I have left the conventional medical model for good in search of brighter pastures! With the amount of painting, dancing, and kissing my baby and wife that I've been doing over the past several days, I encourage you all to try living a life free of the medical industrial complex! I have been liberated, and now I've got the bandwith the shake things up and create the life of my dreams.  The new iteration of my podcast will be titled The Holistic OBGYN Find me at: www.BelovedHolistics.com

Obgyno Wino Podcast

Goodbye! Here's to new beginnings...

Important PSA for healthcare professionals... Theme music by Evan Handyside

Microdose K - Lead With Love and Compassion

Practice Bulletin #136 - Published July 2013 (Reaffirmed 2017) 1. Know your reproductive endocrinology like the back of your hand! 2. AUB-O is classically associated with cycles that differ in length by `10 days or more. Patient with AUB-O also generally don't experience the classical cyclical breast tenderness, mucoid cervical discharge, premenstrual cramping, or bloating seen in ovulatory bleeding. 3. Anovulation is the most common etiology of AUB in 13-18-year olds. Transfusion or hospitalization is rare in this age group, but, when it happens, you should investigate coagulopathy. 4. AUB-O in patients >18 years of age should prompt investigation for hyperplasia/malignancy. 5. Hysterectomy or hormonal contraceptives are the mainstays for treating AUB-O, but neither address the underlying endocrine abnormality. 6 .SIS + EMB is a sweet combo: if both are negative, the likelihood of pathology is extremely low and conservative measures are be offered without you losing sleep Show Notes Theme music by Evan Handyside

Ep 82: Management of AUB Associated W/ Ovulatory Dysfunction

Practice Bulletin #135, Published June 2013 (Reaffirmed 2017) 1. It's none of your damn business why a woman desires a 2nd trimester abortion. There are also a lot of scenarios in which 2nd trimester abortion skills are necessary but that have nothing to what many perceive to be a seemingly easy decision to terminate a pregnancy. 2. If you don't feel confident in your skills as a provider to perform 2nd trimester abortions, do your patients the service of developing a referral relationship with another provider who does. 3. Inducing fetal demise prior to 2nd-trimester abortion does not improve safety or decrease procedure time in case of D&E, but he it does shorten induction time for medical abortion. 4. Misoprostol + mifepristone = the most effective protocol of medical options 5. All methods of contraception are effective on the day of 2nd-trimester abortion apart from cervical cap, diaphragm, or hysteroscopic sterilization (including IUD) Show Notes Theme music by Evan Handyside

Ep 81: Second Trimester Abortion

Practice Bulletin #1114, Published July 2010 (Reaffirmed 2018) 1. Pelvic pain and infertility are characteristic. Severe dyspareunia and dyschezia are indicative of deeply infiltrative disease. 2. The etiology is unknown, but currently thought to be due to the implantation of endometrial glands and stromal cells outside the uterus within the peritoneal cavity due to retrograde menstruation 3. Histologic evaluation of a surgical specimen is the gold standard for diagnosis. Visualization of endometriotic lesions has a high false positive rate. The finding of an endometriomas on imaging studies can alone be highly predictive, though. 4. Excision of endometriosis can improve fertility rates, particularly with the excision of an endometrioma. 5. NSAIDs, COCs, GnRH analogues, and progestins are all great alternatives to surgery for managing endometriosis-related pain Show Notes Theme music by Evan Handyside

Ep 80: Management of Endometriosis

July 2021 Journal Club I'm joined by Emmie Sturgess, DO, an OBGYN, MFM, and friend of the show to review relevant articles from the major OBGYN journals. I promise it's not as boring as it sounds... Show Notes Theme music by Evan Handyside

Ep 79: Journal Club, July 2021

Welcome to Beloved Holistics Radio, a podcast for the holistic OBGYN! Expect summaries of ACOG's practice bulletins, important voices with birth keepers and birth warriors, and discussions around the most up-to-date research and publications. www.BelovedHolisticsRadio.com

Intro to Beloved Holistics Radio

Practice Bulletin #183, Published October 2017 w/ co-host Sara Rosser, CPM (@sararosser) 1. PPH is defined as 1000 mL for either vaginal or cesarean birth. 2. Go with your gut in diagnosing PPH, and do it fast! You can't rely on vital signs or lab work to make the call to action in the acute setting. 3. Uterine atony is the most common cause of PPH. Manage through uterine massage, uterotonics, tamponade, and UAE. Opening up her abdomen to place compression sutures, ligate the uterine vessels, or perform hysterectomy are last resort! 4. Remember the triad of the amniotic fluid embolism: respiratory decompensation, hemodynamic instability, and DIC. 5. As soon as you feel that she's lost too much blood activate your institution's transfusion protocol. Remember that you can never get pre-screened blood fast enough when you actually need it. Show Notes **Visit our friends at The Labor of Love Co. to send a pregnant person in your life a curated maternity or postpartum care package!** Theme music by Evan Handyside

