Tag Archives: Orange County

Gynecology Robotic Surgery is the Future | Fullerton, CA

Pure, Natural, BeautyGynecology robotic surgery is robotic assisted surgery for several gynecological conditions. Using a robot, this enables the doctors of Gunn Center in Fullerton, CA to perform the surgery with the utmost control and precision and with only a few small incisions.

Gynecology robotic surgery can be used for the following conditions:

  • Ovarian cysts and masses
  • Fibroids
  • Prolapse of pelvic organs
  • Cervical cancer
  • Endometrial cancer
  • Some endometriosis
  • Ask your doctor about the many other procedures offered

Robotic surgery is less evasive than traditional surgery that involves making a large incision in the abdominal area. The benefits of a smaller incision are less pain during recovery, less scarring and quicker recovery time.

Surgery doesn’t have to be complicated, contact Dr. Gordon Gunn to learn more about the treatment options available at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.

Urinary Incontinence in Women | Fullerton, CA

iStock_000000705315MediumFor a conservatively estimated 10 million Americans (85% of whom are women), incontinence of urine is socially embarrassing, physically limiting, or a significant disability. In fact, after psychiatric and neurological disorders, the uncontrollable or accidental loss of urine is the second most common reason individuals are placed in nursing home facilities. The true number of non-institutionalized women who have quietly altered their lives because of accidental loss of urine is actually unknown because they are reluctant to discuss their disability. Women are frequently embarrassed and hesitant to admit their problem to their family, friends or even to their personal physician. Among women, between ages of 45-64, 40% are estimated to have experienced incontinence of urine. Women often perceive that their problem is a normal result of bearing children and getting older, and therefore just cope with it. However, they also limit exercising, dancing, traveling and other activities, which would otherwise require them to be away from nearby toilet facilities. They frequently will change the style of clothes they wear to avoid embarrassment. I want my patients to know that urinary incontinence is a symptom of a condition, which is not normal and usually can be successfully treated to restore normal bladder function.

The U.S. Department of Health and Human Services estimates the annual direct cost of care for persons with urinary incontinence to exceed $10 Billion, 70% of which is spent for persons who are not in nursing home facilities. Over one-third of the female sanitary pad market is for coping with incontinence of urine and not menstruation. Product advertising frequently focuses on coping or hiding the problem rather than education and treatment. Regardless of the cause of urinary incontinence, this problem can be cured or significantly improved in most cases.

In women, the most common type of urinary incontinence is called urinary stress incontinence or USI. USI occurs when there is a sudden increase in abdominal pressure during certain activities such as laughing, coughing, sneezing, running, bending, lifting, etc. The primary cause of the problem is a weakness of the pelvic tissues (called prolapse), which normally supports the bladder (called cystocele) and its sphincter. The amount of urine loss with each episode of stress, varies with the degree of weakness, the volume of urine in the bladder, and the intensity of the abdominal pressure. The correction of USI is usually surgical restoration of the prolapse supporting pelvic tissues to a normal position so the bladder sphincter mechanism can function properly.

Another type of urinary incontinence is urge incontinence, in which women perceive the urgent need to urinate, rush to the bathroom, and fail to get there in time. The amount of urine loss can vary with the cause of the urge, the volume of urine in the bladder, and the strength of the pelvic tissue. Urgency and urge incontinence are often associated with frequent urination (called frequency) and getting up at night to urinate (called nocturia). Women who regularly experience urgency and frequency, with or without nocturia, have what is called urinary urgency syndrome, with or without incontinence.

The causes of urinary urgency syndrome can be both physical and non-physical. The most common physical cause is infection of the bladder (cystitis) and/or urethra (urethritis), and it is corrected with treatment of the infection. There are other causes such as chronic inflammation of the bladder, polyps or tumors and certain medications. When no physical cause can be found after a complete medical evaluation, the cause is usually a result of a learned habit. Treatment may include medications, bladder retraining programs and pelvic floor muscle exercises (Kegel Exercises).

