How The Heel Do I Walk In These?

Today I wore a skirt and heels to an audition.  And the role certainly didn't require it.  I was playing a waitress, so I barely looked at the script.  Why?  Before I hung up my apron for good, I had more than 13 years experience slinging food and drink for tips.  I got this.


But what's up with the get-up?  It was a snooty, upscale waiter, but still... a skirt?  And heels?  I looked at those heels and my sore feet rather disapprovingly when I got home.  Three inches?  Get off my feet!  That seemed excessive.  But... haven't I heard about taller shoes lately?  Much taller?  Like, five and six-inch heels?  That's insane!  Right?


So what's up with the tall shoes these days?  Well according to experts, shoe height is at an all-time high.  And who is to blame?  Apparently Lehman Brothers and Bear Stearns.  Yep!  Thought is, that the recession is driving escapism.  Thus, women are towering!  Lady Gaga escaped more than anyone, when she strutted her stuff in 12-inch heels for her "Bad Romance" video.


Yikes!  Sure, heels make women feel taller, thinner, more stylish and sophisticated, but at the cost of pain, stress fractures and safety hazards galore?  


I applaud being fashion-forward, but three inches is my limit.  I'm putting my foot down.  In a flip-flop.

Stop Grinding?

Ever since college I've been grinding my teeth in my sleep.  Obviously it's a bad thing.  I've had many root canals and crowns... not fun or cheap.  Plenty of jaw pain, TMJ, and just soreness.  But over time, I've come to accept it as just a personality quirk.  Part of who I am in my stressful, busy little life.



So, I finally found a mouthguard that I'll actually keep in my mouth throughout the night.  In the past I've found those hard, plastic ones under my bed, thrown across the room, or simply MIA.  It's by Sleep Right and it's soft and flexible and comfortable.  And yes, it helps.  But according to my dentist, it's not enough.


Apparently from all my grinding and clenching, I actually have bone growing under my tongue on the bottom of my mouth.  


So if I keep it up, I will end up with a tongue hanging out of mouth in 30 years or so.  Beautiful.

Ever since college I've been grinding my teeth in my sleep.  Obviously it's a bad thing.  I've had many root canals and crowns... not fun or cheap.  Plenty of jaw pain, TMJ, and just soreness.  But over time, I've come to accept it as just a personality quirk.  Part of who I am in my stressful, busy little life.

The real issue is I need to calm the hell down and stop grinding and clenching my damn teeth.  But how?  Hypnotism?  Muscle relaxants?  Meditation?  


Thoughts????

Me and My Cervix

Me and My Cervix: How I went from terrified to empowered… to healed.

You might say I was a late bloomer. I didn’t have “actual” sex until I was 23...I didn‘t even have oral sex. That didn’t stop me from getting Human Papilloma Virus, more commonly known as HPV . As a teenager, I didn‘t know that anything other than a bad reputation could come from having digital sex (which has nothing to do with a phone or computer but in fact, finger penetration). At 20, I got a letter from my doctor saying that my first pap smear showed squamous cells. At the time, I didn’t think much about it. I talked about it with a few friends and found out it was pretty common and it usually went away on its own. I later found out that more than 80 percent of women had abnormal paps at some point. I thought, “Eighty percent? So then, wouldn’t that be normal?” I decided this was a non-problem problem.

In the years to come, the non-problem problem persisted. I was young, and an aspiring actress, so my health insurance coverage was sporadic and my doctors changed often between HMO’s and Planned Parenthood. It never occurred to me to tell each new doctor the extent of my non-problem problem. I let the latest doctor think she’d either discovered a new problem or that it was just a reoccurrence, something “to keep our eyes on.” There was no clear pattern or medical history established, even though, since my first pap smear at age 20, I’ve never had a normal one.

At 31, I was fully insured and though I’d been in the same Beverly Hills health care system

(Cedars-Sinai) for a few years, I found myself face to face with yet another new doctor. She

asked, so I told her about the history of my abnormal pap smears over the past decade, and she

immediately referred me to a gynecologist. I made an appointment to see the first available

doctor and was in Dr. Vidaria’s office the next week where she biopsied my cervix. I cried

through the entire procedure and I wasn’t entirely sure why. It was uncomfortable but not

particularly painful and for some reason made me feel guilty, dirty and terrified. Did I have

cancer? Could I never have children? Had my sexuality and neglect for my own well-

being actually put my reproductive health -- even my life -- in danger? According to the

National Cervical Cancer Coalition (NCCC), currently in the United States, approximately

14,000 women are diagnosed with cervical cancer disease each year and more than 3,900 women

die in the USA each year from it.

