Scholarship in Memory of Dr. David Wollenman

Dr. David Wollenman was an icon for obstetrics and gynecology here in Irving, TX for over 33 years and brought over 7000 babies into this world. He brought cutting edge surgical techniques to Irving that he learned through experience and at continuing education programs. It was largely due to his influence that we have many of the continuing education goals and current practices here in Irving. He passed from this world in July 2011 after battling against an aggressive form of brain cancer. Because of his love for the Irving area, the medical field, continuing education and medical advancements, and just because of the person he was, MacArthur OB/GYN is honored to sponsor a scholarship in his memory.

The scholarship is awarded to an Irving ISD graduating senior with academic achievement with an emphasis in math and science and current or previous participation in a teen pregnancy program. This year, the scholarship was awarded to Jennifer Consuelo-Martinez.

Jennifer attends Jack E. Singley Academy and will be graduating in the top ten percent of her class. She plans on attending college after graduation and wants to pursue a Bachelor’s degree in Law Enforcement or Criminology.  She also hopes to work with the Irving Police Department while in college. After finishing college, she is planning on enrolling in the police academy and continuing her journey to becoming a police officer.

The road here has not been easy for Jennifer, but she has done a great job. Living in a single parent home with limited resources for most of her life, she has fought the odds and done well. Her biggest challenge, and where she has shined the most, has been in her becoming a teen mother. Her daughter is precious to her and she wants to be a role model for her. She gives much credit to the Irving TAPPS program in helping to guide her with the day to day needs for her as a mother and for her baby.  She credits TAPPS with helping her become a good mother and helping her to stay on track towards reaching her goals.

Jennifer has been involved with many school activities in addition to taking care of her daughter. She elected president of the Criminal Justice club and the captain for her police explorer post. Over the last 4 years, she’s done more than 300 hours of community service including career day with elementary schools, feeding the homeless, helping Army Veterans, Big Brothers and Sisters, police training, crime watch parties, and even dressing up as McGruff the crime stopping dog. Jennifer thinks of others first and seeing a smile on other peoples’ faces really makes her day.

Dr. Wollenman is the reason I ended up here in Irving, so he has forever impacted my life. He was a mentor to me and to many, and I can’t say enough great things about him. I am so grateful to have known him. He would have been happy to know and see Jennifer get this award and to help her get closer to her goals.  I too am proud of this wonderful young lady and am happy that MacArthur OB/GYN has been able to give her this scholarship, while honoring Dr. John David Wollenman.

Participating in Clinical Trials

As a physician, I believe that I wear many hats. Among them are: healer, teacher and student. Since joining MacArthur OB/GYN in 2011, I found that one way to combine these hats into one was by becoming a clinical investigator on the research studies that our office participates in. The impetus for MacArthur OB/GYN to join in these studies came from my partner, Dr. Jeff Livingston, who has a passion for educating patients.

So how does being a clinical investigator in a research study help my patients? For one thing, it offers patients the chance to receive a new treatment or therapy that may help their condition. The study may also involve following patients for an extended period of time and this outcome data may result new knowledge that results in large-scale changes to doctors’ clinical practice. Also, we are able to attract patients who may have been outside our practice; and helping more people in the community is definitely a good thing.

So what clinical studies are we participating in at this time? We are participating in 5 clinical studies, and they are:

  1. A study of a medication to treat Interstitial Cystitis/Bladder Pain Syndrome

  2. A Post-market study looking at the long-term outcomes of two types of sling procedures for urinary incontinence

  3. A study of a medication to treat endometriosis

  4. A study of a medication to treat uterine fibroids

  5. A study of a medication to treat yeast infections.

Each study has specific inclusion and exclusion criteria. In addition, patients generally receive the study medications for free and are compensated for their time. In order to participate, a patient may be identified by one of our doctors as being potentially eligible, or a patient can contact our office and express an interest in participating; in which case they would be scheduled to see one of the doctors who is either the Principle Investigator or Sub-investigator for the particular study.

Hopefully reading this will encourage you if you have one of these conditions (IC/Bladder Pain, Urinary Incontinence, Endometriosis, Fibroids, or Chronic Yeast Infections) to contact Veronica Almanza at 214-223-5479. She can explain the study to you in more detail and arrange a visit with one of our physicians. We are here to help.

