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Speaker 3: Hey, hello ologites. So I put this in the show description,
Speaker 3: but I'm also adding it up top just in case
Speaker 3: you're driving a car, or your working a forklift, or
Speaker 3: you're freeding your chickens or I don't know, if you
Speaker 3: listen to on a high wire, you should not be
Speaker 3: reading text. This is just a pre roll linguistics alert.
Speaker 3: So in this episode, we talk about transgender healthcare and
Speaker 3: we touch on the history of the trans community in
Speaker 3: the US. And when I recorded this episode, in considering
Speaker 3: the inclusion of trans women, I opted for use of
Speaker 3: the term women's health and women as gynecology is currently
Speaker 3: technically but antiquatedly defined. So I thought, okay, I'm making
Speaker 3: sure to include everyone who identifies as a woman. We
Speaker 3: are golden great. No, in so doing, I fucked up,
Speaker 3: and I overlooked and excluded non binary and trans men
Speaker 3: friends in that language, and I'm super, super super sorry.
Speaker 3: I'm so sorry. Some really amazing and compassionate ologites alerted
Speaker 3: me to this, and I just want to say, I'm
Speaker 3: so so sorry that the language I used, like women, lady,
Speaker 3: lady machine made anyone feel unseen. Please know that trans
Speaker 3: inclusion was totally on my mind, but I'm just super
Speaker 3: embarrassed to have missed the mark and overlooked the non
Speaker 3: binary community and trans men community who also rely on
Speaker 3: gynecology for vital healthcare. I thought I had my basis covered,
Speaker 3: and I did. I'm an idiot, So my ologites, each
Speaker 3: and every one of you, I see you, I love you,
Speaker 3: I care about you a bunch, and I will strive
Speaker 3: to do better when it comes to inclusionary language. As
Speaker 3: you know, I'm all about asking smart people dumb questions,
Speaker 3: and even when I think okay, I got this, I'll
Speaker 3: do my best to just double check, triple check. So
Speaker 3: thank you for tipping me off to that that I
Speaker 3: could have been more in the loop about gender versus
Speaker 3: Jenny's and for your patients with me and with each other,
Speaker 3: just as we all learn new things and we evolve
Speaker 3: into an even more inclusive and better linguistically equipped society. Now,
Speaker 3: if you don't encounter it often, it may seem like, well,
Speaker 3: what's the big deal? But I think these are some
Speaker 3: new and really exciting steps towards breaking down a lot
Speaker 3: of gender roles that hold all kinds of people back,
Speaker 3: from CIS to trans to non binary, Like wearing pants
Speaker 3: was illegal for half the population until that was challenged
Speaker 3: and reframed. So if you're dope that you don't have
Speaker 3: to drag a bustle on the subway or fit a
Speaker 3: petticoat into your Nissan CenTra, then we have some brave
Speaker 3: folks who said this sucks and it's impractical to think.
Speaker 3: So likewise with gender and labels and the trans and
Speaker 3: non binary community for undoing some super stark gender expectations
Speaker 3: and roles that don't really fit anyone completely. So thank you,
Speaker 3: I see you. Let's all be super kind and compassionate
Speaker 3: to each other and keep our minds open to learning
Speaker 3: new things, whether it's about snake butts or be dancing,
Speaker 3: or the origins of the universe or another person's perspective.
Speaker 3: So learning shit is cool. I stand by that. Okay, Jino,
Speaker 3: here we go. Oh hi, it's your guidance counselor aliy Ward,
Speaker 3: it's me. First things First, I think I have my
Speaker 3: contacts in the wrong eyes, but I'm just gonna go
Speaker 3: for this. I'm gonna change them later. Let's blaze through. OBG.
Speaker 3: Why not. Let's get into it. Vagina's talk about them.
Speaker 3: Maybe you have one, maybe you want one, Maybe you
Speaker 3: love them, maybe you came straight out of one. They're everywhere,
Speaker 3: they're all around you, and they're pretty handy in terms
Speaker 3: of shooting out humans to continue the survival of our species.
Speaker 3: But how well do you know vaginas? How well do
Speaker 3: you really know them? It's kind of like when you've
Speaker 3: met someone a bunch of times at parties and you're like,
Speaker 3: oh my god, I love her, but you don't want
Speaker 3: to admit that. Like you've never had a real one
Speaker 3: on one and like you don't even text each other.
Speaker 3: You've just hung out like a few times when people
Speaker 3: are drunk. So consider this episode just a deep ass
Speaker 3: dive into the world of vaginas, birth, women's health, mental health,
Speaker 3: self care, hygiene, all things that are happening in parts
Speaker 3: of your body that you only care about when they're
Speaker 3: causing you either great pleasure or great pain. So let's
Speaker 3: talk about gynecology first off, before we celebrate Croutch doctors,
Speaker 3: let's celebrate you. This engine of ologies runs total on
Speaker 3: listener support. It's one hundred percent Indie, so your Patreon
Speaker 3: pledges keep it running from month to month. Thank you
Speaker 3: so so much for doing it. Patroons also get, in
Speaker 3: return to ask the ologists questions, and they get to
Speaker 3: walk around knowing that they're helping cocktail parties everywhere be
Speaker 3: way less vapid. So thanks to everyone who buys shirts
Speaker 3: and dad hats and pins and tots at ologiesmirch dot com.
Speaker 3: You're totally helping to but mice tight. I get that
Speaker 3: you can also support so much by just subscribing and
Speaker 3: reviewing on iTunes, which is free. It takes two seconds,
Speaker 3: and I'm a creep and I read every review and
Speaker 3: this week's warmed my heart so much. It confused my
Speaker 3: soul a little bit TBH. Moneywalk says, just listen to
Speaker 3: the podcast on ichthyology, and I realized that Ali sounds
Speaker 3: very similar to Ellen DeGeneres. What could be better than
Speaker 3: listening to Dory tell you about fish? Do I sound
Speaker 3: like Ellen de Generes? Yes, I am, that's me. Okay,
Speaker 3: back to gynecology. Now, before we dive into where babies
Speaker 3: come from, let's look at the birth of the word.
