These are the thoughts of a cantankerous ol' gynecologist who remembers when things were a little different. I try to find a little humor in my life and the people I meet along the way. Come meet the characters in my world.

Saturday, March 31, 2012

Saturday Images

Weekend Photos from Facebook Friends

I’m not much of a morning person.  So I love to sleep in on the weekends.

This bookcase actually has something to say.  The top three rows are a statement all their own.  For those who don’t get it, answer tomorrow.

Friday, March 30, 2012

Doctor’s Day

Doctor’s Day
March 30, Every Year

Today is the day you need to thank your doctor.  We have had this day set aside since 1933.  It is not generally recognized by people outside the medical community.  Most hospitals and large clinics will have a breakfast or lunch for their physicians.  The symbol for the day is the red carnation. 

The origin of Doctor’s Day was in Winder, Georgia.  Eudora Brown Almond decided to set aside a day to honor her husband, Dr. Charles B. Almond, and the other physicians who worked alongside him.  They mailed greeting cards and placed flowers on the graves of deceased doctors.   

In 1958, a Resolution Commemorating Doctor’s Day was adopted by the United States House of Representatives.  In 1990, legislation was introduced in the House and Senate to establish a national Doctor’s Day.  On October 30, 1990, President George Bush signed S.J. RES. #366 (which became Public Law 101-473) designating March 30 as “National Doctor’s Day”.

Today I would like to say thank you to all my teachers, my contemporaries, and those who follow behind.  Medicine is at a difficult stage right now.  With all the frustrations that we have experienced recently, I still find it rewarding and enriching.  I can’t imagine doing anything else.

Wednesday, March 28, 2012

Traffic light update

Quick update on the traffic light situation:

They have fixed the timing on the middle of the three traffic lights in question (sort of).  It is at least longer.  Now there is plenty of time to get through.

Unfortunately, they have not got the three lights in question timed with each other.  So, traffic backs up at each light.  Enough that the line at the second light may not get through because it gets backed up at the third light enough to leave you in the intersection at the second light.

Remember this is a rural road.  The next stop light isn’t for about 5 miles. 

I will keep you posted.

I love road construction.

I love hearing from the back seat (Mr. Impatient) “Mom, we have to wait?”

“Unless you want me to drive through that car in front of us or have an accident!”


Tuesday, March 27, 2012

Published on Yahoo! Voices today as Dr. Maryellen Smith

New article today

As you may know, in another life, I write articles for Yahoo!  They are published either on Yahoo! Voices or Yahoo! Shine.  Today an article was published that I have been working on for a while.  I have experienced a dreaded EDITOR.  However, I do think it made the article better.  The article is entitled Uterine Fibroids and Fertility.  Here’s the URL:

Friday, March 23, 2012

There are site issues today. I reposted semper fi because I had corrections. I have written this several times. I don't know if or when I will be able to post it. When the site is running correctly, I will fix what is wrong.

Sorry for all the problems.


Semper Fi

Little-known story from the Pentagon on 09/11/2001

During a visit with a fellow chaplain, who happened to be assigned to
the Pentagon, I had a chance to hear a first-hand account of an
incident that happened right after Flight 77 hit the Pentagon.

The chaplain told me what happened at a daycare center near where the
impact occurred. This daycare had many children, including infants
who were in heavy cribs. The daycare supervisor, looking at all the
children they needed to evacuate, was in a panic over what they could
do. There were many children, mostly toddlers, as well as the infants
that would need to be taken out with the cribs There was no time to
try to bundle them into carriers and strollers. Just then a young
Marine came running into the center and asked what they needed. After
hearing what the center director was trying to do, he ran back out
into the hallway and disappeared. The director thought, 'Well, here
we are-on our own.'

About 2 minutes later, that Marine returned with 40 other Marines in
tow. Each of them grabbed a crib with a child, and the rest started
gathering up toddlers. The director and her staff then helped them
take all the children out of the center and down toward the park near
the Potomac and the Pentagon. Once they got about 3/4 of a mile
outside the building, the Marines stopped in the park, and then did a
fabulous thing - they formed a circle with the cribs, which were
quite sturdy and heavy, like the covered wagons in the Old West.
Inside this circle of cribs, they put the toddlers, to keep them from
wandering off.

