Category: Patient Information

Pregnancy is a major event. If you plan for it, your choices can be beneficial to both your health and that of your baby. 

It is very important to consider the role diet, exercise and lifestyle play in your everyday life when you are preparing to get pregnant.  Making positive changes to your lifestyle before pregnancy will benefit you during the pregnancy as well as contribute to the overall health of your child.

Diet

A balanced diet is basic for good health, as what you eat supports the growth of your fetus. To eat wisely, eat a balanced meal as per MyPlate (new food pyramid system).

Folic Acid

Women attempting to conceive should take daily folic acid supplementation for at least one to three months prior to conception.  Folic acid can help reduce the risk of neural tube defects and can be found over the counter in your local pharmacy. The dose recommended may vary depending on specific conditions or medical history in a given patient, but the minimum requirement is 400mcg (0.4mg) daily, and many physicians recommend taking 0.8-1mg per day for the average person. This is the amount found in most over the counter prenatal vitamins.

Keeping Fit

Good health also depends on staying fit. Following an exercise routine before conception can help improve your chances of a comfortable and active pregnancy. The exercise that you can do during pregnancy depends on the exercises you did prior to becoming pregnant. You may continue with your pre-pregnancy routine unless your physician tells you otherwise.

Weight loss should be done before pregnancy and after delivery.

You should not try to lose weight during pregnancy.

Environment

Tobacco, alcohol, and illegal drugs can cause harm to you and your unborn baby. No amount of these substances has been proven safe to use during pregnancy. Now is the time to quit the use of these substances. If you need help quitting, please speak to your doctor.

Making some lifestyle changes now such as eating wisely, staying fit, avoiding tobacco, alcohol, and illegal drugs, and regular visits to your doctor can help ensure you have done your part to prepare for a normal pregnancy and healthy delivery. 

Travel

Travel Precautions

 Considering Pregnancy?

The CDC recommends precautions for women and their partners who are thinking about pregnancy.

• Consider avoiding nonessential travel to areas with Zika if you are thinking about having a baby in the near future.
• If you must travel, take steps to plan for travel.
• If your partner travels to an area with Zika, protect yourself from getting Zika during sex.

What to do if you travel to an area with Zika

If you are not pregnant, but you are thinking about having a baby, here’s what you can do:

• Take steps to prevent mosquito bites.
• Take steps to prevent getting Zika through sex

Talk with your doctor

Women and their partners who are thinking about pregnancy should talk with your doctor about:

• Your plans for having children(https://www.cdc.gov/preconception/planning.html)
• The potential risk of getting Zika during pregnancy
• Your partner’s potential exposures to Zika

Decisions about pregnancy planning are personal and complex.  The circumstances for each woman and her partner will vary.  However,  possible Zika exposure via recent travel or sex without a condom with a partner infected or potentially infected with Zika should strongly consider the following timeline to wait to get pregnant:

 Women

• Wait at least 8 weeks after symptoms start OR from last possible exposure.

Men

• Wait at least 6 months after symptoms start OR from last possible exposure.

Pregnancy is a time of great anticipation. Will you have a girl or a boy? Will the baby inherit your sense of humor or your partner’s compassion? You may have moments of doubt and anxiety as well. Will you experience complications? Will the baby be healthy?

Take comfort in the fact that most babies are born healthy. Still, you may want details about your baby’s health beyond what your health care provider can observe.

Types of prenatal testing

Prenatal testing includes both screening tests and diagnostic tests:

• Screening tests. Prenatal screening tests — such as blood tests and ultrasounds — are routine in most pregnancies. Screening tests can identify whether your baby is more likely to have certain conditions, but they can’t make a definitive diagnosis. Screening tests pose few or no risks for you or your baby. Learn More
• Diagnostic tests. If a screening test indicates a possible problem — or your age or family history puts you at increased risk of having a baby with a genetic problem — your physician will talk with you about newer non-invasive prenatal testing that is available. You may also consider a more invasive prenatal diagnostic test, such as chorionic villus sampling or amniocentesis. These tests do carry a small risk of miscarriage.

Procedures

Screening Tests

Medicine

Click on obstetrics downloads for full list

NOTE:  The remedies listed are all over the counter (OTC) – No prescription required! Please read and follow directions as printed on the label unless otherwise directed by your physician.