Speaker 3: So gynecology it means a science that deals with the
Speaker 3: health and diseases of women. It comes from a Greek
Speaker 3: word jina, which comes from Gwen, which has the same route.
Speaker 3: Are you ready for this as a queen Gwen, Queen
Speaker 3: Jine boom, so just think yes, her majesty y'all rfe jai.
Speaker 3: So let's bow to your queens with a discussion with
Speaker 3: a gynecologist. Now, I had gone to Portland to record
Speaker 3: a few episodes beer Bees, and now this interview with
Speaker 3: a medical doctor who grew up in the Philippines, South Africa.
Speaker 3: She grew up in Argentina, the Netherlands all over. She's
Speaker 3: now based in Portland. She's been in obgyn since nineteen
Speaker 3: ninety seven and she's worked several medical missions in Ethiopia.
Speaker 3: She's a total badass. She spent an hour on a
Speaker 3: Saturday morning getting peppered with questions for me. Now she
Speaker 3: arrived in my hotel lobby, I think a bit confused.
Speaker 3: I'm gonna be honest. I think she was like, what
Speaker 3: am I getting myself into? And I have a dear
Speaker 3: high school friend, Hypaul, and he had put us in touch.
Speaker 3: And I think she's like, who is this redheaded chick
Speaker 3: in a three star Portland hotel? And why am I
Speaker 3: talking to her on a Saturday morning? And side note,
Speaker 3: I had booked it on a hot wire where they
Speaker 3: tell you like it's probably a Shardan or like a Marriott,
Speaker 3: and you're like okay, and then after you pay for it,
Speaker 3: they're like, psych, we gave you a creepy place that
Speaker 3: someone would stay if they're going through a divorce on
Speaker 3: a budget. So this amazingly brilliant doctor shows up and
Speaker 3: on the way to my room she offers that the
Speaker 3: place has a bit of a Motel six vibe, and
Speaker 3: I was gently mortified. I was like, m girl, you
Speaker 3: are not wrong. Please forgive me. I have been foolishly
Speaker 3: caffish by hall wire Anyway, we got to my room,
Speaker 3: and she has the calmest bedside voice of anyone I
Speaker 3: have ever met. I imagine hone from literal decades coaching
Speaker 3: live human births. If a screaming rotisserie chicken made out
Speaker 3: of my own blood were to work its way out
Speaker 3: of an orifice, I would want someone with her calm,
Speaker 3: intelligent disposition calling the fucking shots here. Likewise, if I
Speaker 3: found a rash somewhere delicate or needed my holes probed
Speaker 3: by imaging equipment, her voice, her coolness are goals. So
Speaker 3: she pulled up a chair and we chatted about what
Speaker 3: your gynecologist thinks of your bikini wax, unusual birthing strategies,
Speaker 3: self care, and even like warning, some super sobering statistics
Speaker 3: about assault, how you can help victims, how to wash yourself,
Speaker 3: how to touch yourself, all kinds of great stuff. So
Speaker 3: feel free to recommend this episode to anyone who's a
Speaker 3: woman or whose life has been affected by a woman,
Speaker 3: which is like all of us. So please scoot just
Speaker 3: a little further down the table. It's just a little more. Okay,
Speaker 3: that's too much, okay for gynecologist doctor Philippa Ribbink, So
Speaker 3: here's your microphone, that's yours, and we just talked into it,
Speaker 3: doctor Ribbink, Doctor Ribink. Was there a particular day where
Speaker 3: they're like, we can you can call yourself a doctor.
Speaker 4: Now after you graduate from medical school. The day you graduate,
Speaker 4: you can call yourself doctor.
Speaker 3: Did you no?
Speaker 4: No? No?
Speaker 5: Did it take a minute to like get settle in
Speaker 5: to your identity?
Speaker 4: Yeah, it took a while. It took a while. I
Speaker 4: mean I did in residency, I think from day one,
Speaker 4: so that was a month after I graduated, so it
Speaker 4: wasn't didn't take that long, but yeah, it felt like
Speaker 4: I was acting in the beginning. Really, I didn't feel
Speaker 4: like a real doctor for quite a while. It actually
Speaker 4: took quite probably several years before I stopped feeling like
Speaker 4: I was acting.
Speaker 3: That's really common though, in doctors, especially doctors with a
Speaker 3: lot of empathy. Is that feeling of imposter syndrome.
Speaker 4: It's very common. Yeah, it's very common. I'm not quite
Speaker 4: sure why, but I did a lot of acting in college,
Speaker 4: so it kind of like I was okay with it,
Speaker 4: but I felt like I was.
Speaker 3: Acting quick aside on imposter syndrome because I feel like
Speaker 3: so many smart capable people have it, including so many
Speaker 3: ologists that I meet. First, It's not a syndrome or
Speaker 3: a disease at all. It's just an experience identified by
Speaker 3: two psychologists, doctor Paulineklants and doctor Suzanne IIMs Now. They
Speaker 3: observe that many intelligent, high achieving people, especially women and
Speaker 3: people in ethnic minorities, tend to think that they are
Speaker 3: not intelligent. It's common across so many fields, people like
Speaker 3: my Angelo in Cheryl Sandberg and even Tom Hanks being
Speaker 3: like man Man, I do not belong here. I suck.
Speaker 3: So a lot of people with imposter syndrome don't know
Speaker 3: that other people worried that they don't belong in the
Speaker 3: high ranks that they've achieved. But admitting and talking about
Speaker 3: it tends to really help, if not solve the problem. So,
Speaker 3: by the way, the opposite of this is called the
Speaker 3: Dunning Krueger effect, when people of low ability think that
Speaker 3: they are the best, which can also happen in a
Speaker 3: lot of fields, such as, for example politics. As for
Speaker 3: imposter syndrome, no matter if you're a doctor or a dancer,
Speaker 3: you may have felt like do I belong here? At
Speaker 3: what point did you kind of decide to nurture the
Speaker 3: medical side of your talents, if you are if you're
Speaker 3: also doing arts and acting, Like, was there a moment
Speaker 3: where you're like, I gotta choose.
