Benefits of Nurse-Midwifery

When you find out you’re “expecting” there are so many decisions to make. Will you find out the gender before birth? What names do you like? What items do you have and what items do you need? And, perhaps most importantly, who will deliver the baby? For most women, this means choosing between an obstetrician-gynecologist and a midwife.

There’s no right or wrong answer. Every pregnancy is different, every woman is different and every woman has a different idea about their ideal birth experience and needs to make the decision that’s right for them.

An obstetrician-gynecologist (OBGYN) manages medical complications throughout pregnancy and birth. If you have certain complications that make your pregnancy high-risk, an OBGYN will be equipped to guide you through the pregnancy and delivery, and will be able to perform a cesarean section, if needed. IHA has many trusted OBGYNs in the greater Ann Arbor area.

An OBGYN isn’t your only option, though. A certified nurse midwife (CNM) is a registered nurse who has graduate-level training in midwifery and is certified by the American College of Nurse-Midwives. IHA Nurse Midwives, who have office hours at the new Domino’s Farms building and attend births at St. Joseph Mercy Hospital in Ann Arbor, are trained to handle all aspects of prenatal care, labor and delivery for low-risk pregnancies. CNMs are trained to recognize potential complications during pregnancy and birth, like the need for a cesarean section, for example. In this case, your CNM will consult with the IHA obstetrician that is readily available on the Labor and Delivery unit.

Additionally, CNMs provide care for the well-woman including family planning, contraception, annual exams and problem gynecological visits. CNMs favor a holistic, family-centered approach to pregnancy and birth with a focus on education, support and intervening in the process only when necessary.

While you’re interviewing and considering practitioners, don’t hesitate to ask specific questions about their approach to prenatal care, labor and birth, protocols for complications and anything else that may help you make your decision. The more information you gather, the better you’ll be able to choose the right provider for you and your family.

If you’re interested in learning more about IHA Nurse Midwives, please join us for a midwife-guided tour of the hospital birthing center on October 16, 2014 from 6:00-7:00pm at St. Joseph Mercy- Ann Arbor, 5301 McAuley Drive (the first floor lobby of the birthing center).

2014 Best Doctors

We are pleased to announce 49 IHA doctors have been named to the 2014 Best Doctors in America® list. This list is assembled by Best Doctors, Inc., audited and certified by Gallup®. An exhaustive peer review determines the physicians included in the list; doctors cannot pay to be included. Physicians must meet specific criteria, including credentials and clinical activity, to be included. Only 5% of doctors practicing in the U.S. are selected for each Best Doctors list. There are currently over 45,000 practicing physicians in the country. Congratulations to our 2014 Best Doctors!

What is PEVAR?

PEVAR (Percutaneous Endovascular Aneurysm Repair) is an FDA-approved, minimally invasive procedure for patients with an abdominal aortic aneurysm. An aortic aneurysm is an abnormal enlargement in the wall of the aorta, which is the largest artery in the human body. The aorta supplies oxygen-rich blood from the heart, down through the chest and abdomen area before dividing into the vessels in the legs.

An aneurysm can happen to anyone, at any time, however, your risk increases with age, tobacco use and a family history of heart disease or aneurysms. In general, if you’re an older male, who smokes, has high blood pressure and a family history of hypertension, you’re at a higher risk.

Previously, the only surgical options to fix an abdominal aortic aneurysm were Open Surgical Repair (OPEN) and Endovascular Aneurysm Repair (EVAR). OPEN repair involves an incision in the abdomen directly over the aortic aneurysm, usually from below the breastbone to just below the navel. A long cylinder-like tube called a graft is used to repair the aneurysm. This operation is highly invasive, has a higher short-term and intermediate-term mortality rate, longer hospital stays, longer at-home recovery times, and is not suitable for high-risk patients.

EVAR entails making small incisions in the groin area, above the femoral arteries, uses special endovascular instruments to insert a stent-graft through the femoral artery and into the aneurysm. EVAR is minimally invasive, with lower mortality rates, shorter hospital stays, shorter at-home recovery time, and is safer for high-risk patients.

PEVAR expands upon the minimally invasive concept of EVAR, requiring only small nicks in the skin, meaning there is less blood loss and less pain. It reduces groin complications, hospital time and recovery time, meaning the patient can return to their normal activities much quicker than they could with OPEN or EVAR. It also requires less operating time, making it a more cost effective and less invasive surgical option for patients.

IHA Vascular & Endovascular Specialists are the only certified physicians who can perform the PEVAR procedure at St. Joseph Mercy – Ann Arbor. Personally, I have been performing the surgery for the past year, and it is a routine procedure for me and the other providers here. If you’re a good candidate, PEVAR is a great option that allows the patient very quick recovery time and minimal pain, while still gaining the benefits of a fixed aneurysm.

