Thoughts from Between the Knees

Thoughts from Between the Knees

An enlightened GYN’s perspective on what it takes for women to feel good about ourselves and our health

‘The lovin’ is easy. It’s the livin’ that’s hard’ *

Big Hat, Has Owned Cattle

As a means of introduction, I’m the Boyfriend. Many times I wonder how I should reference myself in connection to her – boyfriend, beau, boytoy, business partner, best friend. Reverse the gender references and she is all that to me – and more.

No matter, I always come regardless of what I’m called. Also, I put the toilet seat down, even in the middle of the night. And like every loveable old dog, I know when to get in bed with her and when to leave for my own.

Yes, we sleep in seperate beds more often than the same one, both under the same roof and just at the other end of the hall. Sometimes we trade and she goes to the other bed and I stay in her bed when she can’t wake me up enough for me to realize I’ve been thrown out. Some daybreaks I wake up early and, like every loveable old dog, sneak back into bed beside her as she dozes the last few minutes before the alarm goes off. For the record, she’s only thrown me out of the house once but she called me back – and I came. Another blog, another time for that relationship fable. Back to sleeping in two beds…

I once thought the quality of a relationship was in direct proportion to the total square inches of skin shared in a lifetime between two consenting adults. I’ve come to understand over time with Bella that the quality of a relationship can be measured by how much you care that your partner – husband or wife, boyfriend or girlfriend, beau and belle – gets a good night’s sleep.

I have something akin to Restless Leg Syndrome – at least that’s the best educated guess I’ve gotten out of a doctor so far. I’ve tried every drug. I actually almost flopped off the operating table during my colonoscopy while on Propofol – as in what they say led to Micheal Jackson’s Big Sleep. The arm and leg flopping with incessant scratching doesn’t keep me awake, but what I do sure makes sleeping hard for her. So I leave the bed when asked or shoved. Hey, I get it. Many nights when I feel the first twitch, I leave without being asked. And she gets it too, the reason I have to go and the reason I hate to leave.

I kinda’ like sneaking back into bed beside her. Or waking up with her trying to fit on a little twin bed with me. I think it lets each other know we care about where we sleep for a lifetime, not just a night.

If someone sleeping, or trying to sleep next to you keeps you awake, or if you (and you know who you are) are a Sleep Thief, talk about it with each other. Better yet, try the separate bed thing and then talk about it when you’ve both had a good night’s rest. You’d be surprised at the benefits that come from it.

How long has it been since you slipped back into bed at daylight with no reason to feel guilty about where you have been?

* Kris Kristofferson, “Nobody Wins

OMG, my kids are adults!

Sometimes I used to feel like being the parent of children would never end. And then, like magic, my kids became grown ups (my daughters are 23 and 21). Fully functional, live independently, do what they want, grown ups. Now what do I do? Do I talk to them like my kids, like a friend, like who exactly? How often do I call, text or email? Do I wait for them to Facebook me? Do I even want to look at their Facebooks? This is so weird. Awesome, but definitely weird. Are there any books about this? Like a Chicken Soup for the Parents of Grownups?

I spent my college and early adult years 3000 miles away from where I grew up, so that I could become an adult very much on my own. Somehow I knew I needed to get away from my childhood influences. I spoke with my parents by phone once a week, and went to visit a couple of times a year, but my world was my own, and they had very little place in it. By the time I lived close enough to see my family regularly, I was in my 30s, married and working. My contacts with them were sometimes tense. I think many in my parent’s generation had difficulty making the transition to being the parents of adults. For a long time I still felt treated like the rebellious 15 yo, my knowledge and experience ignored. Does anyone else’s parents start every sentence with “why don’t you” or “why did you” or “you should have”?

So how do I not do this to my kids? How do I gently offer my wisdom, yet respect their decisions, understanding they have to build their own base of knowledge and experience? How do I create the open door that they will use to ask me for my advice when they need it? Sometimes I tell a story about a similar situation I experienced, and then reflect on how it all turned out. Perhaps the art of sharing a good story about our lives is more effective than giving an opinion about how they should live theirs. And since my kids don’t live near by, I do this by email. Sort of like the old fashioned letter writing that has memorialized many a relationship for future evaluation. Letters are not really a bad thing. They allow both parties to revisit and contemplate the thoughts they are expressing.

For now, I guess I will just play it cool, trying to gauge if they are eating healthy, paying their bills, having fun with friends and building their own lives, without me there every day. I will continue to build my own happy, healthy life, without them here every day. And when we do all get together for a visit, I hope we can gossip, and giggle, and not act like adults at all. But when I allow myself to think about how much I miss them, and how much I love them, it brings tears to my eyes.

Sunny-side up

The best way to get Vitamin D is the old fashioned way – direct from the source, not in pill form. Just remember your SPFs.

Can I go out to play?

Boot camp, hot yoga, pumping iron, triathalons, walks for cures, pilates, zumba, cycling classes. The list of ways to try to get us off our butts seems endless. And yet, Americans are getting fatter and more sedentary by the year. Could it be because we seem to have made being physically active seem like work?

Has anyone been to a playground filled with little kids on a sunny afternoon? Do they look like they are working? No, they seem to run, not walk, and they are laughing: they look like they are having a blast! They are playing! And all the adults just sit by on the bench and watch. Passive, detached. Have they forgotten how to play?

