My Body Myself---Maybe?

I am continually amazed at the myths, untruths and misunderstandings that women have about their own bodies and how they work.  I do a LOT of educating in my day-to-day office sessions, and I always feel good when people leave understanding much more than they did when they came.  I'm not really sure where these ideas come from,other than information incorrectly gleaned from the Internet, or from family and friends, or from TV shows and other media.  One of the least well-understood concepts is that of the menstrual cycle.  My typical "menstrual cycle 101" explanation goes something like this:
The reproductive cycle is sort of a closed loop, involving the brain, the ovaries and the uterus.  The brain signals the ovaries to produce Estrogen.  The ovaries make Estrogen, whose job it is to make a thick blood-filled lining form inside the uterus.  Once it gets nice and thick (ready for something to implant) the brain again signals the ovary. This signal occurs about 12 days after the first day of the last period.  This signal is to OVULATE, or release an egg.  Once the egg is released, it takes a trip in search of a sperm to join with (into the fallopian tube).  What is then "left over" in the ovary after that ovulation, makes Progesterone, another hormone.  Progesterone helps stabilize that lining that has been building up in the uterus.  IF that egg is not fertilized, the levels of Estrogen and Progesterone drop very low, and the uterus, realizing that there is nothing coming to be implanted in the uterine lining, sheds that lining, hence---the next period.  This is quite a delicate balance of signals and hormones (estrogen and progesterone) and organs.  If ANY part of this cycle is not functioning correctly, it will result in either irregular periods, missing periods, and/or possible difficulty getting pregnant.  Once women understand this concept, they have a MUCH better understanding of their own cycle, and will understand the various ways that I can help them manage the problems they may be having with it.  There are explanations like this for so many other bodily functions, and I believe understanding these concepts is important for women to take control of their own health care.  In the "olden days" of Gynecology, when women were not so autonomous, and "The Doctor Always Knew Best", (and that doctor was usually a man), it was not unusual to hear things like, "You're finished having babies, why not just take your uterus out?" at the hint of any problem with the menstrual cycle.  These days,  women should hear about and understand all of their options when it comes to reproductive care.  It is important, and one of the things I love best about my doctor-patient relationships.

The Olden Days Continued

When my parents got married, things were rough.  They came from two different worlds and two different religions.  He had just buried his young wife, and she had just gotten out of an abusive marriage which was annulled  (I always wonder about annulments- do those people REALLY believe that "it never happened"?  More likely they can just deny it and pretend it never happened...)  They met when they were both teaching English as a second language to foreigners...so they had THAT in common.  I guess they were just two broken souls, seeking solace in each other.  My mother came from a big Italian family, and they were very welcoming to my father. My father came from a small Jewish family, and they were for the most part, very UNwelcoming to my mother.  But marry they did,  and in spite of the fact that my mother promised she was not going to have kids, when her sisters all started having babies, she took back her promise.  She pouted, and cried, until my father gave in, saying, "I'm too old to take care of babies" (he was 45, but had many medical problems).  He told her that the burden of taking care of these kids was going to fall mostly on her.  She agreed.  They had my brother, and then me, 22 months apart.  They already had the two (now older---8 & 13 year olds) from my father's first marriage, but by all accounts, they didn't really consider them "their kids"....those older kids were dragged around from relative to relative, and were pushed out of the spotlight by the two new babies.  Parents of that generation for the most part believed that they were good parents if they fed you and put a roof over your head: there was none of this "anticipating my children's needs" or "providing emotional stability" for the kids.  Knowing how my parents were when I was growing up, I can only imaging how they were to these two "leftover" kids.  The good news is that I am close with my older half-siblings.  Although we actually are from different generations, I adore them, and we have a shared history and a lot in common that I can't say I have with anyone else.  We speak regularly although we live on different coasts, and we are genuinely happy when our families spend time together.  The story of what happened with my parents, my "real" (if we must call it that) brother, and me-----not such good news.

