The Birds And The Bees, Part 2

Communicating your Families Beliefs

In my last post, The Birds and the Bees, Part 1, I covered the idea that Parents are the Model for their children. Parents are the number one influence on future decisions teenagers will make regarding their sexuality. As parents how do we guide them through this phase of their lives?

The message that most kids get from their parents about sex is simple:

Rule #1 Don’t do it!

Rule #2 Follow rule number one.

It is important for parents to communicate with their kids what their family believes about sex.

I can not tell you what that belief should be. That is up to you and your spouse but this step is crucial —-Tell your kids. Communicate your beliefs. Express your views, tell your kids what your family believes, whatever that is. If your family believes no sex until marriage— great. Communicate that. If your family believes no sex until you are in love —- fine. If your family believes something different—-no problem; they’re your kids, not mine. Discuss your family’s morals and values. I’m not going to tell you what to say, but you should tell them what your family believes. The morals and values of the family lays the foundation for your children. Once you have done that step now comes the harder question —- If I ask your kids, what does your family believe? Could your kids tell me? It’s a little harder. Many parents feel like they have communicated very clearly, but if I ask their kids “What does your family believe about sex?” The kids don’t know the answer. …… Something to think about…If you have communicated something to your children and they can not repeat it back then the message has not truly been received. It has not been internalized.

When your children are young they will accept the parental views and make them their own. As your child transitions to the teen years, things get more complicated…

As children become teenagers things change.

While the family belief system will still serve as the foundation, your child will begin to develop their own beliefs about sexuality. Parental influence is still a factor but it is no longer the only factor in their decision making. The determining factor is actually what is in their own minds ——-Your child beliefs (not yours) will guide their decisions. This is hard to swallow but crucial for parents to understand.

The average age of the first sexual encounter is 16.5 years old. The average age for marriage is 29.5. That’s a long time to wait and if the only information a child has is “wait until marriage” then that answer may not be enough when they are 27 years old. I grew up in a Christian home. I remember being involved in Young Life and we were taught no sex until marriage. I remember many serious debates around the age of 15 on where exactly was the line? Where’s the loophole? How far can we go? I also remember a funny episode of Seinfeld where they debated what exactly defines when sex has occurred. We wondered about that too at that age.

Using data from the CDC YRBSS before age 13 only 3.5% of kids have had sex. But by ninth grade, it jumps to 20%. By twelfth grade, slightly over half of kids have been sexually active.

As your children transition from elementary to the teen years, our parental communication must evolve.

We must transition from a monologue — telling kids what to believe– to a dialogue. When they are young, you tell them very specifically what to do and your kids do what you say. As they get into junior high, this paradigm shifts. They are still very much influenced by what you say, but their actions are more determined by what they think—what they believe. Our children are growing up and they’re becoming independent. If I ask your children what do they believe about sex would their answer surprise you?

In the next post we discuss some specific communication techniques you can use to improve the dialogue with your child.

Learn more about Dr. Livingston here

Further Reading:

The link from this book cover is tied to Amazon. Proceeds generated are donated to the Irving ISD Teen Parenting program, a drop out prevention program for students who are pregnant or parenting.

 

The Birds And The Bees, Part 1

You Are Their Model

Many people ask me how should they talk to their children about sex. My short answer is parents and their children must have an ongoing lifelong dialogue and not a one-time conversation. This next series of posts are designed to help you open your mind to new ideas and different ways of thinking about how to handle this challenging issue with your kids.

Think about this for a second —— “How did you learn about sex when you were a kid?” Reflect back to those awkward years between sixth, seventh and eighth grade—— kids were talking about sex. You had questions and maybe you asked a trusted friend or sibling. Maybe you saw things on TV, the JCPenney catalog, or if you were lucky you found a copy of the Sports Illustrated Swimsuit Edition. Some kids even performed the 1980’s version of Googling and found an encyclopedia to look things up. The key here is that you found ways to get the answers to the questions on your mind. You filled the void.

So what do our kids do in 2019 to find the answers they have about sex? Our multitasking, Facebooking, iPad playing, Tik Toking, Netflix watching, Intagram posting, Snapchatters have immediate access to information. Just like us they have questions about sex, but the difference is they live in a world of information overload. They are one click away from answers to any question. So specifically, how do kids learn about sex? They learn a little bit in school in health class. They learn from their friends. They learn from other media, TV shows, and music. Most importantly, kids learn a ton from the Internet

Despite all of this access to information what actually influences their decisions? The answer is YOU——The parents. Here is the good news. Parents still matter. Study after study shows this crosses socioeconomic, cultural and racial barriers. The number one influence on what a child believes, and ultimately is going to do about sexuality, actually comes from you. It’s good to know we parents still matter because sometimes it does not feel that way.

