Wednesday 9 November 2016

Frequently Asked Questions: Pregnancy

Even a healthy pregnancy can be a difficult and confusing time. Your body goes through so many changes, some of which can catch you off guard! Friends and family, thankfully, have lots of advice. However, some questions can be a bit embarrassing and, when you’re at the OBGYN, you may be too overwhelmed to remember every question. Don’t worry! We have answers to your women’s health questions.

How do I tell if I’m pregnant?

Early signs of pregnancy include:

1.       Fatigue
2.       Nausea
3.       Frequent urination
4.       Change in appetite
5.       Morning sickness
6.       Breast swelling
7.       Missed period

How are due dates calculated?

The average pregnancy is 266 days from your last ovulation cycle. That is about 40 weeks. If you aren’t sure about your due date, ask your OBGYN! They will be able to tell you.

Can I have sex while pregnant?

Unless your OBGYN has specifically told you not to have sex during your pregnancy, it is absolutely safe to do so. Your baby is protected by an amniotic sac, uterus, and mucus plug in the cervix.

Do I have to take prenatal vitamins?

Yes! Pregnancy is rough on your body. You will need additional vitamins and minerals to protect your body and support your baby. It’s important that you talk to your OBGYN about what vitamins are best for you. There are many options so take some time to find what’s right for you.

Is this heartburn normal?

The combination of increased progesterone and a growing uterus can cause heartburn. There are some ways to try to prevent this however.

1.       Smaller, frequent meals
2.       Walk after meals
3.       Elevate your head and chest while sleeping
4.       Wear loose clothes
5.       Drink ginger root tea
6.       Take antacids

How do I prevent stretch marks?

Stretch marks are incredibly common in pregnancy. Around 90 percent of pregnant women develop them! If you want to avoid being part of that majority, then make sure to drink lots of water, eat a diet high in skin-supporting vitamins, and massage your stomach daily with a moisturizer.

Can I exercise while pregnant?

Unless your obstetrician specifically tells you not to, you can remain active during your pregnancy. Low impact exercises are fine. This includes things like aqua aerobics, walking, tai chi, and yoga. Exercises that involve jumping and contact sports, however, should be avoided.

What is gestational diabetes?

Gestational diabetes is a temporary type of diabetes which develops in some pregnant women. It is caused by the placental hormones. In most cases, a pregnant mother’s pancreas produces around three times as much insulin as normal. This is necessary because the pregnancy hormones impact blood sugar levels. If the pancreas can’t keep up, gestational diabetes can develop.

Anyone pregnant can get gestational diabetes. However, there are some risk factors that increase your odds of developing it. These risks include:

1.       Age
·         Over 25 years old
2.       Race
·         African American
·         Native American
·         Hispanic
·         Pacific Islander
3.       Family history
·         Relative with diabetes
4.       Weight
·         Overweight
·         BMI over 30
5.       Past medical history
·         Had gestational diabetes before
·         Had a precious big baby (macrosomia)
·         Has polycystic ovarian syndrome (PCOS)

Why can’t I control my bladder anymore?

Urinary incontinence is very common during pregnancy. Your baby takes up a lot of space in your torso and can put a lot of pressure on your bladder. This pressure can cause an overwhelming urge to go to the bathroom. Additionally, as the muscles around your uterus stretch out, you can lose some control. Weakened pelvic muscles can cause minor leaks for a few months after giving birth as well.

What is the difference between a gynecologist, obstetrician, and an OBGYN?


Gynecologists deal with a wide range of women’s health concerns. These range from pap smears to STD screenings to breast exams. Obstetricians deal specifically with pregnancy. They will care for you from your first prenatal testing to follow-up after delivery care.

Monday 3 October 2016

Thinking of getting CoolSculpting? Here's what you should know

Cryolipolis or CoolSculpting is a procedure performed by doctors and aestheticians to freeze fat cells at specific targeted areas in your body from where these frozen and dead cells are removed naturally. This is considered to be a better option than liposuction as it is way cheaper and gives good results without any incisions. It also, has no downtime and you can easily revert back to your office or to physical activities. The results of CoolSculpting can be seen after a few weeks and sometimes they may take up to three months.

Despite regular exercise and eating healthy, we all have the 'troubled areas' on our bodies. In fact, a lot of people have pockets of fat stored in certain regions of their body which is genetically determined.

