How do I get a prescription refill?
Most prescription refills can be completed  at the time of your visit. If you need to refill a prescription between office visits, please call our office and allow 24-48 hours for us to submit the information to your pharmacy.

Please allow 3-5 business days for disability insurance forms to be completed.

Do I need a referral?
Many insurance companies require you to obtain a referral from your primary care doctor before seeing a specialist. Please check with your insurance company to see if you need one. If you need a referral, and it is not on file when you check in, we will ask you to sign a financial waiver as a guarantee of payment.

What are your billing policies?
We understand that the cost of medical care can be unexpected. We will do our best to work with you to make payments as reasonable as possible. We will answer all your questions and make sure that you understand everything about your bill.

Gynecology Questions

Q: Do I need to reschedule my pap smear if I have my period?
A: We use the ThinPrep liquid-based pap. You can have a pap smear if you have your period as long as the flow is not very heavy.

Q: How do I know if I have a yeast infection?
A: It is normal to have vaginal discharge and it is normal for it vary throughout the month. Your discharge may be abnormal if it heavier than normal and is associated with persistent itching, burning or a foul odor. If you have these symptoms, please call for an appointment.

Q: What is a Colposcopy?
A: A Colposcopy is a diagnostic tool to determine the cause of abnormalities found in Pap smears. A colposcopy is a visual examination of the cervix, a relatively simple and painless procedure, usually performed in our office. The actual procedure lasts approximately ten to fifteen minutes.

Q: When do I need to start getting mammograms?
A: Women age 40 and older should have mammograms every 1 to 2 years. Women an increased risk of breast cancer should talk with their doctor about whether to have mammograms before age 40.

Post Partum Instructions

Please call our office to make an appointment for your 6 week postpartum visit. If you had a c-section, you will need a 2 week postpartum visit as well.

You may take Ibuprofen which is also known as Motrin or Advil. You may take 600 mg every 6 hours (or 800 mg every 8 hours) as needed for discomfort. Ibuprofen is preferable to Percocet because it does not cause sleepiness or constipation and it is non-addictive. Do not take Ibuprofen on an empty stomach. If you need additional pain relief, continue taking Ibuprofen, and add Percocet or Vicodin. You may take 1-2 Percocet or 1-2 Vicodin by mouth every 3-4 hours as needed for moderate to severe pain. Do not take on an empty stomach. These are narcotic medications that may cause sedation and constipation. Both medications are safe while breastfeeding.

Be sure you are actively preventing constipation- Drink at least 64 ounces of fluids per day and eat a diet rich in fiber (whole grains, fruits and vegetables). Colace, Metamucil, and Milk of Magnesia can also be used to prevent or treat constipation; they are over the counter, safe to use while breastfeeding, safe to use together, and can be taken as directed on their bottles. Prenatal Vitamins/Iron Supplements/Birth Control- If you are not breastfeeding, continue taking your prenatal vitamin for 6 weeks. If you are breastfeeding, keep taking your prenatal vitamin for as long as you are breastfeeding.

If you were taking Iron supplements during your pregnancy, continue until your 6 week postpartum visit. If you have postpartum anemia, your doctor will recommend starting Iron supplements. You may take Iron Sulfate (also known as Ferrous Sulfate) 325 mg 1-2 times per day for 6 weeks. Alternatively, you may take Elemental Iron 60 mg once daily for 6 weeks. Both are available over the counter. Birth control options will be discussed at your postpartum visit.

You may feel tired, anxious or sad and you may notice you cry very easily. This is normal and is called “postpartum blues” or “the baby blues”. These feelings can begin a few days after delivery and usually disappear in about a week or two. Prolonged sadness may indicate Postpartum Depression. Please call the office to speak with us if you are experiencing prolonged or severe sadness.

Breastfeeding is recommended and encouraged. Littleton Adventist Hospital has lactation consultants available to help with questions. If breastfeeding is not chosen, or discontinued, we recommend using an iron-fortified formula.

May be relieved by ice packs and regular feeding from both breasts. Avoid prolonged feeding sessions and ensure a good latch. Keep your nipples as dry as possible between feedings. Be sure to wear a good support bra and allow the nipples to air dry after feeding. Apply ointment (such as Motherlove’s Nipple Cream, bagbalm, cool tea bags, Vaseline and A&D) to any cracks.

Are usually felt as a hard, firm mass without a fever. Gentle massage, hot packs, and frequent feeding from both breasts are the best relief.

Causes a red, warm and painful mass associated with a temperature over 100.4 degrees F. Should this develop, contact our office immediately. The usual treatment is antibiotics and hot packs. Avoid massage, as this can cause the infection to spread. Continue to breastfeed to avoid an abscess.

