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HEALTH & WELLNESSThe Obstetrician/Gynecologist:aWoman’sPartner in Good HealthBy Jamie LoberIt is important to establish a relationship with an obstetrician/gynecologist that you feel comfortable with and trust.“We always recommend finding a good medical home. For a woman, it isthe obstetrician/gynecologist who can keep a good record of how you aredoing and your overall health, check blood pressure and remind you aboutgood nutrition,” says Tim O’Connor, spokesman for Palm Beach CountyHealth Department in West Palm Beach.“It is common for us to get patients as teens and deal with sexuallytransmitted diseases and birth control,” said Dr. Tim Puckett,obstetrician/gynecologist with Royal Palm OB/GYN in Coral Springs.“Wemay later see them having children and take care of them when they maywant a tubal ligation. Later on, they may have problems with their periodsor fibroids and occasionally may need more invasive surgeries such as ahysterectomy.Then we transition them into menopause, so we are involvedwith all of the aspects of women’s healthcare.“We give teens information on birth control, sexually transmitted diseases,abusive relationships and vaccines for the HPV virus.”Obstetricians/gynecologists promote smart choices to teens, such asabstinence or using a condom. Often times, there is misinformation ormiscommunication among peers so it is important for them to visit amedical expert. The gynecologist can also help deal with general healthissues that come up.The right obstetrician/gynecologistwill become a patient’s doctorthroughout her life.“Most things young women go through like colds and bladder infectionscan be managed by their gynecologist. We also make sure everybodyis caught up on their vaccines,” said Dr. Phyllis Toon, obstetrician/gynecologist at Toon and Bataskov, MD, PA, in Boca Raton.Any woman who is sexually active and/or 21 and older should see agynecologist annually.“People say they are going to their gynecologist for a pap smear,” Toon said.“That is something that people can relate to, but that is only one of the thingswe do. On every patient, I listen to their heart, lungs, do a breast exam, examinetheir neck for thyroid problems, examine their abdomen, do a pelvic examand a pap smear snuck in there. In older patients, I do a rectal exam routinely.”Preconception counseling is advised in order to prevent birth defects.“Fetal alcohol syndrome, or the mother is drinking during pregnancy, isassociated with the most birth defects.That can be completely eliminated,”Puckett said. “There has been a huge decrease in spina bifida by increasinga woman’s intake of folic acid.”During pregnancy, it is advised to visit the doctor during the first six toeight weeks.“At the first prenatal visit, we take a detailed history of past medical history,genetic history of both partners and try to identify significant testing thatneeds to be performed to make sure the baby is OK,” says Dr. DavidLubetkin, obstetrician/gynecologist at West Boca Medical Center. Anultrasound is done to document the pregnancy and to match it with thedate of your last period.During and after menopause, the gynecologist tries to make things easierfor patients.“We see issues related to vaginal dryness, postmenopausal bleeding andbladder infections,” Lubetkin said.“It is an established fact that when patients get older, their risk for diseasesincreases,” said Dr. Marsh McEachrane, obstetrician/gynecologist atComprehensive Ob-Gyn in Coral Springs.If problems are caught early, they are often treatable.“If we identify someone with a fibroid uterus when the fibroids are smaller,sometimes we can do less invasive treatment such as arrange for a uterinefibroid embolization or some Lupron Depot that will help shrink thefibroids,” Puckett said.“Many of the gynecologic diseases do not have any symptoms, which iswhy it is important to be screened,” Lubetkin said.When it comes to improving the health of women, science and technologyare on women’s side.“The DaVinci robot allows us to do minimally-invasive surgery,”Puckett said.Even hysterectomies and oophorectomies can be done in a way thatallows the patient to go home in 24 hours, and be back to work soon.“We are switching some from the pap smear to HPV testing, so the papsmear is evolving and may not be the standard of care in the future. Some ofthese other modalities may end up replacing it eventually,” Puckett said.92 MAY 2010