Mesa Obgyn

COVID-19 Update

March 31, 2020 by Dr. Tamar K. Gottfried Leave a Comment

As we all change our habits to slow the spread of the Covid-19 virus, we are exploring new, safer options to take care of our ob/gyn patients. Current recommendations are to avoid any routine office visit that can wait a month without harm. We have not yet been cancelling existing appointments, but that may be required at some point. In an effort to be available for our patients, we will now offer some Telehealth visit options.

We can currently use Facetime, Facebook messaging and will be adding an app called doxy.me to use as well. We will need your email to invite you to the visit.

For our pregnant patients: If you are low risk and feeling well and prefer not to come in for routine visits that don’t need bloodwork or ultrasound, please ask to reschedule to a Telehealth visit. We will ask you to get a home blood pressure cuff / a thermometer/ and a scale at your pharmacy and take your blood pressure, weight and temperature prior to the visit. We will email you a link and a time to log in for the visit like a regular appointment. You will have a 10-15 minute with Dr. Gottfried or Terri. For patients who need monitoring once or twice a week or have other issues needing in person evaluation, we will see you in the office like usual.

For our non- pregnant patients, if you would like to use Telehealth for a counselling or results visit, please schedule a time by calling in , texting , or using zocdoc. We will schedule a visit for you and this will be billed to your insurance using the Telehealth codes.

For all patients who need to come in to the office for a visit, we are doing our best to protect you and to protect our staff . If you have a fever, cough, or are otherwise feeling ill, please call us first to receive specific instructions. For all patients, please come to the visit by yourself if possible to have as few people in the office at a time as possible. Please leave children at home as they may be carriers of the virus without symptoms. If you are coming in for an ob ultrasound, you can have one other person accompany you. We can include other family members in the ultrasound visit via your phone and a conferencing app.

For all of us, please observe social distancing- only leave your house when you have to. Walks outside are okay if away from other people who don’t live in your household. Store visits and food pick ups should only be made by one , low risk member of your household. If everyone goes out to the store or restaurant, it defeats the purpose of social distancing.
Please do what you can to keep you and your family healthy. We are here for you to help you through this difficult time. Please call if we can help in any way.

How to address feminine health questions during the Covid-19 pandemic

March 31, 2020 by Dr. Tamar K. Gottfried Leave a Comment

As we are trying to limit patient traffic through our office during this difficult time, I am thrilled to announce new telemedicine options for ob and gynecology consults.

What is telemedicine? Telemedicine means that you can have confidential access to YOUR doctor or nurse practitioner from the comfort and safety of your home. A lot of what we do in medicine is listening and talking and counselling and coming up with a diagnosis and treatment plan, and that can be done just as easily in a remote setting. We can even look at incisions or bumps or rashes in this format since it is private and secure

How does telemedicine work? First, we schedule an appointment time for your visit and update your insurance information and any demographic information that may have changed since your last visit here. Then, one of the medical assistants Eli or Pattie will call you to update your medical information, and finally, at the time of your visit (it can be a a few minutes delayed since we are still seeing urgent and pregnant patients in the office and are still delivering babies ) you will get an email with the link to your visit. Click on the link and Terri or Dr. Gottfried will be there to speak with you.

What kinds of visits can be done with telemedicine? Any visit that doesn’t require immediate physical exam, ultrasound or lab test can start this way. Birth control consults, birth control pill refill visits, Abnormal bleeding, rash or new skin lesion checks, wound checks, questions about pregnancy symptoms or problems, menopausal symptoms, even consults for our new Viveve procedure, which treats bladder leakage (which can be very helpful if you are coughing or sneezing a lot or exercising more at home). Also, this kind of visit is ideal for consults about lab results or ultrasound or biopsy results.

What are the costs of telemedicine visits? If you are pregnant, these visits are part of the ob package. For gyn visits, these are billed to your insurance just like an office visit, but using different codes Even AHCCCS and Medicare are encouraging patients and doctors to do visits using this technology.