Speaker 4: I always wanted to be a doctor. When I was
Speaker 4: a little kid, I had I had I had a
Speaker 4: heart apperishon when I was a little kid, and after that,
Speaker 4: I always I kind of felt like, well, I have
Speaker 4: to do this when I grow up. And my grandfather,
Speaker 4: who I was very close to, was also a doctor,
Speaker 4: so I kind of wanted to be like him. And
Speaker 4: I always thought I was going to be a doctor.
Speaker 4: And then I went to college and I discovered acting
Speaker 4: and I loved acting, and then I thought, well, maybe
Speaker 4: I'll be an actress in New York City. And then
Speaker 4: I was waiting tables in New York City and kind
Speaker 4: of thinking, wow, I don't really want to do this.
Speaker 4: And I was very good at science, so I didn't.
Speaker 4: In my last year in college, I was like, I
Speaker 4: need to rethink this. I need to do what I'm
Speaker 4: good at and applied to medical school and I got
Speaker 4: in and I ever since that, i've I'm I love medicine.
Speaker 4: It's just it's it's it's the only job I can
Speaker 4: imagine doing. It's the only I don't think there's a
Speaker 4: lot of jobs except for maybe what you do, where
Speaker 4: you can really you can hear stories, people's stories. You
Speaker 4: can listen, you can you can get really intimate details
Speaker 4: about people's lives. And a friend of mine said, you know,
Speaker 4: I don't read literature because I listened to patients all
Speaker 4: day long, and you can't make up this stuff. You
Speaker 4: can't make up this stuff. The degree of kind of
Speaker 4: the views in people's lives you get as a physician.
Speaker 4: Maybe not all physicians, maybe not if you're a radiologist
Speaker 4: or a pathologist, but as an OBGN or a family
Speaker 4: practitioner or an internist, it's amazing. I mean, it's an
Speaker 4: incredible privilege. You get to like listen to people's intimate details,
Speaker 4: and then you get to give them advice. I mean,
Speaker 4: you get to change people's lives, and there's very few
Speaker 4: jobs where you get to do that.
Speaker 3: Do you think that there's something about psychology and stories
Speaker 3: that drew you to women's health in particular?
Speaker 4: Probably? I mean I've always think I've always found there's
Speaker 4: also just something about women's health that's just it's so varied.
Speaker 4: What I do as an OBI Julane is so varied.
Speaker 4: I'm in general Obi Juane. So I get to deliver babies,
Speaker 4: I get to take people to ower, I get to
Speaker 4: do c sections, I get to do I get to
Speaker 4: know people for twenty years. And that's not you know,
Speaker 4: surgeons get to meet someone one day and take out
Speaker 4: a gallbladder and then never see them again. And I
Speaker 4: get to see people whose kids I've delivered and then
Speaker 4: maybe I've taken that they're overari insist or I've you know,
Speaker 4: and I take care of their kids. I you know,
Speaker 4: I saw yesterday, I saw a patient who was a
Speaker 4: Katrina refugee who had nothing when she came here. Now
Speaker 4: are kid's going to go to college? I mean it's
Speaker 4: like I get to see these stories, and I don't
Speaker 4: you know, who gets to have that kind of inside view.
Speaker 4: Even as a journalist, you're like, you know, you get
Speaker 4: to hear a story and then you're in another town. Yeah,
Speaker 4: so you don't get that. You don't get to know
Speaker 4: people on that level.
Speaker 3: Did you find that when you were first starting out,
Speaker 3: was that kind of intimacy was that easy for you
Speaker 3: or did that did that become more easy more natural
Speaker 3: as you gained experience.
Speaker 4: Yeah, I mean, I think it takes time to be
Speaker 4: comfortable with people telling you things that may be someone
Speaker 4: embarrassing and someone you know a little too much information
Speaker 4: or a little bit like, oh my god, I work
Speaker 4: with you and you do that. That's interesting. But I
Speaker 4: think that you know, it takes a while to ask
Speaker 4: the right questions as well. It takes a while to
Speaker 4: ask questions about people's sex lives. It takes a while
Speaker 4: to ask and to learn how to do it without
Speaker 4: judgment and where people are actually comfortable and they're going
Speaker 4: to tell you details, they are important for you to know.
Speaker 4: If you don't ask the question, you're not going to
Speaker 4: get the answer, You're not going to look for the
Speaker 4: the you're not going to be able to make the diagnosis.
Speaker 4: You know, there's people make silly choices sometimes when it
Speaker 4: comes to sex, and you don't you don't find out
Speaker 4: that they've made those silly choices until you've actually asked
Speaker 4: the really specific question. Or there make silly choices when
Speaker 4: it comes to drugs or other things. And again, you know,
Speaker 4: unless you're very specific and you learn how to ask
Speaker 4: questions very specifically without without judgment, and that takes quite
Speaker 4: a while I think that in the beginning, I wasn't
Speaker 4: that good at that.
Speaker 3: Do you have to do a lot of guests work
Speaker 3: with women's health. Are there any cases that you feel
Speaker 3: like really confuse both you and the patient. I feel
Speaker 3: like as as a person with a vagina and someone
Speaker 3: who has friends with them, there's a lot of times
Speaker 3: women's health can absolutely confuse us and say why does
Speaker 3: this hurt? Why is this happening? And do you find
Speaker 3: that that that it's Sometimes diagnoses are difficult to make.
