Sunday, June 27, 2010

Are Regular Periods Normal?

This is a non question for most of us, as we have been brought up in the era since 1960 when birth control was available and a woman expected to have a period every month of her adolescent and adult life save pregnancy.


LET ME EXPLAIN..............

Prior to reliable birth control women were paired ( married) soon after they were fertile. They did not have birth control available, and then bore six to ten children which they breastfed. Most of their adult lives were enmeshed with childrearing and they had few periods.

It was a decision to continue with monthly menses when birth control pills became available as a means for a woman to be certain she was not pregnant. Pregnancy testing was difficult and often unavailable at that time. For years now, pregnancy testing has become available is accurate, and is inexpensive.

That leaves us with the concept of extended cycling for birth control pills that has become recently available in an FDA labeled product. OB/ GYNs for years have been using regular birth control pills for the purpose of avoiding menses for decades. I used to call it the "honeymoon special" or the "cruise special". Someone would inevitably call and tell me that she would be on her 25th anniversary cruise when she expected her period, or that someone would calculate that she would have a period about the time for her honeymoon, and ask me to make a period not happen. That was OK. We are able to use birth control pills to help delay a period. Extended cycling via birth control pills is also safe. The pills are not just for birth control. They help with menstrual control to a degree. There is always some percentage of women who have "break through " bleeding which drives us all crazy.

Come to think of it, there's a lot about gyn practice that should have driven me crazy ( or crazier) years ago. Somehow I manage.

Anyway, extended cycling is safe and convenient. It can be done with the FDA prescribed pills or with regular birth control pills. Just make sure you take 84 active pills in a row, then one week off/ or the placebo pills. You get 4 periods a year. Whoopee!! Nothing is going to back up. It is safe. It is more natural than monthly menses. Now, there's a thought.

Until next time..............

Sunday, June 20, 2010

Thinking about Balance

Are you on pointe dancing as fast as you can?

Balance, balance, balance, that elusive prize..........

This is a topic that has been on my mind lately. I have spent the last several months consumed by moving. First packing, then moving, now unpacking. Deocorating and settling in lay ahead. I am out of balance. All work and no play make Claudia miserable.

And what about you? Can you find time to balance your life? Are you all play and no work? Didn't think so... Finding that elusive spot in life where ying and yang meet, and harmony exists is a hard one. I find that every now and then we achieve it, feeling at one with life and the world. It is not always when we have the best of times, it can be amisdst hardship and privation, but creating that balance is a wonder.

How do some people seem to always be "in the zone" while others are medicated beyond belief to get somewhere out of the ozone? I think it is a matter of philosophy of life and living a purposeful life.

 So to some degree I think it is under our control.
Now isn't that an empowering thought?

Actually taking the time to think about how you want to conduct yourself and your life is not something I was taught. To create the balance that is harmony with your surroundings is the key. Living life with purpose is important, but remembering balance allows you to live the days you are given.

So, work some, rest some, play some, do something for others, do something for yourself, and before you go to sleep tonight, see if you got closer to balance.............

Until next time.........

Friday, June 11, 2010

Routine Breast Imaging or Boob Attack!

Part of the GYN check up is an examination of the breasts.Lots of new controversy surrounding what to do, how to do it and when to get imaging. And what kind of imaging to do.

The young woman has a risk of a benign conditions and tumors. They are found either by the girl herself, or during a gyn visit. Most of the imaging that is done is through ultrasound, as that is helpful for a young (under 30) dense breast. After that the breast starts to accumulte fat, and therefore it is easier for the radiologist to differentiate normal tissue from abnormal. A screening baseline mammogram is done about age 35. From forty on, annual mammograms are still the best way to look at the breast.

What do we ask the radiologist for during these imaging examinations of the breast? We ask them for a consultation regarding your breast. Is there evidence that leads us to need a biopsy ( ie further investigation) or can this breast be evaluated in a normal or other interval? Now the radiologist takes this very seriously, and will ask for not just the routine two picture views, sometimes they will ask to add other modalities such as ultrasound, or other views, like standing on your head. This of course, is something that drives women crazy.

It's like this. You slam the car door on your finger. You go to the Emergency Dept to see if its broken. The radiology tech takes a picture of your finger. They take the film to the radiologist ( or if digital, send it) and ask if it is adequate. The radiologist says no, turn the finger this way and that until she/he decides it is broken or not. Same with the breasts only the radiologist is ususally not sitting there. These routine films take a number. And these days your radiologist may be in India or Austrailia with teleradiology.

At any rate if the views taken are not sufficient to answer the questions posed, they will request that the ordering physician go back and do it again, this way and that.They may want to do ultrasound, or recommend a biopsy either through ultrasound or needle biopsy. They will also compare the films to prior years to guide them what is normal for you.

So that's it. Don't panic if you need more films. Be thankful they are paying attention!

Until next time

Wednesday, June 9, 2010

Is there a lighter side to widowhood?

Who was the Merry Widow? Is she a woman who was in a lousy relationship?

