Posts Tagged ‘ob/gyn’

Introducing The Owning Pink Center & The Pink Partnership Agreement

Tuesday, February 2nd, 2010

Pink Heart SoapsHiya Pinkies! As many of you know, I have been struggling for six months over whether or not to leave my job at the integrative health center where I work. On one level, I adore the people, the space is gorgeous, and my patients are treasures. Compared to my old job in the crazy busy managed care practice where I used to work, it’s heaven. But deep down, I realize it doesn’t align with my vision. Being there has been clipping my wings. And it’s time to FLY.

Introducing The Owning Pink Center

So I took the leap of faith and submitted my resignation just before Christmas, without a clue what would happen next. More Pleaping (taking a Pink leap of faith!) Wheeeeeeeeeeeee!!!!!!!!!!!!!!!  Once again, I found myself letting go, surrendering into what will be, trusting God, and being open to Signs from the Universe. Well, wouldn’t you know it, all the signs have aligned to allow me to bring Owning Pink into bricks and mortar in a beautiful space on 600 Miller Ave in Mill Valley, CA. The Owning Pink Center- where I will join forces with acupuncturists, a nutritionist, a psychologist, and Mojo Mentor Tricia Barrett, our Pink & Green cleanse expert- will be open soon, right down the street from where I have been practicing. It will give us a chance to bring Owning Pink into the real world, to ground what we’ve created in cyberspace and demonstrate how what we do can heal people. I’m VERY excited.

In the process of clarifying my thoughts and dreams, I have been doing a lot of writing about how I think health care can be best received by those in need of healing, and I decided to start with what I call the Pink Partnership Agreement, a contract between me and my patients. After I wrote it, I realized that this is very similar to what we do here at Owning PInk Central. We enter into sacred contract together- with the express purpose of healing ourselves and each other. So I wanted to share it with you here.

The Pink Partnership Agreement
As doctor and patient, you and I are entering into a partnership. As such, I feel it is important to clarify and agree upon what our relationship will entail.

Your Power to Heal
I am here to support you, guide you, offer you tools, and support your process, but I will not “fix” you – for I don’t believe you are broken.

I believe you already have within you the power to heal yourself. When we meet, I will hold up the mirror so you can see that you already have what it takes to optimize your wellness and live the most joyous, vibrant, fulfilling, sexy, healthy life possible.  You are here to be the force behind your own healing. If you are not ready to take this action step, I will be here to nurture and support you, but the process will be less powerful, with fewer results.

Respect for each other and the process

In order for our partnership to be successful, we must respect each other.  I will offer you a treatment plan, but I will also invite you to listen to the intuition of your body and your soul. I will respect your autonomy, and the choices for how we proceed will always be yours.
We will respect each other’s time. I will not make you wait for your appointment, and you will not be late.  We must be present, fully and completely, during our time together. This means we will both turn off cell phones, let go of distractions, and focus all of our energy on your wellness.  We have to be open and tell the truth, even if it is painful or uncomfortable.  We must trust that we are safe together, so we can explore things that may be tough to explore.  We must open our hearts to the loving kindness and compassion that is a necessary part of any healing relationship.

My pledge to you
I promise to respect you, guide you, and help you discover the healing power within you. In exchange, I ask that you follow through on any treatment plan we agree upon. If our treatment plan does not resonate with your body’s wisdom, or if you have financial constraints, please tell me so that we can modify our plan. Follow through is key. We must walk this path together in order to manifest the results I know we can achieve.

This is YOUR life. OWN IT.
Are you on board? If so, sign here. (Insert your signature here!)

The Owning Pink Wellness Center Mission Statement

We believe that the power to heal lies within all of us. Rather than “fixing” you, we aim to offer you tools that will empower you to attain optimal wellness, vitality, and joy. We believe health is the foundation upon which we build the other facets of what makes us whole- our creativity, relationships, career, spirituality, sexuality, and life purpose.  At Owning Pink, we hold up the mirror to reflect back to you what you already know but may not see- that you are beautiful, just the way you are, and that getting your mojo back is not only possible, it’s your birthright!

