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ACCEPTING NEW PATIENTS!


Call today to book your appointment!

131 Medical Park Road, Suite 102
Mooresville, NC 28117

704.663.1282 Phone
704.663.1413 Fax

Office Hours:
M-Th: 7:30am-5:00pm
F: 7:30am-2:00pm

Lab Hours:
M-F: 8:00am-11:00am
& 1:00pm-4:00pm

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About Us

Specialty: Gynecology, Obstetrics

Our team specializes in providing comprehensive medical care to women in a comfortable, caring setting. PHC Lake Norman OB-GYN provides complete obstetric and gynecological services, utilizing the most technologically advanced equipment and procedures available. All practice physicians are fully trained, Board-Certified/Board-Eligible, and Fellows of the American College of Obstetrics and Gynecology. With the addition of Midwife Services, the experienced physicians and staff of PHC Lake Norman OB-GYN provide a full spectrum of services focused on the unique healthcare needs of women.

Patient Forms

Please download the following forms, print, fill out and bring with you to your appointment to speed up your check-in process:

Patient Resources

We’ve put together a useful list of resources for additional information about important topics.

 

Books

What to Expect When You’re Expecting
by Arlene Eisenberg

Chicken Soup for the Expectant Mothers Soul
by Jack Canfield

The Four Seasons of Marriage
by Gary Chapman

Our Providers

James, Al-Hussaini, MD, FACOG
Graduate Education UNC-Chapel Hill Chapel Hill, NC Internship/Residency University of South Carolina Columbia, SC Certifications Fellow, American College of Obstetrics and Gynecology
Laura Arigo, MD
Graduate Education Albert Einstein College of Medicine New York, NY Internship/Residency Winthrop University Hospital Rock Hill, SC
Katie Collins, DO, FACOG
Graduate Education Edward Via Virginia College of Osteopathic Medicine Blacksburg, VA Undergraduate Education Virginia Tech Blacksburg, VA Internship/Residency East Carolina University, Brody School of Medicine Greenville, NC Certifications
  • Board certified, American Board of Obstetrics and Gynecology
  • Fellow, American College of Obstetrics and Gynecology
Grant Miller, MD, FACOG
Undergraduate Education The Citadel Military College of South Carolina Charleston, SC Graduate Education Bowman Gray School of Medicine at Wake Forest University Winston-Salem, NC Certifications Fellow, American College of Obstetrics and Gynecology Internship Medical University of South Carolina Charleston, SC
Nicole S. Wellbaum, MD
Undergraduate Education Davidson College Davidson, NC Graduate Education University of South Carolina School of Medicine Columbia, SC Certifications American Board of Obstetrics and Gynecology Residency Medical College of Georgia at Georgia Regents University Augusta, GA
James Wilson, MD, FACOG
Graduate Education Ohio State University College of Medicine Columbus, OH Residency Memorial Mission Hospital Asheville, NC Carolina’s Medical Center Charlotte, NC Certifications Fellow, American College of Obstetrics and Gynecology
Coral Bruss, FNP-BC
Undergraduate Education Bachelor of Science – RN Kettering College, Kettering, OH Graduate Education Family Nurse Practitioner Frontier Nursing University, Hyden, KY

Services

Gynecology

Preventive Care

A woman’s health needs change throughout her stages of life. We specialize in helping women focus on healthy choices and lifestyles from young women to older adults. Some of the visits as relating to women’s health include physical examinations, thyroid and hormonal tests, mammograms (at age 40+), breast exams, Pap testing, HPV testing (at ages 30-65 on average), pelvic exams, STD testing and more. Discuss setting up your preventative care plan with your PHC Lake Norman OB-GYN professional.

Birth Control

There are many different kinds of birth control (contraception) made available to women today. Options can include hormone shots, pills, patches, IUDs (intrauterine devices) and permanent sterilization. If you no longer want children, tubal ligation is also a simple surgical procedure that is an effective form of preventing future pregnancies by sealing off the fallopian tubes. The providers at Piedmont HealthCare’s Lake Norman OBGYN can discuss all available options for birth control and go over the best method that would work with your body’s chemistry.

Gynecological Surgery (Traditional and Minimally Invasive Surgical Techniques)
Adolescent Gynecological Care
Breast Health
Urinary Incontinence

There are two main types of urinary incontinence. These are stress urinary incontinence (SUI) and urge urinary incontinence.

If you have stress urinary incontinence (SUI), you may lose urine when you:
  • Laugh, sneeze or cough
  • Walk or exercise
  • Get up from a seated or lying position.
If you have urge urinary incontinence you might have:
  • Sudden losses of urine without any warning
  • The inability to reach the toilet soon enough when the urge to void arises
  • To plot out a trip around town based on the location of certain restrooms.
What can I do if I think I have SUI?

First, talk to your provider. With your help, he or she can determine the type and cause of your incontinence, which is the first step toward finding the best treatment for you.

Your provider will probably examine you and will possibly suggest urodynamic measurement tests, which can easily be performed in our office. To learn more information about urodynamic measurement tests, please check out this web site.

If you are having symptoms of urinary incontinence, please feel free to discuss these with any of the providers at Piedmont HealthCare’s Lake Norman OB-GYN.

Infertility (Management and Treatment)

Infertility is a woman’s inability to get pregnant after an extended period of time of attempting to get pregnant, or the inability to keep a fertilized egg in the uterus once pregnant. The causes of infertility can vary widely, so discussing your situation with a PHC Lake Norman OBGYN provider can help you on your journey to becoming pregnant. Although risk factors for infertility for women and men can include smoking, alcohol, poor diet, obesity, age, disease and other health problems, only a thorough exam can help diagnose issues affecting fertility.

Menopausal Management

The shift into menopause is a difficult time for a woman, but our medical team is educated and experienced in helping make the transition as smooth and comfortable as possible. Mood swings, hot flashes, difficulty sleeping, memory instability and even bone density loss all tie to menopause. While some of these symptoms can be helped with lifestyle changes (which can also be discussed with our physicians), the overall effects of the hormone shift may be eased with Menopausal Hormone Therapy (MHT) that involves progesterone and estrogen hormones to steady out the process. It’s important to talk to your doctor to find out if this option is best for you given your current health situation.

Obstetrics

Normal and High Risk Obstetrical Care
Instructions for Pregnant Patients

Congratulations on your pregnancy! Pregnancy is an exciting time when you will experience a lot of physical and emotional changes. You will have lots of questions. Listed below are answers for some common concerns. This reference is only offered as a general guideline. Different answers may apply to women with special problems in pregnancy (e.g. twins or diabetes), and this list is not comprehensive It does contain a great deal of helpful information to be used throughout your pregnancy.

Here at Lake Norman OB-GYN we are happy to offer obstetrical care by board certified / eligible physicians as well as certified nurse midwives. The physicians and midwives work as a team to ensure that you have a quality obstetrical experience. You are encouraged to inquire about both types of obstetrical care that we offer.

CALL COVERAGE

The six board certified/eligible physicians have designated call days and nights. You are encouraged to schedule appointments with each doctor during your pregnancy to familiarize yourself with every member of our close-knit team.

CONTACTING YOUR DOCTOR

Non-emergency questions during office hours:
704-663-1282

You will usually be able to speak directly with a nurse or medical assistant and can always leave a message. Either way, one of the doctors will respond within 24 hours and usually much sooner.