Parents are the model for their children. From the time they are born, your children watch everything you do. They are learning about sex from you all day every day, even when you think they’re not watching. They watch what happens when one parent comes home from work. How did you greet each other? They notice the intimacy, the engagement, the hugs. They see and feel the love a couple expresses for one another. They notice your reactions and emotions. What happened in a movie when there was a romantic moment? How did you react? When mom and dad are talking about other people’s relationships, they’re listening. When an inappropriate joke comes up in a movie or TV show they watch your response. You are their model.

I once heard a speaker described adolescent sexuality with this metaphor. Think of yourself walking down a long hallway with all of these curtains. As you take a step forward, you pull back the curtain and you answer certain questions. As your child gets older you walk further down the hallway and you pullback the next curtain and the next and the next. This is a great illustration of the ongoing dialogue we must have with our children. I believe children are prepared to understand any question they ask. If your child asks you a question then answer it on their level. Don’t be embarrassed or shameful. Since I’m an OB/GYN, you can imagine dinner conversation at my house is often very interesting. So my kids at a very young age asked me, how do you get the babies out? When they were young, the answer was simple. “When the baby is ready to be born, it sends a signal to come out between the mommy’s legs and sometimes I make a cut to help the baby come out through the mommy’s stomach.“ That was the answer when they were young. As they got older, I was able to explain in different language exactly what my job entails. Answer the question that they have.

In our next post, we will dive deeper into the subject of The Birds and The Bees and how to help parents navigate through this difficult subject.

Further Reading:

Is It Safe To Smoke Marijuana While Pregnant?

Smoking Marijuana While Pregnant?

The short answer: No.

The long answer:

There is growing data suggesting that cannabis compounds quickly cross the placenta and can be transferred via breast milk. There is also evidence that shows that marijuana use can affect obstetrical outcomes and embryonic development. There is a link between marijuana use and the following:

  • Low Birth Weight
  • Premature Delivery
  • Small Head Circumference
  • Stillbirth

It’s use has also been linked to poor pediatric outcomes including the following:

  • Trouble with memory
  • Poor attention span
  • Problems with impulse control
  • Poor school performance

Uterine Fibroid Embolization (UFE): What Women Want to Know

Uterine Fibroid Embolization

Dr. Suzanne Slonim is a friend of MacArthur OBGYN. She specializes in non-surgical fibroid treatment with Uterine Fibroid Embolization (UFE).

What is UFE?

UFE is a minimally invasive outpatient procedure to treat uterine fibroids. Fibroids are very common and can cause heavy menstrual bleeding, cramping, bloating, constipation, urinary frequency, back pain, and other symptoms. The technique blocks the fibroid blood supply.

How is UFE performed?

After you are under anesthesia, UFE is performed by passing a tiny tube through the blood vessels directly to the blood supply of the fibroids. Then tiny particles are injected to block the fibroid blood supply. Without blood flow, the fibroids will die. UFE treats all the fibroids in the uterus at once, no matter the size, shape, number, or locations. There is no incision or stitches, and the scar is smaller than a grain of rice. Dr. Slonim does the procedures at the Fibroid Institute Dallas near Central Expressway (US 75) and LBJ Freeway (Interstate 635).

How long does UFE take?

Once you arrive at the Fibroid Institute, the preparation time takes about 30 minutes. The UFE procedure takes about 1 hour to perform. After the procedure, women are monitored in the recovery area for 2 hours. After that your family or friend can take you home.

What is the recovery time for UFE?

After UFE, you’ll be uncomfortable for a few days. Most women are able to return to work 7 to 10 days after the procedure. If you had the UFE on a Friday, you’d be off work the following week and then ready to go back to work by the Monday after that.

Is UFE effective?

UFE has been around since the 1990’s and has a proven track record. In women with symptomatic uterine fibroids, the UFE procedure has been shown to be effective 90% of the time in improving or eliminating the symptoms. It works well for heavy menstrual bleeding as well as the symptoms that come from the fibroids pushing on the organs near the uterus.

Can I have a UFE?

