What is this New “Gentle” C-Section?

Gentle C Section | TP4W

At Triangle Physicians for Women, we continuously strive to stay abreast of new pregnancy, labor and delivery technologies and procedures, all with the thoughtful goal of improving your overall patient experience. One topic that has been gaining recognition and popularity lately is “gentle cesarean sections”.

Since most women enter the labor and delivery unit with specific hopes and expectations for their birth, the process of cesarean sections usually carries an undue sense of “disappointment”, “failure” or “missed opportunity” for the women whose birth plans had to be altered unexpectedly to include the operation. Gone (or need-to-be-gone) are the prenatal instructors who preach au natural, drug-free, vaginal births as the “best” or “only” way to to be “successful”.

With a 32% c-section rate for all births in the U.S., many hospitals and physicians have gone to great lengths to make c-section operations more similar to the experience of a vaginal birth, increasing the acceptance of these medically or surgically assisted births. New moms can embrace this gentle intervention (for any reason) as a full-fledged birth “success”, and enjoy the same maternal advantages of bonding and breastfeeding.

All cesareans involve the surgical removal of the baby through the mother’s abdomen, rather than through the vaginal birth canal, and typically take place behind a veiled blue curtain in a brightly lit, sterile environment. Most c-sections occur with a sense or urgency or emergency, such as fetal distress, non-progressing or obstructed labor (when the baby is positioned feet-down), maternal infection or diabetes.

Jenny Smith, a midwife and co-author of a study published in BJOG, An International Journal of Obstetrics & Gynaecology, was one of the early proponents of this refined technique in 2008. Unlike typical c-sections, this equally safe technique involves lowering the surgical drape so that both parents are able to see their baby’s birth, the partner can cut the umbilical cord, and whenever possible, customized birth plan requests such as music or lowered lights can be part of the process. The anesthetic is subtly dosed so that the woman’s upper body and arms can safely cradle the baby with skin-to-skin contact after the baby is slowly removed from the abdomen. Research has shown that these changes do not increase complications, and with just a few modifications to the hospital’s standard Caesarean procedures, mothers can still have that “birth moment” with their partner and infant, and feel more empowered during the process.

Triangle Physicians for Women is pleased to offer this new patient-centered technique whenever possible, and welcomes your questions and requests for more information on the procedure. Our feeling remains: no matter how your baby arrives, birth is a miracle and joy that should be celebrated and supported.



State-of-the-Art 3D Breast Screenings + All-in-One Annual Visits

Triangle Physicians for Women’s new 3D Mammography suite has been an exciting state-of-the-art upgrade that we’re pleased to provide to our patients.  As medicine advances, TP4W’s administrators strive to keep our practice updated with the newest women’s health resources and conveniences. It’s a promise and a commitment that can – literally – be life-changing for the patients we serve.

You’re in Good Hands

As part of the 3D mammography capabilities at TP4W, it’s important to mention the skilled technician behind the machine, Amanda Bruckner, R.T. (R) (M) ARRT. Those acronyms behind her name list the educational requirements, ethical standards, and certification/licensing exams that Amanda has completed in order to provide you with the very best in care.


Amanda was born in Raleigh, NC and received her Associates in Applied Science in Radiology from Johnston Community College in 2012, before becoming registered in Mammography in 2014. She is currently pursuing a Bachelor’s Degree of Radiologic Science through Adventist University of Health Sciences and plans to graduate in the summer of 2017.


Before joining the TP4W team, Amanda worked as a Registered Radiologic Technologist, Mammographer, and Employee Education Liaison at Johnston UNC Healthcare for 5 years.


Amanda’s  long-term commitment towards “perfecting her ARRT” is another way that TP4W confidently claims the best of one-stop, annual well woman exams in the area, right here in our Cary office.  Being able to complete your annual gynecological exam and breast screening in one visit offers many time-saving and scheduling conveniences, beyond just the health benefits!


So, what’s the difference between 2D and 3D imaging?

3D mammography is especially beneficial for women with dense breasts (40-50% of women aged 40-74 in the U.S.)  Studies have found that women with high breast density have about a 4x-5x higher risk of breast cancer than women with low breast density. This makes breast density a stronger breast cancer risk factor than many other factors known to increase risk.

What is a 3D mammography breast exam?

A 3D mammography exam is very similar to having a traditional 2D mammogram, but far more accurate in earlier breast cancer detection than any other mammogram. Like a 2D mammogram, the technologist will position you, compress your breast and take images from different angles.

3D mammography works by capturing multiple slices (images) of the breast from several angles, creating a layered 3D breast image. Our radiologist is then able to review your breast, one thin slice at a time, almost like turning pages in a book, which helps them make a more accurate diagnosis. Unlike a 2D traditional mammography where doctors can only see the front cover of a book, thus viewing all of the complexities of your breast tissue in a flat image, 3D mammography allows for more detail to be seen.

Is there any additional compression?

There’s no additional compression required with 3D mammography, and it only takes a few seconds longer. 

Why we recommend 3D mammography:

3D mammography is simply a better mammogram. This technology is clinically proven, and it’s the most accurate mammogram available. It is the biggest breakthrough in breast cancer detection in 30 years.

Facts about 3D mammography

  • 3D mammography is clinically proven to be superior to a regular 2D mammogram.
  • Several large studies have shown that 3D mammography detects 41% more invasive breast cancers and reduces the chance that you will need to be called back for additional views by up to 40%.
  • 3D mammography is approved for all women who would be undergoing a standard mammogram, regardless of age or breast type – or whether you are coming in for a screening and/or diagnostic mammogram.
  • Very little X-ray dose is used during the 3D mammography exam, just about the same amount as traditional film mammography, and well within the FDA safety standards for mammography.

Please call us today at 919-678-6900 to discuss your personal health risks, and let Amanda and our team answer any questions you may have about our 3D mammography services.


http://tp4w.com/3d-mammography/
600 New Waverly Place, Suite 310
Cary, NC 27518




Let’s get to know Dr. Vijay Sheshadri

Committed

Walking down the halls of TP4W, you’ll usually see Dr. Vijay Sheshadri multi-tasking — hustling to see patients, researching new medical procedures, and talking about ways to grow & improve everything in his path.  Practicing since 1999, he moved to the Triangle with his wife, Bethany, in 1999 and founded Physicians for Women.  Quite simply, this is one devoted OBGYN who strives to make every patient feel valued and cared for. It’s a level of personal commitment that just comes naturally after over 20 years of doing what he loves.