Emergency calls or onset of labor during office hours:
704-663-1282
Follow instructions guiding you directly to our office staff.

Emergency calls after business hours or on weekends:

Leave a detailed message with the answering service. If you do not get a call back within 15 minutes, call again. If you are still unable to reach your doctor and it is a true emergency, call Lake Norman Regional Labor & Delivery Department at 704-660-4866.

DIET

In pregnancy, you are not eating for two. A healthy woman of normal body weight can meet her nutritional demands in pregnancy by eating a balanced diet while adding a single glass of milk to each meal. Your elemental calcium needs are 1200 mg per day. If you do not tolerate milk, drink orange juice with calcium or take Tums with each meal.

Tums have added calcium and will also help with heartburn. Multivitamins such as Centrum or One-A-Day are adequate to meet your nutritional requirements. A prenatal vitamin with iron supplementation can also be prescribed. Eat a high fiber diet rich in fruits and vegetables and at least two protein/meat servings per day (fish, poultry or lean beef). Do not eat raw or undercooked meat of any kind. Pregnant and nursing women should specifically avoid shark, swordfish, king mackerel, albacore tuna and tilefish because of high mercury concentrations in these species. Limit consumptions of freshwater fish caught by friends and family to a single 3-6 oz serving each week. Notify your doctor if you are a vegetarian or vegan, if you have any history of an eating disorder, or if you are extremely underweight or obese.

Caffeine: 2 cups or less per day of coffee. (A standard-sized cup containing 100mg of caffeine – not a giant “super-charged” glass of Starbuck’s). Try for similar goals with soda or tea.

Nutrasweet: There are no reported adverse effects. Nonetheless, we recommend trying to limit your consumption. Women with phenylketonuria, who required a special childhood diet, should not consume Nutrasweet during pregnancy.

WEIGHT GAIN

Ask your doctor but general guidelines for women are:

If underweight, your goal is 28-40 lbs
If normal weight, your goal is 25-35 lbs
If overweight, your goal is 15-25 lbs
The average woman gains about 8 pounds in the first 20 weeks of pregnancy and about 1 pound per week in the last 20 weeks. (Remember that pregnancies last 40 weeks from your last menstrual period). Avoid gaining more than 1 pound per week in the second and third trimesters to avoid an excessively large infant and to avoid postpartum weight problems.

EXERCISE

Joints become lax in pregnancy. You are at an increased risk for back or joint injury. Your change in size, shape and posture may make you less agile.

Moderate exercise is recommended. Warm up first. Limit exercise to 30-45 minutes, four to five days per week. Swimming, walking, stationary bikes and low-impact aerobics are ideal. Avoid more dangerous activities such as water skiing, snow skiing, and scuba diving. Work to maintain fitness – do not get overheated or push yourself to your limits. Monitor your heart rate closely during exercise. Heart rate guidelines in pregnancy depend on your pre-pregnancy level of fitness. If you were not physically active prior to pregnancy, you should generally avoid heart rates over 140 beats per minute. Otherwise, the general guideline of being able to talk comfortably during exercise is acceptable for physically fit women.

BATHING

Baths or showers are fine. Avoid saunas, hot tubs, Jacuzzis, and steam rooms.

TRAVEL

If your pregnancy is without complications (ask your doctor), you may travel up to the last month of pregnancy (36 weeks). Get up and walk around every 2 hours to stretch your legs and help prevent blood clots.

SEX

With the exception of certain pregnancy complications (e.g. preterm labor, placenta previa, twins, ruptured membranes), you may engage in sexual activity, including intercourse, throughout the pregnancy. Ask your doctor, if you have any concerns.

COLD SYMPTOMS
  • Sudafed (Pseudoephedrine hydrochloride)
  • Tylenol (regular or extra strength)
  • Benadryl (diphenhydramine)
  • Chlortrimeton
  • Guaifenesin cough syrups (e.g. Robitussin or Dimetap)
  • Tylenol Cold or Tylenol Allergy/Sinus contains useful combinations of the above drugs. DO NOT take aspirin or ibuprofen or combination medicines containing these drugs unless your doctor instructs you to.

Consult your doctor for a fever greater than 100.0 degrees F and symptoms suggesting more than just the common cold. Nosebleeds are common in pregnancy and quite often occur with nose blowing.

HEADACHE

Headaches are common in the first and second trimesters. You may take regular or extra strength Tylenol (acetaminophen) throughout pregnancy. Always call your doctor when headaches do not respond to Tylenol, especially in the third trimester of pregnancy.

CONSTIPATION

Eat a high fiber diet and lots of fruits and vegetables. If needed, you may use Metamucil, Fibercon, Colace or Senekot.

NAUSEA/VOMITING

You may take an over the counter medication called Emetrol, vitamin B6 25 mg 3 times a day, or 1 gram/day of gingerroot supplement from a natural food store. Unasom at bedtime can also help. For persistent Nausea/Vomiting your doctor may recommend medication.

WARNING SIGNS IN PREGNANCY WHICH WOULD WARRANT A PHONE CALL
  • Vaginal bleeding
  • Uterine contractions more than four times in an hour while at rest, if you are less than 34 weeks. Often contractions will stop if you empty your bladder, lay on your left side and drink plenty of fluids. If you are having four or more contractions an hour, first try these things and see if they stop. If contractions persist, call your doctor.
  • Rupture of membianes, (breaking the bag of waters). If you think the bag of waters has ruptured, call whether you are preterm or full term. This usually feels like a big gush of fluid or persistent trickle of fluid from the vagina. It is often confused with incontinence of urine. Pregnant women frequently have episodes of urine loss when they bend over with physical activity such as tying shoes, getting in and out of the car, and getting in and out of bed. It is always worth investigating. If you are unsure, call the doctor.
  • Decreased fetal movement in the third trimester – after 24 weeks. Babies should move on a regular basis; however, they also have periods of sleep when they are quiet. During the times of day when your baby is active, you should feel at least 10 movements or kicks in a two-hour period. If the movement count falls short of this, particularly at the time of day when your baby is normally active, you should call your doctor.
ULTRASOUND

Ultrasounds are used for dating pregnancies, assessing growth of the fetus, checking for twins, and checking for certain types of birth defects. Your doctor will discuss the need for an ultrasound during your pregnancy. In general patients will get at least one ultrasound between 16-21 weeks of pregnancy to visualize development of major fetal structures and to confirm the gestational age. There may be additional need for ultrasounds at earlier and later gestations. Not all insurance companies pay for routine ultrasounds.

DIABETES SCREENING

At 24 – 28 weeks of pregnancy, you will be screened for gestational diabetes (diabetes that is first diagnosed during the course of a woman’s pregnancy).

LABOR AND DELIVERY

The following are general guidelines to assist you when you think you are in labor.

