Meet Allison Brubaker MD, Women's Care of WI

A Women’s Care of Wisconsin fertility specialist, Dr. Allison Brubaker can immediately identify a catalyst and inspiration for her interest in the field.

“My mom was told at one point she wouldn’t be able to have children,” said Brubaker. “I’m one of five she gave birth to.”

After being put in such a position—basically being told there was little to no hope other than to visit an adoption agency—Brubaker’s mother had the strength to persevere. But it’s a situation Brubaker doesn’t want other women to have to endure.

“I don’t want any woman to feel like that,” she said. "When women come to see me, I want them to know that there are options and there is someone to help them."

For Brubaker, helping families become pregnant is just one of the things she loves about being an OB/GYN. She enjoys all areas of obstetrics and has a particular passion for the minimally invasive surgical management of uterine fibroids, endometriosis, ovarian cysts, abnormal uterine bleeding, pelvic organ prolapse, and pelvic pain.

The first in her family to pursue a career in medicine, Brubaker was drawn to surgery and knew whatever specific field she chose would have a surgical component. It wasn’t until late in her rotations that she was involved with labor and delivery; she was hooked immediately.

“I was so empowered when I delivered my first baby,” Brubaker said. “It’s just so exciting.”

Brubaker embraces her role as a women’s healthcare specialist and enjoys the wide variety of patients she sees, from young women experiencing their first gynecology visit to those dealing with post-menopausal issues, as well as providing care to the LGBTQIA+ community.

“I believe strongly in patient-centered care,” said Brubaker. “That means listening to patients, educating them on their treatment options, discussing risks and benefits, and letting them choose what is best for their lifestyle.”

Dr. Allison Brubaker sees patients at Women's Care of Wisconsin locations in Neenah and Oshkosh. To schedule an appointment with Dr. Brubaker, please call or text 920.729.7105.

Pelvic Organ Prolapse—What is it?

Pelvic organ prolapse is a disorder in which the pelvic floor muscles stretch, weaken, or become torn causing one or more of the pelvic organs to drop from their normal position. This can occur due to factors such as pregnancy, vaginal childbirth, advancing age, excess weight or chronic constipation and straining a stool. Approximately 5% of women develop prolapse; women in their sixties have the highest incidence of the dysfunction.

• The organs that can be affected include the following:
• Uterus (uterus drops into the vagina)
• Vagina (the walls of the vagina fall in on themselves if the uterus has been removed)
• Bladder (the bladder sags into the vagina)
• Rectum (the rectum bulges into the vagina)
• Small Intestines (the small intestine bulges into the vagina)

In severe prolapse, the woman can see or feel a bulge of tissue at or past the vaginal opening. Most women have mild prolapse, with only a slight dropping of organs and no symptoms. Symptoms of pelvic prolapse can include some or all of the following:

• Feeling of fullness, heaviness or pressure
• Pulling or aching feeling in the lower abdomen or pelvis
• Difficulty urinating or having a bowel movement
• Urine leakage when coughing or using stairs
• Painful or uncomfortable sexual intercourse

If you have symptoms, prolapse may be treated with or without surgery. The goal of treatment is to relieve your symptoms. Your healthcare provider can discuss your treatment options with you. These may depend on several factors, including the nature of your problems, your lifestyle, and your wishes. You may have both surgical and nonsurgical options.

In many cases, nonsurgical treatment is a good choice. This may be true if your pelvic organ prolapse is mild or doesn’t bother you much. To help ease symptoms, your provider may give you a device to wear in the vagina (pessary) or instruct you on pelvic floor exercises.

If your symptoms are severe and disrupt your life, and if nonsurgical options have not helped, you may want to consider surgery. Each type of prolapse is corrected in a specific way, with either open surgery or laparoscopy. Your healthcare provider will discuss which route is best for you.

The providers at Women’s Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care. From adolescence through menopause and beyond, you can depend on us. Meet our providers and learn more about gynecology, pregnancy care, infertility, procedures and surgery, incontinence, osteoporosis, menopause and more at www.womenscareofwi.com. Or call or text us at 920.729.7105.

