Rosemark Newsletter Archive
Select a newsletter:
February 2005: Bringing Health into the New Year
January 2005: Antidepressants and Pregnancy
July 2005: Delivering Your Expectations
October 2005: New Doctor & New Office
Bringing Health into the New Year Providing Primary and Preventative Care for Women
Rosemark serves as a center for primary and preventative care for females of all ages. We handle all women care issues, from the common to complicated. If there is a condition requiring a specialist beyond our means and knowledge, then we will seek their consultation in our patients’ behalf.
As a guide for preventative screening, we recommend all women over 45 should regularly undergo the following: |
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Cervical cancer screening: Every two to three years after three consecutive negative tests for women at low risk, or as recommended by your doctor.
Pelvic Exam: Annually to check the health of your reproductive organs.
Breast exam: Annually by your physician to detect lumps or masses of concern; monthly by you, if you wish.
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Mammogram: Every one to two years in your forties and every year beginning at age 50 to screen for breast cancer.
Lipid profile: Every five years.
Blood pressure: Annually to check for high blood pressure (130/90 or higher).
Bone density test: Recommended for all women ages 65 and older; may be recommended for younger women with one or more risk factors for osteoporosis.
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Colon cancer screening: Regular screening beginning at age 50.
Fasting glucose test: Every three years.
Thyroid-stimulating hormone screening: Every five years beginning at age 50 to check for thyroid problems.
Immunizations: Annual influenza vaccine beginning at age 50; if there’s a shortage of flue vaccine, only women at highest risk need vaccination, including women who are pregnant, age 65 or older, or immuno-compromised; tetanus-diphtheria every 10 years. |
Chocolate is not a bad thing!
By Luana Tomchak, MHE, RD, LD, CDE
Chocolate provides all those warm, comforting feelings of pleasure that come from this display of love shown on Valentines Day, but it is often followed by overwhelming feelings of guilt. How can one type of food make us feel love, comfort, pleasure, and guilt all in one ounce of smooth, gooey, sweet confection? It’s easy! The relationship between females and chocolate is very complex!
First, chocolate is a good source of fat, nicely packaged with sugar. Two favorite combinations because fat carries flavor and sweet flavor is associated with pleasure. Actually, both provide energy. For women, this combination plays a large role in cravings that are triggered by the swing of hormones. This makes perfect sense. The woman’s body was designed to become pregnant, carry the fetus for nine months, and provide nourishment for the infant. These tasks hinge on the availability of "fat stores." Therefore, we have the cravings for high-fat and high-sugar foods.
Another reason we may reach for chocolate is that it contains caffeine. This is the powerful pick-me-up that gets the majority of Americans moving every morning. However, chocolate is not loaded with caffeine. For example, one ounce of dark chocolate contains 15 milligrams of caffeine. Eight ounces of coffee can have as much as 150 milligrams. That means that it would take eight ounces of chocolate to provide as much caffeine as one cup of coffee. Chocolate also contains another mild stimulant, theo romine, so we get two stimulants in one hunk of chocolate. Wow!
Whether you like chocolate because of its sweet flavor, a good pick-me-up, creamy comfort, or for pure healing purposes, it should not come with a boat-load of guilt. The key is to allow small amounts of chocolate, while allowing large amounts of pleasure. So, what’s your pleasure? Hershey’s Kisses or Sees assorted?
Breastfeeding Makes a DifferenceHere at Rosemark we are pleased to provide you with information about breast feeding—the simplest, most loving gift a mother can give to her child.
Scientific studies have shown that breastfed children have fewer and less serious illnesses and allergies than those who never received breast milk. Benefits include reduced risk of sudden infant death syndrome and less childhood cancer and diabetes.
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HoldsThere are many ways to hold your baby while breast feeding.
Cradle hold. The first is the cradle hold. Support your baby’s head in the crook of your arm and hold him with his tummy against yours. Support your breast with your free hand. Because breast exposure is minimal, the cradle hold works well when nursing away from home.
Cross-cradle hold. Second is the cross-cradle hold position. Hold your baby as you did for the cradle hold, but this time use the opposite arm so you are supporting his head with your hand and his body with your forearm. This hold gives you a little more control over his head.
Football hold. Third is the football hold. For this hold, hold your baby alongside you. Support his back with your forearm and rest his head and neck in your hand. This is a good position if you’re recovering from a cesarean because it puts less pressure on the abdomen and the incision area.
Side-lying hold. Finally, the last hold would be the side-lying hold. This is especially useful if you want to nurse while in bed. While you are in bed, lie on your side with your baby facing toward you. Support his head in the crook of your arm to keep his mouth level with your nipple. Place a pillow behind you for added support. This hold is a good choice following a c-section. |
Latching OnGetting your baby to latch on correctly can often be difficult at first; but it will become easier with time. To help your baby latch on correctly, first support your breast with one hand, placing your thumb on the top and your fingers underneath. This is called the C hold. With your nipple or your finger, gently stroke from the baby’s nose to his upper lip, causing him to open his mouth.
Now, as your baby opens her mouth, move the baby closer to your breast until she latches on. When the baby is properly positioned, her lips should cover the nipple and a good portion of the areola.
Breaking the SuctionWhen your baby is finished nursing, break the suction by gently inserting your finger into the corner of her mouth and pulling toward the ear.
