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Why Tuesday?

The Girlfriend's Guide to Health will be updated every Tuesday.... Stay tuned dear readers and let me rock your world.

Tuesday, May 28, 2013

Dogward Down... Way Down.

I should preface this week’s fashionably medical rant by stating up front that I am not a bendy person. Yes, sure I’m pretty flexible and can of course touch my toes. In a pinch, I can balance on one leg and do up a strappy sandal. I have been known to “stretch it out” from time to time after a long run or a very long bicycle ride when my ass is screaming and we are out of pharmaceutical muscle relaxants.

But all of that aside- I am not bendy. This is my politically correct code phrase for saying that I do indeed HATE Yoga. Now, I realize hate is a strong word. Hate is reserved for political regimes that oppress the freedoms of others such as I hate dictatorships or I hate North Korea- No offense really to my cyber sisters in North Korea- not that you are able to read this but heads up- your government is a bit of a bully.

Hate is a word reserved for life threatening and soul crushing diseases- such as I hate Cancer or Diabetes or Heart Disease. or I hate my addiction to expensive footwear. (Heads up- I am learning to accept this last ailment for what it is and to use it to my advantage).

Hate is best relegated to describe severe opinions of the evil in the world around us. I hate Fox News (I’m a socialist, can’t help it) I hate Dr. Oz- sorry girlfriends- he’s a hack who needs to be tempered once a for all.

Then there is the hate for the trivial in our lives, such as my hate towards stirrup pants and lipsticks that have gone bad- the ones that leave a bad aftertaste and an undesirable smell. There is my hate for telemarketers who call my cell and leave a recorded message telling me I’ve been entered to win a cruise (I don’t even like cruises,  but I don’t hate them). Worse still there are the people who stand in airports on behalf of a credit card company and harass me to enroll as I am running for my flight.

Hate like love has its levels. There’s the big bad serious hate and the little annoyances. And then there is my hate for Yoga.

I should say that I really want to like Yoga. I live in downtown Vancouver. Here, Yoga is a religion. Yoga is like the popular girl in high school who has beautiful blond straight hair, gets good grades and is, I am sure really nice. She’s a sweet sister and if I got to know her, I’m sure we’d be friends. But on the surface- Yoga is bitch. There’s too much to learn and not enough of a payback.

Let me explain.

I have been to one Yoga class in my life. This was some years ago when I first moved here and yes, I caved to peer pressure and decided to see what all the fuss was about. I wore my requisite LULULEMON pants and I did not bring my own mat. As someone who feels flip flops should only be worn at the pool/beach or in the shower- I wore running shoes to the studio, just in case the class went terribly wrong and I had to high tail it out of there.

I arrived at the studio  20 minutes before my class. The woman took my particulars and made me fill out a health questionnaire. On it I was asked about my past medical history and any previous medications. I like a true know it all left the sheet blank. I put the name and number for my IN CASE OF EMERGENCY contact, should my downward dog result in a syncopal (fainting) episode and I asked to borrow a mat.

The woman offered me a cup of Jasmine Green Matcha something with orchids and lavender for calm, handed me a purple mat in exchange for a $5 rental fee and showed me to my class.

The room was dim and it smelled like an arm pit. No, not the lovely smelling armpits that are smothered in garden fresh or apple flavoured deodorant. The room smelled like a bad body crevasse. It was the kind of smell where you get a whiff and think “who mixed urine and ammonia together and let it sit for a while?” There was some weird music playing, to get us in the mood. Newsflash- I was there for a good stretch- and a sweat. Firstly if I was in the mood- it would not be for some Sun-Moon Frey bullshit tunes and secondly- I was NOT in the mood.

I picked a space on the floor and decided that eventually like the monkey enclosure phenomemon if I stayed in here long enough- I’d get used to the smell. DO remember the monkey enclosure at the zoo? I do. We went there every Sunday and sure enough within seconds of opening the door to the monkey enclosure the smell hits you. Nothing smells quite so as a pissed off set of monkeys living together, urinating on each other in close proximity. But sure enough within several minutes in the monkey enclosure, I forgot about the smell and focused on the lemurs and chimps at hand.