Mixed urinary incontinence is a combination of both stress and urge incontinence. Often a woman experiencing USI “learns” that if she empties her bladder more frequently, she will be less likely to leak as much urine. Unfortunately, over time the awareness of having a “full bladder” occurs with an ever-decreasing capacity of urine, and she will urinate at more frequent intervals. When the stress component of her incontinence is surgically corrected, she can then retrain her bladder so she will choose when to go to the bathroom. In postmenopausal women, Estrogen replacement therapy will improve the elasticity of the vagina, bladder and urethral tissues, and improve both stress and urgency symptoms.

There are other less common, but important types of urinary incontinence:

Overflow incontinence is a frequent spilling of small amount of urine when the bladder is over-distended, and can occur with certain medications, after pelvic surgery or trauma.

Reflex incontinence is the loss of urine when the person is completely unaware of the need to urinate, such as while sleeping or washing their hands. This type of incontinence may indicate an underlying neurological disorder.

The first step in correcting urinary incontinence is sharing the problem with your physician. Before your visit, you will be given a “Patient History for Urinary Function”. This form should be completed prior to your office consultation. You may also be given a two-day “Voiding Diary” to record the amount of liquids you drink and the number of times and amount you urinate during the day and night. You will also list the circumstances under which you regularly experience urinary urgency or incontinence. After your patient history, physical examination and voiding diary is completed and reviewed, simple office tests are performed which will further identify the primary cause of your incontinence. Once the cause (or causes) is determined, the proper treatment and alternative will be recommended and explained.

Treatment begins with having a thorough understanding of normal urinary function, the cause of your urinary problem, and your treatment alternatives. Successful treatment is a patient-physician team mission, and is an achievable goal.

Contact Dr. Gordon Gunn today at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.

 

Timed Voiding Bladder Program | Overactive Bladder | Fullerton, CA

iStock_000005142700SmallThis is an important part of your bladder-retraining program. When followed consistently you will have significantly improved control over your urgency symptoms, including any urge incontinence. This program started when you monitored the amount and the type of fluids you consumed each day in your Voiding Diary. A normal fluid intake is between 1500-2000 cc (50-70 oz.) per day, which should produce 1200-1500 cc (40-50 oz.) of urine output. The normal bladder capacity before you feel any sensation of urge is about 300 cc (10 oz.). Normal voiding volumes are 210-300 cc (7-10 oz.) with the first morning voiding usually being the largest at 400-500 cc. Your Voiding Diary record will have indicated if any modification is required in the volume or type of fluids you drink.

Your goal with the Timed Voiding Program is to increase your bladder’s capacity and prolong the time interval between urinating up to a minimum of three or more hours. The initial time interval between urinating will be determined by the frequency of urination as recorded in your Voiding Diary.

Attached is a “Voiding Chart for Bladder Retraining” on which you will chart your daily progress for the first week. [Please make five additional blank copies of the Voiding Chart to insure you have a total of six weekly charts.] The Chart is a daily record of your Scheduled (predetermined voiding interval), Unscheduled (when you are unable to suppress the urge without the risk of accidentally urinating), and accidental.

Follow the instructions on the chart as indicated: (incontinence) urinating episodes.

  • Fill in the following on each sheet: Your Name, Date, and Voiding Interval (Hrs.) at the beginning of each
  • Fill in the time for any of the types of urinating (Scheduled, Unscheduled, or Accidental) and place a check mark in one of the three columns:
  • Dark Gray Column: Urinating at the Scheduled Time.
  • Light Gray Column: Urinating at any Unscheduled Time. (when you cannot suppress the urge)
  • White Column: If you Accidentally urinate (incontinence incident), place a checkmark at the time it occurred and add a “D” for Damp or “W” for Wet beside the check mark to indicate the relative amount of urine loss.

Keep your Chart nearby along with a pencil and a clock or timer. Most importantly, maintain your determination to stay with this six-week program.