By body contouring the size and appearance of certain parts of your body will reduce permanently. This is achieved by killing all the fat cells that exist in the problem area. Now, if there are no fat cells, they cannot expand and make the body part look bigger and out of proportion. But, it is important to note that body contouring only reduces about 20 to 25 % of fat cells from that portion of your body and around 70% of the cells are left unaffected. The fat cells that have been treated will not grow back but the remaining fat cells may expand and cause you to gain weight if a good diet and exercise regimen is not followed.

Coolsculpting is considered to be better than ultrasound and other heat-based fat reducing treatments as it explodes the targeted fat cells to remove them permanently without causing any bruising and soreness.

The CoolSculpting treatment should not be assumed to be a weight loss treatment. It is aimed at people who live an active and healthy lifestyle and require a treatment aiming at certain parts of their body and not the entire body.

Here are some important things you should know about CoolSculpting.

1.       CoolSculpting cannot be used to improve your skin laxity. If you skin is lose, this treatment will not help it, in fact, removing fat cells may cause more sagging of skin.

2.       It is one hour procedure for one part of your body. In case, of fat cells removal from the arms, it will take two hours targeting each arm separately.

3.       This procedure is not pain-free, as marketed and can be very uncomfortable during the first five to fifteen minutes of the procedure when vacuum grabs on to your fat and skin.

4.       The treated area appears to be like a stick of butter or a piece of salmon underneath your skin, right after the treatment. It gets weirder as this can easily be massaged down.

5.       To achieve a reduction of 20-25% fat from a body part only one treatment is required but if you opt for more, an additional 20-25% fat reduction can be observed each time, from that area of your body.

6.       In a number of cases, the first time of CoolSculpting may not give you visible and desired results and you might need to go for the second round of CoolSculpting to get what you want.

7.       Recovery time may vary between a few days to a few weeks depending on the patient and is accompanied with soreness and a little bit of bruising, tingling and swelling.

8.       The complete results may take up to a few months to show up varying between a few days to four to six months. This again depends on from patient to patient.

It is important to keep following a healthy diet and exercise regime even after the treatment. If you gain weight after undergoing CoolSculpting, the fat cells already present in the area where the procedure was performed may swell up and reduce the visibility of the results.

Wednesday 28 September 2016

All you need to know about post liposuction care

Liposuction is surgically performed by creating incisions in your body to remove stubborn fat localised at one part of your body, that doesn't go with either diet or exercise. Liposuction incisions are minimally invasive but they still require care post operation for complete and healthy recovery. Liposuction is performed by the insertion of a cannula through an incision. It is then moved around to loosen up the fat localised in that area of the body and then it is sucked out with the help of vacuum created in a syringe.

It is important to note that liposuction cannot be substituted to weight loss through diet and exercise and hence, should not be treated as such. For tightening of loose and sagging skin and the removal of cellulite from the body, there are many other procedures that can be performed, as liposuction is not the best option for these issues.

It is absolutely vital for the patient to take measures to care for the incisions made on their body after the procedure because infection and scarring can easily occur and cause undesirable results.

Things required for the post-op liposuction care:

·         Comfortable and loose clothing
·         Dark towels for the absorption of any leaking fluids
·         Pillows are required to rest the area with incisions to rest upon
·         Bottled water
·         Soda crackers to treat nausea if any
·         Pain medication

What to expect during the first 72 hours after the surgery

1.       Body fluids will flow out on clothes and sheets you sit on or sleep on. This is very normal as this liquid is placed in your body before the procedure is performed for the safe removal of fat.

2.       Physical activities must be avoided on account of the danger of opening of the incisions.

3.       Compression garments help with swelling and also make the recovery process faster. These must be worn at all times except while taking a shower and can be discontinued after being instructed by your doctor to do so.

4.       It is important to keep moving in order to reduce swelling, reduce the formation of blood clots and to help keep bodily fluids to continue moving.

5.       As soon as the anaesthesia wears off, there will be some pain. In case it is unbearable, you must go to your physician who will prescribe some painkillers to combat the pain.

