Pap Smear 101 - What to Expect During and After

There are various routine health exams women must do to ensure that their bodies are free from cancers or other abnormal conditions. These types of tests are very important so that you can maintain good health, and a Pap smear or Pap test is no different. This gynecological pelvic test screens for cervical cancer and HPV (human papillomavirus). A Pap smear may seem scary to think about, especially if it’s your first one! But it is usually very quick and may only be mildly uncomfortable. Once women turn 21 years of age, a Pap smear test becomes routine during your annual gynecology exam. Keep reading to learn what to expect during and after your Pap test and why this exam is so important for your health. 

Why Do You Need a Pap Smear?

A Pap smear is done in conjunction with a pelvic exam, and it is recommended that every woman receives this test every one to three years after the age of 21 – even if you are not sexually active. You may need more frequent tests if you are HIV-positive or have a weakened immune system from undergoing chemotherapy or an organ transplant. Cervical cancer screening is critical for receiving an early diagnosis of cervical cancer. With an early diagnosis, adequate treatment is usually possible. This exam not only detects if cancer cells have already developed- it can also indicate if someone is at risk for developing abnormal cells in the future. This may require further testing. 

What to Expect During a Pap Smear

While you are in the proper gynecological pelvic exam position, with your legs in stirrups, your doctor will insert a tool called a speculum into the vagina to examine the cervix. A sample of your cervical cells will be taken with a brush or spatula, which then will be sent to a lab for testing. This test is done very quickly and you may feel a slight push, irritation, or scraping that feels similar to a period cramp. It’s ideal to avoid having a Pap smear during your menstrual period, especially if your flow is heavy. Menstrual periods can affect the results of the test, so it is best to discuss this with your doctor prior to your appointment if it is your time of the month.

After the Exam and The Results 

After your cervical exam, you may experience a cramping feeling throughout the rest of the day. Although rare, you also might show some spotting up to 24 hours after. If your Pap smear results are normal or “negative,” this means that your test showed no abnormal cells – so you do not have to think about this exam for another year or three! If you have an abnormal Pap smear, this does not mean you have cancer. This often indicates that there are some precancerous cells on the cervix. Your doctor may want to do further testing, such as a Colposcopy. A colposcopy is a further examination of the vagina, cervix, and vulva with a magnified view to locate and determine the extent of abnormal cells.

Put Your Cervical Exam Nerves at Ease With Dr. Quartell in Livingston NJ

If you are looking to schedule a Pap smear exam with a top board-certified OB/GYN in Livingston, NJ, then look no further than Anthony C. Quartell, MD. and Associates. Dr. Quartell and his staff have been treating patients for over 40 years in the field of Obstetrics and Gynecology, specializing in minimally invasive gynecological surgeries. With Dr. Quartell, you will have access to tests and services that are extremely beneficial for your long term health and well-being. For more information about Pap smears or the various services we provide and conditions we treat, be sure to contact us today to schedule your appointment!


4 Things to Know if Your Pap Smear is Abnormal

Pap smears are a screening tool used by gynecologists to detect abnormal cells growing on the cervix. A doctor will collect a sample from the cervix wall to test for any abnormalities. Pap smear tests are a crucial component in detecting cervical cancer and other reproductive-related diseases. About two weeks after the procedure, your doctor will have your results. Ideally, the test comes back negative, however, it is not uncommon for women to receive positive test results indicating an abnormality. To help understand a little more about the process, here are 4 things to know if your Pap smear is abnormal.

Understanding Your Results

If your Pap smear test results come back positive, it means your doctor found unusual cells on your cervix. While many women might panic at the thought of testing positive, there are many reasons this can happen that do not necessarily mean you have cervix cancer. Most often, the abnormal test result means there have been cell changes caused by the human papillomavirus (HPV), the most common sexually transmitted infection (STI). When HPV causes abnormal cell changes on the cervix and this is called cervical dysplasia, which if left unattended, may lead to cancer.

Causes of an Abnormal Pap Test

In addition to HPV, some activities or physical conditions can result in an abnormal Pap test. To prevent false abnormal test results, doctors have agreed on a suggested list of things to avoid when scheduling your Pap smear. While no real preparation is necessary, it is best if you schedule your exam between periods. Having recently menstruated or beginning your cycle soon can potentially influence positive results. In addition, avoid things such as tampons, vaginal cream, smoking, and intercourse for at least two days before your scheduled test. In some instances, cell changes are caused by other infections and conditions. These include yeast infections, bacterial infection, herpes, inflammation, or trichomoniasis.