The Daily Show and Health Information Exchanges

Recently on The Daily Show, a very interesting topic was covered — the lack of interoperability of electronic health records. This was a huge surprise to me as one would not expect the Comedy Central to cover a topic frequently discussed only by health information technology policy wonks.

During the satirical editorial, John Stewart lambasted the fact that the electronic health records from the VA system are unable to communicate with the electronic health records of the Department of Defense. He pointed out the illogic of having two large departments in the United States government having two different systems that cannot exchange information with each other.

While his editorial was hilarious and brilliant, it failed to recognize that the lack of EHR interoperability is one of the central problems in the entire U.S. health system. It is not just these two government agencies that cannot communicate; the problem is much bigger affecting virtually every doctor's office and every hospital in the country. Health information technology experts have been shouting from the rooftops about the need to create a seamless way to share health data for a long time.

In fact, solving this problem is one of the primary aims of the Affordable Care Act through the creation of health information exchanges. Here is the basic problem. A patient goes to the doctor and has blood work done. That lab result will go from the lab back to the doctor. If the patient goes to another doctor or hospital, that lab result is not available for review by the new health provider. The new doctor is likely to simply repeat the test. Now multiply this situation thousands of times across the U.S. health system every day and add in radiologic studies, pathology reports, medication list and others and you can easily see the billions of dollars wasted because these independently operating systems cannot talk to each other. The Affordable Care Act created financial incentives to encourage physician adoption of electronic health records. It also created incentives to facilitate data sharing as part of a program called Meaningful Use.

Ironically, the technology needed to solve the problem of independently operating electronic medical record systems not communicating with each other already exists. This is accomplished through the creation of health information exchanges (HIE). Basically, a HIE allows medical information to be shared from one system to another. This means a patient's health information can live in the cloud and follow them wherever they go. The seamless sharing of health information allows each health provider to have the most updated information to make the best healthcare decisions. This cuts cost, saves time, prevents medical errors and makes life easier for patients and doctors.

So, if the technology to solve this problem already exists why, has it not been done already? There is no easy answer to this question and in my opinion it is unfathomable why HIEs are not up and running everywhere. HIEs are not new.

They exist in some parts of the country with some success (Indiana). Most believe widespread adoption is on the horizon. Policy makers have mostly agreed now on the accepted standard for information sharing. This had been the central "choke point" to developers of this technology. Other issues are EHR vendors hesitate to provide access to proprietary information. Hospitals have concerns about sharing valuable demographic information with competitors. There are many other excuses and all are valid concerns. But while the execution of health information sharing is delayed real people suffer.

John Stewart drew attention to the health concerns veterans — those fighting for our country. He put a face on an important topic that needs to be solved now. He also brought a rather mundane and boring health IT topic to the forefront of pop culture.

One of the keynote addresses at the HIMSS13 this year was delivered by President Clinton. He acknowledged that healthcare costs are approximately 18 percent of GDP, and healthcare costs of other developed countries are in the range of 11 percent to 12 percent of GDP. Healthcare costs at this level are not sustainable especially as baby boomers reach an age that will place a higher level of demand on healthcare.

The emphasis of the keynote address was on the importance of using technology in reducing healthcare costs. Government, business, physicians, hospitals, insurance companies and patients all want to avoid unnecessary tests and have the information timely for patient care.

Technology is available. What is lacking is the will of key leaders to do it now. John Stewart brings an issue that is solvable to "main" street. It is good to laugh at ourselves, but this is not laughing matter.

Am I Pregnant? More Than You Ever Wanted to Know About Pregnancy Tests

This is recurring question for me in practice. Each day someone comes to the office asking if they might be pregnant. In today’s world there is no reason for anyone to be asking this question. There is no reason to guess. There is no reason to wonder if you might be pregnant because you are feeling certain symptoms like nausea and breast tenderness. There is a simple solution everyone can use and in minutes you will have your answer.

Take a Home Pregnancy Test

Home pregnancy tests are very accurate. They are the same tests used in a doctor’s office. Pregnancy tests are available at any pharmacy. They can detect a pregnancy 7-10 days after conception. The best time to take one is when you miss your period. If you doubt the result you can repeat it in 1-2 days. If you were pregnant the hormone level would rise enough for detection.

