Category: Dr. Kossari

Essure Response

Fox LA Essure Concerns

I am terribly sorry that the comment may seem unsympathetic, but it was taken out of context during the edit of the interview which took well over half hour. The editors took out majority of the scientific and informative discussions and only chose a phrase presented out of context to portray a sense of lack of empathy within the medical community. I assure all of you that I take every concern my patients may have to heart and take them seriously. I believe that women have an uncanny ability to suspect problems in their bodies and over the years have come to trust that intuition. Having said that, my heart goes out to those who have experienced any wrong doing. I can only speak of my experience with my own patients and those of my colleagues with whom I have a close professional relationship. Essure in my experience has been one of the safest procedures and our patients are happy with the outcome. That is not to say that it is risk free. Everything we do in medicine carries a baseline risk. But we only recommend it if the benefits out way the risks. With regard to any complications, each case has to be evaluated individually. Placement of these devices, the way the procedure is performed, and choosing the right candidates, and proper follow ups play a significant role in the out come of this or any medical procedure. We cannot make a blank statement that it must be the device causing every problem in the book. “You have to take things with a grain of salt.” If someone is suffering from an ensuing infection after the procedure, it most probably is due to failure in following established aseptic techniques during the operation. This is a common concern with any procedure. The alloy used in making this device has been used in medicine for years. You find them in heart valve replacements and have been used in heart catheters around the world. It was not invented for this device. If a patient has an allergic reaction to the implants, it is not the device that we should pull off the market, it is the physician’s clinical judgment that we have to question.


Natural Pregnancy Heartburn Remedies

Heartburn Remedies

Pregnancy not only comes with excitement, it also comes with some negative side effects, such as heartburn. Even if you never had heartburn before pregnancy, certain foods can trigger pregnancy heartburn. The good news – there are a few natural remedies that can help.

Coconut Water

Coconut water is a natural acid neutralizer. Instead of taking over the counter medicine, try drinking coconut water for immediate and easy pregnancy heartburn relief.

Raw Almonds

Almonds offer many health benefits during pregnancy, including protein and calcium. In addition, almonds neutralize stomach acid, reducing symptoms of heartburn.


Papaya is a delicious fruit that relieves heartburn naturally. You can either eat the fruit by itself if it’s ripe, or you can take chewable papaya enzyme that you can purchase at a health store.

Fennel Seeds

Both fennel seed tea and fennel seed oil can help reduce acid and inflammation. They also help with soothing the digestive system.

What Else You Can Do

In addition to certain foods that help with pregnancy heartburn, there are also ways to avoid getting heartburn while pregnant.

It’s important to have eight to ten glasses of water a day, but don’t drink the water all at once or it will put pressure on the esophageal sphincter.

Watching what you choose to eat is also helpful in preventing pregnancy heartburn. Fatty, spicy food increases the amount of stomach acid. Opt for healthier options such as salmon and grilled meat.

Consult your physician today for more natural heartburn remedies.


Five Ways to Fight Fatigue During the First Trimester

Pregnancy Symptoms

The first trimester of your pregnancy comes with a lot of emotions; happiness, nausea, nerves and, for most women, extreme exhaustion. Here are five ways to beat that exhaustion and enjoy your first trimester!

1. Take Naps

Taking a nap may seem like a luxury after a certain age, but it’s important when you’re in your first trimester. A few extra minutes a day can make everyday tasks easier and less tiring. Don’t take lengthy naps or you will get most likely wake up more exhausted.

2. Load up on iron and protein

Consuming a good amount of iron and protein are important to a healthy pregnancy for many reasons. Not only will it give your baby the nutrients he or she need to grow healthy, but eating spinach, eggs, beans and meats will give you more energy throughout the day.

3. Stay Hydrated

Being dehydrated can increase your fatigue. Avoid caffeinated drinks and sugary drinks because they actually dehydrate you more.

4. Stay Active and Exercise

Push through the fatigue when possible and get some light exercise. Exercising increases your circulation and improves oxygen intake, both of which help with feeling fatigued.

5. Don’t be afraid to ask for help

In order to get that extra 20 minutes of sleep, you may need to ask your partner, parents, friends or family for help with everyday tasks. Getting help with every day tasks can save your energy for when you really need it.

Consult your physician for more information on fighting first trimester fatigue.


Ovarian Cancer Awareness Month

Treating Ovarian Cancer

September is ovarian cancer awareness month. Ovarian cancer is one of the most deadly women’s cancers, affecting approximately 22,880 women each year. During ovarian cancer, one or more malignant cancerous cells are found in the ovaries, which are almond-shaped organs located on each side of the uterus.

Symptoms of Ovarian Cancer

Ovarian cancer is difficult to detect because the symptoms aren’t obvious and the ovaries are deep within the abdominal cavity. The common ovarian cancer symptoms include:

  • Bloating
  • Frequent urination
  • Trouble eating
  • Pelvic pain
  • Pain during sexual intercourse
  • Changes in menstruation
  • Upset stomach or heartburn

Stages of Ovarian Cancer

There are four stages of ovarian cancer and your doctor will determine your stage during surgery. These are the stages of ovarian cancer:

  • Stage I – Growth of the cancer is limited to the ovaries. Stage I includes an A, B and C phase. Each describe exactly where in the ovaries the cancer is located, such as whether the cancer is on the outside of the ovary or whether it is confined to the inside of the ovary.
  • Stage II – During stage II, the cancer involves one or both of the ovaries with pelvic extension.
  • Stage III – Growth of the cancer is in one or both of the ovaries. Stage III also involves the cancer spreading beyond the pelvis and/or spreading to the lymph nodes.
  • Stage IV – Stage IV is the most advanced stage of cancer. At this stage, cancer is seen in one or both the ovaries and it has spread to organs outside of the peritoneal cavity.