Nausea & Vomiting

• Bonine
• Dramamine
• Vitamin B6
• Unisom
• B-Natal Therapops/Lozenges

(see FAQ for more information on nausea and vomiting) 

Indigestion & Heartburn

• Maalox
• Mylanta
• Tums
• Rolaids
• Gaviscon
• Pepcid
• Zantac
• Prevacid

Constipation

• Metamucil
• Citrucel
• Fibercon
• Milk of Magnesia
• Haley’s MO

Diarrhea

• Imodium AD

Hemorrhoids

• Anusol HC
• Preparation-H
• Tucks Medicated Pads

Sinus Congestion & Allergy Symptoms

• Mucinex
• Claritin
• Claritin D**
• Benadryl
• Dimetapp
• Saline Nasal Spray
• Afrin Nasal Spray*
• Tylenol Sinus
• Sudafed**

*Afrin Nasal Spray may be used exactly as directed (2 times daily) for no longer than 3 days.  Due to the addictive nature of this medication, you must throw the bottle away after the 3rd day. 

**You cannot simply get these products off the shelf. They do not require a prescription, but require a signature to obtain.  

*You should NOT take medications that contain ibuprofen or naproxen (e.g. Advil, Motrin, Aleve)

Cough

• Delsym
• Mucinex DM
• Robitussin
• Cough drops

(please read the label to choose the correct formula for your symptoms)

Headaches

• Extra Strength Tylenol
• Tylenol Sinus.  

Under no circumstances are you to take aspirin or any product that contains Ibuprofen or Naproxen. (e.g. Motrin, Advil, Aleve)

Congratulations on your new arrival!  We hope that the following information will be helpful as you return home with your new baby!  

 If you have additional questions call our office and our staff will be glad to assist you.  

In addition, please remember that we encourage you to bring your baby with you to your postpartum visit so that all of our staff may meet this precious bundle!

Afterbirth Pain

Afterbirth pains become progressively more common after each pregnancy because of increasing difficulty of the uterus to return to normal size.  They normally increase at the time of nursing.  Except for the positional impossibility during nursing, good relief can usually be accomplished by lying flat on the abdomen without a pillow for the head.  Naproxen or Ibuprofen may be given at the time of hospital discharge to ease uterine cramping.

Activity

Gradually increase your activity as your strength returns and you begin to feel better.  Careful, slow stair climbing and reasonable lifting are acceptable.  However, you should not allow yourself to become fatigued.  Be sure and allow yourself rest periods as your baby rests.  Let the way you feel and the obvious limitations of fatigue and discomfort be your guide.  You may ride in a car a reasonable distance at any time, and you may drive once you are pain free without the use of presciption pain medications as these may alter your reaction time.

Bathing

Vaginal delivery patients may take a tub bath or a shower at any time.  Warm tub baths will help reduce the discomfort of stitches and hemorrhoids, and may be taken as often as you desire. 

C-section patients may shower after the abdominal dressing is removed or after the epidural has been removed.  Tub bathing needs to be avoided until your abdominal incision is completely healed.

Diet

Your diet should be regular and ordinary.  If you are breast-feeding your baby you should be drinking plenty of fluids, eating three meals a day and continue taking your prenatal vitamins.  Weight reduction diets are inappropriate while breast-feeding.

Clothing

If bottle feeding, wear a tight brassiere 24/7 for a week to avoid breast engorgement.  If breast feeding, wear a nursing brassiere.

Non-Nursing Mothers

There are no medications that we are comfortable giving for “drying up” your milk.  Approximately 24-48 hours after delivery there will be breast engorgement, low grade temperature and breast pain.  You should take Tylenol and use ice packs as needed.  Wear a tight fitting bra (24 hours a day) for about two weeks after delivery to suppress any stimulation to the nipples.

Nursing Mothers

Continue prenatal vitamins for as long as you nurse your baby.  Wash your hands before nursing. Before your milk comes in, offer your baby each breast for only three to five minutes.  After your milk production begins, offer your baby the first breast for fifteen minutes and supplement with the other breast for five minutes.  After twenty minutes a baby is usually “playing” and not nursing.  Expose your nipples to air for dryness the first 7-10 days.  Apply breast cream to dry nipples.  If your nipples become so tender or cracked that you are unable to nurse use nipple shields or a breast pump for several days before resuming nursing without protection on that nipple.  Should your breasts become tender, hard, red or you develop a fever of 100.4 or greater, you may have developed mastitis.  If this occurs, you should continue nursing from that breast (or use a breast pump), take Tylenol and apply hot compresses to that breast between nursing sessions.  If after 24 hours you are no better, please call the office and speak with one of our nurses.

