March Ob/Gyn  
     
     
Frequently Asked Questions
Frequently Asked Questions


How Ob/Gyn is Done at Dr. March's Practice

Obstetrics and Gynecology
There are controversies surrounding many health issues women face today. Dr. March listens to you and works through these issues with each patient as an individual, to help her arrive at the plan with which she is comfortable.

Dr. March is experienced rendering comprehensive women's health care, from the late teen years to menopause and later.

Dr. March performs routine obstetrical care and also care for some high-risk pregnancies (such as diabetes, hypertension, asthma, and preterm labor to name a few). He performs most ultrasounds right in his office.

He also provides care for most gyn problems, such as care for abnormal pap smears and cervical dysplasia (pre-cancer), contraception, pelvic pain, uterine fibroids, abnormal uterine bleeding, urinary incontinence, and pelvic support problems (uterine and vaginal prolapse); in addition to annual gyn check-ups to name a few.

Thirdly, he provides evaluation and treatment for many infertility problems.

Surgery - General Info

Procedure Description:
Surgery - General Info

What To Expect:
Whether your surgery is a short out-patient procedure, a more involved same-day surgery, or will require a hospital stay, you are likely experiencing anxiety and have questions regarding what to expect.
You will discuss these issues at the pre-op visit.

Preprocedure:
Pre-Op Visit:
In many cases, you will have a "pre-op" visit, where you will sit down with the doctor and discuss issues about the surgery, risks, and the expected outcomes. You may expect a physical exam of those body systems that have not been evaluated recently. (For example, it is important to diagnose a breast lump prior to proceeding with a surgical procedure in the next few days.) Bring a list of your current medications to this visit.
Diet:
It is very important that you take nothing by mouth (no food or water) for at least 8 hours before your procedure.
Medicines:
Do not take Aspirin or anti-inflammatories like Ibuprofen (Motrin, Advil) and Naproxyn (Alleve)for 2 weeks before surgery. These inhibit blood clotting and will make you bleed more during surgery. Tylenol is OK to take for pain during this time. The doctor will tell you which of your medicines, if any, you will need to take the day of surgery. Tell the doctor what medications you take, including the dose and frequency.
Stop smoking!

Postprocedure:
FOR PATIENTS STAYING AT THE HOSPITAL, pain and nausea medication through the IV will usually be ordered. You will restart most of your medications. The first day is for rest and recovery, although the nurse will have you deep breath with a spirometer and change positions in order to expand your lungs and prevent complications. It will be important to get up and walk by the night of surgery or the following day. The olden-day complications of pneumonia, blood clots, and bowel obstruction are usually prevented by early activity. The staff will assist with activity. Your insurance company usually pays for a certain number of days for uncomplicated surgery; additional stay will be as needed based on any complicating factors. At your discharge from the hospital, the doctor will give recommendations specific for you regarding activity.

FOR OUTPATIENT SURGERY, you will usually be able to go home 1 to 2 hours after surgery. Someone else should drive you home, and you should not drive for 24-48 hours after surgery.


Ultrasound

Procedure Description:
Ultrasound - Ob and Gyn

What To Expect:
Ultrasound examinations can be done during pregnancy and to investigate gynecologic problems.
Ultrasound machines use high-pitched sound waves transmitted through tissue to produce an echo image of the contents of the pelvic organs. By moving the transducer appropriately, different areas of anatomy in the pelvis can be visualized. The only discomfort (if any) is from mild pressure from the transducer.

If it is very early in pregnancy or if detailed visualization of the ovaries or uterus is needed, a "trans-vaginal ultrasound" is done. A slender transducer, with a clean covering sheath, is placed in the vagina to visualize the contents of the pelvis. KY jelly lubricant is used to make adequate contact between the transducer covering sheath and the body. If an abdominal scan is to be performed, the ultrasound conducting gel will be placed on the lower abdomen.

Postprocedure:
During a prenatal ultrasound examination, we can see whether or not there are twins, which way the fetus is positioned in the uterus, the location of the placenta, motion of the fetal heart and limbs, and the amount of amniotic fluid. Early in pregnancy, measurement of various fetal parts can be used to estimate fetal age and dates. Later in pregnancy, fetal growth can be determined. Despite advances in ultrasound equipment, there are many things that cannot be seen on ultrasound examinations. While gross fetal or pelvic abnormalities often can be ruled out, there are many significant but subtle malformations that cannot be seen. An apparently normal ultrasound does not guarantee a completely normal outcome. Gestational age, maternal size and low amniotic fluid can limit how much detail can be seen. Ultrasound often does, however, provide very useful information to aid in your care.
With gynecologic scans, the size, position, and consistency of the uterus and ovaries, and tumors and masses, can be judged.


