Due to the many significant changes in the health care environment, especially those which make solo practice unsustainable, I have decided to close my medical practice on September 26, 2014.
For your future gynecologic and obstetrical care, I am pleased to recommend the physicians at Premier Women’s Health at 614-459-1000. Alternatively, you may find another physician through your insurance provider network.
Your medical records are confidential, and only with your written permission can a copy can be transferred to another doctor or released to you or another person you designate. The next blog post contains a medical information authorization form which you may sign to allow us to release a copy of your medical information. Please sign the form and return it to my office as soon as possible so we can transfer your records to your new doctor. The form may be returned by mail or faxed to 614-777-6019.
I have been honored to be your physician and I thank you for that privilege. Best wishes for your future health.
Sarah Artman, M.D.
Now accepting Anthem Blue Cross Blue Shield Insurance
We are always evaluating health insurance contracts in order to ensure that we are able to provide our patients with the best possible care. We have recently joined the Anthem Blue Cross Blue Shield panel and will now accept Anthem Blue Cross Blue Shield insurance.
We continue to accept many insurances including Aetna, Medical Mutual, Cigna, Ohio State University plans, Ohio Health plans and many others. Please call us to ask about how we can work with your insurance program.
Has your doctor has recommended a scary-sounding procedure called colposcopy?!
What is a colposcopy and how and why is it performed?
Colposcopy is an office procedure in which the cells on the surface of the cervix can be visualized under magnification. The most common reason for performing a colposcopy is to evaluate the cervix after an abnormal Pap smear. Keep in mind that Pap smears are good screening tests, while colposcopy is a diagnostic test.
A Pap smear is done by gently scraping the cervix and obtaining some cells from the surface. These cells are then analyzed microscopically in a laboratory in order to check for cancer cells. Sometimes the cells are determined to be abnormal, or atypical. While atypical cells are not cancerous cells, they do usually warrant further evaluation by colposcopy.
By using colposcopy to magnify the view of the cervix, I can look for areas of abnormalities and take samples, or biopsies, of those abnormalities. The tissue removed by biopsy is also analyzed microscopically and this result provides the actual diagnosis. Because the colposcopy-directed biopsies contain millions of cells, not just the few hundred thousand cells on a Pap smear, they provide much more information about the health of your cervix.
Now, the bad news about the procedure is that it can be very uncomfortable. I perform the procedure in a regular exam room and the patient assumes the usual Pap smear position on the table. The speculum is placed and this feels just like a regular Pap smear. I then view the cervix through an instrument that looks like binoculars on a stand. This instrument does not touch the patient; I just use it to magnify the view of the cervix. Next I gently apply a mild vinegar solution. Amazingly, the mild vinegar solution works by drying, or dehydrating, the surface a little and this changes the appearance of any microscopically abnormal cells. Next I remove small biopsies from the cervix. These biopsies are usually about 1/16th to 1/8th of an inch in size and feel like pinches. Sometimes this can also lead to a menstrual-cramp feeling or a mild burning. These discomforts usually pass quickly. Then I apply a solution to each biopsy site to make a small scab form and then the procedure is over. The entire procedure takes 5 to 15 minutes. I usually recommend no intercourse or tampons for 5 days after colposcopy.
Before the colposcopy procedure, I often recommend that my patients take a small dose of ibuprofen, provided they do not have any contraindication to this medicine. Check with your own doctor to see if this is allowed. As usual, the information in this blog does not serve to provide any specific individual medical advice and does not indicate any doctor-patient relationship.
As many of my patients know, I am celebrating 20 years in my private practice in gynecology. I am so lucky to love my work and I want to share that with all of you. Every day I am honored to try to help women in some way and this work is so enjoyable to me. I would like to share some of the wonderful words of congratulations patients have sent to me recently:
“You are a physician with a gift of compassion and empathy that touches my heart. I thank you for sharing that with me. Your taking time to listen and truly care and encourage helps me.” Debbie K.
“I was grateful 20 years ago for your services and have been grateful ever since to have been your patient.” Ginny C.
“I appreciate your reassuring words. I am so glad you are my doctor.” Clara I.
“I feel that I am one of many fortunate patients to be privileged to have you as my gynecologist and professional confidant. You really are remarkable in every way. You genuinely understand and most of all listen with your heart. I wish you many more years of doing the work that you so enjoy.” Cathleen C.
“I want you to know how grateful, thankful, and humbled I am by being your patient.” Kelly S.
“I just wanted you to know that you provided the very best experience with a doctor that I have ever had. I have been raving about you and your staff to everyone I know who is in need of a new doctor. My appointment with you was by far the best appointment I have ever had with a gynecologist (or with any type of doctor for that matter) and you were the most sincere and caring doctor that I have ever seen.” Jessica C.
“Thank you for turning an appointment that I normally dread into a wonderful experience.” Susie L.
“I deeply appreciate the instrumental role you played in saving my life – you’re my hero!” Cheryl T.