The Owning Pink Center Philosophy

The health care system in the United States may be broken, but we as individuals are whole, just as we are.  At Owning Pink, we aim to create an entirely new way to heal- one that works from the inside out. Unlike traditional medical practices, where you may be herded in and out in 7 1/2 minutes, handed a prescription for drugs you may not understand, and wind up feeling worse than when you walked in, we strive to let the healing begin the moment you walk in the door.  We value the opportunity to be present with you, to hold space for you, to listen, and to offer you our expertise as an equal partners in your wellness plan.  We believe you are more powerful than you know, that you hold the keys to living fully right in your own hand. Our job is to help you use the keys you already possess and supplement anything else you might need to achieve your health and wellness goals.

Too many people walk around in a daze, unaware that there is a better life out there, just longing to be lived.  When you lack energy, struggle to sleep, experience stress, feel depressed, dislike the way your body looks and feels, and suffer from symptoms and diseases, you may come to accept that this is simply life. We at Owning Pink believe there is more to life than just getting by. We believe you can get your mojo back- and have fun doing so. It’s what Owning Pink is all about- being brilliantly, gleefully, wholly healthy, inside and out.

As human beings, we may manifest symptoms and diseases, but underlying these external manifestations, our spirits know the answers to how we can live more vitally.  We ask our clients questions such as “What does your body need to get better?” And we honor and cherish the answers that come up. We value the wisdom of the body and the enduring strength and resilience of the human spirit. We value YOU.

The practitioners at the Owning Pink Center are skilled at helping you access these answers to help you reclaim the life you know you’re meant to live.  We call upon all of the tools in our collective tool boxes- using traditional Western medicine, natural and functional medicine, nutrition, bioidentical hormone balancing, acupuncture, Chinese medicine, therapy, raw foods/detox cleansing, and a variety of other alternative therapies to help you access what you need to achieve optimal health. Mostly, we practice love, with a little bit (okay, sometimes a lot) of medicine on the side. What does love have to do with medicine? Everything. Trust us on this.  When we approach our bodies with love, acceptance, and nurturing kindness, we pave the way for magic to unfold, the kind of magic we’re blessed to witness every day.

We invite you to step up to the Pink plate. Are you in? We can’t wait to bear witness to your transformation.

So here’s me, Pinkies- Pleaping! I’d LOVE your feedback! What resonates for you? What seems too woo woo or weird? How can we help patients understand what Owning Pink is all about in a medical practice? How are you Pleaping these days? What resistance keeps you from following your dreams?

Jumping off cliffs right and left,

Dr. Lissa

Lissa Rankin, MD

PS. Stay tuned for our new website, how to make appointments, and all the details that turn a dream into reality.

Owning Pleasure, Confidence & The Vulva: My Interview With Mama Gena

Thursday, December 17th, 2009

mamagena

Hiya Pinkies. As part of the research for writing my upcoming book What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend, I had the pleasure to interview Regena Thomashauer of Mana Gena’s School of Womanly Arts. This Pink Goddess is the go-to queen of all things pleasure. For this interview, I took some of the questions gathered from friends, colleagues, and of course you Pinkies, to see what the founder of the Pleasure Revolution had to say. Below is just some of what we talked about. Enjoy, Pinkies, and a big, pleasure-radiating bow of gratitude to you, Mama Gena!

Some women seem like they just radiate sexy, but I’m not one of those women. How can I change that?

If you were born female, you are sexy. That’s the deal – you can’t do anything about it. You just are. You have all the equipment. It’s your birthright. How to step into the experience of that is a question of ownership. Like any inquiry, if you have a dusty old piano that nobody plays, there’s no music. But you can start one key at a time, just like a piano lesson.  Then, you can slowly expand your skill set so you can own the symphony that you are.

There is a chapter in my book (Mama Gena’s School of Womanly Arts : Using the Power of Pleasure to Have Your Way with the World) titled “The Womanly Art of Owning Your Beauty.” Every woman is beautiful, but if you don’t believe it, you’ll never fully step into that beauty. Owning your beauty is an inside job. Owning your beauty is a practice. There are little tiny things that make the difference between a woman who feels hot and a woman who doesn’t. Even if I’m going to the gym, I’m going to put on lip gloss because it will change my experience of myself between home and the gym. I know that, so why would I decline those 4 seconds when I know it will make me feel more confident? Every woman has her own journey and is already equipped with tips and secret steps she will take to feel beautiful. Once you know what’s in your toolbox, it’s there for you to use anytime.

I don’t even know what turns me on. How can I get in touch with that?

Most women don’t know what turns us on. How could you learn? Did your mom pull you on her knee and say “puberty is coming, so we’re gonna learn what turns you on?” And you can’t leave it up to your boyfriend. Guys don’t know what turns on a woman. You can’t expect them to know about our bodies. Not only that, but we don’t have anywhere to go and study.

