Haters

The late Kobe Bryant once said,” Haters are a good problem to have. Nobody hates the good ones. They hate the great ones.” Hmm. He might have been on to something there. Every time I have an experience with a hater, it always gives me pause. I hear or look at the comments and then I feel compelled to go back and look at my office records and my detailed notes to search for the possibility that I went wrong somewhere. I have to tell you, the vast majority of the time, the person’s statements and accusations are false, sometimes wildly so, or at least skewed to the point of their perceived advantage without containing concrete facts.

Yes, I initially fall for it every time. I’m thinking, oh my god, they really think that?! They really think that is true?! As most good physicians with a conscience, we are always striving to do the best for our patients and guide them appropriately. This sometimes requires steering them in the opposite direction of their potentially bad choices. I realize that this technique does not jive with everyone, but I would not truly be doing my job to the best of my ability if I didn’t. So, I don’t plan on changing my strategy any time soon.

The other potentially sticky point about haters is they always get to strike first and get their word out there and sometimes you don’t even get a heads up that it is happening in order to construct a well thought out response. By their first strike method, their opinion resonates with readers and listeners sometimes before you even get to know it’s happening. You know what they say about social media. If it’s on Facebook or Google it must be true right? Well, wrong. Neither Facebook or Google prechecks to make sure that the person has even visited the place or person so whatever you are reading could even be by someone who has never even had contact with whatever they are talking about. At least Google now sometimes gives you a heads up if someone posts about you on Google maps. I have regretfully even had people post that I killed their child, which is definitely something that has never happened.

So, yes the haters can potentially cause damage or mislead. They will always vex me to an extent. I will probably always be looking and verifying. But, when I really think about it, having a hater might be just like Kobe said. It might be that my reach is so far and wide that even the smallest unhappy people with nothing better to do than spread hate are paying attention too. I am going to chose to accept the fact that these folks are just a natural consequence of putting yourself out there to the public. Well, I am going to keep doing it.

Dr. Katz

I can’t help myself. I have to ask. How is a 40-hour course going to be enough training to cover what is has taken me 16 years plus multiple decades to perfect?

I am seeing those ads again about women and menopause. I am seeing the adds that promise that anyone can become a certified menopause coach in just 40 hours and at their own pace. 40 hours and you know it all and charge women whatever you want for your help. Hmm. It sounds too good to be true. Was that all I needed to do? Just take some 40 hour course and I would have been all set years and years ago? No undergraduate.? No medical school? No years of residency specializing in Obgyn and women’s health? No decades of private practice with ongoing and continuous learning to continue to improve my quality of care and guidance that I offer women? It could have just been done with an online course so I could go on and charge women cash for what I offer?

I gotta tell ya, I’m not buying it. I have no regrets about all my extensive investment both monetarily and mentally in my training. It has taken me all this time and continues to take me more continuing time and more learning every day to continue to offer my full attention and concentration to devoting my life to caring for women of all ages. It is what I do. It is who I am. It is what I have spent my life creating. I feel that it requires much more time and devotion than just a 40 hour course.

I continue to be saddened and disappointed about our continuing efforts to diminish the role of physicians in the care of patients everywhere. I understand that there are a lot of you out there who may have been hurt or not gotten the results or attention that you have needed from physicians or health care professionals in the past. I also understand that this makes you resentful and you want to spread this resentment to the medical community in general. I urge you that this is a mistake. There are good, intelligent and well-meaning physicians out there. There are those of us who have the compassion to listen and have good intentions and have your best interests at heart. I urge all of you before you go spending money on these seemingly good short-cut options, please reconsider and seek healthcare and coaching from actual properly certified physicians and medical professionals.

It’s not really true that it’s over. The facts of being a cancer patient.

I saw a post from a friend of mine that really touched my heart and I want to talk about it. This friend has a lovely daughter that suffered from cancer and then a relapse and is having continuing health issues that are saddening and frustrating. It’s as if the initial battle is over but the long-term war is still going. Worse yet, my friend has the impression that no one understands or cares.

Well, I’ll tell ya right now that I understand AND care! This is a firsthand testimonial for me as well. I am a two-time successful cancer warrior with all kinds of ongoing health issues and consequenes. I am grateful to report that I successfully battled both hodgkins lymphoma and primary cns lymphoma. Yep that’s right, whole body cancer and brain cancer, all in a four-year time span. And yet, I am very grateful to report that I still get to be here to crab about it. That is awesome! Who thought I would still even be here in as recently as two years ago. Yep, definitely a big win. Also, I have decided to turn my crazy experiences around and create positive things out of them like my Chemo Peeps group on Facebook. I have decided to use what I went through to help others and pick up the slack for everyone else who is potentially letting them down. I am totally in!

