Obstetrics and Gynecologists

Our OB/GYN providers are dedicated to excellence and will ensure that you are comfortable, safe and secure.  We offer exceptional care through every stage of a woman’s life.  We realize that you are entrusting us with the care of you and your infant. We are happy to be a part of your lives.

Complete care for women

El Rio’s OB/GYN center offers complete care for women through all life stages. Services include prenatal, birth and postpartum care, reproductive endocrine services, gynecologic procedures, menopausal services, oncology services and free pregnancy testing. We specialize in gestational diabetes management.  All our doctors are board certified OB/GYN specialists who are fluent in Spanish.

Our providers work together to offer you complete care, combined with personal attention and convenience. They have worked with us for many years and are dedicated to achieving patient satisfaction.

Gynecology Care

We provide routine gynecologic care, menopausal services, and reproductive endocrine services. Many of our gynecological procedures are performed in the office setting at El Rio OB/GYN Associates.

Your satisfaction is our goal. We appreciate the confidence that you’ve placed in our practice.  Here is a listing of a few of our services.

Well-Woman Annual Examination

Your well-woman annual examination includes a clinical breast exam and a pap smear.

Pap Smear

It usually takes one to two weeks to obtain a pap smear report. If normal, we will send you your results by mail and remit a report to your primary care physician. If an abnormal pap smear report is received, we will attempt to contact you by phone in order to inform you of the results and discuss your follow up care.

Abnormal Pap Smear

Pap smear screening is performed to identify those women who may be at risk for developing cervical cancer later in life. An abnormal result does not mean that you have cancer. An abnormal smear requires additional evaluation to determine if you have a pre-cancerous condition known as “dysplasia”, caused by the HPV virus (Human Papilloma Virus), which, if left untreated, could develop into cervical cancer.

An appointment will be scheduled to perform a colposcopic evaluation of your cervix. During this exam, we will use a magnifying instrument (colposcope) to look for signs of dysplasia on your cervix. A small biopsy is taken to confirm the diagnosis. The biopsy is relatively painless but may cause some cramping sensation.

When we receive the biopsy report, we will contact you and discuss the treatment options available. If the biopsy does not find dysplasia, then a repeat pap smear is usually performed in six months. In cases where mild or moderate dysplasia is found, cryotherapy is used to remove the abnormal cells from your cervix. Cryotherapy entails placing a cold metal probe against your cervix for three to five minutes. It usually causes mild menstrual-like cramping, that subsides when the procedure is over.

For more advanced dysplasia (moderate to severe), we remove the involved area of the cervix with a wire loop procedure called LEEP. This procedure is also done in the office using local anesthesia. We have a pamphlet available in our office which thoroughly explains dysplasia and its treatment.

Clinical Breast Exam

A clinical breast exam (CBE) is performed by a provider who will examine your breasts to determine if there are any unusual lumps, redness or rash.  They will let you know at the time of your exam if everything appears normal.  If a lump is found, the provider will likely request that you have additional tests to determine if the lump is benign (non-cancerous) or if it is breast cancer.

Breast Cancer

Breast cancer is the most common form of cancer among women, accounting for 30 percent of all cancer diagnoses in women. Hereditary breast cancer makes up approximately 5% to 10% of all breast cancer cases.  Most providers feel that early detection tests for breast cancer save thousands of lives each year.

If the provider feels an abnormal lump in the breast, they may suggest that you have a mammogram.  If the mammogram confirms there is abnormal tissue, then it may be necessary to remove a small piece of the tissue and look at it under the microscope to determine if there are any cancer cells. This procedure is called a biopsy. Sometimes the biopsy is done by inserting a needle into the breast and drawing out some of the tissue. If the biopsy shows that there is cancer, then a follow-up care plan will be designed for you.

Self Examination

Women should perform monthly breast self-examinations between their annual exams.  A doctor should be consulted immediately if you notice any unusual changes in your breasts.