Brainy Buckeye 

If you look around his office, you can’t help but notice he’s off the charts – ah – enthusiastic about his allegiance to THE Ohio State University, where he earned his undergraduate degree. As an Ohio native, naturally, he also looked in-state for his Doctor of Medicine degree, which he got from the Medical College of Ohio, then attended the University of Louisville for his medical training.  In addition to his impressive schooling, he is a Fellow with the American Congress of Obstetrics and Gynecology and a Diplomat of the American Board of Obstetrics and Gynecology.

Personal Passions

Family comes first for Dr. Sheshadri.  He enjoys spending time with his wife and two daughters, and when he manages to find a few extra hours, you’ll find him focusing on his martial arts training.  He also enjoys playing tennis and an occasional round of golf.

But one passion of Dr. Sheshadri’s came into his life unexpectedly: sarcoma.  He and Bethany founded the Victory Over Sarcoma Foundation after being diagnosed with the disease himself.  Let’s hear his story in his own words, and why this foundation is so important to him:

I was diagnosed with a very rare type of sarcoma in November of 2010. I was fortunate in many different ways. Despite it being a locally very aggressive tumor, there was no systemic spread. It was in a location that was very easy to remove with great margins. Despite the surgery being large and aggressive, I am lucky to suffer no long term disability. I was able to access some of the most brilliant physicians and staff because of my close proximity to Duke University. So, when I was given this very scary diagnosis, at every point, the ball rolled my way.

Unfortunately, most people with sarcoma are not so lucky. You see, sarcoma is a cancer of the connective tissue. Connective tissue is in every organ in the body. Simply stated, it can be anywhere in the body. This type of cancer has largely been ignored in the research and pharmaceutical world because it affects a small number of people. Unfortunately, the outcomes can be very devastating. Because of the lack of research, the treatment tends to be very aggressive surgical therapy, limited chemotherapy, and radiation. The prognosis is often grim and the attention to cure leaves the survivors often debilitated. Because of its relative obscurity in the eyes of the common medical world, the experts in this field tend to be few and far between. There is a clear need for help. That is why the Victory Over Sarcoma Foundation was founded by my wife, Bethany. You see, while we were in our darkest days, she had made a promise to give back once our family had recovered and triumphed over this disease.

First of all, there are too many people out there that do not have the resources to obtain the best in medical care. Around the time of my diagnosis, we learned about a boy, roughly the age of our daughter, who lived in Tennessee. He had the same diagnosis as mine. They were trying desperately to get him to Duke to be treated. Unfortunately, it was not economically possible for him to do so. He ultimately died 6 months later. It is critical that people be able to access these tertiary care centers for treatment. Something this small can make the difference between life and death. Because the surgery has to be so aggressive, survivors are often left to deal with life changing disabilities. Houses and cars are not built by standards to accommodate these special needs. Once again, there needs to be a way to make these adaptations affordable. This is where we would like to help. Through our foundation and the generosity of our donors and supporters, we would first, like to help those not as fortunate as us to gain access to the best doctors with the greatest knowledge about sarcoma. Then, our goal is the help these survivors live their lives to its fullest.

To learn more about the Victory Over Sarcoma Foundation, or how you can help in Dr. Sheshadri’s mission, please visit the website for information.


Incorporated in Cary, North Carolina in 1999, the Hope for Haiti Foundation is a cause near & dear to our Dr. Grana.  First dreamt up by Jean Elade Eloi, who grew up in a small Haitian village called Zorangé, the Foundation began with the goal of empowering young leaders to spark change, beginning in their own homes.

Hope for Haiti staff, team members and volunteers, like Dr. Grana, dedicate their time, talents, resources, and hearts to helping the people of Haiti, to secure a better future for Haiti by spreading hope and support in five important areas:

Community – advancing growth and vitality to create a foundation of change in Haiti

Education – offering supplies and instruction to the underprivileged children throughout the remote villages and towns of Haiti

Environment – delivering education, tools, and resources for Haitian farmers and citizens

Medical – ensuring care for communities without clinics, hospitals, medical doctors, or nurses

Spiritual – providing development for churches and pastors who need support and encouragement


As a physician, Dr. Grana’s devotion to the organization can be seen through her surgical and medical work in the clinic in Bainet, where she helps equip and support the Haitian staff there. She and the Foundation partners believe that health is the cornerstone of a productive and thriving society, and work to empower the Haitians to take action and affect change in their own nation.  With new nurses, ministers, and teachers already in place, the Hope for Haiti Foundation’s efforts are already quite evident.  Dr. Grana is also very excited about the new birth center that is being built in Zorangé through the Foundation.

Most recently in February 2017, Dr. Grana visited the region and chronicled her journey and photos with us.

We’re pleased to share them with you here:

We literally bring an operating room in suitcases to a clinic that does not have running water.

The people come from all over Haiti and line up and wait in hopes of being seen and possibly having surgery.

The website also has blogs with one written by our post op nurse about being in the operating room with us for her first time.

Rural communities in Haiti lack access to any form of medical care, causing malnutrition, chronic illness, and death

from preventable diseases. To combat this, HFHF focuses its energy on training Haitian medical professionals

who can serve rural communities in Haiti and by supporting Haitian-run medical initiatives.

Rural Primary Care Clinics

HFHF runs two primary clinics in the rural villages of Zorangé and Gandou, each serving a population of about 10,000.

The clinics provide first aid and primary care services, including parasite treatment, hypertension, fevers (Typhoid, Malaria),

women’s health, eye care, a pharmacy, and diagnostic Laboratory.

Additional Medical Projects

Health education through Radio Bigot and community health workers

Water filter distribution

Training traditional birth attendants (matrons)

Vitamin distribution

But the most amazing thing this year is that this “surgery in a suitcase” is becoming routine for our team at Hope for Haiti Foundation. Although the challenges of performing medical procedures in a remote community with limited infrastructure remain, the team’s sheer determination to provide this desperately needed medical service serves as a catalyst to overcome any challenge.

We proudly support Dr. Grana and the Hope for Haiti mission,

and look forward to sharing more stories with you about their amazing work.