Days and nights on call

Being oncall as an Obstetrician and Gynecologist is a unique experience.  Anything can happen, from perfectly normal women having perfectly normal pregnancies going on to have perfectly normal deliveries...to life-threatening emergencies where life-saving decisions need to be made.  Luckily, most of what goes on tends more toward the "normal" categories.  Having had three pregnancies and deliveries myself, and having been at this job for many years now, it gets easier to deal with whatever may come.  Also luckily, I am a "list" person----I have a constant list in my head when dealing with on call activity----a list of all the things that ARE happening, and all the things that COULD happen, and what I should be doing about it, in order of liklihood and priority.  I find that a LOT of my time is spent teaching and explaining to patients and families what can happen, what our plans are, and how the bast of plans may change drastically through the process.  Labor and childbirth can be a scary thing, and explaining things can really help the situation and lessen the anxiety.  One of the things that has been harder as I have gotten older, though, is the loss of good sleep and what that can do to me.  I was a resident in the days where we were still allowed to work 80 hour weeks, stay up all night, and then see a whole clinic-full of patients the next day. (And RIGHT after I was finished with residency, those rules changed---for the better--quite a bit!)  I used to lose sleep and bounce back right away.  Now, the "bounce" is not so immediate.  This past week, I had not had a good night's sleep for 4 or 5 nights in a row....and by the last day I felt like death.  The only other time in life I can equate this to is when you have a newborn baby in the house---especially if you are exclusively breastfeeding......the extreme exhaustion that accompanies waking every two hours to feed the baby, and never REALLY getting the restful, REM sleep that you need....With a new baby that goes on and on. In my opinion, the baby thing got me ready for being an on call doctor, and being oncall got me ready for having a new baby.  I had the pleasure of both of those experiences, since I had two babies BEFORE residency, and one baby AFTER.  More on THOSE stories later.

In The Beginning.......

I guess I'm going to jump around quite a bit on this blog-----there are a lot of things I want to say about the present time,  about my day-to-day life, but in order to see how I got here, I also have a lot to say about where I came from.  The road to wine country was by no means a straight path.  Sometimes I am amazed that I ended up here.....but so happy about the twists and turns that brought me to this place.
I was born in Brooklyn, New York.  After meeting so many people in so many different cities and states, I am convinced that about a third of the population came from Brooklyn or the surrounding areas at some point in their lives.  It's like everyone somehow starts out there, and then takes a different path to their ultimate residence.  Growing up in Brooklyn was quite the experience. At the time I didn't think anything was so unusual about it.  We played on street corners, rode bicycles to the school yard, and ate at the corner "pizza place".  After high school, most of the people I knew dispersed and went in different directions.  I only realized when I became an adult how much the place I grew up and the family I grew up in so directly influenced my decisions and who I would become.  My parents were also from Brooklyn, although one generation back, my father's family came from Poland, my mother's from Italy.  My father was married before.  He was Jewish, and was married to a Jewish woman.  They had two children, my half-brother and half-sister.  Sadly, his wife passed away from cancer at a very young age.  (but no one talked about it in those days).  Having a mother die so young, and a father who probably was grieving, and drinking, and unavailable probably made those kids emotionally unstable and unable to cope.  My father later met and married my mother--a non-Jewish woman who had no idea what she was getting herself into.  His family objected and rejected, the kids were confused and unhappy, and I'm surprised they ended up staying together.  But stay together they did, and several years later had two children together, my brother and me.   I guess I can stop here because there is so much to say and so many more blog posts to say it.

The Noble Profession

I have been an Obstetrician and Gynecologist since 1993, if you include my four years of residency.  I think it is the best Medical Specialty, because about 90 percent of the time it's a "happy specialty". People having babies, getting pregnant, having sex, talking about sex....it is a window into the lives of women and their families that not many get the privilege to see.  But it is a difficult specialty as well.  The endless hours without sleep, the emergencies that can and do happen at any time--the sheer enormity of so many of the decisions that have to be made, and how these decisions can affect the lives of your patients---no wonder many people think I'm crazy for having chosen it.  I've never been a particularly religious or even a spiritual person, but I firmly believe that what I do is a "calling"....that there was a point in my decision making process that something "came to me", and I realized that this is what I SHOULD be doing, and I could do the most good if I joined the ranks of this particular specialty.  I have never been sorry.  There have been times when I felt challenged..exhausted....sad......overwhelmed....but  I have never thought I should have gone into a different specialty  (Not many dermatologic emergencies in the middle of the night!)  I always said that when I do not enjoy it anymore, that is when I will stop doing it----and so far I am nowhere close.

Well, I think I'll give this thing a try

I always thought that blogging would be ideal for me.  I have so many interests, so many life experiences (for good and for bad) and I really love to talk.  I'm nearly 50 (although I sometimes can't believe that, nor can I believe how that number doesn't bother me as much as I thought it would), I live in one of the most beautiful places in the world--The Napa Valley. I have a wonderful, mixed (and sometimes mixed-up) and extended family, and I've been working as an Obstetrician and Gynecologist for about 14 years.  I love to read, travel and exercise, and I do as much of all three as I can.  The journey of how I came to become a physician, how I came to live in Napa, and how my blended family came into existence is an interesting and sometimes unbelievable one.  I am not really sure if anyone is interested in reading about this journey. As a matter of fact, I am pretty sure that my family would NOT be interested in my discussing or describing the details of their past or present lives.  But I've decided to try to discuss and explain, to talk about my thoughts and, to share without revealing too many intimate details.  So we'll see where this goes.....