Can be accomplished at any time. Planning ahead is helpful, beginning with a gradual decrease in the length and number of feedings. Avoid hot showers or any stimulation to the breast area that would encourage milk production. Continue to wear a good support bra, apply ice and bind the breasts tightly. Medication is not recommended to stop breast milk. It is recommended to use ibuprofren to decrease discomfort.

Uterine cramping is normal, especially while breastfeeding. This cramping is how the uterus stops bleeding and returns to its pre-pregnant size. The uterus takes 4-8 weeks to return to its pre-pregnant size.

Postpartum vaginal discharge, also called lochia, usually lasts about 2 to 6 weeks, yet even up to 8 weeks is normal. The color will change from bright red to brownish to tan and will decrease each week. It is normal to occasionally have a heavier gush of blood, especially after breastfeeding or with increased activity. Your bleeding should then return to the amount of flow you had prior to the gush of blood. Normal bleeding is less than a pad per half hour. If you are soaking a large maxi pad (soaked front to back, side to side, through and through) more than every ½ hour, more than once, please call your doctor. Do not use tampons until after your six week postpartum visit. Your period will resume in approximately 6-8 weeks if you are not breastfeeding. If you are breastfeeding, it is common not to have your period.

A “Sitz Bath” is simply sitting in a tub of warm water for 15 minutes, 2-3 times per day. This will help relieve the discomfort. Tucks pads, Witch Hazel and Lanacaine, may be applied to the external vaginal area as needed. You may also use oral pain medications as described above. Stitches will dissolve in 1-3 weeks. You will be more comfortable if you are not constipated; please follow directions above to prevent/treat constipation.

Sitz baths, as described above, can help alleviate hemorrhoid pain as well. You can also use topical agents such as Motherlove’s Rhoid Balm, Tuck pads, Witch Hazel pads, or Preparation H or Preparation HC. Actively prevent constipation.

Rest! Do not do heavy housework or strenuous exercise for two weeks. Walking is the exercise of choice during this time period. If you had a vaginal delivery, and are not taking narcotics, then it is fine to drive. If you had a c-section, do not drive for 1-2 weeks (or longer if you are still taking narcotics). If you had a c-section, then you should avoid heavy lifting for 6 weeks. You may carry your baby in a car seat, but nothing heavier. It is fine to go up and down stairs.

Avoid tampons until your postpartum visit. Do not douche. Generally, we recommend abstaining from intercourse until you are 6 weeks postpartum. However, if you are between 4 and 6 weeks postpartum, you have completely stopped bleeding and your episiotomy is well-healed and non-tender, then it is okay to have protected intercourse.

Reasons to call your provider before your scheduled postpartum visit:

  • Fever greater than 100.4
  • Cesarean incision that is red, draining or increasingly painful.
  • Signs of a breast infection; red and painful area on your breast, especially if
  • associated with fevers greater than 101 and/or flu-like symptoms
  • Foul-smelling vaginal discharge
  • Excessive vaginal bleeding (see above section on vaginal bleeding)
  • Swollen, red, painful area on your leg
  • Chest pain
  • Persistently painful urination or inability to urinate
  • Worsening vaginal or rectal pain
  • Crying and periods of sadness lasting longer than two weeks
  • If you have questions about your infant, please call your Pediatrician

When to Call for Labor

Your contractions should be five minutes apart or less (from the start of one to the start of the next one), about one minute long, for at least one hour. An easy pneumonic for when to call for labor is 5-1-1. Your contractions should be strong enough that you must stop what you are doing, including talking, and breathe through them. If you feel you could sleep through your contractions, you are unlikely to be in labor. If you have a history of rapid labor, please discuss this with your provider at your prenatal visit. When your membranes rupture (water breaks), the fluid will gush or leak. You will not be able to control it. Usually the fluid will run down your leg if you do not have a pad on. Even if you are not having contractions, you should still call the office if your water breaks. If you are unsure if your water has broken, please call us. If the baby is not moving as much as he/she normally moves:

  • Eat or drink something
  • Lay down on your side
  • Count the baby’s movement. If you do not count 10 movements within one hour, call the office.
  • If you are bleeding abnormally:
    • Call the office if you are bleeding as heavily as a period.
    • It is not uncommon to spot or bleed after an exam or at the start of labor.
    • It is not uncommon to see a large strand of bloody mucous, also known as your mucous plug. You do not need to worry about the timing of your mucous plug and can wait to call until your labor signs meet the above criteria.
  • Call the office 24 hours a day, 7 days a week when you go into labor: 303-738-1100. If it is after-hours or during the weekend, your call will be forwarded to our Provider on call.