What to Expect from Your Prenatal TestsBeing pregnant can be one of the most exciting experiences in your life, but it can also feel scary if you don’t know what to expect. The following is a brief explanation of what to expect from your prenatal doctor visits.
Initial Blood AnalysisAn initial blood analysis is done on all pregnant patients, which is essential in helping to determine possible risks for the baby. Usually on your first visit the blood is drawn and checked for blood typing (Rh factor), antibody screening (which can effect a baby’s growth and chance of survival), anemia and infections that may be transmitted to the fetus. These are German measles (rubella), hepatitis B, syphilis, and AIDS. The results are usually discussed with the patient on the next doctor visit, unless, of course, there is a significant issue that needs immediate attention.
Routine TestingPatients are asked to come in every four weeks for their regular prenatal appointment. As they approach their due date, the visits narrow to two week intervals and then every week during the last month. The main purpose for these visits is to gather five simple, but critical, pieces of information to help the physicians in helping the mother and baby to have the best possible outcome. These five things are blood pressure, weight, baby movement, and heartbeat, baby growth, and urine check. The urine is checked for any spillage of protein or sugar.
Neural Defects or Downs TestingBetween 16-19 weeks, a couple has the option of getting a blood test from the mother’s blood to test for neural tube defects or downs syndrome. This test looks at the levels of four specific proteins in the mother’s blood and the results are tabulated in a ratio for the risks of neural tube defects or downs. For example, the results may say 1 in 1,000 or 1, in 5,000 or 1 in 100.
This test is just a screening test and sometimes is not accurate, especially if it says the risk is higher than expected. But it is accurate if the test is negative or normal. If a result suggests a higher than normal risk, then an ultrasound and possible amniocentesis is offered to find out for sure if there might be a problem with the baby regarding neural tube defects or downs syndrome. One must understand that downs and neural tube defects (spina bifida and others) cannot be corrected. They are permanent. Thus, the purpose for testing is either to prepare for the child’s defects, to know things are fine, or to terminate the pregnancy prior to 20 weeks.
Diabetes TestingAt or near 28 weeks is the time to screen for diabetes in pregnancy. This is done by having a pre-measured glucose load of 50 gms (either in a sugar drink or a bag of jelly beans) and then checking your blood sugar level an hour after consuming the glucose. The cut off is 140 for your blood glucose level. If you fail this initial screening test, then a 3-hour test is measured. If you fail more than two out of four results, then you have gestational diabetes and are treated either by a dietary measure or insulin in order to maintain normal sugar level, thus diminishing risks and complications to the mother and baby.
Group B Streptococcus TestingAround 36 weeks, a patient will be screened for Group B Streptococcus. This is a bacteria that some women carry in the vaginal area that can be passed to the baby during the labor and delivery process. In certain instances, the bacteria can cause severe newborn infection or death. It is not an infection to the mother and is part of what is called the "normal flora" or bacteria that we carry. Thus, eradication of such bacteria is difficult and the key is in treating the mother when in labor to decrease the amount of bacteria at that time and the risk of passing it on to the baby.
If you have questions or concerns about your pregnancy, or what to expect from your prenatal tests, please feel free to call our office at 557-2900.
Are You Insulin Resistant?Insulin resistance is a reduced body response to insulin. It occurs when the body is making plenty of insulin, but the insulin is not working properly. Therefore, the insulin cannot accomplish its job. Insulin’s purpose is to open up cells and drive the glucose out of the blood stream and into the cell. The glucose then provides the energy for the cell.
When insulin is not able to open the cells and move the glucose into the cell, the body will make more insulin in an effort to get the glucose out of the blood. This causes the insulin levels to be high in the blood stream. High insulin levels stimulate the appetite, so we tend to eat more and crave carbohydrates. (Carbohydrates break down to glucose—the body knows that insulin and glucose work together, so if you have too much insulin, the body will search for glucose.)
Diet and exercise are important to the treatment of insulin resistance. When we eat a large amount of carbohydrates t one meal, we are putting a lot of stress on the pancreas, which is where insulin is made and secreted. If we eat "no" carbs, then body is deprived of its immediate and main source of energy.
When we exercise, insulin is able to do a better job of moving the glucose into the cells and decreasing the level of insulin in the blood. Below are some helpful terms to remember when talking about insulin resistance: |
Symptoms of Insulin Resistance:
- Chronic fatigue
- High Cholesterol
- Hypertension
- Inability to Lose Weight with Low-Fat Diet
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- Craving Carbohydrates
- Infertility
- Mental Confusion or Irritability
- Sluggishness or Fatigue after Carbohydrate Intake
- Lack of Regular Menses
- Numbness
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- Glucose: The basic unit that each cell of the body uses for energy. Carbohydrates break down to glucose.
- Insulin: A hormone made by the pancreas in response to glucose in the blood stream. Insulin unlocks the cells and drives the glucose from the blood into the cell to be used for energy.
- Pancreas: A small organ that produces and secretes insulin.
- Carbohydrates: One of the three main nutrients derived from food. Carbohydrates are our main source of energy from our diet. The other main nutrients are fats and proteins. Using moderation or lowering the average carbohydrate content in a meal will lower the work load of insulin and, in turn, promote healthy weight control.
