obgyn chandler

My gyn just told me I have antibodies to Herpes in my blood. What does this mean??

January 24, 2012 by Dr. Tamar K. Gottfried Leave a Comment

There are few things that alarm patients more that hearing that they have antibodies to herpes in their blood. What they hear is “I have herpes” even though this isn’t always the case. Many times, tests for herpes antibodies are included in STD panels and in routine blood work for newly pregnant woman. These tests look for evidence of prior exposure to either the Herpes I or Herpes II virus. A positive result can occur if a person has ever been exposed to these viruses. Exposure could happen by coming into contact with the virus through oral or genital contact, even by a kiss from someone with a cold sore.

While Herpes I is usually oral and Herpes II usually genital- either can be found in the other location. Someone who has either herpes virus can be contagious without even having a lesion and pass along the virus unknowingly. Alternatively, a person can have be exposed to the virus and develop antibodies without ever having an outbreak. Just because the antibodies are in the bloodstream does not mean that an outbreak will ever occur. These antibodies can lay dormant for years or even decades. Most of the time, if one partner in an ongoing relationship has antibodies to Herpes, the other person does too. This can be verified with blood work.

In conclusion, the presence of Herpes antibodies on a blood test does not mean that an outbreak of Herpes will ever occur. However, in times of physical or emotional stress, or when the immune system is suppressed (like during pregnancy), there is a higher risk of an outbreak. For this reason, we use preventative antiviral medicines to prevent Herpes outbreaks at the end of pregnancy. More information regarding the Herpes viruses and their diagnosis and treatment can be found at my Mesa Ob/gyn office.

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

I watch what I eat and exercise regularly- why am I not losing weight?

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

Chandler Obgyn Tamar Gottfried discusses weight management over the holidays:

As we prepare to enter the holiday season, many people are focusing on simple weight managment- i.e. not gaining weight between November and January. However, there are those already on weight loss journeys, wondering how to achieve their goals. As I speak to patients in my office about nutrition and exercise a common question arises: Why am I not losing weight?

Although there a million different diet and exercise plans out there, the simple fact remains that in order to lose weight, a person has to burn more calories than she ingests. The most effective nutrition plans advise food journaling ( which means writing down every morsel eaten and weighing and measuring ingredients and portions for accuracy) and calorie restriction. Some people eat the right kinds of food, but eat too much of them due to misjudging portion sizes. While calories, as well as proportions of fat, carbs and protein, do have to be watched in order to have weight loss success, the total number of calories cannot be too high or too low. Many people who are trying to lose weight eat too little or too infrequently during the day. Then their bodies think they are in a starvation mode and hold on to every calorie. That is how someone can eat very little and still not drop weight.

There are many people who exercise daily and become frustrated when the scale doesn’t budge. Again, it is the calories in, calories out idea that can affect weight loss. It has been found that people who exercise regularly may also burn less total calories in the rest of their day, being more sedentary as a reward for having “worked out”. If a person works out and then sits at a desk all day and comes home to sit in front of a computer or a TV, the total calories burned for the day may be low. Additionally, if a person is ravenously hungry after a workout and ends up eating more than usual at the next meal or snack, this will affect the total calories in for the day.

Unfortunately, there is no easy weight loss solution- magic pills aren’t so magic, the success of the HCG diet involves continuing to follow a low calorie diet, and exercise requires a daily commitment to personal challenge. However, in the simplest terms, burning more calories a day through exercise and incorporating calorie burning activities throughout the day, than calories taken in through eating, will eventually result in weight loss success. Luckily there are many more specific tools and plans like Weight Watchers, and the Body Bugg to help people achieve their goals.

As an Chandler Ob gyn physician who has personal experience with weight issues and lifestyle changes, I have a particular interest in helping women address their diet and exercise challenges. Contact my Mesa office for more information.

I’m not sick, I’m pregnant! Why should I deliver in a hospital?

