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October is Breast Cancer Awareness Month

Category: Dr. Warner

Breast Cancer Symptoms

Breast cancer is the most common cancer among American women.

In 2013, an estimated 232,340 women will be diagnosed with invasive breast cancer, while 64,640 will be diagnosed with non-invasive breast cancer. With early detection and treatment, women can fight back against breast cancer.

Diagnosed with Breast Cancer? Here Are Your Treatment Options

  • Breast-conserving surgery and radiation therapy. An operation to remove the breast cancer, but not the breast itself.

  • Total mastectomy. The entire breast is removed. Many celebrities, including Angelina Jolie, Christina Applegate, Kathy Bates and Sharon Osbourne, have spoken out about their choice to receive a double mastectomy.

You Are Not Alone in Your Fight Against Breast Cancer

Receiving a diagnosis of breast cancer can be overwhelming. Hearing the perspective of others who have survived cancer can give you a better perspective on treatment and survival.

Here are a few quotes from famous faces who won the battle against breast cancer:

  • Having had cancer, one important thing to know is you’re still the same person at the end…most people come out the other end feeling more like themselves than ever before.” -Kylie Minogue

  • I look at my cancer journey as a gift: It made me slow down and realize the important things in life and taught me to not sweat the small stuff.” – Olivia Newton-John

  • Cancer gave me the gift of being fearless.”- Today show co-host Hoda Kotb

  • I was diagnosed with breast cancer two months ago and am recovering from a double mastectomy. I don’t miss my breasts as much as I miss Harry’s Law.” - Kathy Bates

What Can I Do To Show My Support in the Fight Against Breast Cancer?

With over 3 million women battling breast cancer today, everywhere you turn there is a mother, daughter, sister, or friend who has been affected by breast cancer.” -Betsey Johnson


Even if you don’t suffer from breast cancer, you most likely know someone who is. Show your support by:

  • Donating to charities

  • Participating in walks and races that give proceeds to breast cancer foundations. Some of the most popular races include the Race for the Cure, Three-Day Walk for Breast Cancer and “Tour De Pink.”


Do your part in the fight against breast cancer.



Ovarian Cancer Awareness Month

Symptoms of Ovarian Cancer

September is ovarian cancer awareness month. Ovarian cancer is one of the most deadly women’s cancers, affecting approximately 22,880 women each year. During ovarian cancer, one or more malignant cancerous cells are found in the ovaries, which are almond-shaped organs located on each side of the uterus.

Symptoms of Ovarian Cancer

Ovarian cancer is difficult to detect because the symptoms aren’t obvious and the ovaries are deep within the abdominal cavity. The common ovarian cancer symptoms include:

  • Bloating
  • Frequent urination
  • Trouble eating
  • Pelvic pain
  • Pain during sexual intercourse
  • Changes in menstruation
  • Upset stomach or heartburn

Stages of Ovarian Cancer

There are four stages of ovarian cancer and your doctor will determine your stage during surgery. These are the stages of ovarian cancer:

  • Stage I – Growth of the cancer is limited to the ovaries. Stage I includes an A, B and C phase. Each describe exactly where in the ovaries the cancer is located, such as whether the cancer is on the outside of the ovary or whether it is confined to the inside of the ovary.
  • Stage II – During stage II, the cancer involves one or both of the ovaries with pelvic extension.
  • Stage III – Growth of the cancer is in one or both of the ovaries. Stage III also involves the cancer spreading beyond the pelvis and/or spreading to the lymph nodes.
  • Stage IV – Stage IV is the most advanced stage of cancer. At this stage, cancer is seen in one or both the ovaries and it has spread to organs outside of the peritoneal cavity.

What are My Treatment Options?

How to properly treat ovarian cancer depends on the stage. There are three main treatment options available, including:

  • Surgery – This is the most common way to treat ovarian cancer.
  • Chemotherapy – Chemotherapy is used in a majority of ovarian cancer treatments after surgery.
  • Radiation Therapy – This is only rarely used for ovarian cancer treatments.


For more information on ovarian cancer awareness month, consult your physician or check out http://www.ovarian.org/.


Five Facts about Twin Pregnancies

Category: Uncategorized

Pregnancy Facts

Finding out you are having twins is an exciting, but somewhat overwhelming feeling. Many mothers wonder how different twin pregnancies are than singleton pregnancies. Check out these five facts about twin pregnancy that a lot of people don’t know!