Abnormal Pap Smear Symptoms

Most changes in cells which cause an abnormal Pap smear do not cause symptoms, such as HPV. However, other STIs can cause irritating symptoms. Itching, pain, or burning in your pelvic area during sex or urination, off-colored vaginal discharge, lumps, sores, or rashes around your genitals are all symptoms you should inform your doctor of.

What Now?

If your Pap smear test comes back abnormal, your doctor may suggest scheduling a follow-up test to see if there is a recurrence of abnormal cells or HPV. Another small biopsy will be taken to be used in comparison with your first results. If your doctor has reason to believe something may not be quite right with your cervix, he or she may recommend additional testing such as a colposcopy. A colposcopy is an examination of the vagina, cervix, and vulva with a magnified view to locate and determine the extent of abnormal cells.

If not done already, your doctor may recommend testing you for HPV. Testing for HPV every 3 years is recommended as certain types of HPV, including types 16 and 18, increase your risk of cervical cancer. Knowing whether you have a type of HPV that puts you at high risk of cervical cancer means that you and your doctor can better decide on the next steps in your health care. Those steps might include follow-up monitoring, further testing, or treatment of abnormal or precancerous cells.

Pap Smear Exams in New Jersey

If you are looking to schedule a Pap smear exam with a board certified OB/GYN in Livingston, NJ, then look no further! At Anthony C. Quartell, MD. and Associates, Dr. Quartell and his staff have been treating patients for over 40 years in the field. For more information about Pap smears or additional services we provide, be sure to contact us today to schedule your appointment!


What New Moms Need to Know About Postpartum Depression

Becoming a new mother can trigger a swarm of powerful emotions, from excitement and joy, to fear and anxiety. But it can also result in something you might not expect – depression. Postpartum depression is a serious mental health condition that can occur in the weeks and months following the birth of a child. For new moms, this can be extremely overwhelming and scary. Postpartum depression can be mistaken for “the baby blues” at first, but the signs and symptoms are more intense and last longer, eventually interfering with your ability to care for your baby and handle daily tasks. Symptoms usually develop within the first few weeks after childbirth, but may begin later – up to six months after birth.

Postpartum depression symptoms may include:

  • Feeling sad, hopeless, empty, or overwhelmed
  • Crying more often that usual or for no apparent reason
  • Worrying or feeling overly anxious
  • Feeling moody, irritable, or restless
  • Oversleeping, or being unable to sleep even when your baby is asleep
  • Having trouble concentrating, remembering details, and making decisions
  • Experiencing anger or rage
  • Losing interest in activities that are usually enjoyable
  • Eating too little or too much
  • Withdrawing from or avoiding friends and family
  • Having trouble bonding or forming an emotional attachment with your baby
  • Having constant doubts about your ability to care for your baby
  • Thinking about harming yourself or your baby

Along with these symptoms, there are five general stages of postpartum depression:

  1. Denial: You’ll think, “I can’t have postpartum depression. This must just be what new motherhood is like. I’ll be fine; I just need more sleep. It’ll wear off.”
  2. Anger: You will have a difficult time understanding why this is happening. You will think, “Why is this happening to me? No one understands what I am going through! This is so unfair!”
  3. Bargaining: In this stage, you’ll try to make a deal with yourself to make things better. “I just need to get the baby to sleep through the night, then I’ll be okay. I just need to work harder.”
  4. Depression: You’ve done everything you could to avoid this, but it’s here. This is the stage where you’ll have awful thoughts such as, “My baby doesn’t deserve me as a mother. My family would be better off without me. I’m never going to be a good mother.”
  5. Acceptance: This is the stage where you finally realize this is real and it is time to get help. “This isn’t normal, I need to get help. I’m going to call my doctor.”

There are many things that new moms can do to cope with these symptoms:

  • Set realistic goals and assume a reasonable amount of responsibility. Let your family and friends help you.
  • Break large tasks into small ones and set priorities. Do what you can, as you can.
  • Find someone to confide in. It’s usually better than being alone and secretive.
  • Exercise regularly. Studies have shown regular exercise can regulate your mood.
  • Expect your mood to improve gradually, not immediately. Feeling better takes time.

As a new mom, the most important thing you can do for yourself is to simply relax. Living an overscheduled life can leave you feeling burnt out. This is when the symptoms really start to kick in and take over. The more work you give yourself, the more you are likely to beat yourself up when you can’t get it all done. Being a new mom is hard. You won’t be able to do it all, and you won’t be perfect. Take it day by day; it will get easier.

