Services

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Annual Wellness Exams

Annual Wellness exams are a way to make sure that you take care of your own healthcare needs so you can enjoy a healthful life with your family and friends and continue to look after those you love.

A complete medical and surgical history is very important to your care, and the process begins by completing questionnaires in your Secure Patient Portal. These should be filled out prior to your appointment in the privacy of your own home. Then at your visit we will verify that the information is correct. Medications and allergies will be noted, so bring a list for ease of recording. It helps if you have dosages and how often each medication is taken.

We know them by their names, not by “the little blue square pill for high blood pressure”. We will review your health habits and your obstetric history if applicable, and make recommendations for improving your health and longevity so you can enjoy the life you’ve built and the family and friends you love. After all, that IS why we are here, isn’t it?

We will measure your height and weight and calculate your BMI. Don’t worry, many people aren’t happy with these numbers. We have a program that can help you get where you want to be, and stay there. We also measure your blood pressure and can direct you with tips to keep it normal.

We will see which screening test are due for your age, including screening for such conditions as diabetes, low thyroid, high cholesterol, osteoporosis and colon cancer, as well as doing a pap, if needed, and ordering routine screening mammograms. Normal results will be provided through your secure patient portal. We will contact you with abnormal results and ask that you schedule a visit to discuss them with your practitioner.

Speaking of paps, did you hear the latest? You will be excited to hear that most people don’t need pap smears every year. This is possible because our testing has gotten better with the advent of DNA technology, and testing for the virus we believe is responsible for cervical cancer. So, based on your age and risk factors, pap smears are not recommended before age 21, and from age 21-30, you may need a pap only every 3 years, if all testing is normal. From 30-65 years, you will need a pap and high risk HPV testing just once every five years, if all testing is normal. After age 65, if you meet well-defined criteria, paps are no longer necessary, and if you have had a hysterectomy that includes removal of your cervix, and you did not have your hysterectomy for cervical cancer, you don’t need pap smears ever again. Isn’t that great?

While you may not need a pap each year, it’s not a good idea to skip annual wellness exams! An annual exam includes much more than a pap. You still have breasts, a uterus and ovaries that are examined as part of your annual exam. We also listen to your heart and lungs, assess your thyroid gland and lymph nodes, examine your abdomen and do a thorough skin examination.

Next, we make certain you know which vaccinations are due for your age group and make recommendations for how to get them done.

If we fill your routine medications, such as oral contraceptives, this will be done from the annual wellness exam as well.

If we fill other prescriptions for you, such as for cholesterol, thyroid, depression, anxiety, and hormone balancing please schedule extra time for this when you schedule your wellness visit. Otherwise, we may need to have you return for a separate visit to review how they are working for you, order necessary lab tests, and will refill those medications at a later time.

An annual wellness exam is often a good time to bring up questions and concerns that have arisen during the year. However, we schedule only enough time for your annual health maintenance exam at this appointment. Depending on the complexity of the problem, we may be able to order some tests based on your concerns, and ask that you schedule a visit in a few weeks to go over the results. In some cases the concern may be so complex, that in order to provide you the very best care, we prefer that you schedule a problem-focused appointment a bit later so we can give it the attention you deserve.

Like you, we want to stay healthy, we want to keep you healthy, and we love what we do. We are happy that we are able to provide your routine health maintenance exams, and look forward to your next visit with us.

In-Office Procedures

These are some of our procedures that we offer in-office to assure you are comfortable and getting the best care possible from our team. These are simple explanations of these procedures, please talk to us to learn more.

Colposcopy is recommended if the Pap test suggests further evaluation of the cervix is necessary. These results could show atypical cells, infection with the HPV virus, or pre-cancerous cells. It is best to re-schedule your appointment if you are experiencing heavy menstrual bleeding on the day the exam is scheduled

A colposcope is a microscope which magnifies the cervix. A speculum is placed in the vagina, and a weak vinegar solution is used to bathe the cervix. Your doctor or practitioner will view the cervix with the colposcope.

If abnormal areas are seen, a small tissue sample will be taken and sent to the lab for diagnosis. Results are usually available in 7 working days.  You may experience mild cramping and may take 4 Motrin or 2 Aleve with food one hour prior to the exam.

Avoid intercourse and strenuous exercise for 7 days following the exam. You may bathe or shower as usual.

CRYOSURGERY OF THE CERVIX

Your doctor or practitioner may recommend a procedure to destroy the surface tissue of the cervix after colposcopy results show a mild abnormality (dysplasia). Cryosurgery is a freezing procedure lasting 3-5 minutes.  Mild cramping may occur; you may take 4 Motrin or 2 Aleve with food one hour prior to the procedure.  You may bathe or shower as usual. Avoid intercourse for at least 2 weeks and until the watery vaginal discharge is over.

