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Women and Calcium: How Much Do You Need, and Where Should You Get it?

milkCalcium is the most abundant mineral in your body, but you also lose it every day through your skin, nails, hair, sweat, urine and feces—and our bodies cannot produce new calcium on their own. If you don’t get enough for your body’s needs, calcium is taken from your bones, causing osteoporosis.

Calcium plays many vital roles in your body, including:

  • building healthy bones and teeth and keeping them strong as you age,
  • sending messages through the nervous system,
  • maintaining healthy blood vessels,
  • regulating blood pressure,
  • preventing insulin resistance (which could lead to Type 2 diabetes),
  • helping your blood clot, and
  • regulating your heart’s rhythm.

Obviously, if you want to enjoy good health, you need to make sure you have enough calcium in your diet. And once you understand the basics, it’s not that hard to include it in your diet and get the calcium you need.

Supplements vs. Food
Your body can absorb more calcium from food than it can from supplements, so your calcium intake should come primarily from the food you eat. People who get most of their calcium from food have stronger bones.

Calcium from food often comes with other beneficial nutrients that help calcium do its job, like Vitamin D.

Doctors advise that you get as much of your daily calcium needs from food as possible and use supplements only to make up any shortfall.  Older women who get high amounts of calcium from supplements seem to have a higher risk of kidney stones and strokes. And using high-dose calcium supplements may increase your risk of heart disease.

How much calcium is right for you?
The healthiest or safest amount of dietary calcium hasn’t been definitively established. Different scientific approaches have yielded different estimates. To ensure that 95 percent of the population gets this much calcium, the National Academy of Sciences established the following recommended intake levels:

  • Age 19 to 50: 1,000 milligrams/day
  • Age 50 or over: 1,200 milligrams/day
  • Pregnant or lactating adult women 1,000 milligrams/day

Good food sources of calcium
So what foods can you eat to get enough calcium in your diet? You probably know about dairy products, like milk, yogurt, and cheese, but here are some unexpected sources:

  • White Beans
  • Canned Salmon
  • Sardines
  • Dried Figs
  • Bok Choy
  • Blackstrap Molasses
  • Kale
  • Black-eyed Peas
  • Almonds
  • Oranges
  • Turnip Greens
  • Sesame Seeds
  • Seaweed

At Chouchani, Sayegh and Bagnarello, we believe in supporting the total health of our patients and our community. If you have any questions about your dietary or nutritional needs, we’d be happy to help. Contact us anytime at any of our three convenient WNY locations.


Where to find Breastfeeding Support in Western New York

breastfeedEveryone thinks that because breastfeeding is natural, that it’s easy. But experienced nursing moms can tell you—it’s not always! If you’re planning to breastfeed, you’re probably going to need some support. Where are your best resources in Western New York?

At the Hospital

When you give birth at Mercy Hospital, Millard Fillmore Suburban, Women and Children’s Hospital of Buffalo or Sisters Hospital, you can expect to receive support from an onsite lactation consultant. Be sure to tell the staff when you arrive that you plan to breastfeed after your baby is born, so they can help you get started correctly, right away.

Most of these facilities also offer breastfeeding classes as part of their preparation courses for new parents-to-be. These classes are taught by experienced, internationally board certified lactation consultants and are designed to help answer common questions and concerns that you may experience during pregnancy. They should prepare you for both the initial breastfeeding experience and what to expect during the first few weeks at home.

At Home

However, we all know that what works one day might not work the next. If you were doing well with breastfeeding at the hospital but things don’t seem to be going right now, or if you just want some reassurance, both Sisters and Mercy hospitals have the Baby Café, a weekly drop-in center where you can get support and guidance from certified lactation consultant nurses.

You can also ask your child’s pediatrician if they have a lactation consultant on staff. Care Connections, a lactation center located in Amherst that serves all eight counties of WNY, provides lactation consultant services for over 35 local pediatricians.

Care Connections also offers home visits by their IBC-certified lactation consultants in addition to onsite breastfeeding consultations. And if you can make the drive to their Amherst location, they rent breast pumps and sell a variety of clothing and accessories designed to make your breastfeeding experience easier.

At Work

If you’ll be returning to work and plan to continue nursing, Millard Fillmore Suburban offers a special class called Breastfeeding and the Working Mother, which will help you prepare to return to work by teaching you to use your breast pump and store your breast milk.
And if you have a question in the middle of the night, there are several great websites out there full of helpful information. Try:

At Chouchani, Sayegh and Bagnarello, MD, we strive to prepare and support all of our patients who want to breastfeed to have a successful experience. In fact, we want any woman who wants to breastfeed to have a successful experience! Please contact us if you have any questions. Our team is here for you before, during and after your pregnancy.