Speaker 4: Yeah, I mean probably Pelvic pain is one of the
Speaker 4: hardest subjects for us all because people come in with
Speaker 4: complaints of pain, and there's so many different things that
Speaker 4: can cause pain in the pelvis because all these you know,
Speaker 4: there's so many different organs in the pelvis and all
Speaker 4: the nerves travel together, so you can have you know,
Speaker 4: you could you could have a hairline fracture in the
Speaker 4: tip of your you know, in the tip of your
Speaker 4: femur in that in your fhemeral head, and that could hurt,
Speaker 4: it could make you hurt kind of in the mid
Speaker 4: line as if you've got, you know, something wrong with
Speaker 4: your ovary, and so the pain, all these pain fibers
Speaker 4: travel together. I've had people with atopic pregnancies on the
Speaker 4: left side and come in with intense pain on the
Speaker 4: right side.
Speaker 3: Side note topic means out of place literally, and it
Speaker 3: refers to an egg instead of implanting in the uterus
Speaker 3: deciding to just like attach to your full opium too
Speaker 3: or elsewhere. So it was like moving into a new house,
Speaker 3: but setting up your bedroom in the driveway. It's like,
Speaker 3: is here good? No, No, that's not good. And sadly,
Speaker 3: topic pregnancies usually do not have a good outcome, and
Speaker 3: they can be super dangerous for both the fetus and
Speaker 3: the mom and they hurt a lot, sometimes in the
Speaker 3: wrong spot.
Speaker 4: It's hard to locate pain just by where people point
Speaker 4: or people say it hurts on this side. And I've
Speaker 4: you know, I remember taking a patient to the ore
Speaker 4: because she had intense pain on the left side and
Speaker 4: she had a cyst on the left side, and she
Speaker 4: was postman a puzzle and she shouldn't have a cyst
Speaker 4: on the left over and we took out our ovary
Speaker 4: and she still had this pain on the left side.
Speaker 4: And then I kind of scratched my head and didn't
Speaker 4: know what to do with her and send her to
Speaker 4: a friend of mine who's a fantastic physical therapist who's
Speaker 4: also a really fantastic diagnostician, and who just kind of
Speaker 4: figured out that she had started playing the flute and
Speaker 4: was hold her body. Really funny, what Emma's just contracting
Speaker 4: her left side of her body and that's why she
Speaker 4: had this intense pain on the left side. So there's
Speaker 4: all this. You know, people people hold their you know,
Speaker 4: hold tension in their iliosois muscles. Huh, they'll hold tension
Speaker 4: in their muscles, So.
Speaker 3: Come again, Okay, those are both part of your pelvic floor,
Speaker 3: which is kind of like a trampoline of muscles holding
Speaker 3: your bowel and bladder and uterus in the right spots.
Speaker 3: So this basin of muscles. Make sure your guts and
Speaker 3: gonads are well supported. Some of us don't even realize
Speaker 3: we've strained them, or don't even know we have them.
Speaker 3: We've never even thanked them once. If you're feeling bad
Speaker 3: about it, just do like a little keegel squeeze right now,
Speaker 3: like a high five, like boop.
Speaker 4: They'll hold tension in some of their muscles and it
Speaker 4: will be and it will feel like pain from thereover
Speaker 4: it will feel pain from their dress and it's really
Speaker 4: referred pain.
Speaker 3: Wow, I didn't even know that could happen. I can't imagine.
Speaker 3: You're like, I played the flute. Let's get this over
Speaker 3: yet here, Like who would have That's that's not something
Speaker 3: you're going to find in a medical textbook, Like.
Speaker 4: No, definitely, it is just kind of you know, I mean,
Speaker 4: sometimes you can get it out through the history. You
Speaker 4: you know, you finding out what kind of work people do,
Speaker 4: whether they stand a lot, and sometimes people have a
Speaker 4: lot of women have had a history of sexual abuse,
Speaker 4: and a lot of times when you've been raped or
Speaker 4: you've been hurt, you'll hold you know, your body remembers
Speaker 4: the pain and it manifests itself later on in life,
Speaker 4: so in various different ways.
Speaker 3: So, having practiced now over twenty years, have you seen
Speaker 3: any attitudes toward women's health or being their own advocates
Speaker 3: for their health, or their attitude it's toward their own
Speaker 3: sexual relationships change it all over the last couple decades.
Speaker 4: Unfortunately, I think women are still somewhat mystified by their
Speaker 4: body more so than they need to be. I think
Speaker 4: there's a lot of information out there on the internet
Speaker 4: that's very helpful, but I don't know how many people
Speaker 4: are actually accessing it. There's an amazing website called oh
Speaker 4: my God yes about that basically talks about female sexuality. Uh.
Speaker 3: Yes, I went to oh mygodyes dot com. Okay, so
Speaker 3: this is a site that raises money for women's sexuality
Speaker 3: research by providing in exchange informative, beautifully shot instructional videos
Speaker 3: behind a paywall. I was like, do I pay thirty
Speaker 3: nine dollars in the name of science to see what
Speaker 3: this is all about? And hell yeah, I used my
Speaker 3: business card and it did it. So let me just say, whoa, dude,
Speaker 3: whoa whoa? Okay, it's this gorgeously shot catacomb of videos
Speaker 3: you can go down about orgasmic tactics such as edging, layering, signaling, orbiting,
Speaker 3: and it's just right up in there. You see it all. Honestly,
Speaker 3: the most striking thing was like, whoa. I have never
Speaker 3: seen someone that you'd work in an office with talking
Speaker 3: or doing sexual things on camera like this. There's like
Speaker 3: no performative moaning, there's no painful looking high heels or
Speaker 3: weird KOI eye contact with the camera. It's just women
Speaker 3: teaching women how to use their anatomy for pleasure. Men
Speaker 3: might be thinking, like, you need a video for that.
Speaker 3: We don't need videos for that, because our bodies are
Speaker 3: human factories with a lot of real complicated parts. Most
Speaker 3: of sex ed that women get focuses on, like mechanics
Speaker 3: like periods, pats, tampons, ovulation, how to make sure dude
Speaker 3: does not put a baby in us when we don't
Speaker 3: want one, et cetera, et cetera. As we learned about
Speaker 3: in the Sexology episode, most women don't come through just
Speaker 3: vaginal stimulation, and no one really talks to us about
Speaker 3: that because for a quarter of our fertile lives, we
Speaker 3: are busy hemorrhaging from are crotch. And that just got
Speaker 3: dropped from the pamphlets they give out in middle school.
