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Prenatal care has evolved and can be provided to pregnant women and their babies from the comfort of their homes. Care is accessed via digital devices such as smartphones, iPads, and laptops via audio and video calls, text messaging, and other forms of chatting. This defines telemedicine in prenatal care.
While telemedicine in prenatal care has its pros and cons and has recorded positive health outcomes, is it the way to go for high-risk pregnancies?
A high-risk pregnancy is one where the mother, the fetus, or both have an increased risk of health problems or adverse outcomes before, during, or after delivery.
Your pregnancy may be considered high-risk if you:
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Typically, while prenatal care is needed for all pregnant women, it is crucial for women with high-risk pregnancies. This population of women require special monitoring or care throughout pregnancy to ensure the best possible outcomes.
Prenatal care in the United States is accessed by 4 million women annually and only 6 to 8 percent of these pregnancies experience high-risk complications. This figure is a lot, running into hundreds of thousands.
Hence, women with high-risk pregnancies will require increased number of prenatal visits, monitoring, tests and examinations, and consultations with their healthcare provider and specialists.
Telemedicine in prenatal care means adopting videoconferences, at-home monitoring, and virtual consultations to replace in-person visits and monitoring at the healthcare facility.
However, not fully. It is impossible to completely rule out in-person visits during prenatal care. Instead, Telemedicine should be seen as a model of care that enhances access to and delivery of health care. The question, however remains, "can high-risk pregnancies benefit from telemedicine visits?"
High-risk patients usually have to work closely with their doctors and care team to prevent, reduce, and manage complications. Generally, they require highly specialized and comprehensive care to manage the several health conditions that may be affecting or may potentially affect the mother, unborn baby or both.
Research shows that prenatal care via telemedicine can be modified for women with high-risk pregnancies. This requires more remote visits to their local OB doctor and other specialists, fetal testing and ultrasound examinations.
The study also suggests that telemedicine is feasible with special recommendations given for certain conditions and services including:
It may seem as though these recommendations have been implemented. A study shows that patients with health conditions such as high blood pressure and diabetes were instructed on how to monitor their blood pressure and sugar levels respectively at home. The results were transmitted to their providers which facilitated active participation of patients in their care and self-efficacy. Subsequently, results of the study showed similar pregnancy outcomes between telemedicine and conventional prenatal care.
Remote consultations with specialists could also encourage care and delivery of high-risk patients in nearby local hospitals.
As a supplementary health care service, our team at My Virtual Physician is available to help guide you through your pregnancy and answer any questions that may arise. We also help with electronically sending orders for tests and examinations while you wait for an appointment with a local OB doctor.
We are in network with many insurance health plans including Medicaid, Medicare, United HealthCare and Blue Cross.
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Did you know that My Virtual Physician is now accepting SilverSummit Health Insurance? That is great news for residents of Nevada’s Clark and Washoe counties. Members can now book an online doctor appointment with no out-of-pocket expense.
SilverSummit Healthplan provides the best Nevada Medicaid plans. Now they are adding even more value to their services by partnering with My Virtual Physician to give members virtual doctor visits. Residents of Nevada can access doctors to treat a wide range of problems, including:
My Virtual Physician’s caring doctors treat patients right in their own home through a video visit. The office provides appointments for Obstetrics/Gynecology (OB/GYN) or Primary Care Physician (PCP) services. And patients can book safely and easily through the patient portal.
Health insurance plans are similar because they usually cover the same services. But different plans may:
Some plans are Health Maintenance Organizations (HMOs). These give members a list of doctors to choose from in their network. Insurance will cover services from in-network doctors, but may not cover the same services with out-of-network providers. My Virtual Physician is thrilled to add SilverSummit to their accepted Insurance Plans lineup and accept new patients.
My Virtual Physician is still adding new insurance plans to the network. But even without insurance, visits are still less expensive than an in-office visit. And the office accepts many forms of payment. Patients also appreciate booking an online doctor appointment because it is more convenient. My Virtual Physician has late evening and weekend appointments for booking. Members of SilverSummit Healthplan can schedule an appointment now at www.myvirtualphysician.com or text the office staff with questions.
To meet the physicians, simply click “BOOK APPOINTMENT NOW” to book your visit. Or visitors can text message questions about the virtual/online doctor benefits.
Every 13 minutes, a woman dies from breast cancer. Unfortunately, many women with the disease do not show symptoms. So, regular screening for breast cancer is critical for early detection and diagnosis.
Breast Cancer screening typically occurs as a part of routine preventative care. Individuals do not have to have any signs or symptoms to have a screening performed by their doctor. Manual exams, ultrasound, thermography, and mammography are a few ways patients are screened for abnormalities. A doctor can explain screening options and when it is time to consider certain tests.
To find out how breast cancer screening aids in the diagnosis of the disease, read on.
Breast cancer can be asymptomatic. In other words, it may have no symptoms. In fact, cases may show different symptoms and examination findings. That is why screening should be individualized for each patient.
Screening means looking for or testing for something when there are no signs.
Many people think that only someone with a family history should worry. Yet, about 85% of breast cancers occur in women who do not have any family history of breast cancer. Rather, genetic mutations that occur as women age increase their risk. The most significant risk factors for breast cancer are being a woman and growing older.
Doctors are trained in the latest research and guidelines. They can tell their patients about the options. And doctors help women decide when it is a good idea to be tested.
Breast cancer is typically diagnosed in one of the following ways:
Mammography is the most common screening method used today. Other testing methods include Digital Breast Tomosynthesis (DBI) and thermography, although these are not widely used.
According to a recent article, doctors are seeing later-stage cancer cases in younger women. This is worrisome because cancers detected in younger women in their 20s and 30s are more aggressive. And they may lead to poorer outcomes.
Doctors are seeing later-stage cancer cases in younger women. This is worrisome.
Early detection is key in cancer treatment. The cost of treatment, risks of complications including death, and length of treatment go down with earlier detection.
If not caught early, cancers can grow and spread. When cancer cells move to other organs, this is called metastasis. Thus, cancer is harder to treat.
The best way to catch cancerous changes early is through regular check-ups with a doctor and routine screening tests to help detect changes early. Online doctors or virtual gynecologists can order mammograms or other imaging tests, and tailor screening plans for women who do not usually see a primary care physician.
Medical researchers continue to look for ways to help doctors with better and more accurate tests.
In 2019, the National Cancer Institute presented a new study that showed Doctors could detect breast cancer up to five years before any clinical signs appear, using a blood test for tumor-associated antigens (TAAs).
Newer research from Johns Hopkins University School of Medicine paired blood tests with other screening tests to determine whether finding and treating cancers identified by blood tests reduced mortality rates. Researchers said that “some screening may actually cause more harm than good.” And so, they used bloodwork with standard imaging procedures.
Results were promising. Researchers concluded that there is hope for a blood test that could eventually reduce deaths from cancers that typically go undetected until late stages. But “any blood test needs to complement and add to standard-of-care screening because standard-of-care screening works.”
Current recommendations encourage most women to have a mammogram beginning at age 40. Here are the most recent guidelines on screening.
My Virtual Physician can offers virtual gynecology services in many states. Women can talk with experts about individualized screening plans. Don’t worry about your risk. Talk to the doctor now.
My Virtual Physician is now accepting new patients.
My Virtual Physician has great news to share. Nevada’s favorite telemedicine provider is now in-network with Anthem Blue Cross Blue Shield (BCBS). Nevada residents looking for an online doctor may be able to book an appointment now with little to no out-of-pocket expense.
Anthem leads the health insurance industry with a strong desire to make healthcare easier and change lives. Anthem health plans serve more than 42 million families. That is why My Virtual Physician (MVP) is proud to join the Anthem Nevada provider network.
BCBS is known for offering members value-added services.
Anthem Nevada’s member support services are unmatched.
And when Anthem Nevada members need to see a doctor, that’s where MVP comes in. Their board-certified, expert doctors care for Nevada patients from the convenience and safety of home.
MVP offers Obstetrics/Gynecology (OB/GYN) and primary care services to residents of Nevada. Whether using insurance or paying out-of-pocket, My Virtual Physician’s pricing is competitive, and the patient care is unmatched.
Take a look at a few of the current online physician services they treat for Nevada residents:
Patients who need to see an online doctor can book now through a secure patient portal. My Virtual Physician is excited about the new Anthem Nevada partnership and is now accepting new patients. Virtual doctor visits are now easier than ever.
Residents of Nevada can find more information about Anthem BCBS in Nevada at www.anthem.com.
To meet our book an online doctor appointment with our physicians, simply click “Book Appointment Now” to book your visit. Or visitors can contact the office for questions about their virtual/online doctor benefits. My Virtual Physician is standing by to help.
Telemedicine is a great choice for women with gynecologic concerns. The My Virtual Physician founder, Dr. Howard, recently joined a call to explain the value of telemedicine in gynecology. So how can virtual gynecology address women's health concerns?
Irregular periods are one of the most common reasons that women see gynecologists. Here's a look at what Dr. Howard shared.
One of the most common questions about Virtual Gynecology is, "how much of gynecology can be dealt with through telemedicine?" How can diseases or conditions be dealt with through a video visit?
One of the most common reasons women see their gynecologist is irregular periods.
Some women have regular but heavy periods, which are abnormal periods. Abnormal or irregular periods are one of the most frequent reasons why a woman will go to the gynecologist. In young or premenopausal women, the most common reason for irregular periods is a hormonal imbalance. In other words, they're not ovulating regularly. Other times, the lining of the uterus is dysfunctional.
One of the most common ways in young women to fix irregular periods is to manage hormones through a trial of hormonal contraception. To be clear, this is through the use of birth control pills.
For a young woman who visits a doctor for irregular periods, the doctor will take a good history. He or she will make sure that there is not a specific reason for the irregularity. For example, if the young woman has previously had an ultrasound that showed she has fibroids, or other specific structural pathology in the uterus, that could explain the abnormal periods.
An online physician can take a thorough patient history through a video visit and prescribe birth control pills. This is one of the most common things that gynecologists do for young women: start a trial of birth control pills.
Young women with irregular periods do not need a pelvic exam initially.