Outside this circle were the 40 Marines, forming a perimeter around
the children and waiting for instructions. There they remained until
the parents could be notified and come get their children.

The chaplain then said, "I don't think any of us saw nor heard of
this on any of the news stories of the day. It was an incredible
story of our men there. There wasn't a dry eye in the room. The
thought of those Marines and what they did and how fast they reacted;
could we expect any less from them? It was one of the most touching
stories from the Pentagon."

Remember Ronald Reagan's great compliment: "Most of us wonder if our
lives made any difference. Marines don't have that problem."

Pray for our men and women who have served and are currently serving
our country and pray for those who have given the ultimate sacrifice
for freedom.

**** This was sent to me on the internet.  I haven’t verified it, but my source is usually factual.  It just made me feel good. 

Addendum, Same day

I posted this on my doctor’s web site.  My doctor friends did the research I did not do.  Unfortunately, my friends, this is not true according to Snopes:

And Snopes will not let me copy the post in any way. 

·        No cribs

·        No marines

·        There was a group of park rangers that helped a bunch of kids later in the day evacuate to VDOT on an empty tour bus

·        One of the parents left his duty station to check on his child.  The duty station was hit and he was spared.

Thursday, March 22, 2012

Interesting resources

ACOG website for your perimenopausal and menopausal patients

Everything your patients need to know about midlife health is available at their fingertips.

FREE online resources at pause.acog.org.

Also, a cool video about fetal development: 

Wednesday, March 21, 2012

Another Routine Disturbance. Sigh!

Will the people who changed the timing for the traffic light please fix it?

Like most people, we drive the same way to school every day.  There really aren’t a lot of choices for us. 

Last week the State Road people were installing a new traffic light along the route.  It replaced one that was already there, so there shouldn’t be any problem.  WRONG!!!!  When they installed it, they didn’t time it the same as it was before.  Traffic is backed up significantly at busy times of day. 

One of those times is when we are going to high school in the morning.  It disturbs Mr. Impatient.  He gets upset and fusses about it.  Then he “perseverates” about it all day.  Mr. Lasermed and I (and Tall Guy and Three Speed) have had to listen to this since last Friday.  That’s when they finished changing the light.

Last night, it went on for about 2 hours. 

Can the people responsible for fixing the timing on the traffic lights please do their jobs? 

Thank you.

New Articles on Yahoo

I have been writing again!  Here are a couple of new articles on Yahoo! Shine:

Second Trimester Normal Pregnancy Body Changes

What happens if you have fibroids and are pregnant?

Note that I also updated the articles list to make it more readable, I hope.  If you have any suggestions for changes, let me know.  Also, if there are any medical topics you would like to have written, please let me know. 

Monday, March 19, 2012

Why Parents go Crazy When Their Triplet Children are Teenagers

If I hadn’t gone crazy by the time my children had gotten to be teenagers, these years would put me in the funny farm.  My boys are in their senior year of high school.  This morning was one of those mornings that make me want to join a convent.  It’s a good thing Lutherans don’t have nuns.

To set the scene:  Three Speed has a paper due for his college English class this evening.  He never gets them done on the weekend.  He seems to like to get up Monday morning at 5:30 AM and do the work when the house is quiet.  He sleeps on the couch downstairs instead of his bed.  I think this is so he will get up.

I was taking my pills before I went up to bed last night.  I turned off the TV before I went upstairs.  I usually leave it on all night.  This was probably the major problem.

Mr. Impatient gets up at 4:30 AM every day.  If the TV isn’t on, he turns it on.  Then he turns on his computer, gets his breakfast and plays on the computer until the rest of us are up and ready to go to school in the morning.  We are normally ready around 7:15 AM.   He goes out about 7:00 to “start the car” and defrost it, if necessary.  Then he perseverates about why nobody else is ready to leave.