Twenty minutes into my yoga class and I was full on into the monkey cage phenomenon. I could not even tell you that my matt smelled like ass- I was far to focused on getting my sun salutations down pat.

Turns out my biggest problems with yoga rest in the following issues:
1.     I am terrible at following orders in a work out class. As someone who came late in life to fitness- I like my independence. I know the yoga teacher is trying to be of service but Greta (my yoga teacher) was just too bossy. Bitch also had it in for me. My bends were never low enough and my downward dog was downright bad. Something about the hip placement.
30 minutes into the class and I was stressed out about the next move.

2.     I don’t like chat during stretching. Give me some wicked music and I am all there. Let’s do that. Let’s hold a class where we play rock and roll and stretch it out. We will call it ANGRY Yoga. It will be for men and women with rage issues and it will take the hath community by storm.
3.     The whole thing is just not my scene. I’m a runner, I’m a cyclist. I’m not a stretcher.
So when a recent study presented at the American Society of Hypertension showed that Hath Yoga in deed lowered blood pressure in patients , I decided my trash talk need to be tempered.

In an attempt to address the benefits of yoga a little more scientifically, the researchers based out of Philadelphia, conducted a randomized clinical trial, with 120 subjects randomized to one of three treatment groups. The three arms included hatha yoga two to three times per week for 24 weeks, a supervised diet/weight-reduction program that included walking, and a combination program that included some yoga and the dietary intervention. The patients were 50 years of age, on average, and had a baseline systolic blood pressure of 134 mm Hg.
Presenting the results of 58 subjects who have completed the study to date, the researchers report that the yoga program significantly reduced systolic blood pressure to 129 mm Hg at 12 weeks and 130 mm Hg at 24 weeks. Diastolic blood pressure was also significantly reduced 2 to 3 mm Hg, as well. In the diet/walking and yoga/dietary intervention groups, there was no significant reduction in blood pressure from baseline.

The most profound thing about the study is that it is not a drug effect and although it is not a huge effect- it is still significant. The results show that these Hatha classes reduce blood pressure by 3-6mmHg. So perhaps a good stretch is not off the table after all.

AS for my first brush with Hatha Yoga? I left early. I spent 30 minutes trying it out a realized it just want not my thing. Don’t judge my girlfriends- we all have out own path in life. I ride and I run like a crazy person and keep my blood pressure down. Some of you attend the Hath class down the corner ( and if you do- bring your own matt) and it turns out your getting some benefit.

That’s the beauty of us my dear girlfriends. From Closed toed pumps to an open toe Dorsay- we all can find our own path in life. Keep moving and keep bending and heads up my sisters- stop once in a while, a remember to give it a good stretch. 

Tuesday, May 21, 2013

Pee Now, Pay Later

Summer is finally upon us dear girlfriends. With summer comes many of natures gifts… Sunshine, clear skies, long walks on the beach, fabulous strappy sandals and off course, my favorite outdoor swim. Yes, my cybersisters I do love me a good strappy sandal and I just adore Kitsilano Pool.

“Kits Pool”, as it is affectionately called is a seawater-chlorinated pool on Kitsilano Beach that overlooks the ocean and the mountains. It is, in short, a little piece of paradise. On a perfect sunny Vancouver summer day, it truly is the only place to be. The pool is 138 metres long, which means that 12 lengths of the pool is a mile. Twenty lengths of kits pool and a ride through Stanley Park allow me to justify the size 8 dress I bought on sale…. It is about 5 pounds too small but with just enough time spent in those glorious outdoor waters this summer and that dress will truly be made for me.

SO this Sunday I found myself swimming in the fountain of youth looking up at the Rockies and the Pacific and the sky each time a took a breath. The world made sense and I could have spent all day in that damn pool. That is until my bladder gave out…

Yes, my girlfriends, I peed in Kits pool. I did not plan on this little bathroom break. It just happened.

Okay that is a lie.