Most women who have symptomatic fibroids are candidates for the UFE procedure. It’s especially good for women who do not want a hysterectomy or who do not want to have any type of surgery. It’s a great choice for women who have medical problems that would make their surgery extra challenging or risky. And it’s perfect for women who would refuse a blood transfusion in case of emergency, like a Jehovah’s Witness. You can’t have a UFE if you are pregnant, if you have an active pelvic infection or if you’ve had radiation in your pelvis. If you are trying to get pregnant, UFE is not the first choice for treating your fibroids.
Wondering if Uterine Fibroid Embolization (UFE) is the right treatment for you?

Download a FREE UFE Check List to help you decide.

How can I get scheduled for the UFE procedure?

Talk to your doctor at MacArthur OB/GYN to see if UFE is a good option for you.  If it is, we can refer you for a consultation with Dr. Slonim. She will explain the procedure to you in detail, including all the risks and what to expect after the procedure. She will need to see a pelvic MRI to make the final determination of whether you are a candidate for UFE. If you are, her office will take care of everything from getting insurance approval to making sure your recovery is going smoothly.

About Dr. Suzanne Slonim

Dr. Slonim founded the Fibroid Institute Dallas and the Fibroid Free movement to help relieve women of painful fibroid symptoms using options other than surgery or hysterectomy. She has successfully helped countless women take control of their lives and become Fibroid Free.

To learn more about Fibroid Institute Dallas visit the Fibroid Free website or Facebook page. Fibroid Institute Dallas is located at 12400 Coit Road, Suite 505, Dallas, TX 75251. Or visit the newest location in Southern Dallas at 1010 E. Wheatland Rd, Duncanville, TX 75116. Please call our offices at 972-392-2900 to make an appointment for a consultation. You can also CLICK HERE to schedule an appointment.

Mental Framing

Change the frame

Change your feelings

Placing a picture in a frame changes the way we view the image.

The same is true for our thoughts and feelings. The way we frame a situation in our mind changes the way we interpret it.

Last night I worked all night and delivered six babies. I can choose to focus on my fatigue, or I can be proud of my accomplishments.

Today I did not follow my diet plan. I can choose to beat myself up over BOTH of my trips to McDonalds, or I can view today as an opportunity to start fresh tomorrow.

Today I drank an inordinate amount of coffee. I can choose to wallow in self pity about why I needed it, or I can be thankful that the amazing drink of the God’s was at my disposal.

Whenever I feel down or frustrated I try to pause and to think through how my mind is framing the situation.

If you don’t like what you see then change the frame.
Change the frame and change your feelings.

Dangers of Douching

The word “douche” means to wash or soak. Douching is washing or cleaning out the inside of the vagina with water or other mixtures of fluids. Most douches are sold in stores as prepackaged mixes of water and vinegar, baking soda, or iodine. The mixtures usually come in a bottle or bag. You squirt the douche upward through a tube or nozzle into your vagina. The water mixture then comes back out through your vagina. Douching is different from washing the outside of your vagina during a bath or shower. Rinsing the outside of your vagina with warm water will not harm your vagina.

In the United States, about 1 in 5 women between ages 15 and 44 report using vaginal douches. There are multiple reasons that women will douche.

  • clean the vagina
  • rinse away menstrual blood after monthly periods
  • prevent odor
  • prevent sexually transmitted disease
  • prevent pregnancy

These are all myths.

While some women say douching makes them feel cleaner, there is actually very little scientific evidence of the benefit from douching. Douching can be linked with and lead to many different health problems. It is recommended by medical providers that women do not douche.

Why should women not douche?

Douching can change the necessary balance of vaginal flora (bacteria that live in the vagina) and natural acidity in a healthy vagina.

A healthy vagina has good and harmful bacteria. The balance of bacteria helps maintain an acidic environment. The acidic environment protects the vagina from infections or irritation.

Douching can cause an overgrowth of harmful bacteria. This can lead to a yeast infection or bacterial vaginosis. If you already have a vaginal infection, douching can push the bacteria causing the infection up into the uterus, fallopian tubes, and ovaries. This can lead to other serious medical problems.

What problems are linked to douching?