This morning, Mr. Impatient woke up Three Speed when he turned on the TV.  Three Speed got upset and turned it off.  He said it wasn’t 5:30 yet.  He was correct about that, but he is never up at 4:30 when Mr. Impatient comes down.  He said Mr. Impatient always comes down at 5:30 (incorrect statement). 

There is a problem with the remotes for the cable and the TV (different remotes – don’t ask).  Mr. Impatient can’t figure them out.  Three Speed got his stubborn up and wouldn’t fix it.  I came downstairs without my glasses, so couldn’t see the remotes well enough to fix it.  Mr. Impatient couldn’t find my glasses upstairs.  I can’t get my knees working well enough for a couple of hours after I wake up to go up and down the stairs very fast. 

I finally convinced Three Speed to turn on the TV so I could go back to bed.  Mr. Impatient didn’t need it loud, he just needed it on.  Now I can’t think straight at 2:00 PM.

Congratulations, Eagles on State Championships in Basketball!!!!!

Thought for the Day 3/19/12

Thought for the Day

Caffeine is proof that God loves us and wants us to pay attention.

Thursday, March 15, 2012

Patient Phone Tag

We have a patient who comes regularly, but never seems to be able to schedule an appointment.  Today there was a message on the voice mail that she had been trying to call us “all day, every day for the last three days”. 

Princess is annoyed.  We are here every day at 8:00 AM.  We answer the phone until at least 3:00 PM.  Even during lunch.  If Princess steps out, I will even answer the phone.  That’s where Maryellen came from. 

So….  We know that she hasn’t tried to call between 8 AM and 3 PM any day this week. 

She wants to blame the fact that she needs to be seen and can’t get in on US. 

Princess called her at 8:05 this AM.  She left a message, because, as usual, this patient never answers HER phone.  She offered her an appointment TODAY.  No phone call back.  Yet. 

Want to bet there is an angry message on the machine tonight? 

Wednesday, March 14, 2012

Thought for the Day 3/14/12

Thought for the Day

A truly happy person is one who can enjoy the scenery on a detour.

Tuesday, March 13, 2012

New Yahoo! Voices Article

Published today

Heart disease in women is different than in men.  We don’t have that crushing chest pain – like an elephant sitting on your chest.  To find out what the symptoms are, check out my new article:

How to Recognize Heart Disease in Women

published today on Yahoo! Voices.  That explains why I was clueless about that shortness of breath and fatigue.  It wasn’t a heart attack, but it is serious heart disease. 

We have it under control.  It fooled me for a while, though.

I hope you learn something.


3/15/12 See comments for problems with the URL.  I'm working on it.  Laser.
Later same day.  Fixed.  When I back spaced to put the URL all on one line, the computer deleted a 1.  Fixed now.  Try it again. Thanks for pointing it out.

Monday, March 12, 2012

Women's History Month and Cancer

IN honour of women's history month and in memory of Erma Bombeck who lost her fight with cancer.

(written after she found out she was dying from cancer).

I would have gone to bed when I was sick instead of pretending the earth would go into a holding pattern if I weren't there for the day.

I would have burned the pink candle sculpted like a rose before it melted in storage.

I would have talked less and listened more.

I would have invited friends over to dinner even if the carpet was stained, or the sofa faded.

I would have eaten the popcorn in the 'good' living room and worried much less about the dirt when someone wanted to light a fire in the fireplace.

I would have taken the time to listen to my grandfather ramble about his youth.

I would have shared more of the responsibility carried by my husband.

I would never have insisted the car windows be rolled up on a summer day because my hair had just been teased and sprayed.

I would have sat on the lawn with my grass stains.

I would have cried and laughed less while watching television and more while watching life.

I would never have bought anything just because it was practical, wouldn't show soil, or was guaranteed to last a lifetime.

Instead of wishing away nine months of pregnancy, I'd have cherished every moment and realized that the wonderment growing inside me was the only chance in life to assist God in a miracle..

When my kids kissed me impetuously, I would never have said, 'Later... Now go get washed up for dinner.' There would have been more 'I love you's, more 'I'm sorry's.'

But mostly, given another shot at life, I would seize every minute; look at it and really see it; live it and never give it back.. STOP SWEATING THE SMALL STUFF!