 I don't think so. I think she is in the recovery phase .

After the first year, after the flashbacks, and after you have settled down, I think there may be a somewhat lighter side to widowhood.

It's kind of like being a  college grad  with the trauma of finals, papers, and projects behind you. The whole world laid open before you. Just take what you want.Pick this, leave that. Do what you want. Now I suppose this probably applies to those of us without little ones at home. At any rate, this has been my experience.

I am in an "exploration" phase of life.

 I was really set on what I wanted from life, and then it blew up in my face like a trick cigar. I have taken to saying that God thinks I am too much woman for just one man, so it is the divine plan for me, in my maturity,  to experience the pleasures and attention of men. And I mean men, plural.  I did not date much as a teen, and into my 20's. It took me until my late 20's to have a serious boyfriend. Since I have been widowed, I have dated men from 38 - 70. They have all filled a purpose, and a niche in my life. The most age appropriate guys seemed easiest to be with. The others are there for me to "stretch" and see how life plays out. My mother called me a cougar. What does she call me when I date the 70 year old, kitten?

So now everyone is very PC, and we are partners. No more boyfriends. Not PC enough. Have to say the man I am partner. Very snooty sounding to me, but don't want to step on any toes. Monogamy has always been important to me, but not now. Honesty remains key. I let everyone know I am seeing more than one guy, and they are OK with that or gone. Exploration deserves some perks.

Of course, there is not always sex involved, and there is STD testing. One of my office mates said I was the only person she knew that would have a date that included blood testing. Yep, that's me. I walk the walk.

Life is open to me, and because I was in a healthy, good relationship, I see the world as good. I know the risks posed, but as a mature woman without kids at home, risk is somewhat ok. Staying completely safe gets me nothing. Just hiding to me. Remember the story about the widow who joined the Knife and Hatchet throwing club? Well, the lesson learned is to go where the boys are.

For me it has been online. What a treasure trove of humanity! How do you advertise to hundreds of millions of people? I think online is key. There are many, many social networking avenues. I picked two or three and went for it. It is easy to screen people on the internet. Just ask a few penetrating questions.
What are penetrating questions? OK, like what frightens you? What were your parents like?
Look for values. Ask about stories that reveal sticky situations and see which side of the coin they fall.
Mostly ask about difficult times. If someone has lost a family member/spouse/child/buddy/job/etc, ask how they managed. Did they get mad, act childish? Did they take the moral high ground? What was important? Did they care for a dying spouse? Did they do right by an ex? That is how they are going to treat you. If you see any red flags, move on. It's easy to do online.

Back to widowhood. It whitewashes everything. You get all kinds of deference, and ascend to a higher plane. Of course, many men assume you were left in the lap of luxury and have lots of cash.
If you are a divorcee, it is assumed you were difficult to live with, and finally drove your husband off, and are desperate for a meal ticket. I have been both, so I know. However, as a working woman, it was obvious I am my own meal ticket, and was not left with a dime.

Why am I talking about men? It always gets back to this, because in the end life is better shared.
All of the pieces in the puzzle seem to come together when there is someone else. So I sit with my puzzle pieces on the floor, looking at them over and over trying to get something to match. Its a new game for me, that I have played before. This time I have the confidence that I can take my time to choose my direction and all will be well. Whether the man comes first, or the direction, no matter. Life is life, and this is my silver lining.

Until next time................

Thursday, June 3, 2010

I can't lose weight!

This is a daily concern from women. With many Americans overweight or obese, it is not hard to figure out the problem. Do one third of people all think they have a hidden illness that will magically make them drop 50 lbs with a pill overnight? I think that kind of delusional thinking or wishful thinking is the problem.

Warnings for decades from the Surgeon General on down have made it clear.

Americans eat too much, and of the wrong kind of food.

Our blessings are also our undoing. True, genetics has something to do with it. There are folks that just seemed destined to gain weight easily. There are those who will be lean.

Behavior has lots to do with this national epidemic.

As a medical student I was once quizzed about what could I name as a health problem. I stated
overnutrition. I was already noting in 1973 that there were more fat people out there, and that the abundance of food was driving a generation to the CABG patch.

Most of this tirade is fueled by an reintroduction to how the other half lives by way of a book
"The Poisonwood Bible" by Barbara Kingsolover. If you haven't read it, by all means, I recommend it.
It is a reminder of the toil people have just to feed themselves. We have become so used to having a drive through life of convenience, and busy ourselves with trivialities to fill the voids.

Paying to exercise? Yes, we have tried to balance our lives by paying good hard earned greenbacks so we can bend and stretch. Unbelieveable. Schools had more balance for children and taught good habits of daily physical activity. At least one hour a day was routine, and more if you liked. Kids are harnessed to computer monitors and have become sedentary. According to recent reports one third won't be able bodied enough to serve in the military, even after basic. Now it is a national security problem!