Research Studies in ProgressOver the last three years, Rosemark has been involved in clinical research studies.
Clinical research studies are research studies conducted by pharmacy companies to look at a new drug medication. Some studies concern medications already approved by the FDA. Others are to seek FDA approval. The benefit of participation for patients is that all labs, medical testing, and exams are covered by companies. Patients are also compensated for their time and travel by monetary means.
Menopausal Women StudyWe are currently involved in many studies. Two are currently open for patient participation. One is for menopausal women. The study is looking at the estrogen patch and its possible ability to alleviate hot flashes and night sweats. This is a patch already available on the market.
Birth Control PillOur other study starts in March and is on a birth control pill. That study will also cover all costs, including medical exams, lab work, and medication, plus monetary compensation for the participants.
If you would like more information concerning any of our studies, or if you know someone who would like to participate, please call our research department at (208) 557-2991, or email our study coordinator at spoole@rosemark.net.
Look for our new office, Rosemark West, opening soon in Taylor Crossing.
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Antidepressants and Pregnancy January 2005
Several recent studies seem to indicate the safety of antidepressant use during pregnancy.
When a woman becomes pregnant and is on antidepressants then the question is the risks involved for the fetus and likewise for the mother coming off her medication. The studies have shown no difference in fetal risks for those taking antidepressants and those not. In fact, those women who stop taking antidepressants run the risk of going into depression again which may result in associated problems. Some of these problems include weight gain and unhealthy habits such as the use of tobacco, drugs, and alcohol.
If a woman truly believes she can come off an antidepressant and do well then she should do so but otherwise the patient should consider staying on her medication. This is particularly so when they near the third trimester and the associated increased risk of postpartum depression.
One study demonstrated that those women who came off their antidepressant during pregnancy had a 70% chance of recurrence. Another interesting finding is that during pregnancy the anti-depressants do not pass into the fetus as regularly as other medication. Thus the fetus receives very low doses of these drugs.
The "bottom line" on the use of antidepressants in pregnancy is to remain on the medication unless one feels that it is no longer required to treat their depression.
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July 2005: Delivering Your Expectations
Participating in Clinical Research Studies
Medical research has traditionally been a process of trial and error. With the help of early detection, many medical probems are preventalbe. Some medical problems are acquired from the environment, genetic make-up and lifestyle. Better research, clinical studies and medication advancement greatly improves out understanding of cause and effect, allowing us to live healthier lifestyles.
Before a medication is made available to the general public, it must undergo stringent clinical testing. Pharmaceutical companies do years of laboratory research and then must apply to the U.S. Food and Drug Administration in order to conduct clinical trials and research studies on humans.
Clinical trials and research studies are essential to the development of new medications and treatments, Clinical trials generally fall into one of the following categories:
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Treatments – Testing new treatments or comparing treatments.
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Prevention – Research and testing on how to prevent healthy people from getting a condition or to stop it from recurring.
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Screening – Clinical trials can detect a certain disease or condition.
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Quality of Life – Clinical trials and research studies’ goal is to improve the comfort and everyday life for those suffering with chronic illnesses.
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Genetics – The role of genes in an illness.
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Clinical trial volunteers (patients) are often suffering with pain, discomfort or inconvenient symptoms that hinder their daily activities. By participating in clinical trials and research studies, patients will be helping develop promising new treatments, while at the same time, possibly reducing their own discomfort and symptoms.
There are several benefits associated with medical research studies; some of those benefits include:
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Taking advantage of new treatments at no cost before they become available to the public.
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Having access to top quality medical care from our board certified physicians and experienced research staff.
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Offering valuable new insights into their condition and help future patients.
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Receiving close monitoring of their condition throughout the study.
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Taking a more active role in their healthcare.
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Promoting the interests of persons who are suffering or have suffered from serious or long-term diseases or disorders.
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Encouraging the provision of the resources necessary for medical research to be conducted.
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Promoting appropriate legislation relating to medicine and medical research.
Rosemark WomenCare Specialists is now enrolling patients in new investigational drug studies in the following areas:
- IV Iron for Post Partum Anemia
- Cholesterol – for Prevention of Stroke and Heart Attack
- IV Iron for Anemia due to Heavy Periods
- Severe Osteoporosis
- Oral Contraceptives for PMS
- IV Iron for Anemia due to poor iron absorption
If you qualify, you mat receive the following benefirs free of charge:
- Extensive Laboratory Testing
- Research Related Office Visits
- Compensation for Time and Travel
- Study Medications
If you would like more information concerning the above, or if you know someone who would like to participate, please call our research department at (208) 557-2991 or click here.
Axis-One Inc. and Rosemark Team Up to Offer You More Services
Anyone can develop a mental illness-you, a family member, a friend, or a neighbor. Some disorders are mild; others are serious and long-lasting. These conditions can be diagnosed and treated. The goal of counseling is to help patients understand the ways they are acting and thinking. Counseling can help you clarify your concerns, gain insight into yourself and others, and learn new ways to most effectively cope and/or resolve problems.
Additionally, counseling provides the opportunity to share private thoughts and feelings in a confidential setting, within a protected time-frame. With this approach, patients can have more control over their lives.