As far as my poor friend, I completely get how if even the acute battle is over, the ongoing war continues, probably forever or at least five years or so. This is why I am afraid to even use the word survivor because I think it implies a kind of permanence that is not really realistic. Heck, I am not even a total of five years out from my first cancer, much less the second. Wow that is a lot to think about. I have all kinds of ongoing medical issues that are the result of my cancers and the treatment for my cancers.

Let’s rattle off a partial list. My thyroid was destroyed with my first cancer treatment, which was not picked up right away until I was almost comatose from sleepiness. That is an ongoing juggling battle to titrate the correct dose so I can remain upright and not have my hair and skin get too dry and fall out. I now have a recurrence of my sleep apnea due to the crazy thyroid and all the fluid weight I retained after all the steroids. Hello cpap my old friend. I have ongoing neuropathies and myalgias that are very unpredictable and sometimes make it hard to move any given day, but I press on anyway. I have all kinds of side effects from the Keppra I was put on at the time when my brain was so full of cancer it was seizing uncontrollably and put me into a coma. We are talking Keppra rage, weird neuropathies, tingles in all the wrong places, crazy reflux, etc. Thank goodness I am on less Keppra now so the side effects are less, but not absent. Realistically, I know I am always going to need it though because I have enough scarring left in my brain because of the treatment that that alone can cause seizures even though the tumors are gone. My diabetes has gone a little nutty as well but I am busy wrastling that back under control with additional medication.

Let’s also talk about the left over emotional and psychological consequences. Yes. Yes. I have a certain amount of ptsd and mistrust after all my medical craziness. I get the slightest twinge and quickly assume the worst, before I try to self-calm and re realize that it is not likely. It takes me a minute though. I have had to go back on my Prozac for this and resume therapy to manage my emotional consequences and help me maintain any sense of calm.

I also get bothered by the fact that as a patient, you essentially have the perception that you have become boring after your particular physician’s part of your treatment is over. It’s as if their little tunnel approach excuses them from caring significantly about you afterward. Again, I am not saying that this is intentional, but I really feel that they have to be better about maintaining a vested interest after your acute treatment is over. It is by far not over for you and they still make you follow up at inconvenient times for at least five years afterward. I feel like this should mean more to them.

The bottom line is, yes, it is correct that the long-term war is still ongoing even after acute phase treatment has been completed. It does matter what you are still going through. Many people are unable to understand this, but, I have to admit, I don’t really need them to or want them to. I don’t wish on anyone what I have been through. This is not an experience I want to share with anyone. It is terrible and draining and awful. I am going to choose to support others and be there if they need me and share stories and support as needed. That’s all I can do at this point. We all need help sometimes regardless of what the issue is at the moment. I hope we can all try to be there for each other. Have the best day that you can and never stop advocating for yourself. That’s all for now.

Dr. Katz

Do you understand now why you should actually care if your partner has pain with sex?

I hear a lot of patients lately telling me that they are having pain with sex, but they feel obligated to continue because their husbands have needs. Umm. What???? You are in pain but you have to muscle through because he has needs? Mandatory suffering? What is this craziness?

Then, it gets somehow worse and I actually ask them if they have brought this up to their partners and most of the women actually say no. Or worse, they say they brought it up and got kind of brushed off and told they need to deal with it or their relationship is over or that their partner has no idea how to help them or doesn’t even want to try. Again, whaaaat?!

Ok, let’s refresh on what a relationship should be in the first place. A relationship should be a healthy, deep, emotional and complex bond between two individuals that encourages each of the persons to live their best and most fulfilled lives. It is not a one-sided show, or at least it shouldn’t be. Both parties should be invested in the other’s happiness, wellness, and future.

Well, on that note, we are going to launch forth into the discussion of pain with sex. It matters guys. You can think about it in an empathetic way or in a mutual beneficial way. The empathetic way would be to look at it as realizing your partner is having pain and want to help because you care about them. The mutually beneficial way would be to realize that it would actually benefit you both to seek treatment for your partner’s pain. Why you ask? Because if they are in less pain, they might actually want to have sex because they won’t be afraid that it will hurt! See where I am going here?

