Interstitial Cystitis: A Cause of Chronic Pelvic Pain

If you think your on going pelvic pain is due to a chronic bladder infection - you might want to think again. Don’t let these symptoms go untreated and undiagnosed.
Interstitial Cystitis is one of the least understood and miss diagnosed causes of chronic pelvic pain. This mysterious condition which consists of sever inflammation of the bladder walls often takes up to four years to identify from the onset of symptoms because diagnosis main consists of ruling out other possible causes such as STIs, bladder cancer and bladder infection.
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Symptoms include chronic pelvic pain defined as pain below the belly button which lasts for six months or more. Chronic pelvic pain can be caused by many things which is why IC is often one of the last conditions ruled out. Pain during intercourse can also be caused by IC. Urinary symptoms, which often lead to confusion for doctors and patients include discomfort, frequency (up to 60 times a day in sever cases) and urinary urgency. Because these symptoms can be caused by bladder infection or bladder cancer, Interstitial Cystitis can go undiagnosed until these concerns are ruled out.
If you are presenting with chronic pelvic pain and your doctor is beginning to suspect CI there are a number of diagnostic test they may recommend.

·         Bladder biopsy – where a small sample of the bladder tissue is take for lab exams.

·         Cystoscopy (endoscopy of bladder) – where a tiny camera is inserted into the bladder to visually examine the bladder walls.

·         Urine analysis – a chemical analysis to make sure that signs of infection are diagnosed and treated.

·         Urine culture – which is where a sample of urine is placed in a medium and bacteria are allowed to grow to show signs of bacterial infections needing treatment.

·         Urine cytology – where a sample of urine is examined under a microscope to identify if abnormal cells are present.

·         Video urodynamics (shows how much urine must be in the bladder before you feel the need to urinate)

Unfortunately there is no cure of Interstitial Cystitis – but there are treatments which can lesson your discomfort and improve your life.
Elmiron is the only medication taken by mouth that is specifically approved for treating IC. This medicine coats the bladder like Pepto-Bismol coats the stomach.
Other medicines which are sometimes prescribed to help with symptoms of IC are:

·         Opioid painkillers for severe pain

·         Tricyclic antidepressants such as Elavil (amitriptyline) to relieve pain and urinary frequency

·         Vistaril (hydroxyzine pamoate), an antihistamine that causes sedation, helps reduce urinary frequency

Sometimes medication can be used in combination with dietary changes which reduce inflammation and irritation to the bladder - reducing symptoms and greatly improving your quality of life. 
Dietary modifications include avoiding the following:

·         Aged cheeses

·         Alcohol

·         Artificial sweeteners

·         Chocolate

·         Citrus juices

·         Coffee

·         Cranberry juice (Note: Although cranberry juice is often recommended for urinary tract infections, it can make IC symptoms worse.)

·         Fava and lima beans

·         Meats that are cured, processed, smoked, canned, aged, or that contain nitrites

·         Most fruits except blueberries, honeydew melon, and pears

·         Nuts except almonds, cashews, and pine nuts

·         Onions

·         Rye bread

·         Seasonings that contain MSG

·         Sour cream

·         Sourdough bread

·         Soy

·         Tea

·         Tofu

·         Tomatoes

·         Yogurt

Experts suggest that you do not stop eating all of these foods at one time. Instead, try eliminating one at a time to see if that helps relieve your symptoms.
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Other more invasive treatments include:

·         Bladder hydrodistention (expanding the bladder by over filling it with fluid while under general anesthesia)

·         Bladder training (using relaxation techniques to train the bladder to go only at specific times)

·         Instilled medications - medicines are placed directly into the bladder. Medicines that are given this way include dimethyl sulfoxide (DMS), heparin, Clorpactin, lidocaine, doxorubicin, or bacillus Calmette-Guerin (BCG) vaccine.

