Making the Connection: Two Emory Physicians Forge an Online Friendship that Extends to the Exam Room

Dr. Cherie Hill and Dr. Stephanie Holt first connected inside a Facebook group for women African-American physicians.

Though they were both Emory physicians – Dr. Holt, an adolescent and pediatric physician and Dr. Hill, an obstetrician and gynecologist – the two hadn’t yet crossed paths in the hospital. 

The Facebook group was a place to connect, network and share experiences. Dr. Hill and Dr. Holt were also both new to the Atlanta area, and the forum provided a great opportunity to meet people. Dr. Hill, who had recently completed four years of residency at Duke University, was eager to build a network of black women physicians. 

“I think that’s a unique experience in medicine and one I wanted to share with others,” she said. 

“The number of black female physicians nationwide is fairly low, according to the Association of American Medical Colleges data. While you may not interact with people who look like you ona day-to-day basis, you can connect with other physicians from all corners of the nation who may have similar experiences to you in medicine.” 

The Facebook group would often fill with requests for career advice or referrals for family members and friends. For Dr. Holt, it became a forum for a very personal reason. 

Self-Diagnosing

In 2014, Dr. Holt began experiencing heavy bleeding. The bleeding was pronounced enough that despite her medical background, she –- like most of us – began searching for an answer online. 

“I did what most people do when they start having symptoms: I Googled it. I went through online materials, compared it to my own experience and medical background and diagnosed myself with fibroids,” Dr. Holt shared. 

Her concerns continued to grow and navigating finding help became increasingly worrisome. “I went to maybe two different GYN-OB practices, and the bleeding hadn’t changed, she said. 

“I had just gotten married, and my husband and I wanted kids. Suddenly, I have this heavy bleeding, and now I’m worried I won’t be able to have kids. It was an overwhelming time,” she continued. 

Dr. Holt acknowledged that she was already aware that there might be difficulty getting pregnant even before the new fear of possibly having fibroids. She, like a growing number of women, had delayed pursuing pregnancy as she continued working toward her educational and personal goals. Now 34 years old, the idea that her age in combination with possible fibroids could negatively impact her ability to conceive was something she was struggling to understand. 

“Here I am, searching online and constantly worrying – am I going to be able to have children depending on the type of treatment I have for fibroids,” she admitted. “I knew I needed to find the right physician to help diagnose and treat me so I could start a family with my husband.” 

As the bleeding continued, Dr. Holt’s husband encouraged her to make her health a priority and seek help. He ultimately suggested that she turn to the group for advice and post for a referral. 

“It takes a certain level of risk to put your personal information out there for everybody in the group. I decided it was worth it to find someone that could give me answers and help me feel better,” Dr. Holt said. 

A few names were offered from the group, but the very first response was from a gynecologist herself. That gynecologist was Dr. Cherie Hill. 

“She replied with a message that was along the lines of, ‘Hi, I’m a gynecologist, and I can see you if you want to come in.’” 

Two Doctors Brought Together

Dr. Hill recalled seeing the post appear within the Facebook group. 

“It read something along the lines of, “Does anyone know a gynecologist who can perform a myomectomy? I’m interested in pregnancy but have been told that I need this fibroid out, and I’m looking for a second opinion.’” 

Being relatively new in the group, Dr. Hill replied. 

“I posted that I would be happy to see her, review her records and to potentially take her on as a patient. Fibroids are very common, particularly in black women. I wanted to try to help another physician,” Dr. Hill said. 

As soon as Dr. Holt met Dr. Hill in person, she knew she had found the right provider. 

“I immediately felt a connection with her,” Dr. Holt shared. “Dr. Hill had a plan that would not only stop the bleeding but also give me the best chance at having a healthy pregnancy. 

“Dr. Hill and I are close in age. Talking with her wasn’t like just talking to a doctor; it was like talking to a friend. She put herself in my shoes, and she was always honest and direct,” Dr. Holt continued. 

Dr. Hill was happy to meet Dr. Holt in-person. During that first appointment, she went through Dr. Holt’s medical history and performed a basic physical exam. The exam confirmed what both doctors expected. 

“Statistically speaking, fibroids are much more common than ovarian masses or other growths that could occur in the abdomen in women,” Dr. Hill explained. 

“Fibroids are often quite apparent once you do an examination. Depending on the size of the fibroids,” she said. “I can usually feel the fibroid extending into the abdomen.” 

The next step for Dr. Holt was an ultrasound. The ultrasound shows how large the uterus is, how many fibroids are present and, potentially, their location. This is often followed up with an MRI of the pelvis. The MRI helps delineate the position of the fibroids and can also identify if the masses arecancer. 

In Dr. Holt’s case, after obtaining imaging and learning the fibroids were not malignant, Dr. Hill recommended removing them before attempting to conceive. 

“If you have small fibroids, maybe 3 centimeters or less and they’re not in the lining of the uterus, those often don’t need to be removed before conception,” Dr. Hill explained. 

“But, if you have fibroids that are larger in size or in the lining, they could potentially degenerate during pregnancy and cause pain. They could also compete for blood supply during pregnancy, which causes a potential risk for growth concerns, the risk of preterm labor or miscarriage.” 

The next step was identifying the best course of treatment for Dr. Holt. This meant taking into consideration her plans for starting a family. 