6.       Swelling is very normal and in many cases, the swelling stays on for the next few weeks (two to three weeks).

7.       A number of plastic surgeons suggest avoiding showering for five days after the surgery and wearing compression garments. After five days, you can shower without causing abrasion or scrubbing in the area of the incision. Also, going in still water (swimming pool, baths, lakes, oceans, hot tubs etc.) must be avoided.

8.       Also, be alert for any signs of infection. If they come up, you must go directly to your surgeon without any delay.

9.       Even after complete recovery, there will be scars, usually very small in the place where the incision had been made. For the most part, they are not very visible and will fade even more as time passes.

Results after complete recovery:

Cosmetic enhancement is the main reason why most people go for this procedure, despite the risks of complications and pain. A lot of patients report positively after the procedure, having obtained the look they've wanted but in a lot of cases, patients remain unsatisfied. The cosmetic result

1.       Scars at the spot where the cut is made to insert the cannula to carry out the liposuction. They are generally very small and will fade away with time but in some cases, these scars may more prominent.
2.       A wavy or bumpy appearance of the liposuction site after the liposuction procedure.
3.       The results after liposuction are very rarely permanent. In case you gain weight after the liposuction surgery and the removal of fat, it may return back to the sites from where it had been removed.

4.       The results after recovery may not be at par with your expectations which can be disappointing.

Monday 26 September 2016

Thinking of getting a breast reduction? Here are some pros and cons

A breast reduction surgery is done to make your breasts look more proportionate as compared to the rest of your physique and it is also done when there is discomfort caused due to them. It is not always true, that beautiful breast means bigger breasts. This procedure is extremely common despite popular notion and is done to relieve any kind of physical pain and to instil confidence in the person who otherwise felt burdened due to their huge breasts.

How do you know if you need Breast Reduction?

1.       When your breasts dis-proportionally become large for your body and cause back, shoulder and neck pain.
2.       When your breasts are very heavy and have the nipples and the areolas pointed in the downward direction.
3.       If the large appearance of your breasts cause emotional burden and lowered confidence level.
4.       If one of your breasts is larger in size or is different in its orientation or shape than the other.
5.       If the large size of your breasts causes difficulty in breathing and your bras squeeze your skin to form grooves on your shoulders with your bra straps.
6.       If you have developed bad posture and are extremely unhappy with how you look overall.

Are you a Good Candidate?

1.       You suffer from one or more of the problems due to excessively large breasts from the list listed above.
2.       It is almost impossible to find bras and other clothing materials that will fit you around your chest.
3.       You are healthy and have no existing or previously existing health diseases, especially heart or lung related.
4.       Your skin has the required amount of elasticity to jump back to the reduced size of your new breasts.
5.       You must be emotionally stable because breast reduction is a major surgery and it is important that the patient is ready, emotionally for it and is patient.
6.       You must know all the facts as discussing every detail of your surgery with your doctor is very important. With knowing the facts, a realistic expectation is an important criterion for deciding if you are a good candidate for this surgery.
7.       If you want to have kids in the future, this surgery can damage the milk flowing process if not the mammary glands and cause problems. It is a complicated process and this kind of complication can occur.
8.       You must be well past puberty and not in the stage of breast development anymore, for a good candidature.

What are some of the Disadvantages of Breast reduction Surgery?

1.       You may develop problems in breastfeeding if you have a baby in the future. This procedure can easily cause damage to the milk flow system. Although, the mammary glands will not be harmed by the surgery but this can still cause issues while breast feeding.
2.       It can leave visible scars and bruising which will take a lot of time of reducing or completely vanish.
3.       A few women also complain of different sized or shaped nipples after the surgery. This unevenness may not be very prominent but this kind of complaint comes along once in a while.
4.       After the procedure, you may experience decreased sensation in areas around your nipples and areolas. This happens because breast reduction surgery can damage the nerves around your nipples.

Click Here For More Information about Breast Reduction Surgery.

Tuesday 20 September 2016

Flu Season Means Urgent Care Season!

Flu season, flu season, flu season! Every year, we are inundated with messages reminding us to be cautious about flu season. It is so easy to get overwhelmed by these messages and start tuning them out. Everyone knows people tend to get sick when the weather gets cold but, in South Texas, we stay happy and warm. That means we don’t have to worry, right?