In summary, we are here for you both in person and remotely. While we are asking routine visits to wait until the recommendation for staying at home has been lifted, we are available for pregnancy and gynecology problem visits and your other female health needs. We still are offering in house ultrasound and laboratory services for your convenience . Please call with any questions or book online through the website.

I’m ready to get pregnant- What do I do now?

July 26, 2012 by Dr. Tamar K. Gottfried Leave a Comment

It is a momentous day in the life of a family when the decision is made to add a member. To ensure the safest pregnancy and delivery, there are many things a woman can do to prepare. First and foremost, a woman should optimize her health before trying to conceive. This means doing blood tests to ensure that her childhood immunizations to illnesses like German measles are still working. It also means going over any medications she is taking to make sure that they are safe during pregnancy. A woman with chronic conditions such as high blood pressure, diabetes or depression should make sure she is in the best control possible prior to getting pregnant.

Another preconception must is starting a daily regimen of folic acid. This can be taken by itself, or as part of a prenatal vitamin. Folic acid helps prevent neural tube defect, a common birth defect. Stopping unhealthy habits is also recommended prior to pregnancy- this includes alcohol, tobacco, and a sedentary lifestyle. Additionally, a women should try to be at her healthiest weight prior to conceiving.

Even before a woman is ready to conceive, she should begin tracking her menstrual cycle. In a typical 28 day cycle, a woman is most fertile 10 to 14 days after the first day of her period. If the cycle is longer, such as 35 days, then her fertile time is 21 days after her period starts. Alternatively, for a woman with a short 3 week cycle, she is most fertile on day 7 of her cycle. To increase chances of conception, a couple should abstain for a few days before the most fertile period, and then begin having intercourse every other day during the fertile time.

It is important to remember that, even in perfect conditions, only 1 out of 5 couples will conceive on any given month. However, 80% of couples trying to conceive will be pregnant within a year. With this information in mind, prepare for pregnancy, and do not be discouraged if it doesn’t happen the first few months of trying. Most couples will achieve their dream in less than a year.

Tamar Gottfried is a Board Certified Obstetrician/ gynecologist practicing general Ob/gyn in Mesa Arizona and affiliated with Banner Desert and Banner Gateway Medical Centers. She can be contacted at 480-545-0059. This is a general interest article only and is not intended to be medical advice. See a medical professional before making medical decisions

My family is complete and my husband won’t get a vasectomy. What is my permanent birth control solution?

October 23, 2011 by Dr. Tamar K. Gottfried Leave a Comment

There have been various options for female sterilization offered throughout the years for women desiring permanent birth control. Previously, women could only get their fallopian tubes tied, cut, burned or clipped through a procedure requiring anesthesia, abdominal incisions, and surgery in the abdominal cavity. This required time off from work and involved the risk of major surgery.

Now there is the option of a sterilization procedure that is easier for women than a vasectomy is for a man. For a vasectomy, an incision is made under local anesthesia into the scrotum and the vas deferens, the tube that transports sperm is cut. With the Essure procedure, women can have permanent sterilization in their Ob/Gyn office under a light anesthesia and without any “cutting’. Using a camera to look into the uterus, small metal devices are placed in the opening of each Fallopian tube. These will cause a natural scarring which will eventually block the tube and prevent pregnancy,. With this procedure, women avoid the hospital or surgicenter copayment, and can walk out of office, relatively pain free, minutes after the procedure.

Essure, like the older female sterilization procedures, is permanent and for women who are sure that they never ever want to get pregnant again. It doesn’t affect their periods or their hormones either. However, some women who use hormonal methods for birth control prior to sterilization notice that their “natural” periods are heavier when they go off of the pill, IUD or shot and lose that benefit. For women that don’t ever want to worry about birth control again, Essure is a wonderful option. A 10 minute office procedure provides permanent contraception and is incision- free.

