A Pelvic Health Story – Poonkulali Suresh

By Jessica Wall

Imagine living with the constant worry of whether you might experience the loss of bladder control – the fear of an accident happening, or the embarrassment when it does.

Unfortunately, this is a real concern that millions of women face on a daily basis, often resulting in a diminished quality of life.

Yet most women suffer these symptoms in silence, believing the idea that “this is a normal part of aging.”

In fact, studies reveal that only ten percent of women with a bladder control problem seek help, and most wait an average of more than six years before doing so.

Poonkulali Suresh knew this statistic all too well. A 47-year-old mother of two, Poonkulali began experiencing bladder control problems about ten years after the birth of her second child.

“The leakage was minimal at first, occurring only when I laughed or coughed,” she said. “However, the symptoms gradually worsened to the point that I was leaking constantly, and it began to affect every part of my life, even my sleep. That was the moment I reached out to my doctor.”

In 2007, Poonkulali discussed her symptoms with her gynecologist and was referred to a urologist, where she was diagnosed with stress urinary incontinence (SUI), or involuntary urine leakage during physical movement, such as coughing or sneezing.

The urologist recommended surgery as her best option; however she was reluctant to the idea of surgery and chose instead to try medication. The medication temporarily helped Poonkulali’s symptoms, but it wasn’t a long-term solution. Then, in 2011, she met Dr. Gary Emerson of McLeod OB/GYN Associates.

“Dr. Emerson was wonderful,” said Poonkulali. “During my first visit with him, Dr. Emerson brought attention to the SUI diagnosis in my medical record and explained more about the condition. Then, he said he could treat it.”

Treatment involved surgery, which still made Poonkulali nervous. However, over the next few years, Dr. Emerson continued to encourage the procedure.

“Poonkulali was the perfect candidate for the suburethral sling procedure,” said Dr. Emerson. “We performed urodynamic testing in our office, which is a simple test that measures how the bladder functions. During the test, Poonkulali experienced urinary leakage, which was a strong indication that surgery was in fact her best option.”

At her appointment earlier this year in January, Poonkulali decided it was time to have the surgery.

“I had complete confidence in Dr. Emerson,” said Poonkulali. “His gentle encouragement and in-depth explanation of what to expect before, during and after the surgery convinced me to go through with it.”

“During the suburethral sling procedure, a tape-like material is placed underneath the urethra, and then each end of the material is anchored to the pubic bone,” explained Dr. Emerson. “This ‘hammock’ effect provides the support necessary to eliminate urinary leakage.”

On February 5, Poonkulali underwent surgery, which proved to be successful.

“For me, the surgery worked fantastic,” she said. “My quality of life is so much higher now. I can jump, cough, laugh, and even sleep without fear or worry.

“Only those who have experienced bladder control problems can understand how enjoyable life is without leakage.”

Since her surgery, Poonkulali has been open about sharing her story with her friends, and to her amazement, discovered that many of them were suffering in silence with similar symptoms.

“Pelvic health is not a topic we may like to talk about, but it’s critical that we do,” she said. “Incontinence should not prevent us from leading active lives. Looking back, my only wish is that I had known Dr. Emerson ten years ago.”

In 2013, McLeod Women’s Services began an effort to raise awareness about women’s pelvic health issues. “Pelvic health” is a new phrase used among professionals in women’s health which refers to conditions such as urinary incontinence, pelvic organ prolapse, endometriosis, and more.

Research indicates that nearly half of all women will experience symptoms related to pelvic health issues at some point in their lifetime, making pelvic health conditions more common than most women realize.

“A new report by the American College of Obstetricians and Gynecologists shows that SUI affects nearly 16 percent of adult women. Among women with the condition, 77.5 percent report their symptoms to be bothersome, and of this group 28.8 percent report their symptoms to be moderately to extremely bothersome,” explained Dr. Emerson.

“The ultimate goal of McLeod Pelvic Health is to educate women on these conditions and help them see that they do not have to live with these symptoms forever,” added Dr. Emerson. “We want them to enjoy the quality of life they deserve.”