Unfortunately, that’s not the case. Flu season doesn’t match the temperature so, even though San Antonio might miss out on snow, we Texans are at risk for illness. If you are going to protect yourself and your family, you’ll need to know what you’re dealing with this flu season.

What is flu season?

Flu season is the period of time when large numbers of people come down with the flu. Unlike the traditional seasons, it is unpredictable in length since it is based on viruses, rather than weather. It also varies between countries.

Generally speaking, for the United States, flu season goes from October to May. It tends to be in full swing from December to February.

Who should get a flu shot?

Getting a flu vaccine is strongly recommended by the CDC for everyone 6 months or older. However, there are some “high risk” groups who should absolutely get the flu shot. These individuals are the ones who, if not treated, could become the sickest and potentially die from the flu.

1.       Children ages 6 months to 4 years
2.       Anyone over 50 years old
3.       People who are immunosuppressed
·         Human immunodeficiency virus (HIV)
·         Immunosuppression caused by medication
4.       People with chronic health problems like:
·         Chronic pulmonary disorders
·         Cardiovascular disorders except hypertension
·         Renal disorders
·         Hepatic disorders
·         Neurologic disorders
·         Hematologic disorders
·         Metabolic disorders
5.       Children age 6 to 18 who are on long-term aspirin therapy
6.       Women who are pregnant
7.       Women who may become pregnant during flu season
8.       Seniors in nursing homes
10.   Anyone who is morbidly obese
11.   Healthcare personnel
12.   Caregivers for children under 5 years old
13.   Caregivers for seniors over 50 years old
14.   Caregivers of individuals with medical conditions that put them at risk for severe complications from flu exposure

Getting the vaccine is an annual event. Each year, the viruses are slightly different. Just because you got the previous year’s shot doesn’t mean you are protected this year. Preventing yourself from getting sick this flu season means treating this year as its own brand new process.

Please note that it takes two weeks after getting the shot for the treatment to become effective. Should you encounter anyone suffering from the flu during that time or if you already had the virus inside you prior to the shot, then it will not be effective.

What is the difference between a cold and the flu?

When you aren’t feeling well, it’s unfortunately difficult to tell the difference between a cold and the flu. Here are the major points that you need to keep in mind when assessing your symptoms.

1.       Body aches
·         Cold: Body aches are unusual with a cold, although not impossible.
·         Flu: Almost every case of the flu is accompanied by body aches. These aches can be very severe for some people. This is a good way to identify if what you are experiencing the flu, as opposed to a cold.
2.       Congestion, runny nose, sore throat, sneezing
·         Cold: Almost everyone with a cold ends up with some sort of nasal symptom.
·         Flu: It is not unheard for someone with the flu to have these symptoms. However, it is not a requirement of the flu.
3.       Exhaustion
·         Cold: Someone with a cold may be more tired than usual but it will not be severe.
·         Flu: Someone suffering from the flu will almost always experience extreme exhaustion.
4.       Fever
·         Cold: It is unusual, but not unheard of, for someone with a cold to experience a fever.
·         Flu: The flu almost always causes those infected to suffer a fever.
5.       Headache
·         Cold: Sometimes a cold is accompanied by headache.
·         Flu: Flus are usually accompanied by headaches.
6.       Location of symptoms
·         Cold: If you feel your symptoms above the neck, you likely have a cold.
·         Flu: If you feel your symptoms throughout your entire body, you likely have the flu.
7.       Typical duration
·         Cold: A cold will last about a week.
·         Flu: The flu will last one to three weeks.

Should I visit a doctor?

While you are still healthy and before flu season is in full swing, it is important to make the time for a quick flu shot. It’s easy to let this errand get away from you but, once you are infected with the virus, your options are much more limited. It is easier to prevent the flu from happening than it is to get rid of once it is here.

If you are concerned that you already have the flu, then you need to visit a doctor quickly. There are prescription medications that can decrease the severity of your flu. However, you must begin treatment during the first 48 hours of becoming sick. Waiting longer will mean the medicine has no impact on your symptoms and recovery time, forcing you to simply tough it out through your flu.
Whether you are still healthy or already feeling bad, an urgent care clinic can be your best friend. It’s unlikely that your primary care physician can get you in quickly enough to provide the medication you need when suffering from the flu. Most people with the flu, thankfully, don’t get sick enough to need to visit the emergency room.


