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Dr. James Murray readily admits that he was once “a typical overfed American physician.”
An OBHG hospitalist at Winchester Medical Center in Virginia, Dr. Murray said that he and his OB/GYN practice partner used to sit in their office and “talk about our poor cardiac family history and delude ourselves with thoughts about how it wouldn’t happen to us.”
After his partner passed away from a heart attack, Dr. Murray knew he needed to make some significant lifestyle changes, particularly with diet and exercise. So about five years ago, he began eating healthier and returned to the form of exercise he enjoyed most in his youth — running.
Central Coast Physicians magazine, a publication of the Central Coast Medical Association (San Luis Obispo and Santa Barbara, CA, counties), highlighted the Ob Hospitalist Group (OBHG) program at Sierra Vista Regional Medical Center in its Spring 2017 edition (p. 29).
Describing the Sierra Vista hospitalist program as “a new layer of safety for women who give birth at the hospital,” the article also noted that the facility now can accommodate vaginal birth after cesarean (VBAC), a procedure that is not available at most medical centers, especially those that lack fully staffed hospitalist programs.
Over time, experienced moms develop their own informal algorithms to prevent unwanted complications with their young ones. These internal systems help them decide whether or not they must immediately spring into action or continue making sandwiches.
For example, a toddler wants to wear cowboy boots and a Darth Vader costume to preschool. The mother’s mind goes through a series of pull-down menus: Is it Halloween? No. Does the preschool have a flexible dress code? Yes. Is the ensemble compatible with the weather? Yes. Will wearing this outfit put my child’s life at risk? No.
Later that morning, as she waves goodbye to her diminutive dark lord, she has successfully avoided an exhaustive, time-consuming conflict with a determined child who is historically inclined to tantrum. She also has met her maternal obligation to keep her child alive.
As the Bible tells it, a virgin mother and her husband notably made due with just the modest means available to them to swaddle their newborn son. She wrapped him in cloths and placed him in a manger, because there was no guest room available for them. (Luke 2:7)
Not much was known in biblical times about prenatal care or safe sleep practices that can reduce the risk for Sudden Infant Death Syndrome (SIDS). Had he been born in modern times — in Finland, for instance — the baby Jesus may have been placed in a utilitarian cardboard box. Rather than gold, frankincense and myrrh, the gifts of the Magi more likely would have been diapers, wipes, and onesies.
Some 80 years ago, in order to address its record high infant mortality, the government of Finland began providing “baby boxes” to families with newborns. Expectant mothers in Finland have to meet just one condition before receiving the free boxes. They have to have at least one prenatal examination within the first four months of their pregnancies.
Just as we hope we’ll never need a hospital, we are immensely grateful it is there. A hospital represents safety. It represents trust. It provides comfort like knowing your mom is running behind you the first time you ride a bike without training wheels, ready to catch you before you fall.
A hospital is much more than bricks and mortar. A hospital is community. It’s the people who work there. It is every individual who touches the life of a patient.
Childbirth is the leading reason for hospitalization in the United States, accounting for more than 10% of hospital stays. The very nature of OB/GYN hospitalist work places our clinicians exclusively in the hospital setting. At Ob Hospitalist Group (OBHG) partner hospitals, the quality of Labor and Delivery care and the level of patient satisfaction are undeniably connected with our hospitalists.
Her name is Nanush Shakernia.
Had it not been for TV host Jimmy Kimmel’s recent monologue viewed by millions around the world (he is pictured here with his family and the new baby), no one may have heard of the attentive, quick-thinking nurse from Cedars-Sinai Medical Center in Los Angeles.
“Nanush,” as Kimmel informally calls her, was on duty the day William “Billy” Kimmel arrived in an otherwise routine birth at the hospital. The delivery had been nearly textbook perfect.
Despite centuries of development and increasing sophistication, midwifery remains a misunderstood profession by much of society. First, a midwife’s scope of service is not restricted to pregnancy and childbirth, as is commonly believed.
The American College of Nurse Midwives (ACNM) has long maintained that nurse midwives in reality are primary care practitioners. That’s because most midwives, working along a spectrum of skills and certifications, are trained to care for their patients in diverse settings across the lifespan.
In addition to attending births, most midwives are able to provide holistic wellness care, gynecological and sexual health care, family planning services, preconception care, postpartum care, and even healthy infant care.
The fact that it may develop suddenly and quickly escalate to life-threatening levels is one reason preeclampsia is so feared. Because it is statistically uncommon (occurring in about 10% of pregnancies), many women don’t think it will happen to them. But you can be sure their OB/GYNs are monitoring for signs of preeclampsia during their prenatal visits.
Preeclampsia is a serious complication of pregnancy that is characterized by high blood pressure, proteinuria (excess protein in the urine), and edema (swelling of extremities). Unchecked, it could lead to liver or renal failure, future cardiovascular issues, stroke, and even death.
Preeclampsia most often occurs after the 20th week of pregnancy, and the only cure is delivery of the baby.
Without question, lupus can be debilitating. Many in the general public know little about the disease, and some believe women with lupus can’t have children. That’s absolutely not true.
With certain precautions, there is no reason a woman with lupus should not be able to have a normal pregnancy and healthy birth. Lupus pregnancies, however, are considered high-risk. In consultation with her doctor, a woman with lupus who is considering pregnancy is advised to plan carefully and, if possible, try to conceive after her lupus has been dormant (no flare-ups) for at least 6 months.
Lupus is a chronic, inflammatory autoimmune disease characterized by extreme fatigue, joint pain, facial rash, skin lesions, fever, headaches, or memory loss. It occurs when the body’s immune system goes awry, attacking its own healthy tissues and organs.
Since the Institute for Healthcare Improvement introduced its “Triple Aim” initiative as an approach to health system improvement, it has become part of the industry lexicon.
Triple Aim proposes to 1) improve patient care experience, 2) improve the health of populations, and 3) reduce the per capita cost of healthcare. A commonly proposed approach to achieving those goals is the patient-centered medical home (PCMH), a system that manages the care of the patient ideally from cradle to grave, coordinating care across services and specialties as well as tracking individual patient progress over time.