However, if birth control pills fail to regulate periods, then a woman may need imaging. In some cases, a doctor may even need to look inside the uterus with a camera to see if there is any pathology. And before any invasive procedure, the doctor must do an exam to see how big the uterus is and which way it points because that will guide any surgery.
But initially, when a woman first presents with irregular periods, a video visit is appropriate because a pelvic exam is not needed up front. The doctor needs a good history followed by a trial of hormonal management. Birth control pills can be prescribed electronically, and the entire visit can be be done virtually.
After a few months, if the patient's periods are still irregular, then it may be time for a pelvic ultrasound. This test can be ordered electronically.
The patient will go to a radiology facility for an ultrasound and the report will be faxed to the physician. In some cases, the doctor will have electronic access to the images if the radiology site has a provider portal. Many facilities do. They may provide referring doctors with usernames and passwords they can use to log in and view the ultrasound results. Depending on what the imaging shows, the doctor may move forward with certain treatments.
Although many people would stereotypically think, "oh, I've got to go in," for irregular periods in a young woman, this problem can actually be dealt with through a video visit, at least initially. Depending on ultrasound results, there may ultimately be a time when a patient must go into a gynecology office. But initially, the assessment and management of abnormal periods can be done entirely through a video visit.
"A lot of people would stereotypically think, 'oh, I've got to go in,' ... you can see that actually, abnormal bleeding can be dealt with through a video visit."
- DR. DAVID HOWARD
Now consider the opposite extreme, a woman who is postmenopausal, having bleeding or spotting, the first thing the OB/GYN might do is get a pelvic ultrasound. If the uterine lining is less than five millimeters thick, a biopsy is not indicated. Current evidence shows that.
This transcript was exported on Sep 16, 2021
Still, a patient who has postmenopausal spotting should be evaluated. Since a pelvic ultrasound is not necessarily needed on a first visit, a woman can choose a video visit.
However, if bleeding is heavy, they should go to an emergency room (ER). An ER doctor can assess why the bleeding is heavy. They can assess the amount of bleeding.
If a woman has one episode of postmenopausal spotting but is worried, they can book a video visit. Through a virtual consultation, the doctor can take their history. Then a pelvic ultrasound can be ordered for the physician to review. After this, the doctor will schedule a follow-up visit by video to discuss results with the patient.
If the lining of the uterus is less than five millimeters thick, then the doctor does not have to do a biopsy. The chances of a patient having endometrial or uterine cancer then is very low.
On the other hand, if the lining of the uterus is thick, more than five millimeters, then a woman does need to go into the gynecologist's office for an exam and possibly a procedure such as a biopsy. Yet, the initial part of the assessment and management of postmenopausal bleeding can be done through video visits.
In summary, medical management for abnormal bleeding can be thought of as a three-step process:
As discussed, the first steps can be done through a video visit. At step three, that is when a woman needs to go in office to see a provider.
In short, abnormal uterine bleeding is a common condition that many women would go in to see their gynecologist for. And a lot of people would think, "how can you deal with that through a video visit?"
It is clear that a doctor can start off with a history through video and order a pelvic ultrasound electronically. In some cases, a young patient in their 20's with irregular periods can start with a trial of birth control pills. Postmenopausal women with irregular bleeding can also be treated through a video visit. In the best case scenario, the case can be managed entirely through video visits.
The uncomfortable truth is that doctors probably do too many pelvic exams. Many times they are not necessary. Sensitivity and specificity of pelvic exams, in many cases, is actually really low. Gynecologists should probably be doing a lot less pelvic exams. And when it is really necessary, physicians should be doing them in a very targeted manner.
History, imaging, and blood work, that is the trifecta that accounts for the overwhelming majority of the diagnostic process in gynecology.
"A careful history, imaging, like a pelvic ultrasound, and sometimes blood work. The combination of those three things, that's what really makes the diagnosis overwhelmingly the majority of times in gynecology."
- DR. DAVID HOWARD
Hopefully, eyes are opened as to how abnormal uterine bleeding can be managed through a video visit. A lot of people would not think that it could. Many still don't realize the value of telemedicine in gynecology.
Connect with Our Board-Certified Gynecologists online now. MVP’s founder Dr. Howard is a board-certified physician practicing in Las Vegas, Nevada. He is passionate about medicine and research. He has authored/co-authored several publications and is among the top 10% of scientific reviewers in the United States. Dr. Howard and his team are now accepting new patients.
This transcript was exported on Sep 16, 2021
One in five Americans face poor access to medical care. In some parts of the country, there are serious shortages of doctors and healthcare services. And this is the case for many women living in Georgia.
Georgia has been greatly affected by a nation-wide healthcare shortage. The need for care, specifically women’s healthcare, has increased dramatically over the past decade. Especially in the rural areas outside of major cities, Obstetrical and Gynecological (OB/GYN) services can be hard to find. Fortunately, My Virtual Physician (MVP) has been able to fill the need for some.
Why is there such a need for OB/GYN services in Georgia? And what can be done about the problem? Here's a closer look at the problem.
According to the Georgia Board for Physician Workforce, the state has:
Hence, the lack of doctors is part of the issue. Some women have no choice but to travel to other cities for care. And others even go without.
In many rural areas, there are no OB/GYNs. And in other parts of Georgia, facilities are closing. According to Becker’s Hospital Review, over 100 hospitals have closed during the past decade. Georgia ranked third for most hospitals closed, behind Texas and Tennessee.
To sum it up, a lack of doctors and hospitals is one piece of the puzzle.
Finding a doctor is one problem. But paying for services is another. Many women in Georgia do not have health insurance. Notably, Georgia's insured rate is ranked 48th in the nation.
Another problem is the state's low high school graduation rate. Lack of education is a barrier for access to healthcare. Women struggling with their health may not know where to go for answers.
Speak to one of our board certified OB/GYN virtual doctors today:
Birth control, sexual health, and menopause are sensitive topics. Women need doctors they can trust. OB/GYNs help women through complicated health changes.
OB/GYNs can treat common problems such as:
In addition to new or worrisome symptoms, gynecologists also provide preventative health services.
For example, OB/GYNs encourage women to have breast cancer screenings after age 45 and bone density scans every two years following menopause.
Without regular checkups, women may face major health concerns as time goes on.
Despite the dismal circumstances, care for women in Georgia and other states is changing.
Telemedicine providers offer a new solution. Board-certified OB/GYNs are treating women in Georgia virtually.
According to the American College of Obstetricians and Gynecologists (ACOG), patients can get the same quality care via telemedicine as they would in person. In some cases, patients say their online doctor experience is even better.
Online doctor appointments are affordable and easy to schedule. As well as that, virtual gynecology visits provide a greater sense of safety and security from the comfort of home.
It is getting easier for the women of Georgia to see top-rated doctors for the virtual gynecology care they need. Dr. Howard of MVP treats patients across the U.S., including Georgia. MVP is a multi-state, multi-specialty telemedicine provider that is quickly becoming the preferred choice for many.
Women who want an online gynecology appointment can text the office at 725-228-8277 or visit the patient portal to set up self-scheduled appointments.
My Virtual Physician offers comprehensive virtual gynecology services to address women’s healthcare needs. Our caring doctors can talk with you about your concerns and provide the experience you've been looking for.To talk with one of our expert physicians near you, book an appointment today.
Have you been looking for a Nevada healthcare provider that is in your Prominence Health Plan network? Look no further.
My Virtual Physician (MVP) is excited to announce a new partnership with Prominence Health Plan. Prominence is a respected plan provider that offers a broad network of hospital and healthcare services to its members. Together, MVP and Prominence are serving more individuals with the high quality online healthcare services they need.
Here’s what this new relationship can do for you.
Prominence Health Plan is a subsidiary of Universal Health Services (UHS), which was recognized by Fortune and Forbes as a top company in 2021.
Prominence focuses on providing their members with options for quality, convenient, cost-effective care close to home.
Prominence Health Plan began in Reno, Nevada as a commercial Health Maintenance Organization (HMO) in 1993. Since then, they have expanded to include Preferred Provider Organization (PPO) and Medicare Advantage (MA) service lines in multiple states including Nevada, Texas, and Florida.
What Does Prominence Cover?
Prominence Health Plan, like most insurers, offers different types of medical plans. Health insurance plans are similar because they cover many of the same services. Yet they can be different when it comes to:
If a plan is called a Health Maintenance Organization (HMO), the insurance plan gives members a list of doctors that are in the network. Choosing a provider that is not on the list may mean that the insurance will not cover any of the visit costs. Members are encouraged to choose an in-network provider so the services will be covered by the plan.
On the other hand, if a plan is called a Preferred Provider Organization (PPO) the member has more options. They can pick any doctor. But choosing an in-network doctor makes services more affordable because of discounts or additional coverage for using in-network providers.
It is easy to see why it is best if your doctor is in-network with your insurance plan. This is one reason why MVP is excited to announce that they have joined the Prominence Health Plan network.
MVP and Prominence have a lot in common.
They both started in Nevada.
They are both well-respected companies.
And both work to provide options for quality, convenient, cost-effective care close to home.
Prominence Health Plan and MVP are a perfect match.
MVP is a multi-specialty telemedicine team, treating patients across the US. They provide comprehensive online doctor visits to treat patients of all ages with care for obstetrical-gynecological, primary care, and pediatric services.
Virtual physician appointments are affordable and easy-to-schedule. Plus, they offer the safety and security of being seen from your home or workplace in convenient after-hours and weekend appointment times. Now with more in-network insurance coverage, MVP’s online physician services are better than ever.
MVP’s online doctors treat gynecological issues including:
As well as primary care concerns such as:
If you need to see a doctor and you’ve been looking for the best care at an affordable price, your search can stop here.
Many health concerns can be solved with a simple online consultation. The team at MVP is available now to meet with you.
Did you know My Virtual Physician is offering a promotion for September? Book now to get a free home blood pressure kit for new patients who complete an online consultation in the month of September. Don’t wait, grab your appointment spot now!
MVP’s founder Dr. Howard is a board-certified physician practicing in Las Vegas, Nevada. He is passionate about medicine and research. He has authored/co-authored several publications and is among the top 10% of scientific reviewers in the United States. Dr. Howard and his team are now accepting new patients.
