Cap Ob/Gyn Springs into the Community in May!

Spring is here, and the doctors at Capital Ob/Gyn Associates of Texas are gearing up for some fun women’s health events next month.

Dr. Catherine Browne will be speaking at the Empowering Women Health Conference on May 5th, 2012. The conference strives to educate women and the community about the myriad women’s health issues and empower women to take care of themselves.  Dr. Browne will be talking about new guidelines in women’s medicine and answering questions like, “Do I really need a pap smear and mammogram every year?” Since the guidelines are always changing, Dr. Browne will tell attendees what’s changing and what you need to know to make informed decisions. This conference is already sold out, but will be one of many Women’s Health Conferences to come so stay tuned for more.

Capital Ob/Gyn Associates of Texas is very excited to be back in the Austin women’s triathlon community this season! Our friendly staff will be volunteering at the Skeese Greets Triathlon  packet pick-up on Saturday, May 12th at Jack & Adam’s Bicycles. Dr.Mushtaler (aka OB JEN) has previously sponsored the Skeese Greets Tri, Sweet & Twisted Tri, Cougar 5k, the Couples Triathlon and the Zooma Half Marathon-Austin. She’s also a triathlete herself, so don’t be afraid to ask questions about training or health while you’re there!

Make sure to keep an eye out for Capital Ob/Gyn around town and please visit our website or to learn more about our practice, OB JEN and Dr. Browne!


Daily Rx Recap: Complications for Mothers with Lupus

OBJen was recently quoted in Daily Rx regarding complications for mothers with lupus.  Read what she said below or click here to read the full article or go to www.dailyrx.com.

More Complications for Mothers with Lupus: Lupus May Reduce the Chance of Live Birth

Before getting pregnant, it is important to know if you are healthy enough to have a baby.  Certain diseases, such as lupus, can make pregnancy risky for both you and your child.

Women with lupus have less live births than otherwise healthy women.

Pregnancy is an exciting time for most women. However, it can be a stressful time as well, especially if the mother has lupus.

While it is entirely possible for a woman with lupus to have a healthy baby, she should also know the risks she faces before she decides to get pregnant.

Évelyne Vinet, M.D., of McGill University Health Centre in Montreal, and colleagues recently carried out a study to measure the number of live births in women with lupus.

The results show that women had 32 percent fewer live births after being diagnosed with lupus, compared to before diagnosis.

“Lupus is in the family of autoimmune disorders,” says Jennifer Mushtaler, M.D., an obstetrician in Austin, Texas. “As a whole, these disorders tend to complicate pregnancy for both mother and fetus.”

Dr. Mushtaler, who was not involved in the study, explains that these autoimmune conditions can lead to thrombophilias, or disorders that promote blood clotting, and other complications that can pose a risk to the placenta.

“As a generalist, I co-manage these pregnancies with a perinatologist,” she says. “We perform more aggressive surveillance on mother and baby during the pregnancy, and have a low threshold for early delivery if indicated on behalf of the baby or the mother.”

The study involved 1,334 women with lupus. These women had a total of 559 live births, which was lower than the expected number of 708 live births.

“After diagnosis, women with [lupus] have substantially fewer live births than the general population,” the authors conclude.

These findings suggest that doctors need to keep a close watch on their pregnant patients suffering from lupus.

The study is published in Annals of Rheumatic Diseases. 

To schedule an appointment with Dr. Mushtaler (OBJen) visit our website.

 


What to Consider When Selecting an Ob/Gyn

Your relationship with your obstetrician/gynecologist is one of the most intimate professional relationships you may have.  Although it can take time for this relationship to develop, you should feel comfortable with this person and should be able to trust your obstetrician/gynecologist with your most private concerns.

Important questions to consider when selecting an obstetrician/gynecologist include:

1.Does she/he have experience caring for and delivering high risk pregnancies?

None of us want to experience a complicated, high risk pregnancy. However, an attending of mine in my training used to remind us at the beginning of every call night, “The sickest patient will be the one you least expect.” Even if you consider yourself to be healthy, pregnancy and labor can unexpectedly become risky to mother and baby. You want to make sure that your obstetrician has the training and experience to handle any surprises from severe pre-eclampsia to acute hemorrhage. If you live in a major metropolitan area, you also want to know if your obstetrician delivers at a level 3 center with in-house anesthesia and an experienced NICU. Hopefully you don’t need those services, but if you or your baby were in grave danger, you would want to feel confident that your obstetrician can manage your care and that she/he has the resources needed to do so.