When left untreated, postpartum depression may last for many months or longer. If you’re feeling depressed after welcoming your new baby, you may be reluctant or embarrassed to admit it. It is important to call your doctor as soon as possible if you are experiencing any symptoms of postpartum depression.


How to Wean Off Breastfeeding

“When should I stop breastfeeding?”

“How do I stop breastfeeding?”

These are two of the most common questions we get from mothers. We all know the incredible benefits breastfeeding provides to the baby: It helps baby’s fight off infection better, lowers risk for asthma and allergies, and creates a special bond between the baby and mom. When is it time to stop though, and how do you get the baby weaned off the breast milk they have grown to know and love?

The American Academy of Pediatrics recommends mothers breastfeed exclusively for 6 months. This means not giving the baby anything else other than what you produce. After 6 months, you can begin to introduce you baby to solid foods, but should continue regular breastfeeding until they are at least one year old. After this point, you can continue breastfeeding as long as you and your child continue to want to. It is going to depend on your child and how much they like the breastfeeding process. Some toddlers are going to be fine breastfeeding, while others won’t want to sit still that long.

Other reasons to stop breastfeeding may be personal, such as the time commitment it requires for both mother and child.  It is completely dependent on your lifestyle and the needs of your child; no ones situation is the same, so don’t compare yourself to other families.

When you have made the decision to stop breastfeeding (hopefully after a year), you may begin a gradual weaning process. You may want to postpone this process if you or the baby is not feeling well, if major changes in the home are occurring, or if you are concerned with allergens.   All of these things will cause unnecessary stress to both the mom and baby, as this is a major change for both.

How-To Wean:

Weaning off of breastfeeding should be exactly that: weaning. Cutting breast milk off cold turkey will be bad for both baby, and painful for mommy. Make the process gradual by cutting off just one feeding per day. Typically, children are more attached to the morning and night feedings, so those should be the last to go.

If your child requests to be fed, don’t deny it from them. Eventually they will be distracted enough throughout the day with different foods and activities, that they will forget all about your breast milk! The time it takes to completely wean your child off breast milk is going to vary from person-to-person. Some women do it within a week, while others take months. Be perceptive about what your child, and you, need.

During the weaning process, ensure that your child is still getting love and affection with mom. Breastfeeding is an intimate experience between a mother and baby, so you don’t want yourself or the baby to feel like they are losing out on affection when the breastfeeding stops.

Nutrition After Weaning

You want to ensure your baby is getting proper nutrition once they begin to wean off of breast milk. If you are weaning before the child is one year old, you want to replace it with a formula. Your baby should not have cow’s milk until after their first birthday.

You also have to consider how the child was drinking prior to the weaning process. Is he/she used to a bottle? A cup? Your baby will have to be weaned off of the breast and learn to use a bottle, and then a cup.

Remember, each family is different and each baby has different needs. Trust yourself and your instincts, along with our recommendations, when it comes to the weaning process. Contact your obstetrician if you have more questions about the breastfeeding and weaning processes to ensure you are doing what is right for you and baby!


Pregnancy During The Winter Months: Your Guide to Comfort

Everyone has their preferences when it comes to prepping for the perfect pregnancy, especially 2nd or 3rd time mothers. For instance, some women love being pregnant during the winter, while others absolutely hate it. Whatever your favorite time of year to be pregnant is, one thing’s for sure — these pregnancy tips will have you feeling safe and cozy even if you despise winter solstice.

Some reasons for not wanting a winter pregnancy are the extreme drops in temperature and shortened amounts of daylight. Generally, people feel trapped indoors because snowy roads don’t leave many options for outdoor activities. Most obstetricians probably will not recommend sledding or ice-skating while you’re pregnant! For most expectant mothers, winter sports typically sound like a recipe for disaster.

These types of limitations, piled onto those of us who are already limited due to our pregnancy status, can leave us feeling extremely secluded. Furthermore, the winter seclusion can easily lead to a mild case of the winter blues. And we don’t need extra emotions zipping us around; our pregnancy hormones are perfectly capable of steering that emotional rollercoaster for us.

Feelings and emotions are just one side of the cold, blustery battle. Other mothers are far more concerned over the weather hazards typically associated with wintertime. A common fear is falling or slipping on ice while pregnant — yikes! Other winter related fears include things like emergency snowstorms, travel issues, car problems, or power outages. Whatever issues winter could possibly bring to your doorstep, if you carefully plan ahead you can surely stay safe, happy, and comfortable throughout your winter pregnancy. Here’s how:

Number one, drink plenty of water to combat dry, winter air. Even though it isn’t summer, you can still get dehydrated. Therefore, you should make it a point to drink plenty of water throughout the day. Water will help you avoid that lightheaded, sleepy feeling.