Ep 78: Postpartum Hemorrhage

Practice Bulletin #175 - Published December 2016 (Reaffirmed 2020) w/ co-host Sara Rosser, CPM (@sararosser) 1. US may be harmful if overutilized. 2. Important uses include pregnancy dating/viability, fetal growth, and amniotic fluid assessment. 3. US pregnancy dating is most accurate in the 1st trimester. If significant discordance exists between US dating  and LMP dating, it may be appropriate to adjust due date. 4. Fetuses at risk for FGR should be monitoring by serial growth ultrasound. It's not recommended to repeat growth ultrasound more frequently than q2 weeks. 5. Growth-restricted fetuses can be monitored through umbilical artery Doppler velocimetry as a means of avoiding bad perinatal outcomes. Show Notes **Visit our friends at The Labor of Love Co. to send a pregnant person in your life a curated maternity or postpartum care package!** Theme music by Evan Handyside

Ep 77: Ultrasound in Pregnancy

June 2021 Journal Club I'm joined by Emmie Sturgess, DO, an OBGYN, MFM, and friend of the show to review relevant articles from the major OBGYN journals. I promise it's not as boring as it sounds...because...I mean...come on...WINE. Show Notes Wine pairing: 2016 Primitivo di Manduria from Antico Sigillo Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)

Ep 76: Journal Club, June 2021

"To help you further understand why we did not get the vaccine, what follows is my assessment of the C19 situation so far. Like I said, there is no doubt that many people were getting very sick over the first half of 2020. What is most challenging for me is the narrative that ensued thereafter, which seems at best misleading and at worst nefarious." www.ObgynoWino.com

Microdose J - The One About the C19 Injection

Practice Bulletin #129 - Published September 2012 (Reaffirmed 2016) 1. In any hypoestrogenic state, resorption begins to overwhelm building, leading to decreased bone density. 2. Treatment is warranted if T-score ≤ 2.5 on DXA scan or if patient has history of vertebral facture or other type of fragility fracture 3. FRAX tool can be helpful in determining usefulness of treating patients in the osteopenic range (T-score < - 1 to ≥ -2.5). It predicts risk of osteoporotic fracture over next 10 years . 4. Bisphosphonates are first-line therapy for all-comers, though raloxifene is also reasonable first-line in younger postmenopausal women. 5. HRT is a great alternative to bisphosphonates in younger women at risk for osteoporotic fracture: ~35% decreased risk of hip fracture (estrogen alone or estrogen + progestin) Show Notes Wine pairing: 2017 Tempranillo from Baron de Ley Varietales Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)

Ep 74: Osteoporosis

Practice Bulletin #132 - Published December 2012 (Reaffirmed 2017) 1. The clinical diagnosis of APS is made through a careful clinical history that takes into account thrombotic events, history of pregnancy loss, and development of preterm preeclampsia. 2. Lab studies to detect specific antibodies can confirm your diagnosis, but these lab studies are not indicated when clinical criteria are not met. 3. The three relevant antibodies on your board exam are: lupus anticoagulant, anti-β₂-glycoprotein, and anticardiolipin 4. The worst consequence of APS is thrombosis. 5. In pregnancy, thrombotic risk is EVEN higher. APS patients with history of thrombosis should be treated with prophylactic heparin throughout pregnancy until 6 weeks postpartum. Show Notes Wine pairing: 2018 Sonoma Zinfandel from Seghesio Family Vineyards Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)

Ep 74: Antiphospholipid Syndrome

Practice Bulletin #128 - Published July 2012 (Reaffirmed 2016) 1. "Normal menstruation" is classified by ACOG as: 5 days of bleeding with cycle length of 21-35 days 2. PALM-COIEN is a classification system for abnormal uterine bleeding. 3. Get good at SIS and hysteroscopy! A meta-analysis found intrauterine cavitary anomalies in roughly 50% of women with AUB 4. Fibroids tend to present as heavy periods. Polyps tend to present as intermenstrual bleeding. Adenomyosis presents with painful and heavy periods. 5. Accuracy of blind endometrial biopsy is great if (a) an adequate sample is collected and (b) the endometrial process is global. A blind EMB can miss cancer if less than 50% of the endometrium is involved. Show Notes Wine pairing: 2018 Cabernet Sauvignon from Los Vascos Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)

Ep 73: Diagnosis of Abnormal Uterine Bleeding in Reproductive-Aged Women

Practice Bulletin #169 - Published October 2016 (Reaffirmed 2016) w/ co-host Sara Rosser, CPM (@sararosser) 1.  Multifetal gestations have overall increased risk of morbidity for both mom and baby. 2. Chorionicity is an important piece of information for managing these pregnancies. Monochorionic pregnancies carry higher risks than dichorionic pregnancies. 3. Outside of dx of cervical insufficiency: available data doesn't support cervical cerclages, bed rest, tocolytics, or pessaries decrease morbidity or mortality associated with preterm birth in setting of multifetal gestation. 4. NIH recommends administration of corticosteroids for any pregnancy, irrespective of GA, at risk of birthing from 24-34 wga within 7 days 5. Unless monoamniotic, twin pregnancy is not a preclusion to vaginal birth Show Notes **Visit our friends at The Labor of Love Co. to send a pregnant person in your life a curated maternity or postpartum care package!** Wine pairing: 2017 Red Blend from King Estate Winery Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)

Ep 72: Multifetal Gestations

Summaries of ACOG's Practice Bulletins recorded while the host guzzles booze and speaks too closely to the microphone. Each episode accompanied by comprehensive show notes, wine recommendations, and unsolicited advice. Pour yourself a glass, and come along, friend. Help us remain the reigning #1 OBGYN Podcast Ever Made!

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Obgyno Wino Podcast

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