Eva Peron, though mostly known today for the Broadway play Evita, or even the Madonna version of the song, “Don’t Cry for Me Argentina”, was first lady of Argentina from 1946 until her untimely death of cancer in 1952.  As February is Cervical Cancer Awareness month, I thought I’d highlight Ms. Peron as an example as to why we must educate ourselves in the prevention of this cancer.

The youngest of five children of Juan Duarte and Juana Ibarguren, María Eva Duarte was born on May 7, 1919, in the little
village of Los Toldos in Buenos Aires province, Argentina. Following the death of her father, the family moved to the larger nearby town of Junín, where her mother ran a boarding house. At the age of sixteen, Evita, as she was often called, left high school after two years and went to Buenos Aires with the dream of becoming an actress. Lacking any training in the theater, she obtained a few small parts in motion pictures and on the radio. She was finally employed on a regular basis with one of the largest radio stations in Buenos Aires.

In 1943 Eva met Colonel Juan Perón, who had assumed the post of
secretary of labor and social welfare in the military government that had recently come to power. Eva developed a close relationship with the widowed Perón, who was beginning to organize the Argentine workers in support of his own bid for the presidency. Becoming Perón’s loyal political confidante and partner, she helped him increase his support among the masses.  O n October 21, 1945, Eva and Juan Perón were married.

Following Perón’s election, Eva began to play an increasingly important role in the political affairs of the nation. During the
early months of the Perón administration she launched an active campaign for national women’s suffrage, which had been one of Perón’s campaign promises.

Because Eva came from a lower-class background, she identified with the members of the working classes and was strongly committed
to improving their lives. She devoted several hours every day to meeting with poor people and visiting hospitals, orphanages, and factories. She also supervised the newly created Ministry of Health, which built many new hospitals and established a successful program to fight different diseases.

In late 1950 or early 1951, it was evident to all
Evita was not well. She lost weight, became paler than usual, and had ankle swelling.  She fainted at a public ceremony on August 23, 1951 and was hospitalized.  Officially it was announced she had anemia,
but in fact she had advanced cervical cancer. Peron ordered a search for the world’s best cancer surgeon, and Dr.Pack from New York’s Sloan Kettering came to Buenos Aires and performed a radical hysterectomy, all without Evita’s knowledge.  Election Day came while she was hospitalized, and photographs showed her casting her ballot, as this was the first time women voted in Argentina. Her course went downhill rapidly, and she was barely able to attend Peron’s inauguration for a second term. She died July
26, 1952, at the age of 33.

Eva Peron’s illness was quite consistent with the profile of cervical cancer. She was only slightly below the average age at
diagnosis, and she undoubtedly had early onset of sexual activity and multiple partners, the 2 best know risk factors.  Peron’s first wife also died of cervical cancer at an early age, suggesting that he himself might have been the source of an exceptionally aggressive form of the HPV virus (the known cause of cervical cancer).

Eva’s influence on her country and the world was
profound and shows no sign of abating, more than half a century after her death. She represented a powerful example of how a woman of modest origins can rise to the highest seat of power, and have profound and lasting influence. Her record in improving the status of women is virtually unassailable. But Eva Peron also stands as a prominent representative of the millions of women who have fallen victim to cervical cancer over the years.

Patient education and screening for cervical precancer and cancer (pap smears) were just beginning at the time of Evita’s illness. Since then, cervical cancer is one of the success stories in the conquest of cancer, with the incidence steadily declining in developing countries. Today, we possess the ability to reduce, and perhaps in the near future even eliminate, this common cause of death and disability in women.  Education is important.  Unfortunately there are
still large segments of the female population living where necessary resources are lacking, and these women still face the dim prospect of the disease and death Eva experienced.