How to Examine Your Breasts

It is normal to have some lumpiness or thickening in the breasts. By examining your breasts once each month, you will learn what is normal for you, and you will notice if any changes do occur. Some women find that doing a daily or weekly self-exam works better for them. You should become familiar with your breasts at all phases of your menstrual cycle. The more you examine your breasts, the better you can learn what is normal for you. Your “job” isn’t just to find lumps, but also to notice if there are any changes in your breasts by following these simple self-examination techniques:

In the shower — with your fingers flat, move gently over every part of each breast. Use your right hand to examine the left breast and your left hand to examine the right breast. Check for any thickening, hard lumps or knots.

In front of a mirror — check your breasts with your arms at your sides. Then raise your arms overhead. Look for any changes in the shape of each breast, swelling, dimpling or changes in the nipples.

Lying down — to examine your right breast, put a pillow under your right shoulder. Place your right hand behind your head. While keeping the fingers of your left hand flat, press gently in small circular motions around an imaginary clock face.

Begin at the outermost top of your right breast for twelve o’clock, then move to ten o’clock, and so on, until you return to twelve o’clock . Each breast will have a normal ridge of firm tissue. Next, move in one inch increments toward the nipple. Keep circling to examine every part of your breast, including the nipple.

Repeat the procedure on the left breast with a pillow under the left shoulder and your left hand behind your head.

Finally, squeeze the nipple of each breast gently between the thumb and index finger. Any discharge, clear or bloody, should be reported to your physician immediately. Continue to perform monthly breast self-examinations.

Mammograms

A mammogram is a special x-ray of the breast that may find tumors that are too small to feel.  Recommendations for mammograms include a screening mammogram once between the ages of 35 to 40. From ages 40 to 50, a mammogram should be done every two years. From age 50 and up, a mammogram should be done every year.

Family Planning

El Rio offers free pregnancy testing at any of our health center locations.  You can make an appointment to discuss your individual needs for family planning or cover this topic with our OB/GYN providers in conjunction with your well-woman exam.

Menopause

Menopause is natural part of a women’s life and many women go through this stage of life without concern.  Many other women find that symptoms interfere with their daily life.  We will evaluate your treatment options based on your individual needs. Common symptoms include:

-  Hot flashes
-  Mood swings
-  Memory problems
-  Vaginal dryness
-  Problems sleeping

Other Services

We offer many other services, including; infertility evaluations as well as treatments for irregular bleeding, pelvic pain and sexually transmitted diseases. Please contact our office with any questions that you may have concerning the services our practice offers and the procedures we perform at our health center.

 

Valuable Information

If you want to research any other OB/GYN topics these websites contain valuable information:

The American College of Obstetrics and Gynecology
- WebMD

Obstetrics Care

Delivering over 1000 babies a year, El Rio OB/GYN Associates provide full obstetrical care. During your pregnancy, you are seen by your own doctor and nurse. Ultrasound exams are performed in our office, along with fetal non-stress tests and biophysical profiles for high-risk pregnancies. We consult with perinatologists, when appropriate. Our patients deliver at Tucson Medical Center, which is located at the intersection of Grant and Craycroft (Southeast Entrance).

Prenatal Care 

When you call our office to schedule your first prenatal visit, you may choose your own obstetrician or have our staff assist you with this decision. In most cases, you will be seen within one week. During the first visit, we will thoroughly review your medical history and identify any potential risk factors that may affect your pregnancy. A complete physical exam will be performed, including a pelvic exam and pap smear. An ultrasound is usually performed at your initial visit to document your due date.

After your exam, we will discuss general health information regarding pregnancy, including: diet/weight gain, risk factors and laboratory testing available.

Fetal Movement Prior to 36 Weeks

At 32 weeks, we will give you a copy of your prenatal records. Please bring these records to every office visit and to the hospital when you are in labor. The earliest time women may feel fetal movement is at 15 weeks, in the early second trimester. You should call us if you suspect decreased fetal movement. If you suspect that there may be a problem, have something to eat or drink, lie down and count fetal kicks or movements. If it takes more than one hour to count 10 movements, then call our office for further instruction.

Delivery of Your Children

We try to attend our own individual patient’s labor whenever feasible. We have an obstetrician from our group on call at Tucson Medical Center’s Labor & Delivery 24 hours a day, 7 days a week, 365 days a year.

The goal in every pregnancy is to deliver a happy, healthy baby at term (greater than 37 weeks). Your due date indicates when you’re entering your 40th week of pregnancy. Generally, we try to prevent premature delivery prior to 35 – 36 weeks. After 36 weeks’ gestation, it is usually safe to allow delivery.