That’s why I write and teach what I do- to educate women about how to begin to learn about their relationship to pleasure. If you don’t know what pleasures you, you’ll never get in touch with your desires. Come to my classes, read my book, but in addition, it’s really key for a woman to just begin to do a little research on her own. Take the time to learn the difference between what it feels like to touch the palm of your hand vs. running your fingers across your belly or down the inside of your thigh. What parts of your pussy (that’s my favorite word for it) feel good?  What pressures might you enjoy? Without learning, you are unable to permit your lover to gratify you.

There’s a scene in the Julia Roberts movie Runaway Bride where someone asks her what kind of eggs she likes, but she doesn’t know. When she dated a guy who liked scrambled eggs, she ate scrambled eggs. When he liked fried eggs, she ate hers fried. When he liked hard-boiled, she ate hard-boiled. In one scene, she finally lines them up and tastes them all, so she can make a decision, independent of any man.

A woman can definitely be seduced into running that kind of experiment with her own body. However, I find that it is even more powerful for women to begin to learn about their bodies and what pleasures them in community where they are able to give each other permission. There’s a way in which having a sister by your side gives you courage and inspiration where you might have lacked it. It’s important to have the support of a community of women.

I can’t even stand to say the word “vagina.” Everything about it grosses me out.  How do you make peace with your vagina and stop feeling uneasy at the mere mention of the word?

It’s not just you. Every woman feels this way. We live in a vulva-unfamiliar culture.

We’ve been educated to feel secretive and to feel shame and humiliation, rather than appreciation. This is a piece of cultural inheritance that we’ve all been handed.

I have a slide show for the School of Womanly Arts of different pussies, and the associated “5 stages of pussy.” The first time a woman sees a photo of a naked vulva, the reaction is to feel nauseated, dizzy, grossed out, and uncomfortable. This is Stage 1. It’s universal.

Then I invite a woman to join me as a fellow researcher, put her researcher’s cap on and begin to look at this magnificent part of the body as if she’s a scientist- study the dimensions, the colorations, the configurations, the mesmerizing brilliance of the structure. Every woman’s pussy is this healthy, phenomenal ecosystem of creation- it’s a miraculous construct. When a woman begins to do some research, taking in the magnificent vista of the vulva and then supplementing this with education about the different parts- the clitoris, the inner lips, the outer lips- she can begin to make friends with her own vulva. This is Stage 2.

Stage 3 is the appreciative researcher. You start to notice that, for example, in this particular vulva, the clitoris is different. You accumulate more data, you have different visuals. You see the differences.

In Stage 4, you become the enthusiast, completely enamored by this miracle that woman is- even the fact that there’s an organ on the body whose sole purpose is pleasure.

Only a certain handful of people will ever make it to Stage 5- rapture over the breathtaking overwhelming beauty of this sacred and phenomenal part of the body. You become like an artist, who with every stroke of their brush- are in complete rapture of the subject, as demonstrated by the artist Courbet was when he painted L’Origine du Monde.

L'Origine Du Monde by Courbert

L'Origine Du Monde by Courbet

I feel uncomfortable with all things sexual and get all wigged out whenever it seems inevitable. What’s my problem and how can I relax during sex?

You don’t have a problem about sex. Your problem is about communication. Talk to your partner about the things that make you uncomfortable and only move at the speed of your level of comfort.  Whenever we take on a new activity, there can be a sense of awkwardness. One remedy for awkwardness is just confessing your awkwardness, and then it goes away.  If you talk, you make space for yourself to get comfortable. Take all the time in the world to do what it takes to become comfortable, and then the experience can become comfortable. People feel like we’re supposed to know what to do from the beginning. The first time you kiss a boy, you expect that you should already have a PhD in kissing. Just slow down. Nice and easy does it.

As I get older, I feel like the fresh young mining village that was my vagina years ago has become an old closed down mining town. Is that all in my head? How can I change it?

A woman’s relationship to her vulva is absolutely completely in the eye of the beholder. If you look at that part of your body as if it’s elegant, luscious, phenomenal, you would have a completely different experience of your sensuality. But as women, we’re not given good role models when it comes to how to fall in love with your pussy. We’re told that this part of our body is not beautiful and will get us into trouble. We’re not taught about the exquisite, rapturous sacred nature of that part of our body that is the pleasure center and the source of life.

