We are pleased that you have chosen Dr. Courtney Hunt, Dr. Kim Hartzfeld, and Desert Jewel Obstetrics & Gynecology to care for your gynecologic needs. Whether scheduling a routine annual exam, a visit to discuss hormone regulation, or even a surgical consult, we strive to serve you with the highest of standards of medical care that are personalized for your needs. We offer pelvic and gynecologic ultrasounds directly in our office for patient convenience and comfort, using state of the art equipment for high resolution and superior, innovative diagnostic capabilities. We thank you for giving us the opportunity to care for you and invite you to browse our featured health topics below.

Novasure Endometrial Ablation back to top If heavy periods have been keeping you from enjoying your life to the fullest, ask Dr. Hunt or Dr. Hartzfeld today about the Novasure Endometrial Ablation. Novasure is the safe, simple procedure that has been proven to help control heavy menstrual bleeding without any need for hormones or hysterectomy. The endometrial ablation results in periods that either cease or become considerably lighter. This 90 second procedure is conveniently done in an outpatient facility. NovaSure can help put an end to the embarrassment and awkwardness that heavy bleeding can cause so that you can go on with your life. Go to www.novasure.com to learn more and read patient testimonials to the success of Novasure.

	Essure Sterilization back to top If you are unhappy with your current method of birth control and wish to have a more permanent, non-surgical option for sterilization, be sure to ask Dr. Hunt or Dr. Hartzfeld about Essure. The Essure procedure is a safe and simple alternative to a tubal ligation or vasectomy. This can be done without general anesthesia or surgical incisions, and is covered by most health insurance companies. Essure is 99.8% effective, and offers a hormone free alternative to permanent birth control. If you are considering permanent birth control, and would like to learn more about the Essure procedure and determine if it is right for you, talk to Dr. Hunt or Dr. Hartzfeld today.
	You can also go to www.essure.com for more information on the safe and simple sterilization procedure.

Birth Control Pills and Other Methods of Contraception
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If you have chosen an oral contraceptive as your preferred method of birth control, there are several important guidelines and side effects to be aware of while taking these pills. Always read the instructions that are in each pack before starting oral contraceptives, and discuss with Dr. Hunt or Dr. Hartzfeld what start method you should follow. Always remember to use a back up method of contraception for three weeks after starting new birth control.

Day 1 Start:
Begin taking the first active birth control pill on the first day of your period.

Sunday Start:
Begin taking the first active birth control pill on the Sunday after your period begins. If your period begins on a Sunday, begin taking the pill on that same day.

Follow the arrows on the pill pack and take one pill about the same time every day. Do not skip pills, and if you miss any number of pills, please refer to the instructions provided with your pack.

Be aware that illness, vomiting, and diarrhea may lower pill protection, and a back up method of contraception should be used during this time. Also, the use of medications such as antibiotics, antispasmodics, antidepressants, antihistamines, and tranquilizers may lower pill protection, so check with your prescribing doctor to see if your current medications interfere with your birth control pills. The pill is not 100% effective and it is possible to get pregnant while using oral contraceptives.

Side effects to using oral contraceptives may include spotting between periods, very light or missed periods, acne, headache, nausea, irritability, darkness of skin on the face, weight gain, breast tenderness, and vaginal infections. Certain medical conditions are contraindicative to oral contraceptive use. These include high blood pressure, heart disease, impaired liver function, pregnancy, abnormal bleeding, diabetes, gallbladder disease, and cancer of the breast/uterus/cervix/ovaries. Other side effects include the chance of blood clot development, heart attack, stroke, liver problems and tumors, high blood pressure, depression, or gallbladder disease, and smoking increases the chances of unwanted side effect occurrence.

While serious complications are possible during birth control pill use, they are very rare. Contact Dr. Hunt or Dr. Hartzfeld if at any time you experience pain in calf, severe headaches, vomiting, dizziness, severe abdominal pain, chest pain, shortness of breath, or blurred vision. Benefits of the birth control pill include are its highly effective birth control protection, as well as decreased cramping and menstrual flow, improved acne, predictable, regular menses, lower risk for uterine cancer, decreased risk of breast cysts/lumps/ovarian cysts/anemia, and lower risk for pelvic inflammatory disease. Click here for a complete list of additional methods of birth control and their effectiveness statistics.

Annual Exams
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An annual exam is an important once-a-year check up for women. It is also known as a well-woman exam, a yearly Pap, or a preventive exam. This type of exam is important for preventive purposes, as the Pap smear is used to detect cervical cancer and other cervical abnormalities. In an annual exam, a general physical exam including breast exam is done, as well as pelvic exam and a Pap smear. An update of your health history and family health history should be discussed with your gynecologist. Medications and the need for any new prescriptions may be discussed, and age appropriate health screenings, such as mammograms, bone density testing, or testing for sexually transmitted diseases, will be scheduled for a future date.

Please check with your insurance to verify coverage for an annual exam/breast exam/Pap smear. Most insurance companies will only cover this visit once a year and many will not cover these services if you are even days early from being due for your yearly exam. Also, Medicare will only cover the Pap smear every two years, unless you are a high risk patient. Be sure to check with your insurance company to verify their coverage standards for the annual exam before scheduling your appointment.