Health problems linked to douching include:

  • Bacterial vaginosis (BV), which is an infection in the vagina. Women who douche often (once a week) are five times more likely to develop BV than women who do not douche.
  • Pelvic inflammatory disease, an infection in the reproductive organs that is often caused by an STI
  • Cervical cancer, douching at least once a week has been linked to a possible increased risk of developing cervical cancer.
  • Vaginal irritation or dryness

Douching can can also be linked to problems with pregnancy:

  • Trouble getting pregnant. Women who douched at least once a month had a harder time getting pregnant than those women who did not douche.
  • Higher risk of ectopic pregnancy. Douching may increase a woman’s chance of damaged fallopian tubes and ectopic pregnancy.
  • Higher risk of early childbirth. Douching raises your risk for premature birth. One study found that women who douched during pregnancy were more likely to deliver their babies early.

Researchers are studying whether douching causes these problems or whether women at higher risk for these health problems are more likely to douche.

Should I douche to get rid of vaginal odor or clean the inside of my vagina?

No. You should not douche to try to get rid of vaginal odor or other vaginal problems like discharge, pain, itching, or burning.

Douching will only cover up odor for a short time and will make other problems worse. Call your doctor or nurse if you have:

  • Vaginal discharge that smells bad
  • Vaginal itching and thick, white, or yellowish-green discharge with or without an odor
  • Burning, redness, and swelling in or around the vaginaPain when urinating
  • Pain or discomfort during sex

These may be signs of a vaginal infection, or an STI. Do not douche before seeing your doctor or nurse. This can make it hard for the doctor or nurse to find out what may be wrong.

What is the best way to clean my vagina?

It is best to let your vagina clean itself. The vagina cleans itself naturally by making mucous. The mucous washes away blood, semen, and vaginal discharge.

If you are worried about vaginal odor, talk to your doctor or nurse. But you should know that even healthy, clean vaginas have a mild odor that changes throughout the day. Physical activity also can give your vagina a stronger, muskier scent, but this is still normal.

Keep your vagina clean and healthy by:

  • Washing the outside of your vagina with warm water when you bathe. Some women also use mild soaps. But, if you have sensitive skin or any current vaginal infections, even mild soaps can cause dryness and irritation.
  • Avoiding scented tampons, pads, powders, and sprays. These products may increase your chances of getting a vaginal infection.

Can douching before or after sex prevent STIs?

No. Douching before or after sex does not prevent STIs. In fact, douching removes some of the normal bacteria in the vagina that protect you from infection. This can actually increase your risk of getting STIs, including HIV, the virus that causes AIDS.

Can douching after sex prevent pregnancy?

No. Douching does not prevent pregnancy. It should never be used for birth control. If you had sex without using birth control or if your birth control method did not work correctly (failed), please contact your doctor right away to discuss the the next steps.

In short, you should not douche. Talk with your Macarthur ob gyn doctor if you have any questions, but trust your body’s own processes to maintain your vaginal health.

Viewing the Solar Eclipse - MacArthur Medical Center

Will the Solar Eclipse Hurt My Baby?

We are all very excited to witness something as rare as a solar eclipse but while this event has some of us rushing to find eclipse sunglasses, it can be a stressful event for pregnant women.

Some cultures have superstitions about an eclipse during pregnancy. For example, women in Mexican cultures are told to avoid it because an eclipse could cause a child to be born with a cleft lip (paladar leporino in Spanish). This superstition can be traced back to the Aztecs. They believed that a normally benign deity named Tzitzimitl would turn into a monster during an eclipse and attack pregnant women. A woman would have to have an obsidian knife (a knife with a blade made from volcanic rock) placed on her belly to protect her. The superstition is still common today but women use small metal objects like safety pins attached to the pants instead of knives.

In the Indian culture it is believed that women and their family members should stay inside during the eclipse and refrain from any activity including working, eating, etc. They believe any object that is touched during the eclipse could cause the baby to be born with a malformation urban birthmark in the shape of the object that was touched!

We now know that pregnancy complications have a variety of causes including genetic and environmental however none are attributed to the eclipse. Pregnant women should be able to go out and participate in witnessing this phenomenon without any concerns of this affecting their pregnancy. Women and men should both take precautions to protect their vision during this time, though. Looking at the eclipse without special protective lenses could cause permanent vision damage so be safe folks!

Allied Health Professionals - MacArthur Medical Center

Allied Health Professionals: What Are They and Why Should I Care?