Endometrial biopsy is done to investigate abnormal bleeding, or as part of an infertility evaluation. Your doctor or practitioner will collect a tissue sample from the lining of the uterus using a thin hollow catheter or a flexible brush.  The procedure will cause cramping for about 5 minutes and then quickly subsides. You may take 4 Motrin or 2 Aleve with food one hour prior to your appointment.  Avoid intercourse or douching for 5 days following the procedure. You may bathe or shower as usual.

The Essure procedure is an innovative sterilization method for women which can be performed in the office without the need for general anesthesia or incisions. It is minimally inconvenient and will allow you to return to normal activities quickly. The ideal candidate for Essure desires  permanent, non-reversible sterilization and wishes to avoid general anesthesia.

Essure involves the placement of a small, flexible microinsert into each of your fallopian tubes using the natural cervical opening for access. Over a three month period, your body tissues grow into the microinserts, and block the tubes. This prevents sperm from reaching and fertilizing the egg, and thus prevents pregnancy.

Because sterilization is not accomplished immediately, alternate contraception must be used during the three months following the procedure. You may use birth control pills, rings, or patches, a depo-Provera injection, foam and condoms, or even abstinence during the 3 month waiting period.  At that time, an X-ray dye confirmation test (HSG) is performed to be certain the tubes are blocked and the microinserts are properly placed. This confirmation test is an important part of the procedure to assure effective prevention of an unintended pregnancy.

The advantages of Essure are permanent, non-reversible sterilization, with no hormones, incisions or general anesthesia, and a rapid return to normal activity. It is as effective, or more so, than traditional tubal ligation. It can be performed in the doctor’s office, and many insurances cover it as an in-office procedure.

Endometrial ablation is a simple, safe, and effective one time treatment that can diminish or eliminate excessive menstrual bleeding disruptive to your daily life.  Both methods we offer, Thermachoice and Novasure, use heat to treat the membrane lining the uterus. This procedure is performed in the office with local anesthesia and oral sedation.  You may usually return to normal activities the following day.

These procedures cannot be done if you desire future pregnancies; in fact, a pregnancy following an ablation is dangerous to both you and a developing baby. It is for this reason we strongly recommend that you or your husband have undergone permanent sterilization prior to proceeding to this very effective way to control heavy menstrual bleeding.

When the results of the colposcopy and biopsy indicate moderate or severe abnormalities, your doctor or practitioner may recommend a LEEP procedure. A local anesthetic will be injected into the cervix.  Abnormal tissue is then removed for diagnosis and treatment with a thin wire loop through which an electrical current is passed. This tissue is sent to the lab for evaluation, and results are usually available in 7 working days.  You may experience mild cramping, and should take 4 Motrin or 2 Aleve with food one hour prior to your appointment.

This LEEP should be scheduled one week after you expect your period to start. The procedure may still be performed if you are having minimal bleeding at the end of your period.

Avoid intercourse, douching, tampons, and strenuous exercise for 4 weeks after the LEEP. You may bathe or shower as usual.

Gynecological & Midwifery

We provide licensed nurse-midwifes to care for you along every part of your journey- family planning, pregnancy & childbirth, and midwifery care. Read more about these services below.

Midwife means “with woman.”  A certified nurse-midwife is a registered nurse with a graduate education in midwifery.  She is certified and licensed as an independent provider to care for you throughout your lifetime. Midwifery care includes annual wellness exams, family planning, prenatal care, labor and birth through menopause.

While a nurse-midwife is especially skilled at educating and supporting normal birth, we understand that birth is a very individual event and each family brings their own unique situation to the birth experience. We partner with you throughout the pregnancy and birth to personalize your birth experience. Care is tailored to your individual needs.  In the event that higher risk problems occur, midwives and physicians work together as a team to deliver the best of midwifery and medical care for both you and your baby. We attend births at Porter Regional Hospital and are working with them to build the birthing options that are important to you!

We would like to introduce Prima Bella Women’s Health comprehensive guide to pregnancy and childbirth!

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Preventative Health Care, Annual Breast and Pelvic Examinations, Well-woman Exams

Pap Tests/HPV testing

Treatments for Abnormal Menstrual Bleeding

Treatment of Pelvic and Vaginal Infections

Screening for and Treating Sexually-Transmitted Infections

Preconceptual Counseling

Natural Family Planning, Contraception and Sterilization

Infertility Evaluation and Initial Treatment

Adolescent Gynecology

Evaluation and Treatment of Pelvic Organ Prolapse

Menopause and Hormone Replacement Therapy

Bio-identical Hormones

Ultrasound and Laboratory Services

Prima Bella Women’s Health offers Family Planning & Infertility guidance and treatments. Please check back soon to find out more information!