Read more:

1)      www.gardasil.com

2)     Eva
Peron: Charisma, Controversy and Cervical Cancer by Roy M. Pitkin, ACOG
clinical review Nov-Dec 2004

3)     Eva Perón
Biography – family, children, name, death, history, wife, school, mother,
information, born, house http://www.notablebiographies.com/Pe-Pu/Per-n-Eva.html#b#ixzz1jqdgxoxP

PS: here’s a link to the new recommendations

http://www.cancer.gov/cancertopics/factsheet/detection/Pap-test

PPS: HERE’S HOW HAPPY SOME OF OUR GIRLS ARE ABOUT THESE GREAT NEWS!!!!!! (CLICK ON MOVIE)

Movie2

UPDATE: THANK YOU ALL WHO RESPONDED TO THE BLOG POST. WE APPRECIATE YOUR SUPPORT. I WENT ON YELP TODAY AND THEY HAVE FILTERED 14 OUT OF THE LAST 17 REVIEWS…ALL GOOD ONES OF COURSE. OUR SCORE IS NOW UP TO 4 STARS ASSUMING THEY DO NOT FILTER THE 3 REMAINING GOOD ONES…WE WILL SEE… DR.T.

Greetings dear patients, friends and VOG family. We hope that as this year begins to wrap up that everyone is doing well…now to business.

I can’t stand  Yelp! As a consumer I find the website biased and the reviews weak.  When looking for places to stay, I use TRIP ADVISOR; when looking for a good restaurant, GOOGLE reviews usually does the trick and when looking for a health care provider (yes even doctors do that) I usually go for VITALS.COM or HEALTHGRADES …so Yelp! is not in my apps my computer or even my “vocab”…until recently when I saw what our office rating was.

Now you may ask “How did you even end up on the stupid website that you dislike so much?” Well, I went to post the monthly blog, typed “volusia ob gyn” on GOOGLE  instead of our address by mistake and  VOILA!! just a few spaces below our actual webpage was the Yelp! link with a fantastic “one star” review. Curious about the content (and seriously regretting it now) I went on YELP!! and this is what I found…

Yelp! likes to “filter reviews”…with what criteria I have yet to figure out. There are 14 reviews I believe…3 bad ones belonging to 1) a person who was never our patient, 2) 2 others that were so insanely innacurate even Yelp! pulled them out. The others are all good..and not a one has remained on the actual site (you have to click under “read filtered reviews”). When we tried to contact them no one       returned our calls or emails. We tried to see if we can delete the office account…nope.

VOG has been open since 1999.  We have delivered over 2500 babies and have over 18000 active patients. Our practice is a family, and our patients are part of that.  We pride ourselves in providing excellent, compassionate care, and are always on the cutting edge of gynecological and obstetrical care. I  do not believe we are a “one star” office.

I would not have wasted time dealing with this jokers but my concern is that in this day and age of social networks and internet traffic, we can’t assume these type of comments won’t deter patients from coming to see us…hopefully most of you hate Yelp! too…

So if you have a free second, would you mind saying a few words about our office? We know we are not perfect…so keep it real!!

Here’s the link (and I expect every single review to get filtered, but I figure if someone clicks on the link and sees “100+ reviews filtered” they will get the picture )

http://www.yelp.com/writeareview/biz/kpb-jWoC3MHRiAuUBmOmhQ?return_url=%2Fbiz%2Fkpb-jWoC3MHRiAuUBmOmhQ

Thank You and have a great weekend!!!

During this time of transition, we at Volusia Ob/Gyn beg your indulgence as we strive to accommodate JoAnn’s patients into the schedules of the four remaining providers.  As always, we will do everything we can to make this change as seamless and painless (for you) as we can.  If you know that your annual exam is scheduled for a few months from now, we ask that you call the office as soon as is convenient so that we can keep you on track for your preventative health maintenance.  If your annual is usually done sometime between September and January 1,  and you were scheduled to see JoAnn, we will make every effort to contact you and keep you on track.  If you haven’t been called and fear that you may have been overlooked (sorry!) please feel free to call and correct our error and keep your annual on track.

 We know that each provider brings a unique perspective, experience, and personality to Volusia Ob/Gyn, and we will truly miss JoAnn’s contribution.  As always, we are thankful that you continue to trust us with the health  of you and your future family.

Sincerely,

The Docs and Staff of Volusia /Ob Gyn

A total hysterectomy implies that the cervix will be removed.  A supracervical hysterectomy, on the other hand, means that the cervix will be left behind.

Removal of the tubes and ovaries is called a bilateral salpingo-oophorectomy.