Meet Gretchen Augustine DO, Women's Care of WI

“Pretty much every visit I have with a patient starts the same way,” said Gretchen Augustine. “I ask them to tell me in their own words, in their own time, why they are here.”

Perhaps that’s why the Women’s Care of Wisconsin OB/GYN develops such a strong connection with them.

“Those first minutes in a first appointment are crucial,” said Augustine. “My patients know their bodies better than anyone else, so I provide them the time, opportunity and space to share what they’ve been through. Details they provide can be very powerful.”

The Michigan native actually started her career in journalism. Her decision to follow a very different path was rooted in being able to connect with people at a deeper level. She returned to school to pursue a degree in osteopathic medicine. That means she’s trained exactly as an MD, but with additional training in manipulative medicine.

“An osteopath is trained to view the patient holistically, to take care of the patient’s mind, body and spirit,” Augustine said. “It’s about finding and treating the root causes of issues rather than simply assigning a medicine to fix a problem.”

A staunch advocate for patient empowerment, Augustine insists that the education of those she serves be a top priority in her practice.

“It’s important patients understand the best options available to them,” said Augustine. “And they need to be comfortable with the treatment and have confidence that it is right for them and that it will be successful.”

Fundamental to women’s medicine, said Augustine, is developing relationships.

“We take care of women throughout the spectrum of their lives, and those of us in the field embrace that role,” she said.

Her patients describe Augustine as genuine, kind, astute, supportive, and funny.

“I laugh with my patients a lot, and I think that’s important,” said Augustine. “Most important of all, though, is that my patients feel heard and know that we’ll be working together on a plan to get them to where they want to be.”

Dr. Gretchen Augustine sees patients at Women's Care of Wisconsin locations in Appleton and Shawano. To schedule an appointment with Dr. Augustine, please call or text 920.729.7105.

Understanding Laparoscopic Hysterectomy

If a hysterectomy is needed, we recommend a type of surgery called laparoscopy. This method has many benefits compared to open surgery.

A hysterectomy is surgery to remove the uterus (womb); this includes removal of the cervix and fallopian tubes. You may need this done because of severe pain, bleeding, pelvic infection, or other problems. Having a hysterectomy means that you will not be able to become pregnant in the future, so be sure to discuss all of your treatment options with your provider.

A laparoscopy is a surgery using a long, narrow tool called a laparoscope. The doctor inserts it and other surgical tools through small incisions made into the abdomen. A tiny camera is attached to the laparoscope, which sends light into the body. The doctor then sees the reproductive organs on a monitor and can view them from multiple angles.

Laparoscopy often helps find and treat the cause of reproductive organ problems in women. And it uses smaller incisions than most other surgeries. That means you can leave the hospital sooner, almost always the same day or you may be discharged the next morning. You may also heal faster and get back to your daily routine more quickly.

Benefits of Laparoscopic Hysterectomy:

• Requires less time in the hospital or surgery center
• Offers a faster recovery
• Causes less internal scarring and smaller visible scars
• Causes less pain after surgery, which allows for a faster return to work
• Has a lower risk of complications

For more information, talk to your provider about how laparoscopy can help you! If you would like to schedule an appointment with one of our providers at Women’s Care of Wisconsin, please call or text us at 920.729.7105.

The providers at Women’s Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care. From adolescence through menopause and beyond, you can depend on us. Meet our providers and learn more about gynecology, pregnancy care, infertility, procedures and surgery, incontinence, osteoporosis, menopause and more at www.womenscareofwi.com.

Incontinence: More Common Than You Think

Did you know that 50% of women have incontinence at some point in their life? Here’s what you can do to take control.

Incontinence is the loss of urine in an uncontrollable fashion. There are many reasons as to why people have it. Some of them are very easy to treat successfully and are easily cured, and some of them are very challenging to cure. But we can usually get significant improvement with treatment. Incontinence is one of my favorite conditions to see a new patient with; I can often cure them outright and almost always make a big improvement for them with fairly little intervention.