The National Institute of Mental Health reported that an estimated 22.1% of Americans ages 18 and older (about 1 in 5 adults) suffer form a diagnosable mental disorder in a given year. This percentage translates to 44.3 million people.
Rosemark WomenCare Specialists has teamed up with June Singletary of Axis-One, Inc. a licensed clinical social worker, to provide therapy for patients who are dealing with emotional disturbance and mental illness. June brings with her over 20 years of experience in social work and medical services. June combines psychotherapy, or talk therapy with appropriate medication to successfully treat emotional, social and behavioral problems. She has vast experience in her field including:
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Play therapy with children
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Addictions counseling
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Therapy with couples, adolescents and children
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Healthcare social work
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Adoption
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Working with victims of sexual abuse and domestic violence
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Loss and grief counseling
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Brief Therapy (8-12 sessions to discuss disorders such as depression and anxiety).
Cognitive-Behavioral Therapy is a way to help you cope with the changes that have taken place in your behavior, and with how you feel. As you work through therapeutic activities, the therapy clearly affects a portion of your brain that is not the same part of the brain affected by your medication. Research has shown that the combination of psychotherapy and medication is the best treatment for most types of mental illnesses.
Axis-One and Rosemark WomenCare Specialists provide confidential and high-quality mental healthcare to individuals, families, adolescents and children. For more information or to make an appointment, please call (208) 557-2980 or click here.
Prevention and Treatment of Sinus Infections
As we enter the spring and summer months many women suffer from sinus infections, particularly during pregnancy. The following are some ways to help in prevention and treatment of recurrent/chronic sinus infections with or without pregnancy.
Most head colds are viral, but if they persist more than 10 days or worsen 5-7 days after onset, than bacteria is more likely a cause or a secondary infection that follow the viral illness. Over 50% of sinus infections will resolve without antibiotic treatment.
A recent study showed that daily nasal irrigation diminishes infection, decreases medication and improves the quality of life. The recipe for irrigation is below:
1) Mix solution: Measure 1 heaping teaspoon of salt (canning/pickling or Kosher salt) and ½ teaspoon of baking soda into a pint container. Add 1 pint of lukewarm water and stir. Fill nasal irrigation cup with about ¾ of solution. (Nasal cups are available from local pharmacies)
2) Position the head: Lean over the sink (about 45 degrees) so that you are looking directly into the sink. Rotate head (about 45 degrees to the left) so that it is on the nostril and its pointing directly over the other. Gently insert the spout of the nasal cup into the upper nostril so that it forms a comfortable seal. (Do not press the spout against the nasal septum).
3) Irrigate the nose: Breathe through the mouth and raise the cup’s handle so that solution enters the nostril. In a few moments, solution will begin to drain from the lower nostril. When the cup is empty, exhale gently through both nostrils to clear excess solution and mucus. Gently blow nose into a tissue.
4) Repeat: Refill the nasal cup. Repeat steps 2 and 3 with the other nostril. Wash nasal cup daily.
Sea-Band Helps Prevent Nausea
A study conducted by Dr. Robert Harrison, consisted of monitoring 102 patients who underwent a laparoscopy procedure. Of the 52 patients in the acupressure group, only 10 of them experienced nausea and vomiting within the first 24 hours. Of the 50 patients who did not apply acupressure, 22 experienced nausea and vomiting within the first 24 hours. The acupressure consisted of pressure being applied by a state-of-the-art design to the wrist. The acupressure was applied by the Sea Band; a wrist band which works by applying pressure with a plastic stud between the tendons.
The Sea Band has also proved to be helpful in women suffering from morning sickness, dizziness, nausea and vomiting. The Sea Band may be purchased from our online boutique click here.
{Source: OB.GYN News}
Frequently Asked Questions Answered
1) What is a Nurse Practitioner?
Nurse Practitioners (NPs) are registered nurses (RNs) who are prepared, through advanced education and clinical training, to provide a wide range of preventative and acute health care services to individuals of all ages. At Rosemark we are honored to have five qualified Nurse Practitioners dedicated to providing you with personable, compassionated medical care.
2) What is a Licensed Clinical Social Worker?
A Licensed Clinical Social Worker (LCSW) is a mental health professional with a Masters Degree (MSW) in social work and two years of supervised clinical experience. Rosemark is proud to have teamed up with June Singletary, LCSW who has over 20 years of counseling experience to provide our patients with expertise in counseling services
3) What is a Physicians Assistant?
Physicians Assistants (PAs) are professionals licensed to practice medicine with physician supervision. PA’s conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventative healthcare and assist in surgery. Rosemark is privileged to have two Physicians Assistants in our office who are devoted to providing patients with the highest quality healthcare in an ethical and compassionate environment.
To learn more about our providers, click here to visit their biographies.