  • Rupture of membranes (broken bag of waters): If you think you have broken your bag of water, even before contractions start, call the office to notify the doctor. Please do not delay in notifying the doctor if you think you have broken your bag of water.
  • If you think you are in labor with your first baby and your bag of waters is intact: As long as the baby has been moving regularly and you are having nothing but bloody show (mucus and blood discharge), you can safely wait to call the office (night or day) until you have been contracting every 5 minutes for 1 hour of such an intensity that you can’t walk or talk during contractions. Please note that it may take several hours at home for your contractions to reach this frequency and intensity with your first baby. If you are uncertain about what to do, page the doctor at any time.
  • If it is your second baby or beyond, your labor will often go faster. If you break your bag of waters and you are not contracting, call immediately. Labor often ensues quickly after ruptured membranes of patients who have previously delivered. Generally speaking, you should call when you are contracting about every 10 minutes for one hour if your bag of waters is intact.
  • Pain in labor as it progresses can be significant. A few women manage without any pain medication but many require IV narcotics or regional anesthesia in the form of an epidural. More than 90% of vaginal births in our practice occur with a labor epidural in place. We will discuss your individual needs during your labor. Know that a variety of pain-relief options exist and no doctor or midwife subscribes to only one of them. We will support you in whatever safe option you select for yourself, whether you want lots of help or none at all.
  • Fetal monitoring used in labor depends on fetal status. Most patients spend much of their time in labor with two external electrodes held against their abdomen with elastic belts to externally monitor the fetal heart beat and uterine contractions. High-risk pregnancies such as twins or preterm labor or pregnancies that go past their due date sometimes require more intensive monitoring including such devices as fetal scalp electrodes.
  • Lacerations frequently occur in the vagina at the time of a vaginal birth. Many women will tear spontaneously as the baby delivers. We do not routinely perform episiotomies – a small cut in the back of the vagina made to create space for the baby to deliver or control the direction and degree of spontaneous tearing. However, every delivery is different, and it is a judgment call that your doctor will make at the time of delivery whether an episiotomy will be helpful. Spontaneous lacerations require suturing and repair just like an episiotomy and will cause the same postpartum discomfort. In either case the stitches we use dissolve over time.
  • Insurance companies are different with regard to hospital stays. It is your responsibility to find out how many hospital days your insurance company allots for uncomplicated vaginal delivery and cesarean section. If you have a medical complication requiring a prolonged stay, your doctor will help arrange it with you insurance company.

All of the above are general guidelines that could help you as you approach your due date. Please feel free to talk to your doctor or midwife about labor and delivery issues as you approach 36-37 weeks. We always welcome questions from you, as well as the family members who accompany you to appointments. We always try to meet your individual needs as long as it ensures safety for both mother and fetus.

Birth Control

There are many different kinds of birth control (contraception) made available to women today. Options can include hormone shots, pills, patches, IUDs (intrauterine devices) and permanent sterilization. If you no longer want children, tubal ligation is also a simple surgical procedure that is an effective form of preventing future pregnancies by sealing off the fallopian tubes. The providers at Piedmont HealthCare’s Lake Norman OBGYN can discuss all available options for birth control and go over the best method that would work with your body’s chemistry.

Preconception Counseling

Counseling is helpful when planning to become pregnant. During preconception counseling, our providers may ask questions about obstetric history (previous births, miscarriages or abortions), gynecological history, medical history, genetic concerns and even any mental health issues that need to be considered before attempting to conceive. Our doctors may order blood tests as well, to help confirm a woman is at her physical, emotional and mental best to increase the chances of a successful pregnancy. Your partner’s health and genetics are also taken into account when making the decision to try and conceive.

Infertility

Infertility is a woman’s inability to get pregnant after an extended period of time of attempting to get pregnant, or the inability to keep a fertilized egg in the uterus once pregnant. The causes of infertility can vary widely, so discussing your situation with a PHC Lake Norman OBGYN provider can help you on your journey to becoming pregnant. Although risk factors for infertility for women and men can include smoking, alcohol, poor diet, obesity, age, disease and other health problems, only a thorough exam can help diagnose issues affecting fertility.

Normal Post-Partum Course
PAIN

Regardless of your route of delivery, you will likely continue to experience some discomfort after discharge from the hospital. Initially, the pain may increase at home when you become more active than you were in the hospital. After the first few days, the pain should get progressively better. Please note that pain from cesarean and forcep deliveries may last longer. Until your pain is resolved, you may use the following for pain relief:

  • Ibuprofen (Advil, Motrin) – mild to moderate pain
    These are non-steroidal anti-inflammatory (NSAID) agents and help to reduce inflammation and swelling. By reducing inflam­mation, they help to prevent and reduce pain. This class of medication is not constipating or sedating. You may take 600­800 mg every 6-8 hours as needed. These medications are available over the counter. No prescription is necessary. Do not exceed 2400mg per day.
  • Norco, Vicodin or Tylenol #3 – moderate to severe pain These are narcotic medications which help to alleviate more intense pain. Use these in addition to an NSAID when needed. Narcotics can make you feel drowsy and you should not drive while taking these medications. They are also constipating. All of these medications contain acetaminophen (Tylenol), so avoid taking additional Tylenol when using these medications. You may take 1-2 tablets every 4-6 hours as needed. Your doctor can give you a prescription for one of these medications prior to discharge.

All of the above medications are safe to use when breast feeding!

NUTRITION

Just as you did during pregnancy, you should continue to strive for a well-balanced diet. Good nutrition enhances wound heal­ing and is also important while breast feeding. Though you may desire to quickly lose the weight you gained during preg­nancy, dieting should not be an immediate priority.

All post-partum patients should continue taking vitamins as these are an excellent source of iron and can help prevent ane­mia. If you had a cesarean section or excessive blood loss with your delivery, your doctor will check for anemia. If you are anemic, your doctor may recommend that you take additional iron supplementation.

Breast feeding typically requires 500-600 calories per day in addition to your normal requirements. You will also need 1000-1200mg of calcium daily. This is equivalent to 4-5 healthy servings of dairy daily. It is also important to stay well-hydrated to ensure adequate milk production.

Lower extremity swelling (edema):
You may notice an increase in swelling even after you are dis­charged from the hospital. Swelling of the hands, ankles and feet typically peaks 7-14 days after delivery. It will gradually improve thereafter. It can be normal for tingling sensations to accompany swollen hands and feet.

You should call your doctor if you notice swelling that is predominantly in one leg and associated with pain.

Vaginal Bleeding (lochia):
You may have heavy vaginal bleeding for up to two weeks fol­lowing your delivery. Sometimes light bleeding can last until 9 weeks post-partum. After a vaginal delivery, bleeding may wax and wane, but in general will steadily decrease as you move further away from delivery. Bleeding after a C-Section is gener­ally lighter and of shorter duration. You should call if you be­gin passing large clots (larger than a golf ball) or are soaking more than one pad per hour.

Do not use tampons and do not douche until after your 6-week checkup!

Resuming Intercourse:
Avoid intercourse until your post-partum visit unless your doc­tor tells you otherwise.

When you do resume intercourse, you may have some initial irritation. Some women experience this for several weeks; sometimes it can last for a few months. This is often the result of vaginal dryness which is commonly associated with breast feeding as well as healing changes. To decrease your discom­fort, you may use a water-based lubricant such as Astroglide or KY Jelly.

It is a good idea to begin considering birth control options. Bar­rier methods include condoms and diaphragms. Hormonal methods include birth control pills, the patch, vaginal ring, and Depo Provera. The best hormonal method to use while breast feeding, to optimize your milk supply, is the pill containing only progesterone. If your milk supply is good, however, tradi­tional birth control pills are a reasonable option. Infra-uterine devices, or IUDs, are other reversible, but effective options that can be placed after your post-partum visit. Permanent forms of sterilization include tubal ligation or tubal occlusion. These require a surgical intervention. Don’t forget about vasectomy as a form of permanent sterilization.