·         Physical therapy and biofeedback (may help relieve pelvic floor muscle spasms)

·         Surgery, ranging from cystoscopic manipulation to bladder removal (cystectomy)

Often treatment is a combination medications, behavior modification and possibly surgery. However, it is worth the effort to find a way to reduce your symptoms and elevate your pain.

When ‘Trying” Isn’t Enough

Most of us think that getting pregnant is the easiest thing in the world, right. You just don’t do anything and within month so stopping birth control you should be planning baby showers. When that does not happen you might start to wonder what is wrong.

At Parkmed we specialize in diagnosing and treating conditions leading to infertility and can help you get on the right track. Our sensitive and knowledgeable Board Certified doctors are happy to sit down with you and answer any of your questions regarding infertility. You can call or send us an email for Appointments.

Infertility is defined as not conceiving a child during a year or more of unprotected sex and is generally grouped into two types.

Primary Infertility is when a couple has been trying for over a year without success. Whereas Secondary infertility is when the couples has had successful pregnancies but of some reason are unable to conceive another child after a year of trying.

There are several reasons that both men and women can be infertile.

Infertility in men or limited fertility can be caused by general health issues and environmental factors. Fertility can be affected by cancer and cancer treatment medications.  Unbalanced hormone levels, scaring from STDs, impotence retrograde ejaculation also can be a factor. Smoking, exposure to pollution, heavy alcohol or drug use or exposure to high heat for prolonged periods of time can also have negative effects.

For women autoimmune disorders, diabetes, cancer, Polycystic Ovarian Syndromes,  Pelvic Inflammatory Disease  , Endometriosis, thyroid disorders and abnormal hormone levels can make ovulation, fertilization and implantation difficult. Also, Eating disorders, obesity, alcohol consumption and over exercise can also be factors. Discussing these issues with your OBGYN can help mediate some of these factors and get you on track for decorating nurseries.
If you are having trouble getting you family started there are tests your OBGYN can do to help figure out what is standing in the say.

Both partners need to be involved in this process because the problems could be on either or both sides. Make an appointment with your OBGYN for both of you.

After a basic physical exam to look for problems you doctor may recommend some tests to look for the source of your infertility.

• Blood tests to check hormone levels, including progesterone and follicle stimulating hormone to make sure that ovulation is occurring.
• FSH and clomid challenge tests. These tests help determine whether a woman has a limited ovarian reserve which can be a negative predictor for pregnancy.
• Hystosalpingogram (HSG). In this test a dye is injected into the uterus and pushed through the fallopian tubes to look for blockages that could keep egg and sperm from meeting.
• Pelvic Ultrasound
• Laparoscopic surgery to examine the uterus and fallopian tubes and possible remove fibroids or other tissue that might be causing problems with conception.
• Luteinizing hormone tests
• Thyroid function test for women.
• Sperm testing for men.

Once these tests are done you and your OBGYN make a plan of treatment which can greatly improve your chances of starting your family.
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Pregnancy Termination: What Are Your Options?

If you’re facing an unplanned pregnancy, you’re certainly not alone. Every year, approximately three million women experience an unintended pregnancy, and many of those will consider abortion. Abortion isn’t uncommon – in fact, as many as one in three women will have an

Manual Vacuum Aspiration

One of the most common early abortion methods is a procedure called manual vacuum aspiration (MVA). MVA, performed in a doctor’s office, is usually done using a local anesthetic. The procedure involves inserting a tube through the cervical opening and aspirating (removing) the contents of the uterus. The entire process is very short in duration, and patients are given pain medication for any discomfort. If you prefer general anesthesia, that is available as well. MVA is less invasive and faster than the common practice of dilation and curettage (D and C) for early abortion. MVA is also silent, and has been shown to allow patients to relax and experience less psychological discomfort than other abortion methods.

