healthy spring

Before the Bump

By Kristen Carmichael, MD and Myesha Johnson, APRN, WHNP-BC

Deciding that you’re ready to start or grow your family is an exciting time, filled with emotions and uncertainties. The first step has been taken; you’ve decided it’s time for a baby! Now what? When and how do I stop using my birth control? How quickly will I become pregnant once I’ve stopped use? Is my age going to be a problem? You’re probably wondering about all of this and more! Scheduling a preconception counseling appointment with your OB/GYN provider to discuss all your concerns is the next step toward achieving pregnancy. Not only will you be able to get answers to your questions, but your provider will have particularly important information to share to get your pregnancy off to a great start, before the bump.

Why consider preconception counseling?

The first eight weeks of fetal development are crucial.  Major organs and body systems have started to take shape.  Often, the first prenatal care appointment (the 1st visit after you find out that you are pregnant) doesn’t take place until 8-10 weeks gestation.  Knowing how to be your healthiest before you conceive means that during the first eight weeks of pregnancy, your baby’s most important stages of development are taking shape in an optimal environment.

What can I expect during my preconception visit?

Your provider will want to review your full medical history.  This includes discussing medications you may take for conditions such as asthma/allergies, diabetes, high blood pressure and depression/anxiety.  Health conditions like these can affect pregnancy, and you will want to discuss how to improve those conditions with your provider. Most medications for such health conditions should be continued until your first prenatal care appointment where your provider will discuss adjustments, if needed.  It is also a good time to discuss the safety of common over the counter medications and supplements you may be in the habit of using.

A discussion regarding your current birth control method will be an important item on the checklist.  This is a good time to talk about expectations about how quickly you may be able to conceive once you discontinue use.  The majority of hormonal birth control methods do not impact your ability to conceive.

Reviewing your vaccination schedule is important, and your provider will address this at a preconception visit as well.  There are some vaccines that should not be given during pregnancy, and you should be careful to avoid pregnancy if a vaccine has been administered recently or needs to be given to get you up to date.

If you’ve been pregnant in the past, your provider will want to review the details of your past pregnancies and deliveries.  If a complication arose with a prior pregnancy, discussion with your provider may help reduce the risk of the same scenario occurring in future pregnancies.

While it can be a bit awkward, be prepared to discuss your sexual history.  If you’ve ever been diagnosed or treated for a sexually transmitted infection (STI), it is important to share this information.  You may be encouraged to be screened for STIs, so any potential infection that is harmful to pregnancy can be addressed prior to conception.  You and your partner will also be asked to discuss your family health history. Your provider will want to know if there are genetic risk factors to consider, and if pertinent, she will counsel you about disorders that could potentially affect your baby.

What changes should I make before trying to conceive?

During a preconception counseling visit, your provider will discuss some important lifestyle factors to consider as you begin trying to conceive.  A healthy diet is key to providing your soon to be baby with good nutrition for growth and development. Adding an over the counter prenatal vitamin or folic acid supplement to your daily routine will greatly reduce the risk of birth defects and add essential vitamins and minerals that you may not get from your diet.  Women of childbearing age should get at least 400 mcg of folic acid daily. Eat a colorful diet with fruits and vegetables of all colors for maximum nutrition and keep sugars and fats to a minimum.

Stay active!  The exercise habits you have prior to pregnancy are safe to continue during pregnancy and encouraged to help maintain a healthy weight.  Being overweight poses an increased risk for developing high blood pressure, diabetes and can lead to complications at the time of delivery.  If you’re not regularly active and are concerned about your weight, discuss ways to improve with your provider.

If you smoke, make every effort to quit before you become pregnant.  Smoking increases the risk of preterm birth and low birth weight infants.  Keep alcohol to a minimum as you begin trying to conceive and stop drinking alcohol as soon as you discover you’re pregnant.  There is no way to study the effects of alcohol on pregnancy or to know for sure how much alcohol causes harm. For that reason, your provider is likely to instruct you not to drink once you’ve conceived.

Good Luck!

If you and your partner need a preconception visit, don’t hesitate!  Dr. Kristen Carmichael is located on the campus of Medical City Las Colinas at 6750 N. MacArthur Blvd, Ste. 304, Irving, TX 75039 and can be reached by phone at 972-247-8757.  Dr. Carmichael supervises Myesha Johnson, MSN, RN, WHNP-BC, a nurse practitioner specializing in women’s health care. They are excited to help start you off on a healthy journey to parenthood!