Breast feeding:
Breast milk is an ideal source of nutrition for your newborn, and breast feeding can be a special experience for you and your baby. Though breast feeding is a natural process, not all babies catch on right away. It is important to be patient and persevere. The nurses on the post-partum floors will help you. Addition­ally, there are lactation consultants available in the hospital to help you with nursing strategies.

Your milk supply will generally come in between days 3 through 5 following delivery. You will likely experience sig­nificant cramping with breast feeding; the hormones that help secrete milk also help the uterus to contract to minimize bleed­ing. Keep in mind that cramping with breast feeding often worsens with successive children.

If your nipples become sore and cracked, you may rub ex­pressed milk into the surrounding tissue. Additionally, you may apply Lansinoh ointment or glycerin pads to protect chafed nipples. Avoid using soap as it can worsen dryness.

If you have breast feeding questions, please call Lake Norman Lactation Services Department:704-660-4373

Blocked milk ducts:
If you develop a firm, tender area on the breast with no overly­ing redness, this may simply be the result of a blocked milk duct. Warm compresses applied to the area, as well as massage and frequent breast feeds/pumping can help to relieve the dis­comfort and occlusion. If there is any overlying pink or red discoloration, it may be a breast infection (mastitis) and you should call your doctor.

Mastitis:
Between 5 and 10% of nursing mothers develop breast infec­tions or mastitis while breast feeding. Initial symptoms typi­cally mimic “the flu” and include aches and chills. The breast may become warm, tender and engorged. The overlying skin may become pink or red. These symptoms are usually accom­panied by high fevers (100.4 or greater). You should continue breast feeding if you develop an infection.

You should call your doctor if you notice any of the ABOVE symptoms.

Breast concerns for non-breast feeding mothers:
If you choose not to breast feed your baby, there are many ex­cellent formulas to choose from. Talk to your baby’s pediatri­cian about specific recommendations.

In order to minimize the discomfort from breast engorgement, wear tight-fitting bras or athletic bras immediately after deliv­ery and continue for at least one week after your milk comes in. Wear them 24 hours per day for about one week. You may also bind your breasts with an ACE bandage or sheet to minimize symptoms. Avoid direct stimulation of the breasts during this time, such as expressing milk or pumping.

NSAIDs or Tylenol will help with the pain. Additional comfort measures include cold compresses or ice packs. Bags of frozen peas can be used as a substitute for ice packs; they conform nicely to the shape of the breast and are not as harshly cold as larger blocks of ice.

Bladder and Bowel Function:
Empty your bladder as soon as you have the urge to void or at least every 3 hours. When your bladder is overly distended, it can cause abdominal discomfort.

Some women will experience leakage of urine immediately following delivery. This usually improves over the six weeks following delivery. Start Kegel exercises as soon as you can after delivery to help strengthen the pelvic floor. Start by con­tracting the muscles you normally contract to stop your stream of urine. In order to do Kegels properly, you should contract these muscles ten times each set, and do three sets per day. Your goal should be to hold the contraction for 2-3 seconds each.

Bowel function should return within 5 days of delivery. Keep­ing well-hydrated and active will help facilitate normal bowel function. You may also use stool softeners and fiber supple­ments as needed. If you have not had a bowel movement by the fifth day following your delivery, call the office for instruc­tions. Do not use a rectal suppository without your doctor’s approval; this may interrupt the healing process.

Hemorrhoids:
Hemorrhoids should improve in the weeks following delivery, however, they may cause some discomfort throughout your recovery period. For relief of pain caused by hemorrhoids, you may use topical remedies such as Tucks pads, Preparation H or Anusol HC. Soaking in a Sitz bath (bath filled with plain warm water) can also be soothing.

You can help prevent worsening of your symptoms by minimiz­ing the need to strain with bowel movements. Staying well-hydrated is very important. In addition, you can also employ the following:

Colace (docusate sodium) is a stool softener that works by drawing more water into the stool. You may take up to 100mg every 12 hours as needed. Colace, as well as its generic ver­sion, are available over the counter and are compatible with breast feeding.

Fiber helps to bulk up the stool, which make bowel movements easier to pass. Fruits and vegetables are high in fiber. You can also use fiber supplements: FiberCon, Metamucil, Citrucel and FiberChoice are all available over the counter and are compati­ble with breast feeding.

Mood:
It is normal to experience the “Baby Blues” in the first several days following delivery. You may have a depressed mood, a sense of feeling “let down” or experience more tearfulness. Most women will experience these symptoms to some degree, and they pass fairly quickly.

Symptoms of post-partum depression can occur anytime within the first year following a delivery and may occur in up to a third of all women. Women who have a personal or family history of depression are at greatest risk.

Rest and sleep are particularly important for your body during the post-partum period. Lack of sleep can certainly worsen symptoms. Try to rest when you can, and if possible, recruit others to assist you with household chores and errands.

If you find that your “baby blues” are not resolving and if you experience the following symptoms for more than 2 weeks, please call your doctor immediately: – feeling tearful, sad, depressed – lack of feeling pleasure from normally pleasant activities

  • decreased energy
  • decreased motivation
  • feeling hopeless
  • inability to fall asleep or stay asleep – decreased appetite
    decreasing weight
  • feeling anxious or restless – poor self esteem
  • lack of concentration
  • thoughts of harming yourself
  • thoughts of harming your baby
VAGINAL DELIVERY CONCERNS

Episiotomy/Lacerations:
You should expect cuts or lacerations to be sore for several days after delivery. Larger lacerations may be sore for up to 3­4 weeks. Your stitches will dissolve on their own; they are usually completely dissolved by 6 weeks post-partum.

It is very important to keep the area clean by rinsing everytime you use the bathroom for about 2 weeks. You may use the hospital-provided squirt bottle for this purpose. The water helps to dilute the urine and prevent burning and stinging and is suffi­cient to keep the area clean. Use pain medications as noted above for discomfort. Additional comfort measures include soaking in a plain warm bathtub. Do not use bath salts or bub­ble baths, which can be irritating. Pat gently or blow the area dry with low heat when you get out of the tub. You may use stool softeners and fiber supplements to prevent constipation and straining. Colace (docusate sodium) is a stool softener that is available over the counter. You may take 100 mg up to every 12 hours. Supplementation with fiber may also be beneficial to prevent constipation. Senekot, Metamucil, Citrucel, Fiber-choice, FiberCon are all safe alternatives that are compatible with breast feeding.

You should call your doctor if you experience pain not relieved by pain medications and tub soaks, fever greater than 100.4 or any foul-smelling discharge from the incision.

Exercise and Lifting:
Walking is always good exercise for any woman, but more rig­orous exercise may cause a laceration to pull apart. Talk with your doctor prior to resuming your normal exercise regimen.

In general there are no lifting restrictions after a vaginal deliv­ery. If you have a large tear, however, your doctor may recommend that you avoid excessive lifting. Check with your doctor prior to discharge.

Stairs:
There are no restrictions regarding stairs following a vaginal delivery. If you are having a significant amount of pain, how­ever, you should move up and down the stairs slowly.

CESAREAN SECTION CONCERNS

Incision:
Your staples will be removed in the hospital prior to your dis­charge. You will have steri-strips placed over your incision. You can get them wet in the shower. Let soapy water trickle over the incision and pat it dry. You do not have to scrub the incision. Pull the steri-strips off in 7 days; if they fall off in less than 7 days, there is no need to worry.

You may take baths. Just be sure to pat your incision dry after­wards.

