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

Get RID of post op restrictions? I think not.

As most of you may or may not know, I have to renew my board certification for obgyn on a yearly basis, often with a multitude of articles and modules that require completion and a series of tests to take. I think they think that it is a good reminder to stay invested and keep up to date. I personally feel that I am capable of that on my own without paying exorbitant fees, but oh well.

Anyway, I regret to say that it is rare that one of these required articles contains information that is either brand new to me or significantly useful. Most of the time I am looking at them and having to read them for credit and just go with that approach. Some of the articles I feel are downright potentially harmful. I need to tell you about one of them.

Most recently, I read an article in a very reputable journal suggesting that we abandon all post op restrictions. Post op restrictions are the what I feel is very necessary guidelines to maximally assure a good recovery after surgery. They include things like holding off from sexual activity for six weeks. No lifting, pushing, pulling anything over a full gallon of milk for six weeks and no driving for a car for at least one week. Yes, I know, it potentially sets a patient up for ultimate boredom and frustration. You are watching your house get dirty. You are watching your kids run amuck. You are missing out on your normally awesome cooking, etc.

However, having said that, I have found that, in my almost thirty years of experience, that these recommendations, while not popular, are the way to go. It is my way of helping to ensure a good recovery for my patients. So, I read this article, claiming that all these recommendations are anecdotal/heresay at best and have no scientific evidence or backing. This article also says that there is the same change in intrabdominal pressure with getting out of a chair as lifting something heavy. I am sorry, but that cannot possibly be true.

So, I started doubting myself. I thought maybe I am being too strict. Maybe these “experts”( that probably haven’t treated an actual patient in years) were right. So, I gave it a try. I gave up the post op recommendations for one set of surgeries for one day. You know what happened? Two of my patients ended up bleeding after wrestling with a dog or picking up their kids since they couldn’t stop….and one ended up back in surgery after tearing their vagina open. That was a definite turn off for me. I guess my anecdotal self realizes after thirty years that not all incisions are created equal. I can see that with a visible abdomen incision you might get a heads up if you are about to make a big mistake and tear your incision open. With a vaginal incision, there is nothing you can monitor visually and no good prior warning signals you have to to tip you off before it’s too late.

The bottom line is, I tried to follow this nonsensical potentially dangerous advice and it backfired almost immediately. So, we are officially BACK to the post op restrictions!

Dr. Katz

The next scan is coming up…again

Guys, I can’t help it. There is like a little internal panic clock that starts ticking once I get within 2 weeks to a month of my next scan. I know they are all necessary. I also know that I have no concrete symptoms to tell me that anything is wrong. And yet, I still go off the rails somewhat. I swear to god I start having or making up some symptoms just due to anxiety. I know, that sounds ridiculous, but it is true so I might as well admit it. I have gotten much better about calming myself down without pharmaceutical assistance tho, so that part is good.

Do any of you out there who have or have battled cancer before go through this? I know the answer is probably yes but I am just asking anyway. How do you deal with it? I am wondering to myself if it will ever go away. I have yet to actually make it to a 5 year post cancer mark with either of my cancers. I am almost there from my first cancer in 2021, but still not quite yet. It’s interesting that I hardly ever think about that one like it’s old news or something. It was still serious but very treatable. It’s almost as if the most recent brain cancer that I had overshadowed everything. Even tho it, too, was treatable thank goodness.

I have had many people tell me that I have no right to call myself lucky since I have had two cancers. I have had many people tell me that at least I had ” the good kind” of cancers. I am not always sure how to filter that input so I just end up smiling and nodding, and then walking in the other direction. As I have had time to think about it, I think that my own personal take on it is a combination of those two inputs.

Yes, I do think that I am lucky that I was able to successfully battle both of those cancers. I think of myself more in terms of a warrior than a survivor, because I do not think that my ongoing vigilance will ever truly be over. I will always have to be on the look out, recent stem cell transplant do over not withstanding. I know that sounds crazy to say and seems like I am not celebrating at all, but actually I am celebrating. I celebrate every single day the fact that I get to wake up in the morning, open my eyes and realize the world around me.

As far as the having the good kind of cancer part, I am not really sure what that would be. I do not think the words good and cancer belong in the same sentence. I would definitely go with the word treatable though. That kind of thinking sometimes sends me in the wrong direction. I start belittling the kinds of cancer that I had because I was able to conquer them when other do not. I know I shouldn’t do this. I realize that the battles I fought successfully were extremely difficult and that nothing should be taken away from them just because I survived. Each cancer battle is it’s own challenging and potentially vicious beast. The strategy that I have chosen to take when I find myself minimizing what I have been through is to throw myself into empowering, helping, and supporting others with cancer. I think it is my best strategy at this point.

So, to all of you out there who have battled, are battling, or know someone who is battling cancer, I sent out all my positive, empowering, and strategizing energy to you. If there is anything that you need or any way you think I could help, I will.

Have a fantastic day everyone.

Dr. Katz