How about you?  Have any questions you’d like to ask Dr. Grana?  Want to share a similar story of hope you’ve experienced?

We’d love to hear from you.


How to be the CEO of your helalth


February 2017 – As I moved from downward dog to warrior to the tree pose at a yoga class recently, the twinges and pulls in my left upper arm again reminded me what I have been through over the last ten months.

Nothing prepares you to hear the words, “You have cancer.”  That was confirmation of my fears after a mammogram, ultrasound and biopsies revealed I had “abnormal” findings. In other words, the “Big C.”  It all started last April when I felt a lump in my armpit while showering.  I thought (and prayed) it was just  an infected bump from razor burn.  One call to Triangle Physicians for Women, and they had me in the office within 24 hours to see Dr. Lisa Grana.  I was due to have my mammogram within the next few weeks anyway, but Dr. Grana expedited everything on my behalf. 

The result? Invasive ductal carcinoma, and it had already spread to my lymph nodes.  That’s what the lump was in my armpit.  How could this have happened?  I never missed a mammogram since turning 40.  But, as I now know, it wasn’t enough.

Like 40% – 50% of women in the United States, I have dense breasts.  That can make it tricky to see growths in mammograms. Fortunately, we live in a region where we have access to some of the best medical and technological advances available today.  Enter 3D mammograms, now available at Triangle Physicians for Women.  3D mammography, also known as tomosynthesis, is the biggest breakthrough in breast cancer detection in 30 years. With an increased cancer detection rate, it is superior to conventional 2D mammography with hardly any difference in the screening process.  While the 2D mammogram takes x-ray images from the side, the 3D takes multiple images of the breast in slices, allowing the radiologist to examine the breast layer by layer. Because more of the breast can be reviewed, it reduces the risk for call backs.   

I was stunned when seeing my 2D mammogram side by side with the 3D mammogram. I had three malignant tumors in my left breast, one nearly an inch wide.  In the 2D image, you couldn’t see them at all because my breast tissue is so dense. But in the 3D image, they lit up like a Christmas tree.  The 3D mammogram saved my life.
3D Mammography for Dense Breasts

I underwent 5 months of chemotherapy, a double mastectomy and two months of daily radiation.  I’m now getting ready to begin a 13-month clinical trial testing a chemotherapy drug that I hope will deter my breast cancer from returning. I often wonder if I had a 3D mammogram the year before, if the tumors could have been spotted sooner and I wouldn’t have to undergo such intense treatments.

So, here’s your chance to be be the CEO of your health.  Please take action and make sure you are doing the following things:

  1. Do monthly breast self exams.  For how-to’s, click here.
  2. See your OBGYN for your annual exam.
  3. Ask your OBGYN if you have dense breasts.
  4. Ask about getting a 3D mammogram.
  5. Remind your friends, sisters, moms and the men in your life to do the same.

Getting a mammogram just got a lot easier, too, now that Triangle Physicians for Women has its own mammography suite, located inside Triangle Physicians for Women’s facility.  It features the highest quality mammography available with state-of-the-art equipment, which can detect 41% more invasive breast cancers.

3D mammography in Raleig

At Triangle Physicians for Women, being a one stop shop for women’s health means you can spend less time away from your family or work.  You can add your screening mammogram appointment to your annual well-woman exam appointment.  And if you need to schedule these appointments separately? No problem; they can do that too.  Plus, it’s never a hassle to get your previous mammogram films/records.  Simply sign an authorization to release medical records form, and they will take care of the rest.

Do you feel empowered?  Get on it!  Be the CEO of your health today.

By Sharon Delaney McCloud
Triangle Physicians for Women Patient
Breast cancer survivor, mom, wife and business owner

_________________________________________________________________________________________________

Triangle Physicians for Women Now Offering 3D Mammography

January 2017

Together, we can beat breast cancer. Triangle Physicians for Women is committed to women’s health and encourages women to take preventative measures against breast cancer. For the ease and convenience of our patients, we are proud to offer our in-house 3D mammography suite.

Breast cancer continues to be the second leading cause of cancer deaths in women. Four out of five women agree that yearly screenings are important, but only 60% are taking advantage of these potentially life-saving exams. With the most advanced technology on the market, Triangle Physicians for Women is dedicated to providing our patients with state-of-the-art mammography to prevent and fight breast cancer.

One of the main reasons women do not have their mammogram is due to time constraints and busy lives. Now, you can get your well woman exam and your mammogram during the same visit. Call us today to schedule your appointment: 919-678-6900.


What is a mammogram?
A mammogram is an X-ray picture of the breasts. Because mammograms can detect tumors before they are seen or felt, they are the most effective way of detecting breast cancer at its most treatable stage. There are two types of mammograms: 2D (conventional) and more recently 3D.


What is 3D mammography?
The 2D mammogram only takes x-ray pictures of the front and side of the breast. With the 3D mammography, multiple x-rays are taken of the breast in layers, creating a 3-dimensional image. More of the breast can be examined by a radiologist, who reviews the image and can make an informed assessment.

Triangle Physicians for Women’s 3D mammography is the best and newest technology on the market, finding 41% more invasive breast cancer than conventional mammography. It is the most accurate mammogram available for women with dense breasts.

The process is very similar to 2D mammography. It takes only a few seconds longer than a conventional mammogram and comes with no additional discomfort, radiation or compression.


When should I start getting annual mammograms?
Factors such as family history can affect the age recommended to start getting yearly mammograms. Some women with extensive family history of breast and ovarian cancer start at age 35. Typically, women begin having mammograms at age 40.  Talk to your provider about when you should start.


How should I prepare for my appointment?
For the most accurate test results (and lower the chances for a call back), do not wear lotion, perfume, deodorant or jewelry during your visit.



4 Questions Your Daughter Has Before Her First Gyno Appointment

December 2016

A first visit to the gynecologist can make a young woman feel nervous, embarrassed, scared or all of the above. Our physicians and midwives make it a priority to make our patients feel as comfortable as possible, but explaining to your daughter what to expect before she even gets to the practice will reduce anxiety about a first exam. Here are some questions we hear often to address before a first visit:


  1. When should I first go to the gynecologist?

The American College of Obstetrics and Gynecology recommends that young women schedule their first exam with an OB/GYN between the ages of 13 to 15. This visit will include an external exam and graduate to an internal exam when your daughter turns 21. If there is any instance of irregularities or vaginal bleeding, an internal exam of the reproductive organs may be necessary sooner.