The “Womanly Art of Sensual Pleasure” chapter of my book speaks to this. A woman who owns her pussy, owns her life. If you don’t feel good about your pussy, you don’t feel good about your life. And if you feel fantastic about your pussy, you feel fantastic about your life. It’s an opportunity not only to own your own beauty, but to learn the journey and the experience of each of the pussy’s 8,000 nerve endings and how that informs your being. If 8,000 desires, decision and dreams are not about pleasure, then you’re not really living what it means to be a woman. The key is to be guided by the physiology and to pay attention to the song that your body wants to sing with you. Learn the poetry that your body wants to whisper in your ear. Open yourself to pleasure and rapture. It will transform you.

The genital tissue is elastic and luscious and responsive for your entire life. You can continue to expand sensually for your whole life. It’s very good to put the key in your own ignition and then you can invite passengers. Women are obligated to do an enormous amount of discovery and self exploration. Once you know how to dance, you can have a good ride on the dance floor.

I wish I felt like Samantha when it comes to my sex, but really I’m more of a Charlotte. How can I improve my sexual confidence?

To improve sexual confidence, recognize that where you are is the perfect launching spot for expanding in whatever direction you desires. Then, communicate from wherever you are. There’s nothing more appealing to a partner than when you say, “Hey, I’m a little shy but I’m so interested in having a rockin’ sex life. I’m so interested in expanding and learning everything you know about sexuality.” Come to a sexual encounter with real interest, real curiosity, and an interest in investing in your own sexual education. It’s such a pleasure to explore – your partner’s experiences, Tantra, workshops in expanded orgasm, etc. The people who take workshops in sensuality are brilliant- they know there’s more to learn, and they’re putting themselves in the position of uncovering new experiences.

The best partner is interested in learning.  When you find a partner who thinks they know everything, it’s the worst. Really, it’s a shared exploration. That’s what intimacy is all about.  Samantha may have a longer resume but it doesn’t mean that Charlotte doesn’t have a better time in the sack, as long as she’s willing to be where she’s at and communicate about it.

How can mothers help their daughters to love and accept their bodies?

Every mother could teach her daughter the correct terminology for her body. Many moms teach their daughters “down there,” or “pee pee” or “wee wee.” They don’t connect a little girl to the power or the privilege of being a woman. I think that it’s really key to teach a little girl that she has a vulva.  What you can see is not a vagina – it’s a vulva. The roots of the word “vagina” mean “sheath for a sword.” But your sexual organs are more than a sheath for a sword. Your vulva is what you can see, and it’s beautiful in its own right.  The best thing a mom can do is feel great about her own body and her own sexuality. Mom has to rock the word “woman” in the way she lives her life and then teach her daughter the proper terminology and encourage her exploration.

Phew!

So, Pinkies, are you blown away or what? And this is just the half of it. Check out Mama Gena’s website, book, and courses to Own your Womanhood and unlock the powerful, miraculous being you are. And of course stay tuned for What’s Up Down There, where all of Mama Gena’s pearls of wisdom will be put to use in my quest to demystify the female body.

Walking with you in sisterhood,

Lissa & Regina

Feel the love and join the Owning Pink community.

Pat Yourself On The Back For a Job Well Done

Tuesday, December 8th, 2009

successI just met two deadlines for two books in one week. The manuscript for What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend was due December 1, and the edits on the galleys for my other book Encaustic Art: The Complete Guide To Creating Fine Art With Wax was due December 3. And I did it, Pinkies! I almost ignored my family over Thanksgiving in order to meet my deadline, but that didn’t seem Pink at all, so I put it off and then worked my tail off to catch up. But I did it!

That night, I went out with my girls to celebrate me and my accomplishments! We ate sushi, watched the full moon from the hot tub, and celebrated. Not only did I meet my deadline, but Dr. Christiane Northrup agreed to write the foreword for my gynecology book. WOO HOO! (A dream come true for me, Pinkies!) I am still reeling- and feeling the relief spread all through my body.

How often do you celebrate YOU? Think back though all of your accomplishments. How often have you taken the time to honor yourself and celebrate your success with those you love? Why is it that we readily share our worries, troubles, and woes while we squirrel away our successes as though they’re reasons to feel ashamed? What if we brought accomplishments out the closet and let the light of glory shine down upon them? What if we could honor them here, rather than hiding them?

