To schedule an appointment you may call our Brunswick office Monday - Thursday 8:30am-5:00pm, Friday 8:30am-12:00pm. Wednesdays our Waycross Office is open 1:30pm-4:30pm. For routine physicals, please call several weeks in advance so we may accommodate your schedule. Payment for routine office visits is expected at the time services are rendered. If we participate with your insurance plan any co-pays and portion of deductible, if not met, are collected on date of service. For your convenience, we accept all major credit cards and participate with most major insurance plans. Please ask us if we work with your plan. Gynecology We perform annual exams for women of all ages and send special reminders to make sure we see each other once a year. PAP smears are done using the most advanced technology available today in order to best protect you from cervical cancer. We supplement our thorough breast exams with mammograms starting around age 40 and surgical referrals for all breast lumps. The American College of Obstetrics and Gynecology recommends that women between the ages of 40 and 49 have a mammogram every one to two years and once annually after age 50. We also schedule colon cancer screenings routinely after age fifty for colonoscopy and bone density testing for osteoporosis. We believe that your health is your most important commodity and we will do our very best to protect you. We offer a multitude of contraceptive options including oral, patch, injectable NuvaRing and Mirena and would be glad to discuss treatment options with you. For those women suffering from "female" problems we offer a wide range of therapeutic options after we thoroughly evaluate your problem. We hope that you will feel comfortable discussing any problems you may have with us. Gardasil: Being vaccinated with Gardasil before you have any contact with HPV types 6,11,16 and 18 helps protects a generation of young women from cervical cancer. Cervical dysplasia and genital warts are caused by these significant human/papillomomavirus. HPV types 16 and 18 cause 70% of cervical cancer cases and HPV types 6 and 11 cause 90% of genital wart cases. Gardasil may not fully protect everyone and does not prevent ALL types of cervical cancer, so it is important to continue regular cervical cancer sceening. Gardasil is not for women that are pregnant. Only a doctor or health care professional can decide if Gardasil is right for you. To learn more about Gardasil go to: Gardasil.com. Obstetrical Patient We would like to see you as soon as you find out you are pregnant. There is a lot of important testing, including sonograms, that take place in these first few months that will help ensure the safest possible pregnancy. Dr. Flournoy does not monitor the entire pregnancy due to semi-retirement, so we will help you in making a transfer to a practice that does, after your 12 week check up. Menopause The average age of menopause is 52 and may be a difficult and confusing time in a woman's life but it doesn't have to be. We pride ourselves on our extensive evaluation and management of the "change of life." We educate our patients extensively on the treatment options that exist for women with "power surges" and other problems with menopausal symptoms. We will discuss all methods including daily pills, weekly patches, monthly injections or implantable pellets which last for three to six months depending on the patient. www.KnowMenopause.com Additional Links on Hormone Pellets: www.indianamenopause.com || www.midlife-passages.com || www.drtutera.com Osteoporosis Did you know that both men and women are at risk for osteoporosis? Osteoporosis is a disease that causes the bones to become weak and brittle. As the bones become more porous, the risk for fracture increases. Women can lose up to 20-percent of their bone mass in five to seven years following menopause, making them more susceptible to osteoporosis and bone fractures. For more information about osteoporosis and the risks involved, contact the National Osteoporosis Foundation at www.n-o-f.org. Bone Densitometry Bone Densitometry screening is part of our Osteoporosis prevention program and an excellent opportunity to counsel women on the risks of osteoporosis and the importance of regular screening. With appropriate screening, diagnostic testing, counseling, treatment, and follow-up, osteoporosis can be prevented and the risk of osteoporotic fracture reduced.    This is an inexpensive way to follow the density of your bones that detect early bone loss that, with proper treatment, could prevent prolonged hospitalization due to major surgery from hip replacement caused by fractures.   Our bone density screening works with ultrasound waves on the patient's wrist.   It only takes a few minutes of time, is performed by a trained professional with immediate interpretation, consult and treatment recommendations by our physician. * Risk factors for Osteoporosis: Older age Female gender  Low weight and body mass index  History of fracture Family history of osteoporosis Caucasian or Asian race           Certain medications                         Diabetics    Insufficient physical activity (couch potato) Estrogen deficiency (due to early menopause, removal of ovaries or  absence of periods  in premenopausal women)                Poor nutrition              Smoking             High alcohol intake *National Osteoporosis Foundation and American College of Obstetricians and Gynecologists Sexual Dysfunction We offer confidential advice and treatment for the very common problems of decreased libido, painful intercourse and vaginal dryness. These distressing problems happen for a variety of reasons and we would be glad to discuss them with you. We feel that all facets of your health as a woman should be as good as possible to promote a happy and a healthy you. Referrals and Second Opinions Regarding second opinions, our office completely concurs with the policy statement of the American College of Obstetricians and