2. What do I expect?

The provider will do a breast exam, while checking for lumps or cysts. Your daughter will be asked to spread her legs apart and put her feet in stirrups, and the provider will do an external exam, looking for swelling or sores. An internal exam checks normality of the uterus and ovaries, where a speculum (instrument that opens the vaginal walls) is used. This can be intimidating for the first time, so encourage her to take deep breaths to decrease discomfort. Depending on her age, she may need a Pap smear.


3. What is a Pap smear?

Women start getting Pap smears at age 21. This is to check for abnormal cells and cervical cancer. A small spatula will scrape cells from the cervix to be sent to a lab. Although uncomfortable, this process does not hurt. Again, deep breaths are key!


4. How do I prepare for my first visit?

Tell your daughter to think about questions to ask your provider beforehand – about contraception, sexual activity, period irregularities, anything. Any questions and/or concerns you have should be addressed and your provider can answer. Assure her that it is okay to feel a little embarrassed since it is the first visit, but remember there are no stupid questions, and nothing that hasn’t been heard before.

There are also questions she should prepared to answer:

  • When was your last period?
  • Are you having any problems with your period?
  • Are you (or have you ever been) sexually active?
  • Is there any possibility you could be pregnant?
  • Do you have any discomfort in the vaginal area?

Did you know our midwives take gynecology appointments? All of our midwives hold the title Certified Nurse Midwife, so they are full-spectrum and are licensed to provide care to women of all ages and stages of life, not just during pregnancy.

Any other questions? Talk to us! Schedule your daughter’s annual appointment over Christmas break! We still have some spots open! Call us at 919-678-6900. To learn more about Triangle Physicians gynecology, click here.


Best Travel Pregnancy Hacks with Triangle Physicians for Women

November 2016

‘Tis the season of traveling! With the holidays fast approaching, it’s hard to avoid a road trip. The best time to travel is during the second trimester, between 14 and 28 weeks. In many cases, this is past morning sickness in the first trimester and before third trimester fatigue. Triangle Physicians for Women has some tips on how to travel most effectively, safely, and comfortably during your pregnancy:

Stay Safe
According to the National Highway Traffic Safety Administration, everyone must wear a seatbelt, although there is a common myth that seatbelts and airbags are unsafe for pregnant women. The seatbelt should be over the collarbone and under the abdomen, and tightly fastened (see below). Safety belts should never be above or across the belly. This ensures the best possible protection for mom and baby.

untitled-design-37

Despite another common myth, airbags should never be disabled. A study by the University of Washington found that out of 3,000 accidents involving pregnant women, there was no higher risk found of fetal distress, placental separation, or cesarean section in those whose airbags deployed. The safety component outweighs the potential risk of not using an airbag for both mom and baby.


Stay Healthy
To ensure you feel your best during the roadtrip, keep extra water bottles in a cooler in the car and continue to drink the recommended 8 oz. per day. Take frequent stops about every two hours to use the bathroom, stretch and take short walks to keep blood flowing and prevent swelling. To avoid fast food, pack a plethora of healthy (and fiber-rich) snacks to eat on the way – trail mix, fruits and vegetables in a cooler, energy, etc.   

Stay Comfortable
Wearing layers is essential – a cotton t-shirt, lightweight wool sweaters, and leggings is the perfect outfit for a road trip with frequent stops. Wear comfortable shoes for the car and bring a supportive pair for bathroom breaks.

With these tips, you can maintain your healthy habits while you are on the road and ensure your trip is safe and comfortable for you and you baby.  As always, please remember every woman should talk with her physician no matter what stage pregnancy before traveling.  Happy travels!


How MonaLisa Touch Can Help Change Lives, Including Help for Breast Cancer Survivors

October 2016 

The providers at Triangle Physicians for Women are excited to introduce MonaLisa Touch!

The MonaLisa Touch is a revolutionary laser treatment for vaginal dryness, vaginal burning and other vaginal symptoms of menopause.


How Does it Work?
The MonaLisa Touch treatment utilizes a laser to deliver controlled energy to the vaginal tissue stimulating cells to produce more collagen. Increased collagen production increases lubrication and sensation in the vagina.

There are three treatments over the course of 12 weeks. Each treatment takes less than five minutes in our office with no anesthesia and little to no downtime.

“We have been using the MonaLisa Touch laser for over a year now and have made a huge impact on many of our patient’s lives with this treatment,” said Triangle Phyicians for Women physician Dr. Lisa Grana. 


Results
Most patients see improvement after the first treatment. There are minimal side effects and a rapid recovery rate. Thousands of women have been treated and reported significant improvement of their symptoms.


untitled-design-33Breast Cancer Survivors
We are excited to offer the MonaLisa Touch Treatment to breast cancer survivors as a safe and innovative treatment option. Physicians are calling it revolutionary and patients are calling it life changing.

Out of 2.8 million breast cancer survivors, 50% experience changes in their gynecological health.

Women who have undergone breast cancer treatment such as chemotherapy, hormone therapy, and ovarian removal may experience what is known as medical menopause. This can be temporary or permanent, depending on the individual. Symptoms for medical menopause are much like those of natural menopause, include vaginal dryness, vaginal burning, pain during sex, and frequent urination.

While many suffer from these issues, only 25% seek medical assistance.

“MonaLisa Touch has offered a great new option for breast cancer survivors to find relief from symptoms of  menopausal atrophic vaginitis,” said Dr. Vulgaropulos. “The significance of this is remarkable considering the obstacles these women have overcome.” 


Treatment
Estrogen replacement therapy is one of the most common treatments for symptoms of menopause. However, this may not be a safe treatment for women who have had breast cancer.

Have questions about MonaLisa Touch? Consult your doctor or visit our MonaLisa FAQ page.


