Her Heart: Lifesaving Facts From Betty


It’s Heart Month.

So, that means it’s time to focus on the #2 killer in our community. We want to start by introducing you to Betty McMahon and thanking her for sharing her encounter with the heart attack that could have killed her.

It didn’t.

There are a lot of reasons for Betty to be sticking around. One of those reasons is an opportunity to tell you what she has learned just in case it might help save your life, too.

Hints of What Was Coming.

Betty is an extremely brilliant woman. There is no doubt of that. She is a Forensic Neuropsychologist with a PhD and extreme respect among her colleagues for her work. That high intelligence didn’t keep her from missing signs her body was giving her months before her heart attack that something might be wrong. And it didn’t help her realize what she was feeling very early one summer morning might be from her heart. Fortunately, she was very smart in one of the decisions she made that morning, a decision that made all the difference in what the rest of her life would be like.

All this month, you’ll hear from those in the group picture with Betty. They are the people who were there when she had her heart attack. And of course, you’ll hear from Betty as she talks straight with you. Straight from Her Heart.

Gerd Or Reflux? Whatever Name You Use For This Tummy Condition, It’S No Fun.

by Jason Hallman November 30, 2015

Dr. Jason Hallman is a gastroenterologist with Digestive Disease Associates. He cares for patients at North Florida Endoscopy Center on the campus of North Florida Regional Medical Center.

Dr. Jason Hallman is a gastroenterologist with Digestive Disease Associates. He cares for patients at North Florida Endoscopy Center on the campus of North Florida Regional Medical Center.

Misery loves company, right?

If that old saying is true, then people who suffer from a stomach condition known as either simply Reflux or (not so simply) Gastroesophageal Reflux Disease or GERD for short, do have plenty of company. Consider these statistics. Sixty percent of the adult population will experience some type of GERD within a 12-month period, and 20 to 30 percent will have weekly symptoms. Approximately seven million people in the United States have some symptoms of GERD. If you are one of them, you probably know what it is. And having plenty of company doesn’t make the misery this conditions causes any better. The good news is that taking action does.


GERD happens when the acid that is normally in your stomach backs up into the esophagus. The symptoms include:

  • Burning in the chest, known as heartburn
  • Burning in the throat or an acid taste in the throat
  • Stomach or chest pain
  • Trouble swallowing
  • Having a raspy voice or a sore throat
  • Unexplained cough

What To Do

Some people can manage their acid reflux on their own by changing their eating habits or taking nonprescription medicines. You should see a doctor if:

Your symptoms are severe or last a long time You cannot seem to control your symptoms on your own Have trouble swallowing, or feel as though food gets “stuck” on the way down Lose weight when you are not trying to Have chest pain Choke when you eat

Treatments for GERD include medicines that work to reduce the amount of stomach acid produced. Depending upon your symptoms, a doctor also might need to perform an upper endoscopy which allows direct visualization of the esophagus and stomach.

Just One Thing: The Basics Of Irritable Bowel Syndrome

by Lauren Gajda November 20, 2015

I don’t know about you, but I’m a visual learner. So for this week’s Just One Thing, I thought why not tell you information about a disorder that affects more women than men but do it in a fun way that’s easy to read and understand.

Enter… the infographic. This week’s topic is about the basics of Irritable Bowel Syndrome.


Do any of these symptoms sound familiar to you? Some people live with IBS and have no idea.

The range of 25 to 45 million people living with IBS is so large because many people are living with it and don’t even know it. If you think you may be one of them, it’s time to talk with your doctor.

Just One Thing to Think About…

The Women’s Center Celebrates 25 Years: Ronnie Jo’s Voice

by Lauren Gajda November 6, 2015

As we continue to mark the 25th Year since the opening of The Women’s Center, we hear this week from another of the voices helping us celebrate this anniversary. This voice comes from Ronnie Jo Stringer, ARNP, CNM, a midwife with Gainesville OBGYN. Ronnie Jo is not only someone who provides care to women who deliver their babies at The Women’s Center, she is also a mom who delivered her beautiful baby boy, Ronald, at The Women’s Center about four and a half years ago. When we asked Ronnie Jo the first word that comes to mind when she thinks of The Women’s Center, she said “family.” So it’s no surprise that this is where her family began.