October 2005: New Doctor & New Office
Rosemark Welcomes Dr. Steve Robison
Doctors Baker, Erickson and Nelson are proud to welcome Dr. Steve Robison to the Rosemark team. Dr. Robison is Board Certified in Obstetrics and Gynecology and is a member of The American College of Obstetricians and Gynecologists. Dr. Robison was raised in Idaho Falls and graduated from Bonneville High School. He received his undergraduate degree from Brigham Young University, and his medical degree from George Washington University in Washington D.C. As an active duty member of the US Army, he further pursued his education and training in Obstetrics and Gynecology in Honolulu, Hawaii, by completing an internship and residency at Tripler Army Medical Center. As a staff physician in the military, Dr. Robison enjoyed caring for active duty soldiers and family members in Heidelberg, Germany, and Fort Campbell, Kentucky. Most recently he served in Baghdad, Iraq, with the 86th Combat Support Hospital as part of Operation Iraqi Freedom. Dr. Robison is excited to return to Idaho Falls with a special interest in women's health. He enjoys caring for women in all stages of life, and believes that trust, respect, and compassion are vital in a doctor/patient relationship. While skilled in traditional medicine, he is open to new approaches in meeting the needs of his patients. Dr. Robison's wife, Ellen, is from Orem, Utah. She previously taught high school English and Spanish, but now enjoys being home with their five children. As a family, they have loved living and traveling in many different places. They also enjoy skiing, camping, and the outdoors. Most of all they just enjoy being together. Dr. Robison is accepting new patients and will be providing services at both Rosemark locations. Appointments may be scheduled by calling 557-2900.
Taylor Crossing Office Now Open
Rosemark WomenCare Specialists is growing and expanding to better meet our patient's needs. Doctors Baker, Erickson and Nelson are proud to announce the opening of their new west side office- Rosemark Walk-in Care for Women; located at 808 Pancheri Drive in the Riverwalk Plaza, part of the new Taylor Crossing. Walk-in, scheduled and routine patients are welcome. We offer prompt, professional health care now in two locations. The new westside location offers:
-Primary and Urgent Care for Women including physical and premarital exams
-Gynecological & Obstetrical Care
-Menopause maintenance and management including Bio-identical Hormones
-Urinary Incontinence Therapy
-Women’s Clinical Research Studies
-Psychological Counseling
Our east side office located on the campus of Mountain View Hospital offers in-house bone density scans, in-house ultrasound laser hair and tattoo removal and spider vein treatment.
Take advantage of our new extended hours at Taylor Crossing, 8:00 am to 8:00 pm Monday through Saturday. For more information on our services and new walk-in care office call 557-2900.
Why Annual Exams are Important
The purpose of your physicians recommendation to have a yearly "pelvic and breast exam," is to screen for potential reproductive health problems, including breast cancer. It is important to have these exams regularly so that any problems you may have can be treated early when they are easier to cure and have less damage.
This screening service typically includes the following:
Basic History and Physical: Your physician will ask you a few questions about your sexual, medical and family history and then will perform a very basic physical exam to check your overall health.
Breast Exam: Your physician will inspect and palpate your breasts and your underarms while your arms are in various positions. We recommend you have this exam yearly
Pelvic Exam : The pelvic exam is separate from a pap smear. Your physician will examine and palpate your reproductive organs for any abnormalities or problems. We recommend you have this exam yearly.
Pap Smear: The purpose of a pap smear is to screen for cervical cancer or pre-cancerous changes in the pelvic area. A pap smear involves collecting a small sample of cells from the cervix, the part of the uterus that extends into the vagina. The cells obtained are placed on a slide and analyzed.
What are the possible test results? Abnormal pap smear findings may indicate the following:
-Infection (including the human papillomavirus, HPV)
-Swelling or inflammation
-Pre-cancerous cell changes
-Cervical cancer
Even under the best of circumstances, a very small number of abnormal Paps may be read as normal (false negative). As in all screening tests, sometimes an abnormal result will be recorded when no disease is present (false positive). For these reasons, all women should have regular cervical cancer screening. Pap smears can detect precancerous conditions. If these conditions are discovered, there is a good chance that simple treatment will prevent the development of cancer. Pap smears are also useful for detecting some types of cervical or vaginal infections
Who needs a yearly exam?
The American Cancer Society recommends that after age 40, women should have a breast exam and baseline line mammogram by a health professional every year. Clinical breast exam (CBE) performed by a health professional, such as a physician, nurse or nurse practitioner, is recommended for women starting at age 20. In July 2003, the American College of Obstetrics and Gynecology (ACOG) recommended an initial pap smear/exam should begin at the onset of sexual relations or by age 21, whichever comes first.
Women age 30 and older -- There are two acceptable screening options for women in this age group, says ACOG. Under either option, women may not need annual screening:
1) Testing using cervical cytology alone. If a woman age 30 or older has negative results on three consecutive annual cervical cytology tests, then she may be rescreened with cervical cytology alone every 2-3 years.
2) The combined use of a cervical cytology test and an FDA-approved test for high-risk types of HPV (human papillomavirus; infection). Under this option women receive both a cervical cytology test and a genetic test that looks for certain high-risk types of HPV known to cause cancer. Once women test negative on both tests they should be rescreened with the combined tests no more frequently than every 3 years. If only one of the tests is negative, however, more frequent screening will be necessary. (The combined testing is not appropriate for women under age 30, since they frequently test positive for HPV that will clear up on its own.)
Exceptions -- More frequent cervical screening may be required for higher women who are infected with HIV, are immunosuppressed (such as those receiving kidney transplants), were exposed to DES in utero, or were previously diagnosed with cervical cancer.
Hysterectomy -- Women who have had a hysterectomy with removal of cervix for benign reasons and with no history of abnormal or cancerous cell growth may discontinue routine cytology testing. Women who have had such a hysterectomy but who have a history of abnormal cell growth should be screened annually until they have three consecutive, negative vaginal cytology tests; they can discontinue routine screening.