I’ve often felt shy about my successes. While you’re sure to get girlfriend support when you’re in the midst of a divorce, who do you tell when four publishers are fighting over your book? Success may trigger people’s own insecurities. It’s not that they’re not happy for you, but your success may shine the light on what they consider their failures. Instead of jumping for joy, you may find that others try to diminish you. They simply can’t handle the light you radiate.

I used to feel hurt by this. Why should I dim my own light just to be accepted? Not that I want to be arrogant, but why can’t I celebrate my successes as vibrantly as I share my frustrations, fears, and failures? I’ve learned to keep quiet, to tone down my dial, and to make an effort to make others feel better.

But why? Why do we do this to each other? Why can’t we be expansive enough to feel another Pinkie’s joy without taking it personally? If you have good news, I want to hear it, Pinkies! I want you to write about how you’ve fallen in love, how you’ve found your dream job, how you’ve been selected for the top notch art show, how you found a literary agent, how your kid just wrote you a love letter, or how your boss just wrote a glowing review about you.  Why are we so hesitant to share the good? I promise, I won’t see it as self-promoting or arrogant. I will see it as a well-deserved revelry for the value that lies within you.

I am trying to keep this in mind as I face certain successes lately. I’m tempted to hide my good news, for fear that it will make you resent me (this is my wound in life, so I’m sensitive about it). But Owning Pink is all about telling the truth, being authentic, and spreading love throughout our community and sharing what’s real- the bad AND the good. Let’s set an example. Let’s make it okay to tell the truth, whatever the truth holds.

Let’s shake up the Pink Posse forum and invite all of us to not just share our trials, but to celebrate our triumphs. Let’s light fireworks and do a little dance when any one of us has a breakthrough.

But first, it all comes back to YOU. Do you honor yourself when good things happen? Do you throw your arms in the air and spin in circles while whooping it up with glee?  Do you believe that your good news is OUR good news? I do…

Believing and dying to dance in your light,

Lissa

New Pap Smear Guidelines & Why The Holistic Health of Women is in Jeopardy

Friday, November 20th, 2009

docpatientGood morning, Pinkies.  I just heard the news (calm down, Lissa. Breathe…) In the wake of the U.S. Preventative Services Task Force’s new guidelines for mammography screening, the American College of Obstetricians and Gynecologists just announced new recommendations that cut back on Pap smear screening. My blood is boiling, Pinkies. WHAT IS GOING ON? Why are we recommending cutting back on women’s health screening? Don’t get me started (yet). Let me fill you in on the news.

New Pap Smear Guidelines:

  1. Instead of recommending that Pap smear screening begin after you’re sexually active, new guidelines say that even a sexually active 13 year old should wait until 21 for her first Pap.
  2. After 21, Pap smears are recommended every 1-2 years until age 30.
  3. After 30, if you’ve had three consecutively normal Pap smears with no history of a seriously abnormal Pap, new guidelines say you only need to do Paps every three years.
  4. If you’ve total hysterectomy for benign reasons, new guidelines say you can skip Paps altogether.
  5. New guidelines recommend quitting Paps sometime between 65-70 if you’ve had three consecutively normal Paps with no abnormal Paps in the past 10 years.

Why the Change?

There is evidence to support the changes.  The truth is that you’re unlikely to go from having a normal Pap smear to having cervical cancer in 3 years, even if you contract HPV. Because cervical cancer grows slowly, it’s still likely to be precancerous by the time it gets picked up. And yearly screening does increase the number of procedures performed, and some of those procedures- such as cryotherapy and LEEP procedure can affect fertility and pregnancy in rare cases.  Plus, cutting back on Pap smears saves precious health care dollars. And if we’re not saving lots of lives and potentially causing harm by implementing procedures that may not be necessary, why do annual Pap smears?

So these guidelines aren’t positively ludicrous like the new mammogram guidelines that threaten to kill hundreds of thousands of women. I understand why they’re recommending pushing back the age of first Pap smear.  HPV, the virus that causes cervical cancer and abnormal Pap smears, is almost ubiquitous among teens. As such, doing Paps will lead to many abnormal results and require colposocopies, biopsies, and possibly treatment such as LEEP procedures, which can affect their pregnancies in the future, leading to scarred cervixes and preterm labor. And many of those abnormalities, if left untreated, would have resolved themselves without treatment.

I can also see why they’ve said that women who have had a hysterectomy can stop getting Paps. After all, they don’t have a cervix. And while there may be scant cervical cells left at the surgical scar inside the vagina, the risk of cervical cancer is exceedingly low.