About Dr. Carmichael

Dr. Kristen Carmichael is an OB/GYN with the Medical & Surgical Clinic of Irving.  After completing her undergraduate degree at Southern Methodist University in Dallas, TX, she went on to attend medical school at the University of Texas in Houston.  She has been in private practice since 2004.  She is a member of the American College of Obstetrics and Gynecology, the American Medical Association, the Texas Medical Association, and many other organizations.  Dr. Carmichael has been awarded the Best OB/GYN in Las Colinas, Coppell, and Irving and has been recognized as a Mom-Approved Doctor by DFW Child.   She loves helping her patients achieve their best health and is most satisfied when they feel educated, engaged and empowered in their healthcare.


About Myesha

Myesha Johnson works with Dr. Carmichael and has dedicated her professional career to helping women achieve their best health by providing the best care she can offer and taking an interest in the needs of her patients. Myesha holds a Bachelor of Science in Nursing and Master of Science in Nursing from The Ohio State University in Columbus. She makes it her priority to provide her patients with quality care and attention. Women’s health issues can be stressful, but Myesha does her best to answer any questions and guide women to achieve their best health.


18 Reasons to See an OB/GYN in 2018

Written by Dr. Kristen Carmichael

Resolutions are made at the beginning of every new year, and a lot of people tend to put health-related goals on their list of what they would like to achieve.  Annual physical exams are one of the ways women can maintain their New Year’s resolutions.  More specifically, having an annual women’s health check-up with an OB/GYN is a great way for women to monitor their health and well-being, and ensure they are being treated properly for any conditions that may arise throughout their lifetime.


There are multiple reasons why seeing an OB/GYN should be a goal for you during 2018.  Whether you want advice on waiting to start a family or if you are ready to have children right away, an OB/GYN can guide you through a wide-variety of women’s health issues, including those completely unrelated to child-bearing or pregnancy prevention.


Let’s take a look at 18 reasons why it is important for women to see an OB/GYN in 2018.

Women’s Health

(1) It may not be common knowledge that OB/GYNs can administer their own vaccinations.  You can actually get vaccines from your women’s health physician for human papillomavirus (HPV), the flu, and other viruses/conditions.

(2) Your OB/GYN can also help with weight management issues and discuss options of diet and exercise that are best tailored to your individual physical fitness level.

(3) If you have any issues with vaginal itching, dryness, discharge, or odor, these are all medical conditions that your OB/GYN will know about and can help you with proper treatment.

(4) Urinary tract infections (UTIs) are common in women due to bacteria getting into the urethra after sexual intercourse.  Your OB/GYN can provide you with tips on preventing UTIs and provide you with medication to help your system rid your body of the infection.

(5) Cancer screening can be done during an OB/GYN visit. Learn about how to test for and decrease your chance of ovarian, uterine, and cervical cancers as well as colon cancer and breast cancer, which is the second most common cancer in American women.

(6) You can also have your annual health screening conducted with an OB/GYN.  They can test for high blood pressure, diabetes, and even bone density if it is something that applies to you.

(7) Many women battle with depression, and this is something your OB/GYN can discuss with you as you talk through the severity of your symptoms and how often they occur.

The Menstrual Cycle

(8) Problems with menstrual periods are another issue you can always discuss with your OB/GYN.  Your doctor can educate you about what your first period will be like if you haven’t had one yet, ways to improve heavy or irregular periods, and  changes to look for during your monthly period that may be abnormal.

(9) Your OB/GYN can also provide you with remedies for painful periods.

(10) Your physician is also a great resource for discussing premenstrual syndrome (PMS) symptoms.  These symptoms vary among women, and you can talk with your doctor about solutions that work best for you.

Sexual Relationships

(11) The topic of sex can be openly discussed with your OB/GYN.  Your physician can explain what happens during intercourse, what may be causing pain during intercourse, and how hormonal changes can affect discomfort during sexual activity.

(12) Your OB/GYN can also discuss the ways to have safe and healthy sexual relationships with your significant other.

(13) Preventing sexually transmitted infections (STIs) is very important. You should discuss with your doctor what steps you can take to lower your risk of becoming infected with an STI or with human immunodeficiency virus (HIV).

(14) Your OB/GYN can also administer a test for STIs and HIV if you are sexually active and would like to be tested.

Preventing Pregnancy and Getting Pregnant

(15) Seeing an OB/GYN gives you the opportunity to discuss birth control options with your physician.  OB/GYNs can help you determine which is the best method for you and your body, whether it be a pill, a patch, an implant, an intrauterine device (IUD), or another option.

(16) When you are ready to get pregnant, it’s important to discuss with your physician what steps to take to ensure a healthy and safe pregnancy.

(17) Your OB/GYN can also conduct an official medical test to determine if you are pregnant.

Menopause and Post-Menopause

(18) An OB/GYN physician can also help you with the challenges you are experiencing during the menopausal and perimenopausal stages of your life.  Vaginal dryness, hot flashes, and irregular bleeding are all issues that should be discussed with your physician.  There are a variety of treatment options available to ease these common problems.