Urgent care clinics fill the space between these two options. You can get in quickly for a shot or medication. There are also no shortage of urgent care clinics in San Antonio! Gonzaba Urgent Care, for instance, has three locations across the city.

Saturday 17 September 2016

Menopause: What To Expect When You Stop Expecting


What is menopause?

More than likely, you’ve already heard of menopause, especially if you are female. Menopause is the 12-month period after the end of your final menstrual period. It is the end of the menstrual cycle. After menopause, a woman can no longer get pregnant.

The process of menopause is completely natural. While no longer fertile, women are still healthy post-menopause. Aging changes everyone’s bodies. Women simply have certain health issues specific to them.

What is perimenopause?

Menopause does not happen all at once, except in cases of hysterectomies. Perimenopause is the period of time winding down the menstrual cycle. This period of time can vary wildly between individuals. In some cases, it may begin 8 to 10 years prior to menopause! In other cases, however, women go through perimenopause in a few months.

The best way to gauge what is normal for you is to talk to your family members. Everyone is an individual but the older women in your family will have a unique insight into what you can expect. Genetics make a difference! Your friends may have helpful tips and tricks but relatives know what experiences your genes may predispose you to experiencing.

During perimenopause, your ovaries will produce less and less estrogen until they finally stop releasing eggs. That is when perimenopause changes into menopause.

What is postmenopause?

After a woman has not experienced her period for a year, she is considered postmenopausal. There are positives and negatives to being postmenopausal. The symptoms suffered during menopause will lessen and a woman can no longer get pregnant, which some consider a relief. However, the lower levels of estrogen can result in some health issues for women. Osteoporosis and heart disease are both more likely for woman who have completed menopause.

What are the symptoms of menopause?

For most women, the major symptoms of menopause are well-known. They include, but are not limited to:

  1. ·         Irregular periods
  2. ·         Night sweats
  3. ·         Hot flashes
  4. ·         Mood change
  5. ·         Weight gain
  6. ·         Slowed metabolism
  7. ·         Thinning hair
  8. ·         Dry skin
  9. ·         Vaginal dryness


Not everyone will experience every symptom. It is similar to menstruation in that, depending on your body, the instance and severity of each symptom will vary. Some women will menstruate every month until perimenopause completes; however, this is rare. It’s far more common for periods to occur sporadically throughout perimenopause. Because of this, it is still possible to get pregnant during perimenopause.

Who experiences menopause?

Everyone who menstruates will eventually go through menopause. While genetics play a large role in determining what is “natural” for your body, the average age for experiencing menopause is 51. If you are under the age of 40 and start going through menopause, this is referred to as premature menopause.

Premature menopause may occur for a number of reasons. The most obvious of which is if a woman has her ovaries removed in a bilateral oophorectomy. The sudden removal of ovaries will result in the immediate loss of the hormones they were producing. Due to the sudden nature of this hormonal change, the symptoms can be severe. It is especially important to keep a doctor up to date on your symptoms if you go through surgical menopause, as opposed to natural menopause.

Premature menopause may also be caused by chromosome defects, autoimmune diseases, and chemotherapy. Women who are receiving radiation treatment for ovarian cancer may stop their periods and experience fertility issues. The damaged caused to the ovaries by chemotherapy or radiation shouldn’t be underestimated so, prior to beginning those treatments, make sure to speak to your oncologist about your women’s health concerns.

Is hormone replacement therapy unhealthy?

Once, hormone replacement therapy (HRT) was standard. However, that is no longer the case. Many women have heard that hormone replacement therapy is dangerous for their health. Unfortunately, there is not a simple yes-or-no answer. Every body is different. Not every woman needs hormone replacement therapy. Some research suggests that, if taken early in postmenopause, estrogen can decrease the risk of heart disease.

There are some risks, of course. Estrogen, when not balanced with progesterone or progestrin can cause growth in the lining of the uterus, increasing a woman’s risk of uterine cancer. Other risks include heart disease, stroke, blood clot and breast cancer.

However, women who experience early menopause and do not take hormone replacement therapy are at risk for anxiety, depression, osteoporosis, coronary heart disease, parkinsonism, and decreased lifespan.

You should consider hormone replacement therapy if you are healthy and experience moderate to severe menopause symptom or have experienced bone loss.