Please schedule a separate appointment if you wish to discuss other health problems that are not included in the annual exam. This will help you to avoid any additional charges that may incur from coverage issues within your insurance policy.

New Prescriptions and Refills
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When desiring a new prescription for health issues that have not previously been discussed with Dr. Hunt or Dr. Hartzfeld, please call our office and schedule an appointment. If you are currently on a prescription and would like a refill, would like to switch to a different brand of medication, or to switch to the generic of the prescription, please contact your pharmacy directly. To expedite such requests, your pharmacy will contact our office and provide us with all pertinent information necessary. Please be aware that we do not fill prescriptions after office hours or on weekends, and the emergency on-call telephone line is not to be used at any time for prescription requests.

Surgery & Office Procedure & Information
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In the days before and after your surgical or office procedure, we understand that you may have questions about how to prepare and what to expect during the recovery process. To make the recovery process as quick and simple as possible, we have several procedure and post operative instructions and expected side effects. Also, if you are scheduled for a surgical procedure outside of our office, please note the following requirements:

• Schedule a 2 week follow up appointment prior to your surgery.
• No eating or drinking after midnight the day of your surgery.
• Be sure to arrive at the surgical facility two hours prior to your scheduled time.
• If you are having outpatient surgery, please arrange for someone to pick you up from the surgery center. You will not be released from the surgery center if your arranged mode of transportation is a taxi cab, but only if someone is physically present to take you home.
• Always confirm the location of your surgery or procedure.

Post Operative and Procedure Instructions

1. Colposcopy or Leep In-Office Procedure back to top
   
   
   • You may return to normal activities within 24 hours, and may shower after the procedure, but please refrain from bathing, swimming, or tampons for one week.
   • After a colposcopy, you may have intercourse after one week. However, if you have had a LEEP, wait until after your follow up appointment with Dr. Hunt or Dr. Hartzfeld before having intercourse.
   • To reduce bleeding after biopsy, a medicated paste was applied to your cervix. This paste will cause a dark, brown/black vaginal discharge for a few days after the procedure. You may also pass a clump of tissue-like material. You may also notice vaginal spotting for a few days following the procedure.
   • Tylenol or Advil may be used for the menstrual-like cramping that can occur after these procedures.
   • Call our office immediately if you notice a temperature greater than 101 degrees, persistent abdominal pain or cramping, foul smelling vaginal discharge, or heavy vaginal bleeding (soaking more than 5-6 pads per day).
     
     
2. Novasure Endometrial Ablation back to top
   
   
   • Please take 600 mg Motrin or Ibuprofen (over the counter) every 6 hours starting 24 hours prior to surgery.
   • You may shower, and your daily activities may be resumed within 24 hours, however avoid driving for at least 12 hours.
   • It is common to have bleeding or spotting for a few days afterward. You will have discharge for up to 6 weeks. It may be watery, brown, yellow, or red. Your first period after surgery may be normal flow.
   • Refrain from intercourse and use of tampons until after your post-op exam in 2 weeks.
   • Please call the office if you experience a fever greater than 100 degrees, persistent nausea and/or vomiting, persistent abdominal pain or cramping, foul smelling or excessive vaginal bleeding (more than 5-6 pads a day), or dizziness and faintness.
   • You will need a 2 week postoperative check. If this has not already been scheduled, please call our office as soon as convenient in order to get a timely appointment.
     
     
3. Abdominal Hysterectomy, Vaginal Hysterectomy, Laparoscopic Hysterectomy,
   Exploratory Laparotomy, Laparoscopy, or Cesarean Section back to top
   
   
   • Begin taking 600 mg of Ibuprofen or Motrin every 6-8 hours with food for pain management.
   • Your activities may be slowly increased over the next 6 weeks, however no driving for two weeks. Refrain from intercourse and use of tampons until after your post-op exam in 6 weeks.
   • No lifting. Anything heavier than 10 pounds is too heavy. No housework, other than dusting, is recommended for two weeks. Nap frequently, as fatigue is also normal following your surgery.
   • Progressing slowly to a regular diet is recommended, but increase your fluid and fiber intake to keep bowels regular. Metamucil or Milk of Magnesia can be used if an irregularity occurs. Constipation may be a problem due to the pain medication or decreased activity.
   • Refrain from tub baths for two weeks, but you may shower. Warm water or a heating pad or hot water bottle to the abdomen or back may also help relax your muscles and relieve your discomfort. As you feel the prescribed pain medication is no longer needed, you may take Ibuprofen for the milder discomfort.
   • If you have steri-strips, they can be removed after 3-4 days. Vitamin E or Aquaphor may be applied to help the incision heal smoothly.
   • Please call our office to schedule a 2-week and a 6-week follow up examination.
   • For all surgery performed under general anesthesia, you may have a sore throat for 24 hours or experience some aches and/or discomfort in the shoulders and chest area for a few days. This is due to the gas used to expand your abdomen during surgery and can be relieved by Tylenol or Advil.
   • Please call the office if you experience a fever greater than 101 degrees, persistent nausea and/or vomiting, unusual bleeding (soaking more than 5-6 pads per day), pain/leg pain in the calf, if incision opens, drainage, has redness or is warm to the touch.

NOTE: Douching is never recommended and should always be avoided during personal hygenic care.