But once those kids hit elementary school, the “organized sports” take over: T-ball, soccer, tennis, dance etc. Instructors, coaches, rules, winners, losers. What happened to just going outside to play after school? And it doesn’t get any better as they get older: music lessons, competitive teams, after school enrichment learning programs. On and on. They begin to understand that they live in a competitive world,and believe that opportunities for success are scarce, available only to those who win. They lose their ability to function without the structure of the “activity”. They forget how to play. It is so sad. No wonder there is so much anxiety amongst our teenagers.

So I vote for more play! Would someone please create an after school program for kids that is like the old “recess” I remember? A teacher standing in the middle of the school yard with a whistle, supervising 100 kids playing various games, everything from kickball to jacks, to jump rope to 4 square. The kids managed the games themselves, without coaches or parents shouting from the sidelines. And maybe there were winning teams, or the kid who could jump the longest without tripping, but by the time recess was over, no one cared anymore. It was about the playing. They were hot and sweaty, and they had fun.

How about an after work “recess” for adults?! Good old fashioned games. Perhaps if adults remember how much fun it is, they would actually go outside with their kids and play once in a while. It might also make them more fit. But it is really about the fun.

Show and Tell

Confession. I got a tattoo at the ripe old age of 53. According to an article in The Huffington Post, I am not alone. Apparently lots of us mid-life baby boomers have decided that we need a little “ink” at this particular time in our lives.

The article touches a bit on motivations, but I would like to explore this more deeply. I know I spent years considering the “what, where, and why” of my tattoo. Yes, it was definitely about making a statement, about celebrating the fact that a really hard part of my life was over: the kids were grown, the 20 year marriage was over, I moved out of my big house in the swim/tennis neighborhood, quit my ALTA team, and stopped volunteering for everything. Actually, I think I crawled into a bit of a cave to lick my wounds for a few years.

And part of the coming out of my cave was getting my tattoo. While the content certainly had to be meaningful, the location was as important. I wanted to be able to show it in public if I felt like it, but I didn’t really want it to be part of a first impression. Rather it would be my “after” statement.

People who know about it always ask if I plan to get another one. No. For me it would detract from the freedom and power I felt getting it, and still feel when I expose it. I can’t see it, but I know it’s there, and I am proud of it.

So if you got your first tattoo over the age of 45, please feel free to share your thoughts about it, along with a picture!

The Wonders of Birth Control Pills

It is hard to believe that birth control pills have only been around for 50 years. For many of us, we can’t imagine life without them. But try to picture life for women before easy contraception.

We got married early, often in our mid-teens. We started having babies right away: really, there were no other options. And we just kept having babies, until we got too old, our insides fell out, our husbands stopped wanting to have sex with us, or they died. Basically, our lives were ruled by our fertility.

Birth control pills became available in the early 1960s. We can now plan our families, or choose not to have children. This allowed us to get a better education, get better jobs, stay in the workplace longer, become financially independent, and sometimes even make more money than our spouses. Birth control pills have truly changed our society. Without easy, safe contraception, equality for women is impossible. Look at 3rd world countries.

So in my humble opinion, birth control pills are the best thing since sliced bread. Not only do they give us the ability to plan our families, they improve a host of problems that can be associated with our menstrual cycles. Everything from acne, to menstrual cramps, to endometriosis, to pre-menopausal problems can be improved with the use of birth control pills. And for these problems, I call them “menstrual cycle management pills”.

Basically, a teenager can go on birth control pills for painful cramps, stay on them until she would like to get pregnant, have her family, and stay on them until menopause. Miraculously, for most women there are no serious long term health problems from using birth control pills. No increase in cancer, no decrease in fertility, no nothing. And there are some interesting benefits to using birth control pills: easier, shorter periods; less ovarian cysts; less endometriosis; less anemia; ½ the chance of endometrial or ovarian cancer! Who knew?!

Is there a best pill? No: 80% of women would be happy with any of the pills. 20% may have to try a couple of different pills to find one that suits them best. The most common side effects for women starting birth control pills are breast tenderness, nausea, headaches, mood swings, and irregular spotting. These problems occur in less than 15% of women, often resolve after the second month, or go away after a change to a different pill. Weight gain IS NOT a common side effect!

So if you have been putting off considering birth control pills as an option for you, make an appointment to discuss your concerns!

Maybe there’s another way…

…than nagging to get your other half motivated to get back into shape. This is from Prevention magazine, via MSNBC.com: http://www.msnbc.msn.com/id/43429948

I'd rather wear the panties, not the pants

Thoughts from Between the Knees I am in my mid-50s. As a gynecologist for 25 years I have had thousands of conversations with women in some of their most vulnerable moments, hoping they can trust me to listen and understand. The idea of sharing my thoughts with the world by typing into the blogosphere does not come naturally. Over the years, my patients have told me I have a unique view of the world, that I tell it like it is and they value my opinions. So I have decided to share my thoughts here. The topics will often focus on healthcare issues, but may wander into public policy, politics, and pet peeves. It is after all, my blog. And unlike with a book, you may respond. Like conversations. Occasionally I will invite my boyfriend, Carlton, to comment on a particular topic. He is smart, funny, thoughtful, and honest. I value his opinions. It is important to understand a man’s viewpoint. They are, after all, half the population. He thinks God created no more facinating creature than us. He has no idea how right he is.

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