2.How will she/he manage a pregnancy that goes beyond the due date? At what point will she/he insist on induction?

These questions tell you a lot about your obstetrician’s medical beliefs and style of practice. Some providers believe that babies should be delivered as soon as possible while others may take a wait and see approach. A seasoned obstetrician may tell you that the answer is not easily defined because she/he will need to consider multiple factors specific to your situation in deciding when and how to recommend an induction.

3.What are her/his views about the use of doulas?

Again, this question tells you a lot about your obstetrician, whether she/he is open to a holistic approach and whether she/he is going to help create a supportive environment. Doulas are labor companions who can help ease anxiety during labor and offer emotional support. A great doula may be someone you hire or it may be a family member or friend. In any case, knowing your obstetrician’s opinion will give you insight into their practice style and if it matches with yours.

4.Will she/he deliver my baby?

No one physician can be on-call 24 hours a day/ 365 days a year. Most obstetricians share call with other doctors in their practice or community. You should know who the other doctors in the call group are and how the call rotation works. Some groups are extremely large so you may not have an opportunity to get to know all of the doctors who may attend your delivery. Other groups are smaller and may have a system in place for you to meet the other doctors who may deliver your baby. Also, in many communities ob/gyn’s perform circumcisions upon request. If this is relevant to you, don’t forget to inquire about it and whether or not she/he uses anesthesia.

5. What is the practice’s policy for handling emergencies?

For example, will your doctor be able to see you on a regular office day or will you have to wait for an opening or see a mid-level provider? Who can you reach by phone during office hours or after hours for an emergency? How long does it typically take for the doctor or a nurse to return your call? Many large groups utilize a nurse telephone triage system, while in a small group you may be able to reach your doctor or nurse directly.

Thankfully routine pregnancy is only 40 weeks, give or take a little bit, so you should also consider your gynecological needs when selecting an ob/gyn. Consider some of the following:

1. How far in advance do I need to schedule a routine annual if I want to see my doctor?

This gives you insight into how accessible the doctor really is. As a mother and working woman myself, I want a physician I can actually see even if nothing is wrong and I am not pregnant. Everyone’s schedule is different so consider how important this is to you. I have had friends tell me they haven’t seen their doctor in years because they cannot get an appointment scheduled for months.

2. Does she/he prescribe birth control?

There are many patients and physicians who do not believe in the personal use of contraception, and this is to be respected. As a woman’s health care provider, however, I believe that an ob/gyn should be comfortable and knowledgeable discussing the factual pros and cons of all methods of contraception. Some birth control regimens may not be suited for women with certain medical conditions. On the other hand, some providers will not place IUD’s in women who have not had children. Be sure that the ob/gyn you choose is able to meet your individual needs.

3. Are you comfortable with the ob/gyn?

I think this is crucial. If you need to discuss STD testing, vaginal dryness and hot flashes or …something smelling badly down there, you need to feel able to do so. Moreover, if you are going to have surgery you need to feel confident that your surgeon is going to take good care of you. You should also consider your own value system and lifestyle. She/he may not live exactly as you do, but your healthcare relationship will be more comfortable if there is understanding and respect.

For additional information about a prospective physician, you can verify licensure with your state’s medical board. You can also verify that your physician is board certified through the American College of Obstetricians and Gynecologists. Both will offer information on a public website.

You can also contact Capital Ob/Gyn Associates of Texas directly at 512-83-OBJEN or visit our website www.capobgyn.com.


Diva Night

The ladies of Capital Ob/Gyn Associates of Texas will be attending Diva Night on Wednesday January 25th from 7:00 – 9:00pm at Texas Running Company Downtown.  This is a great opportunity for any woman with an interest in a healthy 2012!