As you can see, there are plenty of reasons to make seeing an OB/GYN in 2018 a top priority on your list of resolutions for a healthier 2018.  Make sure you get your annual exam scheduled with your OB/GYN.  If you do not have one, Dr. Kristen Carmichael at the Medical & Surgical Clinic of Irving is accepting new patients and is happy to welcome you into her office.




About Dr. Carmichael

Dr. Kristen Carmichael is an OB/GYN with the Medical & Surgical Clinic of Irving.  After completing her undergraduate degree at Southern Methodist University in Dallas, TX, she went on to attend medical school at the University of Texas in Houston.  She has been in private practice since 2004.  She is a member of the American College of Obstetrics and Gynecology, the American Medical Association, the Texas Medical Association, and many other organizations.  Dr. Carmichael has been awarded the Best OB/GYN in Las Colinas, Coppell, and Irving and has been recognized as a Mom-Approved Doctor by DFW Child.   She loves helping her patients achieve their best health and is most satisfied when they feel educated, engaged and empowered in their healthcare.

breast cancer

The Importance of Breast Cancer Examinations

October is National Breast Cancer Awareness Month, and our clinic in Irving is doing its part to raise awareness on this terrible disease. Breast cancer will affect nearly 1 in 8 women in their lifetimes. Each year, doctors diagnose nearly 250,000 cases of breast cancer, one of the leading causes of death in women. Regular breast examinations can go a long way in helping to detect breast cancer early so that doctors can provide you with the best treatments.

Women should also schedule regular appointments with our Irving doctors. On top of simply checking your overall health, doctors will ask you questions and look for any indicators of cancer as well as other common diseases. A great tip for women and men alike is to schedule a doctor’s appointment for the same day near your birthday. That way, you never forget to see the doctor and you can go through the year feeling confident about your long-term health.

Women can conduct breast cancer self-examinations at home. Breast examinations should be conducted in two ways: by look and feel.

Look: using a mirror, inspect the breast for odd colorings, visible lumps, pulls, or dents. You should examine your breasts from a few different angles. Lean forward, put your arms on your hips, stand upright, and stand with both arms above your head. If you are uncertain exactly what you are looking for, you can compare one breast to the other, as they should look similar.

Feel: most women tend to conduct this part of the exam in the shower, as the water helps fingers move easily across the skin. Women should try to feel for any lumps, pain, or tenderness. When feeling for abnormalities, use the pads of the fingers and not the tips. Women should also try to feel their breasts in a few different angles, and check different parts of the breasts.

A few other things to remember: any abnormality of the nipple should be cause to see a doctor; because there is not much tissue underneath the nipple, a lump there should be cause for concern. Discharge of the nipples may also be cause for concern; however, consult with your doctor, as this is not always a sign of cancer. When in doubt, always talk to your doctor. It is better to be safe than sorry when it comes to cancer.

Women should conduct a self-examination every month. However, self-examination is not a substitute for a mammogram. Women should still regularly see their doctor for a mammogram, as this procedure offers much more certainty.


Prenatal Health Tips: How to Improve Life Before Birth

Parents want the best for their children, but did you know that scientists, doctors, and researchers are discovering ways that mothers can help their children before they’re even born? The latest prenatal health tips and studies are demonstrating that a mother can give their children a positive start by choosing healthy habits and taking care of herself.

In a study conducted by King’s College London, researchers discovered that women who displayed signs of depression during their pregnancy were likely to give birth to children who scored lower on cognitive tests later in life (specifically, researchers surveyed test scores of children at 8 years  of age). Researchers also found a link to a mother’s nutrition and her children’s cognitive functions.

The study looked at nearly 7,000 mothers and their children; each pair was looked at 5 times, starting at 18 weeks before birth and when the child turned 33 months old. During this time period, mothers were asked to complete a food questionnaire to also see how their diets may have effected their children. What researchers found was that mothers who improved their diets not only had a chance to ease symptoms of depression, but also helped “reduce risk for atypical fetal development,” according to lead author Edward D. Barker.

A different study, led by Felice Jacka from Deak University and University of Melbourne, supports these findings and establishes “a link between poor prenatal diet and behavioral problems in children.”

Researchers caution that until more tests and research are conducted, researchers can only claim correlation between nutritional health, depression, and child development. They also temper the findings by saying that a child’s development is not necessarily severely hindered by a mother’s depression or nutritional diet.

Regardless, mothers expecting a child will gain a better quality of life by being proactive with their mental health and eating a good diet, packed with nutrient-rich foods and avoiding excessive amounts of salt, bad fats, and sugars. Mothers might help their child get a better start and also enjoy the benefits of a healthier lifestyle.

Expecting a child? The OB GYNs at MSCI can help you make the right prenatal health decisions during your pregnancy. Contact our physicians today and schedule an appointment.