Don't worry about who doesn't like you, who has more, or who's doing what
Instead, let's cherish the relationships we have with those who do love us...

Maybe we should all grab that purple hat earlier.

Wednesday, March 7, 2012

New Video Games, Autism Style

Teenagers these days seem to be addicted to their video games.  Mine are no exception.  They have learned to save and scrimp to pay for their games.  I don’t pay for the games directly.  I might pay them for mowing the lawn or something else, but they pay for the games. 

They spend a lot of time at the video stores.  The people who work at the two local ones have gotten to know them really well.  I have become a useless appendage.  I make sure they have the “club” card, and then wait in the car with my book or my latest crochet project.  Everyone is happy with that arrangement.

Mr. Impatient likes a lot of the old games.  He can generally find games for less than $10 – sometimes less than $2.  We call him the King of Cheap Games.  I’ve seen him get 6 games for less than $10.  He has also bought games on Amazon for $0.01 (plus $3.99 shipping and handling!).

Occasionally he gets really excited about a brand new sports type game.  He has to have it as soon as it comes out.  He will pay full price for it.  I make sure he has enough money in his money pouch (and the club card).  He gets very agitated about who has to have the car after school and who can drive him to the game store.  He has finally learned to go in by himself if Mom is driving.  If the other guys are with him, they will go in because they like to look at the games, too.

Yesterday was one such occasion.  Tall Guy took him to get the game.  They recognized him at the store.  The sales person was quite surprised.  He said, “I’ve never seen you pay this much for a game before!” 

After they came home, he went to his room to play the new game.  We had to drag him out of his room for dinner.  Otherwise, we didn’t see him the whole evening.  That’s one advantage to new video games. 

Monday, March 5, 2012


Autism and Emergencies

This is an interesting video about helping autistic people in case of emergency. 

The man who developed the program is a fire fighter with an autistic son.  He explains how most autistic people are fixated on their routines.  An emergency is definitely out of their routine.  They get excited.  I would say agitated.

Many autistics cannot speak or communicate properly.  When they are upset, they may make funny noises, abnormal gestures like “flapping”, run around, or be absolutely still.  To calm them down, one technique is the “bear hug”.  It works on my son, Mr. Impatient. 

The video is worth watching. 

Saturday, March 3, 2012

Around the Web – Misconceptions about Obstetricians by Dr. Amy

This is from a blog I recently discovered.  Dr. Amy Tuteur is well spoken about Obstetric subjects.  She can be found at http://skepticalob.blogspot.com/.  This particular piece is so well written; I decided to reproduce it in full here.  Link to her site is at the bottom if you want to comment to her.  (Note: she has even more to say about the subject than I do.  She says it very well.)
It seems like every day a new visitor parachutes in to this blog and attempts to "educate" me. Inevitably, the visitor finds that almost everything she says is false. Indeed, almost everything she thinks she "knows" is false. So to spare these visitors embarrassment, and to reach those who are attempting to "educate" me on other blogs, I have compiled the following list. Here's what you should not say to me, and why you should not say it.

1. The US does very poorly on infant mortality.

Infant mortality is the WRONG statistic. It is a measure of pediatric care. That's because infant mortality is deaths from birth to one year of age. It includes accidents, sudden infant death syndrome, and childhood diseases.

The correct statistic for measuring obstetric care (according to the World Health Organization) is perinatal mortality. Perinatal mortality is death from 28 weeks of pregnancy to 28 days of life. Therefore it includes late stillbirths and deaths during labor.
The US has one of the lowest rates of perinatal mortality in the world.

2. The Netherlands, which places the greatest reliance on midwives, has low mortality rates.

No, the Netherlands has, and has had for some years, the HIGHEST perinatal mortality rate in Western Europe. It also has a high and rising rate of maternal mortality. The Dutch government is deeply concerned about these high mortality rates and a variety of studies are underway to investigate.

The most recent study published in the BMJ is early November 2010 revealed and astounding finding. The perinatal mortality rate for low risk women cared for by midwives is higher than the perinatal mortality rate for high risk women care for by obstetricians!