It’s been just over seven years since Ronnie Jo first began working with The Women’s Center. She had just completed graduate school at Georgetown University and couldn’t wait to begin her career in a place that she feels is the best option in town for family-centered care for women.

As a midwife, Ronnie Jo creates special bonds with her patients during their pregnancies. She loves being a part of, what she says, is the most important time in a woman’s life. Ronnie Jo shared different memories with us, but her favorite so far has been being able to deliver the third baby for a special couple and knowing that she was a part of all three of their pregnancies and births.

While that may be her favorite memory as a midwife, her favorite memory of The Women’s Center is of her pregnancy and delivery of her baby boy Ronald here. Her midwife during her pregnancy and delivery was Cyndi Vista, ARNP, CNM, who is still a good friend and colleague of hers to this day.

Ronnie Jo remembers being in a lot of pain on the day she went into labor, but Cyndi was there for her the whole time. It was a long labor, but that’s not what she looks back on. She remembers the faces of the nurses who helped her through labor. She recalls their smiles and their comforting touch. She says words cannot describe how wonderful the care she received was on that day.

When Ronald was born, Ronnie Jo was so thrilled. She says it was incredible to be able to hold him in her arms and know that everything went perfectly – exactly the way she envisioned and hoped it would go. This is what she had been waiting for all these months, and she says it was definitely worth the wait.

Ronnie Jo, husband Chris and son Ronald have so much to be thankful for. Ronald is now four and a half years old and attends preschool. With time going by so quickly, it’s no surprise to her that The Women’s Center is already celebrating 25 years.

During this anniversary year, Ronnie Jo has had the opportunity to look through photos from the past. She loves looking back and seeing all those memories and is excited about the future of The Women’s Center and all it offers to women in our community.

On this 25th Anniversary, Ronnie Jo wants to thank The Women’s Center for welcoming her more than seven years ago and for the guidance, support and amazing memories it has provided so far. She looks forward to continuing to grow and being able to provide women with the birth experiences they desire.

Just One Thing: Pay Attention To Your Digestive System

by Lauren Gajda November 6, 2015

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

Ladies, it’s time to talk about plumbing. No, not the plumping that happens when your pipe at home breaks and water goes everywhere. The plumbing of your body.

We know you may not think it’s polite to talk about our digestive system, but it’s so important that we’re turning the spotlight on Digestive Health for the entire month of November.

So, did you know that everyone’s plumbing is different? Some people go to the bathroom three times a week, and it’s considered normal. Others go three times a day, which can also be considered normal. The most important thing is paying attention to when your body starts acting differently because that’s when you may need some plumbing work.

The warning signs are pretty similar for many digestive disorders – stomach pain, nausea, bloating, gas…. You can read more about common conditions, symptoms and treatments in the articles we’ve posted so far for our Digestive Health Spotlight Series. For now, we ask that you just pay attention.

If three times a day turns into three times a week, it may be time to take yourself in for a service check. Just One Thing to Think About.

Digestive Disorders Affecting More Women Than Men

by Lauren Gajda November 6, 2015

Did you know that some digestive disorders affect more women than men? In this WCJB TV-20 Medical Spotlight, Gastroenterologist Dr. Renata Wajsman discusses how acid reflux and Irritable Bowel Syndrome (IBS) tend to affect more women than men. Why? When should you go to the doctor? What are the treatment options? Watch the video to get the answers you’ve been looking for.

Is This Hard To Digest?

by Lauren Gajda November 6, 2015

Talking about your body’s plumbing may be difficult for some people. You don’t exactly go out for dinner with girlfriends and want to talk about how you haven’t gone to bathroom in four days. And listening to someone talk about their plumping is not easy to digest either. The problem with not talking about the plumbing problems is that they don’t get resolved and, in some cases, they just get worse.