Women looking for a great Obstetrics and Gynecology provider (OB/GYN) in Las Vegas, Nevada, may have trouble. There is an OB/GYN physician shortage in Las Vegas. And the situation is getting worse.
Factors such as physician burnout, population growth, and competition from other parts of the country have created a shortage of OB/GYNs in Las Vegas, Nevada. As a result, some may have difficulty finding the perfect provider to care for their reproductive health.
Women and their partners want an OB/GYN they can trust. Issues like birth control, childbirth, and menopause are delicate matters. Unfortunately, a shortage means there are not enough providers to meet Las Vegas’ needs. Thus, those doctors who are available may be overworked or stretched thin.
Here is why it’s hard to find a good OB/GYN in Las Vegas and what to do about it.
When there are too few doctors to meet a city's demands, it can be hard to find a provider to respond to each patient’s needs. According to NBC News, America is facing an OB/GYN shortage.
Las Vegas, overall, has the most severe OB/GYN workforce shortage.
Other parts of Nevada face an even more serious situation. Some counties lack even one OB/GYN provider. Hence, patients face delays in care. In some cases they are forced to look far away to find a doctor.
Here’s why it is hard to find OB/GYN care in Las Vegas.
And while Las Vegas OB/GYNs may have it rough, the patients suffer too.
OB/GYNs offer services that women need. They provide health counseling, sexually transmitted infection (STI) testing, and more. From puberty to menopause, women need a health expert they can trust. Many patients depend on OB/GYN advice.
Fortunately, Las Vegas residents can now find the best OB/GYNs, right in their neighborhood.
My Virtual Physician has an answer for the physician shortage crisis. Two of the best board-certified OB/GYNs in the nation are on staff and available for appointments near you in Las Vegas.
My Virtual Physician offers OB/GYN visits in Las Vegas with flexible scheduling through telemedicine. While most providers are busy and feel the pressure to treat many patients quickly, My Virtual Physician is different. Online video visits eliminate travel time and the feel of a busy waiting room. Virtual consultations provide a relaxed, personalized, and patient-centered care experience.
During the pandemic, many patients have had questions about staying safe. Some want to know if vaccination is right for them. Women in Las Vegas can now book a visit with My Virtual Physician to discuss their concerns and get real medical advice. Booking an appointment with an OB/GYN in Las Vegas has never been easier.
Are you looking for an OBGYN near you in Las Vegas? My Virtual Physician has two board-certified physicians licensed in Nevada who can address gynecological problems via video visits.
If you would like to talk with a board-certified OB/GYN, you can schedule your appointment online now. My Virtual Physician offers health screening, lab tests, and counseling to meet all of your healthcare needs.
How much fun is dragging a sick child out of the house, trekking to your pediatrician’s office and waiting to be seen? Probably not on many parents’ top 10 list of family activities. While there is certainly no replacement for a physician’s physical exam, telehealth can be an important supplement toward attaining the best care for your child. The ongoing pandemic and public health concern has highly influenced the increased use of telemedicine, which has demonstrated its quite helpful role in assessing acute care issues and health surveillance of certain conditions. The American Academy of Pediatrics advises all children receive well child exams and immunizations through a medical office, however utilizing telehealth for common pediatric complaints may be a wonderful additional asset in order to maintain quality medical care for children.
Telehealth in a practical sense, is the method of exchanging medical advice through the use of technology. Here at My Virtual Physician, it is easy to set up an appointment to “see” a physician through our online platform, after answering the text prompt on our homepage. In some cases, telehealth also encompasses the use of special diagnostic equipment. It is private, and typically hassle-free when you consider the lack of commute time and being able to talk to a physician from the comfort of your living space. In particular for pediatrics, telehealth allows for the presence of both caretaker and child, which is sometimes difficult given conflicting work schedules or occasional need for a third party to bring a child to the office. Another perk is the lack of exposure to others’ germs that are also common visitors in office waiting rooms. One of the best uses for telehealth discovered during the pandemic, is the increased access to physician care. Many specialists are overbooked, however often times, given the flexibility that telehealth allows, they are able to accommodate telehealth appointments into their busy schedules more easily. This allows for more patients to be seen, when an ordinary wait for an appointment could be several months away. In the same light, through telehealth, underserved or rural areas are provided a way to more quickly access care without the burden of travel expenses.
A physical exam is one of the most important aspects to establish a diagnosis for most patients and especially in pediatrics, however many common conditions in children can be “seen” virtually. Some of these include cough and cold symptoms, gastrointestinal complaints like constipation, rashes, allergies, medication management, and depression/anxiety. Sometimes follow up visits from an emergency department can also be done via telehealth. These issues rely heavily on another key component to appropriate diagnosis: an accurate history. It is imperative to provide details of the complaints, including time of onset, any improvement or worsening, as well as additional symptoms, recent travel, past health problems and sick contacts. Fortunately, these are questions that can be answered in conversation over a communication platform.
Parental and caregiver guidance, often given within the context of an office visit, is unique to pediatrics and is another important avenue in which telehealth in this population can be incredibly helpful. Whether asking questions about newborn feeding, normal developmental behavior, screen time, school readiness, bath and swim safety, dental hygiene, prepubertal and adolescent concerns, immunization worries or just seeking advice on how to maintain a positive connection with your child, telehealth is a tool that can provide a safe and relatively efficient way of finding helpful answers from a pediatric expert.
There are some diagnoses that should be referred to an in-person physician. Fever, for example, is one of the most common reasons children visit their doctor. Many times this can be discussed via telehealth initially and often reveals itself to be a symptom of an illness that will pass in time. However, there are instances where telehealth is not sufficient and the child should be seen in an office for a closer look, such as when a newborn has a fever. Likewise, a cut that might require stitches as well as an injury where there is question of a broken bone or significant pain would need more than an initial televisit. It should also be noted that any condition, in which the child is having trouble breathing, is difficult to arouse or wake or is generally having worsening complaints, an in-person visit would be likely more appropriate.
As mentioned above, there really is no adequate replacement to having a physician’s exam, but telehealth certainly affords many safe conveniences that can be practical in pediatrics. Visit My Virtual Physician to learn more about how our board certified pediatricians can help you and your child!
Lung cancer is the second most common cancer in the United States, just behind prostate cancer in men and breast cancer in women. Lung cancer also happens to be the most lethal cancer, accounting for approximately 25% of all cancer deaths. Each year, more men die of lung cancer than from colorectal, prostate, and pancreatic cancers combined, and more women die annually of lung cancer than from breast, cervical, and uterine cancers combined.
The main risk factor for lung cancer is cigarette smoking, associated with 85% of cases. Among smokers, the risk of lung cancer increases with number of cigarettes smoked and duration of smoking history. There is good news though: the risk of lung cancer will decrease with smoking cessation and may even approach that of the nonsmoking population after 10 to 15 years of tobacco abstinence. Meanwhile, associated risks of developing lung cancer from e-cigarettes are currently under investigation.
Each year in the U.S., up to 26,0000 lung cancer deaths occur in never smokers, with an even higher proportion in some geographic areas. This brings us to environmental risk factors of lung cancer, such as exposure to radon, a chemically inert gas from uranium decay, encountered by underground miners and less commonly, residentially, through indoor exposure in the home basement. Asbestos exposure can lead to a type of lung cancer called mesothelioma and can cause other types of lung cancer when combined with smoking.
Arsenic, chromium, nickel, air pollution, and second-hand smoke represent other occupational or environmental exposures associated with lung cancer risk. Patients with treated for breast cancer, Hodgkin and non-Hodgkin lymphomas with high doses of radiation to the chest have increased risk of lung cancer, especially if they smoke cigarettes. Family history is another predictor of increased risk. Other diseases associated with increased lung cancer risk include chronic obstructive pulmonary disease and restrictive lung diseases, including fibrotic disorders like pneumoconiosis.
Finally, there have been dietary associations with lung cancer. An increased risk has been found with diets deficient in vitamins A and C, but supplementation with beta-carotene has been associated with an increased risk (in heavy smokers, the highest-risk populations, in 2 of 3 clinical trials).
On the basis of findings from the NLST trial, screening for lung cancer with low-dose computed tomography (LDCT) scan is recommended for certain patients by the U.S. Preventive Services Task Force (USPSTF). See Table 1.
Table 1. USPSTF Recommendation Summary for Lung Cancer Screening
| Population | Recommendation |
| Adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years | The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery. |
Adults aged 50 to 80 years have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years should screen for lung cancer with LDCT every year. A pack-year is a way of calculating how much a person has smoked in their lifetime. One pack-year is the equivalent of smoking an average of 20 cigarettes (1 pack) per day for a year. These recommendations are available at www.uspreventiveservicestaskforce.org.
If you would like to learn more and connect with a board-certified physician, click to book now on My Virtual Physician. My Virtual Physician offers comprehensive medical services where you can discuss the best screening plan for you with a virtual doctor.
References
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening
Siegel RL, Miller KD, Jemal A: Cancer statistics, 2019. CA Cancer J Clin 69: 7-34, 2019. PMID: 30620402.
Jemal A, Thun MJ, Ries LA, et al: Annual Report to the Nation on the Status of Cancer, 1975-2005, featuring trends in lung cancer, tobacco use, and tobacco control. J Natl Cancer Inst 100:1672-1694, 2008. PMID: 19033571.
Omenn GS, Goodman GE, Thornquist MD, et al: Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med 334:1150-1155, 1996. PMID: 8602180.
Menkes MS, Comstock GW, Vuilleumier JP, et al: Serum beta-carotene, vitamins A and E, selenium, and the risk of lung cancer. N Engl J Med 315: 1250-1254, 1986. PMID: 3773937.
Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group: The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 330:1029-1035, 1994. PMID: 8127329
More than 100 million Americans are living with abnormal blood sugar. Is it possible that you could be one of them? A simple A1c screening blood test shows when levels are too high. Elevated blood sugar means higher risk for diabetes.
A glycated hemoglobin, or hemoglobin A1C, test (HbA1c) is one screening test that checks blood sugar levels. Results show how much sugar is in the bloodstream over time. Testing is accurate since values are not affected by acute illness or stress. A1c screening is recommended for certain populations, including overweight adults and those with other risk factors.