3. Obstetricians are surgeons.

I never understand how anyone has the nerve to say this to me. I AM an obstetrician. No one knows better than I what obstetricians are or are not. I went to college. I went to medical school. I spent four years in obstetric training. I delivered thousands of babies. I have cared for thousands of gyn patients. That some doula who is a high school graduate thinks that she can possibly know more than I about the nature of obstetricians defies belief.

Obstetricians do surgery as part of their practice. That does not make them surgeons. If it did, ophthalmologists and dermatologists would be surgeons too, since they do surgery as a routine part of caring for their patients. Is anyone seriously suggesting that you cannot go to an ophthalmologist for an eye exam because he or she will recommend unnecessary surgery?
4. Homebirth is safe.

No, all the existing scientific evidence and all national statistics indicate that homebirth triples the rate of neonatal death. Even studies that claim to show that homebirth is as safe as hospital birth, like the Johnson and Daviss BMJ 2005 study, ACTUALLY show that homebirth with a CPM has triple the rate of neonatal mortality of comparable risk women who delivered in the hospital in the same year.

The Midwives Alliance of North America (MANA) is well aware that homebirth is dangerous. That's why they are hiding their own mortality rates. They spent almost a decade collecting information on more than 18,000 CPM attended homebirths, announcing at intervals that they would use the data to show that homebirth is safe. So why haven't any of us seen it?

The data is publicly available, but ONLY to those who can prove they will use the data for the "advancement" of midwifery. MANA is quite up front about the fact that they will not let anyone else know what they have learned. Obviously, if homebirth had been anywhere near as safe as hospital birth, they would be trumpeting it from the mountain top. It does not take a rocket scientist to suspect that their data shows that homebirth dramatically increases the risk of neonatal death.

5. Homebirth midwives are experts in normal birth.

This one always makes me laugh. Experts in normal birth? That's like a meteorologist who claims to be an expert in good weather.
I guess they're trying to make a virtue of necessity. Homebirth midwives know virtually nothing about the prevention, diagnosis and management of pregnancy complications. That's a problem when you consider that the only reason you need a birth attendant is to prevent, diagnose and manage complications. You don't need any expertise to catch the baby and make sure it doesn't hit the floor. Ask any taxi drive; he'll tell you.

6. Childbirth is safe.

No, childbirth is INHERENTLY dangerous. In every time, place and culture, it is one of the leading causes of death of young women. And the day of birth is the most dangerous day in the entire 18 years of childhood.

Why does childbirth seem so safe? Because of modern obstetrics. Modern obstetrics has lowered the neonatal mortality rate 90% and the maternal mortality rate 99% over the past 100 years. What has the contribution of midwifery been to lowering those mortality rates? Zero? They've invented nothing, discovered nothing and tested nothing that has had any impact on perinatal or maternal mortality.

7. Childbirth used to be dangerous but that is only because sanitation was poor and women were poorly nourished.

No, the great advances of sanitation occurred in the 1800's and the early years of the 1900's. Not surprisingly, this had a big impact on deaths from infectious causes. However, rates of perinatal and maternal mortality did not begin to drop appreciably since the late 1930's and the discovery of antibiotics. In the intervening years, easier access to C-sections, epidural anesthesia, newer and better antibiotics, blood banking, and neonatology led to dramatically lower mortality rates.

8. C-section increases the risk of maternal and neonatal death.
No, women who die in pregnancy are most commonly women with serious pre-existing medical illness (heart disease, kidney disease) or serious pregnancy complications (pre-eclampsia). C-sections are often done in an effort to save the lives of these women. Sometimes it is not enough. The C-section is what is known as a "confounding factor." Both the C-section and the death can be traced back to the mother's health status; the C-section did not cause the death.

MacDorman and colleagues have attempted to show that C-sections for "no indicated risk" increase the neonatal death rate. Their papers have been roundly criticized because they used birth certificates, not hospital record. Unrelated investigations of birth certificates have shown that, while they are highly reliable for data like weight and Apgar scores, they are highly unreliable for risk factors. Indeed, unrelated studies have shown that up to 50% of women who have serious medical illnesses like heart disease, have those risk factors missing from the birth certificate.