For more information on overactive bladder or any bladder or bowel incontinence problems you may have, Contact Dr. Gordon Gunn today at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.

Don’t Let an Overactive Bladder Take Control of Your Life. | Fullerton, CA

iStock_000014235018SmallHaving an overactive bladder can be distressing. It can ruin daily plans and interrupt sleep. Not sure if you have an overactive bladder? Below are some symptoms that can help you determine if you have an overactive bladder:

  • Sudden and overpowering urge to go to the bathroom
  • Leaking accidents if you can’t reach the bathroom in time
  • Having to go frequently day and night
  • Getting up more than 2 times a night to go to the bathroom
  • Little warning time before feeling you have to urinate
  • Have anxiety about having a wetting accident
  • Using Pads or devices to protect from wetting accidents

Does your constant urination give you fears of going on long trips or family outings? Do you find it hard to sit through an entire movie without going to the bathroom?  Don’t suffer with this affliction.

Contact Dr. Gordon Gunn to learn more about the treatment options available at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.

How Can I Control My Fecal Incontinence? | Fullerton, CA

iStock_000014233903XSmallLiving with fecal incontinence can alter your daily life. However there are steps you can take to help keep it under control. Keeping a food diary is good start. Being able to see what foods you have eaten and how much you have eaten could help you pin point the foods that could be causing a fecal incontinent episode. Many foods cause diarrhea and should be avoided if at all possible. Some of these foods are:

  • Fatty, greasy foods
  • Caffeinated drinks
  • Spicy foods
  • Dairy products
  • Cured meats
  • Alcoholic beverages
  • Artificial sweeteners

When eating, keep it to several small meals instead of few large ones. Big meals cause bowel contractions that tend to cause diarrhea. Don’t drink liquids with your meals. Liquids are what help food process through the digestive system. This tactic will help slow digestion down. However, don’t stop drinking liquids all together. Drinking plenty of water helps to keep stools formed and prevent dehydration which leads to diarrhea.

When preparing your meals, try to include foods that will bulk up your stool. Look for foods that contain soluble or digestible fiber. This includes, bananas, rice, potatoes, cheese, oatmeal, peanut butter, yogurt, pasta, bread and applesauce.

These simple changes to your diet and eating habits could change your daily suffering with fecal incontinence, contact Dr. Gordon Gunn today at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.

Timed Voiding Bladder Program | Fullerton, CA

A loving grandparentThis is an important part of your bladder-retraining program. When followed consistently you will have significantly improved control over your urgency symptoms, including any urge incontinence. This program started when you monitored the amount and the type of fluids you consumed each day in your Voiding Diary. A normal fluid intake is between 1500-2000 cc (50-70 oz.) per day, which should produce 1200-1500 cc (40-50 oz.) of urine output. The normal bladder capacity before you feel any sensation of urge is about 300 cc (10 oz.). Normal voiding volumes are 210-300 cc (7-10 oz.) with the first morning voiding usually being the largest at 400-500 cc. Your Voiding Diary record will have indicated if any modification is required in the volume or type of fluids you drink.

Timed Voiding Bladder Program

Your goal with the Timed Voiding Program is to increase your bladder’s capacity and prolong the time interval between urinating up to a minimum of three or more hours. The initial time interval between urinating will be determined by the frequency of urination as recorded in your Voiding Diary.

Attached is a “Voiding Chart for Bladder Retraining” on which you will chart your daily progress for the first week. [Please make five additional blank copies of the Voiding Chart to insure you have a total of six weekly charts.] The Chart is a daily record of your Scheduled (predetermined voiding interval), Unscheduled (when you are unable to suppress the urge without the risk of accidentally urinating), and Accidental

Follow the instructions on the chart as indicated: (incontinence) urinating episodes.