Do I need a doctor?


While menopause is a natural process, that doesn’t mean it should go unmonitored. As your body changes, you need to make adjustments for your new hormonal reality. Additionally, your healthcare provider can help ease your symptoms to help menopause hit you a little less hard. For some women, menopause isn’t a big deal but, for others, it can be rough. Do not hesitate to ask for help! Places like the Institute for Women’s Health in San Antonio, Texas can help.

Sunday 11 September 2016

Tummy Tuck

Are sit-ups not giving you the flat stomach you want? If you've got too much excess skin in your abdomen that is not responding to diet or exercise, you may need to start considering  a tummy tuck, or what doctors call abdominoplasty.

A Tummy tuck is a surgical procedure that helps flatten and shape the abdomen and waist by removing excess fat and skin and then tightening the underlying muscles. This procedure it's not the same as liposuction (the cosmetic surgery that is used to remove fat deposits). A tummy tuck is very useful for women who have stretched abdominal skin and muscles as a result of pregnancy. It is also a great option for men and women who were once obese and lost a lot of weight. As a result, they may have excess fat deposits or loose skin around the belly. To be a candidate for the tummy tuck procedure, you should be in good physical condition, following a healthy diet, and exercise regularly.

If you're a somebody who plans to get pregnant, the best thing to do is postpone the tummy tuck until you're done having children. During surgery, your vertical muscles are tightened, and future pregnancies can separate those muscles. If you are planning on losing a lot of weight, a tummy tuck is also not a great solution for you. This procedure should be a last resort after you've tried everything else. It should not be used as an alternative to weight loss.

The recommendation is that you wait until after any planned pregnancies and have reached your goal weight before undergoing tummy tuck surgery. This is because further pregnancies or weight loss can undo the results of your tummy tuck by stretching the skin. Another recommendation is that your BMI (Body Mass Index) should be less than 30 to decrease your risk of complications.

During your initial consultation, you should will your cosmetic goals in detail, so the surgeon can tailor your tummy tuck operation accordingly.

Prior to the surgery if you smoke, you will have to stop for a certain period as determined by your doctor. It is not enough just to cut down on smoking; you must stop completely for at least two weeks before the surgery and for two weeks after the procedure. Smoking can increase the risk of complications and delay healing.

The surgery takes approximately 2 to 3 hours under general anesthesia which will put you to sleep during the whole procedure. It is important to have someone who can drive you home once the operation is over and at least during the first night you will need somebody to stay with you. The surgeon will make an incision from hip to hip, and then cut out all the skin between your belly button and pubis. During your tummy tuck, there will be a separation of the skin from the rectus muscles, and then the surgeon will pull and stitch the muscle together, for a firmer abdomen and a narrower waist. After that the surgeon will stretch the skin flap down and over the newly tightened muscles, cut out the extra skin, and reconnect the belly button. There will usually be a couple drains in place to drain any extra fluid once the procedure is done.

Full recovery from a tummy tuck operation usually takes a period of four to six weeks, although you may be able to return to your daily activities in as little as two weeks.  After the procedure is useful if the patients walk for 10 to 15 minutes every 2 hours after the procedure.

Life after the surgery should be really good. With a good diet and being active by regularly exercising, results from your tummy tuck should be long-lasting. While the full tummy tuck will naturally leave a hip-to-hip scar across the lower abdomen, you can always talk about scar placement and length with the doctor before the surgery.

Post-operative complications from any surgery are possible. This may include infection, blood clots, and poor healing which may require further surgery. You can minimize these risks by choosing an experienced surgeon such as Dr. Koneru in San Antonio, who can handle any complications and will give you the attention you need.

If you have had previous abdominal surgery, your old scars could be moved, stretched, or generally more noticeable after the procedure. However, if your scar is below the belly button, it will probably be removed during the tummy tuck operation.


If what you are looking for is just the removal of skin excess and fat, a mini tummy tuck is a good choice for patients. The mini tummy tuck is similar to the full surgical procedure, except that it uses a shorter incision, usually only about 15 cm in length (which is similar to a C-section scar). With this short scar, much less skin can be removed, and the skin is only lifted to the belly button. The mini tummy tuck usually doesn’t remove many stretch marks and can’t correct muscles that have become separated above the belly button.