Those thinking about blood sugar testing or wondering about risk factors should talk to their doctor. Here are some common questions about diabetic screening and A1c testing.
The A1c test can detect diabetes because it measures how much sugar, called glucose, is found in red blood cells. The red blood cells give a “glycemic history” of the past 120 days.
Everyone has sugar in their blood. But diabetics have higher levels. Blood sugar that is too high leads to cell and tissue damage.
When someone is diagnosed with diabetes, their doctor will also use the A1c test to monitor how the disease is being controlled.
A1c readings are measured in percentage. Here is what A1c results mean.
Higher blood sugar levels cause greater A1c values, and they equal greater risk for diabetes.
Early detection is key in diabetes because early treatment can prevent serious complications. When a problem with blood sugar is found, doctors and patients can take steps to prevent permanent damage to the heart, kidneys, eyes, nerves, blood vessels, and other vital organs.
Here are the current recommendations for A1c screening.
The CDC suggests A1c screening to know a baseline for:
They further recommend that any woman who has ever had gestational diabetes should have an A1c check every three years even if results are normal.
The USPTF also says that adults over age 45 should be checked for diabetes using the A1c test. Furthermore, it recommends repeat testing every three years.
The ADA also recommends the A1c test, or other diabetic screening, for all adults at age 45 and over. Additionally, it advises overweight individuals with one or more risk factors to be screened, regardless of age. If results are normal, repeat screening is recommended every three years or less.
How to Get an A1C Test
If you meet some of these guidelines, you might be wondering how you can get a screening test.
A primary care doctor or other licensed provider can order this common blood test. Results take as little as a few business days.
Those who do not have a doctor to order the test, can still get this valuable screening. An online doctor or virtual physician can help. Telemedicine providers work with laboratory partners to treat patients without unnecessary trips to an office.
An online physician sends referrals and lab orders just like a brick-and-mortar doctors office. After going to a lab for blood work, virtual doctors offices schedule follow up video visits to go over the results, answer questions, and discuss treatment plans.
If you would like to talk with one of our board-certified physicians, book and appointment today. My Virtual Physician offers health screening, lab tests, and counseling to meet all of your healthcare needs.
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In the United States, colorectal cancer (CRC) is the third leading cause of cancer, after breast and lung cancer.
CRC almost always develops from precancerous polyps (abnormal growths in the colon or rectum). Screening tests can find precancerous polyps so they can be removed before they turn into cancer. Screening tests can also find CRC early, when treatment works best.
A screening test is used to look for a disease when a person has no symptoms. (When symptoms are present, diagnostic tests are used to find out the cause.)
Regular screening begins at age 45. The U.S. Preventative Services Task Force (USPSF) recommends adults age 45 to 75 be screened. For adults age 76 to 85, the Task Force recommends asking their doctor for screening recommendations.
Talk to a virtual doctor today!
Several screening tests can be used to find polyps and/or CRC (see Table 1 below). There is no single “best test” for any person. Each test has advantages and disadvantages. Talk to a virtual doctor about which test may be best for you and how often to be tested. Testing modality depends on personal preference, individual medical conditions, the likelihood of testing, and the resources available for testing and follow-up.
Table 1. Screening Tests for CRC
| Test Name | Description | Testing Frequency |
| Stool TestsGuaiac-based fecal occult blood test (FOBT) | Uses the chemical guaiac to detect blood in stool. Test provided by health care provider. At home, use a stick or brush to obtain a small amount of stool. Return the test kit to doctor or lab, where stool samples checked for presence of blood. | Once a year. |
| Fecal immunochemical test (FIT) | Uses antibodies to detect blood in stool. | Once a year. |
| FIT-DNA test (or stool DNA test) | Combines the FIT test with a test that detects altered DNA in the stool. This test requires an entire bowel movement be collected and sent to a lab, where it is checked for cancer cells. | Once every 3 years. |
| Flexible Sigmoidoscopy | During this test, the doctor inserts a short, thin, flexible, lighted tube into the rectum through the sigmoid colon (lower 1/3 of colon). The doctor checks for polyps or cancer there. | Every 5 years, or every 10 years with a FIT every year. |
| Colonoscopy | Similar test to flexible sigmoidoscopy, except the doctor uses a longer, thin, flexible, lighted tube to check for abnormalities inside the rectum and entire colon. During the procedure, the doctor can find and remove most polyps and some cancers. Colonoscopy is also used as a follow-up test if anything unusual is found during one of the other screening tests. | Every 10 years (for people who do not have an increased risk of colon cancer). |
| CT Colonoscopy (Virtual Colonoscopy) | Computed tomography (CT) colonography, also called virtual colonoscopy, uses X-rays and computers to produce images of the entire colon. These are displayed on a computer screen for the doctor to analyze. | Every 5 years. |
The screening testing frequencies above are general guidelines and may be different for you if you have certain risk factors for CRC, such as a family history of CRC or detection of high-risk lesion. Testing is generally more frequent for patients who are high risk. Your doctor will help you decide the optimal screening interval.
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If you would like to connect with a board-certified physician, book an appointment with a virtual doctor today. My Virtual Physician offers comprehensive medical services where you can discuss the best screening plan for you
Sexually transmitted diseases (STDs), also called sexually transmitted infections (STIs), are very common, with around 25 million new diagnoses made yearly in the United States. Young people, ages 15-24 years of age, appear to be the most prevalent group to acquire and spread STDs, accounting for about half of newly diagnosed cases in 2018 per the Centers for Disease Control (CDC). Notably, 1 in 5 people in the United Stated have had an STD.
Oral, vaginal and anal sexual encounters are the methods of transmission and these infections vary greatly in their symptoms, severity, curability and prognosis. Treatment has improved over the years and some lifelong conditions now do not preclude a good quality of life. However, some of these diseases can be quite quiet in terms of initial symptoms, and screening tests, or tests to check if a disease is present even when symptoms are not, are a critical way to help reduce transmission and consequences of these infections.
Bacterial Vaginosis, not categorized itself as a sexually transmitted disease, is a condition named for alterations in the normal balance of bacteria in the vagina, which can lead to an increased risk for susceptibility to STDs, as well as preterm labor. A fishy odor may be noted after vaginal intercourse, and pain, itching and burning in this area or during urination, as well as thin, grey-white vaginal discharge, are among associated complaints. Although many cases of bacterial vaginosis clear on their own, antibiotic treatment may be needed at times. Currently, there is no recommendation for routine screening for BV.
Two of the most predominant, but easily treatable STDs, include chlamydia and gonorrhea. Both can spread through oral, vaginal or anal sex. Though either condition may be asymptomatic, some suspicious findings include abnormal vaginal or penile discharge, burning while urinating and pain or swelling of the testicles. Chlamydia and gonorrhea can also reoccur if infectious sex continues, despite prior treatment. Also, having these infections increases a woman’s risk to develop pelvic inflammatory disease (PID), which is damage to the internal reproductive organs, making future fertility a challenge. If infected during pregnancy, risk for miscarriage, preterm labor, low birth weight or an infection in the fluid surrounding the fetus, called chorioamnionitis, increases. Newborns of untreated mothers may also suffer postnatal complications such as eye infections and pneumonia. Pregnant women < 25 years of age, or older pregnant women at increased risk of exposure to gonorrhea or chlamydia, are typically screened at their first prenatal visit. Similarly, it is recommended to screen all sexually active women < 25 years of age, yearly, for gonorrhea and chlamydia, and older women who have multiple sexual partners. All sexually active gay or bisexual men, should also be screened at least yearly, but more often depending on frequency of new sexual encounters/multiple partners. Testing for these diseases can be as simple as a urine sample ordered by a virtual physician, however it is prudent to discuss symptoms and history to determine the best course of screening.
According to the CDC, every 1 out of 6 people in the United States has herpes simplex virus (HSV) infection, oftentimes without knowing it. HSV can be divided into HSV 1, more commonly known as oral herpes, and HSV 2, known as genital herpes. Although designated as such, either can occur orally or genitally. Many people are infected with HSV 1 in their childhood, through non sexual mediated contact with infected saliva. Oral herpes results in cold sores or fever blisters, around the lip and mouth area. Genital herpes, likewise, can demonstrate sores throughout the genital region of infected individuals. Lack of active sores however does not negate infectious activity and the disease can still spread through unprotected oral, vaginal and anal routes. There is no curative treatment for HSV and the virus can go into a dormant phase where no symptoms occur for years, though patients are at risk for recurrent outbreaks, where an antiviral medication may be prescribed. Devastating effects can occur if left untreated during pregnancy, including life-threatening infection to the newborn. If there is history of infection or active infection at the time of labor, a Cesarean section may be indicated. The United States Preventive Services Task Force does not recommend routine screening for HSV in asymptomatic sexually active adolescents or adults, including pregnant women.
Syphilis is a bacterial infection spread through sexual contact, and is divided into distinct phases, first beginning as painless mouth/oral, genital or anal sore(s) several days to several months after initial exposure. This sore or sores will resolve after a few weeks, even without medication. Then a body rash develops, sometimes with swollen lymph nodes, general fatigue and a fever, later. There can be a long period of “latency”, or no symptoms, followed by the last stage classified by neurological, ocular and cardiac symptoms. This is a curable condition, but can cause life-long consequences if untreated, including dementia and blindness, and can lead to death. Screening is indicated for sexually active individuals on a yearly basis, but more often such as every 3-6 months for high risk features, such as multiple partners. This can be performed through a blood test, which may be ordered through a virtual physician’s visit.
Although there are other methods of transmission, typically hepatitis B may be acquired through the sexually transmitted routes mentioned above. Hepatitis C is less commonly sexually transmitted, but spreads through exposure of infected blood, such as in activities like sharing needles in illicit IV drug abuse. Both conditions, though incited by different viruses, have the same impact on the liver and symptoms can overlap, with fever, fatigue, yellowing of the eyes and skin, abdominal pain and changes in urine color. With the exception of individuals living in extremely low prevalence areas, it is recommended that hepatitis C screening be given to a person at least once after the age of 18 years. Additionally, although hepatitis B is a vaccine preventable illness, the USPSTF recommends screening by blood test, those individuals at high risk such as those who inject drugs or share needles, men who have sex with men and immunocompromised patients, such as those with HIV, as well as those living in areas with a 2% or higher prevalence of the hepatitis B surface antigen, regardless of vaccination status. This is especially important given that hepatitis B is a chronic illness that will need lifelong treatment and both viruses present a higher susceptibility to liver cancer.
