My Women's Health Public Service Announcement

There exists a misuse of the medical services, a service requested, and at times demanded that just does not need to occur.  What am I referring to? Going to your Physician or Urgent Care or (UGH!) Emergency room for Pregnancy Testing.  So I give you a Public Service Announcement on Pregnancy Testing!
When you peruse the feminine product aisle of your local Target, you may notice a gazillion and one different types of pregnancy tests.  And those suckers are expensive.  Noone wants to pay $12-14 on a pregnancy test, knowing they will want to test no less than 6 or 8 times to "make sure," (before they become elated or panicky)  so the best kept secret is finding out pregnancy tests are sold at THE DOLLAR STORE!

"The Dollar Store? Those can't be any good!?"

Seriously Ladies, a test, is a test.  Their sensitivities may differ by a small amount (which translates into a day or two) but they all function the same exact way. 

BIOLOGY TIME!!!

When the egg is fertilized by the sperm at the start of the fallopian tube, whether you wanted this to happen, or your friend Al Cohol is to blame, (the egg and sperm don't really care the intention) the egg travels down the interstate of the fallopian tube.  It is not an expressway, so it may take 5-8 days.

After 5-8 days, it pulls over in the 5 star Hotel Uterus for a stay.  Sometimes, all the rooms are filled by obnoxious cysts or fibroids and the egg doesn't get to hang out and you get your period shortly thereafter.

Other times, the welcome mat is rolled out, the blankets are pulled down, the lighting is dim, there are People magazines and chocolate on the nightstand and the egg buries itself into 300 count sheets and goes to sleep (for 9 months.)  IF the egg buries in, it almost immediately starts to produce hCG (Human Chorionic Gonadotropin).  The level of this hormone starts out very low and doubles every two days.  It is in the level of how much hCG  is required to turn a test positive (2 pink lines!) where the tests vary.  But one thing does not change: THERE ARE NO FALSE POSITIVES.  (But do not look at the test after the time is up because it may look positive. Read the directions!) If it is is positive, you are pregnant. No, you are not a little bit pregnant, but pregnant.  You can take another 14 tests, but they are all going to be positive. At this point you can giggle with glee or sob with panic given your situation.

*Side note, you can have a false negative if you have tested too early.  Therefore, wait another two days (yeah, right like any woman can wait that long) and retest because remember the level of hCG is doubling every 48-72 hours.  Or, buy a gross of them and test as often as you want I guess.*

"But doctors must have way better more sophisticated tests, right?" 

Nope. It is essentially the same urine test, with a jacked up price.  You most likely have to pay a co-pay ($10-20), plus an office visit,($160) plus the lab testing ($30-80).  It will cost you about $200 to find out if life as you know it will change dramatically in nine months.   So, save yourself the money (or the bottom of line of Medicare/Medicaid) and head off to the Dollar Store.  You may have to ask for them behind the counter, sometimes they are secured safely with the smokes, but you will save yourself a ton of money. 

"But the blood tests, they are way better right? That is why I demand my provider give me one!!" 

 Ugh... first off, Providers would rather chew on tinfoil than be told what WebMD says you should have done when you demand it.  That aside, a blood test will show a level of hCG if it measurable in your blood.  Does it tell if you are pregnant? Yes. No. Maybe. It is a level. So it MAY mean you are pregnant, or it may mean you WERE pregnant and are now not.  Remember the hCG starts producing right away upon implantation.  But sometimes, the cleaning lady comes out and kicks the egg out of bed after a couple days because the credit card was rejected.  Implantation may not last and endure, thus the hormone may have started producing, but the provider has no way of knowing if it was higher or lower than it was yesterday, thus not knowing if it is a growing pregnancy or a failing pregnancy. 

"So fine, I'm not ever supposed to go to the Doctor?"

Yes, there are times when it is advised! But these are not it:
1. You got drunk on Saturday night, had unprotected sex, and come in Monday for a test.
2. You period was 2 or 3 weeks ago
3. You've taken 26 tests in the last 2 days and they are all positive and you "want to make sure."


You SHOULD get come in for a pregnancy test if:
1. You are having terrible low pelvic pain, and in hindsight you realize your period is late.  You may be experiencing an ectopic pregnancy. (The egg decided to go to sleep at a rest stop along the way instead of arriving at Hotel Uterus.)  A pregnancy test, and most likely some other testing will be done to find the cause of your pain.
2. Uhm... yeah I got nothing.