The last type of hysterectomy (for our purposes) is a radical hysterectomy. This type is done almost exclusively by gyn-oncologists.  They are Ob/Gyns who have spent two or three years after residency training in the treatment of women with cancer of the uterus, tubes, ovaries, vulva, and vagina.  Most women who
have stayed current with their annual exams and pap smears will never encounter the need for a radical hysterectomy.

With the definitions out of the way, I’ll bore you with a little bit of history. Until about 10 years ago, the vast majority hysterectomies in the United States were done abdominally or vaginally.  That means that the uterus was removed either by making an incision on the abdomen (either vertically or a “bikini-cut”) or by cutting the support structures through the vagina.  As you can imagine, to cut support structures and blood vessels through the vagina, it is important the the uterus not be too big.  Additionally, most gynecologists
are hesitant to use the vaginal approach in women in whom the uterus has not descended (fallen) at least a little or in women who have had a  lot of abdominal surgery.  The advantage to the vaginal hysterectomy, though, is fairly obvious.  It allows a much faster recuperation, and in many cases requires no more than an over night stay in the hospital.  Abdominal hysterectomies generally require at least a two day hospital stay and involve a longer recuperation.  The advantage to the abdominal hysterectomy, though is that it
allows the gynecologist to very clearly see and feel the structures that need to be cut and tied. It also allows us to remove very large structures that would otherwise not fit through the vagina.

About twelve years ago, Drs. Tapia and Haddox of Volusia Ob/Gyn performed the first laparoscopic assisted supracervical hysterectomy (LASH) in Volusia County.  The laparoscope is a camera (about 5 mm wide) that is now used in many abdominal surgeries in the United States.  With the laparoscope, we can see into the abdomen as we cut support structures, ligaments, and blood vessels.  This is itsadvantage over the vaginal approach.  In addition to the 5mm incision (made just under the belly button) we make two more incisions on the lower abdominal wall. One is 5 mm and the other is a centimeter.  Through these incisions we can cut and coagulate the structures that are feeding and supporting the uterus.  With the laparoscopic approach, we can remove a very large, undescended uterus, we can be certain that we can remove the ovaries (which we may or may not be able
to do vaginally), and we can send you home the day of or the day after surgery.  As you can see, then, the LASH combines the advantages of the abdominal and vaginal approaches.  As the name implies, most hysterectomies done through the laparoscope leave the cervix behind.  If you have a history of abnormal pap smears or any other indication to have your cervix removed, though, we can
perform a total laparoscopic hysterectomy.  Once the uterus has been freed from its support structures and blood supply, we remove it from the abdomen through a process called morcellation.  This involves cutting the uterus (and ovaries if necessary) into 1  cm strips with an instrument called a morcellator. The LASH allows us to combine the exposure and direct visualisation of an abdominal hysterectomy with the (usually) rapid recovery of a vaginal approach.

Still, if possible, we will perform a vaginal hysterectomy (because the only thing better than small abdominal incisions is NO abdominal incisions).

About 95% of the hysterectomy performed at Volusia Ob/Gyn are done laparoscopically (well above the national average).  Our results have been excellent and our complication rate has been at or below the national average.  Additionally, we have trained other gynecologists in the county on the techniques and methods
involved in performing this operation. If you have any questions regarding LASH or anything else, feel free to contact us. Also we have an actual procedure video under our “services and links” tab.

Dr.M. Desai

So for the past seven years we collect the change and about every other month my secretary Amber will say “Dr.Tapia, the jar is getting heavy”! I then take the jar to a change counting machine and watch the CHA-CHING happen. That little sucker has paid for fluoride treatments for kids, high protein breakfasts for kids (sometimes their only solid meal), education materials, aid for Haiti after the earthquake and most recently helped sponsor midwife education in Guatemala (which has been show to significantly decrease infant mortality).

This year our project is to sponsor a set of helping hands. We hope to help a 15+ mission veteran do her nursing magic in the DR. The trip is this November, we hope to have her all set by the end of September.

So if you could please “hook up” the little jar with some loose change (tax-deductible change that is), he would sure appreciate it. The little guy is getting old, his lid is cracked, the plastic is scratched, but he’s going strong!

If you have any questions feel free to ask me.

Thank You

DrT

Join Florida Hospital this Sunday July 24th, for an informative dinner and tour of the facility. Dr. Robertson will be giving a short presentation. Come meet him and some of our staff who will gladly answer questions about our practice.