Now, we’re not saying you have to talk with your girlfriends about your digestive difficulties over a glass of wine, but talking with your doctor should be a priority. There are so many digestive conditions out there, so for November, we’re turning the focus on dealing with digestive difficulties. What are the most common issues and how can you put an end to them? We’re starting here with a simple article of the eight most common ones.


In a recent study, it was reported that 6 percent of people reported experience reflux symptoms daily, and 14 percent experience symptoms at least weekly. Now you know why we consider this one of the most common digestive difficulties.

When symptoms are frequent, it may indicate that a person has GERD (Gastroesophageal Reflux Disease). GERD can be painful because it’s basically when the stomach’s content come back up into the esophagus.

Common Symptoms:

  • Heartburn
  • Sour taste in mouth
  • Hypersalivation
  • Trouble swallowing
  • Dry cough

Common Treatments:

  • Drugs that reduce acid levels, such as Aciphex, Nexium, Prevacid, Prilosec and Protonix
  • Drugs that reduce H2 blockers, such as Axid, Pepcid, Tagamet and Zantac

In severe cases of GERD, surgeons have the ability to tighten a loose muscle between the stomach and the esophagus. At North Florida Regional Medical Center, we can do this surgery laparoscopically.


Did you know that 25 million Americans will get a peptic ulcer at some point in their lives? Peptic ulcers are sores in the lining of the stomach or first stretch of the small intestine. Some causes of peptic ulcers include smoking and alcohol use. If left untreated, peptic ulcers can be very dangerous and lead to serious infection.Common Symptoms:

  • Burning pain in the middle or upper stomach between meals or at night
  • Bloating
  • Heartburn
  • Nausea or vomiting

Common Treatments:

  • Proton pump medications
  • Antibiotics
  • Upper endoscopy
  • Surgery


Each year, nearly 1 million Americans are diagnosed with gallstones, which are little pebbles primarily made up of cholesterol and bile salts. Getting rid of them usually requires having your gallbladder removed, which is one of the most common US surgeries.

Common Symptoms:

  • Pain in upper abdomen and upper back
  • Nausea
  • Vomiting
  • Bloating
  • Indigestion
  • Heartburn
  • Gas

Common Treatments:

  • Surgery to remove the gallbladder


Between 30 million and 50 million Americans are lactose intolerant. That means they lack an enzyme needed to digest the main sugar in milk.

Common Symptoms:

  • Cramping
  • Bloating
  • Gas
  • Nausea
  • Diarrhea

Common Treatments:

  • Over-the-counter pills to replace lactase in your body


While it’s been reported that 3 in 5 Americans who are 70 years of age or older have abnormal bulges called diverticula somewhere in the walls of their colon, only 20 percent will experience inflammation or infection in those bulges. Those complications are called diverticulitis.

Common Symptoms:

  • Pain in lower left side of your stomach
  • Fever and chills
  • Bloating and gas
  • Diarrhea or constipation
  • Nausea or vomiting
  • Loss of appetite

Common Treatments:

  • Antibiotics
  • Surgery


The two most common forms of Inflammatory Bowel Disease (IBD) are Crohn’s Disease and Ulcerative Colitis.

Common Symptoms:

  • Anemia
  • Rectal bleeding
  • Weight loss

Common Treatments:

  • Prescription of a combination of anti-inflammatories, steroids and immunosuppressants
  • Antibiotics
  • Surgery

Both Crohn’s Disease and Ulcerative Colitis typically arise from a deficiency in one’s immune system that leads to the body’s attach of the gastrointestinal (GI) tract.


Only about 1 percent of the US population has celiac disease, which is an autoimmune and digestive disorder that triggers an attack on one’s small intestine when gluten is introduced to the diet.