Many people think the only person that can provide medical care in a doctor’s office is their doctor. This is a common misconception, as nowadays, there are many different healthcare providers that work together to provide you better care. In our office, we employ physician assistants, nurse practitioners, and certified nurse midwives in addition to our doctors and medical assistants. It is the combination of all of these different providers that makes our office run smoothly. Some of you may have already seen one of these allied health professionals and may wonder why you are not seeing your doctor. Allied Health Professionals help to fill in the gaps when physicians cannot be in the office. As an OB/GYN, you can imagine this happens rather often. When doctors leave for deliveries or surgeries, the physician assistants and nurse practitioners help to see their patients so they are not forced to reschedule or wait for several hours to see their doctor. Midwives perform deliveries at the hospital so that the doctor can spend more time at the office seeing their patients. They also have more flexibility with their schedules, often times having same-day appointments available when your physician’s schedule is booked out several weeks in advance. Together, we work cohesively as a team to better your overall experience at MacArthur OB/GYN.

Some of you might be wondering, what are the qualifications of Allied Health Professionals? All Allied Health Professionals complete rigorous training and education through a certified program. All are able to complete physical exams, prescribe medications, make diagnoses and order lab testing, amongst other things. Here is a chart outlining some of the differences between the 3 types of AHP’s in our office.

Physician Assistant
A PA is a nationally certified and state-licensed medical professional. PA’s practice medicine on healthcare teams with physicians and other providers. They practice and prescribe medication in all 50 states.

Master’s Degree

6 – 7 years

Broad, educated in all medical fields; may choose to do a residency in one field, but not required

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Nurse Practitioner
As clinicians that blend clinical expertise in diagnosing and treating health conditions with an added emphasis on disease prevention and health management, NPs bring a comprehensive perspective to health care.

Master’s Degree or Doctorate Degree depending on program

6 – 8 years

Typically specialized to one field, i.e. women’s health

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Certified Nurse Midwife
CNMs are licensed, independent health care providers with prescriptive authority in all 50 states. CNMs are defined as primary care providers under federal law.

Master’s Degree or Doctorate Degree depending on program

6 – 8 years

Specialized to women’s health; perform deliveries and assist with cesarean sections

5 Secrets to a Healthy Vagina

All women should be concerned about their vaginal health. There are many suggested tips you can follow to provide a healthy vaginal environment.

1. Maintaining a normal pH balance is important for a healthy vaginal environment.

It is recommended to avoid douching, using harsh soaps or feminine fragrances. Any alteration in the vaginal pH could lead to an overgrowth of yeast or bacteria, leading to infection. Some women have a difficult time maintaining a normal vaginal pH, despite their greatest efforts. There is an over the counter product, RepHresh (available in a variety of forms), which can help normalize the vaginal pH.

2. It is imperative to practice safe sex.

Using condoms will reduce and protect you against transmission of sexually transmitted diseases (STD’s). Some of the  more common STD’s are Chlamydia, Gonorrhea, Trichomonas, Human Papilloma Virus (HPV) and Herpes. These STD’s  commonly cause vaginal discharge, odor, itching, burning, lesions or painful ulcerations.

3. Vaginal hygiene is another important key to a healthy vagina.

The genital area should be kept clean and dry. A mild soap, like Dove, is recommended. Proper wiping techniques (front to back) will prevent contamination of bacteria into the vagina. This is especially important after a bowel movement. Cotton under garments should be worn and thongs should be avoided. It is important to remove wet bathing suits and work out clothes after use to avoid creating a warm and moist environment allowing the perfect environment for yeast production.

4. Adequate vaginal lubrication is another important aspect of vaginal health.

Vaginal dryness can potentially lead to labial and vaginal irritation, chafing, tearing and pain during intercourse. There are several over the counter products (KY and Replens, to name a few) which offer daily moisturizers and vaginal lubricants. If you are in your menopausal years, your vaginal dryness could be a result of decreased estrogen production, and you would likely benefit from a vaginal estrogen cream supplement to aid in your dryness and comfort.

5. Your overall health also plays a major role in your vaginal health.

If you are a diabetic, it is important to control your blood sugars. Chronic elevated blood sugars can increase yeast production in the vaginal tissue. Managing your weight is strongly recommended as well. Being overweight in the abdominal region can lead to weakness of the pelvic, bladder and vaginal muscles, which can result in poor control of urine and prolapse of the bladder and/or your uterus. If you are a smoker, you should quit! Smoking can have devastating effects on all organs. Smoking weakens your ability to fight off infection. Smoking will also increase your likelihood of developing cervical and vaginal cancers.

In conclusion, it is important to see your provider yearly for your annual pap smears to screen for cervical cancer. It is advised to seek medical evaluation for vaginal symptoms including: discharge, odor, itching, burning, dryness, lesions or ulcerations, and pain during or after intercourse.

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