RSVP to 888-335-BABY

PS There will be a raffle for prizes…rumor is an IPAD!!!!!!

THIS IS A VERY INTERESTING ARTICLE BY DR.HADDOX WHICH WAS FEATURED IN THE LATEST PARENT MAGAZINE…

X-Rays during pregnancy…..Are they safe?

It may surprise you, but having an X-ray during pregnancy is generally considered safe. In most cases, the benefits of an X-ray during pregnancy outweigh the potential risks.

When you have an abdominal X-ray during pregnancy, your developing baby is exposed to radiation. If radiation causes changes in your baby’s rapidly growing cells, it’s possible that your baby could be at a slightly higher risk of birth defects or illnesses, such as leukemia, later in life. Generally, however, having an X-ray during pregnancy is thought to pose only the most remote risk to a developing baby. Most X-ray exams — including those of your arms, legs, head, teeth or chest — won’t expose your reproductive organs or your baby to radiation. A leaded apron and collar also can be worn to block any scattered radiation. In some cases doubling the thickness of the leaded apron supplies an additional level of safety.

Some X-rays, including CT scans of the abdomen or pelvis may expose the fetus to higher levels of radiation and decisions must be made individually regarding the need for imaging based on the mother’s condition.  Occasionally, alternate imaging such as MRI(Magnetic Resonance Imaging) can be used which will decrease the level of radiation exposure. The safe level of radiation for the fetus varies in each trimester and the total amount of radiation exposure for each test may be calculated by the obstetrician and radiologist.

Recently pregnant women have been concerned about the new full body scanners in airports and their degree of exposure.  Luckily, the amount of radiation emitted via these scanners are miniscule when compared to even a chest x-ray.  However, because this radiation is not absolutely necessary, all passengers may opt out of the body scanners and choose a pat down if there is any concern.  Pregnant patients who are also frequent flyers such as flight attendants or pilots may be exposed to higher levels of radiation while flying and need to consult with their obstetrician.  In many cases frequent fliers may need to stop flying at some point in their pregnancy to limit radiation exposure.

If you need an X-ray, tell your health care provider if you are or might be pregnant. Your health care provider might be able to do an ultrasound instead of an X-ray. In addition, if you have a child who needs an X-ray exam, don’t hold your child during the exam if you are or might be pregnant. Instead, ask another person to take your place.

If you had an X-ray exam before you knew you were pregnant, don’t panic. Remember the risk is very small. If you had radiation treatment for a condition, however, the risks may be more significant. Share any concerns about radiation exposure with your health care provider.

Dr. Linda Haddox

Today in our Daytona Beach office we did 5 Essures!!! So what are they? It is a method of tubal ligation (sterilization) that requires no incisions and can be done under local anesthetic.

Our patients came into our office an hour before the procedure and were given a mild anti-anxiety pill and an injection to relieve cramping and relax the fallopian tubes before the procedure. We then administered the local anesthetic. Now you know I (Dr.Tapia) am a certified chicken and do not like to see my patients in ANY discomfort. All 5 ladies said the local anesthetic was a piece of cake!! We then did the procedure in all 5 patients and again they all said discomfort was NOT AN ISSUE!!

Our Essure representative Anthony said he was impressed with how smooth our first day went, how well trained our staff was and I’m pretty sure he said we were the best office EVER (ok, maybe he didn’t exactly say that..but I’m certain he said we were the coolest office ever!!)

So ladies…if your baby-making days are over… ask your VOG doctor about Essure. If you don’t have a VOG doctor yet…what are you waiting for!!!

Here is the website         www. essure.com

During one of her prenatal visits we discovered that my uncle, Dr. W.D. Robertson, a traditional family medicine physician from Medina, Ohio had delivered her back in the 80’s in their small community hospital. I talked to him and since Medina was a small suburb, I wasn’t surprised when he told me he remembered her and the family.

On May 16^th, 2011 I had the privilege of attending the delivery of her wonderful baby girl. All of our deliveries are unique, but this one was just a little bit special in a different way.

Congratulations to the Haney family!

Here are pictures of my uncle, Dr. W.D. Robertson at Jennifer’s birth in 1984!

And introducing Jennifer’s baby girl Avabella Mahala

~ Dr. Robertson