Going Into Labor

After 36 weeks, we instruct our patients to call us when contractions are occurring between 5-10 minutes apart for one or two hours. You may call sooner if you have had a history of rapid labors or your contractions are extremely uncomfortable.

Always call us right away if you are bleeding or if you think your water broke. (This may be a large gush of fluid or a constant trickle of fluid.)

Umbilical Cord Blood Banking 

The cord blood that remains in the umbilical cord after your baby’s birth has the potential to save lives. There are special cells in the baby’s blood called stem cells. These stem cells have the potential to become virtually any type of human tissue.

You can now opt to save these valuable stem cells for future medical needs of your baby or immediate family. The process is called cord blood banking, which requires freezing the stem cells obtained from the umbilical cord at the time of delivery. The process is painless, since the blood is drawn from the umbilical cord attached to the placenta after the baby is born, and takes only a few minutes of the doctor’s time to collect.

The frozen stem cells act as an insurance policy for your family should there be a medical need for them in the future. Most people associate the use of stem cell transplants with leukemia patients that otherwise would have required a bone marrow transplant to obtain these important stem cells. Stem cells are also being used in patients with sickle cell disease and other anemias. They may also be useful in treating an immunodeficiency or genetic disorders of metabolism. Future research will surely find other uses for stem cells, such as growing your own skin in case of burns requiring skin transplants.

If you are interested in banking your newborn’s cord blood, you must make arrangements prior to delivery. We have information pamphlets in our office regarding the company that stores the blood here in Tucson, along with the costs associated with the collection and storage of the blood.

For additional information, call 1-888-CORD BLOOD or visit the cord blood registry website at www.cordblood.com.

Medication Refills

Please ensure that you plan ahead on your refills by calling your pharmacy before you run out of your medications. Call your pharmacy at least one week in advance to obtain your prescription refills. The pharmacy will inform you if you do not have any refills left on your prescription.

Please contact our office during regular office hours to obtain prescription refill authorizations. You can contact your doctor’s nurse either directly, or by her voice mail to obtain your refill or have your pharmacy fax a refill request. Please have all necessary information available when you call: medication name, dosage and frequency, and pharmacy name and phone number.

Appointments

Appointments are scheduled:
Monday – Friday 8:00 a.m. to 4:00 p.m.

First and third Wednesday of each month 9:00 a.m. to 4:00 p.m.

(520) 670-3909

Patients are seen by appointment Monday through Friday from 8:00 a.m – 5:00 p.m. and on the first and third Wednesday of every month 9:00 a.m. – 5:00 p.m. Appointment times may vary, depending on the location and availability of physicians. Our staff will assist you with obtaining an appointment with the physician and office location of your choice. If a patient is unable to keep a scheduled appointment, or may be late, we ask that our office be contacted as soon as possible.

We try to see our patients on time; however, due to the nature of an OB/GYN practice, there may be unexpected emergencies. If we know in advance that a physician is going to be late or delayed, we will make every attempt to inform our patients and reschedule the appointment, if necessary. We ask that each patient keep us appraised of any address or contact telephone number changes. We will also request current patient insurance information when appointments are scheduled.

Emergency appointments are available for new and established patients. Please assist our staff by providing us with all pertinent information when requesting urgent care, including; symptoms, medications,emergency room care documentation and x-ray/ultrasound studies. This will assist us in making the appropriate determination of the care that you may require at that time and allow us to obtain medical records prior to your visit with us.

El Rio OB/GYN nurses and staff are specially trained to answer specific questions and provide information to referring physicians and their patients. We will make every attempt to return your call by the end of the day on which we are contacted.

Emergency Care

Our triage nurse will speak with you and determine the best course of action with input from your doctor.

Our physicians are available 24 hours a day for emergencies. If a patient has an emergency, please contact our office at 520-670-3909. In a life-threatening emergency, please call 911 or have the patient go to the nearest Emergency Room and ask that the patient’s physician be called for assistance. Our doctors practice at Tucson Medical Center. Our patients should call El Rio OB/GYN Associates before going to the hospital (see Labor Instructions under Prenatal Care).

OB GYN Locations

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