Healthy Focus

Pregnant? How to Protect Your Health

A healthy pregnancy doesn’t just happen—it’s an amazing collaboration between you, Mother Nature, and your doctor.

Sandra Boxell, MD, OB/GYN
Paris Women’s Center

Having a heart-to-heart with your physician pre-conception or at the start of your pregnancy can help you address any concerns that crop up as a result of your personal medical history. And while every pregnancy is unique, here are some general tips that can help both you and your baby stay healthy during these important nine months.

1. Control pre-existing conditions.
Taking a look at your family history, chronic conditions and pre-existing conditions is step one: Lupus, diabetes and weight issues are among the most significant. In fact, being overweight or underweight can impact conception and a healthy pregnancy, says Sandra Boxell, MD, OB/GYN at Paris Women’s Center. Talk to your physician about controlling your blood sugar levels, watching your weight, and the effects of any medication currently prescribed.

2. Watch what you eat.
A balanced diet is the Rx for everyone, but women who are pregnant or are planning to be have specific dietary needs. First, add a multivitamin with folic acid to your daily routine. Consider a folic acid supplement of 400 to 800 micrograms starting at least three months before conception if possible, says Dr. Boxell. Continue dosages through the early part of your pregnancy, as folic acid helps prevent serious birth defects.

Pregnant women should also shy away from certain foods, or at least eat them in strict moderation. Fresh deli meats should be heated prior to eating. Rash fish should be avoided. Cooked fish should be limited to only eating twice per month. Caffeine is also on the “to avoid” list. Two cups of coffee a day appears to increase the risk of miscarriage in the first trimester, cautions Dr. Boxell.

The U.S. Food and Drug Administration Web site (www.fda.gov) provides details on which seafoods are most and least likely to have high mercury levels. Dr. Boxell says you should try to stop eating these fish even before conception, because mercury can stay in the body for a long time. But you do not want to avoid seafood entirely, because the omega-3 fatty acids found in fish can positively affect brain development of the fetus. Look for farmed seafood or consider omega-3 supplements in addition to eating the approved fish on the FDA list.

3. Get moving.
Again, exercise is essential for anyone looking to improve their health, not just aspiring new moms. Typically, you can continue any exercise program you regularly did pre-pregnancy, says Dr. Boxell. But if you were sedentary before conceiving, you should begin to exercise gradually, under your physician’s supervision.

4. Think about mental health.
There is a strong movement to recognize the risk of postpartum depression, and the disease occurs in as many as 10 to 15 percent of deliveries, Dr. Boxell estimates. A history of depression or postpartum depression can be a risk factor, but if you already take antidepressants, don’t automatically assume you will need to suspend treatment during your pregnancy. Some antidepressant medications are considered safe during pregnancy.

Dr. Boxell adds that women with strong support systems seem to weather postpartum depression better. Start thinking now about who you can lean on if the initial adjustment to life with baby is difficult.

5. Get vaccinated.
The flu shot gets the most attention, but it is essential to be up-to-date with other vaccinations such as hepatitis, chicken pox, German measles and rubella. Generally, pregnant women are discouraged from receiving live vaccines, which is why some vaccinations need to be administered before conception.

3 Controllable Conditions that Impact Pregnancy

1. Diabetes
2. High blood pressure
3. Infectious diseases

To make an appointment with Dr. Boxell, call 731-644-8225.


How to Make the Most of Your Next Doctor’s Appointment

When you’re visiting your doctor, you want to quickly get the medical help you need—or a clean bill of health—and then get on with your day.

But not so fast. Before any important meeting, such as a job interview, it pays to do your homework. A doctor’s appointment is no different.

These pre-appointment pointers can help you use the time with your doctor wisely, so you quickly get the right diagnosis.

Bo Richardson, III, MD
Transitions Health & Eagle Creek Clinic

Make a list. What are the medical issues you’ve had in the past, and what’s bothering you health-wise right now? Make a list and bring it with you to every doctor’s appointment. When your doctor asks: “What can I do for you today?” to bring focus to the purpose of the visit, you can launch right into your symptoms.

“If you feel embarrassed about your symptoms, practice saying them out loud in the car on the way to your appointment,” says Bo Richardson, III, MD with Transitions Health & Eagle Creek Clinic.” Or, just hand a list of symptoms to your doctor, so you don’t even have to say them.” Whatever your concerns, know that your doctor has likely heard and seen it all, and that your medical appointment is a safe haven.

“We sign a HIPAA document that says nobody can say a word,” Dr. Richardson says. HIPAA—the Health Insurance Portability and Accountability Act—protects the privacy of patient health information. So put your symptoms right out there where your doctor can address them.