When to Discontinue Screening -- Physicians can determine on an individual basis when an older woman can stop having cervical cancer screening, based on such factors as her medical history and the physician's ability to monitor the patient in the future.
Insurance and Billing Issues with Annual Exams
Your health insurance plan may not provide coverage for preventive services. If you have questions about whether preventive (screening or yearly) services are covered under your health insurance plan, we encourage you to talk with your benefits provider or representative. There is a common mis-conception that women need to wait for their yearly exam to address other medical concerns or ailments. Rosemark is legally required to bill the insurance carrier in a manner that represents the services actually provided to you using the industry accepted billing and coding standards. Accordingly, the charges for an encounter that includes both "wellness/yearly" and "problem-oriented" services must be broken into:
1) The preventive "wellness" exam which includes history and other questions related to overall reproductive health and well-being, and
2) The "problem-oriented" exam, with questions related to the history of your problem or illness, with further physical examination, diagnostic testing or treatment provided as necessary.
Since there is no single "visit" code that describes the work the physician performs when they conduct both preventive service and a problem oriented service, physicians are instructed to charge two separate "visit" codes (similar to charging for a visit and a procedure when both are performed during the same encounter).
Our office is committed to providing healthcare services in a cost-effective, comprehensive, patient-friendly, yet legal and ethical manner. Intentionally, misrepresenting the services that were provided to you when billing them to your insurance carrier could result in charges to your physician submitting a false claim against a health care benefit program-an action recently defined as violation of federal law, as amended with the Health Insurance Portability and Accountability Act (HIPAA), August 1996.
We thank you for choosing us to assist you with all of your health care needs. We provide primary care services for women of all ages; from colds and allergies to infertility and surgery we strive to be your provider of choice. If you have any questions about this information, please feel free to contact us at (208) 557-2900.
Women's Clinical Research Studies Update
Rosemark WomenCare Specialists is now enrolling patients in investigational drug studies in the following areas:
-Cholesterol lowering medications for prevention of Stroke and Heart Attack.
-IV Iron for Anemia due to Heavy Periods (18 and older).
-Osteoporosis (55-85)
-Oral Contraceptives for PMS (18-49).
-IV Iron for Anemia due to poor iron absorption or history of Gastric Bypass, Inflammatory Bowel Disease or Chronic Kidney Disease (18 and older).
-Vaginal Symptoms associated with menopause (40-65)
-Endometriosis (surgically diagnosed within the last 5 years, must be 18-45)
If you qualify, you may receive the following benefits free of charge Study Medications, Extensive Laboratory Testing, Research Related Office Visits, Compensation for Time & Travel. If you would like more information concerning the above, or if you know someone who would like to participate, please call our research department at (208) 557-2991 or (208) 557-2982.
Rosemark Offers Help for Urinary Incontinence
Recent advances in the treatment of urinary incontinence have provided new options for improved bladder control without surgery or expensive prescription medications. Popular in Europe for over 30 years, these techniques are now available in the US. Incontinence is often dismissed as a normal part of aging.
However, bowel and bladder incontinence is abnormal at any age and is treatable and often curable. Recent estimates state that at least 25 million Americans are significantly affected by chronic urinary incontinence. No other medical problem in the US directly affects so many Americans and receives so little attention from the medical community, government, new media, and medical research funding agencies.
Incontinence is often incorrectly perceived as trivial or merely a hygiene problem. In fact, it is a serious medical disorder, frequently under-diagnosed and inadequately treated, which can lead to significant morbidity and death. The annual cost to people affected by incontinence and the society exceeds $26 billion. Incontinence can be a symptom of many distinct underlying causes. Accurate diagnosis is crucial to successful treatment. Recent advances in office-based pelvic floor therapy give women a nonsurgical treatment option for some types of urinary incontinence. Dr. Baker refers to it as "bladder physical therapy." Most insurance plans and Medicare carriers cover its cost. Ask our providers about how you can benefit from urinary incontinence treatment.
If you experience:
-Abdominal, urethral or vaginal pain
-Urine or bowel loss when you sneeze, cough or lift a heavy object
-A need to go to the bathroom too often
-Occasional "accidents," if you can't get to the toilet in time
-Involuntary bladder emptying
We can help to improve your quality of life. Take our questionnaire on our website click here
or call us at 208) 557-2900 so we can assess your needs and develop appropriate treatment options.
Bioidentical Hormone Therapy Options
What are bioidentical hormones?
Today, women can choose from many hormone therapy options to treat menopausal symptoms such as night sweats, hot flashes and vaginal dryness. When something is referred to as a “bioidentical hormone,” it is structurally identical to the substance as it naturally occurs in your body.
facts: Your body produces three different kinds of estrogen. These are:
1) Estradol, or E2, the primary estrogen produced during your reproductive years.
2) Estrone, or E1, the primary estrogen produced during your menopausal years.
3) Estriol, or E3, the weakest form of estrogen, primarily available during pregnancy.
During menopause the bodies need for different estrogen levels may cause uncomfortable side effects and a common solution is hormone replacement therapy. Hormone therapy can be synthetic conjugated forms or plant derived forms. The plant derived forms are bioidentical and absorb as is. The conjugated forms are broken down by the body into the bioidentical forms.