For more information about PEVAR, please call 734.712.8150.

Travel Preparations and Travel Medicine

When preparing for vacation most people choose to focus on what to pack, their itinerary and what attractions they want to visit. But what about required and recommended vaccinations? Most people are aware of the need for Yellow Fever vaccines if you’re heading to Africa or South America, but do you know what you might need if you’re headed to Boreno or Mexico?

Travel medicine is a growing niche within healthcare. Meeting with a travel medicine provider allows you and your family to receive tailored immunizations and prescriptions based on current health, medical history, travel plans and past immunizations.

We understand the need for personalized consultations prior to your trip. At IHA Midwest Travel Care we have over 20 years of experience preparing people for their travels. During your appointment you can expect:

  • Counseling and written information about the effectiveness and possible side effect of vaccines received
  • Advice about consumption of water and food, and ways to avoid traveler’s diarrhea
  • Recommended preventative medications and packing a medical kit
  • Latest US government health advisories for your travel destination and current listings of US embassies and consulates
  • Tips for air travel and jet lag, and how to handle altitude related illnesses
  • Assessments for travelers with specific needs (pregnant women, young child, elderly, chronically ill)
  • How to locate English speaking physicians

IHA Midwest Travel Care is located in the new IHA Domino’s Farms Medical Center, 4200 Whitehall Drive, Suite 150, Ann Arbor.

 

Why Choose Breastfeeding?

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Breastfeeding, or giving your infant expressed breast milk, is the most natural source of nourishment for your infant. When you choose to breastfeed your baby, you are providing him/her with the best possible infant food, and no product has ever been as time-tested as human milk.

Mother’s milk contains all the nutrients your baby needs and is more easily digested than any other baby food. Breastfeeding provides extra protection to infants against many common childhood infections such as: gastrointestinal, respiratory, ear, urinary tract, and dental caries. Breast milk has also proven to protect against more serious illness such as meningitis, juvenile diabetes, celiac disease, childhood cancer, acute appendicitis, and liver disease. There has even been research to support that breast milk helps to reduce the risk of SIDS (sudden infant death syndrome).

Not only does breastfeeding provide so many priceless benefits to your infant, but it also turns out to the best for a mother’s body as well. The lactation process causes changes in the mother’s body that benefit her directly. Some of these benefits include: helping the uterus get back in shape faster after delivery, changing metabolic rates thereby enabling most mothers to lose pregnancy weight gradually without dieting, protection against breast and ovarian cancer, urinary tract infections, and osteoporosis.

How Do I Prepare to Breastfeed My Infant?

Reading and taking a prenatal/breastfeeding class can be helpful. Many mothers find it most helpful to talk to experienced professionals such as a lactation consultant, nurse practitioner, pediatrician, nurse midwife, or obstetrician. There is no replacement for advice from your family members or friends who have breastfed; they often have many useful tips.

However, because every mother and baby is different, the real experience will come after the baby is born. It will be a learning process for both of you, and patience is key. A supportive team of family, friends, and professionals will be valuable to you. Also, it would be helpful to check with your insurance policy before your baby is born to see if they will help cover the price of a breast pump. Most nursing moms find it beneficial for many reasons to have their own pump. Optimally, you might want a support pillow such as a Boppy, a nursing bra, breastpads, Soothies gel pads, and PureLan cream.

Who Will Help Me With Breastfeeding/Pumping After Delivery?

Your labor and delivery nurse or midwife will likely be the first person to help with breastfeeding and/or pumping after the delivery of your infant. Next, the nursing staff and lactation consultants at the mother-baby unit will be happy to assist you with breastfeeding. Once discharged home, you will have access to help through your pediatric office. IHA has many experienced pediatricians, nurse practitioners, PAs, and lactation consultants who would love to help with this life changing experience. If you have questions or concerns, or would like to schedule an appointment, please call 734.995.2950.

Back to School Physicals and Immunizations

With the kids going back to school soon, now is a great time to get their annual checkup by their physician or health care provider. This visit is also the best time to make sure their immunizations are up-to-date with the current recommendations and school requirements.

Most school-aged children receive several vaccines at their 4, 5, or 6-year-old checkup, and then the next set of vaccination occurs at 11 or 12 years of age. However, each year the physician will assess the child’s status of vaccines to make sure he or she is up-to-date.