Get your story straight. While relaying your symptoms, be prepared to provide context. If you have a headache, for example, don’t just say or write: “I have a headache.” Instead, mention what you were doing when the headache started and how you felt. Talk about how bad the pain is/was. What does your headache stop you from doing?

If you’re visiting the OB/GYN, expect your doctor to ask about your menstrual bleeding patterns if you’re not in menopause—whether, for example, you bleed outside the time of your period, if you’re ever in pain and how long your symptoms have been occurring. “If you’re sexually active, you can also expect questions about intercourse, sex drive and issues with discharge,” says Dr. Richardson. Be prepared to add specifics, which will help your doctor understand the nature of your problem, if there is one.

“Studies show that 80 percent of diagnoses can be made just based on your story, the story of your illness and your medical history,” according to Dr. Richardson.

Gather up your medications. If you’re taking medication, don’t assume it will be listed in your electronic medical record or that your doctor will be able to figure it out. “I can’t tell you how many patients say, ‘I take two pills. One is blue and one is white,’” Dr. Richardson says. Bring your pill bottles to your appointment so your doctor can see exactly what you’re taking and how much, to avoid either overprescribing medication or prescribing a drug that negatively interacts with what you are already taking.

Recruit an appointment pal. Even if you’re going to a routine appointment, it’s often helpful to have someone with you to make sure your needs are met. “You may not be feeling well, or feel tired or fearful,” says Dr. Richardson. Your appointment buddy can provide support and also advocate for you by asking questions you have.

Doing this kind of pre-appointment prep is ideal. If you can’t get to it, however, don’t reschedule your appointment. Research shows that women often will go to other people’s medical appointments, such as their parent’s or their child’s—but not their own. And no matter how much you’re juggling, keep in mind there’s nothing more important than your health. “Just come to your appointment anyway,” says Dr. Richardson. “We can figure it out later. I’ll just be glad you’re here.”

Your Checkup Checklist

If you’re not sure what to talk to your doctor about at your next appointment, here’s a checklist of topics that can help get the conversation started.

Your health numbers, including blood pressure, cholesterol, fasting blood glucose, body mass and body mass index (BMI). These numbers help your doctor assess your risk of chronic disease, such as diabetes and heart disease. How do your numbers compare with the ideal?

Your family medical history. What illnesses or diseases run in your family? Talking with your doctor about them can help you both develop a targeted prevention plan.

Your medical history. Bring your doctor up to date on the surgeries and procedures you’ve had, your menstrual cycle and your bleeding patterns, and whether you’re in any pain now.

To make an appointment with Dr. Richardson, call 731-641-2707.


HCMC Spotlight

Meet Sandra Boxell, MD, OB/GYN, Paris Women’s Center.


Meet Bo Richardson, III, MD, Transitions Health & Eagle Creek Clinic.


Roasted Vegetable Soup

Bell peppers are low in calories and high in vitamin A and C, making them an excellent choice for a healthy immune system and maintaining good vision. They are also a beneficial source of vitamin E, which plays a role in keeping our skin and hair looking healthy.

Ingredients:

1 medium red bell pepper, cored, seeded and diced
1 medium yellow bell pepper, cored, seeded and diced
1 jalapeño chile, cored, seeded and minced
1 cup corn kernels (cut from 2 ears)
4 teaspoons canola oil, divided
1 pint grape tomatoes, halved lengthwise
1 large garlic clove, minced
1 celery stalk, trimmed and chopped
1 small red onion, chopped
½ teaspoon crushed dried oregano
¼ teaspoon ground cumin
¼ teaspoon pepper
4 cups (1 quart) reduced-sodium vegetable broth
2 tablespoons minced fresh cilantro

Optional toppings and add-ins: unsalted baked tortilla chips, cooked black beans, reduced-fat shredded Cheddar cheese

Directions:
Place red bell pepper, yellow bell pepper, chile and corn kernels in a shallow roasting pan. Drizzle with 2 teaspoons canola oil. Roast in preheated 400-degree oven for 15 minutes, stirring once. Add tomatoes, stir and roast an additional 15 minutes, stirring once. Meanwhile, heat remaining 2 teaspoons oil in Dutch oven over medium heat. Add garlic, celery and onion. Cook for 5 minutes or until vegetables are tender. Stir in oregano, cumin and pepper. Remove roasted vegetables from oven and add Dutch oven. Stir well. Add broth. Bring to a boil; reduce heat to low and simmer 5 minutes to blend flavors. Sprinkle on cilantro. Serve with one or more optional toppings if desired.

Makes 4 generous servings.