Kiss and Tell?

Yesterday's post (regarding how a dentist was successfully sued for $1.5 million for giving his girlfriend a sexually transmitted disease) apparently generated quite a bit of water cooler discussion. What if he didn't KNOW he had HPV? Should he still be held liable? How can you PROVE someone gave you a specific disease?
The truth is that the only way to KNOW 100% for sure that someone gave you an STD is if you have never been physically intimate with any other person before your current partner- and that includes any form of intimacy that can occur with your pants off. Kissing on the mouth can certainly pass herpes, but in general, kissing, hugging, holding hands and other forms of intimacy that occur with your pants on are "safe".
Viral and bacterial infections often show up within a few days to weeks of exposure, but the sneaky part is that many of them can silently hang around for weeks, months, and even years in some cases. Obviously, if you are with partner A today, and with partner B several months later, then break out with an STD a few weeks into the second relationship- the picture is cloudy. Certainly, odds are better that it is the recent partner, but bacteria and viruses don't come with identification labels (though that would be so helpful!)
The other confounding feature is that symptoms from these infections tend to come and go until the infection is diagnosed and properly treated. In the interim, many people assume they are "cured" because their blister or discharge or discomfort goes away. Unfortunately, that is exactly when they are likely to pass the disease along to another partner.
So, the jury in this case had much to ponder, but the preponderance of evidence strongly suggested this man did, in fact, give his girlfriend BOTH genital warts AND HPV that caused pre-cancerous changes to her cervix. And, for the record, the evidence was strong enough to hold up under appeal.
I hope this high profile case will generate more honest discussions between partners, as well as make people think twice (on both sides) before they kiss and do NOT tell!
BOTTOM LINE: STDs are often SILENT, so expect your partner to get tested before he or she can "prove" his or her disease-free status!

GLAMOUR Reports $1.5 Million Lawsuit for STD!

Have you seen the September issue of GLAMOUR? Well, look closely at the article: "I Sued My Ex for Giving Me an STD- and I WON!" It's a fascinating case, actually. In short, a guy and gal got together. The girl had done "due diligence" in revealing her past sexual history, and had asked him about his. He reported NO history of STDs and said he, in fact, was in a "dry spell" and hadn't been with anyone in a long time. What's next?
Girl believes guy. Girl sadly develops genital warts AND abnormal Pap smears that are pre-cancerous. (To be clear, these are both caused by HPV, the Human Papilloma Virus, but represent infections by TWO DIFFERENT strains of HPV, as warts do not turn into cancer.) Back to the story- meanwhile, guy has-oops- impregnated another girl during the not-so- dry spell...
Now, the girl who caught the HPV is in law school, and not only knows her rights, but wants to be certain to protect any future women this guy chooses to be less than honest with, so...voila! Lawsuit.
Here is the best part: Girl WINS lawsuit, including an appeal, for $1.5 MILLION!
You can read part of my opinion about the case on page 338 of the magazine, but here are a few more thoughts:
1. People LIE about having STDs- it's embarrassing, they don't want to be rejected, and they think they wont get "caught."
2. Completely HONEST people may not actually KNOW that they have a disease, because so many are SILENT.
3. Perhaps we need some new media-worthy "catch phrase" for people to ask to see proof that their potential partner has been recently tested for ALL STDs- "Show me the papers"? "Papers before clothes?" "Proof, not promises?" "Reality before Romance?"
4. You cannot tell by LOOKING who has an STD. (This guy was a medical professional- a dentist- perfect case in point!)
5. IF you give someone else an STD, you CAN be found liable in a court of law. KNOW YOUR OWN STATUS as well as asking potential partners their status.
6. STDs are COMMON and cross all racial and socio-economic boundaries- don't be fooled into thinking that beautiful, rich, popular people are disease-free!

BOTTOM LINE: You CAN and WILL be held liable for giving someone a sexually transmitted disease. If you are not practicing abstinence, GET TESTED and swap results with any future partners BEFORE you are intimate.

Still Can't Sleep?

