Thursday, Sep 26, 2013

Breaking the Cycle of Domestic Violence

One in four women in the United States will be a victim of domestic violence at some point in her life. 

It was this alarming statistic that prompted four Orange County women to found Human Options, an emergency shelter providing long-term assistance for battered women and children. What started in Laguna Beach in 1981 as a crisis hotline, soon become the first battered women’s shelter in south Orange County and to date has helped more than 300,000 people.

How common is domestic violence?  Consider these facts:

• 1 in 4 women will be physically assaulted by a jealous boyfriend or husband during her lifetime

• 1 in 5 teenage girls will experience dating violence

• Children who grow up in homes with domestic violence are more likely to become abusers or be abused

• One third of all 911 calls reporting domestic violence are made by children

If you’re interested in learning more about Human Options and their great work, check out their website here.  And if you’re interested in joining us at their annual fall luncheon on October 17 with this year’s keynote speaker, Dr. Drew Pinsky, go here.


Wednesday, Sep 18, 2013

Body Image: Before, During and After Pregnancy

Every Mother Counts, an organization near and dear to our hearts, is having a Google+ video chat this Friday, September 20 at 10:30 a.m. (PST) on a topic of great interest to most of us: body image — before, during and after pregnancy.

Join Christy Turlington, Dr. Jessica Zucker, PhD clinical psychologist specializing in maternal mental health, and yoga instructor/blogger, Jennifer Pastiloff for what’s sure to be an interesting discussion.  For more details and instructions on how to join in, go here.

Thursday, May 30, 2013

Practicing What I Preach

Seeing women through pregnancies and for their annual exams, I am constantly encouraging them to take care of themselves. Oftentimes however, our slightly crazy, slightly three-ring circus lives get in the way.  I get it, I really do.

We all wear many different hats: daughter, sister, wife, mother, friend, employer, employee, doctor, caretaker –– the list goes on. By nature, we’re nurturers and the demands put upon us by our jobs, our families and ourselves (not to mention emails, text messages, cell phones and lap-tops) keep us rushing from one task to the next.  Stress builds, sleep lacks. Nutrition and exercise get pushed to the bottom of the pile.

This past year I experienced what it means to practice wellness.  I signed up for a yoga and surf retreat in Costa Rica, only knowing one friend among the five women taking this same journey. At various points getting ready for the trip, I wondered if all the work and planning and juggling just to get away to relax was all worth it.  And it was, every minute.

While on a hike the first day there, I thought about all of the things that contribute to a sense of health and well being. We were in the jungle, going from one waterfall to the next.  The peace and tranquility, the lack of electronics, the connection to nature were all so simple, yet so vital to the calm that we felt. How to bring this feeling back became a huge focus for me.

We can’t always escape for a week, but we can learn to make our own personal wellness a priority. Even if it’s a 10-minute walk on your lunch break.  Or a long, deep breath.  Or a pause to watch the sunset.  A sip of fine wine. Laughter with friends.  Giving your cell phone a rest, or better yet, a complete digital detox. Or a simple yet hugely meaningful hug from a child.  Embrace those moments as a contribution to your own wellness and most of all –– enjoy the journey.


Dr. Gigi Kroll

Friday, Mar 08, 2013

International Women’s Day

In celebration of women everywhere — for all the great things we’ve done, and all the great things still to come.

{The above image shows the evolution of this year’s International Women’s Day Google Doodle. More on the day here.}


Friday, Feb 15, 2013

The Difference Between Your Annual Exam and Your Pap Smear


For many of us women, getting our yearly pap has always been an important part of taking care of ourselves. During that appointment, we talk to our doctor about many health issues including: weight gain/loss; heavy, painful, or irregular menstrual cycles; contraception and family planning; STD (sexually transmitted disease) prevention, screening, and treatment; cancer screening and family risk assessment;  alcohol, tobacco, and drug use; and other general principles of fitness, nutrition, stress and living a healthy lifestyle.Now, more than ever, it is important that women see their doctor regularly. That being said, there has recently been a change in the recommendations regarding yearly pap smears.