Dr. Hill understood that the ability to possibly conceive and carry a child naturally was very important to Dr. Holt and her husband. Dr. Hill, whose background includes robotic arm-aided minimally invasive surgical treatments, decided that proceeding with a robotic myomectomy (robotic removal of fibroids) would cause the least amount of damage to her patient’s uterus. It would also provide a more comfortable and faster recovery. Most importantly, there would be less potential for the development of scar tissue, creating a better chance for post-surgical conception. 

Making the Cut

A myomectomy is a type of surgery that is designed to remove fibroids or growths in a woman’s uterus; these are sometimes called leiomyomas or myomas. Typically these growths are benign (cancer-free). 

A robotic-assisted myomectomy is just one type of surgical procedure designed for the removal of fibroids. The incision is smaller than a standard surgery – 8 to 12 millimeters as opposed to the potentially 12 plus centimeters typical with a laparotomy (open, abdominal surgery). 

Infection risk is often lower, and pain is decreased, requiring less use of pain medication or narcotics. The result for patients is a shorter hospital stay and faster recovery. 

While Dr. Holt was asleep under general anesthesia, Dr. Hill placed a tiny camera through small incisions made in Dr. Holt’s lower belly. A small tube sent gas into the abdomen to inflate the area around the uterus and enable Dr. Hill to have a better view of the growths targeted for removal. The tools used to remove the fibroids are manipulated using a robotic controller. This allowed Dr. Hill to make exact and small movements within the uterine wall to remove the fibroids. 

“As a surgeon, you have greater dexterity with the use of the robot because of the pitch and yaw on the robotic arm.” Dr. Hill explains. 

Once it was confirmed that all growths had been removed, Dr. Hill removed the camera and tools, the incisions were closed and bandaged. Dr. Holt was able to go home the same day. 

Following Doctor’s Orders

As a physician herself, Dr. Holt was insistent on following every post-procedure instruction given from Dr. Hill. 

“Fibroids can grow back. In the ideal situation, the patient would already have a partner that she plans to proceed with pregnancy with or a sperm donor that she plans to use for insemination so that within the first one or two years after surgery she can conceive, hopefully before any fibroids grow back.” Dr. Hill stated. 

“The uterine muscle also has to heal before conception. Depending on the extent of dissecting that we do into the uterine muscle, that period may be three to six months,” she continued. 

Dr. Holt was instructed to wait long enough for the muscle to heal so that there aren’t any pregnancy complications from just having had the surgery itself. 

“I had the surgery in December 2014, and then I found out that I was pregnant around July 4th of 2015,” Dr. Holt laughed. 

“I just remember being elated when I heard she was pregnant. It’s indescribable,” Dr. Hill said. “You always hope that your patients will achieve their dreams and goals, and if you played a tiny part in that process, it’s just an amazing feeling. 

To not only share in the excitement, but then play the role of educator and discuss with patients the risk but also reassure them that this was the right treatment course and that they should have a successful, healthy pregnancy is a role and responsibility Dr. Hill relishes. 

“There was no question that Dr. Hill was going to deliver our baby.” Dr. Holt stated, “In fact, Dr. Hill was pregnant at the time herself, so I did see her colleagues for a few appointments, which I was okay with as long as she was still able to deliver!” she shared. 

Dr. Hill did indeed return to deliver Dr. Holt’s baby. 

“She was able to carry her pregnancy to full term, deliver her baby and have an uneventful delivery without any complications. There was no uterine rupture, no hemorrhage, no prolonged hospitalization: Everything went smoothly,” Dr. Hill said. 

An essential benefit to addressing her fibroids pre-conception, outside of an uneventful pregnancy and delivery was the quality of life post-delivery. 

“She wasn’t dealing with heavy periods because the fibroids were gone. So, she was able to enjoy her baby and not have to worry about those lifestyle interruptions,” added Dr. Hill. 

Baby Times Two

When Dr. Holt returned to Dr. Hill pregnant with her second child all of the wonderful warm feelings came up again. Once again, she relied on Dr. Hill to help her navigate her second pregnancy in a slightly different fashion than her first. 

“We went through her pregnancy with one difference the second time around,” Dr. Hill said. “Our Maternal- Fetal Medicine Division was involved, checking to see if the fibroids had grown back and if there were any other considerations necessary to ensure a healthy pregnancy.” 

A Lasting Connection

“I think the power of social media to connect people is so interesting,” Dr. Hill shared. “We found each other on Facebook after she posted a simple question looking for a recommendation and then, lo and behold, she was an Emory faculty member.” 

Dr. Hill and Dr. Holt’s paths have continued beyond patient and physician as their careers at Emory continue to grow. 

“We’ve been in medical education day together and been able to get to know each other professionally. It’s been inspirational to watch her receive accolades at work and live a great lifestyle as a mother and physician,” Dr. Hill shared. 

“It’s been great to be part of another young black women’s journey as a physician and as a patient. As providers, it can be tough and anxiety provoking to diagnose yourself because you know enough about the specialty to probably be scared, but not enough to truly understand your options. Now, we can continue our relationship as professionals. After all, pediatricians and obstetricians work together a lot,” Dr. Hill concluded. 

Schedule an Appointment

Learn more about the General Gynecology and Obstetrics team at Emory Healthcare by calling 404-778-3401 or by visiting our Website.