BUT (and this is a gigantic BUT) there is a GINORMOUS problem here that carries far-reaching consequences for women’s health, and I can’t keep this quiet. Though women come to the gynecologist under the guise of their annual Pap smear, they actually come for WAY more than that.

Here are some examples of issues I handle under the guise of an annual Pap smear exam:

  • Sexual problems that threaten your relationship
  • Debilitating depression and anxiety
  • Chronic fatigue that prevents you from living vitally
  • Pelvic pain, often as the result of sexual abuse you have never confessed to anyone until I hold the sacred space for you and invite you to tell the truth
  • Urinary incontinence that causes so much shame and embarrassment that you might not leave the house, much less exercise or pursue your dreams
  • Menstrual disorders like hemorrhaging or menstrual cramps that cause you to miss work and other important life functions.
  • PMS/PMDD that may be hampering a happy life
  • Interstitial cystitis symptoms that make you feel like you constantly have a UTI
  • Menopausal symptoms that threaten a woman’s relationships, sleep, work, and life
  • Relationship counseling
  • Parenting advice
  • Losing your mojo

And that doesn’t even include the oh-so-necessary annual breast exam, internal pelvic exam to check for ovarian tumors and such, and the opportunity to make sure a woman is up to date on other cancer prevention procedures, such as colonoscopy in older women, or the HPV vaccine for teens.

Now, ACOG does say you should still talk to your doctor about getting an annual pelvic exam. (Thank you ACOG.)  But are insurance companies going to cover a routine pelvic exam in the absence of a Pap smear?  Are women going to go? So many women will hear these new guidelines and think, “Cool! I can skip the gyno for 3 years!”

By changing its guidelines, ACOG is going against the other main authorities on cervical cancer. The American Cancer Society and the U. S. Preventative Services Task Force both recommend that women get their first Pap test within three years of having sex, or at age 21- whichever comes first.

I respect evidence-based medicine and understand the rationale for these guidelines. I went to Duke and Northwestern and learned all the ivory tower beliefs about  practicing based on evidence, not anecdotal speculation or emotion-based care.  BUT….

What Do I Think?

Hmmm…I guess I think all the guidelines that have come out this week are missing something critically important in medicine.   As leaders in women’s health, what messages are we putting out there? Somewhere along the way, governing bodies in medicine have forgotten the most vital aspect of what we doctors do. When they are reviewing data to make these guidelines, they are focusing only on what “cures” someone. But they have forgotten that there is a difference between healing and curing.

Let’s take a huge leap and assume that cancer screening is completely worthless and doesn’t prevent cancer at all. Is there not some value to the other types of healing work we doctors provide under the pretext of the annual Pap smear? Women don’t make separate appointments to talk about their sex life or whether they’re living as vitally as they might.  They lump those things under the umbrella of a Pap smear.  Many women feel like they’ve been handed a “You’re worthless” card at birth.  I try to extract that card and replace it with a hot pink one that says, “You’re lovable, valuable, beautiful, and worthy.” This kind of work cannot be proven in a scientific study. But is taking away a woman’s excuse to visit her gynecologist taking away that hot pink card as well?

I’m not suggesting we do unnecessary testing or procedures just for the sake of getting a woman in the door. Ultimately, you have to be your own advocate for your health and wellness. But I worry about the far-reaching effects these kinds of guidelines will have for women who misunderstand and fail to hear the part about annual exams still being a critical part of women’s wellness.  What if they get lost in the system? Especially underprivileged women, who may not be educated enough to advocate for their own well-being.

My fear is that cutting back on cancer screening will not only increase a woman’s risk of cancer. It may also limit a woman’s access to the kind of healing good doctors can provide.  For most of my young patients, I am their primary care provider.  The Pap smear is what gets them in the door.  If you hear that you only need a Pap smear every three years, you may go three years without anyone talking to you about whether you’re living as healthfully and joyfully as you possibly can.

And you can be sure that insurance will cut back your coverage. If ACOG says you don’t need a Pap smear, your visit will likely only get covered if you have an ICD-9 code diagnosis like endometriosis or fibroids. And let me tell you- there’s no ICD-9 diagnosis for losing your mojo or cancer prevention.