A pap smear is a test (designed in the 1950’s) where cells are collected from the cervix and looked at under the microscope to see if they have precancerous (dysplasia) or cancerous changes. In the past, the cause of cervical cancer was unknown, but we knew that cells would change slowly until cancer progressed. If we could detect the precancerous cells and remove them, we could prevent cancer from developing.Over the past 20 years,  we have learned that cervical cancer is caused by a virus called HPV (human papilloma virus). There are many types of HPV and they are numbered from 1-90. Some types are worse than others. The 2 types that cause over 90% of all cervical cancers is type 16 and 18. In fact, there is now a vaccine (; recommended for children 9 years and older) that can protect against those two viruses and 6 & 8 (the two that cause external genital warts). HPV is transmitted by sexual contact. In fact, if a patient has not been exposed to the HPV virus, they cannot get cervical cancer.It’s also clear that it takes time between an HPV exposure for invasive cancer to develop. Because of the new information that we now have excellent data on, all the large medical groups (American College of OBGYN, American Cancer Society, U.S. Services Preventive Task Force, and American Society for Colposcopy and Cervical Cytology, ASCCP, have changed the guidelines for pap smear screening. These guidelines suggest starting screening at age 21 and continuing every 3-5 years until age 65, assuming no abnormal results. In the screening process, exposure to HPV is assessed and more frequent intervals or procedures may be recommended.

It must be emphasized that this does not change the recommendation to see your doctor yearly and have a comprehensive physical exam. Ideally, evaluation of a healthy woman should start before she is sexually active or if she is having menstrual irregularities or problems. We recommend yearly visits starting by age 18, at which time we assess height, weight, blood pressure, and examination of the breasts, vulva, cervix, uterus and ovaries (external and internal female organs). Blood work, cultures (for infections), vaccinations, medications and other studies can also be ordered. Planning and preventing pregnancy, heart disease, cancer risk, depression, headaches, menopausal symptoms, and a host of other risk reduction strategies are reviewed. In fact, decreasing the frequency of pap smears allows the physician and patient more time to focus on other more pertinent, health-focused topics.

To summarize, a woman’s yearly exam is an important, necessary part of healthcare maintenance. The pap smear may  no longer happen every year, but is just as important that you be seen regularly so that all of your healthcare needs can be addressed.

Dr. Gigi Kroll and Dr. Amy VanBlaricom

For more detailed information on the new pap smear screening guidelines, please see the ASCCP algorithem at

Thursday, Jan 17, 2013

Protecting Yourself Against the Flu

Every year the flu virus varies and therefore, a new vaccine is necessary to protect yourself.  By getting a flu shot, the body makes antibodies that will fight off the flu virus if you get exposed to it from another sick individual.

 A few flu facts: 

– people can be contagious for up to five days before they become sick

– annually, the flu accounts for 20-40,000 deaths in the US.

– immunocompromised people are particularly vulnerable: elderly (over 65), cancer patients, newborns (under six months), and pregnant patients

– this year (2013) has been a particularly bad year with most states facing epidemic proportions and some states declaring a health state of emergency

 Signs and symptoms: 

– classic flu symptoms are high fever (>101.5), body aches, and dry cough

– other symptoms such as a headache, sore throat, weakness (and more) may also exist

The flu shot is safe for pregnant women at any gestational age of their pregnancy (the flu mist, a nasal injection, is not recommended). Some contain Thimerosol, a preservative containing mercury. The amount of mercury is equivalent to a can of tuna fish and is harmless to a developing fetus. Nonetheless, there are also manufacturers that make a preservative-free version.

We recommend all of our pregnant patients get vaccinated. If you haven’t yet, do so as soon as possible. All family members of pregnant patients should be vaccinated as well, especially if the baby is due before May to protect the newborn.

If you develop flu symptoms, please call our office (do not come in as we do not want to infect other patients!). Individuals with flu symptoms should be started on Tamiflu (75 mg twice daily for 5 days) within 48 hours of the onset of symptoms. This will decrease the severity and length of illness. At times, respiratory distress in flu patients will require hospitalization.