HIV, or human immunodeficiency virus, eventually progresses to acquired immunodeficiency syndrome (AIDS). Fortunately, through screening and early detection, appropriate prophylactic and supportive agents can be provided to help maintain CD4 counts and stable immune status in order to prevent, or at least slow, this advancement. It is generally recommended that adolescents beginning at 13 years, through adulthood, into the 60s, be screened via blood test, at least once as part of routine health maintenance. For those in higher risk categories, such as individuals with multiple sexual partners, men who have sex with men and those who share needles, screening may be advised yearly or with more frequent intervals depending on individual circumstances. Once again, this is a blood test that may be ordered through a virtual doctor visit.
While prevention of any illness is optimal through regular visits with a physician, screening tests have proven to be useful in early detection of otherwise asymptomatic diseases, allowing for quicker treatment. In particular, sexually transmitted diseases are relatively easy to screen for through blood or urine samples. If you have questions or concerns regarding your need to be screened for these conditions, it is quite simple to schedule a virtual visit with one of our physicians at My Virtual Physician, and we can help determine which testing is right for you. In addition, depending on the results, oftentimes follow up guidance or medication can also be provided! Schedule a visit today!
Half of adults over the age of 50 are at risk for broken bones. Maintaining healthy bones is important for a long healthy life.
Osteoporosis (OP) is a condition of weakened bones. Thin bones are at risk for fractures. OP screening can be an important part of staying healthy. Early disease detection and treatment may prevent complications later. Broken bones are painful and costly. Luckily, screening tests like the Dual-Energy Xray Absorptiometry (DEXA) scan alert doctors of problems early.
DEXA scans or other OP screening tests are advised for some at-risk groups. To find out if you should be concerned about bone testing today, read on.
OP is more common in adults than you may believe. One health department called it a major public health threat.
OP screening may prevent:
People with OP may not know anything is wrong until they suffer an injury. With advanced bone disease, normal activities can cause bones to break. Studies have shown that many patients do not get the right treatment for low bone density (LBD) despite the great prevalence, complications, and costs of fractures related to bone disease.
Therefore screening tests for bone loss are important to your health. Doctors or specialists can diagnose problems with weak bones before they become serious.
OP affects one-in-three women above 50 years old. It is also a serious condition for men.
It is best to talk to a doctor about when to get a screening test. They can explain the test and treatment options. Physicians will also answer questions about what to expect.
Currently, we have a few recommendations for OP screening.
The NOF advises a DEXA scan of the hip and spine for:
Also, they also encourage testing in those with:
The ISCD has similar guidelines. They recommend DEXA scan of the hip and spine for the same groups above, but also in:
AACE recommends a DEXA scan for
The AACE says that the lumbar spine and proximal femur are the best sites for testing.
The USPSTF recommends screening for OP in women 65 years or older. Also in younger women with certain risk factors. At this time the USPSTF does not have a recommendation for men.
ACOG currently urges screening for women 65 or older and those under age 65 with risk factors for fracture. They also say physicians should screen patients using the FRAX tool to define their risk of a major fracture.
The FRAX® tool evaluates fracture risk in patients. Based on the score, a 9.3% or higher risk should be referred for a DEXA scan.
The DEXA scan is a quick and reliable test for measuring bone mineral density (BMD). It aids in the diagnosis of OP.
The scan usually takes around 15 minutes. And it doesn't hurt. First, the patient lies down on an open table.
Next, a scanner passes over the body. It sends two X-ray beams. And the machine tells how the rays pass through the bones. This shows how thick or thin they are. The results give the doctor a good idea of how healthy the bones are.
Like other medical tests, a DEXA scan is ordered by a healthcare professional. Typically, doctors or specialists can write a prescription or send a referral. Virtual doctors and online physicians can also arrange this test for their patients.
OP screening may be a part of your yearly check-up. Or it can be used to check on certain risk factors.
Thanks to telemedicine, it is now fairly easy to get this important test. An online doctor can tell you about OP screening and answer your questions. Online appointments are convent. Patients meet doctors from wherever they are, on a mobile device or smartphone.
My Virtual Physician offers screening consultations at little or no out-of-pocket cost. They can order blood tests, imaging or scans, X-rays, and more. And in some cases, same-day appointments are available.
Many screening tests are covered by health insurance or medical benefits. Check with your insurance to see if any out-of-pocket payment is required. Medicare pays for bone density testing every two years for adults over 65 with some risk factors.
My Virtual Physician offers full preventive care services for men and women. To talk with one of the top physicians, click to book an appointment now. The MVP caring experts help patients with screening plans that are tailored to their healthcare needs.
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Sources:
This past year tested many young businesses. Telemedicine is not new. But the My Virtual Physician (MVP) business model is. The virtual doctor practice offers the best in online doctor services as a direct-to-consumer multi-specialty provider licensed in multiple states. Regardless of 2020's challenges, the MVP virtual doctor team didn't slow down. They focused on their path to becoming the #1 online doctor and forged ahead.
Over the last 12 months, MVP worked hard to bring high-quality medical care into homes in 15 states. They now offer online pediatric, gynecologic, and primary healthcare services for patients of all ages. Plus, they provide same-day scheduling for online physician appointments, some in-network insurance benefits, and five-star customer service.
As the #1 online healthcare provider, MVP doctors get to know their patients. Quality care is emphasized, and they aim to provide the best patient satisfaction in telemedicine. Here’s what patients are saying about MVP's online doctors:
“I would give My Virtual Physician more stars if I could”
“Dr. Howard has the best personality and is very friendly.”
“The future of medical visits; what better way to social distance.”
“A+ would recommend to everyone.”
Since their launch, MVP has opened new offices and added service lines such as nutrition and diabetic care. The practice has partnered with more online doctors and added office staff. Just this Spring, MVP enhanced their patient portal for self-scheduling, and integrated a program to trend patient reviews.
This one year anniversary milestone is cause for celebration. It is exciting, and this is only the beginning. Despite any challenges that lie ahead for this medical practice, their progress shows that the future is very bright for My Virtual Physician.
Congratulations to Dr. Howard, Dr. Masghati, Dr. Ayyagari, and all of the My Virtual Physician Staff.
With warm weather comes more opportunity for pool and beach time, and it’s important to refresh ourselves on water safety around our pediatric patients.
According to the Centers for Disease Control (CDC), drowning is the leading cause of injury-related death in kids ages 1-4 years. Drowning is the second leading cause of death, second only to motor vehicle accidents. Males have about a two-fold risk over females and African American children are nearly 5.5 times more likely to die by drowning than their Caucasian peers. The good news: drowning is essentially preventable.
When you see the Pediatrician for routine child well checks, some of the topics discussed fall under the category of anticipatory guidance. Anticipatory guidance are things to expect as a child develops along their trajectory and how to manage it. Water safety is a topic often reviewed during in person or virtual doctor visits. Common questions that may come up during a water safety conversation are:
Important Tip: Remember that a young child can drown in as little as an inch or so of water. We can not emphasize enough the importance of direct and uninterrupted supervision, early and safe water exposure as well as prevention measures.
The American Academy of Pediatrics advises swim lessons begin as early a year old and many swim facilities offer swim readiness training to toddlers and their caretakers. As affordability may be a concern to utilize commercial schools, you can check your town’s park and recreational facility to discover potential options for discounted pricing for more local community programs. The decision to begin swim lessons may vary for some families depending on the child’s physical and emotional development, but swimming is a life skill and starting in toddlerhood has been shown to reduce the risk for drowning. Infant swim lessons are not recommended due to lack of evidence to support that swim lessons in this age group lower drowning risk.
Young children are naturally curious and move quickly. The majority of drownings occur in settings without appropriate supervision or safety in place. An in-ground, residential pool is required to have a barrier fence of at least four feet high and surrounding three sides of the pool with the house acting as the fourth side. If this is the sole barrier, door alarms should be placed on the doors that open to the pool. It is further protective to have an actual four-sided barrier fence surrounding the pool itself with an automatic locking gate. Additionally, another layer of protection is a pool cover, however these should never be used alone without barrier fencing.
Open bodies of water, such as lakes or oceans, present some of their own unique challenges, including poor visibility compared to a pool, and potentially strong currents. Using a life vest approved by the US Coast Guard is always recommended for children exposed to outdoor water.
Aside from physical barriers, supervision is imperative: direct and constant. Equipment malfunction, such as a broken gate latch or failure of proper life vest use, can lead to more risk, which is then mitigated by your constant presence with the child/children. Never take on water supervision with children while intoxicated and never leave older children to watch younger children. “Touch supervision”, or being at arm’s length of the child, is advised by the AAP. Ideally, getting into the water can be more helpful in acquainting children with safety while also promoting a fun experience.
With these ideas in mind, you can feel more secure about your young water-lovers taking on a healthy and splashingly good summer! For any additional questions or concerns you may have regarding swim safety, scheduling an online doctor visit with My Virtual Physician is a quick and convenient way to reach our Board Certified General Pediatricians, who are happy to help! My Virtual Physician provides parents with high quality medical care via video visit and are able to treat a variety of health conditions. Schedule a virtual visit today!
Meet Dr. Aravinda Ayyagari! We are ecstatic she has joined our My Virtual Physician practice.
She is a board-certified pediatrician with almost 20 years of experience. She serves on several hospital committees and enjoys volunteering her time in different settings ranging from the local school to the board of Easter Seals, and even traveling to El Paso, TX as a volunteer physician at a migrant center. She also serves as the state of Delaware CATCH grant coordinator to increase children’s access to healthcare services.
In her free time, she enjoys traveling, cooking, exercising, and spending time with friends. She loves hiking with her husband and two children in various destinations both domestically and internationally - covering Asia to South America. As a family, they have been amazed at how people are much more alike than different. They are looking forward to their next adventure!