  • Fill in the following on each sheet: Your Name, Date, and Voiding Interval (Hrs.) at the beginning of each week.
  • Fill in the time for any of the types of urinating (Scheduled, Unscheduled, or Accidental) and place a check mark
  • Dark Gray Column : Urinating at the Scheduled Time.
  • Light Gray Column: Urinating at any Unscheduled Time. (when you cannot suppress the urge)
  • White Column: If you Accidentally urinate (incontinence incident), place a checkmark at the time it occurred and add a “D” for Damp or “W” for Wet beside the check mark to indicate the relative amount of urine loss.

Keep your Chart nearby along with a pencil and a clock or timer. Most importantly, maintain your determination to stay with this six-week program.

Contact Dr. Gordon Gunn today at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.

Your Bladder | Accepting Patients in Brea, CA

iStock_000008712786SmallUrinary urgency is the sudden, overwhelming feeling of the need to urinate. Urinary urgency can disrupt sleep, work, sexual activity, relationships and social interaction. Women who frequently experience urinary urgency usually knows where the nearest bathroom is located (toilet mapping). When the urge strikes they rush to the bathroom and the uncomfortable urge sensation is relieved. If they fail to get there in time, an accidental loss of urine may occur and is referred to urinary urge incontinence. The loss of urine can vary between a few drops to a large amount. Urgency and urge incontinence are often associated with the need to urinate more frequently (frequency of more than eight times per 24 hours), and the need to get up at night to urinate (nocturia). Women who regularly experience urinary urgency and frequency (with or without nocturia or incontinence) have a condition called urinary urgency syndrome (also called overactive bladder or OAB). Their daily lives are influenced, and frequently controlled, by their bladders. These symptoms can lead women to change behaviors and adopt preventive coping mechanisms, such as limit daily travel, quit exercising and dancing, reducing fluids, avoiding sexual intimacy, and wearing pads or adult diapers.

Urinary urgency can be caused by two general categories of disorders: Physical and Habitual
Physical Causes of Urinary Urgency
1. Infection in the bladder or urethra
2. Polyps or tumors in the bladder or urethra
3. Caffeine, citrus juices and alcohol
4. Diabetes Mellitus
5. Interstitial cystitis
6. Neurologic disorders (multiple sclerosis, Parkinson’s disease, spinal cord trauma)

Physical causes can usually be diagnosed with office testing called urodynamics. Actual bladder contractions (called motor urgency or detrusor instability) are usually due to a specific physical disorder. Treatment is directed at both the cause and symptoms.

Habitual
The normal bladder will hold at least 15 oz. (450 cc) of urine. When your bladder is “full”, you feel the urge to urinate. However, you should normally be able to suppress that urge, until it is convenient to go to the bathroom. The brain initiates the process of urinating after you are sitting on the toilet by sending nerve impulses to the urethra to relax and to the bladder to contract. When the pressure within the bladder exceeds the pressure in the urethra, urine flows (hopefully into the toilet).

If the bladder contracts abnormally (bladder instability), a sudden increase in pressure within the bladder signals the brain to start the voiding reflex. A sense of urinary urgency may occur and if the pressure in the bladder exceeds that in the urethra, loss of urine will occur. When there is no physical cause of urgency (habit), there usually is no increase in bladder pressure. However, the brain can learn to associate specific actions, places or times with the feeling of the need to urinate. However, it is usually not associated with a bladder contraction or with a full bladder.

Most commonly, urinary urgency or overactive bladder develops gradually over time. It is frequently associated with stress urinary incontinence (loss of urine associated with sudden increases in abdominal pressure, such as coughing, sneezing, laughing, running, etc.). Patients may learn that voiding more frequently may decrease the amount or urine loss with stress incontinence episodes. Often the sudden onset of urinary urgency can be associated with a specific activity; i.e., driving into your driveway at home, inserting your house key into the door lock, putting your hands under running water, or even seeing a bathroom. In most cases, the bladder function is normal and the brain is sending false messages (sensory urgency).
Completing a Urinary Incontinence Questionnaire and a 24-hour Voiding Diary, a pelvic floor physical examination and simple office bladder testing (Urodynamics) can usually establish a definite diagnosis. Correction of habitual urinary urgency involves a bladder-retraining program. Surgery is rarely indicated.