If you miss your period or if you think you might be pregnant here is what you do. Wait until it has been at least 10 days from the date of possible conception or even better wait until you miss your period. Buy a home pregnancy test and follow the directions exactly as written on the box. It is best to use the first urine of the morning as it is more concentrated. The tests ability to detect HCG hormone will be higher allowing an earlier positive result if you are pregnant. Usually the tests recommend waiting about 3 minutes before reading it. If you let the test sit too long the the test may show a false positive result. A false positive is when the tests shows you are pregnant when you actually are not.

Pregnancy tests work by detecting a hormone called human chorionic gonadotropin, HCG. A hormone is chemical produced in your body. As soon as fertilization and implantation occurs this hormone begins to be produced. It then roughly doubles (increases by 66%) every 48 hours. Because of this predictable rise in HCG, a home pregnancy test will be accurate about 7-10 days after conception. By the time you miss your period a pregnancy test has an extremely high likelihood of being correct. A home pregnancy test can detect an HCG hormone of about 20. This highly sensitive test allows very early detection. In other words - you can trust the test results.

A blood pregnancy test done in a doctor’s office works a little bit differently. A blood test still detects HCG hormone but with this test an actual numeric level is given instead of a yes or no answer. A blood pregnancy test is slightly more accurate, but they also take longer and require a doctor’s visit. To simply answer the question “Am I pregnant?” a blood test is rarely needed. Here is an example:.

Let’s say you had unprotected intercourse and were concerned you might be pregnant. Ten days later you did a home pregnancy test and it was negative. On that same day you also did a blood pregnancy test. The home test said not pregnant but the blood test showed you were in fact pregnant with a BHCG level of 19. Notice this BHCG level is 1 point too low to for a urine pregnancy test to detect it. It is true that the home test gave you the wrong result, but remember that HCG doubles every 48 hours. If you waited two days and repeated the test urine test your hormone level would be about 38. The urine test would easily detect it. Had you simply waited until you missed your period before taking the home test the HCG level would be way above 20. The home test would have worked fine in the first place.

Often patients have done a home pregnancy test which showed they are not pregnant but they do not believe the result. My advice is to TRUST THE TEST. If you do not believe a negative result simply repeated in 1-2 days. If your test is still negative then you are not pregnant. You may need to schedule a visit to discuss irregular menstrual cycles if your period does not come. If your test is positive then there is no reason to keep repeating the test. Save your money for diapers because you are pregnant. Take your prenatal vitamins and schedule your first prenatal visit.

Winner of the 2012 MacArthur OB/GYN Scholarship

When I found out I was pregnant with my daughter, I was 16 years old and just about to begin my junior year of high school. I was afraid and anxious, but most of all worried because of my future. Junior year is the main year that many colleges looked at, primarily because of SAT’s and such. I was afraid that I wouldn’t be able to graduate due to failing grades and the six week maternity leave. I remember crying because I had put it in my head that I possibly won’t be able to attend college since all of my earnings would go towards my child and her expenses. As I attended my classes and walked through the halls at my high school, I wondered, “What’s the point of even being here and graduating if I’m just going to struggle and probably not even go to the university that I want to attend?” I agonized over the thought of dropping out, and I almost did if it wasn’t for the support of Mrs. Samantha Garza.

Mia was born in April of 2011 at the end of my junior year, and that’s when the pressure to go to college intensified. Once senior year began in August of 2011, I started noticing how all of the friends that I used to have were excited to graduate and move on with their lives. I’ve seen a lot of girls who have had children in high school graduate, but either they just settled down and had more kids after high school, or they went to college for a semester and then stopped altogether. I thought long and hard about what I wanted to do with my life and put numbers together. I didn’t want to settle for working long hours just to live from paycheck to paycheck. I didn’t want to be settling for a cramped apartment or living with my parents for the rest of my life depending on welfare to get me by. Although there are some outliers when it comes to this, statistics towards living under the poverty line with no higher education as a teen mother was chasing after me. It just wasn’t in my plans to NOT go to college. My parents never went to college; they didn’t even graduate high school. They came over to the United States to give us a better life and I was set on making them proud. Everyone expects for teen mothers to fail, and with that much negative expectation, I wanted to change the views of people.