Dr. Ayyagari speaks Spanish and some Telugu. She enjoys caring for patients of different cultural backgrounds.
Most recently, she started Bridge Care Pediatrics, a direct primary care which provides all pediatric and newborn housecalls. www.bridgecarepeds.com
Menopause is manageable. If you or someone you know is going through this stage of life, you may be wondering how to manage menopause.
Menopause is a natural process that many people associate with uncomfortable symptoms. Many women report mood swings, hot flashes, night sweats, and weight gain. Despite the unpredictability, menopause is manageable. With a basic understanding and simple lifestyle choices, women can thrive during this time.
How do you manage some of the common complaints? Well, it helps to start with a grasp on what causes this change.
Menopause is a time in a woman’s life when the menstrual cycle stops. During this period, the ovaries produce less of a hormone called estrogen. Changing hormonal levels affect many body processes.
Three phases make up the process of menopause:
Premenopause (“pre” means "before"): years before periods stop, estrogen levels decrease and periods may become irregular
Perimenopause (“peri” means "around"): the ovaries lower estrogen production, and periods stop; when a woman has not bled in 12 months, she has reached menopause
Postmenopause (“post” means "after"): after menopause, symptoms become milder and less frequent
Menopause generally affects women in their 40’s or 50’s. Studies show that the onset age of menopause is affected by many factors, including genetics (age the mother began menopause), the number of pregnancies a woman has had, body mass index (BMI), physical activity, and other factors. The average age for menopause in the United States is 52.
Symptoms may last during the postmenopausal time for up to four or five years, but they will become lighter.
Menopause varies among women. Yet, many report some common symptoms.
Empowering women with understanding about the natural process, and recommending lifestyle changes known to improve signs and symptoms, helps patients and their doctors manage menopause.
So, below you will find details about what causes these common complaints, and ways to manage them.
Mood swings happen with menopause because of changing hormone levels. Estrogen decreases during menopause. This important hormone relates to production and regulation of other key hormones such as serotonin, dopamine, and norepinephrine.
Serotonin is a mood-stabilizing hormone. Thus, fluctuating estrogen levels can lead to a disruption in serotonin production.
In other words, women in perimenopause may notice that they feel more emotional, sensitive, anxious, or worried.
To reduce or prevent mood swings, women should practice healthy habits, including:
Doctors believe that night sweats and hot flashes occur during menopause because of hormones. Estrogen and progesterone hormones help to regulate body temperature. During the natural process of menopause, when hormone levels change, many women find that they experience periods of feeling very hot to the point of sweating, even though their environment has not changed. Night sweats are episodes that occur while sleeping.
Hot flashes vary from seconds to minutes. They may happen once a day or 20 times in a day. Some women never experience them at all.
To deal with hot flashes, women could:
Weight gain is another common complaint of menopause. And it happens because, you guessed it, hormone changes. Estrogen plays an essential role in regulating fat storage. As estrogen levels go down during menopause, there are changes in the way the body stores fat. Also, for many women in their 40’s and 50’s, activity levels decrease, and metabolism slows. This triple whammy makes weight gain probable.
To prevent menopausal weight gain, women might consider:
Menopause symptoms generally become less intense and less frequent as time goes on. Some women may experience few or none at all. Yet, if you feel like your symptoms are severe or disrupt your life, you should talk to your doctor. There are other medical treatments, such as medications or hormone replacement therapies, available.
To talk with one of our board-certified physicians, click below to schedule an appointment. My Virtual Physician offers comprehensive OB/GYN services to address women’s healthcare needs. Our caring experts can treat menopausal signs and symptoms. If you have suggestions for other topics you want to read about, let us know! Don’t forget to follow us on social media.
If you have ever wondered if your blood pressure is normal, you are not alone. We know that maintaining readings in a healthy range can help prevent serious life-threatening conditions. So, is there a magic number for blood pressure?
There is no “magic number” for blood pressure, because readings are affected by many factors and can vary throughout the day. Rather, there are clinically defined ranges that doctors consider normal, elevated, or pathologic. A reading is considered "normal" when it is less than 120/80 mmHg.
Hypertension is a medical condition in which blood pressure is too high. The World Health Organization (WHO) says that over a billion people have hypertension, but fewer than one in five have the problem under control. So when does high blood pressure become hypertension, and how do we manage it? Read on to find out.
Blood pressure is determined by the force of the blood that is pumped from the heart into the body’s largest vessels, called arteries.
Readings are written as two numbers. The first or top number, called the systolic reading, should be less than 120. Systolic pressure measures the force inside the arteries when the heart contracts and pushes blood from the heart. The second or bottom number, called the diastolic reading, should be less than 80. Diastolic pressure measures the force inside the arteries when the heart is relaxed or resting, in between beats.
Both readings are measured in millimeters of mercury, written as “mmHg.” Depending on where, when, and how it is checked, you may get slightly different readings. Your numbers change throughout the day. This means that blood pressure readings must be evaluated over time.
According to the American Heart Association, a "good" reading is less than 120/80 mmHg. High blood pressure, or hypertension stage I, starts at 130/80 mmHg. At this stage, your doctor will probably recommend steps to try to lower your pressure. Interestingly, some doctors debate about these numbers, and at what point a patient should be treated.
What is undisputed, however, is that the risk of heart disease and stroke is doubled for each increase of 20 mmHg systolic and 10 mmHg diastolic. Keeping your number under 120/80 decreases the likelihood of health dangers including death.
Many factors affect your readings, including:
Regardless of what causes your high blood pressure, we know that over time it causes serious complications. Hypertension changes the walls of blood vessels. Damaged arteries and vessels stiffen and reduce blood flow. In other words, This process harms vital organs.
Many factors affect what your blood pressure reading is. Similarly, several things can lower your numbers.
The National Institute on Health (NIH) recommends the DASH diet. This eating plan, named the Dietary Approach to Stop Hypertension, gives guidelines for a balanced, heart-healthy diet. You can read more about the DASH eating plan here.
Cardiovascular activity strengthens the heart and can actually lower your systolic and diastolic pressures. The American College of Sports Medicine (ACSM) recommends exercise for prevention and treatment of hypertension. Find the guidelines here. The ACSM asserts that regular exercise can result in reduction of 5-7 mmHg which means a 20-30% risk reduction.
If you are overweight, losing weight will decrease your number. According to Cardiologist Dr. Matthew Alexander, even a 5-10 pound weight loss could lower your blood pressure by 5-20 mmHg.
Stress, anger, and fear-based emotions affect the cardiovascular system. Over time, chronic stress can lead to hypertension.
Practices such as biofeedback, mindfulness, and meditation counteract these feelings. Studies have shown the power of the mind to improve body function. For instance, recent research concluded that stress management therapies can decrease systolic pressure 6-10 mmHg.
If you have high blood pressure, or if you’ve already tried these suggestions to lower your numbers without success, it may be time to talk to your doctor. That is to say, doctors can prescribe a personalized treatment plan to get your readings into a safe range. In some cases, that plan includes medications. For example, there are many drug therapies available today, including diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), calcium-channel blockers, and more. A doctor can recommend the best treatment for you.
In summary, there really isn’t a “magic number” for everyone because many factors affect the reading. If you worry that yours is too high, be proactive in making lifestyle choices that are known to help lower blood pressure to a safe range.
To talk with one of our board-certified physicians, click below to schedule an appointment. My Virtual Physician offers healthcare services to address all of your healthcare needs. Our caring experts treat high blood pressure and can help with your medication questions. If you have suggestions for other topics you want to read about, let us know! Don’t forget to follow us on social media.
Stefanie:
Welcome, everyone! Thank you for joining us today.
My name is Stefanie and I'm part of the team here at MyVirtualPhysician. We are a direct to consumer, multi-specialty, telemedicine provider operating in multiple states.
It is Talk Tuesday and we are back with our weekly educational series, talking with our experts, exploring some common healthcare concerns that we see, and hopefully answering some questions you may have.
Today our physician expert is Dr. Daniel Kessler and one of our telemedicine providers. We are talking about coping with anxiety during the holidays.
Stefanie:
Well the holiday season is upon us and I know that this year has been challenging for many, so some people are already stressed or anxious and not looking forward to the holidays. Is it normal to have anxiety during this time?
Dr. Daniel Kessler:
It can be common to have feelings of anxiety during this time.
The Oxford dictionary defines anxiety as feelings of worry, nervousness, or unease, typically about an event or something with an uncertain outcome that may be coming. These can be normal and natural. Many people have these feelings from time to time. During the holidays, Americans may feel financial strain as it can be a season of shopping and gift-giving. They may have to come together with family members that they don’t often see or grieve separation from loved ones and relationships can be challenging or cause anxiety and worry. Many adults have unrealistic expectations for the holiday and that can create anxiety. And already busy schedules can feel the burden of holiday events and activities that can make you even more busy, anxious, or restless.
Stefanie:
That makes sense, the holidays can definitely cause anxiety, the worry, nervousness, or unease. So when is anxiety abnormal, or when is it a problem?
Dr. Kessler:
In some cases, those thoughts or feelings become intense and excessive, or individuals may become focused on common everyday events or situations that generally should not produce those feelings or at one time did not make the person feel that way. This type of anxiety usually causes physical symptoms such as sweating, racing heartbeat, or even weakness and feeling tired all the time.
This second more extreme sense of anxiety may be out of the norm, and may require evaluation by a healthcare professional.
Stefanie:
Are there other symptoms, other than the intense feelings you mentioned, that someone could look for or identify as signs that they should get help, or someone they know or care about should see a physician?
Dr. Kessler:
Symptoms of an anxiety disorder can vary from person to person so if someone is concerned they should talk to their doctor.
But some other signs or symptoms could include:
Stefanie:
So Dr. Kessler, these may be reasons to talk to your doctor about your anxiety. But for our listeners who may experience some mild feelings of stress or worry around the holidays, and maybe they are reluctant to talk to anyone about them yet, can you tell us about coping with anxiety, and specifically for coping with anxiety during the holidays?
Dr. Kessler:
Sure, There are definitely some steps you can take to manage mild anxiety.