I could have gotten out of the pool, walked across the deck and relieved myself properly in the bathroom… but it was cold outside despite the sun and the pool was a balmy 27 degrees Celsius. I was happy in my pool. I was swimming and I was content. The water had chlorine in it and I had to pee. So I swam into the corner of the pool and let my bladder enjoy the view.

What is the harm? Why am I telling you this?

Well it turns out people who swim swallow water.

Very little empirical evidence is available to indicate how much water is ingested while swimming, but a number of estimates have been suggested in the last 70 years. Dr. Shuval (1975), in a review of standards associated with bathing beaches, suggested that swimmers ingested about 10 ml of water per bathing day. World Health Organization (2003) guidelines assume that 20 to 50ml of water is ingested per hour of swimming related activity.

A survey was conducted online between April 30 to May 3, 2009, among a national sample of 1,000 U.S. adults, using the field services of TNS Omnibus showed that 20% of people who swim in public pools pee in them.

The average volume of urine in a single micturation session (pee) is about 250ml.

Kitsilano pool is 138 metres long. There are 2.5 million litres of water in an Olympic size swimming pool. I estimate kits pools had about 7.5 million litres of water in it.

If we do the math, there are easy 10 people pissing in the pool at any given time. (There were about 50 present on this day.) This equates to about 2.5 litres of urine in 7.5 million litres of water.

If my math is correct (my mother would be so proud) that is 0.03 parts per million. Now, stay with me….

The average person actually swallows about 10-20 ml of water (2-4 teaspoons) according to a wildly accepted study in 2006 in the Journal of Water Health. I can go into detail how they determine this but safe to say- they took swimmers, put them in a pool and then measured their urine for chlorine byproducts and did the math as to how much chlorinated water was swallowed… very scientific, I must say.

This then equates to about a drop of urine swallowed every 20 swims.

Now, we’ve all gone to the washroom once or twice and forgot to wash our hands… Yes? I’m not saying we make it a habit but it does happen from time and again…

Take that into account 6 months worth of swimming in a public pool daily has the same urine exposure as forgetting to wash your hands after a good pee.

There. The evidence has relieved my guilt. I peed in a pool dear girlfriends. I’ll try not to do it again…. But I am human after all. Find it in your hearts to still love me and move on. Science has.

Tuesday, May 14, 2013

Out Damn Spot

As I write this week’s guide, be warned my sisters- my face in is recovery. Let’s just say, I’ve had a little “procedure” shall we?

Oh fret not my sisters- it was not a big deal and although yours truly may have a flare for the dramatic (this of course explains my addiction to Italian fashion) I am just fine.

You see my sisters- I have or shall I say had a SPOT on my face. Vanity or not, just to the left of my nose there was indeed a brown discolouration the size of a fingerprint. It is (or rather was) a café au lait colour and well, recently it began to really piss me off.

Now I should tell you in my recollection this spot has indeed been there for about a year. But it is only in the last few months that I noticed that said café au lait  colour developed a stronger brew. My spot went from mild blend to a café Verona almost overnight. This is of course my witty way of saying that the spot grew darker in colour.

I should tell you that I sought many an opinion for this dermatological dilemma. I asked colleagues and had formal consults regarding the spot on my face. I convened international summits of said spots. (No I did not… I’m just being dramatic).

When it first appeared I thought nothing of it. Like most woman of my age- I spent my teens lying in a back yard in the 1980’s on a plastic chaise lounge covered in baby oil waiting for the sunburn that would soon “turn into a tan”. You remember those fabulous lawn chairs don’t you? The ones made in the late 1970’s with the strips of vinyl woven across that when you laid on them, face down for long enough- you were left with linear imprints of the vinyl on your face and across your chest?

I was not worried about the spot on my face because 3 independent Dermatologist friends told me it was just sun damage. I reasoned that having almost burnt my face of on the side of Mount Kilimanjaro would indeed do that to a girl.

Full disclosure, my sisters- I suck at wearing sunscreen. It’s not that I don’t see its value, hell yah I do. It’s just that I’m rather inept at remembering. In fact it has come to the point that my beloved is now tasked to remind me to put it on.