Insomnia. We've all had the occasional night or two when no matter what we try, we simply cannot fall sleep. Usually those sporadic nights have an identifiable stressor- a test, a job interview, or a change in time zones. For theses occasional situations, I have no problem with my patients taking a sleep aid (prescription or over-the-counter.)
Chronic insomnia, however, is a whole different ball game. Every night becomes a challenge and by 2:00am you're beginning to panic about how you'll be able to function in the morning. Patterns emerge of heavy caffeine intake in the morning to "get going", then an afternoon "pick me up" coffee or soda, followed by a glass or two of alcohol to "relax and wind down" from the day. Most people know caffeine is a stimulant, but did you know even morning coffee can impair your quality of evening sleep? Alcohol, though a sedative, may help people relax and fall asleep, but realize that it,too, disturbs the quality of sleep. So how can you break this pattern? Here are a few ideas that might help.
1. Start your day with exercise. Even a quick fifteen minutes of brisk walking will release adrenaline and help decrease your need for caffeine. Did you know exercising 30 minutes daily yields the same amount of mood enhancement as a low dose of an antidepressant? (Don't exercise just before bed, though, because as noted above, that adrenaline release will keep you up!)
2. Create a bedtime routine. If you have children, you know how important this is, and it works for adults as well. Take a warm bath or shower, appeal to your senses with relaxing aromatic bath soaps or gels, and then GO TO BED. Do not pass GO and collect $200. This means no stopping to unload the dishwasher, fold clothes, check email or watch television. If you want to read or watch t.v., do it before your shower. Get in bed, close your eyes, and consider some form of relaxing breathing or meditation.
3. Cover your alarm clock. Check it three times before you cover it if you need to, but if it's covered, you'll break that habit of waking up at exactly 2:17am each night. Yes, you might still wake up, but if you're not seeing the clock, it's easier for your brain to go back to sleep because you're not gearing up all the emotions that come with seeing that dreaded early morning time.
4. Consider an underlying medical issue.Medical causes of chronic insomnia include an underlying issues such as sleep apnea, restless leg syndrome, thyroid disease, anemia or depression. Make an appointment with your doctor to discuss it!

BOTTOM LINE: For the occasional sleepless night, go ahead and use a sleep medicine if you'd like, but if you're taking a sedative every night and stimulants every morning, recognize the habits that are aggravating the problem and make some healthy changes!

Just for the Women- Period.

Okay, today I want to talk about periods- menstruation- so this is for the women. Periods, like bowel movement patterns, are unique to each individual. In the textbooks, periods occur every 28 days, and last for a week. In reality, there is more variation. When an adolescent starts having periods, they are often very unpredictable for the first six months to a year. At that point, most young women establish a pattern that they can recognize and therefore predict when their next period should arrive. Some may be as short as 21 days, others beyond 30, but what is important is recognizing what your pattern is. Consider the modern calendar- a period tracker app- for your phone to figure out your cycle.

Are terrible cramps okay? Well, no- absolutely not! First of all, we have several medicines that might help, from ibuprofen and its cousins to using the contraceptive pill to help decrease the amount of cramping and blood loss. Additionally, for women who have pain outside the range of "normal", we begin to be concerned about endometriosis, a condition where extra tissue that belongs inside the uterus may have migrated outside of the uterus into the pelvis, and be stuck on the intestines or fallopian tubes, causing pain especially at ovulation (mid-cycle.)

Please do not suffer in silence! If you have "terrible periods" that make you miss school, work or fun stuff, make an appointment with your doctor! There are many ways your doctor can minimize your pain and help your life to NOT revolve around your menstrual cycle. Additionally, if it's PMS symptoms that drive you nuts (bloating, headaches, mood swings, and breast tenderness), there are simple behavioral modifications like quitting caffeine, increasing your calcium intake and increasing aerobic exercise that will help.

BOTTOM LINE: TALK to your doctor if you have questions about your period, and know we have many more answers beyond Midol or "the Pill".

Back To School Already??

Argh! Where did the summer go? Well, summer is nearing an end, and now we have the back-to-school rush. Our office is filled with last minute sports physicals and the mountain of forms that come attached. Please call your kid's physician now (if it's not already scheduled) and remember to bring in the school's paperwork with you to the visit, to save both you and us time and effort.

Why do we make you come in? First and foremost, because kids grow, bodies change, and we need to SEE them to be able to accurately assess them! Whether they are at risk for being overweight, have developed asthma or allergies, or simply started having periods- we need to know so we can appropriately treat them! Most schools require a doctor's note for even routine, over the counter medicines for headaches and cramps. Before we okay that, it would be nice to know more details- are the headaches turning into migraines? How frequent are they? Does the medicine upset your stomach? Etc. On the business end, yes, we charge for this. Not to be crass, but would you ask your pest control service to fill out forms certifying your house was termite-free without expecting a charge? It does take time and effort to check immunization records and fill out forms, so part of the business of medicine is that our offices expect payment for that time.