It is very important to keep your incision dry when you are not bathing. If you notice that it is becoming warm and moist, you can place a gauze pad over the incision to absorb some of the moisture.

A healthy incision may have some areas of firmness or hard­ness as the underlying tissue heals.

You should call your doctor If you notice any redness around the incision, drainage from the incision or any fever greater than 100.4

Expect to have a slight pulling sensation within the wound for several weeks to months. You may also experience some numbness or tingling around the incision site for several weeks.

Exercise and Lifting:
Walking is always good exercise after surgery. It helps to minimize infra-abdominal adhesions, or scar tissue, and helps to restore normal bowel function. It is also helpful in preventing blood clots from developing after surgery. More strenuous ex­ercise may disrupt your healing wound; it is best to resume your normal exercise regimen after your 6-week post-partum visit.

You should not lift anything heavier than the baby (or ten pounds) for 6 weeks. Premature straining may cause a hernia.

Stairs:
Climbing stairs is fine after surgery, but take them slowly. Try to minimize the number of times you must go up and down stairs each day while you are still having pain.

ALL PATIENTS SHOULD NOTIFY THEIR DOCTOR IMMEDIATELY IF THEY DEVELOP ANY OF THE FOLLOWING:
  • Fever > 100.4
  • Pain not relieved by pain medications
  • Heavy vaginal bleeding (>1 pad/hour, large clots)
  • Depressive symptoms
  • Redness around the breast
Ultrasound

Ultrasound scanning (sonography) is technology used to scan the tissues and organs inside the body which. Sound waves create images of organs and tissues. The process is completely painless. It’s most commonly used to track fetal development inside the womb and to examine pelvic organs and ovaries for the presence of any other abnormalities. The specialists at the PHC Lake Norman OBGYN are trained in this technology and use it for the betterment of your health.

In Office Procedures and Services

Endometrial Ablation

Menorrhagia occurs in 1 out of every 5 women and is defined as unusually heavy and/or long-lasting menstrual periods. Many women do not seek treatment because they are embarrassed to discuss their periods; they think their bleeding is normal because it has always been that way; or they are afraid of the treatment options. If your period lasts a long time or is so heavy you need to change pads or tampons every 1 or 2 hours, then you may have monorrhagia.

There are several different ways to treat your heavy periods, including hormones, hormone-releasing lUD and D&C; and for women who are finished having children, hysterectomy and endometrial ablation are also options.

Endometrial ablation is a procedure that permanently removes the lining of the uterus through the quick delivery of radio frequency energy. Your ObGyn physician can perform endometrial ablation in the office with* or without general anesthesia that can put an end to your heavy periods and the resulting symptoms. Approximately 95% of patients experience little to no significant pain during the procedure and it does not require incisions. Patients go home the same day and are typically back to work in 1 or 2 days. Most women see a great decrease in their level of menstrual bleeding with about 91% of women reporting normal bleeding or less and 40-50% reporting no bleeding at all. Many women also had a significant reduction in painful periods and PMS symptoms.

You and your doctor can decide which treatment option is best for your menorrhagia.

Sterilization

Sterilization is a permanent type of birth control method. One option is severing the fallopian tubes completely and closing them off, known as tubal ligation. Another method for closing the fallopian tubes involves inserts placed inside the tubes to block them. Tissue will then grow around the inserts to keep them in place. PHC Lake Norman OBGYN is available to help discuss which sterilization option is best for you.

Infertility

Infertility is a woman’s inability to get pregnant after an extended period of time of attempting to get pregnant, or the inability to keep a fertilized egg in the uterus once pregnant. The causes of infertility can vary widely, so discussing your situation with a PHC Lake Norman OBGYN provider can help you on your journey to becoming pregnant. Although risk factors for infertility for women and men can include smoking, alcohol, poor diet, obesity, age, disease and other health problems, only a thorough exam can help diagnose issues affecting fertility.

Ultrasound

Ultrasound scanning (sonography) is technology used to scan the tissues and organs inside the body which. Sound waves create images of organs and tissues. The process is completely painless. It’s most commonly used to track fetal development inside the womb and to examine pelvic organs and ovaries for the presence of any other abnormalities. The specialists at the Women’s Center are trained in this technology and use it for the betterment of your health.

Colposcopy

A colposcopy is an office procedure that is recommended when you have an abnormal Pap smear. This procedure should be done when you are not experiencing your menstrual period so that your cervix can be fully visualized. After placing a speculum in your vagina, a magnifying scope is used to look at your cervix for signs of abnormal cells. Biopsies are performed to sample the abnormally appearing areas. You may experience mild cramping and discomfort. Bleeding also occurs from the biopsy sites, which is controlled with a medicine called Monsel’s solution. You can expect a “coffee-ground” like vaginal discharge for 5-7 days after the colposcopy. It is okay to use liners or pads as needed. The results of the biopsies are available 7-10 days after the procedure. You will receive specific follow up instructions once your health care provider has reviewed the biopsy results. Please call the office if you have not received results of follow up instructions in two weeks.

Preventive Care

A woman’s health needs change throughout her stages of life. We specialize in helping women focus on healthy choices and lifestyles from young women to older adults. Some of the visits as relating to women’s health include physical examinations, thyroid and hormonal tests, mammograms (at age 40+), breast exams, Pap testing, HPV testing (at ages 30-65 on average), pelvic exams, STD testing and more. Discuss setting up your preventative care plan with your PHC Lake Norman OB-GYN professional.

Obstetrics Care Information

Instructions for Pregnant Patients

Congratulations on your pregnancy! Pregnancy is an exciting time when you will experience a lot of physical and emotional changes. You will have lots of questions. Listed below are answers for some common concerns. This reference is only offered as a general guideline. Different answers may apply to women with special problems in pregnancy (e.g. twins or diabetes), and this list is not comprehensive It does contain a great deal of helpful information to be used throughout your pregnancy.

Here at Lake Norman OB-GYN we are happy to offer obstetrical care by board certified / eligible physicians as well as certified nurse midwives. The physicians and midwives work as a team to ensure that you have a quality obstetrical experience. You are encouraged to inquire about both types of obstetrical care that we offer.

CALL COVERAGE

The six board certified/eligible physicians have designated call days and nights. You are encouraged to schedule appointments with each doctor during your pregnancy to familiarize yourself with every member of our close-knit team.

CONTACTING YOUR DOCTOR

Non-emergency questions during office hours:
704-663-1282

You will usually be able to speak directly with a nurse or medical assistant and can always leave a message. Either way, one of the doctors will respond within 24 hours and usually much sooner.

Emergency calls or onset of labor during office hours:
704-663-1282
Follow instructions guiding you directly to our office staff.

Emergency calls after business hours or on weekends:

Leave a detailed message with the answering service. If you do not get a call back within 15 minutes, call again. If you are still unable to reach your doctor and it is a true emergency, call Lake Norman Regional Labor & Delivery Department at 704-660-4866.

DIET

In pregnancy, you are not eating for two. A healthy woman of normal body weight can meet her nutritional demands in pregnancy by eating a balanced diet while adding a single glass of milk to each meal. Your elemental calcium needs are 1200 mg per day. If you do not tolerate milk, drink orange juice with calcium or take Tums with each meal.