Common Symptoms:

  • Abdominal pain
  • Bloating
  • Chronic diarrhea
  • Vomiting
  • Constipation

Common Treatments:

  • There is no cure for celiac disease, but most people manage it with a gluten-free diet.


Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

Just because you fail to have a bowel movement, does not necessarily mean you are constipated. People think they have to have a bowel movement every day, but the truth is, anywhere between three times a day and three times a week is normal.Common Symptoms:

  • Stomach discomfort
  • Have not had a bowel movement in days

Common Treatments:

  • Over-the-counter remedies like Milk of Magnesia
  • Laxatives

Constipation is best avoided through regular exercise, a diet high in fiber and hydration. It’s best to see a doctor if you have not had a bowel movement in a week because constipation can lead to more serious issues, such as hemorrhoids or anal fissure.

While this may seem like a lot of information, this is just a brief overview. We will have so much more information to share with you throughout the month. Stay tuned.

Image acknowledgement for front page image: Image courtesy of marin at FreeDigitalPhotos.net

The Women’s Center Celebrates 25 Years: Dr. Cotter’s Voice

by Pamela Rittenhouse October 28, 2015

For 25 years, The Women’s Center of North Florida Regional has focused on delivering the kind of care the women of North Central Florida deserve, which is, of course, the very best care possible! During this anniversary year, we want to celebrate by sharing memories from patients, providers and physicians.

The Women’s Center that Dr. Michael Cotter is so proud to be a part of can be seen through the window over the desk at his OBGYN practice.

The Women’s Center that Dr. Michael Cotter is so proud to be a part of can be seen through the window over the desk at his OBGYN practice.

His Father’s Footsteps

This week’s voice from The Women’s Center comes from Dr. Michael Cotter. Dr. Cotter is an OBGYN who opened his practice on the North Florida Regional campus and began delivering babies at The Women’s Center back in 1994. Dr. Cotter graduated from Emery University, attended Medical School at the University of Miami and did his residency at the University of Florida. There was never a question about where he would open his practice. He’s a native of Gainesville and is the son of a very well-known OBGYN, Dr. Julian Cotter.

“My dad was the world’s nicest guy,” Dr. Michael Cotter says. “He was a great doctor, a great example to follow, and he was always very supportive of me.”

For Dr. Cotter, There’s Family at Home and Family at Work!

Dr. Cotter’s practice, Gainesville OBGYN, is not the only thing that has been growing over the years. So has his family and the wife and children that are his pride and joy.

Dr. Cotter says, like his father, he loves the opportunity to care for women for a long period of time as their lives change and healthcare needs change, too.

“I have patients I’ve been seeing for more than 20 years. The first babies I delivered were twins, and they have turned 21. It means a lot to me to continue to see these patients and know them and help them.”

The level of care available at The Women’s Center is something Dr. Cotter is proud of, and he gives credit to nurses. “The biggest thing that makes The Women’s Center so special is the nursing care. They’re really committed and do an excellent job in working with me and all of the physicians.”

Dr. Michael Cotter says physicians are only one part of excellence in delivering women’s healthcare services. Nurses and midwives who share the philosophy of care are critical, and he points to Certified Nurse Midwife Ronnie Jo Stringer as a perfect example.

Never Sit Still. Grow.

Dr. Cotter also points to the addition of the Maternal Fetal Medicine service line, Neonatal Intensive Care, the growth of Gynecologic Oncology, the presence of breast surgery specialists and Gainesville’s dominant robotic surgery program as examples of advanced care for women delivered at a very high level.

“I’m also pleased with the progression of our care in a holistic fashion where we think about the entirety of women’s healthcare needs, their lifestyle goals and their family members. Our philosophy is to treat the woman instead of her diagnosed healthcare condition.”

Preventing prematurity is a passion for Dr. Cotter, and it’s something he thinks about a lot. “Preventing premature birth is truly the #1 thing we can do for babies. We’re making a lot of headway. Use of progesterone for women who have had a previous spontaneous pre-term delivery at 16 to 20 weeks reduces delivery prior to 30 weeks by 50 percent. This has made an enormous difference, and we want to keep up our focus on preventing prematurity.”

