Getting the Most Out of Your Doc Visit

headshot_whitecoat

Dr. Jen Mushtaler (OB JEN)

We all know that scheduling timely and routine visits to the doctor is an important part of an overall healthy lifestyle.  However, many patients feel like their visits to the doctor are rushed. Here are some helpful tips from the insiders to help you get the most out of your appointment.

Scheduling is key.

First step to a successful visit is in the scheduling. Make sure you let the scheduler know what you need to address with the doctor so that your doctor can schedule the appropriate amount of time. Otherwise, your doctor may then be rushed to give everything full attention, and sometimes additional procedures need prior authorization with insurance. In our office, we try to schedule patient’s appropriate time based on the stated reason for the visit.

Plan head so you are not rushed.

Second, make sure you are not rushed for your appointment. We have had patients try to squeeze something in before they have to pick-up children or make a work meeting or another appointment. Ask the scheduler what is a reasonable amount of time to allot for your visit. Also, some days of the week may be more or less busy in the doctor’s office and may require more time. Many things can happen at your appointment time to get even the best planned schedules behind, so give a little extra wiggle room in case.

Bring a list of your medications with you.

Bring an accurate list of your medications with you to your appointment. Better yet, bring all your prescriptions and any vitamins with you. Some medications can interfere with each other or worse, be harmful, so you want your medical providers to have an up-to-date and complete list. Also, be sure your provider knows if you have stopped medications as well. New to the doctor? Bring a written list of any medical issues and previous surgeries.

Bring a list of questions for the doc.

Most of my patients are great about jotting down questions for their visit on their phone or I-pad or an old-fashioned piece of paper. I love it and encourage all patients to do that. It is easy to get nervous or even side-tracked during a visit and then remember after you left that you wanted to ask about something that did not get covered. Also, let your doctor know at the beginning of the visit that you brought your questions. It helps us to plan the time during your visit to allow for discussion.

Getting additional tests?

Ask your doctor specifically what labs they will order so you can make sure that those labs are drawn. Then make sure you know the timeline for your results and how those will be communicated. Some offices are able to let patients check their own results online. In our office, we notify patients of results. I am not a fan of no news is good news because I have seen results get lost that need follow-up.

Getting a new prescription?

Confirm with your doctor what medications are being ordered. Most prescriptions are now faxed electronically, but to be your own best advocate you should know what medications you are taking, old and new. Also, sometimes pharmacies will offer to substitute generics and that’s when some mistakes can happen.

Check prescription coverage with your insurance company.

Another helpful hint, if you know you will be needing a particular type of medication, check to see what the level of coverage is with your insurance company. Different medications may have different co-pays, so if your doctor knows what is covered at tier 1, they may be able to help guide you to something more affordable and just as effective. Unfortunately, we don’t have that information and it is certainly not our intention to prescribe a medication the patient will be unable to take because of costs. For example, birth controls are covered by insurers now, but not all name brands or types may be covered by a particular plan. Don’t forget to have your pharmacy of choice ready to give your doctor’s office as well.

Happy scheduling!

Remember, the best way to get the most out of your appointment is to make sure that both you and your doctor’s office have scheduled appropriately and that you are prepared with an up-to-date list of medicines and concerns to be addressed.

To schedule an appointment with Capital Ob/Gyn Associates of Texas, visit www.capobgyn.com or call 512-83-OB-JEN.

Collecting Shoes for Love – Dando Amor

This year Capital Ob/Gyn Associates of Texas is participating in the Dando Amor Shoe Drive – giving love and blessing the lives of children throughout the world by putting shoes on their feet.

We’ll be collecting shoes in our front office lobby now through March 31st.  Drop off gently used children’s shoes of any size during your scheduled appointment or swing by any time during office hours.  Your donation is greatly appreciated so start cleaning out those closets!

Capital Ob/Gyn Associates of Texas
12201 Renfert Way Suite 325
Austin, TX 78758
512-83-OBJEN

About Dando Amor – Shoes for Love
Dando Amor is a non-profit charity organization that takes regular service trips to Ecuador and Burkina-Faso Africa.  Last year over 12,000 pairs of shoes were collected for orphans in these countries.

View these videos from recent service trips to Africa:

http://www.youtube.com/watch?v=ZNPP2zrxn7E

Learn more about Dando Amor here.

dando amor

dando amor shoe drive

To schedule an appointment with Capital Ob/Gyn Associates of Texas, contact our office at 512-83-OBJEN or visit our website at http://www.capobgyn.com.