Tips for Ovarian Cancer Prevention
September 2016

Ovarian cancer is the #1 cause of gynecological cancer deaths, and 1 in 75 women will develop it at some point during their lifetime. The American Cancer Society predicts that there will be over 22,000 new cases of ovarian cancer this year. September is Ovarian Cancer Awareness Month, so now is a better time than any to talk about prevention, risk factors, and symptoms.


ovarian-cancer-ribbon-300x179

Family History
An estimated 15% of all ovarian cancer diagnoses are linked to hereditary factors. A woman’s risk of developing ovarian cancer is increased if her mother, sister, or daughter has had ovarian, breast, or colorectal cancer. These cancers can be caused by an inherited mutation in certain genes that increase risks. There is also an increased risk if there has been cases of ovarian cancer on the father’s side.

Pregnancy and Birth Control
Women who carried their baby before the age of 26 have a lower risk of developing ovarian cancer. Every pregnancy after that decreases the risk even further. Breastfeeding has also been proven to decrease the risk.

Oral contraceptives have been proven to reduce the risk by 30 – 60% for women who have used them for over three years. The decrease in risk can last up to 30 years after women stop taking the pill.

Lifestyle
Being active and eating right are ways to reduce the risk of cancer. Obese women (those with a body mass index of 30 or higher) are at a higher risk of developed ovarian cancer.

Gynecological Surgery
Tubal ligation (tubes tied) reduces the risk by two-thirds and a hysterectomy (removal of the uterus) reduces the risk by ⅓. A new procedure, called total laparoscopic hysterectomy, can be done through cameras and is very low-risk.  

“Because the incisions on the abdomen are very small in a laparoscopic hysterectomy are able to return to a normal life in 1-2 weeks,” said Triangle Physicians for Women physician Dr. Vijay Seshadri.

For women with a high risk of ovarian cancer, a bilateral salpingo-oophorectomy (removal of fallopian tubes and ovaries) may be recommended.

Like all cancer, early detection is key. Yearly women’s tests may detect other reproductive cancers early on, but ovarian cancer is usually too small in the early stages to be found during a Pap test or pelvic exam. This is why it is important be aware of family history as well as symptoms. The more common symptoms are bloating, pelvic and abdominal pain, and urinary symptoms (such as urgency and frequency). Other less frequent symptoms include fatigue, back pain, menstrual irregularities, pain after sex, constipation, and difficulty eating.

Many of these symptoms occur often for women and can perceived as normal. It is recommended that if any occur for more than a few weeks to contact their primary care provider.

Only 20% of ovarian cancer is caught in the early stages. About 14,240 women will die from ovarian cancer this year. This month, help Triangle Physicians for Women raise awareness for ovarian cancer and encourage preventative care.


Prenatal Yoga Classes at Cary Practice – Triangle Physicians for Women

August 2016 

Yoga is a well-known exercise regimen that keeps the mind and body healthy, and it’s proven that exercising while pregnant is beneficial for both Mom and baby! Prenatal yoga is specifically designed for women during any trimester of pregnancy, and is more beneficial than traditional yoga classes. Here are some reasons why you should sign up for Prenatal Yoga classes at Triangle Physicians for Women:

IMG_9586
Relieves Anxiety & Stress

Normal pregnancy comes with its own unique anxiety and stressors!  By practicing mindfulness, routine breathing exercises, and learning to feel in tune with your ever-changing pregnant body, we find that women who practice prenatal yoga are more likely to be less stressed than those who don’t.  The exercises performed during prenatal yoga classes are proven to regulate heart rate and blood pressure while naturally increasing endorphins which serve to create mood stability and increase energy levels.

“So much of prenatal yoga is allowing women’s bodies to rest because so much of being pregnant is exhausting,” says Holly Healy, who teaches the bi-weekly prenatal yoga class at Triangle Physicians for Women. “My class is more about restoring women’s bodies.”  


Relieves Common Pregnancy Pains

There are normal “discomforts of pregnancy” which occur throughout the pregnancy. Whether it is nausea during the first trimester, back pain in the second, or shortness of breath in the third, prenatal yoga exercises and poses help to alleviate the naturally occurring “normal miseries of pregnancy”. The stretching movements that typically start off a prenatal yoga class work to increase circulation, which in turn reduces swelling and body aches.

Holly starts her class off by asking the group (usually of about 2 to 4) if anyone is experiencing specific discomforts, and then tailors her class to relieve the pain in that area. Most of the pain comes from the body compensating for the baby’s growth that helps relieve tension.


Prepares for Labor

Research shows that those women who practice prenatal yoga during pregnancy will spend less time in labor than those who do not have an exercise regimen in place. Prenatal yogis also experience less pain during and after giving birth. Increasing the strength and flexibility in muscles during pregnancy, prepares women for childbirth, often making them feel more in control and confident during labor and delivery.

Deep breathing is also a big part of the class, contributing to the preparation of labor and delivery. “In prenatal yoga, there’s a heavy focus on breathing, and figuring out which breathing pattern works best for each person,” Holly says. “Allowing them to focus on it in class can prepare them for breathing practices during labor and delivery.”


IMG_9589 (1)

Meet Like-Minded Moms

In addition to all the mental and physical benefits for both Mom and baby, prenatal yoga classes allow women to meet like-minded moms-to-be, creating a bond between them. A prenatal yoga class makes for a supportive group, and a memorable experience that women can enjoy along with their pregnancy.

Prenatal yoga with Holly is offered on the 1st and 3rd Friday of each month at 7:00pm at Triangle Physicians for Women,600 New Waverly Place, Suite 310.  Bring $10 cash, your yoga mat, and written clearance from your OB doctor in order to participate. Register with Holly via email: healthybabync@gmail.com.

_______________________________________________________________________________________________________________

prenatalyoga2

Calm Your Mind and Connect with Your Baby

Where: Triangle Physician’s for Women
             600 New Waverly Place, Suite 310
             Cary, NC

When: 1st & 3rd Wednesday of each month
            7:00 – 8:15pm

Cost: $10

Taught by Holly Healy, FNP, IBCLC. Holly has been teaching yoga for 15 years is AAAI yoga certified, Kids Yoga Certified, and certified in Pre and Post Natal Yoga. 

Register by emailing Holly at healthybabync@gmail.com. 
Bring your yoga mat and medical clearance from your doctor!

 _______________________________________________________________________________________________________________

mommy&meyoga

Join us for Mommy & Me Yoga!

Where: Triangle Physician’s for Women
             600 New Waverly Place, Suite 310
            Cary, NC

When: 2nd & 4th Friday of each month
            6:15 – 7:15pm

Cost: $15

Taught by Holly Healy, FNP IBCLC and AAAI, Pre/Post Natal, & Kids Yoga Certified.