Upbeat Marketing and Texas Running Company are joining forces to bring the women of Austin a night of wellness, networking and shopping. Austin’s brightest, most passionate healthcare providers will be gathered in one place for an expo-style event to help women better understand and embody wellness! Diva Night will be a casual setting with shoe and bra fittings, complimentary chair massage, food and beverages, and of course fabulous vendors.

Admission is COMPLIMENTARY.  Each attendee will receive a Healthy Diva Goodie Bag and entry into our event raffle. Ladies of all backgrounds and interests are invited to come as they are and bring their friends – post-work, post-workout or pre-night out!

The Prima-Vendors Include Nike, CW-X , MyFitList, CryoStudio, iGnite Your Life, Austin BodyWorker, Austin Woman Magazine, Capital OB/GYN Associates of Texas, Austin Family and Sport Chiropractic and My Fit Foods.

Make sure you stop by on January 25th, 2012 from 7-9pm at Texas Running Company Downtown located at 1011 W. Fifth Street, Suite 110, Austin, Texas 78703 to see Dr. Mushtaler and Dr. Browne.  We look forward to seeing you there!


Capital Ob/Gyn Attends the Bridal Extravaganza

Happy CoupleDr. Mushtaler (OB JEN) and the staff of Capital Ob/Gyn were thrilled to attend the 2012 Austin Bridal Extravaganza this weekend at The Palmer Event Center in Austin.

When planning a major life event such as a wedding, the last thing on a woman’s mind is often her health.  However, engagement can be a crucial time for the bride and her husband to discuss important topics such as birth control and family planning.  The questions start to come up – Should we start birth control? When do you want to have children?  How many children do you want?

During this exciting time, many women are looking to find an Ob/Gyn who can partner with them in their health care needs – and they should look no further than Capital Ob/Gyn!  We offer a full range of obstetrics and gynecology services for all stages of a women’s life, including:

  • Well-Woman Exams
  • Contraception/Birth Control
  • STD Testing
  • Pre-Natal Counseling
  • Low & High Risk Obstetrics
  • Fertility Treatment and more!

It was a pleasure meeting so many beautiful brides this weekend as well as their family members and friends.  We look forward to supporting them as they begin this new chapter in their lives and look ahead to their future family and health care needs.

To schedule an appointment with Dr. Mushtaler, visit www.capobgyn.com or call 512-83-OB-JEN.


Daily Rx Recap: Mother-Infant Separation is Stressful

Dr. Jennifer Mushtaler, affectionately known as OB JEN, was recently quoted in the Daily Rx regarding separation between mother and infact following birth.  Read below to see Dr. Mushtaler’s comments, or click here to view the full article on www.dailyrx.com.

Mother-Infant Separation is Stressful
Newborns fare best when kept with mother after birth

(daily Rx) It’s long been the traditional hospital procedure; after a baby is born, it is whisked away by medical staff to be measured, cleaned and swaddled. Until recent years, newborns were often kept in the nursery away from their mothers.

Still today, there is much separation between babies and their mothers in hospitals directly after birth. And researchers say that isn’t good for either.

Newborn babies need their mothers.

Barak E. Morgan, Ph.D. of the University of Cape Town, led a recent study of maternal-neonate separation (MNS), which is a Western norm in medical practice. Morgan and his colleagues measured heart rate variability in 16 full-term newborns at two days old, to determine their stress levels. The babies’ heart rates were measured for one hour when sleeping in skin-to-skin contact with their mothers, and when sleeping alone, before discharge from the hospital.

The babies showed a 176 percent increase in anxious autonomic activity and an 86 percent decrease in quiet sleep when separated from their mothers, compared with skin-to-skin contact. Researchers concluded that mother-baby separation is associated with a dramatic increase in physiological stress response in infants, and has a profoundly negative impact on their quiet sleep duration.

“There is good research to support that separation of mother and infant has deleterious side effects on both mommy and baby,” says Jennifer Mushtaler, M.D., an obstetrician in Austin, Texas. “I encourage my mothers to have skin-to-skin contact immediately following birth including birth by cesarean section.”

She adds that skin-to-skin contact not only when nursing or sleeping, but also at other times, is highly beneficial. “Most experienced mothers will attest to the benefits of swaddling their infant to their bodies when they go about their day and for soothing a colicky or crying baby.”