Tums have added calcium and will also help with heartburn. Multivitamins such as Centrum or One-A-Day are adequate to meet your nutritional requirements. A prenatal vitamin with iron supplementation can also be prescribed. Eat a high fiber diet rich in fruits and vegetables and at least two protein/meat servings per day (fish, poultry or lean beef). Do not eat raw or undercooked meat of any kind. Pregnant and nursing women should specifically avoid shark, swordfish, king mackerel, albacore tuna and tilefish because of high mercury concentrations in these species. Limit consumptions of freshwater fish caught by friends and family to a single 3-6 oz serving each week. Notify your doctor if you are a vegetarian or vegan, if you have any history of an eating disorder, or if you are extremely underweight or obese.

Caffeine: 2 cups or less per day of coffee. (A standard-sized cup containing 100mg of caffeine – not a giant “super-charged” glass of Starbuck’s). Try for similar goals with soda or tea.

Nutrasweet: There are no reported adverse effects. Nonetheless, we recommend trying to limit your consumption. Women with phenylketonuria, who required a special childhood diet, should not consume Nutrasweet during pregnancy.

WEIGHT GAIN

Ask your doctor but general guidelines for women are:

If underweight, your goal is 28-40 lbs
If normal weight, your goal is 25-35 lbs
If overweight, your goal is 15-25 lbs
The average woman gains about 8 pounds in the first 20 weeks of pregnancy and about 1 pound per week in the last 20 weeks. (Remember that pregnancies last 40 weeks from your last menstrual period). Avoid gaining more than 1 pound per week in the second and third trimesters to avoid an excessively large infant and to avoid postpartum weight problems.

EXERCISE

Joints become lax in pregnancy. You are at an increased risk for back or joint injury. Your change in size, shape and posture may make you less agile.

Moderate exercise is recommended. Warm up first. Limit exercise to 30-45 minutes, four to five days per week. Swimming, walking, stationary bikes and low-impact aerobics are ideal. Avoid more dangerous activities such as water skiing, snow skiing, and scuba diving. Work to maintain fitness – do not get overheated or push yourself to your limits. Monitor your heart rate closely during exercise. Heart rate guidelines in pregnancy depend on your pre-pregnancy level of fitness. If you were not physically active prior to pregnancy, you should generally avoid heart rates over 140 beats per minute. Otherwise, the general guideline of being able to talk comfortably during exercise is acceptable for physically fit women.

BATHING

Baths or showers are fine. Avoid saunas, hot tubs, Jacuzzis, and steam rooms.

TRAVEL

If your pregnancy is without complications (ask your doctor), you may travel up to the last month of pregnancy (36 weeks). Get up and walk around every 2 hours to stretch your legs and help prevent blood clots.

SEX

With the exception of certain pregnancy complications (e.g. preterm labor, placenta previa, twins, ruptured membranes), you may engage in sexual activity, including intercourse, throughout the pregnancy. Ask your doctor, if you have any concerns.

COLD SYMPTOMS
  • Sudafed (Pseudoephedrine hydrochloride)
  • Tylenol (regular or extra strength)
  • Benadryl (diphenhydramine)
  • Chlortrimeton
  • Guaifenesin cough syrups (e.g. Robitussin or Dimetap)
  • Tylenol Cold or Tylenol Allergy/Sinus contains useful combinations of the above drugs. DO NOT take aspirin or ibuprofen or combination medicines containing these drugs unless your doctor instructs you to.

Consult your doctor for a fever greater than 100.0 degrees F and symptoms suggesting more than just the common cold. Nosebleeds are common in pregnancy and quite often occur with nose blowing.

HEADACHE

Headaches are common in the first and second trimesters. You may take regular or extra strength Tylenol (acetaminophen) throughout pregnancy. Always call your doctor when headaches do not respond to Tylenol, especially in the third trimester of pregnancy.

CONSTIPATION

Eat a high fiber diet and lots of fruits and vegetables. If needed, you may use Metamucil, Fibercon, Colace or Senekot.

NAUSEA/VOMITING

You may take an over the counter medication called Emetrol, vitamin B6 25 mg 3 times a day, or 1 gram/day of gingerroot supplement from a natural food store. Unasom at bedtime can also help. For persistent Nausea/Vomiting your doctor may recommend medication.

WARNING SIGNS IN PREGNANCY WHICH WOULD WARRANT A PHONE CALL
  • Vaginal bleeding
  • Uterine contractions more than four times in an hour while at rest, if you are less than 34 weeks. Often contractions will stop if you empty your bladder, lay on your left side and drink plenty of fluids. If you are having four or more contractions an hour, first try these things and see if they stop. If contractions persist, call your doctor.
  • Rupture of membianes, (breaking the bag of waters). If you think the bag of waters has ruptured, call whether you are preterm or full term. This usually feels like a big gush of fluid or persistent trickle of fluid from the vagina. It is often confused with incontinence of urine. Pregnant women frequently have episodes of urine loss when they bend over with physical activity such as tying shoes, getting in and out of the car, and getting in and out of bed. It is always worth investigating. If you are unsure, call the doctor.
  • Decreased fetal movement in the third trimester – after 24 weeks. Babies should move on a regular basis; however, they also have periods of sleep when they are quiet. During the times of day when your baby is active, you should feel at least 10 movements or kicks in a two-hour period. If the movement count falls short of this, particularly at the time of day when your baby is normally active, you should call your doctor.
ULTRASOUND

Ultrasounds are used for dating pregnancies, assessing growth of the fetus, checking for twins, and checking for certain types of birth defects. Your doctor will discuss the need for an ultrasound during your pregnancy. In general patients will get at least one ultrasound between 16-21 weeks of pregnancy to visualize development of major fetal structures and to confirm the gestational age. There may be additional need for ultrasounds at earlier and later gestations. Not all insurance companies pay for routine ultrasounds.

DIABETES SCREENING

At 24 – 28 weeks of pregnancy, you will be screened for gestational diabetes (diabetes that is first diagnosed during the course of a woman’s pregnancy).

LABOR AND DELIVERY

The following are general guidelines to assist you when you think you are in labor:

  • Rupture of membranes (broken bag of waters): If you think you have broken your bag of water, even before contractions start, call the office to notify the doctor. Please do not delay in notifying the doctor if you think you have broken your bag of waters.
  • If you think you are in labor with your first baby and your bag of waters is intact: As long as the baby has been moving regularly and you are having nothing but bloody show (mucus and blood discharge), you can safely wait to call the office (night or day) until you have been contracting every 5 minutes for 1 hour of such an intensity that you can’t walk or talk during contractions. Please note that it may take several hours at home for your contractions to reach this frequency and intensity with your first baby. If you are uncertain about what to do, page the doctor at any time.
  • If it is your second baby or beyond, your labor will often go faster. If you break your bag of waters and you are not contracting, call immediately. Labor often ensues quickly after ruptured membranes of patients who have previously delivered. Generally speaking, you should call when you are contracting about every 10 minutes for one hour if your bag of waters is intact.
  • Pain in labor as it progresses can be significant. A few women manage without any pain medication but many require IV narcotics or regional anesthesia in the form of an epidural. More than 90% of vaginal births in our practice occur with a labor epidural in place. We will discuss your individual needs during your labor. Know that a variety of pain-relief options exist and no doctor or midwife subscribes to only one of them. We will support you in whatever safe option you select for yourself, whether you want lots of help or none at all.
  • Fetal monitoring used in labor depends on fetal status. Most patients spend much of their time in labor with two external electrodes held against their abdomen with elastic belts to externally monitor the fetal heart beat and uterine contractions. High-risk pregnancies such as twins or preterm labor or pregnancies that go past their due date sometimes require more intensive monitoring including such devices as fetal scalp electrodes.
  • Lacerations frequently occur in the vagina at the time of a vaginal birth. Many women will tear spontaneously as the baby delivers. We do not routinely perform episiotomies – a small cut in the back of the vagina made to create space for the baby to deliver or control the direction and degree of spontaneous tearing. However, every delivery is different, and it is a judgment call that your doctor will make at the time of delivery whether an episiotomy will be helpful. Spontaneous lacerations require suturing and repair just like an episiotomy and will cause the same postpartum discomfort. In either case the stitches we use dissolve over time.
  • Insurance companies are different with regard to hospital stays. It is your responsibility to find out how many hospital days your insurance company allots for uncomplicated vaginal delivery and cesarean section. If you have a medical complication requiring a prolonged stay, your doctor will help arrange it with you insurance company.
    All of the above are general guidelines that could help you as you approach your due date. Please feel free to talk to your doctor or midwife about labor and delivery issues as you approach 36-37 weeks. We always welcome questions from you, as well as the family members who accompany you to appointments. We always try to meet your individual needs as long as it ensures safety for both mother and fetus.
In-Office Hysteroscopy