Over-the-Counter Medications & Breastfeeding

The same list of OTC medications that are approved during pregnancy may be used while breastfeeding your baby.  “Natural/Herbal” products are generally not tested or approved by the FDA.  This mean adequate data is not available to ensure safety while breastfeeding and should be avoided unless a specific product is recommended by your physician.

Intercourse

This should be postponed until after bleeding stops and stitches are healed (usually 3-4 weeks).  Condoms and vaginal foam may be used for contraception.  Depo Provera, another option, may be given in the hospital for contraception if desired.  Other birth control measures will be discussed at your six weeks checkup.  Breastfeeding is NOT a means of birth control.

Stool Softener

Avoid constipation.  You will be discharged with a stool softener you should take every day to keep the softening agent in your system.  A Fleet’s enema is indicated if you have not had a bowel movement within 4-5 days after delivery.  These are obtained without a prescription.  If loose or diarrhea stools develop, please discontinue taking the stool softener.

Exercise

Exercise such as sit-ups and straight leg lifts may be performed when your baby is 3 weeks old.  After a C-section, these exercises should be postponed until after your checkup.  Walking is a good exercise that may be started after discharge from the hospital until activities that are more strenuous are permitted.

Bleeding

A flow will last an unpredictable number of days, gradually diminishing.  This is usually finished by the time of the six weeks check up.  The next normal period will ordinarily appear within eight weeks of delivery, or much later if breastfeeding.

Douches

Douching is not necessary and we do not recommend.

Circumcision Care

Dress as often as necessary with Vaseline gauze (available at any drugstore) or use plain Vaseline and no gauze.  Be sure to pull the foreskin back before applying the Vaseline.

Postpartum Blues

Many new mothers experience this.  At times you may fell that you are on an emotional rollercoster.  For most patients this is a short-lived event probably made worse by fatigue, postpartum discomfort, and a perception of being overwhelmed.  These feelings will subside and your attitude will become more positive.  However, for some patients, the depression is more severe, lasting longer than a few days.  If this is the case, please contact our office.

Removal of Staples or Steri-Strips

Following a C-section, if you have staples present in your incision please call the office to have them removed within a few days after discharge.  If you have any Steri-Strips present (small pieces of tape covering the incision), remove these as they begin to peel up and become loose.  If these have not started to loosen by 7-10 days after your delivery, moisten them in the shower and remove them.

Postpartum Checkup

After you are discharged from the hospital, please call the office to make an appointment for your 6 weeks check-up.  Following this postpartum exam (unless directed otherwise by your physician) your next appointment should be in 6 months, at which time a Pap smear and yearly physical will be performed to return you to an annual well exam schedule.

If you do not pass your Modified Glucose Tolerance Test, you will be required to take the Full Glucose Tolerance Test.  (Be aware that if your Modified Glucose Tolerance test blood sugar is >190, you will automatically be considered Gestational Diabetic and be sent for Diabetic Counselling).  Please follow the instructions below, and click on the link to download the diet.

Full Glucose Tolerance Test – This is the definitive test that will evaluate for gestational diabetes.  You will be in our office for at least 3 hours.  You should sit quietly for the duration of the test because excessive movement may cause blood sugar to elevate.

1. Schedule a lab only, morning appointment. 
2. Follow 2000 calorie diabetic diet for 3 days prior to test.
3. Do not eat or drink anything (except water) after Midnight the night prior to testing.  You must be fasting to begin this test.
4. Upon admission to the lab, a fasting blood sugar will be checked.  You will then be given a measured amount of glucose to drink.  This drink should be consumed within a 5-minute time span.  From the time you began drinking the glucose, your blood sugar will be checked at 1 hour, 2 hours and 3-hour intervals.
5. During the test one of our nurses will take the opportunity to talk with you about gestational diabetes and give you written information regarding your doctor’s recommendations for follow up for anyone who is diagnosed as a Gestational Diabetic.  Our doctors want all of our OB patients to be well informed and receive follow up quickly should it be needed.
6. One of our nurses will contact you within one week regarding your results.  Please call us if you do not receive a call.

Gestational Diabetic Diets:

Please review this document for Gestational Diabetic Diet guidelines.