The research findings were published in the journal Biological Psychiatry, and reported in the Wall Street Journal.

To schedule an appointment with Dr. Jennifer Mushtaler, please visit www.capobgyn.com or call 512-83-OBJEN.


Daily Rx Recap: Thyroidism in Pregnancy

OB JEN was recently quoted in the following article by Daily Rx regarding Pregnancy Thyroid Screenings.

Read on to learn more or click here for the full article: http://www.dailyrx.com/news-article/thyroid-reduction-problematic-mother-and-fetus-15925.html

(dailyRx)  For women who are pregnant, reduced thyroid function can have adverse effects on both the woman’s health, and that of her unborn baby. These effects can include the risk of miscarriage and premature birth, but the universal screening of pregnant women for thyroid disfunction is still controversial due to costs.

Thyroid autoimmunity, in which a person’s immune system attacks and damages the thyroid, also puts the mother at higher risk of developing postpartum thyroiditis (swelling of the thyroid) and hypothyroidism (low thyroid hormone production).

Pregnant women should ask their doctor about thyroid screening.

Only women at high risk for developing thyroid dysfunction are recommended for screening traditionally. Chrysoula Dosiou, MD, of Stanford University School of Medicine, and colleagues from several other universities the University developed a computer model to compare the cost-effectiveness of three screening strategies: universal screening with thyroid-stimulating hormone and anti-thyroid peroxidase antibodies during the first trimester, risk-based screening, and no screening.

Patients who receive a positive screening test would receive follow-up testing and treatment with thyroid hormone when indicated, under the developed model. The model takes into account the development of adverse obstetrical outcomes during pregnancy, postpartum thyroiditis, and overt hypothyroidism during a woman’s lifetime.

Using the model, researchers found that universal screening for autoimmune thyroid disease in the first trimester of pregnancy is cost-effective compared with screening of only high-risk women. Both the risk-based and universal screening options are cost-effective when relative to no screening.

“Interestingly, the current guidelines do not support universal screening,” says Jennifer Mushtaler, MD and an obstetrician in Austin, Texas. “However, the risks associated with untreated hypothyroidism in pregnancy are well-known. It is good to see a model that evaluates the cost-benefit profiles in the general population to show merit to universal screening.”

Findings from the model study were presented at the 81st Annual Meeting of the American Thyroid Association in October 2011.

To learn more about Dr. Jennifer Mushtaler, founder of Capital Ob/Gyn Associates of Texas, call 512-83-OB-JEN or visit www.capobgyn.com.


Please Welcome Dr. Browne to Cap Ob/Gyn!

Cap Ob/Gyn Associates of Texas is pleased to announce the addition of a new physician to our team, Dr. Catherine Browne! Dr. Browne comes to us with 10 years of experience in gynecology and obstetrics from the beautiful state of New Mexico. Dr. Browne is a Board Certified Ob/Gyn with the American Board of Osteopathic Obstetricians & Gynecologists. She served 7 years in the U.S. Army providing medical care to active duty women and military wives and devoted 2 years to serving the indigent and uninsured in Montgomery, Texas.

Dr. Browne went into women’s medicine in 2000 because as a woman, she wanted to connect with female patients to provide compassionate, comprehensive and up-to-date medical care. She majored in chemistry at University of Puget Sound in Tacoma, WA, where she taught workshops on alcohol awareness and date rape awareness while working two or three side jobs. Additionally, she coordinated campus-wide food drives and tutored inner-city elementary aged kids.

After college, Dr. Browne worked in organic chemistry at the Los Alamos National Laboratory in Los Alamos, NM and later at an allergy and asthma research center, while saving money for medical school. Dr. Browne then went to medical school at the Chicago College of Osteopathic Medicine in Downers Grove, IL. After graduating, she went into the field of obstetrics and gynecology, completing her internship and residency at Tripler Army Medical Center in Honolulu, HI. She has recently moved to Austin, TX, with her husband and their two young children, ages 2 years-old and 6 years-old.

Like most women, Dr. Catherine Browne is a daughter, a mother, a spouse and a friend. As a career woman, she juggles home life and work life, blending her love of family with her love of teaching and medicine. We know that you will find Dr. Browne’s gentle and reassuring manner to be a great fit with the rest of the staff at Capital Ob/Gyn Associates of Texas!