Speaker 3: They're like, oh, yeah, I guess you could come to
Speaker 3: I guess if you figured it out.
Speaker 4: I think it's kind of changing. I mean, I think
Speaker 4: the last year is very interesting to me because I
Speaker 4: think there's all these different you know, maybe because of
Speaker 4: the Me too movement, maybe because of reaction to the election,
Speaker 4: or there's there are many more TV shows that talk
Speaker 4: about female sexuality that very openly. So I think I
Speaker 4: kind of feel things are changing now, but I don't,
Speaker 4: you know, I don't know. I mean, there's still I
Speaker 4: see a lot of women with pain with sex. There's
Speaker 4: a lot of great information out there about that. Women
Speaker 4: are coming very very mystified about it, and I really not.
Speaker 4: They don't know how to access information on the internet
Speaker 4: and how to find how to find the right sources.
Speaker 4: They come and they come in with a lot of shame.
Speaker 4: I'm a lot of shame, or they hear things like, oh,
Speaker 4: just continue to have sex because it will get better,
Speaker 4: and they come in. By the time they come and
Speaker 4: see me, they've got they've had pain for so long
Speaker 4: that their muscles are completely tense, and it will take
Speaker 4: ages for us to kind of reverse what's happened. I
Speaker 4: think things may be changing now, but I in the
Speaker 4: twenty years I've been here, I haven't necessarily seen. You know,
Speaker 4: there are people that know how to access information and
Speaker 4: will from either books or from the internet, and know
Speaker 4: how to take what's you know, they know how to
Speaker 4: separate the bullshit from the true information. And there's also
Speaker 4: people that just get mired in the details and then
Speaker 4: really come in with some really cookie concepts.
Speaker 3: So do you find that people sometimes over google before
Speaker 3: an appointment and they're like, I think I figured this out,
Speaker 3: and you're like.
Speaker 4: Well, yeah, people do. And again, sometimes people come in
Speaker 4: and they've googled things and they've really find they've found
Speaker 4: some stuff that I've never heard of, and they've really
Speaker 4: and they educate me. There's also people that come in
Speaker 4: and they've just really gone down a rabbit hole and
Speaker 4: they just are it hasn't helped them. So again, I mean,
Speaker 4: I don't know what makes people good at finding information
Speaker 4: and what makes people bad at it, But I you know.
Speaker 3: Is there any book you think that every woman should
Speaker 3: read about her own health?
Speaker 5: Like? Is this in Our Bodies Ourselves kind of a thing?
Speaker 3: Is that say? Like is there a should there be
Speaker 3: a textbook?
Speaker 4: There should be? And I think Our Bodies Ourselves is
Speaker 4: kind of outdated, and Joy of Sex is a kind
Speaker 4: of outdated. I mean I think there's Yeah, I think
Speaker 4: there should be something that's That's the thing about female
Speaker 4: sexuality is that they're so you know, it's finally being studied,
Speaker 4: it's finally being studied in a more kind of scientific way.
Speaker 4: I remember textbook when I was in residency that talked
Speaker 4: about it was a surgery textbook, I talked about treatment
Speaker 4: for vulvar cancer and some vulvar cancers that are invasive
Speaker 4: that are spread. The treatment is removing the entire volva,
Speaker 4: including the clitoris.
Speaker 3: Let's take a few quick sex for a quick rundown
Speaker 3: of the key players in a gynecologist eye line. Now,
Speaker 3: when you say vagina, such as in my vagina wants
Speaker 3: to text him, but my heart knows better, or I'm
Speaker 3: sorry I stole your brownie. Please do not kick me
Speaker 3: in the vagina. Friend. What we're probably referring to, you're
Speaker 3: right for this is a vulva, which is such a
Speaker 3: moist sounding word. But I am a grown ass woman,
Speaker 3: and I just learned one minute ago that the vagina
Speaker 3: is just the muscular canal. That's your baby shoot. The
Speaker 3: vult is everything else external, including the pubic mound, the
Speaker 3: labia majora that's your burger bun. The labia minor there's
Speaker 3: your lettuce. The glitteris your pee hole, your vage opening.
Speaker 3: That's all your vulva. You've been calling it by its
Speaker 3: sister's name, vagina all this time, but it's like whatever
Speaker 3: I'm used to it. So, as she was saying in
Speaker 3: some cancers if they spread, they remove all or part
Speaker 3: of the vulva.
Speaker 4: This surgery textbook said that after that, some woman will
Speaker 4: still achieve orgasm. And I read that and I tried
Speaker 4: to find the reference for this, yeah, and I could not.
Speaker 4: There wasn't a reference for it. It was just a statement
Speaker 4: in the textbook, but it wasn't referenced. So I kind
Speaker 4: of thought, where on earth do they get this information?
Speaker 4: And I kind of know where this information comes from
Speaker 4: because I've worked with those doctors and they know. The
Speaker 4: patient comes in and says it's everything's still fine with
Speaker 4: your husband, and patient says, yes it is, and hence
Speaker 4: the conclusion that woman can still achieve orgasm, which is
Speaker 4: a lot of bullshit. Yeah, I mean there's no I
Speaker 4: never found a reference for that statement.
Speaker 3: If things are fun for your husband, they must be
Speaker 3: fun for you.
Speaker 4: So I think that, you know, finally there's people that
Speaker 4: are actually doing scientific research on female sexual pleasure on
Speaker 4: female bodies, and I think that's really important.
Speaker 3: I think that's astounding that it hasn't been that it's
Speaker 3: such an afterthought, I mean to women's health in general.
Speaker 3: I mean, I feel like the focus is tends to
Speaker 3: be more on reproductive I feel like we prioritize making
Speaker 3: more babies rather than having more orgasms.
Speaker 4: Probably, yeah, I mean I think it's all like, you know,
Speaker 4: who's telling the story, you know? I mean it's just
Speaker 4: like I think for ages, men have been telling the story.