Bottom line is, I am encouraging you to care if your partner has pain. I am encouraging you to help them seek help, from someone like me, for their issues and begin the steps to revitalize your intimate relationship. It will benefit you both …and it’s the right thing to do!.

Dr. Katz

Hello all you vaccine haters and fear mongers! This one is for you!

Guess what I just saw in the news today! South Carolina is having a major measles outbreak! 88 new cases in just the last three days and over 600 all together! Why is this happening you ask? Oh I know! It’s because people have taken a stand and are not getting vaccinated because it is their right to make a decision for all the rest of us 5 and under and 20 and up and immunocompromised to intentionally expose us to this terrible illness.

Is measles fatal you ask? The answer is YES. It can be. It can be FATAL in up to 3 in a 1000 cases. This rate is much higher in the immunocompromised. So, it’s not nothing. It does matter and lives are being compromised with this no vaccine decision making. You may also ask well this wasn’t before when we were not vaccinating. This is where you are really fooling yourself. It wasn’t happening before because we still had the benefit of herd immunity from those who had been vaccinated. It takes a few years for those numbers to fall enough for the disease to resurge. Yes, I said resurge, not come back. You see, it never disappeared in the first place. It has always been there simmering. We just adequately used vaccines to prevent it.

Let’s go through the measles process. First you have incubation, when you are infected with no symptoms. this lasts 7 to 21 days. So, you can be out there infecting everybody without even realizing it. Then you have the prodromal phase with the fever, the cough, the runny nose(coryza) and red eyes. This lasts 2 to 4 days. Then you move on to the exanthem phase when the red and blotchy rash appears and spreads from the face down to the whole body. This part lasts 3 to 5 days. Then, you finally make it to the recovery phase when symptoms gradually fade but the fatigue can last a long time. So, we are talking about over a month of yuck.

The vaccine, first offered in the 1950s, offers protection for your whole life. Measles is even more contagious than Covid that we are all afraid of. Measles was so common before vaccine that most people developed immunity just from getting it. Yes, that is true. I will give you that part. But, if you are one of the unlucky ones that is immunocompromised or you are under five, it could kill you.

I just can’t rectify to myself the option of refusing something that is available to us and is actually proven beneficial. I just can’t rectify to myself putting others at risk without their knowledge and making decisions for them without their consent. For those of you out there refusing vaccines and “taking a stand” and “not letting anyone tell you what to do,” congrats. All you are doing is putting others and yourself at risk. Please rethink it.

Dr. Katz

Laser hair removal. What’s it all about and how can you help it be successful?

Laser hair removal can be a magical thing. We take a laser with a specific beam link to specifically target the juicy root bulb of the hair follicle in it’s active phase and voila! Hair falls out and stays gone! I’m talking permanently gone! It beats a lifetime of painful waxing in my book any day.

So, as I mentioned, laser hair removal is effective when it targets the juicy root bulb of the hair follicle when it’s in its active phase of growth. Well how often is that? For all hair from the waist up, it is about every four weeks. With all hair below the waist, it is about every eight weeks. About how many sessions does it take, depending on the hairiness of the patient, to remove it completely and permanently? It takes an average of six of those monthly or bi-monthly session per body part. It is not a one and done scenario so if you are expecting that, you will be disappointed. Now if you are hairy like a bear or wolf, it may require more. The laser can only do so much

How do you increase the success and decrease the discomfort of your hair removal sessions? First, come on time at the proper intervals. Second, have yourself shaved to the point that there is only a few mm of hair sticking up above the skin surface. Third, have you skin absolutely bare with no lotions, potions, or tanners or cleansers. If there are any substances on your skin, it can confuse or worse, intensify the beam and you will get burned. This is why it’s important to read all those papers and follow the instructions.

I would also advise that you get an actual consult with a test spot before you pay for laser hair removal. This way you can get a small spot treatment with the laser, observe for 24 hours and make sure there is no skin reaction and that the settings picked are appropriate.

Lastly, not every laser can treat every skin type. All lasers are not created equal. Skin types 1 thru 3 and Asian skin type 4 require a shorter Alex beam. Darker Hispanic, Indian, and African American skin types are type 5 and 6 and require the longer Yag beam. Without using the proper beam, the laser could get confused between the patient’s skin pigment and the pigment of the hair. Then, skin damage or burning could occur.