When my family found out about my plans, there were mixed feelings about things. I had some support, but mostly I would hear, “How are you going to raise a child if you aren’t working full time” and “you can’t go to college if you have no money.” Either way, there was the issue of money always being brought up wherever I turned. I didn’t want to work full time and set aside college. The pressure was on because I honestly wasn’t going to have any financial help. My parents weren’t going to pay for me and I had no job at the moment, so I desperately searched around in hopes of finding something.

I first heard about the MacArthur OB/GYN scholarship through my high school counselor. She gave me a list of scholarships to look at on the Irving Schools Foundation website and as I was scrolling down, one specific link caught my eye. As I read the requirements for the posting of the OB/GYN clinic, I realized that I fit all of the points to be able to apply for it. I thought to myself, “Well it’s worth a shot, why not?” I went ahead, applied and anxiously waited to hear back from the board. I didn’t think that I was going to be the receiver of the award; it was my pessimistic nature to believe in such thoughts, but when I found out that I won I was so overjoyed that I think I cried a bit. NOW there was no excuse for me not to attend my first year at college. There was no excuse for me to say, “I can’t go to because I don’t have the cash for it.” I signed up for classes at my local junior college and walked into lecture hall on the first day, ecstatic because I was actually attending.

This scholarship gave me more than enough to pay for classes and books for both the first and second semester. My first year of college was paid for, and I grinned ear to ear because my education was all that I had going for me. BUT not only did this scholarship help me with school, it also gave me the last bit of cash that I needed to buy my car to be able to drive to and from work, school and the babysitter’s. It helped me to be able to work and save up so that I can pay for my next year of school without having to worry about making the deadlines for the payment plan I had originally set up. Many people don’t realize how grateful I am to the Wollenman Family and the MacArthur OB/GYN clinic for donating this money to help me. The amount might not have been much for certain people, but it was more than enough for me.

I honestly feel that this will really help many future college students a lot. The award goes out to high school students who are involved with a group having to deal with teen pregnancy issues. I personally was involved with TAPPS, the Teenage Pregnant and Parenting Students group. It was run by Ms. Garza and included all of the teen mothers on campus. In a way, we were our own support group as many of us were shunned against by our fellow peers. The people applying don’t have to be a teen parent, but raising awareness towards this is VERY important.

I don’t regret my daughter. She is the reason I decided to attend college to better myself. However having her so young, has made certain things financially, physically and emotionally difficult. So many people can benefit from this help, and it can go toward classes, books, daycare or anything else that might be needed to be able to attend school! I deserve a chance just like everyone else does; after all, what really sets me aside from any other college student other than just a few minor details?

So to everybody reading this, this scholarship helps out in a great deal of ways. Good luck to the next winner! I certainly have benefited very much. I am now currently working on my transfer basics to be able to attend TWU and reach my career plan of becoming a certified Nurse-Midwife. With the help of the Wollenman family and the staff at MacArthur OB/GYN, I’m taking the first step towards the rest of my life. What will help all of you?

Take Two Apps and Call Me in the Morning

Will doctors recommend health apps to patients? There has been an explosion in health apps. Patients are using them for weight loss, calorie counting, exercise monitoring, ovulation calculation and for many other health needs. But to truly integrate the concept of health apps in the health care system healthcare providers will need to get involved. There is discussion in the health IT world lately regarding physician adoption of technology specifically mobile health apps, electronic record systems and patient portals. Doctors have now been plugged into the equation for technological innovation. This represents a paradigm shift for doctors. Life was much simpler when all we had was a pager and a stethoscope.

On the other hand, incorporating new innovation is nothing new for doctors. Physicians are constantly exposed to innovation. We are approached with new medications, new surgical devices, new equipment and new lab tests. Frequently, doctors are pitched a new product and have to decide whether to integrate it into practice or to pass for now. With medications, medical devices and lab tests the decision to accept and adopt is complex. It involves analyzing safety, efficacy, cost and other factors.