Wow! I am amazed and so grateful to have such kind patients. You are my reason for doing this! If you have any comments to share, you may submit them using the contact form under the ‘Directions’ tab. Thank you!
“Help! What is HPV and why is it on my Pap smear?” Have you recently had that scary phone call from the doctor’s office after a Pap smear? Here is some information about HPV and what to do about it.
The Human Papilloma Virus (HPV) is a common cause of abnormal Pap smears. This virus was first identified several decades ago. Over 80 different types have been identified and different strains may lead to different symptoms ranging from genital warts, to abnormal Pap smears, to no symptoms at all.
The virus is very common and recent studies suggest that 80% of sexually active men and women may carry the virus. Only a few percent of affected women will ever develop genital warts or an abnormal Pap smear. In most cases the viral infection is totally asymptomatic and the majority of men and women never have a problem.
The virus is highly sexually infectious. There is a significant chance that HPV will be contracted from exposure to an infected partner. Although condoms do reduce transmission rates of HPV and many other conditions, condoms do not totally prevent transmission. There is currently no concern for household members or other casual contacts; good personal hygiene is adequate.
Why is this virus important? A growing body of evidence suggests that some types of HPV can be a cause or a contributing factor in the development of premalignant or malignant changes in the genital tract, especially on the cervix. These are called High Risk types of HPV. The cervical changes can show as Atypical Cells on a Pap smear. Therefore if a Pap smear shows Atypical Cells, the Pap specimen is then usually tested for High Risk HPV. If the Pap smear does show High Risk HPV, colposcopy is usually recommended. In addition, if a Pap smear shows evidence of premalignant changes (dysplasia), then a colposcopy is recommended to determine the extent of the problem. Colposcopy is an office procedure in which a microscope-like device is used to examine the cervix. Very small biopsies are also usually taken during the colposcopy.
There are other strains of HPV which can cause genital warts. These appear on the external genitals of both men and women and can cause pain and itching. They can be removed with a variety of treatments. These will be discussed in another post.
Like other viruses, there is no cure for HPV. It is important to remember that many cervical HPV infections will go away or become latent without any treatment. Therapy should be aimed at realistic goals such as removal of visible warts and removal of dysplasia or premalignant changes.
Although HPV can be spread sexually, there is no evidence that treating asymptomatic male partners is helpful in the management of HPV. If your partner does have symptoms or visible warts, he should be evaluated by his physician. There is no reason for monogamous couples to change their sexual practices because HPV is diagnosed.
HPV vaccination is a proven way to reduce protect against viral infection. The Gardasil® vaccine protects against 4 types of HPV: two that cause cervical cancer and 2 that cause genital warts. The vaccine can be given to girls and young women between ages 9 and 26 years old. The vaccine is ideally given prior to any sexual activity, but can still be effective even if activity has already occurred. We have offered the vaccine since its release and believe strongly in using it for disease prevention.
If you have had abnormal Pap smears, we would be happy to review these results and perform an examination of your cervix in order to determine your risks. We have all the necessary equipment in our office for colposcopy and for treatment of abnormal cells in order to prevent cancer.
Welcome to our new blog. One of the best things about my chosen profession is that I get to talk with women all day and, ideally, to help them. Although the internet has provided people with access to enormous amounts of information, that can often be overwhelming, and such information is easily misunderstood. I hope to use this blog to clarify some of the issues about which I am often asked.
For starters, I’d like to discuss the difference between a Pap smear, a pelvic exam, and an ‘annual exam.’
A Pap smear is a sample of cells, typically taken from a women’s cervix, which is examined microscopically at a laboratory in order to detect cervical cancer or precancerous cells. I perform a Pap smear by using a speculum to view the cervix and using a soft plastic brush to gently scrape off some cells. The cells are then placed in a specimen jar and sent for examination by professionals at a pathology laboratory. The report is sent to me, usually within a week. I will then determine any action, if needed. The frequency of Pap smears is determined by many factors including age and past history.
A pelvic exam is a visual and manual inspection of a woman’s genital area. This does not necessarily include a Pap smear. A pelvic exam performed in an emergency room or for assessment of problems will not usually include a Pap smear. A pelvic examination can be used to evaluate problems such as pain, abnormal bleeding, or abnormal discharge. A pelvic examination will also usually be part of an ‘annual exam.’
The ‘annual exam’ refers to a preventive health maintenance visit which is usually performed on a yearly basis. The elements of this visit vary according to the woman’s age and other factors. This would generally include measurements of weight, blood pressure and other elements. The yearly exam of a woman usually includes review of medical history and any problems, medication use, menstrual pattern, conception goals, and risk factors such as smoking, exercise and stress. The physical exam will usually involve thyroid, breast, abdomen and pelvic examinations. A Pap may or may not be part of an annual exam.
I hope this provides some clarification. Please visit the email page if you have any questions or comments. Thanks!