Author: laurakdoc

I am a board-certified obgyn and aesthetics specialist, a mother and a wife. I have been in solo practice for over 20 years. I am also a musician and a beginner tapper. My colleagues and friends thought that I should start blogging to share my thoughts with the world. Here's to hoping that my blog will make you laugh, make you think, and sprinkle in some helpful info in between.

Let me be your safe obgyn space

I have been an obgyn for over 30 years. I have heard a lot of things over the years from patients. Some of them actually break my heart just to hear them. Mind you, when I do hear them, I do my best to keep a straight and compassionate face, but inside I am screaming what in the god damn hell?!

Ok let me explain. I have had so many new patients lately that have told me at length the previous trauma and horror that they experienced at their previous obgyn office. They tell me stories of getting yelled at while they are naked. They have told me stories about how they have been dismissed when trying to express any concerns. They have told me that their previous exam or procedure experiences were so painful and terrible that never wanted to return. They are often telling me these tails with visible tears in their eyes.

I have to say up front that all of these tails are very hard to hear. They make me want to tear up! No wonder women

almost losing my life more than once to stop me from being faithful to previous physicians. I guess these women are smarter than I am at getting out sooner. So, in a sense, that is a good thing that they are not accepting that terrible level of care anymore.

Here is yet another downside to doing this however. A lot of these women are not just stopping seeing their previous doctor, they are stopping seeing obgyns all together and going years and years without care. Please ladies, this is a big mistake! I urge you to give some of the rest of us a chance so that we can actually find any issues that you might not even know that you have before it’s too late. A lot of these patients are coming in to see me after years of neglect and then I am ending up being the one to find things that are now advanced and terrible and require extensive treatment. Almost all of these things could have been caught much sooner with much simpler consequences if the patient had felt comfortable in coming in the first place.

The bottom line of all this is simply this. I am asking you to give me a chance and let me be your safe obgyn space. I do not yell or scream. I do not berate. I am an excellent and compassionate listener. Give me a shot at helping you take an investment in your own health. I will try my best not to disappoint you. My only goal is to help you be invested in your own body and health and to live your best quality of life.

Dr. Katz

Reflections on an amazing conversation

I reconnected the other day with a young man that I have watched as a dancer since he was a little boy. I have marveled at his talent and strength. I have admired his growth and independence as an artist. His pictures and videos are nothing short of amazing. He dances and travels all over the world now and here he was working in a local restaurant with his family. He didn’t recognize me at first until I identified myself as a former dance mom acquaintance. Then, he smiled and immediately began to engage in conversation and even sat down in my booth.

That young man and I had an amazing, thoughtful, reflective, and meaningful conversation that really lasted. We talked about life, our experiences, our mottos, our goals, and our beliefs and reflections on the world in general. He was truly engaged and interactive. We talked without the use of cell phones or ipads, just words and direct eye contact. It was some real old school wonderful. I was so glad that this young person was interested in what I had to say and became so curious that he came back for even more discussion.

This is what I love about my life. I love that I can be so approachable that even people who have not seen me in a long time can feel comfortable enough to come up to me and have a meaningful interaction. I consider this a true blessing. I wish that more young people had enough conviction, courage, and social skills to do this on a regular basis. This is a quality about myself that I continue to nurture. I feel like I have so much potential to give and contribute. I want to be able to share real thoughts and feelings and actually learn and pass on what I’ve learned. I just want to pass it on, for those that want it, whenever they want it. We need to share what we know with the people that want to learn, regardless of age or situational differences. We can all benefit from these interactions. Let’s go for it everybody!

Dr. Katz

Could someone please explain to me why the actual physical exam has gone so out of style?

The other day in doctor land, I was having a conversation with a fellow physician and was talking about the cardiovascular findings I found. They kind of snickered at me and said, “What? You still use your stethoscope? Mine is sitting in the corner collecting dust.” I was appalled and shocked at this answer. Yes I still use my stethoscope. Yes, I do have a vested interest in knowing if their heart and lungs are ok before I have them go under anesthesia. Umm, if I don’t think they could survive the surgery I shouldn’t do it correct? Isn’t that part of the whole picture? Aren’t I responsible for the whole person? You know what? I don’t even need an answer. I already know it’s the right thing to do.