Marie Wolfe

By Jamie Vance Hayes

The day after Christmas in 2013, Marie Wolfe was not feeling like herself. As farfetched as it seemed to her, Marie purchased a home pregnancy test to satisfy her curiosity. The 43-year-old mother of two children, 14-year-old Jackson and 11-year-old Ruthie, was in shock as she held the positive test in her trembling hands.

Being pregnant seemed so unbelievable to me, especially since I had undergone fertility treatments with both of my other children,” she said.

Marie called her friend, Andi Atkins, a nurse practitioner with McLeod OB/GYN Dillon to relay the news. “I immediately burst into tears when she answered,” said Marie. “I was scared and nervous because of my age. Fortunately, Andi put my mind at ease and scheduled an appointment for me to come in the following Monday.”

This appointment was Marie’s first visit to McLeod OB/GYN Dillon. “I have friends who had positive experiences at McLeod OB/GYN Dillon and highly recommended the doctors there,” she said. “I really felt like I was in good hands as soon as I entered the offices.”

Throughout her pregnancy, Marie saw the four different providers within the practice. “It really did not matter which doctor I saw -- they all were great,” said Marie.

Several months into her pregnancy, Marie noticed a spot on her foot had started to change. She sought care from Katie Freel Smith, a physician assistant with Dillon Family Medicine.

“She immediately biopsied the spot, and when the results came back I learned it was melanoma, a type of skin cancer,” recalls Marie. The medical team explained to her that the hormones present due to her pregnancy caused the melanoma to grow rapidly. Surgery was required to remove the cancer, and Marie could not put weight on the affected foot during months six through eight of her pregnancy.

“It was a rough couple of months, but I lived through it with prayer and patience,” said Marie.

On August 6, 2014, Marie and her husband, Christian, welcomed their third child, Annabelle Rose Wolfe, to the family. Dr. Marla Hardenbergh delivered baby Annabelle at McLeod Dillon.

“Dr. Hardenbergh was great. Her compassionate bedside manner and confidence made us feel so at ease,” said Marie.

She added that her stay in the hospital was excellent. “All of the nurses were fantastic. They made an extra effort to make sure we were comfortable, offered assistance and always responded quickly when needed. It was also special to share our birth experience with nursing staff that we have known for years, like Tracey Campbell.”

The night before Marie was planning to take little Annabelle home, she developed a horrible headache. “After having an epidural or spinal injection, a patient has a small chance of developing a ‘post-dural puncture’ headache,” explained Dr. Hardenbergh.

Marie remained in the hospital for an additional day for monitoring. As with most post-dural puncture headaches, Marie’s pain subsided when she laid flat. For ten days after leaving the hospital, Marie was on bed rest to alleviate the pain.

“I was fortunate to have round the clock help from family and friends to help care for Annabelle,” she said.

Marie and her family also grew closer to Dr. Hardenbergh during her follow-up appointments. “We developed a friendship with her during this journey, and we are grateful to have found such a highly skilled physician right here in Dillon,” said Marie. “We had a memorable experience at McLeod Dillon and McLeod OB/GYN Dillon. The staff is very caring and took excellent care of Annabelle and me.”

Marie also relied on her strong Christian faith during her pregnancy -- from the shock of pregnancy at an advanced age to the discovery of the melanoma.

“This is a perfect example of how God has a plan for each of us. Annabelle has brought so much joy to our family, and we know He had a hand in this,” added Marie.

 

Eddie and Amy Powers

By Jessica Wall

Eddie and Amy Powers of Effingham, South Carolina, were ecstatic to learn that they were expecting their first child, a baby boy. Amy experienced a normal pregnancy until Saturday, June 13, 2015, eleven weeks before her due date, when she began having contractions. Amy was admitted to McLeod Regional Medical Center on June 15 and developed a fever the next day, indicating a possible infection in the baby, so her physicians induced labor.