Hope this clears things up. Here’s to being hair free!

Dr. Katz

” I felt like you were speaking directly to me!”

These are the amazing words I just heard the other day from a new patient. At first I didn’t know what she was talking about. I inquired further. The patient clarified that she had been watching me and watching my videos on Facebook. She said the resonated so much with her that she felt like they were videos and lessons made especially for her.

I was blown away. This was the most amazing compliment ever. Let me be perfectly clear. There is nothing that I do in my life that is done for the goal of receiving compliments or praise. Everything that I do is because I believe in doing it and want to project as much positivity and inner strength as I can into the world. However, compliments are amazing when people bother to give them. We all spend way too much energy into negativity rather than positivity. It is truly a blessing when someone expresses positivity in any way. I am always up for it and am grateful to receive it.

This patient had such sincerity. This is what I have started hearing lately and what I have been striving for for years. To everyone that has initially poo-pooed my online social media efforts as meaningless or useless, I say aha! It is not for nothing! It is actually working! I have mentioned this suggestion at staff meetings to provide a suggestion for reaching out to people to advertise good services only to have people dismiss and shrug. Good thing I didn’t listen to them and kept on going.

I have finally attempted to reach my ultimate goal, to be able to reach current and future patients and pre let them know that I am truly there for them and that I see them as individuals and that I truly am ready to care for them for the entire lives if they let me. I am ready to empower them and help them advocate for themselves. I am ready to help them realize that they are allowed to put themselves as a priority for their own physical and emotional well-being. I am ready to assist them in realizing their own self-worth. So, ladies, if any of the rest of you are looking for someone to care comprehensively and completely for you for the rest of your life, I’m right here in Monroe, Mi.

If you ever need some additional info about anything in general, please feel free to check out other entries in this blog or my podcast Straight Talk with Dr. Laura. Happy reading or listening!

Dr. Laura

Let’s talk about them orgasms.

Here is a recap of one of my favorite articles about orgasm. This is a very important topic that is often overlooked and not talked about as if it is some kind of taboo. However, I would venture to say that we talk about men’s erectile function and dysfunction all the time. So, let’s chat about the ladies for a minute.

Did you know, that depending on the source you read, there are anywhere from 4 to 15 types of orgasm? I didn’t realize that myself. Apparently the brits think there are like 15 where most of the American literature describes 5 or so. The article I am about to discuss talks about the different types of orgasm and was endorsed by human sexuality expert Dr. Laurie Mintz. So, here we go.

Here’s a few fun introductory facts. Did you know that women that allow themselves to experience a variety of sexual behaviors are much more likely to achieve orgasm than those who don’t. What do I mean by behaviors? Ok let’s say it out loud together: new and different positions, oral sex, sexy talk, and fantasies. There are also studies that say that women are more likely to achieve orgasm if their last sexual encounter involved a combination of deep kissing, manual genital manipulation, and oral sex in addition to vaginal penetrative intercourse. So, get out there and get creative to increase your chances of orgasm!

You really need to think of an orgasm as an intense and pleasingly unique event. Some women describe it as an earthquake whereas other experience a sort of undulation or ripple. This is a very personal experience and is unique to every woman.

There are all kinds of arguments among scientists with regard to categorizing female orgasms. They also argue about ridiculous things like the right way or better way to orgasm. I think they are missing the point. However you get there is the right way for the individual woman. Hurrah that she made it there in the first place. There is no instruction manual needed here.

So, instead of talking about the types of orgasm, let’s discuss the top categories of places that a woman finds enjoyable for stimulation. I think number one has to be the clitoris. It literally has more small nerve endings in a small space over any other part of the body. It is the only human organ specifically designed for pleasure. Most women actually require at least some clitoral stimulation at some point during sex to reach orgasm. Let us not forget the clitoris. Keep in mind that there is still variety woman to woman on where, near, or at the clitoris that allows her the most desirous response. Keep in mind that I am not trying to imply that the clitoris is some magic button. There still needs to be some finesse and creativity involved. Sometimes if the partner doesn’t quite have the touch, a good old-fashioned vibrator can come in very handy. There are actually whole books written on the history of the vibrator. Did you know that the vibrator actually came into being because women were using up the city water supplies to stimulate themselves with faucets etc so that someone had to invent a vibrator to stop women from using up the water supply! It actually had a practical, money saving initial purpose. Nowadays they are hopefully just for fun.