This typically occurs around long sporting events- say marathons- where I am going to be out in the element for 5-6 hours and my dreamy husband makes the requisite statement in a conversation that goes something like this:
 “Sweetie, did you out on sunscreen?” my beloved asks.
“Yes, my love.” I say in a rush.
“Are you lying to me?” he asks sweetly.
DAMN. I am a horrible person.

And so I run the race with not much protecting me from the skies above. Such is it as well in the race of my life.

A few years ago I invested in and SPF moisturizer in the hopes that I could eliminate the hassle of putting added sunscreen on my face. I reasoned that if it was in the moisturizer I was good to go. Problem solved.

And then my spot appeared.

Yes, it was benign and yes, it can be treated. I will tell you the details shortly, I just wanted to cut the drama short and up front. But the problem was that it indeed messed with my head. You see my mother had skin cancer when I was a kid. Sometime in the late 1970’s she went to the hospital for a few days and came home with a large bandage over her left cheek. I can recall this in very vivid detail because I remember her telling us about how they were going to cut out the spot on HER face and then stretch the skin to make up for the place where the spot used to be.

Needless to say- you tell this kind of story to a7 year old kids and it sears itself on their memory while it is totally freaking them out. So imagine how many primordial neuroses were tapped into when a spot appeared on my face in exactly the same place as my mothers? Imagine my continued emotional paranoia when said spot got darker and a little bigger?

But then I met my lovely new Dermatologist- name with-held here. He is perfection. After a very thorough consultation he assured me that my little spot was an actinic keratosis. It turns out I also have some melasma on my upper lip. These are two common forms of browning discolorations that occur on the skin and are both often in response to age and/hormonal changes…. Who knew my 40’s would be so awesome? Can’t wait for the menopause!

My lovely doctor gave me a special cream for the melasma and suggested I have laser therapy on my face for the brown spot on my cheek (aka the keratosis- but I will call her Foxy Brown for fun).

And so this afternoon, I let a perfect stranger with a chit load of qualifications put some ice cold gel on my face, tape some UV protector goggles on my eyelids and then take a serious laser to my money maker.

The procedure feel like someone snapping a rubber band repeatedly on your face. This is followed by a flash of light across your skull. The sensation can only be compared to the experience of having someone light off firecrackers somewhere underneath your temple – not painful- but quite a light show. It’s not unpleasant actually- it’s just weird. Twenty minutes later, I was done. My face felt a little sunburned and the technician rubbed some vitamin C serum on it. I lay there with an iced towel wrapped around my face and contemplated what the days to come would be.

Yes, I could go swimming tomorrow. Yes, I could work and run and cycle and do all my activities. Yes, there would be some redness and my spot would likely blister. No I should not pick at it (oh how they knew me well).
Yes, it would take more than one treatment for Foxy Brown to leave my face but I should feel confident that she would indeed go.

The procedure being used to get rid of my sunspots was indeed called Intense Pulse Light or IPL.

IPL uses intense pulses of  non-coherent light distributed over a range of wavelengths from 500 nm to 1200 nm. The technology is used for both hair removal and for laser spot removal.

IPL brown spot removal works through firing short bursts of intense light at the skin, using a tiny hand-piece designed specifically for this purpose.  The light is absorbed by the colour in the pigmented cells, causing them to heat up and be destroyed.  As the epidermis replenishes itself the melanin rises to the surface of the skin, where it dries to form a micro-crust, which gradually flakes away leaving clear skin.

Of course this process takes time and I am told the full effect will be appreciated in about 4-6 weeks.

The same principle applies for hair removal in that the light targets the colour in the hair follicle and kills it.

Heads up sisters- I am also a hairy girl. I can blame the sun for the spots on my face. I can blame my Eastern European ancestry for the hairs on my lip. And so IPL is the perfect treatment for me… spots and hair be gone.  Two birds with one laser? That is a modern technology I can get behind.

Side effects my girlfriends are minimal. According to a study published in Dermatological Surgery in 2002, IPL is rather safe. The study looked at the side effects of IPL over 390 consecutive treatments.