You may think I’m biased. After all, I’m a gynecologist. It’s my business to have people come in for Pap smears, so of course, I would oppose these new guidelines. But the truth is that most gynecologists lose money by doing a Pap smear. The cost of the visit exceeds what insurance companies will reimburse most of the time. And since Medicare already doesn’t cover annual Paps, we usually eat the cost for older women who want to get Pap smears but don’t have coverage. So trust me, for most gynecologists, this is not about money.  One of my dear friends in San Francisco (a total Pink God) is closing his practice- declaring bankruptcy- because he simply can’t make ends meet with a busy insurance-based practice. It breaks my heart. He is one of those doctors who, like me, practices love, with medicine on the side.  Why does the system not embrace him? Why have we replaced doctors like him with technology, scientific data, and task forces? (*crying now*)

And why are they cutting back on only women’s health screening? Why not PSA testing for men? Not to be all conspiracy-theorist on you, but you can’t convince me that there aren’t some sexual politics caught up in all this. With all the advances we’ve made in women’s rights and women’s health over the years, why are we going backwards? Won’t somebody please stand up and shine the light on the Emperor’s new clothes?

I get that we need to cut back on health care costs. But come on, people. Must we do it at the expense of women? Can’t we focus our energy on tort reform or capping profits for insurance companies. Is this really the way?

For me, it’s all about advocating for holistic women’s health- the big kind, the kind that looks at a whole human being, not just a breast or a cervix. The only way we can help women holistically is to get them into our offices, provide a safe, sacred space for healing, and show up- fully present- to help them get in touch with what their body needs to be whole.

What Will I Do In My Practice?
I think you should be given a choice. The way I see it, it’s my job to present the data and help you understand the risks and benefits of cancer screening. If you want to get a yearly Pap smear and mammograms after 40- Fine. If you’d prefer to stretch out your screening or skip it altogether, no problem. It’s your body- your choice. I’m just here to help you understand your options and deal with whatever comes up.

The Bottom Line
Please, Pinkies, regardless of what you decide to do about your Pap smear or your mammogram, please don’t stop seeing a doctor every year.

Our Broken System

Thinking of how these new guidelines may limit your access to health care breaks my heart.

This system is so BROKEN. Hand me the suture and a needle driver. I want to stitch the fragmented, fractured, hemorrhaging heart of medicine back together again.sutured heart

Waiting, with hand outstretched- “Suture, please,”

Lissa

The Difference Between Curing and Healing

Tuesday, November 17th, 2009

lissabuddhasmall

The Origins of Pain

I saw a patient today who inspired me- let’s call her Sally.  She suffers from a host of medical conditions that threaten to rob you of your mojo- fibromyalgia, chronic fatigue syndrome, and chronic pelvic pain.  When this young woman walked into my office, she looked like crap. Before looking at her chart, I thought she had cancer.  Gaunt and pale, her skin hung on her skeleton like she was in the last grip of life.  During the first half hour, she didn’t smile once. I felt the anxious tug we doctors feel when we see people like this, the one that says “I’m not going to be able to help this person,” which triggers insecurities and, often, judgments, in our own minds. It becomes about us, rather than being about them. We have a tendency to turn off because we don’t want to fail. But I vowed not to do this.  Sitting in her presence, I was determined to be present for Sally and sit with whatever is true, rather than letting my own stuff get in the way.

What is true for Sally is that she has spent the last decade plagued by pain, fatigue, and a body that is betraying her.  She has been to universities, fancy alternative medical clinics, and specialists. Someone told her that her condition is “incurable,” and somewhere, a while back, she decided to believe them. But she never gave up trying to be well.

When she came to see me for a gynecologic complaint, I heard her words, but what I saw in front of me told me that her condition was deeper than what her words betrayed. This was not about a pain in her pelvis, this was about a core wound.  I listened while she talked about her pelvis, but I focused more energy on watching her, feeling her, being with her in the moment. What rang out loud and clear was this message: “I am not well.” And yet, I could see this glowing, radiant energy beneath the surface, a vision of a vibrant, vital being, leaping in the air and spinning with glee.

Unbidden, she began to tell me about her favorite place, a remote town near Santa Fe, where she owns a vacation house. She fantasizes about quitting her job, living there full time, and spending time with animals in some way. Currently, she owns her own business, selling software to help people maintain their gardens.  She works until 2am many nights, finishing projects and meeting deadlines. A team of people bow to her leadership. Years ago, she gave birth to her company from a place of passion, but lately, she dreads everything about it. It has become her ball and chain, and she suspects it is related to her illness.