On June 16, Amy gave birth to Jackson Alan Powers. Nearly three months premature, Jackson weighed three and a half pounds and measured approximately 15 inches long.

He was immediately transferred to the McLeod Neonatal Intensive Care Unit (NICU).

“Everything was so unexpected,” recalls Amy. “Jackson had so many difficulties from the very beginning. He suffered from seizures, anemia, and an infection, among other things.”

Doctors then discovered that Jackson had an underdeveloped brain and brain stem as well as severe gastrointestinal complications that interfered with his ability to swallow and digest milk.

On July 5, three weeks after Jackson’s birth, physicians briefly removed his breathing tube and gave him oxygen through nasal prongs.

“This was the first, and only, time we heard Jackson cry,” says Amy. “It was a beautiful sound.

Forty-five minutes later, physicians re-intubated Jackson.

During Jackson’s entire stay in the McLeod NICU, Amy supplied breast milk for his feedings.“I had not intended to breastfeed, but because of Jackson’s critical condition, I knew that my milk was the best medicine for him,” says Amy. “Although I was never able to breastfeed Jackson because of his feeding tube, I pumped as much as I could because I knew that was the best thing I could do for him.”

In a hospital, premature infants are vulnerable and exposed -- through their skin, lungs, and digestive system -- to a very unnatural environment where complications can occur. However, a mother’s milk is a vital component for increasing the infant’s immunity to those potential infections or diseases. For this reason, many neonatologists today treat human milk as a “medication” instead of a source of nutrition.

Five weeks into his stay in the McLeod NICU, Jackson continued to experience complications. On July 22, he was transferred to another hospital, where he stayed for another five weeks.August 25 is a day that Amy and Eddie will hold dear forever. It was the first time they saw Jackson open both his eyes.

“I cried as I watched him look up at me like that,” recalls Amy. “I had been waiting for this moment for more than two months.”

However, shortly after this happy moment, Jackson developed Necrotizing Enterocolitis, a serious infection that primarily affects premature babies and babies with very low birth weights, for the third time.

Jackson could fight the infection no longer.

“We lost Jackson on Saturday, August 29, 2015, at 12:30 p.m.,” says Amy. “He was in my arms when he passed, and we have been heartbroken ever since.

“I wish my milk had worked the miracles I was counting on, but God had other plans,” she continues.

After Jackson’s passing, genetic tests revealed that he suffered from pontocerebellar hypoplasia, a rare genetic disorder which affects brain development and often leads to severe complications.

Because of Jackson’s gastrointestinal problems, he was unable to use much of the milk Amy pumped, so when she learned that McLeod Regional Medical Center was a depot site for the Mother’s Milk Bank of South Carolina, she decided to donate her extra milk.

“Eddie and I saw firsthand the importance of human milk, and we wanted to give other babies a fighting chance,” recalls Amy. “We hope that by donating this milk, Jackson’s milk, we can help other babies.”

On November 4, 2015, Amy became the first milk donor to the McLeod Regional Medical Center Depot Site. With Eddie by her side, Amy donated 322 ounces of human milk.

“This is a special moment for us,” says Eddie. “We do this in honor of Jackson.”

 

Bryana Hipkins

By Jessica Wall

The journey to parenthood stirs a myriad of emotions -- joy, anticipation, wonder, and excitement. However, one Myrtle Beach couple, Bryan Hipkins and Jessica Usher, learned firsthand how quickly happiness can give way to fear and worry.

On December 2, 2015, at approximately 25 weeks into her pregnancy, Jessica arrived at a local hospital after her water broke. The examination indicated that Jessica suffered from Preterm Premature Rupture of Membranes (PPROM), or a rupture of fetal membranes prior to 37 weeks.

Because PPROM can lead to serious complications for both the mother and baby, including an increased risk of intrauterine infection and preterm delivery, Jessica’s physician ordered her transfer to McLeod Regional Medical Center.

McLeod Regional Medical Center offers specialized women’s and newborn care, including the Level III Neonatal Intensive Care Unit (NICU), the only NICU in this region.