I get it, for those of you out there that hate the physical exam. Sure, it’s invasive, especially the part that involves my specialty. Who wants to have to get naked for their doctor? I know it’s not a thrill for me either. But, without it, we can actually cause harm without realizing we are doing it. We can have the best intentions in the world and proceed accordingly and still fuck it up and hurt the person in the end. I am willing to bet that that person who did not want a physical exam would have no hesitation to come back and sue you if they got hurt. Let’s think about that just for a second from the cover your ass perspective. Does that convince you yet that we should do them? Or, how about, liability aspects aside, we should care enough that the whole person is in good shape with some certainty before we start making recommendations. Hmm. Sounds like a no brainer to me. I am going to forge ahead and keep doing complete exams with the option of a chaperone to be available if they want. Have a great day everybody!

Dr. Katz

I’m coming up on my two year anniversary and I am nervous.

Ok, so, on June 3rd of this year, it will be two years since I was discharged from the hospital after my stem cell transplant for my second cancer. This is about how far I got when I thought I was in the clear from my first cancer, so I am nervous. I just have to make it beyond this point to be able to believe that my cancer free status will stick,

I decided to go big with the second one…brain cancer! Primary CNS lymphoma. Thank the lord it was a treatable one, but still scary and awful nonetheless. I thought to myself at the time what the heck? Two cancers in four years! Something had to be messed up in my baseline so I thought a do over was what was needed. I have to admit I didn’t fully understand what a grueling and terrifying process that was going to be. Let me explain. First, they have to determine that your cancer is fully treated and in remission. That in and of itself is not easy task with months and months of inpatient chemo. Then, you get not long enough of a break before launching into the stem cell process.

The stem cell process needs to be done within a certain time window as to not allow the freshly treated cancer to return. You need to first inject yourself with what’s called granulocyte colony stimulating factor to get you white blood cells/stem cells to rocket themselves into the millions! Then, you have a triple lumen inserted into your chest that you get to mess around with for a long time to make the harvesting process easier. Then you spend the majority of a day getting harvested through that port. It’s kind of like a reverse plasma pheresis machine that is drawing them out of you for hours. I think I broke records that day with how many I was able to donate to myself and how quickly they came out. I think I was only there for about six hours as opposed to the normal 8 or 10 or 12. I think I overshot the donation mark by several million.

Then, you get another little break and then it’s into the hospital you go. You have to stay anywhere from ten days to a full month. Here is where the real danger begins. The goal of this hospitalization is to blast you with chemo until your white cell numbers are so low that they need to be manually counted! This kind of chemo is so fierce it will have you having crazy diarrhea and nausea and having to shower ever two hours so your skin does not peel off. It is real cannon ball type stuff. It drops your hemoglobin and platelets down to transfusion levels as well. Then, here is where the timing gets really tricky. They need to plan your antibiotics actually BEFORE your immune system bottoms out entirely. Otherwise, you start getting all those terrible infections that a normal immune system would fight against.

Unfortunately, I was not so lucky. My antibiotics were started a little late in my opinion and I got three different infections. I was septic, somewhat out of my head. I had a fever. I had rigors, which are the kind of shakes that literally make it hard to talk or move or do anything. They are very scary. You have to do some really strong narcotics to even make a dent in them. Also, when you have all those infections, you are not allowed to leave your room to do the walking necessary to further stimulate your immune system to take the new cells and regenerate. You are kind of defeated at both ends. That just added to the frustration and fear because I was very motivated to help myself in my own recovery and that got in the way of that.

But, even so, I was able to get out of that hospital in ten days anyway! I think it was a combination of all the prayers, baseline decent health, and force of my own inner strength. I am so so grateful for all of that. There is a part of me to this day that would like to be a part of educating the hospital staff further so something like this doesn’t happened to someone else. Unfortunately, no one was up for that education so those attempts went nowhere.

Overall, I am extremely grateful to even be alive to be writing this for you. There is nothing better than getting to open your eyes in your own bed next to your husband and hanging out with your kids and pets. Nothing. I already had a great appreciation for everything around me but now it is magnified even further. So, my final thoughts are to concentrate on my upcoming anniversary with as little fear as possible,and try to embrace all my future possibilities. Cheers to everyone’s good health and embracing what you have!

Have a great day and a Happy Easter!

Dr. Katz

You actually listened to me doctor!

This wonderful statement was said to me at a patient appointment the other day. These words both fill me with happiness and joy and sadness at the same time. I am thrilled to hear them, but I find it unsatisfying and somewhat sad that I was the first person to take this patient’s concerns seriously and even bother to address them. This patient had been to so many doctors and desperately attempted to ask so many questions, all for naught. She left every previous physician office with no answers and only more frustrations rather than solutions.

