Kristen Eckler, M.D., Harvard Medical School's Comments
Apr 28, 2008 | comments: 3
Dear Kathryn,
Thanks for the information. There are so many solutions to keeping one's breast milk supply going while returning to work; thanks for giving us another one that seems very easy.
Be well,
Kristen Eckler MD
Apr 10, 2008 | comments: 2
Dear Jill,
Glad to hear that you found the article helpful. Best of luck with your future plans.
Be well,
Kristen Eckler MD
Feb 7, 2008 | comments: 3
Thanks to the readers for checking out the article. I am glad you found it helpful.
Be well,
Kristen Eckler MD
Feb 14, 2008 | comments: 10
Dear Readers,
Thanks for your comments and humor. In reply to Elizabeth's experience, the answer is "yes". Many women can feel a twinge or pain with ovulation. The medical term is mittleschmerz. As always, if you have more questions or concerning symptoms, please contact your health care provider for a more in-depth discussion.
Be well,
Kristen Eckler MD
Jul 27, 2007 | comments: 17
Dear Gather Readers,
Many thanks for your comments and feedback. As always, some extremely important points were raised that deserve further discussion.

First, there really is no excuse for a health care provider not returning phone calls. However, a reality of today's chaotic health care environment is that persistence is often required. If your call is not answered, then call back.
If a practice consistently doe not respond to calls, then I suggest you seek another practice.

Next, I greatly appreciate the comments of Mary S and KF, which highlight other options for treating low mood and depression such as exercise and behavioral therapy. My apology for not more specifically discussing non-medical treatments, which are just as important as drug therapy. The lack of attention was not an intentional oversight; rather, most of my patients want information specifically regarding medication risk. However, both exercise and behavior therapy are important tools in treating mood disorders. Thanks again for bringing these important modalities to the discussion.

Be well,
Kristen Eckler MD
Jun 29, 2007 | comments: 20
To Kristen Capodilupo and Michelle C: It is possible to have an ectopic (tubal) pregnancy and a normal intrauterine pregnancy at the same time, but it is very rare unless a woman has undergone fertility treatment, like clomid or in-vitro fertilization (IVF). An early ultrasound, at about 6 weeks of gestation, should be able to confirm the location of a pregnancy.
Jun 29, 2007 | comments: 20
To Elizabeth B: It is important to wait about 6 weeks after birth to have intercourse because the vagina, cervix and uterus need to heal. After a vaginal birth in particular, intercourse could re-injure any tears that occurred with the delivery. The risk of infection is also increased because the cervix is dilated. That said, some women feel great and want to have sex. If it is the woman's choice and she is feeling back to "normal", then she is unlikely to have any problems from intercourse. Whenever a woman decides to resume sexual activity, she needs to make sure she has a contraceptive plan, such as condoms, birth control pill, etc. While pregnancy does not increase one's chances of conception after a delivery, it does not prevent immediate conception either. I have had some patients come back pregnant at their 6 week postpartum visit.
Jun 29, 2007 | comments: 20
Dear Gather Readers,

Thanks to all who have read this article and responded. I am always grateful for your feedback and questions.
Jun 14, 2007 | comments: 13
To Stephen Cabral- great question about artificial sweeteners. This is always a tricky question as there is no long term data. Given that aspartame (Nutrasweet brand) is made of two compounds common in the brain, it is reasonable to assume that it could impact fetal brain development. My recommendation is to avoid these substances until there is good long term data showing safety.
Jun 14, 2007 | comments: 13
To Lisa X.- you are most correct about the important role of protein in the diet. As you noted beans, nuts and nut butters are great protein sources for folks who follow a vegan diet. One word of caution on these specific foods; they are calorie dense. Translation: a little bit has a lot of calories, and therefore goes a long way.
Jun 14, 2007 | comments: 13
Dear Gather Readers,
Thanks again for your feedback.
May 31, 2007 | comments: 15
Dear Michelle,
It sounds like you have a lot of things going on in your world. I fully support your decision to find a care provider with whom you are comfortable. Pregnancy, even if medically normal, is not easy. You may want to consider a doula for your labor and delivery as well; she is a non-medical support person who helps the mother with the stress of the labor. Good luck with your pregnancy.
Be well,
Kristen
May 31, 2007 | comments: 15
Dear Lisa X.
Great point- thanks so much for your reminder about discussing all medications and supplements with your physician. I will definitely add that to my next version.

As for women with disorders such as PCOS and endometriosis, I do have a few thoughts:

For the PCOS component, this is a metabolic disorder that seems to impair fertility by changing the hormonal environment of the ovary and limiting ovulation. While much is still being learned about this disorder, a common theme seems to be impaired glucose tolerance and increased body weight. Although we do not yet have a cure, exercise and weight loss help many women restore normal ovulation. On the treatment side, medications such as metformin and clomid have helped many women as well.

Endometriosis is a bit more frustrating because there are no clear actions to modify it. Studies show that the time to conception takes longer in endometriosis patients. Fortunately, for most women, the overall fertility rates are not that different. My suggestion is to do everything you can to preserve your current fertility such as diet, exercise, and prevent sexually transmitted diseases. Once you decide to become pregnant, I would speak with an obstetrician/gynecologist or fertility specialist if you have not conceived in 6 months of timed intercourse.

Be well,
Kristen
May 31, 2007 | comments: 15
Dear Bunmi J.
I can only imagine how frustrated you feel. I would strongly recommend that you have a consultation with your obstetrician/gynecologist or a fertility specialist. Based on the brief piece of history above, you deserve a full evaluation that includes bloodwork, radiologic studies, and a semen analysis of your partner. I wish you luck with your future plans.
Be well,
Kristen
May 31, 2007 | comments: 15
Dear Dalal,
Thanks for your very important comments. You are absolutely right that the current obesity epidemic in the U.S. has a significant impact on the field of obstetrics. I cannot emphasize enough that a normal body weight/bmi is critical to long lasting, and in this case multigenerational, health.
Be well,
Kristen
May 31, 2007 | comments: 15
Many thanks to all of you who took the time to read and respond to my first blog. I greatly appreciate your time and the feedback. Be well, Kristen
 
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