Some physicians have the early adopter mentality. At home, we are the first to buy the latest iPhone (even though our current one works fine). We also rush out and buy a 3D television (much to the annoyance of our spouses). Early adopters are the first to try a new surgical technique. Other physicians are more likely to wait and view the success or failures of the early adopters before deciding to jump in.

In many ways physicians are already leading the way in mobile health. The majority of doctors are using smart phone and physicians are early adopters of the iPad. Physicians are using apps clinically within the daily workflow. I use AirStrip OB daily to monitor my patients in labor and Epocrates to check medications. Using medical apps has gone mainstream and Health apps are flooding the market. This trend will continue as the Internet itself moves from the laptop to mobile. We know physicians will use health apps but will they prescribe apps to their patients as a direct part of patient care?

It is very important that app developers understand the physician mindset if you expect us to use apps and to recommend your product to patients. We will not utilize or recommend a health app just because it is cool or just because we can. Adoption is unlikely to be based on cost, efficacy and safety. Your app needs to meet two simple criteria. First, the app needs to make physicians' lives easier. Second, it needs to make the care we provide our patients better.

Currently I prescribe a few in clinical practice. I suggest for weight loss. I like the for my pregnant patients. I suggest the app for access to physician driven health information. Our practice is about to release our own app for our practice in 2013.

So will physicians recommend apps to patients? Absolutely! Give us something worthwhile and we will be all over it. We ask very little in return - make our lives easier and make the care we provide better.

Scholarship in Memory of Dr. David Wollenman

Dr. David Wollenman was an icon for obstetrics and gynecology here in Irving, TX for over 33 years and brought over 7000 babies into this world. He brought cutting edge surgical techniques to Irving that he learned through experience and at continuing education programs. It was largely due to his influence that we have many of the continuing education goals and current practices here in Irving. He passed from this world last year in July after battling against an aggressive form of brain cancer. Because of his love for the Irving area, the medical field, continuing education and medical advancements, and just because of the person he was, MacArthur OB/GYN is honored to sponsor a scholarship in his memory.

The scholarship is awarded to an Irving ISD graduating senior with academic achievement with an emphasis in math and science and current or previous participation in a teen pregnancy program. This year, the scholarship was awarded to Elvira Mancillas of Nimitz High School.

Elvira, smiling big in the middle of the picture above, is standing here with some of the MacArthur group and Dr. Wollenman’s wife, one of his sons, and his two daughters. Elvira is more than deserving of this scholarship. She will be graduating in the top 15% of her class and plans on pursuing a career in nursing. Her goal is to become a maternity nurse. Elvira knows that goals don’t just happen, so she has a plan and is working hard to make her goal a reality. She plans on completing her prerequisites at Northlake and El-Centro before transferring to TWU to pursue her nursing degree. Elvira has taken Advanced Placement/Honors classes to help prepare for her upcoming education. She is a leader in school and has served as captain of her volleyball team. She has also been involved in track and field and in basketball. For those of you lucky enough to have known Dr. Wollenman, you know what a sports aficionado he always was... “I’m a homer,” he would always say when referencing his love for his local sports teams.

Elvira is one of eight children in her family and really understands what it means to work hard. Not only has she excelled in academics and athletics, but she has been able to hold a job in customer service relations for Pizza Hut. Having been her doctor, I can see how she’d be perfect in a job where people skills are needed. Elvira really is a people person and this will help her as a nurse. She says that perseverance is her main personal strength. I agree and think that she is just tougher than she looks. I took care of her and delivered her daughter just a little over a year ago. Elvira says that she did have to grow up quickly at age 17 when she had her baby girl. Undoubtedly she struggled, but she persevered, worked and is working hard, and has done so well for her and her daughter. I am really proud of her and was happy to hear that she was picked to receive this scholarship.

Dr. Wollenman is the reason I ended up here in Irving, so he has forever impacted my life. He was a mentor to me and to many, and I can’t say enough great things about him. I am so grateful to have known him. Also, I was fortunate to be Elvira’s doctor and deliver her baby. And I am proud of this wonderful young lady and am happy that our practice is helping her get a little closer to achieving her goals, while honoring Dr. John David Wollenman.
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1 Comment

  1. thank you!

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