Some important vaccine highlights this year include:

The meningitis vaccine: One of the newest recommendations is a second dose of the meningitis vaccine for high school students, usually at the age of 16; the first dose has been routinely given at 11 or 12 years of age. Meningitis is an infection of the lining of the brain and spinal cord that can be more easily transmitted when students are in close contact with each other. The HPV vaccine: This vaccine—which prevents genital warts in boys and girls and cervical cancer in girls—is now approved for boys ages 9 to 26 and has been approved for girls of the same age since 2006. It is a series of three vaccines, and the first dose is usually given at 11 or 12 years of age. Because the vaccine is to prevent a sexually transmitted infection from occurring, it is important that children get this vaccine before they become sexually active.

The tetanus-diptheria booster: Your child’s tetanus boosters should be up to date, especially because the booster contains the vaccine for pertussis, also known as whooping cough. Pertussis has been on the rise in Michigan recently, but the risk of this respiratory illness can be greatly reduced with the vaccine. Although immunizations are an important part of the annual checkup, the visit to the office is also an opportunity for the physician to review the child’s growth, eating habits, school performance, social interactions, and safety. The health care provider will do a complete physical exam and assess the child’s need for any testing. Additionally, he or she will be able to provide recommendations to the parent and child about topics such as healthy eating, exercise, risk reduction, and any other areas of concern that have come up during the visit.

IHA Domino’s Farms Medical Center Now Open!

We’re excited to announce the opening of the brand new IHA Domino’s Farms Medical Center. The state-of-the-art 42,000 square-foot building, located on Whitehall Rd. near Earhart Rd., is the new home to a variety of IHA practices, including a new Urgent Care location, open 14 hours a day Monday-Friday, and 10 hours Saturday and Sunday. Other patient-centered programs and services being offered are: pediatrics, internal medicine, obstetrics and gynecology, certified nurse midwives, dermatology, pediatric neurology, imaging and ultrasound, travel medicine, physical therapy and lab services. We look forward to welcoming you to this new kind of medical center – one that is centered on you!

 

 

First Floor

IHA Imaging & Ultrasound – Domino’s Farms
734.434.0539

IHA Internal Medicine – Domino’s Farms
734.995-0303

IHA Midwest Travel Care
734.995.0308

St. Joseph Mercy Clinical Laboratory
734.712.7136

IHA Urgent Care –Domino’s Farms
Open 7 days a week, including holidays
Monday-Friday 8:00am-10:00pm
Saturday-Sunday 9:00am-7:00pm
734.995.0308

Second Floor

IHA Primary Pediatrics – Domino’s Farms
734.677 DERM (3376)

IHA Pediatric Neurology Consultants
734.622.5000

IHA Dermatology– Domino’s Farms
734.769.3896

St. Joseph Mercy Physical Therapy
734.712.7171

Third Floor

IHA Ann Arbor OB/GYN– Domino’s Farms
734.434.0477

IHA Nurse Midwives
734.572.9600

 

Spring has Sprung! Seasonal Allergies and Children

This time of year seems to be appreciated by most who live in Michigan. The children can finally begin to go out to play and families can spend some quality time outdoors. Unfortunately, along with onset of spring comes the sneezing, the coughing and the itchy, watery eyes. For most parents, the hardest part is trying to distinguish these typical symptoms from a cold. Generally speaking, if your child does not have a fever and the sneezing and watery eyes occur every year around the same time, it is usually seasonal allergies. Children with seasonal allergies can also manifest signs of dark circles under their eyes called “allergic shiners” or little wrinkles in the middle of their nose because they are constantly taking the palm of their hand and wiping their nose upward, commonly referred to as the “allergic salute.”

 

 

In Michigan, different seasons sprout different allergens (substances causing allergy symptoms). In the first few weeks of spring, the pollen coming from trees (elm, maple and birch) are likely to blame. In late spring and summer, grass pollens and some weeds begin to spread throughout the air. By late summer and fall more weeds, especially ragweed, produce their strongest pollen, usually until the first frost. In the fall, some molds will also develop due to decaying leaves. Molds can be found year-round whenever conditions are damp and humid.

Allergens can irritate the body and activate what is called the histamine response. This gives children the symptoms of sneezing, itchy watery eyes and scratchy throat. If these symptoms persist they can start to cause swelling or inflammation symptoms in the nasal passages. Thick mucus can block the nasal passages, and infection can potentially develop. Other complications from seasonal allergies are that they may trigger asthma or wheezing, or they may complicate eczema. For children and adults alike, nasal saline flush is best to open blocked passages. Medication for seasonal allergies usually begins with a trial of anti-histamine oral medicines. Studies have shown, however, that nasal sprays can be more effective at treating seasonal allergic symptoms because they prevent the allergen from triggering the histamine response right at the source. There are also natural ways to combat seasonal allergies, such as air conditioners and indoor air filters. Some research has shown that citrus fruits rich in vitamin C may provide anti-histamine benefits and help reduce allergy symptoms.