Speaker 4: I think, finally women are telling the story. Women directors
Speaker 4: are directing movies and telling stories. There's TV shows that
Speaker 4: are you know, written by women, directed by women, and
Speaker 4: it's finally women are telling the stories. So I think
Speaker 4: we'll get more, you know, science kind of being spent
Speaker 4: on issues that are important for women. I think we
Speaker 4: need more women telling stories. We need more women in science,
Speaker 4: We need more women asking questions. So, ladies, exactly exactly.
Speaker 3: Did you gravitate toward gynecology because of your own interests
Speaker 3: in it? Necessarily?
Speaker 5: Were you?
Speaker 3: Were you kind of mystified by things and you thought this,
Speaker 3: if I'm mystified and I like science, maybe other people are.
Speaker 3: Or did you like the idea of delivering babies?
Speaker 5: What was it?
Speaker 4: Is? A rape pict a mactricod in college, So I
Speaker 4: think that kind of made me interested in women's health
Speaker 4: and them. Just in medical school, I mean, there were
Speaker 4: there there were two fields I loved psychiatry, but that
Speaker 4: happened to be because I did medical school in New
Speaker 4: York City and the psychiatric hospital was paying Whitney at Cornell,
Speaker 4: and it was just such a fantastic psychiatric hospital, and
Speaker 4: the psychiatrists were the smartest doctors I met, and it
Speaker 4: was just fascinating. And then the second field I really
Speaker 4: loved was obi. It just obig in. I just absolutely
Speaker 4: fell in love with it. I really had no experience
Speaker 4: with delivering babies before I started medical school. I just like,
Speaker 4: I just fell in love with the field.
Speaker 3: I'm so sorry that happened to you, by the way, that's.
Speaker 4: I wasn't a rip victim, was a ripe victim advocates.
Speaker 3: I thought, you said, I'm so sorry, advocate. Okay, so
Speaker 3: this is super embarrassing. But when she said rape victim advocate,
Speaker 3: I missed the advocate part of that sentence. So that
Speaker 3: was the most embarrassing and delicate conversational hiccup of my life.
Speaker 3: So thank you for witnessing it. I had never heard
Speaker 3: of a rape victim advocate, but doctor Rabink explained, I.
Speaker 4: Went to the er to like be with rape victims.
Speaker 4: So they had a program that we they when you
Speaker 4: could be you could train to become a Rape Victim
Speaker 4: Act advocate and you were on call and if some
Speaker 4: if a rape victim went to the er, you would
Speaker 4: go with them and sit with them basically during the interview.
Speaker 3: How did you get involved with that?
Speaker 5: Oh?
Speaker 4: No, someone there was a flyer up in my college.
Speaker 4: I went to a woman's college. I don't know.
Speaker 3: That's dope.
Speaker 4: It was cool, it was a thing, it was cool,
Speaker 4: it was good, a good thing to do.
Speaker 3: In an ideal world, perpetrators of these violent crimes wouldn't
Speaker 3: do this. And we all know society has a long
Speaker 3: way to go in addressing our culture of violence. And unfortunately,
Speaker 3: I hear these stories from people I know a lot.
Speaker 3: Every woman seems to have had a sexual experience that
Speaker 3: should not have happened to her, or a near brush
Speaker 3: with one, and those stories are so common, They're incredibly common.
Speaker 4: I mean, it's just it's astonishing how many women have
Speaker 4: been sexual assaulted, are raped. It just is astonishing and
Speaker 4: underreported as well. Underreported. I mean we used to say
Speaker 4: one and four. I think that's probably more one in two.
Speaker 3: Wow.
Speaker 4: God, that's.
Speaker 3: I think. I'm hoping I'm hoping that women will start.
Speaker 3: This will start some kind of tide of speaking up.
Speaker 3: I feel like this even the last couple of months
Speaker 3: has been the first time that you really hear people
Speaker 3: speaking out about it. Because the repercussions are so so much.
Speaker 3: There's so much sharper for women than they should be ever,
Speaker 3: and they should be for any other victim of anything else.
Speaker 3: So for more information on programs to help support victims,
Speaker 3: one resource is rain dot org are ai n N
Speaker 3: dot org, so check that out. So all right, in college,
Speaker 3: she spent some time being on call for volunteer work.
Speaker 3: What about now when it comes to being an OB?
Speaker 3: Are you is your life always? Are you always on call?
Speaker 4: No? I'm in a group. I could never always be
Speaker 4: on call. That I mean, I don't I know that
Speaker 4: OB's used to do that, and I think they had
Speaker 4: wives that would like take care of their personal needs
Speaker 4: and we're somehow able to do it. I would never
Speaker 4: be able to pull that up. Now. I work in
Speaker 4: with a lovely group of physicians and we cover each other.
Speaker 4: And our group was actually the founders of my group
Speaker 4: really felt that in order for us to be good physicians,
Speaker 4: we had to take care of ourselves. We couldn't take
Speaker 4: care of other people if we didn't take care of ourselves.
Speaker 4: So we from the very beginning that they the group,
Speaker 4: we never took call for ourselves twenty four seven. We
Speaker 4: always covered each other so that if you had a
Speaker 4: dinner date, you could go to your dinner date. You
Speaker 4: didn't have to cancel your dinner day just because someone
Speaker 4: was in labor. And patients, you know, our patients hear
Speaker 4: that from the you know, the first the day they
Speaker 4: come in the door. You know, I work in a group.
Speaker 4: We take we cover each other for call. Whoever's own
Speaker 4: call is going to do your delivery, maybe maybe one
Speaker 4: of my wonderful partners. And you know, if you if
Speaker 4: that's not okay with you, then you need to find
Speaker 4: a different physician.
Speaker 3: And when when you say taking care of yourself is,
Speaker 3: of course that makes you a better doctor. I think
Speaker 3: that's so interesting, especially when it comes to women's house.
