It really isn’t supposed to smell like flowers, cake or pie down there.( To douche or not to douche)

Say it with me…feminine…hygiene…products. Whenever I hear a patient say,” Eww. It smells like vagina down there,” I find myself wondering well what the heck is it supposed to smell like for chrissake? It SUPPOSED to smell like vagina….BECAUSE IT IS A VAGINA! C’mon people. Let’s get real here. I would just like to know who first started the trend of convincing women that it shouldn’t.

Let’s go over a few vaginal facts and a few feminine hygiene product facts. Spoiler alert! They are not actually good for you! I am going to attempt to rationally explain why so bare with me please. What you choose to do with this information is completely up to you, but don’t say I never tried to save your hinterlands from ruin.

OK. Here we go. We all know that feminine hygiene products have been around for what seems like forever. I am talking decades at least. There are wipes, washes, deodorants, douches, creams, sprays, etc. You name it. We’ve got it. Everyone of them is geared toward reducing odor, using after intercourse, or cleaning up vaginal discharge. Did you know that there was a study in 2006 that reported that most women start using douches or feminine washes in their teen years, usually between 15 and 19 but some start as early as 10 years old! Whoah. There are mixed results demographically regarding whether Black and African American women tend to douche more than White and Hispanic women. Some studies say yes. Some say no.

You can see how the advertising gets you. Who hasn’t seen a commercial or a ad about getting rid of period funk or that not so fresh feeling? This kind of marketing can easily make some women ashamed of their own natural odor and set up an unrealistic expectation of some flowery fresh scent that is supposed to be down there. It is just one more way that we are potentially messing with a healthy self image. I am not on board with that. I think I have even found some of that stuff in my daughters’ bathroom!

Let’s talk next about what the biological environment of the vagina and vulva are supposed to be like. Vaginal ph changes throughout the lifetime of a woman. Usually during reproductive years, the pH ranges from 3.8 to 4.4. This range is essential because it allows the normal bacteria of the vagina to flourish. Bacteria called Lactobacillus are supposed to be there to protect it. Well, the pH balance in feminine hygiene products, regardless of what they tell you, is widely variable and usually contain ingredients that make the vagina way too acidic. We have studies that show that these products start wiping out the Lactobacilli within 2 hours and can even eliminate them all together by 24 hours! When this happens, an inflammatory reaction occurs because a substance called interleukin-8 starts increasing because the normal healthy bacteria are not there to stop it. This potentially leads to a much more wide varied growth of different bacteria, which in turn leads to bacterial vaginosis, yeast infections, urinary tract infections, generalized itching and discomfort and even a greater risk of sexually transmitted diseases. A lot can happen when we get rid of the vagina’s natural defense system. On top of killing all the normal bacteria, the chemical in some of the products actually breaks down the vaginal wall. Here’s a kicker on top of that. Once women start having itching or discomfort from the products, they think they need more product to stop the itching! It really is a vicious cycle.

This is the last thing that I would like you to think about. Once you have damaged the vaginal environment, it can be very tough to impossible to restore it. Most research indicates that it will require at least two weeks after the last time a woman used an irritant to get any relief. Let me tell you, that is a rough two weeks without out much recourse available. Those are my patients that end up coming in chronically miserable and there is not a lot we can do but wait for all of the product to leave their system.

Listen, I am not about to call out any products by name but I am telling you that I am not a fan of anything out on the market right now. You never know, new items may come out in the future that are more conscientious of the natural vaginal flora. But, in the meantime, I advise you to just say no!.

Dr. Katz

My colonoscopy experience was awesome!

Ok. Ok. I know what you’re thinking. Eeew. How is that possible? There is nothing good about a colonoscopy. Am I right? Well, yes, you are right. A colonscopy is kind of shitty…pardon the pun. What I am really referring to is the experience and how I was treated. Let me explain.

I chose to have my colonoscopy NOT incognito, but at my local hospital Promedica Monroe Regional, where I go to work every day. Trust me, these people have seen the best and the worst of me for over 20 years now. They have saved my life multiple times, helped me in the OR, helped me deliver babies, etc. We have listened to each other. We have complained together and rejoiced together. Sometimes I see them more than my own family. But wait, they are part of my family! They are just not the family I live with. So, why not let them in on my health too?

From the moment I walked in, all crazy haired and no make up on,(yikes) they greeted me like family. We joked and laughed while they checked me in, while still making sure that all the proper protocols were followed. They managed to treat me like a patient, a doctor, and a family member all at the same time. Bravo! I almost cried…literally. Everybody stopped by to see me. They explained things as if I was fresh off the street with no medical knowledge. That might annoy some people/docs but I love it. We should explain everything to everybody. You never know if you might have a total brain fart about something you do every day….when it’s actually YOUR turn! As a matter of fact, I was stressing more about this stupid colonoscopy than I did about all my cancer stuff and chemo and procedures for the last year and a half. What the heck?! It was as if I just couldn’t handle the thought of maybe even one more thing being wrong. Thank God they treated me like family. It put me at ease right away. They went over and above. I have never considered myself on any sort of VIP terms because that’s just who I am. I even asked them why the special treatment? You know what they said?

Doc, you been through a lot and we all love you. We just want to take care of you like you take care of us. You are one of our own. I think my heart about burst out of my chest, in a good way, right at that moment. I realized then that they do see me. They see how much I care. They see how hard I try every single day, because I want to not because anyone tells me too. We have a mutual respect. I try to treat everyone well in the hopes that they treat me well. That’s what a team should be. It’s what I love about what I do. Well, I have to tell you, the ProMedica Monroe Regional Hospital team was the best I’ve ever seen! See you at work Monday guys! I love you!