1. Twins have a lower birth weight, but the mothers gain more weight throughout pregnancy.

Carrying two babies causes women to gain more weight during pregnancy. Women who are a normal weight should aim to gain about 37-54 pounds throughout the pregnancy as opposed to 25 to 35.

2. Extra Folic Acid is a necessity when you are having two babies

Folic acid helps reduce the chance of birth defects, such as spina bifida. The amount you need increases with each baby you are carrying. One milligram of folic acid is the recommended amount for twin pregnancies.

3. The chance of delivering early is higher with twins

More often than not, moms carrying twins go into labor around week 36 or 37. Though most women get concerned when they deliver early, if a baby is born after week 34, there isn’t a reason for concern. Even if babies are born after 34 weeks, there is still a chance the baby will be born at a low birth weight.

4. Morning sickness is more common with twin pregnancies

Morning sickness is caused by the hormone human chorionic gonadotropin, which is higher during twin pregnancies. Even if women experience more morning sickness in their first trimester, the feeling subsides around week 12 or 14.

5. There is a higher chance or conceiving twins naturally in your 30s and 40s.

Conceiving when you are older may increase the chance of a twin pregnancy. Ovulation patterns change as you get older, which means there is a possibility you could be ovulating two follicles at the same time when you’re older.

For information on twin pregnancies, consult your physician.



What to Expect For Your First Annual Gynecological Exam

Category: Uncategorized

What to Expect For Your First Gynecological Exam

Going to the gynecologist isn’t something women eagerly anticipate. The anxiety and discomfort women feel is increased when it’s their first annual exam. There are a few things to keep in mind before having your first annual exam.

Who should I prepare for my exam?

The most important thing to do before your first gynecological exam is research. Women should be prepared to discuss their family medical history and be ready for questions about their menstrual cycle. Some of the most commonly asked questions your provider may ask include:

  • When was your last period?
  • How long does your period typically last?
  • What age did you start your period?
  • Are you sexually active?

What should I expect for my annual exam?

The pelvic exam only lasts a few minutes and the exam itself doesn’t hurt. Most physicians will explain the process before beginning the exam, asking questions throughout the process is encouraged. The pelvic exam consists of the following steps:


  • Your doctor will typically begin the annual exam with a breast exam to check for lumps that may be a sign of cancer.
  • Your physician will then check the external genital area for irritations, cysts or other problems.
  • Next, the physician will insert a speculum, which is an instrument that is used to examine the cervix and vaginal walls. During this time, the doctor will also conduct a pap smear to check for cancerous and pre-cancerous cells.
  • The last step in the physical exam is for the physician to check the uterus, fallopian tubes and ovaries by inserting gloved fingers into the vagina and pressing on the abdomen.


Not only does the annual exam ensure that you maintain good gynecological health, but it is also an opportunity for you to catch health problems in the early stages.


If it’s time to schedule your annual exam, please contact our office.




Steps to Treating Urinary Incontinence

Urinary incontinence is not something that any woman wants to deal with. While common, incontinence can be due to a wide variety of factors, like age, having a baby, genetics, and illnesses. If you are dealing with urinary incontinence, then you know it comes along with embarrassment and frustration. The good news is that there are ways to treat your condition. With many different options, you will want to discuss those options with your doctor.

At Home Techniques

You cannot completely cure your incontinence at home, but there are definitely things you can do that will help the issue to some level. Here are some things you can do at home to deal with your condition:

  • Training your bladder by teaching yourself to hold your urge to go a little longer each day.
  • Scheduling your visits to the bathroom about every two to four hours.
  • Avoiding beverages that make you need to go quicker, like alcohol, caffeine, and foods that are high in acid.
  • Kegel exercises to build strength in the muscles of the pelvic floor.
  • Wearing incontinence pads or underwear
  • Using a catheter

These at home methods are often just methods of dealing with the urinary incontinence. However, if you only have the mildest of versions, they may be feasible. If you have more severe cases of urinary incontinence, then you will need to talk to your doctor about your options, such as medications or surgical procedures.


There are a few different medications that your doctor may prescribe. Of course you will still need to use other methods like some of those above, but when taken together, they can be successful for some types of urinary incontinence. Here are some of the medications that your doctor may prescribe.

  • Duloxetine. This is an antidepressant that can be used for the types of urinary incontinence called stress incontinence.
  • Imipramine. This is also an antidepressant that can be used to treat stress incontinence.
  • Topical Estrogen. This low dose estrogen can be found in three different forms: vaginal cream, patch, and ring. The topical estrogen can be used to build the strength of tissues in the urethra and the surrounding areas.
  • Anticholinergics. These medications are designed specifically for those who have an overactive bladder. They come in many names, including Detrol, Ditropan, Enablex, Toviaz, Sanctura, and Vesicare.