Register by emailing Holly at healthybabync@gmail.com. 
Bring your yoga mat and a blanket for your baby! Babies 6 weeks – 12 months welcome! 

_______________________________________________________________________________________________________________

Recognition1

Triangle Physicians for Women Earns National Recognition for Patient-Centered Care

NCQA Patient-Centered Medical Home™ standards emphasize enhanced care through
patient-clinician partnership.

The National Committee for Quality Assurance (NCQA) announced that Triangle Physicians for Women has received NCQA Patient-Centered Medical Home (PCMH) Recognition for using evidence-based, patient-centered processes that focus on highly coordinated care and long‐term, participative relationships.

The NCQA Patient-Centered Medical Home is a model of primary care that combines teamwork and information technology to improve care, improve patients’ experience of care and reduce costs. Medical homes foster ongoing partnerships between patients and their personal clinicians, instead of approaching care as the sum of episodic office visits. Each patient’s care is overseen by clinician-led care teams that coordinate treatment across the health care system. Research shows that medical homes can lead to higher quality and lower costs, and can improve patient and provider reported experiences of care.

“NCQA Patient-Centered Medical Home Recognition raises the bar in defining high-quality care by emphasizing access, health information technology and coordinated care focused on patients,” said NCQA President Margaret E. O’Kane. “Recognition shows that Triangle Physicians for Women has the tools, systems and resources to provide its patients with the right care, at the right time.”

Triangle Physicians for Women exceeded national standards for:
– Communicating with primary care clinicians to exchange key information and establish coordinated care plans.
– Providing timely access to care and clinical advice based on patient need.
– Measuring and improving performance over time.

About NCQA
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used measurement tool in health care. NCQA’s website (ncqa.org) contains information to help consumers, employers, and others make more informed health care choices.
_______________________________________________________________________________________________________________

Welcome Dr. Ronald Rogers

Dr Ronald Rogers OBGYN

Dr. Ronald Rogers

Triangle Physicians for Women is thrilled to announce that one of the area’s most trusted and favorite OBGYNs is joining our team.  Dr. Ronald Rogers brings decades of experience to our practice.

A native of Raleigh, Dr. Rogers was inspired early in life by his grandfather, both a physician and dentist, to pursue a career in medicine. Today Dr. Rogers is an accomplished physician acclaimed by patients for his personalized care, and recognized by the medical community for his clinical contributions.

Dr. Rogers worked his way through N.C. State University earning his Bachelors Degree and Masters Degree, with honors, in Physiology and Biochemistry. He graduated from the University of North Carolina School of Medicine and spent two years in General Surgery completing his internship at the University of Alabama at Birmingham Hospital. He then returned to North Carolina to complete a residency in Obstetrics and Gynecology at UNC. He served as a UNC faculty member as an assistant professor for three years before entering private practice.  Interesting note, Dr. Rogers delivered the very first baby at WakeMed Cary Hospital!

Dr. Rogers is a Diplomate of The American Board of Obstetrics and Gynecology and a Fellow of The American College of Obstetricians and Gynecologists. He was presented the “Young Investigator Award” from the American Society for Reproductive Medicine (ASRM) as a resident at UNC, and was voted by the medical students at University of Alabama Birmingham as Surgical Resident of the Year. The faculty at UNC awarded Dr. Rogers the Outstanding Laparoscopic Surgeon award, and NC State University honored him as the Outstanding Young Alumnus.

Dr. Rogers lives in Raleigh with his wife, Kathryn, and his four children.

________________________________________________________________________________________________________

Postpatum Education and Support NC
Postpartum and Education Support is an organization dedicated to the emotional wellness of mothers. We offer support for mothers and their families, provide resources for health care providers, and heighten public awareness of perinatal mood disorders.
We also offer Moms Supporting Moms (MSM) is a peer-led, judgment-free support group for women struggling with issues related to pregnancy, delivery and early motherhood. Our weekly support group meetings provide a confidential and safe environment for sharing stories, discussing problems and seeking solutions. We meet 7:00 – 8:30pm every Thursday Mid-Carolina Ob-Gyn offices, Medical Plaza of Rex Hospital 4414 Lake Boone Trail, Suite 300; Raleigh, NC 27607.   Click here to learn more.

______________________________________________________________________________________________________________


What is this New “Gentle” C-Section?

At Triangle Physicians for Women, we continuously strive to stay abreast of new pregnancy, labor and delivery technologies and procedures, all with the thoughtful goal of improving your overall patient experience. One topic that has been gaining recognition and popularity lately is “gentle cesarean sections”. Since most women enter the labor and delivery unit with…

Read More
3D Mammography

3D Mammography

Triangle Physicians for Women is pleased to offer our patients the latest technology and convenience in Women’s Health. In our effort to provide one-stop, annual well woman exams, we are now offering the convenience of 3D mammography in our office for your annual breast screening.  It’s especially beneficial for women with dense breasts, which make up…

Read More

Sara Dowd, CNM

Sara Dowd, Certified Nurse Midwife, was born in Pinehurst, NC. She received her Bachelor of Science in Nursing at Winston-Salem State University, and then went on to graduate with a Master’s. Sara worked as a Registered Nurse at both First Health of Carolinas, then WakeMed Raleigh and WakeMed Cary since 2001. Before joining our team, Sara…

Read More

April Horner, CNM, MSN

April Horner is delighted to make North Carolina her home after relocating here from Florida.  She spent ten years in nursing at a high risk obstetrics practice and as a clinical instructor for nursing students before earning her Master of Science degree in Nurse Midwifery from Frontier Nursing University.

Read More

Certified Nurse Midwives

Triangle Physicians for Women is a collaborative practice in Cary, NC near Raleigh/Durham with seven Certified Nurse Midwives providing 24/7 midwifery care at WakeMed Hospital in Cary. Learn more about our wonderful midwives by clicking on their individual biographies. You also can read more about their services at Triangle Midwives.

Read More

Ronald G. Rogers, M.D., M.S., F.A.C.O.G.

Ronald Gray Rogers, MD, MS, FACOG is a board certified obstetrician and gynecologist who has been caring for women in the Triangle area for more than 18 years. In fact, Dr. Rogers delivered the very first baby at WakeMed Cary!