If you've got a child entering 7th grade, be aware that this is a mandatory vaccination year- Varicella (chicken pox), the meningitis vaccine, and a tetanus booster (Tetanus, Diptheria and Pertussis, TDaP). Got someone starting kindergarten? The new requirements include a hepatitis A series (2 shots) and Varicella. If you live in Texas, here is the press release that details these changes: http://www.dshs.state.tx.us/immunize/school/schoolchangesmemo.pdf

Every parent knows how hard it is to get back into the school routine, and that includes waking up EARLIER than summer for most. Please do not let your kid have that "last week of summer" excuse to stay up and sleep in even later! A week or two before school begins (which is NOW, in Texas) start cranking back bedtime and rising earlier. Sleep cycles are not happy when they are abruptly disturbed! Do it gradually, and the teachers will thank you, plus your mornings will be far less grumpy once the school bell rings!
Enjoy the last bit of summer and good luck for the upcoming school year!

BOTTOM LINE: Get those ducks in a row, and remember medical forms and sports physical requests can overwhelm doctors offices this time of year, so get yours scheduled now if they are not on the books yet!

The REALITY Behind Sex-ED

Today I am excited to share that my book, Seductive Delusions: how everyday people catch STDs, has been officially adopted by the North East Independent School District (NEISD) in San Antonio, Texas. The NEISD is the 8th largest district in Texas, and home to over 66,000 students. The Superintendent, Dr. Richard Middleton, recognizes that sex education is a challenging and often controversial topic, but with the shocking statistics of sexually transmitted diseases- especially in our teens- is excited to offer a new approach.

The NEISD has a wonderful program called Big Decisions, and they tackle multiple issues facing freshmen and beyond- from nutrition education, to digital citizenship (internet saavy/etiquette), to- yes, STDs and sex education. The teachers are excited to break away from boring statistics and dry textbooks to the reality-based stories in Seductive Delusions. Classroom discussions will not be putting students to sleep this year!

My book shares stories of successful young men and women as they are diagnosed with an STD. There are no steamy sex scenes nor bad language to further embarrass anyone. I should be clear that each story represents hundreds of patients that I have seen (that's the whole problem- this is COMMON!!) and I chose names that were the most popular baby names from 18 years ago, so the names would be super common, as well. What you WILL see is the conversations that take place behind closed exam room doors across America each day, including what to expect during each step through the discussions with the medical staff, the exam, any procedures, possible prescriptions and even emotional reactions as the patient processes the implications of the diagnosis.

This morning on KVUE Daybreak, we discussed this for our local viewers. Check it out on: http://www.kvue.com/home/The-reality-behind-sex-education-99929109.html and take a look at your school's approach. Let me know what's new in your community!

Grow Your Own!

Don't worry, I'm talking about TOMATO plants, here! Why bother growing your own? Wow, I can list a million reasons- starting with it TASTES better, and ending with it costs less AND there are no pesticides, but let me tell you my favorite reason. I love growing tomatoes because our daughters will EAT them. Period. Yep, that's the biggie!

I think I was in college, trying to impress a boyfriend, the first time that I actually choked down a tomato in a salad. Ironically, our kids are growing up hearing me ask at every restaurant "with EXTRA tomatoes on the salad, please". I truly love tomatoes now. How did we end up with home-grown?

Well, it's kind of funny. Our girl scout troop made tiny terrariums to start growing different types of spices and tomatoes. We made them outside on our deck. Our daughter decided to plant only tomatoes- "for Mom". They grew like weeds, and in a couple months, they were over three feet tall, starting to bear fruit, and needed to move outside. We moved them outside, where they promptly died within a week (very sad.) BUT-here's the kicker-apparently, seeds from the scout planting session must have blown off the deck and into our landscaping in our back yard, unbeknownst to us. Lo and behold, mixed in with our planted lantana, was several huge tomato plants, covered with tiny tomatoes! Well, we dug out the lantana, left the tomatoes, and as I type, we have nearly thirty tomatoes on the vine! These hearty plants grew with complete benign neglect, as we had absolutely no idea they were out there! Gotta love Austin weather.

At any rate, since "we" grew these plants, our girls were proud of them and decided to taste them. I'm happy to report that they now enjoy running out back at dinner time to gather up some fresh tomatoes for everyone's salad- not just Mom's!

BOTTOM LINE: Get kids to expand their palates by letting them grow some food or spice plants- even in pots on the windowsill!

PS. Happy August 1st! As with every first of the month, I want to remind you to CHANGE YOUR AIR FILTERS!