A hysteroscopy is a thin, flexible scope used to look into the uterus for imaging purposes. This procedure can be done in the office and involves no anesthetics and causes very little discomfort. A hysteroscopy allows our providers to obtain full detailed images of the uterus and fallopian tubes to reveal abnormalities.

Incontinence Surgery TVT-O

There are many types of incontinence and various treatment options. Sometimes our medical providers will recommend surgery depending on the type and severity of the patient’s incontinence. Tension free vaginal obturator tape (or TVTO) can be an effective method in restoring proper bladder function in women. The tape is made of a permanent Prolene mesh and is positioned to support the middle of the urethra. This method has shown to be more effective than drug treatments and less invasive than other bladder correcting procedures that can leave one hospitalized.

Laparoscopic Hysterectomy

A laparoscopic hysterectomy is a procedure to remove the uterus. Our OB-GYN physicians perform this procedure by making a few incisions on the abdomen and in the belly button. A camera allows the performing doctor to remove the uterus through the tiny incisions. Laparoscopic hysterectomies are typically performed on an outpatient basis.

Preconception Counseling

Counseling is helpful when planning to become pregnant. During preconception counseling, our providers may ask questions about obstetric history (previous births, miscarriages or abortions), gynecological history, medical history, genetic concerns and even any mental health issues that need to be considered before attempting to conceive. Our doctors may order blood tests as well, to help confirm a woman is at her physical, emotional and mental best to increase the chances of a successful pregnancy. Your partner’s health and genetics are also taken into account when making the decision to try and conceive.

Menopausal Management

The shift into menopause is a difficult time for a woman, but our medical team is educated and experienced in helping make the transition as smooth and comfortable as possible. Mood swings, hot flashes, difficulty sleeping, memory instability and even bone density loss all tie to menopause. While some of these symptoms can be helped with lifestyle changes (which can also be discussed with our physicians), the overall effects of the hormone shift may be eased with Menopausal Hormone Therapy (MHT) that involves progesterone and estrogen hormones to steady out the process. It’s important to talk to your doctor to find out if this option is best for you given your current health situation.

Minimally Invasive Surgery Options

Minimally invasive surgery options can be performed in office or in an outpatient setting. Advanced technologies means minimal scarring and fewer incisions. Laparoscopic practices are used to perform many different types of procedures such as hysterectomy and myomectomy (for treatment of endometriosis and ovarian cysts).

Vaginal surgery (through the vagina) is also a very minimally invasive procedure and has been proven to heal faster than abdominal surgeries.

Endometrial Biopsy

This procedure involves removing a small sample of the lining of your uterus for testing purposes. The cells can give our doctors a clearer picture of hormone levels, as well as look for or observe abnormal tissue. Endometrial biopsies may be needed for those experiencing difficulties getting pregnant, abnormal uterine bleeding or to check for uterine cancer.

Genetic/Hereditary Cancer Screenings

In a portion of women diagnosed with some manner of reproductive cancer such as breast or ovarian cancers, a certain percentage have inherited that increased risk for it. PHC Lake Norman OB-GYN offers screenings and testing to help determine one’s potential risk for developing cancer. Family history is a consideration for additional testing outside of normal screenings such as Pap smears and mammograms. Our providers can discuss genetic and other diagnostic testing available to those who may be at higher risk and can discuss options for addressing those potential risks.

Post-Operative Care Instructions

Cesarean Section
GENERAL MEASURES

A hard ridge should form along the incision. As it heals, the ridge will recede gradually.
Use an electric heating pad, or a warm compress to relieve incisional pain.
Shower as usual. You may wash the incision gently with mild soap. Resume tub baths after 2-3 weeks.
Don’t douche unless advised to by the doctor.

MEDICATION

Prescription pain medication should generally be required only for 2 to 7 days following the procedure.
You may use nonprescription drugs, such as acetalminophen, for minor pain.

ACTIVITY

Resume daily activities and work as soon as you are able. Full recovery normally takes about 6 weeks.
Resume driving once you can operate the vehicle without pain, usually 1 to 3 weeks.
Avoid sexual intercourse for 4 to 6 weeks or as directed by your doctor.

DIET

No special diet.

NOTIFY OUR OFFICE IF

Any of the following occurs:
Pain, swelling, redness, drainage, or bleeding increases in the surgical area.
Bleeding soaks more than 1 pad or tampon each hour.
You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.

Episiotomy
GENERAL MEASURES
  • Bathe and shower as usual. You may wash the incision gently with mild unscented soap.
  • Cleanse the surgical area with warm (not hot) water after urination or bowel movements.
  • Take warm baths several times a day as long as you experience discomfort.
MEDICATION
  • Stool softener laxative to prevent constipation if needed.
  • You may use nonprescription drugs such as aceta­minophen or ibuprofen for minor pain.
ACTIVITY
  • Follow doctor’s advice on resuming, or beginning, a post­partum exercise program.
  • Resume sexual relations as directed by your doctor or when a follow-up medical examination determines that healing is complete (usually about 3 to 6 weeks).
DIET

Eating a high fiber diet will help prevent constipation which is common after childbirth. Increase your fluid intake as you increase your fiber intake.

NOTIFY OUR OFFICE IF

Any of the following occurs:

Pain, swelling, redness, drainage or bleeding increases in the surgical area.
You develop signs of infection: general ill feeling and fever, headache, muscle aches, dizziness.