Baby Birthing Class November 20th

Capital Ob/Gyn Associates of Texas now introduces birthing classes!

Our first class will be held Wednesday, November 20th from 5:30 – 8:30pm. Registration is $60 per enrollee (patient & support person).

Topics for the birthing class will include:

  • Pregnancy & Post-Partum
  • Labor & Delivery Experience
  • Parent & Newborn Care
  • Car Seat Safety
  • Lactation Basis
  • Q&A Session
  • Tour of The St. David’s Women’s Center

Bring your infant car seat, favorite pillow(s) and wear comfortable clothing.  There will be a few hands-on exercises involved.

The class will be taught by Cindy Warner, RN and will take place at our office.

Capital Ob/Gyn Associates of Texas
12201 Renfert Way, Suite 325
Austin, TX 78758
512-836-2536

Please make checks payable to Capital Ob/Gyn Associates of Texas prior to class date.
*Classes are limited so reserve your spot today!

Stay tuned for more available class times to be announced!
- The Staff at Capital Ob/Gyn Associates of Texas

birthing class in austin

Breast Cancer Awareness Balloon Launch

October is National Breast Cancer Awareness Month, and the Capital Ob/Gyn staff was honored to participate in the Breast Cancer Awareness Balloon Launch on Friday, October 18th.  To celebrate the brave women who have battled breast cancer, white and pink biodegradable balloons were launched from the St. David’s North Austin Women’s Center to benefit the Breast Cancer Resource Center of Central Texas.

We are a team of women committed to caring for other women, and this important cause is close to our hearts.  We celebrate the women who have survived the battle with breast cancer and remember those who were not so fortunate.

NAMC_BreastCancerView KVUE News Coverage of the event HERE.
(Segment begins at 23 min, 25 seconds)

View KXAN News Coverage of the event HERE.
(Segment begins at 29 min, 11 seconds)

About Breast Cancer Resource Centers (BCRC)
http://www.bcrc.org

Breast Cancer Resource Centers (BCRC) of Texas is a centralized source of information, education and support that empowers those affected by breast cancer to navigate through diagnosis, treatment, recovery and beyond as active, knowledgeable participants in their healthcare.

Staffed by breast cancer survivors, BCRC strives to reduce mortality rates by assisting Central Texans diagnosed with breast cancer as they confront obstacles that stand in the way of their treatment or affect their quality of life. We help eliminate barriers related to insurance, employment, family relationships, inability to pay for services, and end-of-life decisions.

To learn more about Capital Ob/Gyn Associates of Texas and our services, visit our website at http://www.capobgyn.com or call 512-83-OB-JEN.

Numbers Show Vaccine Helps Reduce HPV Cases

Screen Shot 2013-07-12 at 11.11.31 AM

Dr. Jennifer Mushtaler was recently asked to share her professional opinion on the effectiveness of the HPV vaccine on KVUE.  Read the article below or watch the video on KVUE.

AUSTN — The HPV vaccine remains controversial, however, numbers recently released by the Centers for Disease Control and Prevention showing the vaccine’s effectiveness could help quell some of the skepticism.

Cases of human papillomavirus, or HPV, have decreased 56 percent in young girls since the vaccine was first introduced in 2006 according to the CDC.

“This is very exciting news,” said Jennifer Mushtaler, M.D., an obstetrician and gynecologist with Capital OB/GYN Associates of Texas at St. David’s Women’s Center. “We’re seeing that reduction in risk cancers for our young women, which is very important and the reduction is greater than anticipated.”

CDC officials admit they were surprised by the vaccine’s effectiveness, and so too were University of Texas students KVUE spoke to.

“I remember it was just a few years ago that people started talking about it,” said Wynne Davis, a UT student. “There was really the push and all the ads on television for it, but I didn’t expect it to drop that quickly.”

“It is a really significant decrease,” said Angela Lin, a UT student. “With all the current medical breakthroughs and progress in science and technology and everything, I guess it really doesn’t surprise me.”

The only disappointing news according to the CDC is that only 50 to 60 percent of young women are getting the vaccine. The agency was hoping that number would be closer to 80 percent. Dr. Mushtaler says there’s still a bit of a disconnect over the value of the vaccine.

“Because we’re vaccinating for diseases that are transmitted sexually the message can get confused about the intent of the vaccine,” she said. “The intent of the vaccine is to help protect young people from (certain) types of cancers no matter when they choose to become sexually active.”