The subjects had the procedure done and then photos were taken immediately following as well as individual evaluations by the patients immediately following the procedure and two months after.

Side-effects observed were: transient erythema (n = 30), late evanescent erythema (n = 3), mild pain (n = 43), moderate pain (n = 6), crust formation (n = 9), superficial burning (n = 1), isolated vesicles (n = 3), transient hyperpigmentation (n = 8), transient hypopigmentation (n = 1), paradoxical effect (n = 5), persistent local heat sensation (n = 1), and minimal scar (n = 1).

The study concluded that although some pain is common, sever side effects such as scaring are rare (1 in about 400 treatments)

And so here I sit, another week gone. My face still feels like I’ve had too much sun and the little kid in me can’t wait to wake up every morning for the next 6 weeks to see what my face will look like.

As a doctor I am amazed every day by the wonders modern medicine has to offer. We really do live in the future; a future where one day you can lay down on a table, shine a glorified light on your skin and wait a few weeks to watch it disappear. No matter what happens tomorrow my sisters… today was a very good day.

Tuesday, May 7, 2013

The Ultimate Girlfriend's Guide

A Good Tuesday to all my sisters. How yah been? How’s the week going? Anything new to report?

Enough with the questions but o understand that I am interested in your point of view. Speaking of which, I do have news.

Just this past week I spent some time on a couch filming with a fellow sister who is working on a  project about inspiring women. Your’s truly was a such girlfriend.

Let me set the scene. The project which is called “A Little Fix” is a web series featuring interviews with women who have something to say and something to teach. My understanding is that this project is based on the idea that when two women sit down for a conversation; an exchange of ideas, they indeed can inspire other women.

So there I was the subject of such a conversation.  My new sister, Emily, (I don’t think she’ll mind) sat me down on a fabulous set in Gastown and asked me all sorts of girl to girl questions about what makes me tick. Perfectly in synch with my mode of action, I spilled it.

As my sisters know- I do love to chat and when faced with a good question, I do love a good answer. And so Emily and I had a lovely afternoon chat over sparkling water and by camera light about such issues as:
Is Feminism a good or bad word?
What’s it like to be Childless by Choice?
How does one turn Multitasking into an art form?
Where do people find Inspiration?
Why are women so judgmental of other women?

The course of our conversation did indeed run smooth as we joked about our everyday including:
Why some people sweat more than others?
What’s it like to be profoundly honest about everything in one’s life?
How do you navigate being very straightforward with people without coming off too bitchy? (answer: you don’t. People often think you are a bitch…. You just learn when to apologize for it)

I left our meeting with a mind full of ideas about what defines us as women and what we want for ourselves and our species.

You see my sisters- sometimes being a girl really can be a emotional mine field. Make no mistake- I love being a woman. Never mind the footwear and clothing, I love being unexpected at every turn. I relish in being highly underestimated one moment and truly overvalued the next.

I relish in a world that constantly asks me to define myself on a the basis that I have a uterus and am not afraid to use it. I’m serious- this is not just the wit and the estrogen talking.

But there are those times when the double X chromosome job can sometimes be a bit of cluster-fuck can’t it? If we chose work over home life we’re heartless male wanna-be’s. If we stay at home and raise our children, we have failed to live up to our potential. If we try and do both…. We suck.

As women we rejoice in the sisterhood when it suits our own self worth. We are constantly looking outside ourselves for a relative validation form those around us. Women as a rule use other women as points of care for our own life stories. We evaluate our own self worth based on what we see out the window and not what is really in the mirror.

I could not help but think after my moment in the spotlight how all too often as women we define ourselves by what we see around us relative to ourselves and not by who we really are and what we really want.

Where does this relative thinking come from; this reflective needs assessment, if you will?

When did women place so much stock in the opinions of the many over the value of the one? 