Know Your Options:
Those medications that are bioidentical are:
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Estrace (Estridol)
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Prometrium
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Estrogel
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Estrasorb
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Climara patch
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Vivelle patch
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Alora patch
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Estraderm patch
Those patients taking Biortri estrogen compounds are getting the estrace ground up and placed in gel form. Basically, all of the above mentioned forms of estrogen are bioidentical and are being formulated into a different method of administering into the body.
How do we determine what our options are?
When you meet with one of our providers to discuss your options, together you will develop a plan to alleviate those symptoms. For more information on bioidentical and hormone replacement therapy
click here or call our office at (208) 557-2900.
2006 A New Year in Women's Health
Rosemark Get's 4D Ultrasound
Rosemark WomenCare Specialists in Idaho Falls; now has the Philips iU22 ultrasound system which combines advanced diagnostic imaging capabilities with an intelligent system interface that streamlines ultrasound exams for patients and clinicians. The Philips iU22 features 4D (or, real-time 3D) imaging technology allows patients to view the baby’s and internal organs as if they were being held in their hands. The system's powerful imaging capabilities support a variety of other common exams, including the vascular, abdominal and gynecological anatomies. It also offers advanced imaging capabilities specifically beneficial in the evaluation of breast masses.
"Ultrasound imaging is hugely beneficial because it is a relatively low cost and non-invasive way to look inside the body," said Dr. Barbara Nelson, Rosemark physician. "With the new Philips system, we are acquiring an extremely high level of diagnostic information and can provide answers for our patients more quickly and easily. Plus, results from the ultrasound exam often reduce the need for more invasive procedures." In addition, the system's revolutionary workflow features greatly benefit the sonographer, or ultrasound technician, and their patients. The iU22 features an adjustable, articulating flat screen LCD monitor that can be positioned so that it can be viewed from almost any direction. This allows patients the ability to see images during scanning, as well. The system can be operated by intelligent voice-command when the sonographer is in tight quarters or needs both hands for scanning. A highly moveable control panel increases the sonographers' flexibility to work around the patient. Early clinical use by physicians indicates that the new ultrasound system has the potential to:
· Make ultrasound exams much faster
· Help patients and their physician better visualize and understand their condition
· Help identify the nature of suspicious breast lesions sooner utilizing new, higher resolution, higher frequency transducers
· Enhance diagnostic capability, thus reducing or eliminating the need for more expensive or invasive tests and procedures
· Provide clearer ultrasound images, especially in difficult-to-image patients
Rosemark offers patients and non-patients the opportunity to have a 4D/3D photo session. Because most insurance companies do NOT cover 4D/3D Ultrasound, this is an extra expense to you. For $150, you will receive up to a 20 minute 4D live ultrasound that can be put on VHS, CD or DVD+R. You will also receive one still photo that you can use for your scrapbook, baby book or picture frame. To qualify for a photo session, you must have had a full 2nd trimester ultrasound and have prepaid the $150 dollars. These sessions are scheduled at a different time than your 3 trimester ultrasound. We recommend that they be performed at 30 weeks, since the baby will have developed better features. Call today to schedule your appointment at 557-2900.
Women's Immunizations are Important
The Advisory Committee on Immunization Practices (ACIP) makes the official federal recommendations for the use of vaccines and immunizations in the United States. The ACIP consists of 15 experts in the field associated with immunizations who have been selected by the Secretary of the U.S. Department of Health and Human Services and below are some of the guidelines they have established for women, specifically expectant women as to why immunizations are important.
The ACIP recommends that because of the increased risk for influenza (flu) related complications, all women who will be pregnant during the influenza season (December through March) should be vaccinated. Dr. Robison explained that, “vaccination can occur in any trimester. Only inactivated influenza vaccine (inject able) should be given to pregnant women (not the live, attenuated intranasal vaccine). The vaccine should also be given to the following individuals:
· All women 50 years of age or older
· Women who have a chronic medical condition (s), such as chronic pulmonary disorder, asthma, or chronic kidney or blood disease.
· Women who work as caregivers or in healthcare.
· Women who are household contacts or in-home care givers to children 0-23 months of age. In addition, any child older than 6 years of age should be vaccinated as a precaution to reduce the likelihood of becoming ill with influenza should be vaccinated.
·Women and family members that are affected with low immunity systems or suffer from respiratory or other acute and chronic disorders.
Influenza is the most frequent cause of death from a vaccine-preventable disease in this country. From 1990 through 1999, an average of approximately 36,000 influenza-associated pulmonary and circulatory deaths occurred during each influenza season. In addition to fatalities, influenza is also responsible for an average of 200,000 hospitalizations per year.
Vaccines must always be dispensed with a prescription or order from a prescription or order from a physician or other healthcare provider authorized to prescribe medications such as Nurse Practitioners or Physicians Assistants.
In reference to vaccinations that women need, adults should be given a routine booster dose of tetanus every 10 years. Adults without documentation of receiving a basic series of tetanus and diphtheria.
What about Hepatitis A and B?
