Wednesday, December 29, 2010


I have a lovely patient whose issues with her sexuality I understand. She has always been very sexually responsive, and this waned recently. For  her, it was most distressing. We tried a few things, and found the right balance to get things back on track. For this she is most appreciative. She gave me a bottle of
 KY Intense for Christmas. What a woman!

What I really like about this lady, is that she did not give up with the first try. She allowed me to work with her to get to her happy place. That is most unusual as we have been led to believe that answers, solutions, and cures are almost instantaneous with coming to a doctor's office. Testing sometimes is done in real time with immediate read outs of imaging and results of tests. Online access to results fast tracks communication.

Medical problems are usually not acute, and develop over time. Diagnosis and treatement sometimes takes time, as well as healing. Just some thoughts next time you go to the Doctor. Discuss time. Be explicit about your expectations for the visit, and make sure you and the doc communicate on the importance of your problems to you. We can then address the issues with you on a level that speaks to you clearly.

Hope this helps.

until next time..........................

Tuesday, December 14, 2010

The Unhappy Vagina or Something's Wrong Down There

OK, I have become an ambulatory gynecologist. What does that exactly mean? After doing annual womens' health screening, my number two most seen problem is the UNHAPPY VAGINA.

I just returned from a meeting of the American Society of Colposcopy and Cervical Patholgy. Otherwise known, as cervix , vagina and vulvar specialists. We wreaked havoc on the psychological health of the media guy who ran the slide shows. We were fascinated by all the varying lumps and bumps on the vulva, new and terrific diagnoses of "Unhappy Vagina Syndrome".

Many women come in to see the gyn with a "something's wrong down there" problem. It's up to me to figure it out and fix it. AND FAST. This is usually a problem that occurs on Friday and needs to be fixed by Friday night. Monday, hmmm somthing may not be quite right. Tuesday, OK maybe I should get something. Wednesday is a trip to the drugstore. Thursday, it's not gone, and getting worse. Friday gets a call to the gyn. GET ME IN NOW!

Most of what women self diagnose as yeast infections are not. They are a myriad of other problems, some infectious, and many are from irritants and allergens.

About one third are correctly self diagnosed and treated at home with over the counter medications. Of those that need the doctor, we never see anything uncomplicated. It can be from a week to years in the making. From normal cervical mucus, to a mixture of problems that envies an onion. After upteen years I have gotten pretty good at figuring this stuff out.

I have a secret weapon, Ladies Magic Cream. I have sent the secret formula to Clevland Clinic to see if it is worth commercializing. We'll see. In the mean time, it is always worth a trip to the gyn to figure out if it is an infection, what type, mixed or single. Irritant, allergen, hormonal, or normal.

Yeast grows in especially hot and humid conditions. For heaven's sake, lose the underwear at bedtime.
Cool and dry makes a happy vagina.

Bacterial Vaginosis is the newer name for nonspecific vaginitis, gardenerella, etc. This is an upset in the normal bacterial ecology. Someone other than the lactobacilli grow, and a stinky discharge with burning is the winner. This is treated with antibiotics. Over the counter stuff rarely works.

Irritants come in all types. The changes in your detergents, soaps, clothing, shampoo, pads, etc will make you red and on fire. The tip is to lose the irritant and soothe the unhappy vagina. It ususally takes a trip in to see the extent of the damage to Rx something to relieve inflammation and institute a regimen of healing.
The bathtub is your friend. No soap, just water.

Allergens are rare, and have a delayed reaction. That is the key difference between them and irritants. Again, discovery and avoidance is how it is managed.

All in all, my experience validated me as a major geek interested something that would get you in prison in several countries.

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

Wednesday, December 8, 2010


Hello all
The Holidays are upon us, and cyber week was a grand success! I was minding my own business when...I browsed through to find a movie one of my sons's wanted. In the featured cyber week ads were TVs.

Hmmm I thought, wonder if one would like to find its way to my bedroom? Or maybe the spirit of Xmas will fill me and I will see if my Mom would like one to replace her ancient tube. Well I am on the Amazon page, and call Mom. No she says, her tiny kitchen TV is just right for her and that 32 inch flat screen won't fit. OK then, now I am still thinking about the bedroom, when the mouse wanders over to the upper right hand of the screen, and I click to close out the page.

At least that's what I thought I did. No, I find out on Tuesday next. I look up the " Where's My Stuff" part of Amazon to find the movie I purchased for sonny boy. It asks if I want to track my ORDERS, emphasis on the S.
Just what have I done? Well looks like that 32 inch flat screen is on a truck headed for Grandma's house. I have ONE CLICKED MY MOTHER A TV.

This is at 8:30 am. My Mother is a night owl and rarely wakes prior to 9am. I call her. Ma, Ma listen, I need your help. I accidently ordered a TV and it is headed to you NOW. It is on the truck for delivery. I have her attention.

She bolts out of her fog, and starts up with " I can't wait all day for UPS, I have a hair appointment" and I have to go to the doctor. My ride is going to pick me up at such and so. I am now begging her to help me out of my embarassing mess. I frantically look up the returns part of Amazon. Seems simple enough. Reason for return... hmmmm. stupidity is not listed. OK, not wanted anymore ( or ever, actually ). I click, the instructions say, not to worry, the UPS driver will come get this TV tomorrow with a return label. My cost can go up to a total of $18.86. Chump change for idiocy. I am so happy free shipping goes both ways. I am hoping that this will not be a disaster.

By now my mother has all her feathers ruffled, going on and on about the UPS driver, needing to be home, and having to go to her appointments. I am pleading, just let him push it in the door and wait for another nice man to come take it away......Please Please...... She is near hysterical thinking they will leave it in her hallway in a NYC apartment building. God no I hope, gone in 60 seconds flashes through my mind.

Now I am guilty thinking I am going to give some poor guy a hernia dragging the TV to her apartment just to have her tell them what a moron her daughter has been, then the next guy the same rant when he comes to pick it up. I am sunk.

OK Mom, its not going to be a little box. It's a 32 inch flat screen TV. Big Box. Ok, ok, hopefully they won't show up until 7pm when you are back from the doctor. Ok she says. I cross my fingers.
Give me the tracking number she asks. Ok, I whimper.

I am terrified to call her in the evening to see how things have gone. She has called UPS to track the package. On the truck, out for delivery they say. They advise her to refuse delivery. Return to sender.
The driver eventually drags the TV to her apartment. Its a woman. Worse than I feared. She pleads with my mother to keep the TV. Lady, its a 32 inch flat screen TV someone wants to GIVE YOU for Xmas!!

No, Mom insists, her little tube is just fine. TAKE IT BACK. Ok, the driver says and drags the thing back to the truck. Now my mother lives on the 19th floor of a high rise. This has not been a good day for the UPS lady. I am doubly guilty again hearing the tale.

Well, its back on the truck. I hope.

Hope your HOLIDAYS are filled with the joys of the season. I know mine are.

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