Treatment of Habitual Urinary Urgency and Incontinence:
The goal of a bladder-retraining program is to regain control and not be a victim of your bladder. This will always include the first two listed below.
1. Awareness and Refocusing:
Bladder retraining begins with understanding the mechanism of urinating (discussed above) and reconditioning the urgency reflex. Postponing the act of urinating without leaking any urine can be achieved with changing your focus whenever the urge to urinate strikes. Consider taking the following steps:
(a) When the urge strikes, stay still and do 3-4 ‘Slow Twitch’ Kegel pelvic contractions AND
(b) Visualize walking slowly to the bathroom to perform any task other than
(c) Then, act out your visualization sitting on the toilet (i.e. adjusting the towels, sorting the medicine cabinet, etc.)
(d) After you have completed your task, proceed to use the toilet. thinking of the act of urinating.
Simply put: this mental refocusing along with the pelvic contractions will delay your brain from sending impulses to your bladder and urethra until you are actually ready to urinate.

2. Pelvic Floor (Kegel) Exercises – this program of strengthening your pelvic floor muscles should be a part of your normal urinating routine and is performed every time you finish urinating Refer to article entitled ‘Kegel Exercises – How to Strengthen Your Pelvic Muscle’.

When these two steps are not as successful as you wish, then the following programs may bring success.
1. Medications – various drugs that relax your bladder may be used to relieve the sense of urgency. These can cause a sense of dryness in your mouth. If this side effect occurs, suck on hard candy rather than drink excessive fluids. Common medications include Detrol LA 4 mg., Ditropan 5, 10, 15 mg, Vesicare 5, 10 mg,
2. Time Voiding Program – this is a program in which you will be urinating at fixed time intervals and doing your best to suppress the urge to urinate until the next scheduled time.
3. Pelvic Floor Electrical Stimulation – this is a device, which is inserted into the vagina and painlessly causes your pelvic floor muscles to contract. This program is used only after the other programs have been tried and your urinary urgency symptoms persist.
4. Biofeedback – a program designed to help you suppress the urge and postpone urinating.

Contact Dr. Gordon Gunn today at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.

Urinary Tract Infections: Diagnosis, Treatment and Prevention | Fullerton, CA

Branch of dogwood blossoms against a dark backgroundEvery year, over 11 million women develop a urinary tract infection, (also known as a UTI, a bladder infection or acute cystitis). These infections are more common in women than men, primarily due to the normal female anatomy, with the urethra (tube leading from the bladder to the outside), located very close to the vaginal opening. This allows bacteria from the vagina, and especially the rectum, to enter the bladder, and subsequently cause an infection. Sexual activity is the most common cause for developing a UTI, but pregnancy, advancing age, lack of estrogen, and diabetes are common contributing factors for developing these infections.

Typical symptoms from a UTI, are pain with urination, frequent urination with the urgency to void, and possibly pelvic pain or pressure. More severe symptoms are a general ill feeling with fever, and possibly even confusion. However, it may be possible not to have any symptoms at all, which is why your urine is usually tested at the time of your routine office visit.

To properly diagnose a UTI, a urine sample can be quickly assessed in the office to confirm the presence of bacteria or its by-products. The healthcare practitioners will presumptively treat an infection with antibiotics, but a culture of your urine is required to determine the exact type of bacteria present, as well as to ensure that the bacteria has not developed resistance to the antibiotic prescribed. This test usually requires 48 hours for the laboratory to complete. If the practitioner determines that you need to be placed on a different antibiotic, you will be notified as soon as possible. The length of treatment is determined by the severity of the infection, or if you have any underlying medical conditions which could make curing the problem more difficult. You may also be given another medication along with the antibiotic, which acts as a “bladder anesthetic” to relieve the discomfort as the antibiotics begin to work. Another option is to add a teaspoon of baking soda to half of a glass of water, and drink this twice a day.