Mushtaler says the vaccine is now being recommended for girls and boys — girls ages 11 to 26 and boys ages 11 to 21. Dr. Mushtaler says early research has shown there’s a higher rate of immunity when children are vaccinated at a younger age.

To schedule an appointment with any Capital Ob/Gyn physicians, call 512.836.2536 or visit www.capobgyn.com.  We look forward to seeing you soon at Capital Ob/Gyn!

What To Tell Your Teenagers About Plan B “Emergency” Contraceptive

Screen Shot 2013-07-01 at 2.55.50 PM

 

The politics around women’s healthcare and reproductive choices have been interesting as of late to say the least. We have seen Planned Parenthood vilified, and concurrently, we have seen gains in women’s access to Preventive Exams as well as the expansion of birth control coverage. Recently, the FDA approved Plan B for sale to minors over-the-counter. Although Plan B is not associated with long term medical risks, use of Plan B is not guaranteed to prevent pregnancy, and incidental birth control does not address a multitude of other unintended consequences, particularly in young men and women.

I am a mother of two young girls who at this lovely age still think that boys are gross and annoying. I know that in short order this will all change. I have given much thought as to how I will educate my daughters about their sexuality and their safety. Too often young people falsely believe that  ”I won’t get pregnant from one time,” or “I won’t get herpes,” or “I’ve had the Gardisil vaccine so I won’t get HPV”. While I applaud the many changes in women’s healthcare, over-the-counter availability of Plan B to minors gives me pause about young women’s emotional and physical well-being as it relates to unplanned sexual encounters. The easy access of a simple pill can give the false illusion of being able to erase actions from the night before.

woman-in-pharmacy-selecting-medicationsAs a woman’s healthcare provider, I am an advocate for access and education, but I admit that I am concerned that Plan B may give young people a false sense of security regarding pregnancy prevention without acknowledging unintended consequences such as the emotional risks of unplanned and unprotected intercourse and the risks of STD’s. Unlike condoms, which are used at the time of sexual activity, Plan B does not offer any protection from STD’s, nor does it require forethought to action. Unfortunately, I have recently met with two teenagers who had been pressured to have unprotected intercourse and then take Plan B. Each of these young women, broke down in tears of fear and shame that saddened me greatly for them.

Now, more than ever, our daughters need to be educated on what it means to choose to be sexually active or to choose to be abstinent. More importantly, they need to be taught that they have a choice to say “No thank you” and mean it. Our daughters also need to be educated about unsafe situations, how to recognize them, and how to avoid them. A young woman who desires to be sexually active should be made to feel comfortable coming to an Ob/Gyn so that she can choose a reliable method of birth control and receive complete medical care and advice, something she won’t get from an over-the-counter package.

So what do you tell your teenagers about Plan B? First, have the discussion and discuss your value system and why that set of values is important. Second, educate them on all birth control options that are available and what they do and do not protect against. Third, encourage them to ask questions from trusted adults, to think about their choices, and to seek medical advice when it is needed.

Our team is committed to the well-being of each woman that walks through our door.  To learn more about our practice visit www.capobgyn.com or call us at 512-836-2536 if you have any questions or to schedule your next appointment.

Will One Drink Hurt the Baby?

OB JEN recently contributed to an article in Daily Rx regarding the consumption of alcohol during pregnancy.  You can read the full article below.

cutebaby

Alcohol drinking during pregnancy debate continues

(dailyRx News) One of the common questions pregnant women might wonder is whether they can drink any alcohol at all while pregnant. One glass of wine? One sip? Will it hurt the baby?

A recent study looked at that question in terms of children’s cognitive skills and behavior. This study took into account a large range of possible factors that could affect the children’s performance.

These researchers found that the children of women who drank one or two drinks a week or less did not appear to suffer any negative brain or behavior effects.

However, this study’s findings are contrary to some previous research. The findings also do not mean women should have any drinks during pregnancy.

“Ask your OB/GYN about drinking alcohol.”

The study, led by Yvonne Kelly, PhD, of the Department of Epidemiology and Public Health at University College London in the United Kingdom, looked at whether light drinking during pregnancy affected women’s children at age 7.

The 10,534 children involved in this study are part of a long-term study that has involved home visits when the children were 9 months, 3 years, 5 years and 7 years old.

At each home visit, the researchers interviewed the mothers about their drinking habits (during and after pregnancy), their children’s behavior, the family’s socioeconomic circumstances, the family’s demographics and the social environment of the child and family.