INFLUENZA VIRUS IN PREGNANCY FACT SHEET


MARCH OB/GYN INFORMATION SHEET
INFLUENZA VIRUS AND PREGNANCY 8/26/2009

GENERAL INFORMATION:
- Influenza viral infections cause infections that can be more severe in certain categories of people, the list of which includes pregnant women.
- Seasonal Influenza Virus: We recommend immunization against seasonal influenza virus in our pregnant patients. We typically (but not always) purchase and receive influenza vaccines during the month of October. This vaccine is not mandatory and some patients may have lower risk circumstances or may decline vaccination for any reason. But we follow the Centers for Disease Control (CDC) recommendations, which recommend vaccinating all pregnant women.
- If you have access to the vaccine against seasonal influenza vaccine outside of our office, this is acceptable. Please provide documentation of this vaccine so we can enter it into our office record.
- Only use the injectable influenza vaccine in pregnancy. Never obtain the inhaled influenza vaccine.

- "Novel influenza virus H1N1": This is currently under study. A vaccine has not been developed as of this writing. If and when it is developed, it is likely, but not certain, to be offered to pregnant women. The CDC has said it will likely be given in two doses 21 days apart. Based on limited supply, and the fact that private purchase will not be allowed, it is quite likely the best source for receiving this will be the Wake County Health Department. If we can obtain vaccine for H1N1 virus, and it is cleared for use in obstetrics, we will make it available to our pregnant patients. Prevention and treatment precautions are similar to those for seasonal flu virus. Stay tuned.


PREVENTION:
Use frequent hand washing. Cover mouth/nose when coughing and sneezing. Keep a small bottle of hand sanitizer with you for frequent use after contacts with other people. Consider using a surgical mask. Avoid close contact with those who are sick; stay home if you are sick. Avoid large, hand shaking, hugs, etc in public and in crowded areas as much as possible. Be careful in close contact areas like working in a nursery or teaching a class.

BREAST FEEDING:
With influenza-like illness, it is recommended to either provide your infant expressed breast milk that is fed to baby by another person who is well, or nurse baby wearing a mask after thorough hand washing. Ask your pediatrician for other recommendations regarding the newborn infant.


CALL US IF:

1. You are in close contact with someone who has (a) laboratory-confirmed or (b) is being treated for suspected H1N1 influenza virus.
2. You have flu-like symptoms:
a. Temperature more than 100.4 degrees F or 38 degrees C.
b. AND, respiratory symptoms (cough, sore throat, etc).
c. Severe, new onset muscle aches, headaches, and other body aches are common.
3. We encourage those who suspect influenza infection to obtain testing for seasonal or H1N1 influenza viruses using a facility that is familiar with pulmonary infections and primary care practice. These practices and facilities include primary care physicians (PCP or GP), county Health Department, and Urgent Cares.

Resources:

www.cdc.gov
www.cdc.gov/h1n1flu
http://whb.ncpublichealth.com/
www.epi.state.nc.us/epi/gcdc/H1N1flu.html

NC CARE LINE: 800-662-7030


Staff Information


Our qualified and well-trained staff is committed to our philosophy of comforting, assisting and serving our patients. From scheduling, to reception, to clinical nursing, to insurance and claims, they focus their efforts on courtesy, respect, helpfulness, competence and integrity. In addition, they are devoted to expanding their quality of service through continuing medical education coursework. These are only several areas of our practice committed to excellence where, we trust, you will find a pleasant change of pace.
Bridget is our office supervisor and billing specialist. She has undergone coursework devoted to medical administration and is committed to our patients and practice. Need administrative help or billing help? She is the person to contact.
Becky is a certified medical assistant. She has experience in Ob/Gyn in both private practice and academic medicine at a university medical center prior to joining us.
Jennifer is our receptionist and the pleasant person who is the entry point into our practice. If you need to schedule an appointment or find the right person with whom to speak, she is the right person to contact.