This is NOT how it is supposed to be folks! We are supposed to listen! We are supposed to be invested! We are supposed to love our job enough to do it well and to the fullest of our capability! We are not supposed to just barely show up as if we are forcing ourselves through drudgery or see so many patients in a day that we just file them through like some sort of herd. We need to listen. We need to provide individualized, thorough, compassionate care to every single patient that walks in the door. We need to let go of any preconceived notions that we may have heard elsewhere or told by someone else. We need to let go of any held on judgements based on previous experience. The only person that matters is that patient that walks in the door. Let’s get our crap together people and do the job that we were meant to do.

If you are a patient out there who has felt neglected, frustrated, and not listened to, please reach out until you find a physician that does listen. You are worth it!

Ponder this for a moment and have an amazing day.

Dr. Katz

Just think, two years ago my friends and family were throwing a benefit for my brain cancer and now today, I am playing in a concert instead!

Wow! Just wow! A whole crap ton of good has happened in just two years. I am sitting here on my couch, with a head full of hair, looking outside at all the Michigan winter goodness. I am not nauseated. I am not bald. I am not waiting to hear if I am going to live or die. My dogs are passed out next to me. I am blogging comfortably to all of you!

This is really freaking awesome. I am feeling so grateful and so at peace. I am grateful to just be alive and on this planet. I am grateful to feel well enough to pause to almost complain(lol) about daily trivial things. I am proud and amazed that both of my businesses still exist. I am grateful for my awesome family. I am grateful for my amazing staff. Yep, lots of gratitude here for sure. I can’t stop talking about it.

Just think about this for a minute, only two years ago I wasn’t completely sure that I was going to make it out of that second cancer. Yep, SECOND CANCER! As if one wasn’t enough somehow. Ok, I say that facetiously. Any cancer is more than enough. Sometimes, if you don’t take a minute to joke, you run the risk of being too emotional all the time.

Have all my significant hardships and health issues taken a toll? Well, of course they have! Who wouldn’t have a healthy side of ptsd at times after all I have been through. That is a normal response. I still have times where a random or twinge or perceived symptom somewhere shoots me over the edge in a second, until I have time to take a breath and regroup and remember that the present is very different than the past. I am not perfect at this but I am working on it. I work on this not over-reacting thing like every single day.

Still, having said all that, my overall attitude is one of gratitude. For all those of you out there who cannot fathom how I could feel blessed in anyway, think again! It is a matter of perspective my friends! The bottom line is that I still have the pleasure of existence on this planet! I am still able to care for my family! I am still able to take care of women everywhere! What’s not a blessing about that?! Yep, I’m gonna go with the I am blessed attitude. Have a fantastic day everyone! Embrace what you got. You never know when it could be taken away. Enjoy what’s good right now dangit!

Dr. Katz

Hormone safety= actual exam and proper follow up

First I want to shout out a huge hurray that we have finally refuted/retracted that study from decades ago that hormones were bad. Personally I ignored it anyway because I knew it was done wrong, in the wrong age group on women that already had preexisting risks of all the complications mentioned. I refused to let women suffer and kept on prescribing, in the right patient, with the right risk profile, and with the proper follow up. And, guess what? No one got cancer or got harmed or died. Sounds good right?

So, nowadays, well, actually this has been going on for awhile, everyone thinks that they can easily become hormone experts and prescribe whatever they want to anyone. They are literally handing them out like candy on Halloween. It sounds good, but here’s what they are missing. They are not examining anybody, which the patient incorrectly perceives as a bonus. They are not doing any ultrasounds on those with an intact uterus to see what is going on in the pelvis. And, most of them are relying on some outsourced lab to tell them what to prescribe in the first place and ending up putting patients on doses that are way above what is recommended. To top it off, they are not following up or screening them properly in any way and potential harm risks are missed.

I am going to say once again, how potentially egregious this approach is. Yes, I know I have said this many times, but it bears repeating. I keep seeing patients over and over again who have been going to these non-hormone experts and getting all kinds of hormones and then they finally end up seeing me, probably only because they are tired of paying cash not for an exchange in the quality of care. Then, I need to sit them down and explain how an exam and an ultrasound are necessary so that I can pre-evaluate for any risks or problems before we even start. I get it, I am not ready to provide the instant fix without any patient responsibility or any responsibility from me. Yes, that is true. I am determined not to intentionally cause harm. I also, tend to not rely on anyone else’s information and obtain my own before proceeding. This is sadly a problem for some because they perceive that a limited amount of time and investment and efficiency alone should be their own qualifying characteristics of good care.