I waited anxiously for 10 days for my biopsy results and never received a call. I was frustrated that I had to call the office myself, but my frustration gave way to relief when Dr. Vidaria called me back to give me great news. “Your tests came back normal. Make an appointment to check back in six months to be sure.” I felt positively joyful. I said, “That’s so great! Thank you!!” I immediately started dialing my closest friends, those I’d confided in about this yucky, scary topic, and gleefully gave the news.

During my third call, call waiting beeped in, and Dr. Vidaria was on the line. “Did I just talk to you? Oh well, we did actually find something on the second test, so you’re going to need to have a LEEP.” she informed me.

I was stunned. “What? You just called and said I was fine.”

“Right, but there was something abnormal on your second test.”

“But, I don’t understand…you just said…”

Big sigh from Dr. Vidaria, “You don’t understand.” she said sounding frustrated and annoyed. Another sigh. “Well, then you should make an appointment to come in and see me so I can explain it to you.”

Filled with fear, not to mention rage at her condescension, I yelled into the phone, “Maybe you should get your facts straight before you call your patients!”

I shared my Dr. Vidaria story with my general practitioner and was in to see my new

gynecologist, Dr. Varkey within a week. She was kind and sympathetic and biopsied my cervix

in four different places (three of which I was later told were perfectly healthy). I asked her

about getting Gardasil, the new vaccine against HPV that had just been released. She informed

me that being over the age of 26, my insurance will most likely not cover the approximate cost of

$450 for the vaccine. And, since condoms clearly don’t protect you from HPV, my best bet at

prevention for the future was having just one sexual partner for the rest of my life. Great. As if

there wasn’t enough pressure on a 31- year- old single woman with a dating disorder to “find the

one.” Now I couldn’t even test drive.

Dr. Varkey insisted that if my new biopsy results came back positive for HPV, I had to

have a LEEP (loop electrosurgical excision procedure which uses a thin, low-

voltage electrified wire loop to cut out abnormal tissue in the cervix) performed as soon as

possible. Fearful tears and snot fell down my face as I asked her if I could have kids. She said

that I could, but she would “just really watch me” and “we’ll be really careful.” She gave me a

prescription for Hydrocodone and 800mg Motrin and instructed me to take the dosages before

and after the procedure.

While I awaited my results, I spent hours on the internet researching the LEEP. The primary

word that popped up in my search results was “miscarriage,” which sent me spinning. I already

felt so irresponsible and guilty about putting my own health in danger, but imagining the

consequence of a failed pregnancy (which WAS my fault) seemed unbearable. I felt forever

punished. I cried so much during that time. One minute I was calmly unloading the

dishwasher, the next I was on my knees with spit running out of my mouth, sobbing. I

continued to feel so guilty and I was so afraid (so was my 9-year-old golden retriever, who spent

much of that time very confused, with his tail between his legs). I felt that I was, now and

forever, officially “damaged goods.”

My internet searches turned out to be more than just a catalyst for my next breakdown, however.

In fact, the hours spent at my keyboard proved to be both enlightening and empowering. I

found a study in 2006 that had shown significant success in regressing cervical lesions in

women who took Celebrex, an anti-inflammatory drug usually used to treat arthritis. Results

published in the journal Gynecologic Oncology showed that cervical abnormalities improved in

75% of patients treated with Celebrex and 31% of patients treated with placebo. A complete

disappearance of detectable cervical abnormalities was experienced by 33% of patients treated

with Celebrex and 15% of patients treated with placebo.

Further, I found studies with similar results from EGCG (the main ingredient in green tea) and

Indole-3-Carbinol, a nutrient mainly found in cabbage. I also learned about a laser ablation

therapy which uses a high energy beam of light that evaporates the abnormal tissues and has

lower failure and recurrence rates than with cryosurgery (freezing cells to remove them) or

LEEP.

I was ready to share my findings with Dr. Varkey and discuss a treatment plan I was comfortable

with that didn’t involve removing a large part of my cervix and thereby increasing my chances of

failed pregnancies.

Armed with all of my research, I was ready to learn my biopsy results. When I called Dr.

Varkey, she informed me that the severity of my pre-cancerous cervical cells had progressed

from Stage 1 (CIN 1, or cervical intraepithelial neoplasia, in doctor-speak) to Stage 2 (CIN 2).

She said that she wasn’t aware of any of the studies regarding alternative therapies I told her

about, and added that she didn’t have the time to research them herself. She insisted I go ahead

with the LEEP. I was speechless and scared.