Speaker 3: We don't take care of ourselves. What are the basic
Speaker 3: tenets of like making sure that you're not ragged and
Speaker 3: it's not affecting your body. I'm asking this for selfish
Speaker 3: reasons because I'm always ragged.
Speaker 4: Get enough sleep when you can, don't drink too much alcohol.
Speaker 4: Have friends, do things with your friends, have family, do
Speaker 4: things with your family, go on vacation, you know, do
Speaker 4: things that have nothing to do with medicine. Go to
Speaker 4: the movies, read a book, learn a new language, do
Speaker 4: other things. And exercise. We all, like, everyone in my
Speaker 4: group has an exercise routine and we stick with it religiously.
Speaker 4: It's so important. And eat healthy. I mean those are
Speaker 4: kind of I mean, they're basic things that everyone should do.
Speaker 4: Don't eat chunk food.
Speaker 3: What's your exercise routine?
Speaker 4: I go to yoga twice a week, and then I
Speaker 4: do this bizarre exercise called gyrotonics, and I take a
Speaker 4: private lesson with this Russian ball arena who tortures me.
Speaker 4: I'm Russian. I had to do this when I was
Speaker 4: a kid, and you have to do this?
Speaker 5: What is it?
Speaker 3: Does it involve a gyroscope?
Speaker 4: No, it's it's kind of like pilates, but it's more
Speaker 4: three dimensional than pilates. It's an amazing core muscle exercise routine.
Speaker 4: A lot of what I do is bending over and
Speaker 4: holding my body in funny positions when I'm waiting for
Speaker 4: someone to deliver or.
Speaker 3: Okay, I looked this up and it's not rotonics. It's
Speaker 3: technically gyrotonic, followed by an R in a circle like
Speaker 3: a registered trademark. Gwyneth Madonna. They're both into it. And
Speaker 3: videos I watched feature these super ripped Swan Lake types
Speaker 3: stretching cables around with such elegance they look like a
Speaker 3: live puppets doing this slow sweeping modern dance performance. It's
Speaker 3: also expensive, but there are group ons. If you're thirsty
Speaker 3: for abs, you're a gyro guino.
Speaker 4: I'm a gyrog. I'm not like there's actually three gyrogyos
Speaker 4: in my group. We're a group. We actually thought about
Speaker 4: having a group retreat and doing a gyrotonics class.
Speaker 3: You guys need T shirts and I run and I walk,
Speaker 3: so make sure it gets get some exercise.
Speaker 5: Yeah, I think we need a like a women's health Bible,
Speaker 5: and that should be chapter one and then the rest
Speaker 5: of things, like what.
Speaker 3: The hell does cervix? Okay, So cervix means neck and
Speaker 3: it's the lower part of the uterus that serves as
Speaker 3: an opening to your vagina. Now, I try to find
Speaker 3: a fun fact about a cervix that you would like,
Speaker 3: and it might be uncomfortable. So I'm just gonna sing
Speaker 3: it fast in case it's on comfy, so you can
Speaker 3: just tune out the words and grips the music if
Speaker 3: you need to. Okay, So your cervix has glands that
Speaker 3: make mucus and you can monitor it to figure out
Speaker 3: how fertile you are, and it's thicker and acidic when
Speaker 3: you're less likely to get knocked up. But it's stretchy
Speaker 3: and clear like an egg white when you have more
Speaker 3: estrogen in my be ovulating, and that aspect of being stretchy, like,
Speaker 3: for instance, a mucus has a name, and the Internet
Speaker 3: says it's pronounced like this spin barkie hee. I'm sorry
Speaker 3: I did that to you. And also there's nothing less
Speaker 3: sexy than a robot describing your cervical mucus. Okay, let's
Speaker 3: change the subject. This is a dumb question. But when
Speaker 3: people are going to the gynecologist and they're like, oh
Speaker 3: my god, I need to get a bikini wax, does
Speaker 3: any of that really matter? Because I feel like there's
Speaker 3: so many women I talk to who are like, oh man,
Speaker 3: I'm going I'm rogging this bush. Oh that's embarrassing. Does
Speaker 3: it get a colle just ever really care?
Speaker 4: Actually, I actually tell everyone, don't shave. Oh okay, because
Speaker 4: hair is there for a reason. So where I mean,
Speaker 4: if you talk to all the vulvar specialists in the country,
Speaker 4: everyone's like, don't shave.
Speaker 3: Really, Yeah, It's so cool that out there right now
Speaker 3: there are vulvar specialists, like real ones, and not dudes
Speaker 3: on spring break wearing shirts proclaiming that they're volvar specialists.
Speaker 3: They're not.
Speaker 4: I mean, I see people coming with like nasty feilculitis
Speaker 4: because they've shaved or they've waxed or whatever, and I'm
Speaker 4: always like, you know, I also think the shaving has
Speaker 4: kind of made people so much more aware with what
Speaker 4: their vulvat looks like in their labya and like there's
Speaker 4: like so many people that think their laby are too
Speaker 4: long and that they need to be reduced or cut
Speaker 4: off and and I think part of that's because everyone's
Speaker 4: shaving and so you can see them more. And there
Speaker 4: are so many different normal shapes of volvas, and the
Speaker 4: range is amazing.
Speaker 3: And.
Speaker 4: I think people have this idea of what that needs
Speaker 4: to look like that's really artificial. So there's all the
Speaker 4: plastic surgery that people are doing on their volva. I
Speaker 4: think part of it is the result of and part
Speaker 4: of the result. Part of it is the result of
Speaker 4: internet porn. Part of it is the result of everyone
Speaker 4: shaving and thinking that this is kind of what it
Speaker 4: needs to look like, and there really isn't a specific
Speaker 4: way that it needs to look like.
Speaker 3: I was that was one of my questions that I
Speaker 3: was going to ask if you've seen in your practice,
Speaker 3: like with lybiaplasty has become more and more popular as
Speaker 3: we have more access to images that maybe are it
Speaker 3: has I mean, it's it's there's My practice is.