Most people put up with it and hope that it’s going to get better, or put if off until tomorrow, only to realize that several years have passed and it’s only gotten worse.

In generations past, people have looked at the loss of urine as a normal part of aging or normal consequences of childbearing, both of which I think are mistakes. What I would encourage people to think about is the fact that although incontinence is not painful, it’s not normal. People really don’t like to deal with it because it’s embarrassing. But they should realize, it’s very common, and often very easy to treat.

However, correctly treating incontinence means also that you have an understanding of what the true diagnosis is, very much like a headache. There are many different causes for it and the headache itself is usually a symptom of an underlying abnormality of some type, just as incontinence can be caused by many different things. 

Relief for women dealing with bladder control issues typically takes one of three routes:

• It can be as simple as a 10-minute outpatient procedure or a prescription for  medication.
• It may require a combination of therapies to get someone to a much better function.
• Sometimes we need to treat an underlying, undiagnosed urinary tract infection, which should be evaluated further, as it could possibly be a sign of other diseases such as MS or diabetes. 

There are varying levels of incontinence, all of which can be diagnosed and treated to help you return to a normal, active lifestyle.

Spasm and bladder irritability:

• Conditions where a person is urinating frequently and up a lot at night with a sudden sense of urgency (similar to the television commercials you see)
• Tends to be a neurologic, irritational aspect to the bladder
• There are a handful of different medications that are typically used to treat this

Stress incontinence:

• People leak a small amount of predictable urine every time they cough, sneeze, lift or jump
• Will not get better with time
• Often times this can be treated effectively with proper Kegel exercises, but a lot of times that treatment requires ongoing and continuous exercise by the person, and sometimes even then it won’t hold up over time
• Should that fail, we can proceed with a small, 15-minute, outpatient procedure that is very successful (such as some type of sling procedure), which in the past was a very big surgery and nowadays really can be done quickly with a very fast return to full function status

When incontinence affects how you function, what you’re doing, your clothing choices or travel plans, it’s just a shame not to get an evaluation and treatment—because so often, it is actually fairly easy to fix with many different treatment modalities. 

Suffice it to say, there are many treatments for many different causes in the many unique types of patients out there. But I would encourage readers to not for a minute think that this is a normal part of aging and something they simply have to “put up with.”  I would encourage them to seek medical evaluation and intervention, because if you’re thinking about the fact that you’re leaking urine, then it is probably affecting you on a daily basis.

Dr. Eric Eberts is an Obstetrician/Gynecologist at Women’s Care of Wisconsin. Contact Dr. Eberts at 920-729-7105.

The providers at Women’s Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care. From adolescence through menopause and beyond, you can depend on us. Meet our providers and learn more about gynecology, pregnancy care, infertility, procedures and surgery, incontinence, osteoporosis, menopause and more at www.womenscareofwi.com.

The Benefits of In-Office Procedures

There has been an interesting transition over the years from a surgery done originally in an inpatient setting, where the patient would stay in the hospital for several days, to an outpatient surgery setting.  We have essentially accomplished this with procedures up to the hysterectomy, which once was a 4-day hospital stay and included 8 weeks of recovery. Oftentimes, it can now be a same-day surgery, going home the same day. That, of course, is for the big surgeries.  Twenty years ago we were doing operating room procedures for urinary incontinence and bleeding and it again started off as inpatient surgery, migrated to outpatient surgery and recently has become essentially an office procedure. 

Many advantages of in-office procedures have become apparent, and this drive will continue in the future as it offers many excellent outcomes, opportunities and advantages for the patient as well as for the health care system from a delivery standpoint.   First, this transition is based upon the idea that these procedures are becoming less invasive.  When these procedures are done here in the office setting, as opposed to the hospital setting, they also offer more of a personal savings while delivering an equal or better outcome.  These issues in combination with an office setting save the health care system, insurance companies and oftentimes the patient a very significant amount of money. This is because the procedures become less intricate with fewer people involved, faster stays, fewer drugs and less equipment is required.