Next, make room for 3 to 5 sessions of exercise each week. Of course walking is great for pregnancy aches and pains, but you can always try prenatal yoga. Sometimes paying for prenatal exercise classes ahead of time will give women the extra pep they need to workout. Winter isn’t an excuse to stay in and watch TV all day. Basic exercise will keep your muscles feeling loose and relaxed — not to mention the amounts of anxiety you’ll eliminate. Exercise is great for stress relief!

Number three, always wash your hands and avoid touching your face. You don’t want to get sick while pregnant. It’s very uncomfortable and you’re limited to the types of medications you can safely take. According to the US Centers for Disease Control and Prevention, “pregnant women should get the influenza vaccine to help prevent the flu”.

Number four; it is crucial to plan for winter weather before it strikes. Invest in non-skid boots. You never want to slip on ice, let alone while being pregnant. Also, make sure you’re receiving regular weather alerts and keep a stash of emergency supplies in your household at all times. Keeping emergency supplies stashed in your car would be ideal too! Supplies should definitely include candles or flashlights, water, and extra food. You never know when there’s going to be a power outage.

Extra blankets and clothes can’t hurt either. Your warmest coat might get too snug once you hit your 3rd trimester! Make sure to stock up on lots of layers, especially if you’re in the 3rd trimester during those cold winter months.

And finally, share some hot tea or hot cocoa with family and friends. Winter is a great time to get cozy and hang out with the people you love most. Spending quality time with others will keep pregnant mommies happy and healthy any time of year! Make sure to still go to your regular appointments with Dr. Quartell throughout your pregnancy.


Minimally Invasive Surgery: Spotlight on Gynecology

What is minimally invasive surgery?

Minimally invasive surgery is a procedure that is performed through tiny navel or abdominal incisions instead of one large opening. Because the incisions are small, patients tend to have fewer complications, less pain and scarring, and a quicker recovery time compared to traditional surgery. Gynecologic surgeons were pioneers in developing laparoscopic surgery. Laparoscopic surgery is a minimally invasive technique that utilizes an electronic device called a laparoscope. The laparoscope is a viewing tube (camera) through which structures within the abdomen and pelvis can be seen. It can be used for both diagnosis and treatment of gynecologic conditions. Your doctor may suggest laparoscopic surgery if you are experiencing unexplained pelvic pain, infertility or have a history of pelvic infections. Common conditions that laparoscopic surgery might diagnose are endometriosis, pelvic inflammatory disease, reproductive cancers and more.
Laparoscopic procedures in Gynecology

Is a gynecologic condition affecting your health? Many conditions and symptoms can impact your day-to day life, normal activities and emotional well-being, such as:

  • Pelvic Pain
  • Abnormal or very heavy bleeding
  • Uterine Fibroids
  • Pelvic prolapse
  • Cancer

Laparoscopic surgery can be performed for a wide range of gynecologic procedures including Laparoscopic Supracervical Hysterectomy, Laparoscopic Total Hysterectomy, and Robotic Myomectomy to name a few. Minimally invasive surgery is becoming more and more common in hospitals. A laparoscopic hysterectomy is the second most common procedure for women in the United States, and over 600,000 procedures are done each year. Laparoscopic hysterectomies are a minimally invasive procedure for the removal of the uterus or womb, which in some cases includes the ovaries and fallopian tubes, making it a total hysterectomy procedure. During the procedure, the doctor will make a tiny incision at the belly button to insert a camera. The camera or laparoscope will allow the doctor to see what they are doing during the procedure. The doctor will be able to complete the procedure through 2-3 very small incisions instead of the traditional 3-6 inch incision in open surgeries. The small incisions allow the doctor to have a better look at the anatomy and stay extremely precise. Conditions such as uterine fibroids, pelvic adhesions, persistent pain or bleeding, and cancer have all been effectively treated through laparoscopic hysterectomies.

Advancements in Minimally Invasive Surgery

Laparoscopy was originally just used for diagnoses and eventually evolved into less invasive surgery. However, laparoscopic surgery is not the only minimally invasive technique around that can be used for gynecological conditions. Minimally invasive surgery has now advanced to robotic-assisted surgery also known as the da Vinci Surgical System. Robotic-assisted surgery allows the surgeon to perform even the most complex procedures through small incisions with an enhanced 3D high definition-view of the inside of the patient’s body as well as enhanced precision and control. The surgeon’s hands control every movement of the robotic arms. The surgeon can make the arms rotate and move in any direction, extending the range of the surgeon’s touch while still using laparoscopic techniques.

