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.

600 New Waverly Place, Suite 310
Cary, NC 27518

Let’s get to know Dr. Vijay Sheshadri


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.


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. 

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.” 

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.


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.

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:

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.



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!



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! 



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.


Breastfeeding Research – Volunteers Needed

Attention forst time Moms of Triangle Physicians for Women and Midwifery: Laura Fitzwater Gonzlaes is a doctoral student at North Carolina State University in the Department of Sociology.  For her dissertation research she interviewing first-time parents who are planning to breastfeed. This study has been approved by the NCSU Institutional Review Board for the Protection…

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Celebrating National Midwifery Week

Recent research has highlighted alarming gaps between what women say they want from their health care and the services they actually receive. Despite stating they want a health provider who will discuss and offer family planning and birth options, a survey of more than 1200 women throughout the United States conducted by the American College…

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New Classes Being Offered at Triangle Physicians for Women

We are excited to announce a new partnership with Karissa Binkley of The Birthing Nest.  Karissa will be offering classes to Triangle Physicians for Women patients.  Sign up now for the first class, Comfort Measures in Labor, scheduled for Friday, July 12th at our office on New Waverly Place.

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General Nutrition and Wellness Resources

GENERAL INFORMATION Healthy eating http://www.choosemyplate.gov/healthy-eating-tips.html http://www.eatright.org/Public/ Nutrition information for vegetarians &vegans http://www.choosemyplate.gov/healthy-eating-tips/tips-for-vegetarian.html http://www.choosemyplate.gov/food-groups/downloads/TenTips/DGTipsheet8HealthyEatingForVegetarians.pdf Meal Planning http://www.mayoclinic.com/health/meal-planning-tips/MY01734/rss=10 http://www.cdc.gov/healthyweight/healthy_eating/meals.html http://www.webmd.com/diet/healthy-kitchen-11/brown-bag-lunches How to read nutrition labels http://www.mckinley.illinois.edu/Handouts/nutrition_labels/nutrition_labels.html Tips for eating healthy when dining out http://www.choosemyplate.gov/healthy-eating-tips/tips-for-eating-out.html Healthy sample menu & recipes http://www.choosemyplate.gov/healthy-eating-tips/sample-menus-recipes.html http://www.mayoclinic.com/health/healthy-recipes/RecipeIndex Healthy cooking – recipe substitutions http://www.mayoclinic.com/health/healthy-recipes/NU00584    http://www.mayoclinic.com/health/healthy-recipes/NU00585 Exercise /physical activity http://www.choosemyplate.gov/physical-activity.html Info on artificial sweeteners http://www.mayoclinic.com/health/artificial-sweeteners/MY00073

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Nutrition and Wellness in Pregnancy

NUTRITION & WELLNESS IN PREGNANCY Preparing for pregnancy – Healthy Habits http://www.umm.edu/pregnancy/000102.htm Info on folate/sources: http://www.womenshealth.gov/publications/our-publications/fact-sheet/folic-acid.pdf Nutrition in pregnancy http://www.choosemyplate.gov/pregnancy-breastfeeding.html http://www.mayoclinic.com/health/pregnancy-nutrition/PR00108 Food Safety www.mayoclinic.com/health/pregnancy-nutrition/PR00109 http://www.webmd.com/baby/features/foods-to-avoid-when-youre-pregnant http://www.choosemyplate.gov/pregnancy-breastfeeding/food-safety.html Preventing listeriosis http://www.choosemyplate.gov/pregnancy-breastfeeding/baby-safe-from-listeriosis.html Which fish to eat/not to eat during pregnancy http://epi.publichealth.nc.gov/oee/mercury/safefish.html Calculate how much weight should you gain during your pregnancy http://www.choosemyplate.gov/pregnancy-breastfeeding/pregnancy_weight_gain.aspx Exercise during pregnancy http://www.webmd.com/baby/guide/exercise-during-pregnancy Nutrition therapy…

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Gestational Diabetes

GESTATIONAL DIABETES http://www.cdc.gov/pregnancy/diabetes-gestational.html Ways to reduce risk of type II diabetes after having gestational diabetes http://www.diabetes.org/diabetes-basics/prevention/checkup-america/gdm.html http://www.ndep.nih.gov/media/FS_Post-GDM.pdf Snack ideas for diabetes management http://www.diabetes.org/food-and-fitness/food/planning-meals/snacks/ Recipes for diabetes management http://ndep.nih.gov/media/MQC_recipebook_english.pdf http://www.mayoclinic.com/health/diabetes-recipes/RE00091 Exercise & Diabetes http://www.mayoclinic.com/health/diabetes-and-exercise/DA00105

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Nutrition Therapy and Specific Nutrients

NUTRITION THERAPY & SPECIFIC NUTRIENTS Weight loss http://www.choosemyplate.gov/weight-management-calories.html http://www.webmd.com/diet/guide/health-and-diet-eating-healthy Iron deficient anemia & food sources of iron http://www.webmd.com/a-to-z-guides/iron-deficiency-anemia-topic-overview http://ods.od.nih.gov/factsheets/iron/ Sources of Calcium http://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/ Sources of Vitamin B-12 http://ods.od.nih.gov/factsheets/vitaminb12/ Polycystic ovarian syndrome http://www.eatright.org/Public/content.aspx?id=11182 Wellness information for menopause http://www.webmd.com/menopause/guide/staying-healthy-through-good-nuitrition