Dr. Katz

I have been really struggling with how to be a good parent lately.

Parents tired of noisy children who are running and shouting Tired mother and father sitting on couch feels annoyed exhausted while noisy little daughter and son shouting run around sofa where parents resting. Too active hyperactive kids, need repose concept parenting stock pictures, royalty-free photos & images

Wow! I have been really struggling in the parent department lately. There have been so many unforeseen and unpredictable changes in the last two and a half years that have really affected my relationship with my kids and none of them are in my control.

The ongoing pandemic has ripped us all away from our usual social environments and has taken away many traditional milestones and events. As adults, we have missed out in person interactions with work colleagues, family gatherings, and the ability to be at loved one’s side during illness or hospitalization. This has been difficult but our capacity to recover is greater because, for the most part, we have plentiful stored memories to fall back on. For our kids, they are missing once in a lifetime experiences like prom, last sports games, and in person graduations. It has been argued that they should “get over it” because these events are nothing compared to high schoolers of the past who had to leave school to go off to war, etc. Last time I checked, no one is comparing prom to Nam and they shouldn’t start now. Missing these key social interactions has caused some long-lasting psychological damage for these kids. They will never get these moments back. The level of depression that I have seen is tremendous and it affects everything.

On top of the pandemic, I got cancer and my husband had a heart attack, one right after the other. My kids almost lost both parents in one year. As much as they put up an outside facade, I know this affected them tremendously. How could it not? They don’t treat us the same way. I get the feeling that, even though we survived, a part of them didn’t. A part of them walks around every day waiting for the next shoe to drop and they can’t seem to stop. There is just a little air of underlying depression and doom almost every day. It kind of breaks my heart.

There has also been a sense of life is too short no matter what is going on for them. This sounds like it should be a healthy realization, encouraging them to live life to the fullest, but instead I worry that it has become an excuse for unhealthy choices and directions. I am just at a loss as to how to handle it.

As a parent, I feel like I should be jumping on or punishing these poor choices or at least trying to redirect them. I worry that I am not doing my job if I don’t. I am concerned that it will seem like I don’t care if I don’t react. But really, it’s not true. I talked to my therapist about this. She explained to me that punishments don’t really work in this situation. Most punishments that I could think of would really only punish me and the other people relying on my kids in the long run. Taking away phones, jobs, privileges, and cars just mean that I will have to do a lot more driving, spending, and won’t be able to communicate remotely with my kids. She assured me that I am not being a bad parent by not reacting to every single thing and leaving some things up to my kids to figure out. It doesn’t mean that I don’t care. It doesn’t erase my validity as a parent. Ultimately, the consequences of their actions need to be theirs. Making myself overly upset about it does not help anything and is counterproductive. She advised me to take a step back and I think she is right. Overly obsessing and punishing and trying to address every little thing only increases my stress, increases the negative attention impact on my relationship with my kids and gets me no where. It can only end badly. I need to put a stop to the distracting inner struggle and keep growing and moving forward. I need to refocus. I need to no longer punish myself for not being there when I was sick or my husband was sick. I need to be patient. I can help them more by living my best life by example than fighting every day. I am not saying that I plan to let them run me over. There are limits. I am just saying that I need to pace myself and realize what is really important. Everything I have been through, my kids have been going through too and it’s not over yet. This is going to be a marathon, not a sprint.

Dr. Katz

The Nissan and the Lexuses..or….why don’t I fit in?

Every morning, my little Rogue and I drive to work together. When I find my way into the parking lot at the hospital, I am always greeted by a fleet of Lexuses, Teslas, and Maseratis, etc, all parked incorrectly, the vast majority taking up more than one spot. I drive around and around, looking for somewhere to park and end up finding something a little more remote, despite my doctor’s parking pass, and I squeeze my little Rogue in and head up to my office. Sometimes I look back at my goofy little car with the Mechagodzilla on the dash and my fuzzy dice in the window and just kind of giggle a bit. It does look kind of out of place amongst all the other luxury vehicles but it’s just…more….me.

I realize at that moment that it is kind of a metaphor for how I don’t exactly fit with my colleagues at any one time. I have spikey hair. I have tattoos. I don’t act like I am better than anyone else. I talk with people not at them. I am not employed or owned by anyone. I don’t see a high volume of patients like cattle on certain days. I say what I think while at least attempting to be professional and appropriate at the same time. I am pretty goofy and I like to laugh. My job is not just a drudgery to me. I love it and hopefully it shows! ( By the way, I am not saying that everyone is like this. These are just some differences I have noticed over the years in some cases.)

I used to perseverate a LOT about the fact that I was so different. I felt this pressure to conform, fit in, be a grown up all the time, get in line….all that. In fact, I worried about that until this last year as a matter of fact. Then, I got cancer and my whole world changed. I definitely had an epiphany YOLO moment. I realized that life is too short to try to mold yourself to others’ models. Being you is your best chance to be able to live YOUR life at YOUR best. In fact, I have noticed that since embracing my uniqueness more lately, I feel like I have attracted more patients, built better relationships , and been more successful. I think the key was getting more comfortable with who I am and caring less about the opinions of others. That removed an unnecessary distraction that was just getting in the way of my own success. Now, let me be clear, I am not advising anyone to be out of control or fly in the face of every applicable convention that is laid before them. I am not saying to never go by the rules. I am just saying to enjoy….being……YOU!

Dr. Katz