Indian Gestational Diabetic Diet

Wet/Dry (High Carbohydrate) Diet for Nausea and Vomiting: 

Dietary Habits may be a contributing factor in the development of nausea and vomiting in pregnancy.  Small, frequent meals, fairly dry and high in easily digested carbohydrates are more readily tolerated.  Liquids are best taken between the meals.  The diet is served in small feedings.

Foods to Avoid:  Beverages with meals: Soups, Jell-O, ice cream, sherbert or popsicles with meals: Melons-watermelon, cantaloupe, honeydew; Gas forming vegetables (broccoli, brussel sprouts, cabbage, cauliflower, dried beans, peas, onions, turnips, pumpkin, rutabagas, and sauerkraut); Pies and pastries; Jams and preserves; and Highly seasoned foods.

Sample Menu:

Crackers at bedside.

Breakfast:  Banana, egg (scrambled or poached) Toast

Lunch:  Sandwich with mayonnaise and lean meat, canned peaches

Dinner:  Lean meat (2oz), potato, rice, or noodles, canned pears, roll

Snacks mid-morning, mid-afternoon, late-afternoon, evening, and bedtime:  Alternate Jell-O, sherbert, Peanut Butter, and crackers.  Try to keep something on your stomach at all times.

For Other Healthy Eating Plans Please Visit:

www.americanheart.org and  www.diabetes.org

Adams Patterson Telehealth

Dear Patients,

In order to keep our patients and staff as safe and healthy as possible during the current Cornovirus health situation, we will be offering Telehealth visits for certain types of pre-approved appointments.

While virtual visits are not appropriate for all conditions, we are often able to provide telephone or video call care for these common complaints:

• Urinary tract infections
• Some types of vaginal infections
• Birth control counseling and prescribing
• Menopausal issues
• Medication follow ups
• Discussions regarding test results
• Rashes
• Allergies
• Constipation, diarrhea or vomiting
• Follow up visits for chronic gynecology visit issues
• Some types of minor obstetrical complaints
• Anxiety/ Depression medication management

Please keep in mind that since a physical exam, laboratory testing and diagnostic imaging cannot be performed via video conference, we cannot schedule Telehealth visits for conditions which require these types of evaluations. Our office is open and will still be scheduling these types of visits in the office.

Most of our major insurers are covering Telehealth visits at this time.  You will be billed through your insurer and any applicable co-pay will be collected online prior to your Telehealth visit. If your insurer does not cover Telehealth, you will be asked to provide online payment at the time of your Telehealth visit. The Telehealth visit fees range from $50-$150.

It is possible that after video-conferencing, you may be asked to come in for an in-office visit if it becomes obvious that we need to perform a physical exam or any testing that reaches beyond the abilities of video conferencing.  If this is necessary you will not be charged for the Telehealth visit.

We are providing video conferencing through doxy.me, a video conferencing platform that is HIPAA secure. All data is encrypted, your sessions are anonymous, and none of your information is stored on the platform.

How to:

Appointments for telehealth visits can be made by calling 901-767-3810. 

No need to download software or create an account. Just use your smartphone (easiest) or computer or tablet with a camera and microphone. Supported browsers are Chrome, Safari and Firefox only.

To connect with your doctor, you will be sent a personal link via text during a prespecified time period (i.e. Thursday, 10:00-10:45 am). Promptly click the link and sign in to your video call using your first and last name. Be sure to enable your camera and microphone when prompted.

JOIN A CLINICAL RESEARCH TRIAL

Adams Patterson and Clinical Research Trials

Every person is unique and what motivates you or any individual to volunteer for a clinical trial is also unique.

Speak to one of our recruiters at our partner, Medical Research Center of Memphis, to find out more about our clinical trials at (901) 623-2585.

Why Join a Clinical Research Trial with Us?

• Personal attention from our experienced staff of medical professionals
• Education regarding your condition and the available treatment options
• A thorough physical examination, often including lab work, EKG, ultrasounds, comprehensive screenings, and other tests, all at no cost
• Immediate test results whenever possible
• All prescribed medications provided at no cost during your time in the study
• Access to treatment and medication currently unavailable to the general public
• Open sharing of all lab work and test results with your primary care physician
• Compensation for time and travel
• Your participation will help make new medication and treatment options available to others
• Possible improvement in the symptoms related to your medical condition

Inform Yourself on Clinical Trials with Independent Resources:

U.S. Food and Drug Administration

National Institutes of Health

Centerwatch – FAQ for Volunteers of Clinical Trials