PPROM occurs in three to 19 percent of pregnancies and accounts for nearly 30 percent of preterm deliveries, according to Dr. John Chapman of McLeod OB/GYN Associates. Risk factors of the condition include: history of preterm births, amniotic fluid infection, multiple fetuses and prior history of PPROM.

On December 7, at 26 weeks and four days, Jessica underwent a C-section, performed by Dr. Chapman, and gave birth to Bryana Renee, who weighed just two pounds and seven ounces.

McLeod Neonatologist Dr. Tommy Cox, along with several members of the NICU team, accompanied the labor and delivery team to prepare for Bryana’s immediate transition to the unit after birth.

Bryana required a ventilator for breathing support and then quickly progressed to needing oxygen only through nasal prongs.

“Seeing our daughter lying in an incubator brought us to tears,” recalled Bryan. “My 11-month tour in Afghanistan as a member of the Army did not even compare to our NICU journey.”

Shortly after Bryana’s birth, Bryan and Jessica held her for the first time.

“Bryan and I felt overwhelmed, and a bit nervous, holding this tiny baby in our arms,” said Jessica. “We will treasure that moment forever.”

They also experienced Kangaroo Care, or skin-to-skin contact, with their daughter. Kangaroo Care involves the nurses putting Bryana directly on her mother’s and father’s chests.

Kangaroo Care not only promotes bonding between the parents and their baby, but also regulates the baby’s body temperature and encourages a smoother transition to breastfeeding.

On December 21, at two weeks old, Bryana received her first echocardio gram. The exam revealed Patent Ductus Arteriosus (PDA), a congenital heart defect common in premature infants where the blood vessel connecting the heart’s two major arteries does not close after birth, allowing blood to flow into the lungs. This adds stress to the heart and if left untreated, can lead to congestive heart failure.

Dr. Cox consulted with McLeod Pediatric Cardiologist Dr. Charles Trant , and the two physicians initiated multiple trials of medication to close the PDA, but Bryana continued to struggle.

Consequently, she underwent a PDA ligation, a surgical procedure which involves closing the open PDA with stitches or clips, at a facility where these types of specialized surgeries are performed.

“Besides the PDA, Bryana fared well compared to most babies born at 26 weeks,” explains Dr. Cox. “Fortunately, Bryana developed none of the other major complications associated with prematurity such as retinopathy of prematurity (visual disturbance), necrotizing enterocolitis (GI problems), or -- the most feared -- Intraventricular Hemorrhage (IVH), also known as a brain bleed.

“We avoided these complications, in part, due to the infection control initiative undertaken by McLeod approximately ten years ago,” continues Dr. Cox. “Anyone who comes into contact with an infant in the NICU -- staff, parents, family -- must wash their hands for three minutes. Other measures include using sterile alcohol before touching an infant, cleaning the infant’s space every day, and removing intravenous (IV) lines as quickly as possible to reduce the risk of a bloodstream infection.

“The combination of these efforts allows our infants a greater chance to thrive.”

On March 25, 2016, after 109 days in the hospital, Bryana went home.

“As first-time parents, we expected to take our baby home with us right after her birth,” said Bryan. “We did not expect her to remain in the hospital. However, the NICU staff treated us -- including Bryana -- as part of their family. We appreciate their care and support, and we feel incredibly blessed to have a happy, healthy daughter.”

Today, Bryana continues to thrive. Now attempting to sit up, she weighs 13 pounds and brings joy to everyone around her

For 12 years, Jessica has raised funds for McLeod Children’s Hospital and Children’s Miracle Network Hospitals (CMNH) as an Associate at Walmart Supercenter in Surfside (Store #574). Only now does she fully realize the impact of these funds in providing compassionate care to children

“In all the years of fundraising for McLeod Children’s Hospital and CMNH, I never understood how the money directly supported pediatric patients,” says Jessica. “However, after the birth of my daughter, I not only learned firsthand how our efforts impact the children treated at McLeod, but also gained a deeper appreciation for having a Children’s Hospital so close to home.”