In many cases, surgery is the best option for urinary incontinence. If you have severe incontinence, then a surgical procedure can be a permanent solution so that you do not have to continue dealing with the embarrassing problem.

  • Pelvic Sling. This sling is made from natural body tissue to create a hammock type device that will support the urethra.
  • Bladder Suspension. A section of muscle will be used to create a device that will support the bladder neck. This helps to take pressure off the urethra.

You have a number of different options to treat urinary incontinence and you will definitely want to discuss each with your doctor.

Questions to Ask Your Doctor if You Have Heavy Bleeding

There are many different complications with heavy menstrual bleeding that you may not have even thought of. For example, many women who have a condition that causes heavy bleeding could suffer from anemia and iron deficiency, which can be dangerous to their health. If you think you have a problem with heavy bleeding, you will need to contact your doctor and discuss your condition as well as your treatment options. Remember that anytime you are dealing with your health, you should have your questions answered before you decide on any treatment option.
To help you get started, here are important questions you should ask your doctor. You may have more questions that you would like ask, but this is a good place to start.

Questions to Ask Your Doctor

  • Is my level of bleeding categorized as abnormally heavy? Not all cases of heavier than normal bleeding would be considered clinically heavy. Your doctor can help you decide if you have a condition.
  • How do I know if I have low iron because of my bleeding? A blood test will most likely be conducted and then your doctor will give you suggestions for an iron replacement therapy.
  • Can you go over my treatment options and tell me the advantages, disadvantages, and risks of each? In some cases, you will have choices and you will want to understand each of those choices before you make a decision.
  • How will you go about diagnosing my condition? Your doctor should discuss testing procedures and what you will need to go through in order to determine the cause of your bleeding.
  • In severe cases, like endometriosis, is hysterectomy my only option? Surgery could be the best option for you so that you do not have to continue suffering, but you may wish to explore other options before you choose this measure.
  • If I should consider endometrial ablation, can you tell me more about the success rates and complications of this treatment? This surgical procedure has numerous uses and it could be the right one for you, but you need to know more about it.
  • Will you be able to treat my condition or will I be referred to a specialist? There are some cases when a specialist will be called in and you may need to determine what specialist you will like to see.
  • What are the success rates of the treatment we have chosen for my bleeding? Some treatments may not be as successful and you will want to take this into consideration before choosing one particular treatment over another.

Heavy menstrual bleeding is a common condition that affects many women for various reasons. You will need to go to a doctor in order to determine what condition from which you are suffering. Be sure to get all of your questions answered so that you can choose the best treatment option to suit your needs. Do not be afraid to ask any questions you may have no matter how small they may seem.

Understanding My Birth Control Options

The modern world is certainly different from what women had to deal with years ago. Thanks to advances in science and technology, women have a variety of birth control options. These days, you can find choices that guarantee against pregnancy with ratings up to 99.9% if you make use of them properly. You can choose from birth control options that will best suit your lifestyle, but be sure to discuss your top choices with your doctor in order to pick the right one. Here are common choices for birth control that you could consider:

Barrier Methods of Birth Control

Barrier methods include those that block the sperm from ever reaching the egg. They include the following:

  • Contraceptive sponge along with a spermicide
  • Diaphragm
  • Cervical cap
  • Female condom
  • Male condom

These types of birth control methods are considered to have the higher chance of failure when compared to other methods. For example, the male condom is about 97% effective. That does not mean they are not viable means of birth control. They just do not get the complete assurance you could find in other choices.

Hormone Based Birth Control

These types of birth control are, by far, the most common. The most important thing about the hormone based methods is that they must be used as directed to be dependable. They include the following:

  • The pill
  • The contraceptive patch
  • Shots or injections
  • Vaginal ring

When used properly, these methods are about 99% effective. The common failure of the methods comes from human error.

Implant Methods of Birth Control

For those women who wish to have dependable birth control without having to remember to take a pill every day, there are implantable devices. They include:

  • Implantable rods
  • IUDs (intrauterine devices)

These two options are long-term methods of birth control. They last up to 10 years. They, especially the rods, should not be used if you think you may wish to have children in the near future.