November 13, 2011 by Dr. Tamar K. Gottfried Leave a Comment

Chandler Obgyn Tamar Gottfried discusses why you should deliver your baby in a hospital;

In past centuries, most of the babies in this country were born at home with midwives. Infant and maternal deaths were not an uncommon occurrence. Over the years, more and more births were done in hospitals by physicians, and labor and delivery became a medical event. The availability of safe cesarean delivery, antibiotics, epidurals and advanced neonatal care improved the safety of the labor and delivery process for moms and babies.

In more recent decades, there has been another shift in opinion to a care model that allows moms to have the safety of hospital delivery with some of the comforts of home. Long gone are the routine shaving and enemas and episiotomies of the past. Now, hospital based labor and delivery units can offer bedroom-like rooms, wireless fetal monitors, birthing balls and squat bars and nursing support and encouragement for a natural delivery with the safety of operating rooms and neonatal teams minutes away for the rare emergencies that happen.

While the majority of labors are uneventful and proceed without incident, emergencies can occur without warning. A perfectly normal labor and delivery for an experienced mom can turn scary in minutes if the placenta stops working suddenly, a baby’s shoulder gets stuck, a baby doesn’t breathe at delivery or if bleeding doesn’t stop after the baby is born. While some women are classified as “high risk” during the pregnancies and these types of problems are anticipated, obstetric emergencies can happen to anyone. For this reason, hospital delivery brings a level of comfort and security for expectant parents.

Home birth has been around since the dawn of humanity and, under the care of experienced midwives, continues to be an option for low risk women. As my colleague puts it- if you ride on the freeway at 100 mph on a motorcycle without a helmet, you may make it to your destination, but you are taking a risk. It is the same with home birth- it can be safe, but when unexpected events occur, transfer to a hospital is a necessity and the time it takes to get there can critical for mom and baby.

In the instances when emergencies develop, I am always happy to be practicing in the safety of a hospital like Banner Desert Medical Center, with a a level 3 Neonatal ICU, a full children’s hospital, and 24 hour neonatologist on site , with advanced techniques to stop maternal bleeding available, with 3 operating rooms staffed and ready to go, with high risk pregnancy consultants and ultrasound right there, and with anesthesiologists assigned 24/7 to the maternity ward. My patients who choose to have a more natural, unmedicated delivery can do so in a safe and supportive environment. That is why, as an Ob Gyn in Mesa, I recommend hospital delivery for my patients.

If a pregnancy is full term at 37 weeks, why can’t I be induced?

October 21, 2011 by Dr. Tamar K. Gottfried Leave a Comment

Although pregnancies are considered to be full term after 37 weeks, there are advantages to waiting until 39 weeks to deliver. Pregnancies are dated from the mom’s last menstrual period, not from the date of conception. Full term pregnancy is a range rather than a date, with 37-41 weeks considered to be full term.

There has been a lot of press lately about the ideal time to electively deliver a baby. Recent recommendations from the March of Dimes and the American College of Obstetrics and Gynecology take into account the fact that babies are healthier if they are born after 39 weeks. Babies born from 35-38 weeks, considered near- term, have more problems with feeding, maintaining their temperature and other factors than babies born after 39 weeks. They are also more likely to spend time in the Neonatal Intensive Care Unit and not go home from the hospital with their mothers.

Banner Health Care, based in Arizona and including Banner Desert Medical Center in Mesa Arizona, has been leading the way in the movement to only electively deliver babies after 39 weeks. This new policy only applies to elective (non medical) deliveries- not to medically indicated ones. For example, if a mother has high blood pressure, or if the fluid around the baby is low, or if her water breaks and her labor needs to be induced or if she’s in labor, she will be delivered even if she is not 39 weeks along. On the other hand, if a mom is planning a repeat cesarean delivery, or wants to deliver on a specific day, or is simply tired of being pregnant, that will have to wait until she is 39 weeks. This policy ensures that that babies are born at the safest time for them and their mothers.

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