Is there a down side to Essure? It does require being on a back up method of birth control for 3 months after the procedure, while the device is scarring into the Fallopian tubes and causing the permanent blockage that will prevent pregnancy. This is still less than the waiting period after a vasectomy.

If you are considering a permanent birth control solution to prevent pregnancy and tired of waiting for your husband to do the task, please contact my Mesa Ob/Gyn practice to schedule an appointment.

When is vaginal discharge abnormal?

October 20, 2011 by Dr. Tamar K. Gottfried Leave a Comment

For many women, vaginal discharge is a common occurrence. It can be difficult to know which discharge is normal and which needs medical attention. Many women try to diagnose themselves, based either on their prior experience or on over the counter tests. However, more than half of women who self diagnose a yeast infection are incorrect in their diagnosis. Additionally, the otc tests, which rely on the pH or acid/base balance of the vagina can be difficult to read and interpret. Results can be confused by other factors as well.

A general rule with vaginal discharge is that it should not be smelly or cause itching or irritation. A discharge that has an unpleasant or fishy odor, and/or is bubbly or frothy could be Bacterial Vaginosis, an upset in the chemical balance of the vagina, which requires prescription antibiotics to treat. An extremely bad smelling discharge can also be a sexually transmitted infection such as Trichomonas, Chlamydia or Gonorrhea. If a discharge causes itching or burning, it could be any of the above. It could also be yeast or even an allergic reaction. While many yeast infections have the typical curdy white thick discharge, some present with other symptoms and can be more challenging to diagnose.

In an Ob Gyn office, the diagnosis of vaginal infection is made not only by examining the discharge, but usually by doing a confirmatory lab test that can detect even low levels of bacteria or fungus. These tests take at least 24 hours for the result to come in and then, if positive for infection, a prescription can be called in to the pharmacy if needed.

Sometimes a vaginal discharge is examined and the tests do not confirm an infection. A mucousy/ slimy clear discharge can actually be normal since the vagina cleanses itself by producing discharge. Some people produce more discharge than others do due to factors such as medications, the use of an IUD (intrauterine device) or changes in the menstrual cycle.

In conclusion, there are a wide variety of vaginal discharges, some normal and some not. The best way to distinguish which is which is a trip to the Gynecologist for an exam and testing. While over the counter tests and creams can seem to be time savers, their use sometimes delays making the correct diagnosis and getting the correct treatment for a vaginal infection.

1520 S Dobson Rd
Suite 316
Mesa, Arizona 85202

When do I take a pregnancy test?

October 15, 2011 by tamargottfried Leave a Comment

Urine pregnancy tests check for the presence of a chemical in urine that is produced in larger and larger amounts during the first months of pregnancy. They can be positive as early as a few days before a period is missed and stay positive throughout a pregnancy. A woman should take a pregnancy test if her period is late or if it is lighter than usual and there is a chance she could be pregnant. Pregnancy tests are more likely to be positive if the urine is concentrated- that is why the first urination of the morning is often recommended, especially if it is very early in the pregnancy. If the urine is very dilute, very watery, the test may still be positive around the time of the missed period, but the positive sign may be lighter. If a urine pregnancy test is negative, it may be too early, or the urine may be too dilute. If the period doesn’t come, or if there are other signs of pregnancy, the urine pregnancy test should be repeated in a few days or at a time when the urine is more concentrated.

Why do a pregnancy test at a doctor’s office? At our Mesa obgyn office, the urine pregnancy tests work similarly to the ones at home. Many people are unsure if they’ve done the test right, or if they can trust their home test, so they come in to do it at an Ob office and this is fine! At our office, if your test is positive, we can start you out with some vitamin samples and schedule your first Ob visit. If the test is negative and we want more precise information, we can order and draw a blood pregnancy test. Coming in to do a pregnancy test in an Ob office can give you peace of mind and it is free and doesn’t cost a cent!

Tamar K. Gottfried, MD
1520 S. Dobson Road, suite 316
Mesa, AZ 85202