The importance of a monthly breast self-examination

ID-100111147-breastexamYou probably mean to do your breast self-exam (BSE) every month, but it often slips your mind, right? Or maybe you’ve heard that some people don’t think BSE is helpful in detecting breast cancer early and increasing the likelihood of survival. But experts still believe that BSE is a useful and essential screening strategy, especially in conjunction with regular physical exams by a doctor and mammography. Why?

Sure, there are statistics that say things like:

  • About 20% of the time, breast cancers are found by physical examination rather than by mammography
  • Nine out of 10 breast masses are detected through BSE.

But put aside the numbers and the science. The point is, in order to keep yourself healthy, you need to know your body better than anyone else! And being proactive with your health means doing whatever you can to lower your chances of developing breast cancer—which includes making sure that if breast cancer does develop it is caught early, in a treatable stage. With early detection and treatment, the five-year survival rate for breast cancer soars to more than 90%. Plus, performing your monthly BSE will help to determine what is normal for your breasts, and help you recognize a change.

The experience can be frustrating—for example, you may feel things but not know what they mean. But the more often you do it, the more you’ll learn about your own breasts and what’s normal for them, and the easier it will be for you to tell if something different or unusual is going on.

Perform your BSE 6 days after your period or on the first day of the month, if you no longer have periods. Remember that everyone’s breasts are different, and that any changes you see or feel can be related to aging, your menstrual cycle, pregnancy, menopause or hormone use.  Regular BSE will help to identify changes that require further evaluation and possible treatment.

What should you look for?

  • Lumps, hard knots or thickening in the breast or underarm area
  • Unusual swelling, warmth, redness or darkening that does not go away
  • Change in the size or shape of your breast
  • Dimpling or puckering of the skin
  • An itch, scaly sore or rash on the nipple
  • Pulling in of the nipple or other parts of the breast
  • Nipple discharge that starts suddenly or is bloody
  • Pain that is localized in one area and that does not vary with your monthly cycle

Nobody wants to think about getting cancer. But the fact is, taking the time to check yourself out is your best defense when it comes to caring for your health. If you have any questions about how to perform your BSE, ask your doctor – or call Chouchani, Sayegh and Bagnarello, MD.  We’d be happy to offer any help you need.

Photo courtesy of


Got the winter blues? The importance of taking Vitamin D in the winter months

ID-100206385-sunMedical professionals have known for decades that everyone’s vitamin D levels drop in the wintertime, especially those who live in the northern part of the country. Why is it a problem? Because vitamin D deficiency is connected with several health issues, especially anxiety and depression, and you may need to take extra action to keep your vitamin D levels high enough, and steady.

Vitamin D helps your body use calcium to build and maintain strong bones. It may also increase muscle strength to help prevent falls and broken bones as you age. And low levels of vitamin D have been linked with high blood pressure, diabetes, hypothyroidism, arthritis, and cancer.

Then there’s seasonal affective disorder (SAD), a type of depression that occurs during the winter months, when there’s not much sunlight. Vitamin D deficiency can actually cause depression year-round.

Why is it so hard to get enough vitamin D in the winter? Mostly because of the lack of sun.

Your body gets vitamin D from three places: sunlight, food and supplements. Your body makes Vitamin D when your skin is exposed to the ultraviolet light (UVB rays) from the sun. During Western New York’s snowy, often overcast winter days, you won’t get enough UVB rays to make enough vitamin D. And the foods where vitamin D is found—cod liver oil, fatty fish like salmon, mackerel, sardines, herring and tuna and eggs—are often high in fat and low in popularity. It’s no wonder most of us need to supplement!

How much should you take? If your doctor has tested your vitamin D levels and found them to be too low, he or she may prescribe a very high level supplement to be taken for a short period of time. After that time, a maintenance dose should suffice.

It’s been proven that women who take supplements in winter are able to significantly elevate their vitamin D levels compared to those who don’t take supplements. It’s yet another way you can take care of yourself and your health, something that the doctors at Chouchani, Sayegh and Bagnarello encourage. Please make an appointment with us if you have any health concerns you feel we can help you with!


Robotic Hysterectomy — What should you expect?

Earlier this month we featured an article about what a Robotic Hysterectomy is and why someone might need this surgery. In this article, we also covered the benefits and risks of this procedure. At Chouchani, Sayegh and Bagnarello we perform the Robotic Hysterectomy with the da Vinci®Surgical System – which means there are very small incisions and a quicker recovery time than traditional hysterectomies.


What is a Robotic Hysterectomy?

