Frequently Asked Questions

The information provided by Advanced Healthcare for Women and E. Daniel Biggerstaff, III, M.D. is for informational purposes only. As each woman is unique, do not rely on this information for diagnosis and treatment. We cannot guarantee the accuracy of the content and advise that you see a qualified Health Care Professional for individual needs and care.

Does Dr. Biggerstaff participate with my insurance plan?

It is a good idea to contact your insurance company direct as plans can change.

What lab or hospitals are in my insurance plan?

Prior to your appointment, call your insurance carrier to verify which labs and hospitals are in your network. This will give you the most accurate information.

What are my financial responsibilities at the time of my appointment?

All co-pays and deductibles are due at the time of service. For office procedures and outpatient surgery, we will contact you with estimated amounts due when the services are rendered.

Is Dr. Biggerstaff accepting new patients?

Yes, Dr. Biggerstaff is accepting new patients.

Can I get a refill on birth control pills or hormones before I am seen?

A medical history and physical examination should be done before a new or refill prescription is given.

Appointments - when does Dr. Biggerstaff see patients?

Patients are scheduled Monday through Thursday from 8:30 Am till 4:30 PM.

Do’s and Don’ts before appointments - Is there anything I should or should not do prior to my exam?

Patients should not douche or have intercourse 48 hours prior to a PAP smear. Discontinue any vaginal medications 3 days prior to a PAP smear or examination for a vaginal infection.

Does Dr. Biggerstaff do tubal reversals?

Dr. Biggerstaff does perform tubal reanastamosis. If you are considering having this procedure, you should obtain a copy of the operative report from your tubal ligation and bring it with you at the time of your appointment.

What about infertility?

Infertility has been an area of interest for Dr. Biggerstaff for many years. There are many causes for fertility problems that Dr. Biggerstaff evaluates and treats. He has special expertise in treating endometriosis as a cause of infertility.  He does not do IVF (in vitro fertilization) but will be happy to assist you in getting this care should it be appropriate. 

When is the fertile time in my cycle (when does ovulation occur)?

Ovulation usually occurs approximately 14 days before the onset of your next menses. If you are trying to time sexual intercourse to improve the chances of pregnancy, abstain from intercourse for 2-3 days; then have intercourse 17 and 15 days before the onset of your next menses. Over-the-counter ovulation kits can make timing of ovulation more accurate.

How long should I be off of birth control pills before trying to become pregnant?

A general rule is to stop the birth control pills three months before you plan to try to get pregnant. Most women will resume ovulation within this time frame, assuming you were ovulating before you went on the pill.

How long will it take to get pregnant?

It can take a couple with no fertility problems up to a year to become pregnant. Dr. Biggerstaff recommends you use an ovulation kit to help with timing of sexual intercourse if you are not pregnant in 6 months.

Are there any special precautions when I am trying to become pregnant?

You should treat yourself as if you are pregnant – avoid alcohol, unnecessary medications and over-the-counter drugs; limit caffeine intake, get plenty of rest; avoid tobacco use; eat healthily. Dr. Biggerstaff also recommends taking a prenatal vitamin before you actually become pregnant.

Does Dr. Biggerstaff deliver babies?

No, Dr. Biggerstaff does not deliver babies anymore. When his patients become pregnant, he follows them through the first three months to make sure everything is going well and then helps them find an obstetrician.

 

How do I decide whether or not to take hormones?

Your personal and family health history should be considered when making this decision. This should be an individualized decision that is made with you and your physician.

Are some hormones safer than others?

Recent data from the WHI (Women’s Health Initiative) study showed an increased risk of breast cancer and cardiovascular disease when taking estrogen plus progestin. It is important to take a progestin or progesterone with the estrogen if you still have a uterus to prevent uterine cancer. A recent study from Sweden showed no increased risk of breast cancer in women taking estrogen alone (usually women who have had a hysterectomy). Progesterone (the natural hormone the ovaries produce) may be safer than its synthetic cousin, progestin. Although we do not have large studies to prove this, transdermal estrogen (the patch) may reduce the risk of cardiovascular disease when compared to oral estrogen.

What about natural hormones? Are they safer?

First we must define what we mean by natural. A generally accepted definition is those substances that are bio-identical to those found in the body. Do not be mislead by the fact that something is natural. A good example of a natural substance that is not safe is ephedra, which is found in many over-the-counter weight loss preparations and has been responsible for a number of deaths. With that said, natural progesterone may be safer than synthetic progestin. Regarding estrogen, Dr. Biggerstaff does not know of any data that proves natural estrogens have any advantages over synthetic estrogens.

Are there any alternative to taking hormones?

The approach to treating the menopause and post menopause depends on what you and your physician want to accomplish with the therapy. Is it to relieve night sweats, decrease mood swings, treat vaginal dryness, or prevent osteoporosis. There are many alternatives to hormones – discuss this with your physician.

Surgery

What are my restrictions after surgery?

Activity after surgery depends on what surgery you had. The following are general guidelines, but your specific limitations should be discussed with your physician. With minor surgery such as a hysteroscopy and D&C, you should be able to resume unlimited activity the day after surgery.

With a laparoscopy, you should be able to return to work in most cases within 3-7 days. Strenuous activity should be gradual and depends in part what procedures you had done at laparoscopy. Sexual intercourse may usually be resumed in 3-4 weeks.

After major surgery done laparoscopically such as hysterectomy and bladder repair, you should be able to drive a car within a week, when you are steady on your feet, not taking narcotic pain medication. Dr. Biggerstaff advises his patients to return to work in 2-4 weeks. Surgery completed laparoscopically, compared to that done with a large incision, results in a much faster and easier recovery. Generally sexual intercourse should be avoided for 6 weeks unless your physician advises otherwise. If you have had repair of pelvic prolapse (dropped bladder and/or rectocele repair), most physicians advise no heavy lifting (over 10 pounds) for 3 months.

Generally, you can take a shower after any minor or laparoscopic surgery when you are steady on your feet. Dr. Biggerstaff usually closes small incisions with steri-strips. After showering, gently pat the steri-strips dry – do not rub them. The steri-strips may be soaked and pulled off like a Band-Aid after 7 days.

Are there any special precautions for bowel function after surgery?

Dr. Biggerstaff routinely has patients do a preoperative bowel prep for most surgeries except for minor procedures. It may take 4, 5, or 6 days to have a bowel movement after a bowel prep. After most surgeries, you will be more comfortable if you do not let yourself become constipated. Drink plenty of water, eat foods high in fiber, and use stool softeners and laxatives as needed. It is safer not to self-administer enemas postoperatively, especially if you have had a rectocele or posterior repair. Many patients have problems with constipation when taking narcotic pain medication; use stool softeners and laxatives as needed.