Unlike standard laparoscopic surgery, robotic-assisted surgery allows an experienced surgeon to have more freedom of motion to perform precise operations. However, laparoscopic surgery and robotic-assisted surgery both have the same benefits of less scarring, shorter hospital stay, and fewer complications.  If you are experiencing pelvic pain, abnormal bleeding, fibroids, pelvic prolapse, or have a type of gynecologic cancer, your doctor may suggest laparoscopic surgery or robotic-assisted surgery.

Dr. Quartell is a recognized leader in the field of laparoscopic and laparoscopic robtic gynecological surgery. Make an appointment with Dr. Quartell today by calling 973-716-9600 to further discuss if this procedure is right for you.


Urinary Incontinence

If you experience the loss of bladder control, which is a common and yet embarrassing problem, you may qualify for uro-dynamic testing.
Uro dynamic testing allows for your healthcare professional to evaluate the problem properly and determine which treatment would best help you.

Ranging from occasionally leaking urine when you cough or sneeze to having a sudden urge to urinate that is so strong you are not sure you will make it to the toilet,the symptoms can be inconvenient to painful.

Your healthcare professional will exam you and do a thorough work up to see what is causing the incontinence, such as possible tumors the block the urinary tract, stool impaction, and poor reflexes or sensations which could mean there is a nerve- related cause.

Your provider may perform a urinalysis test, blood tests, an ultrasound, cystoscopy or urodynamic testing which is comprised of various techniques that measure the pressure in the bladder and the flow of urine.

Anthony C. Quartell, MD & Associates serves Livingston, N.J., Millburn, N.J., West Orange, N.J., Verona, N.J., Caldwell, N.J., Florham Park, N.J., Whippany, N.J., East Hanover, N.J. and surrounding areas.


Urinary Tract Infections

Most urinary tract infections are bladder infections, which is usually not serious if it is treated quickly.

When germs get into the bladder, kidneys or tubes that connect them, they can cause an infection. If you don’t take care of the infection right away it can spread to the kidneys which can cause permanent damage and be serious. Normally, the germs get into the tube that carries the urine from the bladder to outside your body. This tube is called the uretha.

Females tend to have more bladder infections than males most likely because women have shorter urethras,therefore; it is easier for the germs to get inside and travel to the bladders. Some situations that make it easier to get the infections would be: having sex, if you have diabetes, if you are pregnant, if you have something blocking the urine flow such as kidney stones.

Some symptoms include:

Feeling pain with urination

Feeling like you have to urinate often but only a little urine comes out

Pain in your lower abdomen

Your urine smells bad, is cloudy or looks pink

Pain where your kidneys are (on one side of back under ribs) Fever, chills, nausea, vomiting…
It is important to call your healthcare provider as soon as you experience these symptoms so that he or she can evaluate you properly and treat you accordingly.

Anthony C. Quartell, MD & Associates serves Livingston, N.J., Millburn, N.J., West Orange, N.J., Verona, N.J., Caldwell, N.J., Florham Park, N.J., Whippany, N.J., East Hanover, N.J. and surrounding areas.


HPV (Human Papillomavirus)

HPV is a very common sexually transmitted infection, in fact; it is the most common one in the United States. Most men and women who are sexually active will get it at some point in their lives.

HPV is spread through sex, whether vaginal, or oral, by having sex with someone who is infected. You do not always develop symptoms right away as it could take years to experience any symptoms making it difficult to know who transmitted the infection to you.

Usually you will not experience any symptoms, however; some people develop genital warts. Also when a woman gets an abnormal pap test result during cervical cancer screening she may find out that she has HPV. Unfortunately, some people do not find out until they develop cancer.

Even though there is no treatment for the actual virus, it can be prevented by getting vaccinated at 11 or 12 years old through age 26 for females. Genital warts can be treated as well as cervical pre-cancer if women are disciplined about getting routine pap tests.

Anthony C. Quartell, MD & Associates serves Livingston, N.J., Millburn, N.J., West Orange, N.J., Verona, N.J., Caldwell, N.J., Florham Park, N.J., Whippany, N.J., East Hanover, N.J. and surrounding areas.

  • Dr. Anthony C. Quartell has been recognized by New York Magazine and New Jersey Monthly numerous times in the category ‘Best Doctors’. In addition, he was rated and awarded ‘The Patients’ Choice Award’ by his patients!


  • Dr. Anthony C. Quartell was rated and awarded ‘The Patients’ Choice Award’ by his patients!



The practice of Anthony C. Quartell, M.D. & Associates is dedicated to providing for the special health needs of women of all ages.

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