Ladies, your body is an AMAZING machine.  Take some time to learn about it, its' signs and signals and when you are fertile and not.  If you have no desire to have a child, do something about it, because we are wired to reproduce and it is your body. For the most part, reproduction is our bodies' default mode.  And should you find yourself wondering if you are pregnant, save yourself some money, your medical providers time, and head to your local Dollar Store for a pregnancy test (or 6.) 
 

A little funny from our friends at SNL!

  
*Disclaimer, I a not a physician but I sleep with one. And once many moons ago I wrote many boring papers to get my Bachelor's Degree in Nursing and had some years as an ICU nurse.* 





 

To the Girl without a Prom date:

It is that time of year again when the trees are starting to spurt new buds, the perennials are poking green tips out of the ground and the trees are filled with chirping birds--  Spring. It is a wonderful time!  Except if you are a teenage girl who has yet to be asked to prom.

The prom experience has taken on a life of its own.  There are prom dress shows (like bridal shows)  that showcase the latest fashion.  Social Media has one-upped itself with photo after photo of "Promposals" (excuse me while I puke a little in my mouth) and the craziness that it stirs up is overwhelming for me, a 40 year old woman.  I can not imagine the range of emotions it must create in an unasked girl.  For the young men, the anxiety that the rampant "Promposal" trend must induce would be enough to make any hesitant or shy guy just forgo asking anyone.  Rejection is hard enough... Rejection after you have designed and executed  a unique and creative "Promposal" would be humiliating.

To those who have dates, go and have fun! It is a great event, that you get to look and feel beautiful for, but it is a DANCE.  Maybe a nice supper too if you are lucky.  But it is not a mini wedding, it is not a commitment ceremony, it is fun! Be safe and have a great time! (and wear those new shoes a bit before that night or your feet will hate you.)And be safe!

Now to the girl who is still waiting to be asked.  It sucks.  It hurts.  And you know what? It is in no way ANY REFLECTION OF YOUR DATE-ABILITY OR ATTRACTIVENESS!  My guess is you are probably a girl who falls into a few of the following characteristics: shy, independent, strong, outspoken, smart and or having an old soul.

Girls with these fantastic characteristics can not be easily put in a box.  Guys (not men) are threatened by these girls.  They are not sure what to do with them.  But please have no fear and do not change who you are.  There are men out there who will cherish these qualities.  They will appreciate your strength and independence.  They will look with awe at your ability to process things around them from a point a view that your old soul allows you to have.  They will know that you are not actually all that shy, but rather, quiet, and when you do speak it is poignant, deep and/or absolutely brilliantly hysterical.  Please do not let the lack of invitation to this one event let you think, for one moment, you are not desirable or worthy of a date.  You are beautiful, and smart, and kind and you will go on to do amazing things. Trust me on this.

I'll let you in on a little secret... those beautiful dresses? Yes, they are gorgeous, and mostly made in China, and made cheaply and the crystals fall off and the zippers pop and the bedazzling was most likely sewn on by a child. And since you are a compassionate person, with a worldly view, you don't want part of that anyway, right? Well, I know, I want a pretty dress too... even at 40, I do... but take that upwards of $400-$800 that you would spend on a dress.. (actually you only need half of that), and go buy yourself a great jacket or pair of boots that will take you through the remainder of high school.  Something that will take you through some amazing ass-kicking times and tears and rejections and joy and it will have its' own story.

But you, the unasked girl, you are going to be fine. Actually AMAZING.  And to the boys who can't recognize these girls... don't say I didn't warn you when your 10 year reunion rolls around. 

Learning to Fall

It was one of those rare winter days we are granted in North Dakota which is in the low 30's and calm.  It is the kind of weather perfect for sledding and snowballs, and the hill in the yard was calling the children's names.

We all headed outside, and as I tended to Bill, our goat with attachment issues, the kids shot down the hill on their sleds.  Their squeals and screams filled the air as their plastic luges careened off shrubs and dirt piles.  At one point, my daughter took a World Class Wipe-Out, crashing into some bushes, the sled continuing to skitter down the hill without her.  I paused, heard no tears, only the giggling of her brothers and the crumbling of her pride, and surmised she was fine.  I watched her sulk away to a row of hedges, I assumed to lick her wounds.  Her crash and burn reminded me of something Anne Lamott wrote about, when her friend taught her the valuable lesson of learning how to fall on the ski slopes.  I needed my daughter to not quit just because of a spill so I went to talk to her, only to discovered she had not been sulking but was quietly creating an arsenal of snowballs which she unloaded on me when I went to speak with her.