If a child has repeated symptoms around the same time every year, it may be helpful to discuss with your pediatrician if your child may have seasonal allergies. If the symptoms persist, allergy testing is also an option to try to figure out exactly which allergens to avoid.

Additional Information about Seasonal Allergies

What are allergy tests?

How do allergies occur?

Patience Pays Off for You and Your Baby

It is becoming more common for mothers who are nearing the end of pregnancy to request an induction of labor early, but waiting until natural labor occurs is good for both the mother and the baby in a healthy, uncomplicated pregnancy. A pregnancy is considered full term between weeks 37-40. Even though 37 weeks is the earliest point of a pregnancy being considered full-term, there is still so much growth and development that is happening in the last couple weeks of pregnancy.

 

 

It is hard to believe that there would be any benefit to the mother to stay pregnant any longer than she would absolutely have to, but there are several reasons to not induce labor unnecessarily (elective induction). Here are a few benefits for the mother:

 

  • Increased likelihood that you will go into labor on your own when your body is ready, which can improve your labor experience
  • Fewer medical interventions to start or continue the labor process
  • Increased success with breastfeeding since the baby is more interested in eating
  • Decreased chance of having a cesarean section

 

The baby seems to get the most benefit of not electively inducing labor. Here are some things mothers can focus on in the last weeks of pregnancy so they know they are doing the most for their baby:

 

  • Important organs, especially the brain, have time to fully develop
  • Less likely to have breathing, hearing or vision concerns immediately after birth and long-term
  • Increased interest in eating and a better latch during breastfeeding
  • Better at maintaining their body temperature and blood sugar levels following birth
  • Able to transition to the outside world easier
  • Less likely the baby will be separated from the mother for testing thus decreasing the initial mother-baby bonding

 

There are many favorable reasons to not pursue an elective induction that both the mother and the baby can benefit from. Ask your provider about helpful techniques that can mentally and physically help you with the last few weeks of pregnancy. Certified nurse-midwives are knowledgeable about ways that can help pregnant women get the most out of their pregnancies even in the last couple of weeks. In addition to caring for pregnant women, certified nurse-midwives also provide routine gynecological care to women of all ages. This includes pre-conceptual care, family planning, annual exams, contraceptive counseling and menopausal care.

Keeping Your Family Safe in the Sun

July is here with blue skies, hot days and summer vacation. It is time for picnics, parks, swimming and playing in the sun. Here are some tips for enjoying the sun safely:

  • Wear long-sleeved shirts, long pants and wide-brimmed hats. If that is not practical for you, wear a cover-up or t-shirt.
  • Stay in the shade as much as possible, especially between 10 a.m. and 4 p.m., when the sun’s ultraviolet (UV) rays are at their strongest.
  • Wear wrap-around sunglasses that provide as close to 100% UV protection as possible.
  • Stay hydrated by drinking plenty of water.
  • Generously apply sunscreen 15 minutes before sun exposure, and reapply every two hours (more frequently when swimming or sweating).

 

FDA labeling of sunscreens has changed to make it easier for you to choose a product that provides adequate protection from the harmful effects of the sun. Look for a sunscreen that is labeled “broad-spectrum” and has an SPF rating of at least 15. “Broad-spectrum” means that it protects against both UVA and UVB rays. UVB protection prevents sunburn, but both UVA and UVB rays can cause skin cancers. UVA rays also cause premature skin aging, such as sun spots, wrinkles and “leathery” skin. If a sunscreen does not have the label “broad-spectrum,” it may not have UVA protection. Sunscreens are no longer able to contain labels saying that they are waterproof. Instead, they may be labeled “water-resistant” and list a time period that they are proven effective in water (40 or 80 minutes).

It is best to keep babies under six months of age out of the sun due to their thinner, more sensitive skin. Keep them in the shade with long sleeves, pants and hats. If it is not possible to avoid sun exposure, apply sunscreen in small amounts to exposed areas, and wash off afterwards.

Though most of us enjoy the sunny days of summer, it is very important to keep in mind that the sun’s radiation is classified as a human carcinogen. According to the American Cancer Society, skin cancer is the most common type of cancer in the United States, with over two million new cases found each year. Broad-spectrum sunscreen with SPF 15 or higher does not completely protect from harmful UV rays, but it does help when combined with other sun protection measures. While enjoying your time outdoors this summer, please remember to protect your skin, even on cloudy days. Help your family to develop good sun protection habits that will benefit them throughout their lives.