Then I heard Dr. Varkey say, “I know, I know, why me…”

I wanted to come through the phone line, shake her and yell, “No! Not ‘why me!’ I’m not a victim; I’m trying to fix this! I‘m taking responsibility -- finally -- for my own health and trying to find a way to fix this that I‘m comfortable with!”

I was too shaken to actually say anything.

“Look,” Dr. Varkey said, “I’m just trying to save your life.”

Instead of responding, I hung up and cried. I cried so hard that I took my clothes off because I was so hot, the entire time knowing it didn’t really make sense to be this upset. I also knew it didn‘t make sense for my doctor to say something so alarming to me. I wasn’t going to die. I wasn’t facing a lifetime of pain or suffering. But was I facing a dangerous future of wheelchair or bedridden pregnancies as a result of having part of my cervix removed? Would I miscarry? More than once? How could I forgive myself then? Something just felt so incredibly wrong at that time about having the procedure done. I felt more alone and left in the dark than before. Why did my doctor seem so “quick to cut? “ Would she remove more of my cervix than actually needed “to be safe? “ Why didn’t my doctor perform other procedures such as laser ablation? Why didn’t she know more about the clinical studies and therapies I’d researched? Why was she scaring the hell out of me?

During my internet searches, I’d learned of a clinical trial in Costa, Mesa, CA, that was testing a topical gel that showed promising results in regressing cervical lesions in patients whose lesions were CIN 2 and higher. Within a week, I was in Robin Black’s office qualifying for the study. During my first visit, I remember looking at the walls in her modest office and noticing that something was missing, and then suddenly snapping out, “Are you a doctor?” She wasn’t. But she was a nurse practitioner and a specialist in colposcopy and had 17 years of experience under her belt in women’s health. Under the supervision of an MD, she was heading a double-blind, placebo-controlled study testing a topical gel containing the drug 4,4’Dihydroxybenzophenone-2,4-Dinitrophenylhydrazone. Participants had a fifty-fifty chance of receiving either the drug or placebo which was applied intravaginally once a day for five days in a row, then repeated after approximately 23 days. Participants were to receive a LEEP on the final study visit. A major benefit of the study however, was that participants who received the study drug would likely show a regression of their cervical lesions which meant that they would become smaller and less cervical tissue would need to be removed.

Six visits to Robin Black’s office came and went, and I never felt left in the dark. Robin (who I

began to refer to as my “non-doctor doctor”) photographed my cervix on two different occasions,

showing me exactly where my lesion was and how big it was. She also showed me the different

sized wands used to perform the LEEP (the loops vary in width from 5 to 25 mm). By the

fourth visit there had been no improvement in the condition of my lesion which meant I’d most

likely received the placebo. Robin, without ever downplaying my health concerns or fears,

assured me that my lesion was actually quite small and would require what she called a “baby

LEEP”, using the smallest of the wands. Along with Robin’s non-alarmist attitude, seeing

the lesion and the instruments somehow put me at ease -- it demystified the procedure, turning it

into something physically and emotionally manageable. No one was trying to “save my life.”

Robin informed me there was no need to take the prescription painkillers Dr. Varkey had

prescribed and that two ibuprofen pills the morning of the procedure would be sufficient. Robin

also suggested that Dr. Varkey wanted me to take the painkillers to ensure I was calm and

relaxed during the procedure and that Dr. Varkey likely made it sound like a “life or death”

situation to make sure I had the procedure done and not ignore the problem anymore.

My roommate and best friend, who insisted it was not a problem to take a day off from being a defense attorney at a prestigious LA law firm, took me to my LEEP appointment, which lasted about twenty minutes. I wasn’t scared anymore. I trusted Robin and I was ready to put this behind me. I listened to my iPod during the procedure, and a few songs later, it was over. Robin showed me the small pink piece of my cervix she’d removed floating in a plastic cup. No sex or tampons for a month, she told me, and then it would be like it had never happened. The part of my cervix that had been removed would completely regenerate.

I had slight cramping the day of the LEEP (alleviated by red wine and shopping). After a week, the scab fell off, causing light bleeding. That was it. No longer damaged goods.

At first, I’d prayed I’d get the study drug, but when it was obvious I had gotten the placebo, ultimately, I was glad. That meant someone else with a more severe case (CIN 3, 4, or 5) might have gotten the drug, which was so much more important. And I felt privileged to have played a small part in what might be an enormous step forward for women’s health -- something that might actually “help save someone’s life” someday. I was healthy again and proud of myself for taking an active role in my health and honoring my instincts regarding my healthcare providers and my treatment options. After all, huge fancy Beverly Hills healthcare system or “non-doctor doctor” in a small Costa Mesa office, it’s still what is best for my physical and emotional health we’re talking about. That doesn’t have a zip code.