Read More

Vaginal Health: MonaLisa Touch

Have you experienced changes in your vaginal health since menopause or because of breast cancer treatment?  Did you know that as many as 50% of women experience changes in their vaginal health. It’s OK to talk about it – because now there is a new therapy at Triangle Physicians for Women that really works! ________________________________________________________________________________________________________________________…

Read More

Welcome to Triangle Physicians for Women

Welcome to Triangle Physicians for Women, a comprehensive obstetrics and gynecology practice in Cary, NC that has been serving women of all ages and stages of life since 1992. What makes Triangle Physicians for Women so unique is the collaborative approach. The team consists of board certified obstetricians and gynecologists and Certified Nurse Midwives. It…

Read More

Patients Needed

Is a lack of sexual desire affecting your relationship? If decreased sexual desire is affecting your connection, it’s time to take the next step to reconnect! Decreased sexual desire is a real medical condition, known as Hypoactive Sexual Desire Disorder (HSDD). The Reconnect Study is a clinical research study designed to evaluate the safety and…

Read More

New OB Patient Videos

Welcome to Triangle Physicians for Women’s video resource center for new obstetrical patients.  Please select the video topic below you would like to view and make note of the code that appears at the end of each video so we can document that you have watched it. Routine OB Care Video Rhogam Video Prenatal Testing…

Read More

Will You Help?

Triangle Physicians for Women and InterAct of Wake County are teaming up to help women and children who have been in an abusive situation have a better Christmas. We invite you to participate in this wonderful opportunity to give back to our community in such a warm, thoughtful way this holiday season.  InterAct is a…

Read More

Certified Nurse Midwives

Triangle Physicians for Women is the only practice in Wake County with five Certified Nurse Midwives providing 24/7 midwifery care at WakeMed Hospital in Cary.  Learn more about our wonderful midwives by clicking on their individual biographies.  You also can read more about their services at Triangle Midwives.

Read More

Physicians

Our physicians at Triangle Physicians for Women are all Board Certified in Obstetrics and Gynecology with many years of experience.  Please select a physician from the menu to learn more about them.

Read More

Videos from Triangle Physicians for Women

Pregnancy and Diet Exercise During Pregnancy Normal Weight Gain During Pregnancy Vaginal Birth After C-Section Being a Patient at Triangle Physicians for Women Midwife and Physician Philosophy Changing Your Mind About Epidurals Types of Midwives What a Certified Nurse Midwife Does Why Be a Midwife? Creating a Birth Plan Can Physicians Attend Births with Certified…

Read More

Lauren Anderson, CNM

Lauren Anderson relocated to Chapel Hill, NC from her hometown of Charlotte, NC.  She  graduated from the Medical University of South Carolina with a Bachelor of Science Degree in Nursing in 2008.

Read More

Eating Disorders

EATING DISORDERS Anorexia nervosa http://www.womenshealth.gov/publications/our-publications/fact-sheet/anorexia-nervosa.pdf Binge eating http://www.womenshealth.gov/publications/our-publications/fact-sheet/binge-eating-disorder.pdf Bulimia http://www.womenshealth.gov/publications/our-publications/fact-sheet/bulimia-nervosa.pdf

Read More

Menopausal Management

What is menopause? Menopause is a normal, natural event—defined as the final menstrual period and usually confirmed when a woman has missed her periods for 12 consecutive months (in the absence of other obvious causes). Menopause is associated with reduced functioning of the ovaries due to aging, resulting in lower levels of estrogen and other…

Read More

Nutrition & Weight Loss

Nutrition & Weight Loss Services We are excited to announce the addition of Nutrition Services by Maria Kennedy, MPH, RD, LDN.  Our nutrition care includes complete nutrition assessments and individualized nutrition care plans for patients based on their needs, medical conditions and lifestyles. Specializing in the following: ·         General nutrition/wellness ·         Diabetes/Gestational Diabetes ·         PCOS…

Read More

Urinary Incontinence

Urinary incontinence (UI), or bladder leakage, is the loss of urine control, or the inability to hold your urine until you can reach a restroom. Incontinence can range from the discomfort of slight losses of urine to severe, frequent wetting. Millions of people experience incontinence and it can have a profound impact on their quality…

Read More

Patient Information from Triangle Physicians for Women

Confidentiality Confidentiality is a keystone of our practice. Any time you speak with one of our doctors, nurses, or midwives, you can be sure that the conversation, your fears, and your concerns are kept in the strictest of confidence. Triangle Physicians for Women adheres to the strict HIPAA (Healthcare Information Portability and Privacy Act) standards…

Read More

Summary of Obstetric Visits

Routine prenatal care consists of approximately 14 prenatal visits. These visits are spaced out throughout your pregnancy. Typical prenatal visits consist of asking certain screening obstetric questions, checking your blood pressure,hecking your urine for glucose and protein, measuring your belly, listening for the fetal heart beat and answering your pregnancy questions and concerns. Some visits…

Read More

Policies

Our office is open Monday through Thursday from 8:00 am – 5:00 pm and Friday from 8:00 am to noon. However, we offer 24-hour on-call coverage in the case of an emergency situation. View Our Policies

Read More

Preoperative Instructions

Having surgery requires preparation.  As a result, there are certain things that need to be done to ensure optimal safety and preparation.

Read More

Postpartum Care

Congratulations on the birth of your new baby!   We have enjoyed being a part of your pregnancy.  As with pregnancy, the postpartum period brings significant physical and emotional changes, and recovery from childbirth typically takes 6-8 weeks.  We hope this information proves useful in your transition to motherhood, but if you have unanswered questions,…

Read More

Aesthetics Procedures

Triangle Physicians for Women offers a wide range of aesthetics procedures to help you look and feel your best.  We partner with our sister practice, Cary Med Spa and Wellness, located around the corner next to WakeMed Cary Hospital. Many of the professional services can help reduce stress and anxiety that people often feel while…

Read More

Infertility

What is infertility? Infertility affects one in eight couples is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. If you have been trying to conceive for a year or more, you should consider an infertility evaluation. However, if you are 35 years or older, you should begin the infertility…