I think that the number two position belongs to that famous G-Spot. I have literally had patients come in to ask me if I could help them find it because they or their partners were unable to. Let’s clarify the G-spot. The G-spot itself is located in the lower third of the way into the vagina( closest to the entrance). There is way more involved than just a spot. It actually includes a multiple of organs, including the internal, non-exposed clitoris. Pressure on this spot, which is not actually just a spot, is undeniably delicious for a lot of women. A little pressure directly upward one third of the way into the vagina can be amazing. Either fingers or a vibrator will do. Over time, the vagina loses its formerly downward angle and becomes more straight on, so it becomes a little more difficult for the penis to hit that spot. Yet another potential bummer of aging. But, the good news is that I have simple office procedures to restore that angle and fix that issue!

Let’s talk about the third option, which is the blended climax option. This occurs when a woman has the intensity of the initial clitoral stimulation followed by vaginal stimulation. That is literally a best of both world situation.

Finally, let’s talk about the fourth option…multiple orgasms. This is definitely the potential holy grail of options. We seem to forget about these options, mostly because if there is a male partner involved, there is always a downtime refractory period before he is able to ejaculate again. So, no offense to the men, but then he is laying there, all satiated when the woman is still very much ready to go! Women have no downtime! We are hardwired completely differently and are able to have multiple orgasms with a single sexual encounter! Yay! A bonus for the women!

The bottom line is, we shouldn’t forget about the orgasm. We should pay attention, get creative, soak it up, take our time, be adventurous and enjoy!

Dr. Katz

Will ya stop harassing me about my decision?

So, I made a decision recently that apparently has the whole world and my whole staff reeling. I made the executive decision to give my own personal patients my own personal cell phone number to be able to contact me after hours. I know what you are thinking. What…the…hell?!

Now, let me explain. I gave all the options like 25 years of chances. I gave out all my correct contact info to my hospitals multiple times over the last 25 years, often specifically with me myself showing up to all the departments and hand giving and directly communicating my correct contact info both verbally and in some kind of printed form, while watching the personnel actually change it on the computer or in some kind of antiquated roladex.

Still, I move out of everyone’s line of sight for a minute with cancer number two and suddenly everyone has lost or forgotten all my contact information! They were giving my patients an old house phone number, that I haven’t had in over 15 years. Then, they were giving out my office fax number. Well, no one is going to be able to reach me with that one either. Or, they were giving out my office number, where no one is after hours. This happened even after I re re went back and reshared all my actual contact information myself to all these departments and places. So, in the meantime my patients suffered, there was miscommunication, and my patients had to pay for all these errors in communication, and, I knew nothing about it until it was too late each time.

So, I finally came to the decision that enough is enough. I am not busy delivering babies anymore. I have my phone on me at all times. I can fully answer any questions or solve anything in minutes no matter where I am or what I am doing, and the patients benefit from that. Barring the occasional time where I would miss an actual call, they can text me and make sure that I get their message in a different way. I am planning to stick with this plan. So far it is working out much better and I can provide explanations and comfort in a way that no one else can. I am ready to pull my pants up and do my job and do my best due diligence for my patients. I have made it clear that my number is for urgent matters only and so far patients are following that guideline. I think I am going to stick with it.

Dr. Katz

You have to try this place!

I was at my regular and now routine oncology appointment, to once again establish that I am once again cancer free…still! This appointment I finished in record time so I figured out I would have plenty of time to finally visit one of the famous brunch places in Detroit. I won’t even mention their names because all of you probably already know. You know, the places that don’t take reservations, don’t have set parking options, and make you wait a long time, for what I am sure is excellent food. Well, I tried to get to all of those places without success. They either had no available seating, no parking, or the wait would be at least an hour and a half.

So, I decided to throw caution to the wind and randomly pick a new place that had only existed for just over a year, and turned out to be just down the street from the hospital where my appointment was. If only I had pre realized that they had their own parking lot I would not have had to wrestle with the Park Detroit console for so long. Nonetheless, I paid for a spot and made my way down the street to the restaurant.

Wow, I walked in and it was truly charming. The menu was awesome. The people were friendly. The food had a lot of variety and was amazing, The whole atmosphere was very welcoming and not at all pretentious. The service was great. My entree was the non-loaded shrimp and grits with a brown sugar iced shaken espresso. Wow! Basically what I’m saying in a nutshell is, you gotta try this place! Now get your butt in there!

Dr. Katz