take the same medication and respond differently to it—the same can happen in acupuncture. Usually we get pretty good results with most things, especially more complicated conditions, and I think that’s where the stress piece comes in. Most people don’t have adverse reactions to acupuncture, which is the nice thing. Side effects are much more minimal. In fact, there can be positive side effects, like sleeping better or feeling more relaxed.

Q+A: Obstetrics & Gynecology // Dr. Diana Wang

What do you do as an Ob-Gyn?

As an Ob-Gyn we have the honor to apply all specialties of medicine to our work. Unlike other specialties, this field allows us to use our skills as counselors, and medical diagnosticians, and radiologists, and psychiatrists and surgeons. It encompasses a varied amount of skills and it makes our job exciting and always changing. We see patients for well women health checks or preventative care, to continue to make sure each women’s health is maintained at their highest potential. We also help women learn about their fertility, and assist with pregnancy. We act as guides throughout a pregnancy and perform deliveries and C-sections. As women have many ailments such as pelvic pain, endometriosis, heavy menstrual bleeding, ovarian cysts, tumors, gynecological cancers that may develop in their lifetime, we act as diagnosticians and we can also perform the treatment through medicine and/or surgery. It is definitely a fulfilling role to play in someone’s life, and we are privileged to do what we do. 

In the time you’ve been practicing, what is the best change or advancement that has been made in your specialty?

The best advancement in the time of my practicing years is the onset of minimally invasive surgery. You may have heard of laparoscopic or robotic surgery, which has almost made open surgeries—where a large incision is made on the body—almost obsolete. 

Laparoscopic surgery consists of using small 0.5-1cm incisions in the umbilicus or other areas to allow placement of a camera and other instruments to perform surgery. Since the onset of this type of surgery, large cases such as hysterectomies that once required a large incision to perform, can now be done as an outpatient. The patient can go home the same day, and the occurrence of large blood loss, infection, and thromboembolism (blood clots) have been reduced significantly. It is important for women nowadays, no matter if you are in the work field or a stay-at-home mom, to return to your life as soon as possible. This advancement in surgery has made a large impact on the improvement of life. 

What are some questions that you think patients are too nervous or uncomfortable to ask?

As Ob-Gyn doctors, we are here to answer and listen to questions that people are afraid to ask and reassure them that it is OK to ask. Many questions in multiple aspects of a patient’s health may seem embarrassing or hard to ask but we are here to help educate and allow every woman to better understand their bodies, and to be able to appreciate more how it works. Questions regarding sexuality, pregnancy, fear of miscarriage, and fear of not being able to get pregnant are just some ideas that many women are afraid to ask.

Do genetics play a large role in a healthy pregnancy or do lifestyle choices carry more weight?

That’s an interesting question because both do in its own way. However, healthy genetics automatically preclude a healthy pregnancy, and once a healthy pregnancy has begun, lifestyle factors may complicate or improve certain aspects of the pregnancy to a degree. That being said, miraculously, by design, a healthy fetus can withstand more than one would think. The resilience that has been endowed to a fetus during a pregnancy by design gives it an unimaginable resilience to allow it to survive all kinds of outside factors, and still have a very healthy outcome. 

When should we seek help for infertility?

Infertility is something that many women have a fear of—especially now that a large portion of women are beginning to have children later in life. Therefore, it is never too early to discuss with your doctor what factors can affect infertility and have an overall health history assessment to determine if there are any risk factors that may be an issue. Communication and understanding your own body can help you and your doctor make a plan as to when to have a more detailed evaluation regarding your fertility.