Please extend a warm Austin, Texas hello and howdy to Dr. Catherine Browne!

To schedule an appointment with Dr. Catherine Browne, please contact Capital Ob/Gyn Associates of Texas at 512-836-2536 or visit our website www.capobgyn.com. Dr. Browne is currently accepting new patients and looks forward to helping you with your most intimate of health needs.


The Vitamin D Deficiency Pandemic – Not so Fast!

Some researchers have warned that vitamin D deficiency is akin to a silent epidemic. However, recent data from the Institute of Medicine reveals that the majority of people are getting enough vitamin D and calcium. Although quite plausible, there is not enough data to support claims that vitamin D can help
protect against cancer, heart disease, diabetes, MS or pre-eclampsia of pregnancy to name a few.

What are the recommendations for vitamin D and calcium intake?

It is recommended that young women ages 9-18 consume 1300 mg/day of calcium and 600 IU/day of vitamin D. Healthy women ages 19-51 including those who are pregnant or lactating should consume 1000 mg/day of calcium and 600 IU/day of vitamin D. Women ages 51-70 should consume 1200 mg/
day of calcium and 600 IU/day of vitamin D. Women older than 70 years should increase their vitamin D consumption to 800 IU/day in addition to 1200 mg/day of calcium.

Should I take a calcium and/or vitamin D supplement?

Most individuals can achieve the recommended amounts through proper diet and nutrition, and it only takes 10-15 minutes of sun exposure to generate your daily vitamin D requirements. Research shows that most people get 600-900 mg of calcium daily from diet alone. There is also a recommended upper safe limit of 2000 mg/day of calcium and 4000 IU/day of vitamin D. Excess calcium and vitamin D has been associated with calcifications in blood vessels, kidney stones, cardiovascular risk and surprisingly falls and fractures. Some natural food sources of vitamin D include cod liver oil, salmon, mackerel, and fortified milk. If you are going to supplement your diet, check for USP verification on the label.

Should I have my vitamin D level checked?

Only those persons at risk for vitamin D deficiency need to have their levels screened. At risk persons include pregnant and nursing women, obese individuals, darker skinned individuals, persons who have undergone prior bariatric surgery, persons with Crohn’s disease, and persons with osteoporosis.
There are several other serious medical conditions in which vitamin D testing is also recommended so speak with your doctor first.

Don’t have one? Come see OB JEN at Capital Ob/Gyn Associates of Texas.
www.capobgyn.com


Pap and a Piece of Chocolate

I am going to let you in on a little secret. I have been practicing obstetrics and gynecology for over ten years now, I have cared for thousands of women through all manner of women’s medical issues, I have been pregnant and delivered two wonderful daughters, and I still dread going to the ob/gyn for my exam.

Will my ob/gyn use the plastic or the metal speculum? Did I shave too much or too little? Oh, fiddlesticks! I just realized I totally forgot to shave my legs, and I will have to leave my socks on because I am way overdue nail polish on my toes. Oh please Lord let my deodorant be working extra hard today because I can’t stop thinking about plastic or metal and now I am beginning to perspire and my
appointment isn’t until this afternoon. Yes, ob/gyn’s dread their own ob/gyn exams, too.

A few years ago my young girls became accomplished statisticians. They had concluded with reasonable probability that if we were going to visit the pediatrician, one or both of them would be statistically likely to receive a shot. Not wanting them to dread (read violently resist) going, I proposed that if they
received a shot, we would go for a treat of their choice afterwards. It worked!

Then I had a wonderful thought! What if my patients were to receive a small treat to ease the anxiety of coming to the ob/gyn? Something sweet and thoughtful that acknowledges that you might not have really wanted to, but you came in to take care of yourself? Sitting in a jar on the table you will ALWAYS find an assortment of small chocolates. Please help yourself, and we won’t tell anyone if you take two pieces.
We know, we understand; you were very brave.

To schedule an appointment with Capital Ob/Gyn Associates of Texas – Home of Pap and a Piece of Chocolate – please visit www.capobgyn.com or call 512-83-OB-JEN.