Back to women and weight. It has been my observation that by 18 a woman will have lived out her ability to lose weight easily. This is different for men. They hit the wall around 30.So that driver's license weight at 16 is about as low as you go without moderation in food intake, and physicial exercise, and women will start off as a 120 lb teenager but by age 30 will have put on the freshman 15, 15lbs for the first year of marriage and another 20lbs apiece for each baby. Now at 30 we have a woman who is teetering at 200 lbs.  This only accelerates after menopause. Not good. Increases in metabolic rate are only through physicial exercise.

This is now a lifetime problem that gets thrown in the GYN's  lap of "it must be my hormones". True a few people will be hypothyroid. I have been wishing for that my adult life. No such luck.

The moderation in food intake is where we commonly make all the mistakes. Portion sizes are out of control. Most women complain they only eat one meal a day,and it is a salad, and can't lose weight. The mathematics of weight make it simple to calculate. More is going in than being used. The extra is sticking to you. FIND IT and BANISH IT FOREVER! Look at how much salad dressing you are using. REALLY GIRLS, did you think the salad dressing was water?

Look at the cokes, crackers, chewing gum, snacks, and how your food is prepared. IT IS CREEPING UP ON YOU AND ALL AROUND YOU..........FLUSH IS OUT AND TURN YOUR BACK ON THAT LIFE. Don't be so busy you don't prepare your own meals. Mealtime with the family is a sacred event that should be attended on a daily basis. It is the glue that keeps a family together and healthy. It is where communication happens, and lives are shared. It is a cornerstone of the family.

Throwing a bag of take out on the table is just not right.

 It means high fat, high salt, and heart attack city for you and your family.It teaches your children you are too busy to care about nutrition for yourself or your family. Just quiet their bellies and get it out of the way.

Pay attention to caloric intake, physicial expenditure and you will open a new chapter of health and wellness in your life and those you love. Stay away from prepared foods as much as possible, and find fresh foods that need to be peeled,cut, washed and otherwise "prepped". Buy a good knife and a pair of sneakers.

Until next time..................

Wednesday, June 2, 2010

The Car

I think of myself as a capable woman. But I do have a very large chink in my kevlar.

I really don't know anything much about cars, and that is how I like it. My concept of a car is that it is a thing that gets me from point A to point B in more or less comfort and safety. Driving is another matter.
Now, I do enjoy driving like a bat out of hell. That's fun. So I look for cars with the power to go fast.

It is an overwhelming annoyance to fill the tank with gas, let alone remember and pay attention to a maintenence schedule. So I tend to drive cars with flashing signals to tell me when the gas is low, when I need to change the oil, and have a 911 button, connected to a navigation system and a concierge service.If the little bugger doesn't work right, I am very put out. Like this weekend.

Believe you me, this was the icing on the cake! I returned from Denver from a lovely wedding. The day started with me waking up in the Mountain Time Zone a couple of hours earlier than needed. I lollygagged and finally got to the parking lot of the airport hotel, ready to scoot to the gas station and then turn in my rental car.

Not good. Try the darn thing again. No luck. Call AVIS and tell them THEY HAVE A PROBLEM. I told them where to collect their miserable junk heap, not to charge me for the day or the gas, and tossed the keys the front desk clerk and boarded the shuttle.

Forward past a long flight to Tampa and then a four hour delay. I had a good book,but it was getting toward the end of the book, and I'm on Weight Watchers, so I couldn't just drown my boredom in chocolate.
Well, after finally getting back to my little home airport, collected my suitcase and tromped off to the garage with my hi tech open the door remotely clicker.
After a bit of wandering late at night alone in a parking garage I found my little darlin and a GD thing happened. Quick phone call to the daugher in law who gives me the emergency number to call for the extra $199/ year I pay to get me out of this kind of trouble.

OK we'll attempt a remote door unlock. Just pick a time from 5 minutes to 17.5 hours from now for us to try it. This is not a joke, they want you to pick a number from out of a hat to ATTEMPT a remote unlock. Now when I got this car and was told that the assistance # could remotely unlock your door, they didn't tell me about this little piece of news #1 it doesn't always work #2 you have to hang around to wait for it . They explained the longer that they got to unlock the door remotely the more likely it would be successful. Well, there I am in this garage with a target painted on my forehead, late at night by myself, and they are asking if I am in a safe place.

OK I'll give you 30 minutes.

During these 30 minutes in 90 degree heat at 10pm, I am phoning a man I am seeing. My mind is saying
He is a man, who ultimately is responsible for all mechanical things, and I am taking this personally.

In realtiy I am describing my tale of woe. He lives in California and comes to see me in Florida about once a month. This just plays into my concerns he is not really going to move here, or he would have been here to run interference in life for me. OK, I have now joined the dark side. Women who want a man to take care of them. That's why I was married. This is about the only time I really really really miss being married.
On the other hand, my first husband told me to read the manual when I broke down about 50 miles from home. That was a day I realized the marriage was doomed. So I don't have a good track record with men and THE CAR.

The upshot is that I marched off, took a taxi home, got the extra clicker/key and begged a ride back to the airport, where I put putted back home. I ususally don't do drama, but there are exceptions.

Until next time................