Permanent Solutions

If you know that you do not want children in the future, then you may want to consider surgical solutions. These methods completely take away the chance of fertilization, so they are the most dependable. However, since they are permanent, you should consider them carefully before making the decision to use them. They include:

  • Female implant sterilization
  • Vasectomy for men
  • Tying or cutting the fallopian tubes in a woman

Emergency Contraception

Called the “Plan B” pill, this emergency contraception can be used the morning after unprotected sex. It has to be taken within 72 hours in order to be effective. This method is not made to be used as a regular birth control but instead as an emergency method in the cases of forgotten birth control, birth control failure, or rape.

As you can see, you have plenty of different birth control options. That means, you can choose one that will best suit your lifestyle. Be sure to discuss the birth control option you would prefer with your doctor so that it can be determined if it is the best choice based on your health and wellbeing.


We’re in! We Support a nation free of disparities in health and healthcare.

Category: Dr. Warner

NPA LogoThe mission of the NPA is to increase the effectiveness of programs that target the elimination of health disparities through the coordination of partners, leaders, and stakeholders committed to action.

The goals of the NPA and its National Stakeholder Strategy for Achieving Health Equity are:

  • AwarenessIncrease awareness of the significance of health disparities, their impact on the nation, and the actions necessary to improve health outcomes for racial, ethnic, and underserved populations.
  • LeadershipStrengthen and broaden leadership for addressing health disparities at all levels.
  • Health System and Life ExperienceImprove health and healthcare outcomes for racial, ethnic, and underserved populations.
  • Cultural and Linguistic CompetencyImprove cultural and linguistic competency and the diversity of the health-related workforce.
  • Data, Research, and EvaluationImprove data availability and coordination, utilization, and diffusion of research and evaluation outcomes.

Learn more >>


Struggling With Heavy Periods?

Category: NovaSure

1 in 5 women suffer from heavy menstrual bleeding. More than just a hassle, they take physical, emotional, and social toll as well.

NovaSure®, a one-time, five-minute procedure lightens or ends your heavy period. With no pills or hormonal side effects, menstrual bleeding is dramatically reduced or stopped.

NovaSure Works in Four Simple Steps:

NovaSure first stepYour doctor slightly opens your cervix (the opening to the uterus), inserts a slender wand, and extends a triangular mesh device into the uterus




NovaSure first stepThe mesh gently expands, fitting to the size and shape of your uterus




NovaSure first stepPrecisely measured radio frequency energy is delivered through the mesh for about 90 seconds, gently removing the lining of the uterus




NovaSure first stepThe mesh device is pulled back into the wand and both are removed from the uterus




Interested in learning more? Check out our section on [NovaSure].

Questions to Ask Your Doctor if You are Considering Permanent Birth Control

For some women, permanent birth control is the best option to guarantee that they will not have any more children. However as the name explains, permanent birth control is, well, permanent. In very few cases are these procedures reversible. Before you make the decision to go with a permanent option, you will want to ask your doctor all of the right questions. Be sure you know everything you need to about the procedure before you make a decision.

Below are a few questions that you should ask your doctor before you make your decision.

General Questions

  • What are my options for permanent birth control?
  • Is a permanent option the right one for me?
  • Are there other options that I should consider before I make the decision?
  • What type of birth control, permanent or nonpermanent, would you recommend?

Ask these questions in the beginning. They will give you a good starting place to determining if permanent birth control is the right choice for you.

Tubal Ligation and Implant Birth Control

Tubal ligation is a common procedure in which the fallopian tubes are tied so that the eggs cannot travel to the uterus. Permanent implant birth control includes placing specialty material in the fallopian tubes so that scar tissue will form and completely block the tubes.

  • Should I consider tubal ligation or permanent implant birth control?
  • What are the risks to each of these surgical procedures?
  • Are both of the procedures always successful? If not, what is the failure rate?
  • How do you go about each of the procedures?
  • What type of recovery can I expect from the procedures?
  • What are the benefits to choosing one of these procedures?
  • Would you recommend one of these to me as my own permanent birth control method?


Emotional Factors

The most important thing to remember is that permanent birth control methods should only be chosen if you absolutely know that you never want to have children. There are emotional factors to consider. How will you handle it if you change your mind at a later date and wish to have children? Consider all of the ramifications of the birth control that you are choosing before you go through with any procedure.

Permanent birth control could be the right option for you since it completely cuts out your chances of becoming pregnant at a later date. Make sure to ask all of the questions above when you talk to your doctor to help you make the right choice.