Robotic Hysterectomy might sound a little like something out of a science fiction movie, but in reality it’s a cutting edge, minimally invasive procedure, that is at the forefront of gynecology.

Did you know that besides the C-Section, the second most performed surgery on women in this country is the hysterectomy – or the removal of the uterus?

What are the most common reasons why a woman would need a hysterectomy? 

Here are a few of the most common reasons…

  • Benign fibroid tumors
  • Cancerous tumors
  • Uterine prolapse
  • Endometriosis
  • Long-term abnormal uterine bleeding
  • Chronic pelvic pain

Why robotic?

Benefits of the robotic-assisted laparoscopic hysterectomy include:

  • Smaller incisions, and as a result smaller scars.
  • Less pain and a shorter hospital stay after surgery.
  • An easier and possibly shorter recovery at home.

Are there any risks?

As, with any surgery, there are always risks involved.  Your physician will determine if the benefits of the surgery outweigh complications that may arise.  Although this is a relatively safe procedure, some risks include:

  • Reaction to the anesthesia
  • Infection
  • Bleeding
  • Damage to other organs inside the abdomen
  • Blood clots that form in your legs and may travel to your lungs

At Chouchani, Sayegh and Bagnarello we perform the Robotic Hysterectomy with the da Vinci®Surgical System.  Using this cutting edge technology, we are able to dramatically decrease pain and speed up the recovery process. Through tiny, 1-2 cm incisions, our surgeons using the da Vinci System can operate with greater precision and control, minimizing the pain and risk associated with large incisions while increasing the likelihood of a fast recovery and excellent clinical outcomes.

Are you a candidate for this type of surgery?  Find out more about this amazing procedure.  Or call our office at (716) 633-6363 for details.


What is a high risk pregnancy?

preggersWhat if your doctor tells you you’re considered a high-risk pregnancy? What does that mean, and what can you do about it?

Being called “high-risk” may sound scary, but it’s just a way for doctors to ensure that you get special attention during your pregnancy. It usually means that you or your baby has an increased chance of a health problem—not that you or the baby will definitely have one.

What kind of conditions will put you in the high-risk category?

  • You have a health problem such as diabetes, cancer, high blood pressure, kidney disease, heart valve problems, sickle cell disease, asthma, lupus, rheumatoid arthritis or epilepsy
  • You smoke or use alcohol or illegal drugs
  • You are younger than 17 or older than 35
  • You are pregnant with more than one baby
  • You’ve had three or more miscarriages
  • Your baby has a genetic condition, such as Down syndrome, or a heart, lung, or kidney problem
  • You’ve had past problems such as preterm labor, preeclampsia or eclampsia
  • You’ve already had a baby with a genetic condition
  • You have an infection, such as HIV, hepatitis C, cytomegalovirus (CMV), chicken pox, rubella, toxoplasmosis or syphilis

Will my doctor treat me differently for a high-risk pregnancy?

You’ll have more regularly scheduled visits to the doctor, and you may have more ultrasound tests to keep an eye on your baby’s growth. Genetic testing may also be done, especially if you are 35 or older or had a genetic issue in a past pregnancy.

Can a pregnancy become high risk later?

Yes. Sometimes a medical condition develops during pregnancy for either mom or baby causes a pregnancy to become high risk. Some complications include:

  • problems with the uterus, cervix or placenta
  • severe morning sickness
  • too much amniotic fluid
  • too little amniotic fluid
  • Rh (rhesus) sensitization, which can occur if your blood type is Rh negative and your baby’s blood type is Rh positive

What can I do to stay healthy during a high-risk pregnancy?

  • Seek regular prenatal care so your health care provider can monitor your health and your baby’s. Visit a specialist in maternal-fetal medicine, genetics, pediatrics or other areas if necessary.
  • Establish a good relationship with your doctor and with other doctors in the practice. You’ll want to feel comfortable discussing any concerns you might have and know that any of them can treat you if necessary.
  • Eat a healthy diet. A daily prenatal vitamin can help fill any gaps. Consult your health care provider if you have special nutrition needs due to a health condition, such as diabetes.
  • Gain weight wisely. Work with your health care provider to determine what’s right for you.
  • Avoid risky substances. If you smoke, drink alcohol or do illegal drugs—quit. But get your health care provider’s OK before you start or stop taking any medications or supplements.
  • Talk to your doctor about any health problems you have and any medications you are taking.

At Chouchani, Sayegh and Bagnarello, we pride ourselves on providing personal and friendly care to each and every patient. If you have any questions or concerns about your pregnancy or your prenatal or postnatal health, call us any time at 716.633.6363.

Disclaimer: The medical information provided in this article is of a general nature and cannot substitute for the advice of a medical professional.