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What You Need to Know About Endometriosis

What is Endometriosis? Endometriosis is a condition in which the endometrial tissue, which should line the inside of the uterus, grows on the outside of the uterus – sometimes causing infertility. Endometriosis presents itself in many ways, some women have chronic pelvic pain, some experience infertility, and others may have no symptoms and the diagnosis…

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Birth Control Options

Dr. Spyro Vulgaropulos discusses some of the different birth control options available for patients at Triangle Physicians for Women.

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How to create a birth plan.

Certified Nurse Midwife Heather Zeidler discusses how a woman can devlop her birth plan with expert guidance from midwives and OBGYNs at Triangle Physicians for Women.

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Have you really seen your baby yet in utero?

Triangle Physicians for Women offers 3D/4D Ultrasound of your baby so you can get a really good look at his or her beautiful face. 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…

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Pelvic Pain Diagnosis/Treatment

Pelvic Pain Diagnosis/Treatment Pelvic pain is an uncommon but significant problem in some women. Careful assessment of pelvic pain with a reasonable diagnosis and comprehensive treatment program is the first step toward relief and return to function. Studies Show: Nearly 15% of women aged 15-50 in the U.S. suffer from chronic pelvic pain 10% of…

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DaVinci Robotic Surgery Now Through Triangle Physicians for Women

Triangle Physicians for Women’s Dr. Spyro Vulgarolpolus and Dr. Lisa Grana offer the most advanced, least invasive surgery using the DaVinci Surgical System at WakeMed Cary Hospital . Only da Vinci overcomes the limitations of both traditional open surgery and conventional minimally invasive surgery. The da Vinci System is a sophisticated robotic platform designed to…

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Privacy Policy

Triangle Physicians for Women values the importance of maintaining the privacy of your individually identifiable health information (IIHI). When you visit our practice, we will create records regarding your health and the treatment and services we provide. We are required to maintain the confidentiality of health information that specifically identifies you. We are also required…

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Medical Records

Obtaining medical records requires that you sign a medical records release. This can be done at our office or at the office of your next provider. We provide this service to you or your future doctor at no charge.

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Information about our fees, accepted methods of payment and forms.

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At Triangle Physicians for Women, we accept a variety of insurance plans. If we participate with your insurance company, we will require you to pay your deductible or co-payment at the time of treatment, and we’ll file your claim for you. If we do not participate with your insurance company, you will be required to…

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Although our website is that of a medical practice, please do not use any of the information found here in lieu of seeing a professional. To the best of our knowledge, the information provided here is true and accurate. However, some of the content may not be as current as possible. Please contact our office…

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Information for understanding our legal requirements pertaining to your personal information.

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Hospital Affiliations

At Triangle Physicians for Women, we are affiliated with WakeMed Cary Hospital and Rex Surgery Center of Cary. We chose to work with WakeMed because of their family-first. Here, mothers giving birth are able to make choices during labor, delivery, recovery and postpartum care. WakeMed also has a highly-skilled team of professionals who are prepared…

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Disease and Diet: Outsmart Your DNA Destiny

If modern science has taught us anything, it’s how powerful genes can be. Their crazy-complicated codes inform everything from our intelligence to our height to our health future. But emerging research in an exciting field called epigenetics is pointing to a game-changing fact: Through certain behaviors, we might be able to redirect our destiny and…

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Our Services

Service Headline One If modern science has taught us anything it’s how powerful genes can be. If modern science has taught us anything it’s how powerful genes can be. Read More → Service Headline Two If modern science has taught us anything it’s how powerful genes can be. If modern science has taught us anything…

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Baby Gap Yields Unique Challenges and Rewards

Courtesy of Carolina Parent Magazine July 2011 Featuring Triangle OBGYN’s Dr. Spyro Vulgaropulos It isn’t unusual to see moms in their late 30s and early 40s sporting a baby bump while cheering on an older child’s athletic endeavors. Families raising children with large age gaps between siblings often have one foot in teenage tirades while…

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Triangle OBGYN Medical Team Performs Follow-up Cancer Surgery on Gorilla

 September 10, 2008; Cary, NC – A team of medical  professionals from Triangle OBGYN and Duke University Medical Center successfully performed a difficult and  intricate surgery August 27, 2008 on “Donna,”  a 39 year old, female Western Lowland Gorilla who lives at the North Carolina Zoo in Asheboro, NC. Senior Veterinarian Ryan De Voe, DVM…

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New VBAC Guidelines

The cesarean delivery rate in the United States has increased from 4.5% in 1965 to 32.3% in 2008 (Guise JM, 2010). Meanwhile, the rate of Vaginal Birth after Cesarean (VBAC) has decreased from its peak of 28.3% of all women with a prior cesarean delivery in 1996 to the most recent rate of just 8%…

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Urinary Incontinence Treatment

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…

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