Probably the most important thing is self care and self awareness. Many people overlook taking care of themselves during this season, which is often about giving to others. But you have to be aware of how you’re feeling, and take care of your mental and physical health during this time.
So here are 6 things that we can all do, to try to stay healthy and happy this holiday and keep anxiety at bay.
Number 1 - Adequate hydration
Don’t forget to drink 8-10 glasses of water each day. When you are dehydrated, you won’t feel your best. Also keep in mind drinks like coffee and alcohol may contribute to anxiety so it can be helpful to limit or cut out caffeine and alcohol for a time.
Number 2 - Good nutrition
Stress can cause changes in your metabolism, or how you burn energy. Skipping meals leads to spikes and drops in blood sugar that can wreak havoc on your system. It is important to eat regularly and maximize your nutrient intake with healthy foods. Taking a multivitamin won’t hurt either.
Number 3 - Get enough sleep
National Sleep Foundation guidelines say that the average adult needs seven to nine hours of sleep. Staying up late at holiday parties and getting up early to wrap presents can be detrimental to your health. Practice good sleep hygiene by setting a bedtime and sticking to it when you can.
Number 4 - Exercise
Studies show that physical activity is excellent for mental health. If you find yourself anxious or worried take a walk or a jog, practice yoga, whatever physical activity that you find enjoyable.
Number 5 - Stay connected to others
Social isolation can be a symptom of anxiety and may also trigger it. During the holiday season, make it a point to stay connected to family and friends. Communicate by phone or in person when possible. When separated from loved ones, look for settings where you can volunteer. Many charities offer opportunities to serve. Being with others can suppress feelings of anxiety or depression. It is helpful to share feelings with others and reach out when you can.
Number 6 - Be intentional with your schedule
Set boundaries with your time, and don’t feel about declining invitations if they cause stress, anxiety, or depression. Limit events that cause excessive worry. You want to be connected, but you also want to be selective in some way, and make the best of your holiday season. It can also be helpful to stick to your normal routine. Change can cause stress so just be aware of that.
Stefanie:
Thank you Dr. Kessler, you have given us some great tips for coping with anxiety during the holidays.
I appreciate you joining us for Talk Tuesday and telling us what we need to know about anxiety. For everyone else joining us as well, this has been Talk Tuesday with MyVirtualPhysician. If you would like to talk with one of our board-certified physicians about your health concerns, you can check out our website at www.myvirtualphysician.com. We look forward to talking with you again, and we hope you have a great week.
Stefanie:
Welcome, everyone! Thank you for joining us today.
My name is Stefanie and I'm part of the team here at MyVirtualPhysician. We are a direct to consumer, multi-specialty, telemedicine provider operating in multiple states.
It is Talk Tuesday and we are back with our weekly educational series, talking with our experts, exploring some common healthcare concerns that we see, and hopefully answering some questions you may have.
Today our physician expert is Dr. Daniel Kessler, Primary Care Physician, and one of our telemedicine providers. We are talking about a topic affecting one in ten Americans, Diabetes.
Dr. Kessler, thank you for joining us today.
Stefanie:
Let’s start by talking about Diabetes statistics. According to the American Diabetes Association, in 2018, 10.5% of Americans were estimated to have diabetes and about one-fifth of those were undiagnosed. Those are pretty significant numbers. Should people be concerned about diabetes?
Dr. Daniel Kessler:
Well that depends. We know about risk factors that can increase the likelihood of getting Type II diabetes. The CDC says you’re at risk for developing type 2 diabetes if you:
If you have non-alcoholic fatty liver disease you may also be at risk for type 2 diabetes.
So for individuals with risk factors, there should be some concern or at least awareness.
Stefanie:
So let’s talk about early detection. Why is it important? Why is early detection key in diabetes?
Dr. Kessler:
Early detection is key in diabetes because early treatment can prevent or at least slow serious complications. When a problem with blood sugar is found, doctors and patients can take effective steps to prevent irreparable damage to the heart, kidneys, eyes, nerves, blood vessels, and other organs.
An article in the Current Opinion in Endocrinology, Diabetes and Obesity journal recognized that there are many reasons why earlier detection of diabetes could be of benefit to the individual and the healthcare system, because it creates the opportunity to treat the high blood sugar.
Furthermore, undiagnosed diabetes is often associated with potentially-preventable, costly complications. ER visits and hospital stays can be expensive!
The base estimated cost of living with diabetes is around $9,600 per year. This includes prescription medications, diabetic testing supplies, doctors appointments, and routine care. This cost will be higher for uncontrolled or unmanaged diabetics who more care, more medications, more doctors appointments. Early detection can save thousands of dollars.
Stefanie:
So Dr. Kessler, for our listeners who may not be familiar with diabetes, can you tell us what a diagnosis of diabetes means? What is diabetes?
Dr. Kessler:
Sure, Diabetes is a metabolic disorder in which your body is not able to efficiently turn the food you eat into energy, leaving sugar to build up in the bloodstream. This creates two problems: the cells are not getting the sugar energy they need, and the sugar is accumulating in the blood. High blood sugar, known as hyperglycemia, causes damage to many tissues and organs of the body. This is why diabetes is a serious condition that can be dangerous.
Normally when you eat, your body breaks food down into glucose. As your blood glucose level rises, the pancreas releases insulin. Insulin is a hormone that tells body cells to let the glucose inside.
In diabetes, either your pancreas does not make insulin correctly, or your body cells do not react to the insulin the way they should. This means that the glucose stays in the blood, which is why diabetics experience high blood sugar, also known as hyperglycemia. Over time, hyperglycemia can damage nerves and blood vessels.
Stefanie:
I understand. And how do doctors know that the pancreas is not making insulin right or the body cells not reacting to the insulin?
Dr. Kessler:
Well, a blood test can determine if a person has diabetes. There are two tests commonly used.
A glycated hemoglobin test, known as a hemoglobin A1c (HbA1c) test, measures the glycated form of hemoglobin to determine the three month average of blood sugar. This blood test takes about a minute to perform, and results are generally available in two to three days. A normal HbA1c is below 5.7%. Prediabetes is 5.7 to 6.4%. A result of 6.5% or more is classified as diabetic. Another test doctors use to detect diabetes is a fasting blood glucose, or fasting blood sugar (FBS), test. This blood test measures the basal (base) sugar levels of the blood. Testing is usually performed in the morning after the patient has had nothing to eat or drink for eight hours or more. This test may take around ten minutes and results can be immediately available. A normal FBS is 70-100 mg/dl (3.9 - 5.6 mmol/L). An abnormal fasting blood sugar test may be repeated by the doctor or additional tests may be performed for confirmation of the abnormal blood sugar reading.
Stefanie:
And what these tests find, high blood sugar, can it go away? Can diabetes go away, or can early diabetes be cured?
Dr. Kessler:
Diabetes is a chronic condition which means it may not go away. It is possible, however, to reverse some of the effects of diabetes, and to even go into a remission state for those with Type II Diabetes. Remission in diabetes means that your blood sugar levels are within the normal range and you have not required medication to manage your blood sugar for six months or more.
Lifestyle changes like a healthy diet, daily exercise, and weight management can improve the way your body uses insulin, and can improve the prognosis for someone diagnosed with diabetes.
Stefanie:
Thank you Dr. Kessler, you have definitely helped me to understand diabetes better and how important it is for individuals to know their risk and talk to their physician to prevent problems and even get diagnosed and treated early!I appreciate you joining us for Talk Tuesday and telling us what we need to know about early detection in diabetes. For everyone else joining us as well, this has been Talk Tuesday with MyVirtualPhysician. If you would like to talk with one of our board-certified physicians about diabetic screening or your risk, you can check out our website at www.myvirtualphysician.com. We look forward to talking with you again, and we hope you have a great week.
In 2018, about 10.5% of Americans were estimated to have diabetes. Furthermore, about one-fifth of those cases were undiagnosed. It is important that individuals know their risk, and talk to their doctor about screening when it comes to diabetes. So, why is early detection key in diabetes?
Early detection is key in diabetes because early treatment can prevent serious complications. When a problem with blood sugar is found, doctors and patients can take steps to prevent permanent damage to the heart, kidneys, eyes, nerves, blood vessels, and other vital organs.
With simple tests for early detection, patients can make changes to reverse diabetes and even go into remission. Read on to learn more.
Diabetic care often focuses on treatment of the condition. While treatment is important, early detection increases the potential for effective changes early in the disease process.
An article in the Current Opinion in Endocrinology, Diabetes and Obesity journal recognizes that there are many reasons why earlier detection of diabetes could be of benefit to the individual and the health system, because it creates the opportunity to treat the high blood sugar and the risk factors for heart disease that often show up with diabetes. Individuals who don't know that anything is wrong may suffer long-term effects such as cardiovascular disease and stroke.
Furthermore, undiagnosed diabetes often results in potentially preventable, costly complications. Hospital stays could be avoided if patients are aware of their illness and work to manage it.
Diabetes can be expensive. The estimated cost of living with diabetes is around $9,600 per year. This covers prescription medications, diabetic testing supplies, doctors appointments, and hospital care. Medical expenses rise drastically when emergency room visits are needed for unmanaged diabetic complications.
Diabetes is a disease in which your body is not able to efficiently turn the food you eat into energy. Sugar then builds up in the bloodstream. Therefore, two problems arise: the cells are not getting the energy they need, and sugar is accumulating in the blood. High blood sugar, known as hyperglycemia, causes damage to tissues and organs of the body. That is to say, this is why diabetes is a serious condition that can be dangerous.
Normally when you eat, your body breaks food down into sugar molecules, called glucose. After that, the particles get into the bloodstream and your blood glucose level rises, signaling the pancreas to release insulin. Insulin is a hormone that tells body cells to let the glucose inside.
In diabetes, either your pancreas does not make insulin correctly, or your body cells do not react to the insulin the way they should. As a result, glucose stays in the blood, which is why diabetics experience high blood sugar, also known as hyperglycemia. Over time, hyperglycemia can damage nerves and blood vessels.
A blood test can determine if a person has diabetes. Doctors commonly use two tests to check for diabetes.