The Abortion Pill

Another option for early pregnancy termination is the abortion pill. This at-home alternative to in-office procedures gives you more control over your abortion process and allows for greater privacy. The process starts with some tests to verify your pregnancy and overall health. Next, you’ll be given a tablet (called Mifepristone) to take while you’re in the office. This stops the development of the pregnancy. You’ll also be given a second medication (called Misoprostol) to take at home 24 to 48 hours later. This medication completes the abortion by allowing the pregnancy tissue to pass from the body. Because this process involves cramping, you will be encouraged to take pain medication to make it more tolerable. You’ll be asked to return to the office two to three weeks later to verify that the abortion process is complete.

Abortion Services in NYC

At ParkMed in NYC, abortion services are available in a comfortable, professional environment, from caring and experienced providers. The professionals at ParkMed understand that patients considering pregnancy termination have questions, so they take the time to provide you with the information you need to make the best decision for you.

Committed to excellence in women’s healthcare, ParkMed serves women from all walks of life, treating each patient with the respect and compassion they deserve. The center offers immediate appointments and free pregnancy tests. And the center accepts Medicaid as well as most private health insurance plans. If you’re considering abortion, the experienced gynecologists at ParkMed provide the expert care you need.

ParkMed

800 Second Ave
New York, NY 10017

Phone: 212-686-6066

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What to Expect During Manual Vacuum Aspiration

If you’re considering abortion, safe and confidential services are available at ParkMed in NYC. Abortion costs, logistics and potential side effects are probably at the forefront of your mind as you consider pregnancy termination. You’ll want to learn as much as you can about your options, and have a thorough understanding of what to expect before, during and after your procedure.

When you visit ParkMed in NYC, your abortion costs, options and potential complications will be thoroughly explained in order to help you make the best decision. One of your options – manual vacuum aspiration (MVA) – offers a safe, affordable and less invasive alternative to other in-office abortion procedures like electric vacuum aspiration (EVA) and dilation and curettage (D and C).

The Procedure

MVA is most commonly used during the first 5 to 12 weeks of pregnancy (the early first trimester). MVA is performed in the clinic, usually while the patient is awake. You’ll be asked to lie on an exam table with your feet in stirrups, just as you would during a gynecological exam. The procedure involves inserting a tube through the cervical opening and aspirating (removing) the contents of the uterus.

The entire process is relatively short in duration, and you'll be given pain medication for any discomfort. And unlike a D and C, MVA does not require general anesthesia (although general anesthesia is usually available if you prefer it). Also, MVA is associated with a lower risk of infection than other types of of in-office abortion procedures.

MVA at ParkMed in NYC

As compared to other in-office abortion procedures, MVA is less invasive, involves less psychological discomfort, and is usually associated with lower abortion costs. In NYC, women have access to safe, immediate pregnancy termination with MVA at ParkMed.

The experienced gynecologists at ParkMed generally offer MVA as a first resource. It can also be used if, for some reason, the abortion pill is ineffective. Because ParkMed understands that you may have questions and concerns about the abortion process, the entire team takes the time to ensure that you have all the information you need to make the best decision, and that you’re well-educated about what to expect during your procedure.

At ParkMed in NYC, abortion costs are often covered by Medicaid or your insurance, and any out-of-pocket expenses will be clearly explained to you before you undergo the procedure. Since 1971, the women’s health specialists at ParkMed have been helping women deal with unplanned pregnancies safely and confidentially.

ParkMed

800 Second Ave
New York, NY 10017

Phone: 212-686-6066

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Pregnancy Termination with the Abortion Pill: What to Expect

If you’re considering abortion, you have two options: an in-office procedure or at-home abortion through the use of medication. According to Marcus Byers of NYC abortion provider ParkMed, medication abortion (more commonly known as the “abortion pill”) has become a popular option for early pregnancy termination because it allows for greater privacy and gives patients more control over the abortion process.

At ParkMed in NYC, the abortion pill is one of several options available to women considering pregnancy termination. Here, Byers explains what to expect from pregnancy termination with the abortion pill.

Your First Visit

Pregnancy termination using the abortion pill starts with some tests to verify your pregnancy and your overall health. These tests will include a urine test, blood test and sonogram. You’ll also be given the opportunity to ask questions and learn what to expect over the course of the abortion process. In order to use the abortion pill, you usually need to be between five and eight weeks pregnant.