The researchers also assessed the children’s cognitive skills using tests in reading, math and spatial skills when the kids were 7. The children’s teachers also filled out mailed questionnaires about the children’s behavior.

During the home visit when the children were 9 months old, the mothers described how often they drank alcohol while pregnant: every day, 5-6 days a week, 3-4 days a week, 1-2 days a week, 1-2 times a month, less than once a month or never.

Women who drank any alcohol each week were asked how many units they had each week, and women who drank less than twice a month were asked how much they drank during those times. A unit was defined as “half a pint of beer, a glass of wine or a single measure of spirit or liqueur.”

Overall, 13 percent of the women never drank alcohol before, during or after pregnancy, and 57 percent did not drink alcohol during pregnancy but did after pregnancy.

Almost a quarter (23 percent) of the women were considered “light drinkers” who had one to two units of alcohol per week or per occasion (if less than once a week) while pregnant. Seven percent of the women drank more than twice a week while pregnant.

When the researchers analyzed the results of the cognitive tests and behavioral assessments, they took into account a wide number of variables that might affect the results besides the mother’s alcohol intake during pregnancy. These included the following:

  • mother’s age
  • whether the pregnancy was planned
  • whether the mother smoked during pregnancy
  • whether the child was a first-born
  • ethnicity
  • single parent family
  • a combined score related to the mother’s answers to questions on life satisfaction, relationship quality and social networks
  • number of children in the household
  • child’s age
  • the child’s birth weight
  • highest level of the parents’ education
  • family income
  • mother’s mental health
  • which discipline strategies the parents used (frequency of ignoring, smacking, shouting, sending to the ‘naughty chair’, removing treats, telling off and bribing)
  • how the mother rated her competence as a parent
  • how the mother rated the closeness of her relationship with her child
  • whether the mother currently drank alcohol
  • how frequently the child was read to
  • whether the child had regular bedtimes

Before adjusting for these variables, the researchers found that the children born to women who were light drinkers during pregnancy had slightly lower (better) behavior scores and slightly higher cognitive test scores than the children of moms who did not drink during pregnancy but did drink afterward.

After the researchers adjusted for those variables, the behavior scores evened out a bit and were no longer “statistically significant” except for the boys’ behavior as rated by teachers.

Not being “statistically significant” means that the difference between the kids of light drinkers and the kids of non-drinkers was too small to determine whether those differences were related to the alcohol intake during pregnancy.

The difference in cognitive skills between the kids of light drinking pregnant moms and non-drinking pregnant moms also evened out after adjusting for variables, with one exception. The sons of women who were light drinkers during pregnancy still had slightly higher spatial and reading skills than the boys of women who didn’t drink during pregnancy, though the differences were small.

“In this large, nationally representative study of 7-year-olds, there appeared to be no increased risk of a negative impact of light drinking in pregnancy on behavioral or cognitive development,” the researchers wrote.

“Prior to statistical adjustment, children born to light drinkers appeared to have more favorable developmental profiles than children whose mothers did not drink during their pregnancies, but, after statistical adjustment, the differences largely disappeared,” they wrote.

“Our findings from regression models and PSM support the suggestion that low levels of alcohol consumption during pregnancy are not linked to behavioral or cognitive problems during early to mid-childhood,” they wrote.

However, these findings, from a single study, do not change the advice of OB/GYNs and certified nurse midwives to women.

“I am frequently asked about ‘just one glass of wine on occasion’ and I counsel patients that there are many factors that contribute to fetal alcohol syndrome and developmental deficits,” said Jen Mushtaler, an OB/GYN in Austin, Texas, and a dailyRx expert.

“As we do not completely understand how this happens in utero, the American College on Obstetrics and Gynecology advises women to refrain from any alcohol consumption during pregnancy,” she said.

Dr. Mushtaler suggests patients ask themselves a question to consider whether having one drink is okay.

“My advice to my patients is to ask themselves if anything were to go wrong, would they blame themselves and feel guilty,” she said. “If the answer is yes, then the one glass of wine is not worth drinking.”

The study was published April 17 in BJOG: An International Journal of Obstetrics and Gynecology. The research was funded by the Economic and Social Research Council. The authors declared no conflicts of interest.

To schedule an appointment with any Capital Ob/Gyn physicians, call 512.836.2536 or visit www.capobgyn.com.  We look forward to seeing you soon at Capital Ob/Gyn!