Gynecologists. In brief, we encourage, and usually require second opinions whenever there is any doubt or alternative regarding course of treatment. We routinely refer patients for a variety of reasons to specialists, depending on the problem at hand. Infertility We offer a comprehensive infertility evaluation. This enables us to pursue either a medical or surgical approach, depending on the cause. If no anatomical problems are discovered either by x-ray, ultrasound, hysteroscopic or laparoscopic surgery, then infertility drugs or hormones might be indicated. If a surgical problem is found then either laparoscopic or micro-surgery could be employed. The male factor is also investigated and treated if necessary. In-Office Procedures MIRENA SYSTEM: A NEW ALTERNATIVE TREATMENT TO A HYSTERECTOMY The Mirena provides treatment for heavy and painful periods without having to face the decision, expense and recovery time from a hysterectomy. There are a number of conditions that can cause heavy periods. The most common causes are hormonal imbalances and/or benign (non-cancerous) growths, such as fibroids or polyps. One in five women suffer from heavy periods. This bleeding can be emotionally and physically devastating, causing many women to limit their activities and lifestyles. The Mirena is a very small device placed in the uterus by a healthcare provider during a routine office visit. It contains progesterone hormone and releases tiny amounts locally into the uterus. The release of the hormone does not interfere with your body's natural hormone maintenance. After a brief adjustment time, varying from patient to patient, your number of bleeding days is likely to decrease and your periods may even stop altogether. By one year of use, there is a 90% reduction in menstrual bleeding and about 20% of users have no bleeding or spotting at all. How does the Mirena work? The progesterone in Mirena reduces the monthly thickening of the lining of your uterus. Less thickening means less menstrual flow Eventually, your menstrual flow may stop completely Once Mirena is removed, your menstrual cycle will return to the way it was before you used Mirena It is safe and effective up to five years of which it can be replaced for continual treatment. It should be noteworthy that The Mirena is used also to prevent pregnancy but does not protect against HIV (Aids) and other sexually transmitted diseases. You should ask us and learn about other birth control methods so that you and Dr. Flournoy can choose the one that is best for you. SONOHYSTEROGRAPHY: What is saline infusion sonohysterography(SHG)? SHG consists of imaging the uterus and uterine cavity using ultrasonography while sterile saline is installed into the uterine cavity. The purpose of sonohysterography is to detect abnormalities of the uterus and endometrial (uterine) cavity. The usual indications for SHG are abnormal uterine bleeding; infertility; recurrent spontaneous miscarriage; congenital abnormalities of the uterus; preoperative and postoperative evaluation of the uterine cavity; suspected intrauterine adhesions (scar tissue), polyps, fibroid tumors, IUD's and further evaluation of possible uterine abnormalities suspected during routine ultrasonography. HYSTEROSCOPY: A hysteroscopy is a procedure that allows a view directly inside your uterus and is done without incisions. It can help Dr. Flournoy identify the causes of uterine problems through a very small telescope no larger than a pencil and can be used to treat some of these problems. Fibroids, polyps, cancer and adhesions are common problems that may be seen during hysteroscopy by helping with the diagnosis and treatment of uterine problems. Hysteroscopy can provide the peace of mind you may need to get on with your life and back to activities you enjoy. D & C: Dilation and curettage of the uterus is a procedure commonly perform to determine the cause of abnormal uterine bleeding. Having this procedure preformed in-office under local anesthesia provides care without the inconvenience and expense of an overnight stay in the hospital. Following your in-office D & C procedure, you will recover in your own home in the company of family and friends. You will be scheduled for a follow-up visit to be sure you are healing well and to discuss the results of your D & C with Dr. Flournoy. COAPTITE: NON-SURIGAL RELIEF FOR STRESS URINARY INCONTINENCE OR SUI, is another name for the accidental leakage of urine. SUI is more likely to occur in women who have experienced pregnancy, natural childbirth, strenuous exercise, weakened muscles in the pelvis, or gynecologic surgery. There is no reason to simple accept urinary leakage as a normal part of life. Today, a number of treatments are available that can help you live a normal active life again. Coapite implants offers a safe and easy non-surgical approach to SUI. The Coapite implants helps keep you dry by remodeling and supporting your weakened urethra from within. This support helps restore function of the urethra muscle, giving you more control to avoid accidental leakage and is approved by the FDA. Coapite implants are implanted by a physician in his or her office in less than 30 minutes. Restoration with Coapite implants can help you avoid risks and complications associated with surgery. Most women find that they can return to routine activities the same day as the procedure- with little to no downtime. Be as dry as you want to be-ask us about Coapite implants. SONOGRAMS During the first 12 weeks of pregnancy we may perform a sonogram to allow us to visualize your little one for the very first time. Of course our Sonographer is monitoring the early development of your baby, giving you the peace of mind for a healthy head start. Cystometrograms We offer complete urodynamic testing for evaluating stress urinary incontinence. This is urine leakage that occurs when you cough, sneeze, jump etc. We provide this service in our office as an added convenience to our patients.