While you’re at the office, you’ll be given a pill (called Mifeprestone), which must be taken before you go home. This medication stops the development of the pregnancy by blocking the hormone progesterone. You’ll also be given a second medication, Misoprostol, which you’ll take at home sometime within the next 48 hours.

The Next 48 Hours

When you’re ready, sometime between 24 and 48 hours after your visit to the clinic, you’ll take the second medication. This medication allows the pregnancy tissue to pass from your body. Because this process involves some cramping and bleeding, you’ll be encouraged to take pain medication and to stay close to a bathroom. You should expect to experience period-like bleeding for a few days, or even weeks, after this process is complete.

Your Follow-up Visit

You’ll be asked to return to the clinic about two or three weeks later for some tests to verify that the abortion process is complete. This visit will include a urine test, sonogram and exam by the doctor. You may still be spotting at this time but it is important to come in for this visit anyway as remaining tissue or blood in the uterus can cause problems later.

Abortion in NYC

For women considering pregnancy termination in NYC, abortion services are available in a comfortable, professional environment at ParkMed. Since 1971, the women’s health specialists at ParkMed have been helping women deal with unwanted pregnancies safely and confidentially. If you’re considering abortion, ParkMed provides you with the information you need to make the best decision, and treats you with the care and respect you deserve.

ParkMed

800 Second Ave
New York, NY 10017

Phone: 212-686-6066

The Billboard Battle Continues in CA

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Why has America’s skyline become the most recent place to attack abortion rights in the United State? Why is race this issue? Because it is more cost effective then TV or radio and because using race as an issue to upset and confuse seems to be the newest approach in the New Right’s culture war.
Two Anti Choice groups, The Radiance Foundation and the Issues 4 Life Foundation, have joined together to place 60 billboards around the city of Oakland, CA attacking African American women’s decisions regarding reproductive health. Leaders of these groups are again targeting Planned Parenthood.

“They heavily advocate a singular ‘choice’ that feeds their $1 billion dollar taxpayer subsidized budget,” says Ryan Bomberger, co-founder of the Radiance.
Planned Parenthood denies both the charge that they are increasing abortion rates or that it encourage minorities to have abortions.

Planned Parenthood has clinics mainly based in low income areas because their goal is provide quality health services to these communities.  It is important to note that only 3 percent of the services the agency provides each year are abortion services. The other 97 percent of what Planned Parenthood does includes cancer screenings for both men and women and other health care services, including birth control.

“The reason why there’s a different rate of abortion (in minority communities) is because those communities lack access to preventative health services,” said Lupe Rodriguez with Planned Parenthood.

These billboards are only one ripple in a wave of this type of advertising put up by anti – choice groups around the country keying into race and fear of genocide as incentives to persuade minorities that there is a conspiracy with abortion at the center.
In February there was the LifeAlways billboard in New York City stating that “the most dangerous place for an African American is in the womb”, which was removed after one day because of vocal protests from the community.

In March Chicago saw the 30 billboards claiming that future African America leaders were being aborted at “alarming rates”.

The Latina / Latino community saw its billboard from anti-choice groups in June of this year, stating the same message as the New York billboard with only the minority group changed. Again the billboard was taken down – but not without causing a stir.

So what does any of this accomplish?

By choosing to poke at America’s more vulnerable point, race relations, anti-abortion groups have succeeded in scaring and angering a lot of people. Yes, minorities are vulnerable in US society. Yes, the US has a horrible history of inequality and detrimental treatment of minority groups. As a culture we need to accept that history and address it – not use it to confuse and deceive.
It is important to realize that minority groups have higher statistics when it comes to unintended pregnancy and abortion, not because anyone is convincing then or coercing them into these decisions. These communities have the least access to health care nation wide.

Going after Planned Parenthood, and other medical providers that service minority communities, is a huge mistake because it will only limit services – not only abortion services – which are already scarce.
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