Hepatitis B vaccine has been recommended for everyone age 0-18 years in the United States since 1998. Persons at risk for or diagnosed with STD’s or persons with more than one sexual partner in the last six months need to be vaccinated. Women who have been previously vaccinated still need to be screened during their pregnancy. It is safe for pregnant women to receive the Hepatitis B vaccine because it does not pose a risk to the fetus or no apparent adverse affects to the fetus.
In reference to the Hepatitis A vaccine, women who want to be protected against the virus should be vaccinated. Women who frequently travel out of the United States or who reside in heavily populated areas are more likely to acquire Hepatitis A.
Both Idaho Falls Rosemark locations are offering the flu (influenza) vaccine and
do not require patients to have a physicians order prior to receiving the
Vaccination. Vaccinations do not require appointments, but patients wanting to
be vaccinated are urged to call-in to confirm availability. For more information
about influenza, avian flu or vaccinations, make your appointment today with
one of our health professionals.
More information on vaccination schedules may be found at:
www.immunize.org or www.vaccineinformation.org
The One-Stop-Shop For Women's Healthcare
Consider Rosemark as your “one-stop-shop” for all of your womencare needs. We have four physicians and eight nurse practitioners and physician assistants eager to answer your health concerns.
In addition to providing obstetrical and gynecological care, we also provide in-house ultrasounds, NST’s, bone density assessments, mammograms, in-office GYN procedures, conduct clinical research studies and provide lab services. Our goal is to provide patients the opportunity to receive all of their women’s healthcare in one location. Patient accessibility and quality healthcare are high priorities and we offer two Idaho Falls locations, a Blackfoot facility, extended office hours and walk-in patient care to provide as a service to our patients.
Now Serving Patients in 3 Locations
Our physicians work together as a group and have 47 years of combined experience in obstetrical, gynecological and surgical medical care. Together they provide excellent coverage 24 hours a day, every day. As a commitment to provide improved patient access and medical care, the physicians are now seeing patients in Blackfoot, every Tuesday morning from 9:00 am to noon we are providing routine obstetrical care, gynecological care, menopause management and well-women exams. We are practicing at the Blackfoot Medical Clinic, located at 1441 Parkway Drive.
Rosemark Walk-in Care for Women; located at 808 Pancheri Drive in the Riverwalk Plaza, part of the new Taylor Crossing, welcomes walk-in and routine patient appointments. Our physicians, nurse practitioners and physicians assistants take turns rotating their services at both Idaho Falls Rosemark locations. The west side location at 808 Pancheri Drive offers:
• Primary and Urgent Care for Women; including physical and premarital exams
• Gynecological & Obstetrical Care
• Menopause maintenance including Bio-identical Hormones
• In-house Ultrasound
Our east side office, located on the campus of Mountain View Hospital at 2327 Coronado Street; offers in-house:
• Bone density scans
• In-house 3D live/4D ultrasound
• In-house obstetrical and gynecological procedures
• Clinical research studies
Urinary Incontinence-assessment and pelvic floor therapy
• Laser hair, tattoo removal and spider vein treatment.
• In house mammography
Take advantage of our extended hours at Taylor Crossing, 8:00 am to 8:00 pm, Monday through Saturday; or at our east side location Monday through Friday 8:00 am to 8:00 pm and Saturdays 9:00 am to noon.
For more information on our services or to schedule an appointment at any of our locations call 557-2900 or visit us on the web at www.rosemark.net
What's an EMR?
President Bush announced in 2004 that the Health Information Technology’s plan was to make the United States’ health care more accessible, safe and affordable. His 2006 fiscal year budget includes $125 million for health information projects that test the effectiveness of new technology and allow the widespread adoption in the health care industry. An important step in this plan included signing the Medicare Prescription Drug, Improvement and Modernization Act of 2003, which called for standards to enable electronic prescribing for the Medicare part D program.
Rosemark WomenCare Specialists is in the early phases of implementing an Electronic Medical Record (EMR) system that is in compliance with President Bush’s health initiative. The EMR will allow both Idaho Falls offices and Blackfoot office to simultaneously access patient health information and as a result, eliminating the need for patient chart courier services. The EMR will allow patients to further participate with their appointments and have greater access to their health information.
Rosemark is looking for an EMR system with a patient portal which allows patients to pre-register, schedule appointments, update demographic and insurance information and pay their bills online. Dr. Ty Erickson, Rosemark physician said, “the EMR will allow us to be more efficient in our clinical and patient interface processes. It will allow patients to access to their personal medical information through a password protected system and allow them to further participate in their office experience. Ultimately, the EMR technology will provide organized, timely and more efficient management of your health information.”
Initially, the EMR will require more staff and patient interaction in order to get all of the appropriate information transferred. As we move into our EMR transition, your understanding and support of this new method of medical documentation is appreciated in advance.
Are You Menopausal and Concerned About Vaginal Symptoms?
If you are:
· 40 to 65 years of age
· Have not had a hysterectomy
· Have not had a period for at least 6 months
· Have at least one moderate to severe vaginal symptom such as dryness, irritation, itching, or pain with sexual activity
You may be eligible to participate in a clinical research study exploring an investigational medication to treat the vaginal symptoms of menopause. Qualified participants will receive at no cost; study related tests and investigational medication, study related medical and gynecological exams and mammogram. Compensation for time and travel is available to qualified participants. Please call us at 557-2982.
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