Lastly, remember that the flu is spread by respiratory droplets. Keep yourself healthy by avoiding exposure to sick individuals, frequent hand washing, not sharing eating or drinking utensils, and lots of hand sanitizer!

{above photo from here}

Monday, Dec 17, 2012

From Our Family to Yours

Photography by Victoria O’Leary

Monday, Nov 19, 2012

Gratitude, Kindness and Compassion

In this season of gratitude, we thought we’d highlight a cause very near and dear to our hearts.  It’s called Casa Teresa and it has provided a home, as well as training and education, to more than 5,400 pregnant women here in Orange County over the last 35 years.

For most of us, pregnancy is a happy and exciting time as we await the birth of a much-wanted, much-loved baby.  But for some, like the girls at Casa Teresa, it’s a very different story.  The majority of them have had neglected or abused childhoods, and the pregnancies are unplanned.  Casa Teresa takes them in — often when they have nowhere else to go — teaches them and helps them to turn their lives around.

To learn more about Casa Teresa, to get involved, or to donate, go here.  To watch a very compelling and emotional story of one of their girls (Marsha), go here.  And if you can join our effort by dropping off anything and everything to help an expectant mom and baby in need, please check out the list below.  Items can be dropped at our office until December 22 and we’ll take them to Casa Teresa.

Enormous thanks for your kindness and compassion, and wishing you and your families a very happy Thanksgiving.

Urgent need items:

– diapers (all sizes)

– strollers

– maternity clothes (new or lightly used)

– car seats (infant and toddler size)

– maternity sleepwear

– slippers & socks

– gift cards (grocery stores, Target, Walmart)

– baby clothes (new or lightly used)

– pillows (new)

Tuesday, Nov 06, 2012

Staying Informed















A question that is often posed to us by moms-to-be-of-boys is this: to circumcise or not to circumcise?  We thought we’d provide the latest findings from a study by the American Academy of Pediatrics (AAP) and endorsed by the American College of Obstetricians and Gynecologists (ACOG).

The findings?  The American Academy of Pediatrics shifted their former neutral position on the subject to stating that the benefits outweigh the risks of newborn male circumcision.

Why? According to their findings, circumcision helps to prevent urinary tract infection early in life, and later in life — HIV infection, human papillomavirus infection, genital herpes and penile cancer.  It also reduces transmission of certain sexually transmitted diseases and risk of cervical cancer in sex partners.  They go on to say that evidence shows that circumcision does not impair sexual function or satisfaction.

Of course, circumcision should be performed only by highly experienced providers (pediatricians, obstetricians or surgeons).  For further information on the topic, read more here.

{Above photo by Victoria O’Leary.}

Tuesday, Oct 16, 2012

The Best Parenting Advice Ever

We happened upon this interesting article about the best parenting advice ever. It doesn’t cover the small stuff — like how to make a better pb&j or sneak vegetables into your child’s meals.  Rather, it’s about the big stuff, like how to help build a happier, more confident child and how to enjoy the journey.

A favorite part of the article is below.  For a link to the original article, go here.

One of the very best pieces of parenting advice that I ever received was from the writer Toni Morrison. It was May of 2000 and my daughter Ellen was just shy of her first birthday. Ms. Morrison was on Oprah talking about her book “The Bluest Eye.” Oprah said, “Toni says a beautiful thing about the messages that we get about who we are when a child first walks into a room,” and she asked Ms. Morrison to talk about it.

Ms. Morrison explained that it’s interesting to watch what happens when a child walks into a room. She asked, “Does your face light up?” She explained, “When my children used to walk in the room when they were little, I looked at them to see if they had buckled their trousers or if their hair was combed or if their socks were up. . . . You think your affection and your deep love is on display because you’re caring for them. It’s not. When they see you, they see the critical face. What’s wrong now?” Her advice was simple, but paradigm-shifting for me. She said, “Let your face speak what’s in your heart. When they walk in the room my face says I’m glad to see them. It’s just as small as that, you see?”