Dilatation and Curettage
GENERAL MEASURES
  • Don’t douche unless your physician recommends it.
  • Expect slight vaginal bleeding during recovery from surgery. Use a sanitary pad to protect clothing. Avoid tampons temporarily; they may lead to infection.
MEDICATION
  • Antibiotics may be given during, or following, the procedure to help prevent any infections.
  • Prescription pain medication should generally only be required for 2 to 7 days following the procedure.
  • You may use nonprescription drugs, such as acetaminophen, for minor pain.
  • Hormones, if necessary to correct an imbalance.
ACTIVITY
  • Resume driving in 1 or 2 days.
  • To help recovery and aid your well-being, resume daily activities, including work, as soon as you are able.
  • Resume sexual relations when spotting ceases.
DIET
  • No special diet.
NOTIFY OUR OFFICE IF

Any of the following occurs:

  • Vaginal discharge increases or smells unpleasant.
  • You experience pain that simple pain medication does of relieve quickly.
  • Unusual vaginal swelling or bleeding develops.
  • You develop signs of infection: general ill feeling and ever, headache, muscle aches or dizziness.
Dilation and Extraction
GENERAL MEASURES
  • Following the procedure, rest quietly at home for the remainder of the day.
  • Heat helps. If you have pain, place a heating pad or hot-water bottle on the abdomen or back. Hot baths frequently promote muscle relaxation and relieve discomfort. Repeat the baths as often as they provide comfort.
  • You will probably experience intermittent bleeding for the next 10 to 14 days, which may be light or moderately heavy–decreasing with rest and increasing with standing, walking, or other activity. Use external sanitary pads for bleeding.
  • If contraception is desired, it can often be initiated shortly after the procedure. Speak with your doctor about this.
  • Your next menstrual period should begin 4 to 6 weeks after the procedure.
MEDICATION
  • Prescription pain medication should generally be required for only 2 to 7 days following the procedure.
  • You may use nonprescription drugs, such as acetaminophen, for minor pain.
  • Antibiotics may be prescribed to reduce risk of infection.
ACTIVITY
  • Normal activities may be resumed almost immediately.
  • You should have no sexual relations for 1 week following the operation.
DIET
  • No special diet.
NOTIFY OUR OFFICE IF

Any of the following occurs:

  • Vaginal discharge increases or smells unpleasant.
  • You experience pain that simple pain medication does of relieve quickly.
  • Unusual vaginal swelling or bleeding develops.
  • You develop signs of infection: general ill feeling and ever, headache, muscle aches or dizziness.
Abdominal Hysterectomy
GENERAL MEASURES
  • Hospital stay may be 2 to 4 days.
  • To keep lungs clear, cough frequently while using appropriate support. Deep breathing aids are frequently available.
  • Once home, someone should be available to help care for you for the first few days.
  • Use an electric heating pad or a warm compress to relieve incision pain or gas pains.
  • Shower as usual. You may wash the incision gently with mild soap.
  • Use sanitary napkins–not tampons–to absorb blood or drainage (discharge is normal, but has an unpleasant odor).
  • Aftereffects of surgery may include constipation, urinary symptoms, fatigue and weight gain.
MEDICATION
  • After surgery, medicines for pain, gas, nausea or constipation may be prescribed.
  • Antibiotics if infection develops.
ACTIVITY
  • To help recovery and aid your well-being, resume daily activities, including work, as soon as you are able. Recovery at home may take 1 to 3 weeks, with full activities resumed in 6 to 8 weeks.
  • Resume driving once you can operate the vehicle without pain, usually 1-2 weeks.
  • Sexual relations may be resumed in 4 to 6 weeks (or when advised).
DIET
  • Clear liquid diet until the gastrointestinal tract functions again
    Then eat a well-balanced diet to promote healing.
NOTIFY OUR OFFICE IF

Any of the following occurs:

  • Vaginal bleeding that soaks more than 1 pad per hour.
  • Increased pain or swelling in the surgical area.
  • Signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
Vaginal Hysterectomy
GENERAL MEASURES
  • Hospital stay may be 1 to 3 days (occasionally longer).
  • Once home, someone should be available to help care for you for the first few days.
  • Use an electric heating pad or a warm compress to relieve any discomfort.
  • Shower as usual.
  • Use sanitary napkins–not tampons–to absorb blood or drainage (discharge is normal, but has an unpleasant odor).
  • After effects of surgery may include constipation, urinary symptoms, fatigue and weight gain.
MEDICATION
  • After surgery, medicines for pain, nausea or constipation may be prescribed.
  • Antibiotics if infection develops.
ACTIVITY
  • To help recovery and aid your well-being, resume daily activities, including work, as soon as you are able. Recovery at home may take 1 to 3 weeks, with full activities resumed in 6 to 8 weeks.
  • Resume driving once you can operate a vehicle without pain, usually 1 – 2 weeks.
  • Sexual relations may be resumed in 4 to 6 weeks (or when advised).
  • Most women experience no change in sexual function.
DIET
  • No special diet.
NOTIFY OUR OFFICE IF

Any of the following occurs:

  • Vaginal bleeding that soaks more than 1 pad per hour.
  • Increased pain or swelling in the surgical area.
  • Signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.

FAQ'S

Where is our office located?

Our office is located off of I-77, exit 33. We are attached to the back side of Lake Norman Regional Medical Center in the Medical Pavillion, 131 Medical Park Rd. Suite 102, Mooresville, NC 28117.

Which hospital are you affiliated with?

We participate with Lake Norman Regional Medical Center. All our admissions and/or surgical cases go through that facility.

Can I fill out any paperwork prior to my appointment?

We have online options that you can download demographic information and your medical update forms, print them and bring them with you. We have found patients feel this speeds up their registration process. This option is located on our home page under Customer Care.

When do I schedule my first OB visit?

You would schedule your first OB visit 4 – 6 weeks after you miss a period.

Do you accept my insurance?

We participate with the following insurance plans: Aetna, Aetna MDCR, Cigna/Great West, Choice Care through Humana, Coventry, First Health, Health Care Savings, Humana, Humana Gold MDCR, Mamsi, Medcost, NC Inclusive through Medcost, Multiplan/PHCS, One Health, Medicare, Primary Physicians Care, Tricare Standard & Prime, United Health Care, Wellpath, United Health Care Medicare (Not Secure Horizons)

Do you accept Medicaid?

We accept Medicaid for OB care and referrals/consultations from your primary care physician. Patients may be liable for a co-pay that is determined by Medicaid. Routine annual exams should be scheduled with your primary care physician. Medicaid Family Planning waviers are not accepted. Please present your insurance card on your office visit to verify eligibility.

I have Medicaid or I am going to try and get Medicaid & Pregnant what do I do next?

You should do one of the following:

  1. Go to your local Health Department to get a pregnancy confirmation. Get your estimated due date to take with you to the Department of Social Services.
  2. You may make an appointment with our office for a Pregnancy Confirmation visit. This will be a nurse appointment & pregnancy test only and the cost is $45.00. You may also bring your own unopened pregnancy test and this cost would then be $25.00 – fees are due at time of service.

You then would complete the Medicaid application at DSS. It can take up to 45 days for DSS to process your application. Bring a copy of your application to our office at your new OB visit. If you have not received your Medicaid within 60 days, you will be self pay for the pregnancy.

When you are approved for Medicaid coverage contact our office immediately with your recipient ID number.We will retro file 2 months prior to your receiving your Medicaid coverage. This retro filing process only applies during pregnancy. We will not retro file Medicaid after delivery. Ultrasound visits will not be retro filed due to prior authorization requirements.

Once your pregnancy is completed & all payments/charges have been filed and received from Medicaid, we will review your account for any applicable refunds due.

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Reviews

“Dr. Wellbaum is freaking amazing she is a very sweet lady who definitely knows how each person feels being pregnant. I could not have chosen a better OBGYN since moving here she reminds me of the one I had back home . This doctor is a blessing to have.”

– Espy A.

“All of your team members are so positive, professional and just lovely people to see and work with. Thank you for serving us with excellence!”

– Brooke K.

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