I need to please ask all of you to reconsider before using these non-hormone expert alternative options. They are often expensive for one. Also, they are often actually dangerous. Just in these last three months alone, I have had a return of patients from the past who left to pursue these alternative options, only to return over ten years later to seek care from me again, and find out that they now actually have cancer that was missed while they were never getting examined or followed up properly. These are heartbreaking and preventable situations. I feel saddened as I need to tell them what is actually going on because they had been previously convinced that everything was good and paid a lot of money too. Nonetheless, despite these sad and potentially frightening situations, it is my job to protect and care for them properly. It makes me end up being what they see as the bad guy, when in reality I am the one trying to rescue them before it is too late.

I just need to say it one more time. Please reconsider before going to one of these places for hormones or women’s care. If it is a well-meaning primary care provider who doesn’t know better not to give estrogen alone to a patient with an intact uterus or a fancy beautiful place that requires no actual physical exam or ultrasound, please reconsider. By using these resources, you are, in fact, putting yourself in potential danger.

Dr. Katz

Nope, blood ties do not entitle or excuse you.

For those of you that have read my autobiography, Me Myself and My Story, you already know that there is whole lot of family issues, abuses, tragedies, mental health trouble that has flowed freely throughout my life. Having said all that, I still am grateful that I have turned out the way that I did and I am proud of the person I choose to be. Part of the point of writing that autobiography was not to be a vengeful tell all, it was hopefully to point out that any person still possesses the right to choose a better direction somehow if they want to. I like to think that I am a prime example of that.

Having said that, yes, there have been multiple family members that I have not been close to for years for various reasons. Some of them took in negative input fed to them by others with no opportunity for me to repute it. I didn’t even know that was going on in the first place. Fortunately a lot of those folks have come around and are now in my life again and I am very grateful. There were a lot of years wasted and missed though.

To add to this, I realize that I have done things that have upset people. In my perspective, those things were done with a purpose and intention for good and for protection. I have sent people to prison for abuse. I have spoken my mind at public gatherings. I have dismissed certain people from my life when their level of toxicity crossed the boundary that I had set and was literally compromising my mental and physical health. I do not regret any of these actions. They are what I had to do to protect myself and my family. I have to admit, I do not understand those who force themselves into family holidays and gatherings despite a long history of abuse and mistreatment. I am not sure if they feel that they don’t have any choice or if they are supposed to because there are blood ties involved. Either way, it only allows further damage and abuse to continue. I have seen many people dismiss past wrongs with no concrete apology or resolution. I understand that forgiveness is divine, but for myself, I need at least a little actualization that it happened in the first place or even the two little words “I’m sorry.” for that to be enough for me to re-interact. I feel like that is a minimum requirement to say the least. I have come to realize the phrase friends are the family that you chose is quite accurate. As much time as I have struggled to maintain family relationships, I have not noticed all the friends and non-toxic family members that are right there waiting to spend time with me. This is something that I have vowed to strive better for in my future. This is a plan that I am going to stick with.

I just want to end this explaining myself session with some words of advice and self-advocacy. No blood ties justify or excuse terrible or abusive behavior. It is within your power to seek out non-toxic relationships for the benefit of yourself and your mental health. It is sometimes a very difficult decision, but is definitely the healthier one.

Have a peaceful day.

Dr. Katz

Let me explain to you why I know about more than just the vagina.

I get asked or questioned all the time about how I seem to have knowledge about things that are not just about the pelvis. People say things like how do you know about that? Aren’t you just a lady doctor? Don’t you just care about the vagina? How do you know about anything else well enough to make recommendations about other health issues. I think that literally other physicians, internists, and family practitioners are somehow threatened or feel insecure about this.

Trust me, there are no worries here. Let me explain. I was fortunate enough to have completed my training in the 90s. During this time, Obgyn was temporarily reclassified as primary care. Therefore, during my residency, I got training in family practice, internal medicine, er, surgical ICU, in addition to my root Obgyn training. I am very grateful for this because it has allowed me to know more than just my specialty. I also make it my business to keep up on the latest in these other health issues as well. Do I portend to know more than a family practitioner? No. In addition to that there should be no worries about my taking over the care of your patient. I am well aware of my limitations and know exactly when to refer the patient back to you for further direction and care. I am now and have always been a physician who knows her boundaries and limits. I am also aware that we should all be members of the same patient team and should be willing to work together for the patient’s interest. That should always be our mutual goal. Have a great day everybody.

Dr. Katz

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