What are My Treatment Options?

How to properly treat ovarian cancer depends on the stage. There are three main treatment options available, including:

  • Surgery – This is the most common way to treat ovarian cancer.
  • Chemotherapy – Chemotherapy is used in a majority of ovarian cancer treatments after surgery.
  • Radiation Therapy – This is only rarely used for ovarian cancer treatments.

For more information on ovarian cancer awareness month, consult your physician or check out


Five Facts about Twin Pregnancies

Is a twin pregnancy different than a normal pregnancy?

Finding out you are having twins is an exciting, but somewhat overwhelming feeling. Many mothers wonder how different twin pregnancies are than singleton pregnancies. Check out these five facts about twin pregnancy that a lot of people don’t know!

1. Twins have a lower birth weight, but the mothers gain more weight throughout pregnancy.

Carrying two babies causes women to gain more weight during pregnancy. Women who are a normal weight should aim to gain about 37-54 pounds throughout the pregnancy as opposed to 25 to 35.

2. Extra Folic Acid is a necessity when you are having two babies

Folic acid helps reduce the chance of birth defects, such as spina bifida. The amount you need increases with each baby you are carrying. One milligram of folic acid is the recommended amount for twin pregnancies.

3. The chance of delivering early is higher with twins

More often than not, moms carrying twins go into labor around week 36 or 37. Though most women get concerned when they deliver early, if a baby is born after week 34, there isn’t a reason for concern. Even if babies are born after 34 weeks, there is still a chance the baby will be born at a low birth weight.

4. Morning sickness is more common with twin pregnancies

Morning sickness is caused by the hormone human chorionic gonadotropin, which is higher during twin pregnancies. Even if women experience more morning sickness in their first trimester, the feeling subsides around week 12 or 14.

5. There is a higher chance or conceiving twins naturally in your 30s and 40s.

Conceiving when you are older may increase the chance of a twin pregnancy. Ovulation patterns change as you get older, which means there is a possibility you could be ovulating two follicles at the same time when you’re older.

For information on twin pregnancies, consult your physician.



Things Every Woman Should Know About PCOS

PCOS Facts

Polycystic ovary syndrome, or PCOS, affects more than five million women in the United States. If you suffer from onset adult acne, are having trouble getting pregnant or if your hair is beginning to fall out, you may have PCOS.

What is Polycystic Ovary Syndrome?

Polycystic ovary syndrome is a group of symptoms that occur from a hormonal imbalance. Often times, it causes women to produce more male hormones than normal. It often causes women to have one of three conditions:

  • Limited ovulation

  • An increase in androgen levels

  • Fluid-filled cysts on ovaries

Symptoms of PCOS

PCOS symptoms often start mild and can vary from woman to woman. Common symptoms include:

  • Cysts on the ovaries

  • Acne

  • Excessive weight gain or trouble losing weight

  • Extra hair on the face and body. The hair is usually thicker and darker than normal.

  • Irregular menstruation. Some women have only a few periods a year, while others don’t have periods.

  • Infertility . Due to abnormal menstruation, a lot of women don’t ovulate.

  • Depression or mood swings

  • Pelvic Pain

  • Skin tags

Treatment for Polycystic Ovary Syndrome

There is no cure for PCOS, but there are treatment options that can lessen the symptoms.

Modifying your lifestyle by limiting processing foods and adding more whole grain foods can help lower blood glucose levels and balance hormone levels. Medications, such as birth control pills, diabetes medications, fertility medications and medicine for increased hair growth can also help reduce the symptoms.


Contact your physician today for more information on PCOS.


Questions to Ask Your Doctor if You are Considering Permanent Birth Control

For some women, permanent birth control is the best option to guarantee that they will not have any more children. However as the name explains, permanent birth control is, well, permanent. In very few cases are these procedures reversible. Before you make the decision to go with a permanent option, you will want to ask your doctor all of the right questions. Be sure you know everything you need to about the procedure before you make a decision.
Below are a few questions that you should ask your doctor before you make your decision.

General Questions

  • What are my options for permanent birth control?
  • Is a permanent option the right one for me?
  • Are there other options that I should consider before I make the decision?
  • What type of birth control, permanent or non-permanent, would you recommend?

Ask these questions in the beginning. They will give you a good starting place to determining if permanent birth control is the right choice for you.

Tubal Ligation and Implant Birth Control

Tubal ligation is a common procedure in which the fallopian tubes are tied so that the eggs cannot travel to the uterus. Permanent implant birth control includes placing specialty material in the fallopian tubes so that scar tissue will form and completely block the tubes.

  • Should I consider tubal ligation or permanent implant birth control?
  • What are the risks to each of these surgical procedures?
  • Are both of the procedures always successful? If not, what is the failure rate?
  • How do you go about each of the procedures?
  • What type of recovery can I expect from the procedures?
  • What are the benefits to choosing one of these procedures?
  • Would you recommend one of these to me as my own permanent birth control method?

Emotional Factors

The most important thing to remember is that permanent birth control methods should only be chosen if you absolutely know that you never want to have children. There are emotional factors to consider. How will you handle it if you change your mind at a later date and wish to have children? Consider all of the ramifications of the birth control that you are choosing before you go through with any procedure.
Permanent birth control could be the right option for you since it completely cuts out your chances of becoming pregnant at a later date. Make sure to ask all of the questions above when you talk to your doctor to help you make the right choice.