After the barrage had ceased, I told her that if she never learned to crash and burn or wipe out magnificently, she would miss out on so much in life. It was the same thing when I figure skated. If you never learned how to fall, you would never be able to try to jump.  In life it is the same thing.  I wish I would have learned to fall earlier in my life because God knows I've had some wipe-outs.

To me, it is all a matter of physics. To feel extreme joy, you need to be able to sit and feel complete defeat and heartbreak. In order to know someone fully, you need to first know yourself.  In order to feel like you are flying, you need to be willing to crash and burn.  As Newton taught us, for every action there is an equal and opposite reaction.  Life is supposed to be in a pendulum action, but I think we sometimes get stuck on one side.  Feeling pain, or sadness is feared and so we do everything in our power to not feel it, or avoid it, and in turn we never really know what true happiness can feel like.  Or we get comfortable in the pain and misery, and thus self sabotage ourselves in order to remain in the suck because joy would be so unfamiliar and frightening.

We are meant to fall, and we are going to fall, so ultimately the objective is to fall with grace. I know many of my falls in my 20's looked like this: "Look at me! I'm falling! Do you see I'm falling? Hey! I'm falling. I fell. Did I tell you I fell?" That is not graceful.  In fact it was probably pretty annoying.  Falling with grace looks a lot like that old lady in that really bad commercial that yells, "I've fallen and I can't get up."  It is learning to identify when you have taken a big enough spill that you need to reach out to those you love, and who love you, and ask for a hand.   

It is the ability to sit amongst the debris and reconsider going down that icy hill on roller skates, with a tail wind from behind and a strong dog on a leash pulling in the front.  It is the reflection of the warnings from those who know and love you cautioning you may bite it big.  It is the growth that comes from standing back up after your head and heart are clear and the little birds have stopped circling you.

The reality is learning to fall requires us to surrender. Surrender to gravity and to the unknown.  And we fight it because, well, we are humans with control issues. In the end the goal really is just to get up one more time than you fall.  
 

The man in the cafeteria

My daughter and I sat in the hospital cafeteria awaiting a followup appointment.  We were sharing a monster cookie... the same delicious fantabulous monster cookies I coveted at 2am on my night-shifts when I worked there many moons ago in a different lifetime. My daughter chattered on and on and on, her nervous anxiety bubbling out in a continuous stream of senseless blather that combined with the dull hum of lunching hospital workers.  Over my daughter's shoulder I noticed a gentleman dining alone.  He was probably in his 70's.  He had finished his meal and was sitting in the booth slowly twirling a straw in his hands.  His gaze was very far off.  I knew that gaze, and though I didn't know him, I knew his story.

The look I saw in his eyes was the look of someone losing their love.  I imagine his wife was a few floors above us, possibly in the Critical Care Unit or Oncology Ward.  His face showed the exhaustion of someone who had been doing this, dining alone, a little while now.  Time in the hospital takes its toll on a person in warp speed.  Days quickly meld into each other by the 24hr nature of a hospital and the physical exhaustion experienced by family members is only trumped by the emotional exhaustion.  His stoic face barely veiled the exhaustion, and pang.

When I looked at him, I felt almost voyeuristic like I was seeing memories as they played out in his mind.  The day he met her.  The day he held his first born.  The years of drought that brought poor crops and little money, yet somehow they survived.  Together.  They succeeded and failed together.  And now he looks on a potential rest of forever, alone.

The disharmony between his palpable ache and my daughter's effervescent yammering was almost overwhelming.  I tuned into her and time and my sensory input sped up ten fold.  I looked at him, and it's like that scene in the Matrix when everything freezes.  He was taking inventory of their memories together, replaying every detail he can recall, hoping she has known just how much he needed her, and loved her.  And wondering how, just how he will go on without her.

I wanted, longed actually, to say something to him.  But there really are no words for these times.  In the same way there is no way to accurately describe the feeling of holding your first child, or watching someone take their last breathe, there are no words that can bring understanding or comfort to standing on the threshold of being alone.  It is a time solely intended for feeling, experiencing, witnessing.  Anything I would stammer to say would be as awkward as a bullhorn blaring during a sunset.

As I reluctantly got up to leave, I gave the gentleman one last glimpse.  I wanted to know how the story was going to end, I wanted it to be wrapped up in a nice little package like a 30 minute show.  But I know that isn't how life unfurls, as much as we would like it to.  It is this discordant symphony of life and death, youth and age, joy and grief that, with faith, plays out meaningfully in the end.