9. Induction harms babies.

No, induction lowers perinatal mortality. The yearly CDC data on births shows that as the induction rate has risen, the rate of late stillbirth has dropped by 29% and the neonatal death rate has not increased.

10. If childbirth were dangerous, we wouldn't be here.
This represents a profound lack of knowledge about evolution as well as a profound lack of knowledge about childbirth. Evolution does not lead to perfection. Evolution is the result of the survival of the fittest, not the survival of everyone. Human reproduction, like all animal reproduction, has a massive amount of wastage. Every woman was born with millions of ova that will never be used. Every man produces billions of sperm that will never fertilize an ovum. Even when a pregnancy is established, the miscarriage rate is 20%. That's right. One in five pregnancies dies and is expelled and yet we are still here. Human reproduction is perfectly compatible with a natural neonatal death rate of approximately 7% and a natural maternal death rate of approximately 1%.

11. US maternal mortality is rising.

Despite a rather histrionic political report from Amnesty International making that claim, US maternal mortality is not rising and has even dropped in both of the past two years. Why does it look like it has risen? Because the standard death certificate has been revised twice in the past two decades in order to more accurately capture maternal deaths. The new death certificate has revealed maternal deaths which otherwise would not have been counted. There is no evidence that maternal deaths have increased; it's merely that reporting of those deaths has improved.

12. Women are designed to give birth.
Women are not "designed": they have evolved and evolution involves trade offs. Babies with big heads tend to be more neurologically mature, so having a big neonatal head has evolutionary advantages. A small maternal pelvis makes it easier for a woman to walk and run, providing her with an evolutionary advantage. Those two advantages are often incompatible. The woman with a small pelvis may have been able to survive by outrunning wild animals, but when it came time to give birth, she was more likely to die because that small pelvis could not accommodate a large neonatal head.


The above statements have two things in common. First, they are wrong. Second, they are passed back and forth between natural childbirth advocates who "teach" each other they are true. That's why it is impossible to become "educated" by reading natural childbirth books and websites. Most of their information is flat out false, and they are entirely insulated from scientific evidence. Natural childbirth advocates make up their "facts" as they go along. They don't read the scientific literature. They don't interact with science professionals. Indeed, professional natural childbirth advocates take special care to never appear in any venue whether they might be questioned by doctors or scientists. They know they'd be laughed out of the room. That's okay with them as long as there is a large pool of gullible women out there who will believe them and buy their products.

It is important that those who are parachuting in to "educate" me understand that they literally have no idea what they are talking about. Most of what they think they "know" is factually false. And they demonstrate that every time they utter one or more of those twelve statements.

Friday, March 2, 2012

Blog Notes I

Just a few notes on my blog:

February was interesting.  I posted something I borrowed from a friend, who got it from Facebook, and my blog went viral!  I had been getting 40-60 visitors per day.  One day I had over 5000.  I started the blog in August, 2011.  I had about 8000 visitors until mid February.  Now I have over 30,000.  I hope some of those visitors liked what they read and continue to visit. 

I wrote a post about how many different countries visitors had come from on February 4.  There were then just over 40 countries.  Today we hit 80 countries.  If you don’t see your country’s name on the side, I missed it.  Put it in the comments and I will add it. 

I have learned a lot of geography.  RĂ©union (which only got the little accent because I copied it from Wikipedia) is the newest country that I added to my list.  I have had to look up a lot of countries to see where they are.  [As I was checking before posting, someone from Dominica came to visit.  Hello!]

I have finally found all of the articles on Yahoo! from Dr. Maryellen Smith.  It has been interesting.  Yahoo! has been redoing its site this month.  The last article is: Multiple Pregnancy – the Roller Coaster of Twins, Triplets or More:

I have to admit that the format of the page (see upper right) that has all the articles on it is a bit crazy.  I may have to copy it to word and redo the whole thing.   I will continue to add articles as I write them.

I am getting somewhat better technologically.  Not great yet.  I am still in the stone ages.  Thanks for hanging in there with me.