Here at Women’s Care of Wisconsin we have transformed many surgeries over the past years.  Traditionally, these procedures were urinary incontinence and LEEP procedure of the cervix, which have been done in the office setting successfully for more than twenty years.  We have now added several other office procedures that nationally and state-wide continue to be done in hospital settings. Women’s Care does office Botox for incontinence of the bladder and frequency and urgency symptoms.  This procedure is very effective when other medication has not been successful.  There’s no incision, it typically takes about 20 minutes, it’s often covered by insurance, very durable and we have again had very excellent outcomes with this in the office-based setting.

Likewise, hysteroscopy and ablation, which is the destroying of the lining of the uterus, has also migrated to the office setting and is often covered by insurance. This procedure is done to effectively eliminate or at least successfully diminish the amount of pain and bleeding encountered by a woman during her cycle. With this procedure, there are no incisions, it only takes a few minutes of time and offers the ability for the patient to return to work typically the next day.  This procedure is particularly helpful in an office setting as we are able to perform this procedure at a much lower cost to the insurance company and that is often reflected in what the patient has to pay. We are effectively delivering this procedure in a fashion that is if anything better, more pleasing to the patient, a fraction of the cost, and has an identical outcome.

While all of these office procedures have offered significant cost savings to patients and their insurance companies, the goal has been to offer better service with the same outcomes in a more personal setting.  I think we have achieved this and we have been able to bring the cost down while delivering this perfect triad of advanced care.  By creating an environment where we can have less paperwork, fewer handoffs between strangers and essentially taking this into an office setting where the patient can oftentimes be functioning the next day. At Women’s Care we are continuously improving ourselves as we drive towards a better delivery system in general. In particular, Women’s Care strives to deliver to our patients and our communities excellent care of which we can all be proud.

If you have any questions, feel free to contact us and see what services we can provide for you. I’m sure that you will be most pleased with the outcomes that we can deliver.

Dr. Eric Eberts is an Obstetrician/Gynecologist at the Appleton and Neenah locations of Women's Care of Wisconsin. Contact Dr. Eberts at 920-729-7105.

Providers at Women’s Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care. From adolescence through menopause and beyond, you can depend on us. Meet our providers and learn more about gynecology, pregnancy care, infertility, procedures and surgery, incontinence, osteoporosis, menopause and more at www.womenscareofwi.com.

 

 

The Importance of Full Term Pregnancies

Pregnancy is one of the most exciting and vulnerable times of a woman's life. Most of us have thought about pregnancy and how our pregnancy would go long before we were actually pregnant. Most of the time, everything goes just right. However, almost one in eight women deliver preterm (defined as less than 37 weeks).                                                      

If a woman believes she is in preterm labor, she should call her doctor immediately and be evaluated. 

Why do women give birth early?

Half of preterm deliveries are because of preterm labor, while the other half has a medical indication for early delivery such as preeclampsia or their bag of water may have broken early.

Who is at increased risk?

There are some risk factors for preterm delivery. They include women with a history of preterm delivery, short cervical length noted on ultrasound, a history of cervical surgeries such as a D&C, and smoking (another reason to quit, ladies). If a woman is found to have a short cervical length, there are medical management options. Women with a history of preterm delivery are treated with medications in later pregnancies. 

The providers of Women’s Care believe having a healthy pregnancy starts before a woman is pregnant. Healthy babies begin with healthy mothers. We promote a well-balanced lifestyle to our patients, which means preconception care, proper nutrition, routine exercise, a healthy, safe environment, as well as a daily prenatal vitamin with folic acid. With good guidance, avoidable conditions that may have everlasting consequences may be prevented. We would love the privilege to take care of you and answer any questions you might have about pregnancy care or preterm deliveries.

The physicians at Women's Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care.

Meet our providers and learn more about infertility, gynecology, pregnancy care, midwifery services, procedures and surgery, incontinence, osteoporosis, menopause management and more at www.womenscareofwi.com. Or call or text us at 920.729.7105.