A glycated hemoglobin test, known as a hemoglobin A1c (HbA1c) test, measures the glycated form of hemoglobin to determine the three month average of blood sugar. This blood test takes about a minute to perform, and results are generally available in two to three days. A normal HbA1c is below 5.7%. Prediabetes is 5.7 to 6.4%. A result of 6.5% or more is classified as diabetic.
Another way a provider can use a blood test to see if you have diabetes is a fasting blood glucose, or fasting blood sugar (FBS), test. This blood test measures the basal (base) sugar levels of the blood. Testing is usually performed in the morning after the patient has had nothing to eat or drink for eight hours or more. This test may take around ten minutes and results can be immediately available. A normal FBS is 70-100 mg/dl (3.9 - 5.6 mmol/L). The doctor may repeat the fasting blood sugar test or order additional tests to confirm an abnormal blood sugar reading.
Diabetes is a chronic condition which means it may not go away. It is possible, however, to reverse some of the effects of diabetes and go into a remission for those with Type II Diabetes. Remission in diabetes means that your blood sugar levels are within the normal range and you have not required medication to manage your blood sugar for six months or more.
Lifestyle changes like a healthy diet, daily exercise, and weight management can improve the way your body uses insulin and can improve the prognosis for someone diagnosed with diabetes.
Diabetes is a global health problem. Health officials expect that rates will only continue to increase. Risk factors such as family history of diabetes, obesity, and sedentary lifestyle increase likelihood that you may get diabetes and so it is important to be proactive in your health and talk to your doctor about your risk for diabetes. .
If you would like more information on diabetic screening, or want to talk about your risk with one of our board-certified physicians, click to schedule an appointment. My Virtual Physician treats conditions including hyperglycemia, diabetic screening, counseling and more. If you have any suggestions for additional topics you want to read about, let us know! Don’t forget to check out our podcasts for more and follow us on social media.
Colagiuri, Stephen; Davies, Daniel The value of early detection of type 2 diabetes, Current Opinion in Endocrinology, Diabetes and Obesity: April 2009 - Volume 16 - Issue 2 - p 95-99 https://doi: 10.1097/MED.0b013e328329302f
Harris, M. I., & Eastman, R. C. (2000). Early detection of undiagnosed diabetes mellitus: a US perspective. Diabetes/metabolism research and reviews, 16(4), 230–236. https://doi.org/10.1002/1520-7560(2000)9999:9999<::aid-dmrr122>3.0.co;2-w
Narayan, K. M., Chan, J., & Mohan, V. (2011). Early identification of type 2 diabetes: policy should be aligned with health systems strengthening. Diabetes care, 34(1), 244–246. https://doi.org/10.2337/dc10-1952
Stefanie:
Welcome, everyone! Thank you for joining us today.
My name is Stefanie and I'm part of the team here at MyVirtualPhysician. We are a direct to consumer, multi-specialty, telemedicine provider operating in multiple states.
It is Talk Tuesday and we are continuing our weekly educational series, talking with our experts, exploring some common healthcare concerns that we see, and hopefully answering some questions you may have.
Today our physician expert is Dr. Salome Masghati, a practicing gynecologist and minimally invasive surgeon and one of our telemedicine providers. We are talking about a problem that may affect one in ten couples at some point, Infertility.
Dr. Masghati thank you for joining us today.
Let’s start by talking about what is Infertility?
Dr. Masghati:
Infertility is a diagnosable medical condition in which a couple has been unable to conceive a pregnancy despite unprotected intercourse.
Stefanie:
Can you tell us some of the causes of Infertility?
Dr. Masghati:
Infertility in women can have many different causes, such as abnormal ovulation, pelvic inflammation, endometriosis, hormone abnormalities, tubal scarring etc. Infertility in men is commonly caused by problems with sperm cells. Aside from these physiological causes, factors affecting fertility can include age, health status, and lifestyle factors such as stress, diet, or smoking. They work to keep you healthy later if you are exposed to a live virus. Marijuana use and heavy drinking have also been shown to cause decreased sperm motility in men.
Stefanie:
So when should a couple seek a medical opinion about getting pregnant? Is there a time frame, say?
Dr. Masghati:
The general rule of thumb is one year for women under the age of 35, and for women over the age of 35 they might seek a medical opinion sooner, after maybe six months of trying to get pregnant. Other reasons to see a doctor when planning a pregnancy might include history of miscarriages, men who have trouble maintaining erection or women with irregular menstrual cycles. Also couples who have had sexually transmitted infections and are now unable to conceive a pregnancy may need to see a doctor, and individuals who have been exposed to toxic chemicals or chemotherapy as in the case of a childhood cancer or something of that nature.
Stefanie:
When couples seek help for infertility concerns, what can they expect?
Dr. Masghati:
Usually the doctor will start with a history and physical, and then they may order blood or urine testing, hormone testing. The doctor may evaluate both partners to try to determine if there are any abnormalities, and then they will go over test results and recommendations with you. Some of these tests can be ordered by me through My Virtual Physician visits, but some need to be followed up in person with a physician in the office.
Stefanie:
And after this evaluation, what sort of treatment options might be recommended, or are available?
Dr. Masghati:
There are medications available for men and women that can increase chances of getting pregnant. Intrauterine insemination, or IUI, is a procedure in which a physician can insert sperm into the uterus at the time of ovulation to help with conception. And for other cases, fertility specialists may offer in vitro fertilization, known as IVF, which is a surgical procedure in which a woman’s eggs are retrieved, fertilized, and then transferred back into the woman’s uterus.
Stefanie:
What is the success rate of a procedure like in vitro fertilization?
Dr. Masghati:
Women under the age of 35 can expect about a 50% success rate for in vitro fertilization, but it is a very complex process that requires intense testing and monitoring and can be costly, anywhere for $20,000 - $50,000.
There is also the possibility to address infertility issues through functional medicine, which is a type of medicine where we look at the patient in a more holistic approach. Functional medicine and integrative medicine can be helpful to couples who have been unable to conceive.
Stefanie:
Dr. Masghati, you have shared some great information today and answered questions that I think many couples may have on their minds. I appreciate you joining us for Talk Tuesday and telling us what we need to know about infertility. For everyone else joining us as well, this has been Talk Tuesday with My Virtual Physician. If you would like to connect with one of our board-certified OB/GYNs, or for more information, you can check out our website at www.myvirtualphysician.com. We look forward to seeing you again and we hope you have a great week.
Starting a family is a goal for many couples. Unfortunately, one in ten couples may have some difficulty getting pregnant and require medical treatment. If you've been affected, you might be wondering about infertility: when is it time to see a doctor? My Virtual Physician has board certified physicians who specialize in infertility and are available for virtual doctor visits.
Infertility is a diagnosable medical condition in which a couple cannot conceive a pregnancy despite unprotected intercourse. It can be caused by many factors.
In women, most often, abnormal ovulation causes infertility. In men, usually problems with sperm cells, such as sperm count or function, cause difficulty conceiving.
Aside from these physiological causes, factors affecting a couple's fertility include their age, health status, and lifestyle factors such as stress, diet, or smoking.
According to the American College of Obstetricians and Gynecologists, women who are overweight, underweight, or exercise too much may have difficulty getting pregnant, and men who are heavy drinkers or smoke marijuana since these are known to lower sperm count and movement.
In some cases, doctors cannot determine the cause and refer to these cases as unexplained infertility.
Generally, it is time to consult your physician about getting pregnant if you are under the age of 35 and have been unable to conceive after one year of unprotected sex. Women over the age of 35 and those who have irregular menstrual cycles or have known abnormalities with their reproductive system, should talk with their doctor much sooner, after six months.
Infertility affects both people in the relationship. There is a 30% chance the infertility is related to male factors in a traditional couple, 30% related to female factors, and a 30% chance a combination of both factors. Therefore, anyone in the relationship may need to discuss options for starting a family. Here are some reasons to see a virtual doctor:
When you consult your physician about infertility, you can expect that they will begin your care with a complete history and physical exam. They may order blood testing, urinalysis, hormone tests, or other diagnostics to check for abnormalities. It may be necessary to have your partner undergo an exam and diagnostic testing also. Your physician may order an ultrasound or an X-ray as well.
After all of the tests, you will meet with your physician to discuss the results and go over treatment options and recommendations. After you decide on the treatment plan that is best for you, you will receive support and guidance in your process to get pregnant.
Medical treatment and new technologies can increase your chances of getting pregnant. One or both partners in a couple may undergo treatment.
Medications may be taken by mouth or injected. There are drug therapies for both men and women aimed at increasing egg production or sperm count. A list of medicines frequently prescribed for infertility treatment can be found here.
In some cases, blockages, scar tissue, or abnormal growths require surgical intervention. Procedures may be laparoscopic: meaning performed through small incisions in the abdomen for a minimally-invasive procedure.
Today, the two most common infertility treatments are intrauterine insemination (IUI) and in vitro fertilization (IVF).
IUI is a procedure during which a physician injects sperm into the uterus at the ovulation time. This method is least invasive and most cost-effective but has lower success rates. The estimated success rate is 10-20% for a single cycle of IUI, but additional rounds increase chances, and in three to six cycles, the success rate is up to 80%.
IVF is a complicated procedure requiring surgical retrieval of a woman's eggs, fertilization in a laboratory, and then transferring the fertilized eggs back into the uterus. Women under the age of 35 can expect a 50% success rate for IVF treatment, but this process requires intense testing and monitoring and can cost $20,000 to $50,000.
Starting a family can be challenging, and your physician may offer options to guide you through the process. Infertility is a medical condition that affects many couples, and there are treatments available.
Need to talk to a physician now? My Virtual Physician has Board-Certified OB/GYN's that are available for virtual doctor appointments and are able to answer any questions you have and guide you in the right direction. The online doctors at My Virtual Physician, not only address infertility and reproductive endocrinology, but also irregular periods and painful periods, and many more gynecological conditions.
If you still have questions or you would like to discuss your problem with our board-certified OB/GYN specialists, click below to schedule an appointment. My Virtual Physician treats conditions, including infertility, irregular periods, sexually transmitted infections, and more. If you have any suggestions for additional topics you want to read about, let us know! Don’t forget to check out our podcasts for more and follow us on social media.