The Power to Heal

Last year, fed up with being sick, she considered quitting her job. She went as far as selling her primary residence, with the intention that she would live full time near Santa Fe. With money in the bank to help support her, she settled into a new life. And miraculously, her symptoms disappeared. For two whole months, she felt like a vibrant twenty year old, brimming with energy and vitality.  She hiked every day, ate wholesome food, wrote in her journal, and meditated. “I did everything right,” she said. And her body rewarded her with new life.

Then her mother had a heart attack, and she left Santa Fe to return to California, where she is now caretaking her family. Because she is back in the area, she has resurrected her business. Within days of returning to her old life, her symptoms reappeared. She has been coming to our integrative medicine center almost weekly ever since. Her thick chart belies a series of supplements, laboratory tests, and referral letters that conclude, “There is nothing we can do.”

Yet, to me, seeing Sally for the first time, the answer is obvious. Her body has already told her what it needs to be healed. She needs to release the expectation she has placed on herself to care for her family.  She needs to let go of her business. And she needs to move back to that small village near Santa Fe, where her body knows how to heal itself.  Only I can’t say this to her. It is not my place to give advice.  Advice implies that someone is broken- and nobody is broken.

Instead, I ask her, “What does your body need in order to get better?”

She says, “I need to find care for my mother, let go of my business, and move back to Santa Fe.”

Bingo.

When she says this, I see, for the first time of our visit, a faint smile. I ask her what she will do when she is there. She says, “Hike, ski, paint, play with my dog. Maybe start a new business, something related to animals.” Her smile widens. She begins to talk about the steps she would need to take in order to put this plan in place. Some steps she has already begun, as she has known intuitively what she needs to do. Within moments, she is grinning. I ask her how her pain feels in this present moment- right here, right now, and she says, “It’s gone.”

Then something shifts. A dark cloud wafts across her. She curls her shoulders inward.  Her smile disappears. Her brow furrows. Sally says, “I can’t do this. And what’s the point? My doctor said there was no cure for my condition.”

Healed Versus Cured

I can’t help telling her the story of my father. Dad was diagnosed with a gigantic goomba of a brain tumor when I was 7 months pregnant. A body scan revealed that there was cancer everywhere. A biopsy confirmed metastatic melanoma, which comes with a near certain death sentence. My father, a physician who did his senior thesis on melanoma, knew the facts about his prognosis. So when he called me one morning at 4am to say that he had a vision and that God had come to him to tell him he had been healed, I groaned. “Oh no,” I thought. “The brain tumor is growing. He’s delusional. And he’s in denial.”  I nodded and told Dad I was thrilled that he was healed, but I dreaded the repeat body scan that would tell him the truth. When the body scan showed that the tumors were growing, Dad got quiet. He didn’t speak of his vision again. My heart ached.

A month later, Dad failed to experience any of the expected symptoms of a gigantic brain tumor. He had no headaches, no seizures, no vomiting, no dementia. He was plain old Dad, only with a bald head from the whole brain radiation they gave him.  So when Siena was born and Dad said, “Can I go now?” I wasn’t prepared. What did he mean, “go?” What exactly did he plan to do?  Dad said he was going to quit eating and die a peaceful death. He wanted our permission. Reluctantly, we gave it.

Dad kissed us goodbye, and when I asked whether he was scared, Dad said, “I’m not scared. I’m joyful.” He kissed away our tears, closed his eyes, and died peacefully 48 hours later.

Only in retrospect did I learn a very important lesson- one that has fundamentally changed the way I practice medicine. I realized that, in spite of my skepticism, Dad had been healed- that there is difference between healing and curing. I always thought they were the same.  Now, I realize that you can healed without being cured, and you can be cured without being healed.  I spent 12 years of medical education learning how to cure people, but no one once spoke to me about healing. In fact, we don’t even use the term “Healing” in reference to patients. We might talk about a healing wound, but a healing patient? Nah. Too woo-woo.

The Whole Picture

So when that doctor told Sally that she would never be cured, he failed to look at the whole picture. Yes, there may not be a drug she can take to rid herself of symptoms permanently. But I absolutely believe that she can be healed. Her body has already proven it to her.  The power to heal lies within us all, if only we tap into it.

What about you Pinkies?  What needs to be healed in your body, your soul, your heart, your life?  What would it take to feel better? What steps might you take to put a healing plan into place? How can we support you?

Committed to helping you (and me) heal,

Lissa