The risk of not treating a bladder infection can result in the infection ascending into your kidneys, and possibly damaging these vital organs. Treatment of these serious infections may require hospitalization for intravenous antibiotics.

Recurrent UTI’s (more than 3 per year) can be a symptom of a more serious problem that will require further investigation. However, even after an extensive evaluation, some women are simply more prone to infections, and “prophylactic” antibiotics may be used to limit the return of an infection.

For women who are more prone to bladder infections, prevention is key:

• Women who are sexually active should void both before and after intercourse to limit the amount of bacteria in the bladder. Also, some lubricants, oils and spermicidal jelly may also make an infection more likely.

• Voiding regularly throughout the day (every 2 to 3 hours), will limit the amount of bacteria in the bladder. You should also ensure that you empty your bladder completely, and if needed, by “double voiding” (urinate normally, stand up, then sit down again and attempt to finish emptying your bladder)

• Drinking an adequate amount of liquids will continually wash out the bladder. Water is preferred, as soda, coffee and tea may make it more likely to get an infection.

• After a bowel movement or urinating, wipe from the front of the vagina to the back toward the rectum, away from the urethra.

• Frequent changing of sanitary napkins or tampons can limit infections.

• Avoiding hot tubs or highly chlorinated pools, as well as removing your wet swimsuit as soon as possible, can also limit bacterial exposure.

• Cranberry juice and cranberry pills (no calories) have been proven to reduce UTI’s.

 

Contact Dr. Gordon Gunn today at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.

 

 

 

Women at a Greater Risk for Heart Disease than Men | Fullerton, CA

iStock_000004537186SmallMost people think that heart disease is a problem only for men. However, more woman than men dies from heart disease every year. Woman need to understand their risks and symptoms to reduce their chances of heart diseaseDr. Gordon Gunn of Fullerton, CA wants you to be aware of the risks heart disease and the things you can do to reduce that risk.

Besides the common risks for heart disease like high cholesterol, high blood pressure and obesity, other factors may play a role in the development of heart disease in women.

  • Low levels of estrogen after menopause.
  • Smoking – greater risk factor than in men
  • Stress and depression – affects woman’s heart more than men’s
  • Metabolic syndrome – fat around your abdomen, high blood pressure and high blood sugar shows a greater impact on woman’s hearts than men.

What you can do to reduce your risk of heart disease.

  • Maintain a healthy weight
  • Quit smoking
  • Exercise
  • Eat a diet low in saturated fat and cholesterol

Woman’s health differs from that of a man’s and requires its own special attention with proper diet, exercise and overall health and wellness.

Contact Dr. Gordon Gunn today at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.

There is Hope for Relief of an Overactive Bladder with InterStim Therapy | Fullerton, CA

mature woman blonde greyFinding relief from the symptoms of overactive bladder can be a long journey. InterStim Therapy is an option for patients who have not had success with, or could not tolerate, more conservative treatments. InterStim Therapy is not intended for patients with a urinary blockage.

What Is InterStim Therapy?

InterStim Therapy is a proven neuromodulation therapy that targets the communication problem between the brain and the nerves that control the bladder. If those nerves are not communicating correctly, the bladder will not function properly. The InterStim system uses an external device during a trial assessment period and an internal device for long-term therapy. We may decide to try InterStim Therapy by going through a trial assessment period. Based on the outcome of the trial assessment,we will work with you to determine the next step that is right for you.

InterStim Therapy was created by Medtronic, the developer of the pacemaker, and has been FDA approved since 1997 for urge incontinence, and since 1999 for urinary retention and urgency-frequency.

To find out if InterStim Therapy can help you,Contact Dr. Gordon Gunn to learn more about the treatment options available at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.