The point is that often our own perception of ourselves make these definitions or judgements in the first place. I think that we as a sisterhood all too often reflect back from others the attitudes of ourselves. We see women not having children and make a judgement call about our own childless choice. We see a stay at home Mom and wonder about our own choice to work and have child-care. We make dinner and envy those with the means to outsource food prep. We feel the need to secretly defend our life choices- from shoe purchase to cleaning lady to job satisfaction all in an attempt to please an imaginary status quo.

When did it become mainstream for women to care so much about what others think at the expense of their own self worth?

I sit each day with brave (men) and women of all shapes and sizes trying my best to help them be more in a world that often insists that they don’t measure up. There comes a time in every day when I wish beyond wishing that I could somehow transplant in them a sense of well being…. A moment of “Good enough”. If only we could put on self confidence like we do perfume- spraying it at will to help cover up the smell of the everyday.

I’ve thought about this for a while now. You see I really believe that my parents raised me with an unordinary sense of self esteem. I mean- I grew up to believe that I really could do anything. Now so many years later- I live everyday with a man who really does believe I am a superhero. That kind of faith really can empower a person.

I have no doubt that there are studies that support the concept that if you want a little girl to grow up into a strong self actualized woman- you should tell her everyday how fabulous she is and highlight for her the depth of her skill set.

My Mom and Dad did just that. And when I moved away, I built a life with a man who every morning walks me through the Vancouver West End and builds up my ego for another day of battle.

I can’t help but wonder what the world would be like if we all had someone in our lives who tells us everyday how special we are. I wonder how that will translate over days and months as we slowly turn those words into actions and actions into our own belief system. How, if over time we eventually KNEW that we indeed were something else….what would the world look like if little girls everywhere grew up to be women who in turn became their OWN role models- no longer in need of an external measuring stick to actualize their own self worth?

Would we cure cancer and achieve world peace or would there just be an army of estrogen to contend with? Is this what the founders of feminism had in mind when they sat down years ago in the hopes of setting me and my sisters free?

Modern feminism is historically divided into three waves. First wave feminism began in the 18th and 19th centuries and continued into the early 1900’s and focused on the legal inequalities including the Suffragettes.

Some feminist historians say  first wave feminism began in 1789 during the French Revolution with the women who led the March on Versailles. Others say it began in Sweden in 1718 when tax paying women were given the right to vote. Much of the suffragette movement focused on the legal rights of women regarding voting and taxes.

Women received the vote in Denmark and Iceland in 1915 (full in 1919), the USSR in 1917, Austria, Germany and Canada in 1918, and many countries including the Netherlands in 1919, Turkey and South Africa in 1930. French women did not receive the vote till 1945. WTF France? Liechtenstein was one of the last countries, in 1984. VERY small country…. Enough said. (who knew there was small country syndrome?)

Second wave feminism is thought to have occurred between the 1960’s and 1980’s and is what my generation would classically call Feminism. (back then it was indeed CAPITALIZED)

This wave broadened the debate of women’s right to include gender inequalities, gender norms and the role of women in society. Here is where we talked issues like abortion, equal pay and a woman’s role in the home and society.

The third wave of feminism began in the 1990’s and continues until today. According to feminist historians (no capitals here) it is seen as a continuation of the second wave of feminism and a response to its failures. My understanding is that this wave of feminism tackles issues such as the modern woman’s feminine mystique, how to be a woman and still be a lady and finding some sort of middle ground for the 1960’s feminist in today’s world.  The third wave of feminism also focuses on gender inequality among women of all ethnicity. Where the first two waves of feminism were seen as focusing on the upper and middle class white woman, the third wave of feminism tries to further the cause among women of colour.

It’s interesting to review feminist’s history. There are definitely some iconic women who indeed stand out. From  Simone de Beauvier to Margaret Sanger to Betty Friedan to Gloria Steinem to Audre Lorde- my life is gifted by the struggles of some pretty pioneering sisters before me. These are women whose voices rang true so that mine could indeed be heard.

So excuse me my sisters if this week is more of a philosophical sonnet than a scientific rant. I could not help myself but to ponder the female mystique and see what came out the other side. Not happy with my feminine philosophies? Blame my second X chromosome…. That bitch made me do it.