Read More

3D/4D Ultrasound

3D/4D Ultrasounds offer the miracle of tomorrow…today!   3D/4D Ultrasounds can provide a positive bonding experience between parents and their unborn baby. If you would like to see what your baby “looks like” using the full capabilities of state-of-the-art 3-D/4-D ultrasound, you can schedule a 20 minute session between 26-29 weeks, at which time you…

Read More

Pediatric & Adolescent Gynecology

At Triangle Physicians for Women, we have the training to address the gynecological needs of children and adolescents, especially those with underlying health problems. We place particular emphasis on wellness and prevention, in order to educate young women to care for and respect their bodies. When working with young patients, we focus on the tender…

Read More

Nurse Midwifery

Triangle Physicians for Women is proud to be serving women and families in the Cary, Raleigh, Durham area since 1992.  As a collaborative practice combining the expertise of board certified OBGYNs and Certified Nurse Midwives, we have found the best of both worlds in caring for our patients. The practice hired its first midwife more than…

Read More

Obstetrics Treatment & Support

Having a baby is an exciting and wonderful time in a couple’s life. Our goal is to give our patients the most comprehensive general and high-risk obstetrical care possible. In addition to providing obstetrical care, we plan to provide other services, such as obstetrical massage, prenatal classes and mother baby photography. The great thing is…

Read More

Family Planning

Birth control becomes increasingly complicated with each advancement. Today, there are more methods of contraception available than ever, and finding the method that works best for you can be a challenge. At Triangle Physicians for Women, we offer a wide variety of family planning options to fit the needs of each individual. These options range…

Read More

Specialized Surgeries

Our doctors are experienced in a variety of gynecological techniques. We are trained in basic gynecologic surgery, advanced laparoscopy, specialized surgery for female incontinence & pelvic prolapse, as well as in advanced surgical techniques for the treatment of infertility, including tubal ligation reversal and Essure/Adiana reversals. With our training and experience, we are able to…

Read More

Bio-identical Hormone Replacement

Have you lost all interest in sex?  Help is here to improve your sexual health. You don’t have to be a patient of Triangle Physicians for Women to be diagnosed and treated using bio-identical hormone replacement therapy.  Call now for a consultation.

Read More

Nutrition and Wellness Program

We are excited to announce the addition of Nutrition Services by Maria Kennedy, MPH, RD, LDN.  Our nutrition care includes complete nutrition assessments and individualized nutrition care plans for patients based on their needs, medical conditions and lifestyles. Specializing in the following: ·         General nutrition/wellness ·         Diabetes/Gestational Diabetes ·         PCOS ·         Weight Loss ·         Chronic…

Read More

Lisa Marguerite Grana, M.D., F.A.C.O.G.

Lisa Marguerite Grana, M.D., graduated Cum Laude with distinction in Psychology from Duke University and went on to receive her medical degree, with honors, from the University of North Carolina School of Medicine.  In 1992, she was a resident of Obstetrics and Gynecology for the University of Colorado Health Sciences Center and was Administrative Chief…

Read More

Gerald G. Mulvaney, M.D., F.A.C.O.G.

Gerald G. Mulvaney, MD, FACOG graduated from the Boston University School of Medicine in 1978. He completed his residency in Brooklyn, New York at King’s County Downstate Medical Center in 1982. He then moved to Goldsboro, North Carolina and opened a private practice.

Read More

Sameh K. Toma, M.D., F.A.C.O.G.

Dr. Toma graduated from University of North Carolina at Chapel Hill School of Medicine in 1988 and completed his residency there in July 1992. During his residency he conducted significant research in and has published several articles about infertility, endometriosis, and fetal well-being. Dr. Toma, who holds an undergraduate degree in electrical engineering, used his…

Read More

Vijay Sheshadri, MD, FACOG

Vijay Sheshadri, MD, FACOG is board certified in obstetrics and gynecology and has been practicing since 1995.  Originally from Ohio, Dr. Sheshadri earned his undergraduate degree from The Ohio State University and went on to get his Doctor of Medicine from the Medical College of Ohio.  He attended the  University of Louisville for his medical…

Read More

Spyro Vulgaropulos, MD, FACOG

Spyro Vulgaropulos, MD, FACOG graduated from the University of North Carolina at Chapel Hill with honors in 1988 and completed his obstetrics and gynecology residency at UNC in 1992. He is board certified in obstetrics and gynecology. Dr Vulgaropulos returned to Raleigh to join Triangle OB/GYN after practicing for five years with the Fallon Clinic…

Read More

Jessica Ramirez-Trower, CNM, MSN

Jessica Ramirez Trower, CNM, MSN relocated to Cary, NC from Coral Springs, Florida.  She graduated from Broward Community College School of Nursing in 1995.  She received her Bachelor of Science degree in Nursing, with honors, in 1997 from Florida International University.

Read More

Heather L. Helton, CNM, MSN

Heather Helton, CNM, MSN, began working in obstetrics in 2001.  As a Certified Nurse Midwife, Heather enjoys working in Triangle Physicians for Women’s positive, collaborative and open-minded clinic environment.

Read More

Katie Calvillo, CNM, MSN

Katie Calvillo, CNM, MSN has been a Nurse-Midwife and Women’s Health Nurse Practitioner since 2006.   After receiving her Bachelor of Science in Mathematical Science at UNC-Chapel Hill, Katie worked in actuarial consulting before returning to school to pursue a career in women’s healthcare.

Read More

Mary Charles Sutphin, CNM

Mary Charles Sutphin, CNM has been a nurse-midwife for more than thirty years. She joined Triangle Physicians for Women in the Fall of 2008 after having practiced midwifery in the Raleigh area for 25 years. Prior to that, she practiced in Beckley, West Virginia where she was one of the first nurse-midwives to be licensed…

Read More

Maria Kennedy, MPH, RD, LDN

Maria completed her undergraduate degree in Food Science with a minor in nutrition in 1993 and completed her Master of Public Health – Nutrition Degree from the UNC School of Global Public Health in 2012. Maria is a Registered Dietitian and is a Licensed Dietitian/Nutritionist.

Read More

National Nutrition Month

Maria Kennedy, MPH, RD, LDN No matter what stage of life you are in, proper nutrition is a must. Maria can help you understand how your diet enhances your health.   Let’s get to know more about what an expert like Maria can offer during National Nutrition Month. Registered Dietitian Nutritionist Day Fact Sheet Purpose Registered…

Read More