Dr. Cotter’s practice has grown from one physician (him!) to four plus four certified nurse midwives and several other support staff. Growth, Dr. Cotter says, is a good thing!

Other priorities for Dr. Cotter include low birthweight babies and decreasing the rate of cesarean sections. In addition to that, he’s moving fast to manage the growth of his practice. For 16 years, he was in practice pretty much on his own. In the past 5 years, three physicians and four midwives have joined the group.

“We’re growing, but in our practice and the entire Women’s Center, we want to make sure women who come to us for care know they will receive advanced quality care in a setting that is relaxed, comfortable and welcoming. That’s what it’s all about.”

We have so much to celebrate in this 25th Anniversary Year, and we thank Dr. Michael Cotter for his work at The Women’s Center and for sharing his thoughts. There’s more to come. No matter how many years go by, The Women’s Center will be here doing all we can to raise the bar for women for a very simple reason. Health is Beautiful.

Just One Thing: A Warning About Warning Signs

by Pamela Rittenhouse October 16, 2015

In our understandable fervor to make sure no woman on the planet fails to understand the formula for breast cancer screening and early detection, we have stopped talking about something really, really important.

The formula, of course, is following guidelines for Clinical Breast Exams, Self Exams and Screening Mammograms. But guess what? Not all breast cancers are detected by mammograms. Fortunately, that’s not true for most breast cancers, but it’s true for some. That means we need to know the warning signs of breast cancer.

I’ll be honest. I came up with the idea for this topic because I realized that I had no idea what the warnings signs are. Maybe I knew them at one time and just forgot them in the comfort of knowing I follow the above-mentioned formula.

The warning symptoms are not terribly complicated or hard to understand. It won’t take long to read about them, and it’s definitely worth the minutes it will take. You’re already here on the website – just click on the article that starts out with the words, ‘WHOOPS! When did we stop talking about…’

To rephrase, if breast cancer warning signs stared back at you in the mirror, would you recognize them?

Just One Thing to Think About.

Whoops! When Did We Stop Talking About…

by Pamela Rittenhouse October 15, 2015

…Warning Signs of Breast Cancer?

Thanks to awareness of the fabulous benefits of mammography in screening for breast cancer, as well as other imaging advances, the disease in most women is picked up very early and staged for treatment well before there are any warning signs. This is a great thing because it has increased survival for patients tremendously. Having said that, not all breast cancers are detected by mammography. We need to know the warning signs of breast cancer so we don’t miss them. If these signs appear, we want to recognize them quickly and take action fast.

So, What Are the Warning Signs?

The warning signs of breast cancer are not the same for all women. The most common signs are a change in the look or feel of the breast, a change in the look or feel of the nipple and nipple discharge. Be sure to watch for these signs and get in touch with your healthcare provider right away.

  • Lump, Hard Knot or Thickening inside the Breast or Underarm Area
  • Swelling, Warmth, Darkening or Redness of the Breast
  • Change in the Size or Shape of the Breast
  • New Pain in One Part of the Breast that Does Not Go Away
  • Puckering or Dimpling of the Skin
  • Itchy, scaly Sore or Rash on the Nipple
  • Pulling in of Your Nipple or Other Part of the Breast
  • Nipple Discharge that Starts Suddenly

Often, experiencing some of the conditions above is not breast cancer but a benign or noncancerous breast condition. But you cannot know that for sure unless you see your doctor or other healthcare provider.

It may help to look at images that give you an idea what the symptoms listed above may look like. Examples are available online. So is more in-depth information on this topic. We encourage you to take a few minutes, read, learn and remember. Getting our mammograms and clinical breast exams plus self-exams are terrific, but we can’t stop there.

Knowing the warning signs is just as critical. It’s one more way of Standing Up to Breast Cancer.