Speaker 4: We're it was started by two hippies, so it's we've
Speaker 4: got a little more hipie dippy practice, although the two
Speaker 4: hippies have since moved on, and I do not like
Speaker 4: the Grateful Dead. So that's actually one of my interview questions.
Speaker 3: That's so specific.
Speaker 4: Like I said, no, I grew up with the sex Pistols,
Speaker 4: Oh my God.
Speaker 3: So perhaps as a future gynecologist she was influenced by
Speaker 3: the sex Pistols seminal album never Mind the bullocks. Bullocks
Speaker 3: mean testicles in British slang, back to trimming or labya.
Speaker 4: So not so much in my practice. I haven't you know,
Speaker 4: I occasionally have done labial plasties, especially in cases where
Speaker 4: like one labya is way longer than the other, or
Speaker 4: when there's so long that they're really rubbing and it's
Speaker 4: really uncomfortable, where when they are athletes, they just is
Speaker 4: a problem. So I've done labioplasts in those cases. I
Speaker 4: don't get that many requests for just purely cosmetic labio plasties.
Speaker 4: But I know physicians that are practicing elsewhere that are
Speaker 4: you know, that's a big bulk of their practice. And there,
Speaker 4: you know, I know there's in New York there's a
Speaker 4: specialist of maternal fetal medicine, high risk e cetrics that
Speaker 4: left his specialty and all he does is labia polasties
Speaker 4: and he advertises on the internet the before and after
Speaker 4: picture and has all these stories from women that felt
Speaker 4: always felt horrible and felt that they were ugly and
Speaker 4: now they feel so much better. And I, you know,
Speaker 4: to me, it's just like there is no normal. You know,
Speaker 4: let's let's talk about what's normal. Let's talk about the
Speaker 4: range of of what the volva needs to look like,
Speaker 4: and let's and I think what the only thing that
Speaker 4: makes me really hopeful is that we're starting to see
Speaker 4: more women's bodies that are slightly different in advertising. We're
Speaker 4: starting to see women's bodies on TV that are not
Speaker 4: the perfect model that whoever decided was the perfect model.
Speaker 4: I'm hopeful that we're finally going to have some more
Speaker 4: except that women are finally going to learn how to
Speaker 4: accept their body the way it is right because I
Speaker 4: think that's them. That's what it's about.
Speaker 3: I guess, and being an advocate for your own health
Speaker 3: is accepting your body as fine as it is. I
Speaker 3: think women have such a Women do tend to have
Speaker 3: a bit of an antagonistic relationship with their body because
Speaker 3: it's because of perfection standards. I mean, I know, I
Speaker 3: feel like every woman I know has something that they're No.
Speaker 4: One likes their own boobs.
Speaker 3: Yeah, it's like, really, it seems like.
Speaker 4: Very few people really find that their rests are they're
Speaker 4: either too big, they're too small. There's no better lesson
Speaker 4: you could learn your daughter. Teach your daughter then love
Speaker 4: your body the way it is.
Speaker 3: It's a lot cheaper, awesome, it's a lot cheaper than
Speaker 3: plastic surgery. Okay, let's pivot to have some iud chat
Speaker 3: intrauterine devices IUDs. They can last three to six years
Speaker 3: and be super effective in preventing pregnancy, so they interfere
Speaker 3: with sperm motility. They booby trap your cervical mucus to
Speaker 3: make fertilization harder. In some cases they poke your uterus
Speaker 3: to make you think you're already prayer so than an
Speaker 3: egg won implant. So that's very lay women's terms. They
Speaker 3: also can deliver hormones. They can help with heavy periods
Speaker 3: like the marina IUD.
Speaker 4: You know some people don't tolerate the marine IUD.
Speaker 3: I was going to ask you about about iud's how
Speaker 3: much more common they're becoming, and if they're pretty painful
Speaker 3: if someone's considering one.
Speaker 4: It depends on where you are, I mean on the coasts.
Speaker 4: I think they're a lot more painful. Right before the election,
Speaker 4: I think I was putting into IUDs a day. Really,
Speaker 4: these people are afraid they're going to use contraceptive benefits
Speaker 4: and they you know, an IUD in last five years
Speaker 4: or ten years, depending on what kind of valued.
Speaker 5: Do you have.
Speaker 4: We've always put in a whole, We've always put in
Speaker 4: a lot of valuds. I once did a review for
Speaker 4: a legal case from somewhere in the Midwest, and they
Speaker 4: you know, the patient was never offered an IED and
Speaker 4: she presented with heavy bleeding. One of the first things
Speaker 4: we would do in someone who presented with heavy bleeding
Speaker 4: would be to offer them amber an id because it
Speaker 4: reduces menstrual blood loss and it's so effective that my
Speaker 4: you know, I worry about my residence getting enough experience
Speaker 4: doing hysterectomies because we don't do that many hysterectomies anymore.
Speaker 4: We use we use the IED.
Speaker 3: When it comes to ovarian reserve and eggs, I feel
Speaker 3: like I know a lot of people who are waiting
Speaker 3: a little bit longer to have children. Maybe they're in
Speaker 3: their mid thirties, late thirties before they're considering starting a family.
Speaker 3: This is a maybe. Maybe this is a stupid question.
Speaker 4: Maybe it's not.
Speaker 3: If you've been on birth control preventing ovulation for a
Speaker 3: number of years, does that mean that you have more
Speaker 3: eggs or not? No?
Speaker 4: Okay, I mean it's good to be on the birth
Speaker 4: control pill for many years because it decreases a chance
Speaker 4: of you developing endometriosis, So it suppresses endometriosis, so it
Speaker 4: preserves fertility. In that way, it doesn't preserve fertility in
Speaker 4: terms of a very reserved It's not that you don't
Speaker 4: have eggs. It's just that your ovaries become more unresponsive,
Speaker 4: So it doesn't it's not just the number of eggs
Speaker 4: you have left. It's more just the responsiveness of your ovary.
Speaker 3: Do you recommend women who are waiting to have a family.
Speaker 3: Is there a time when you're like, get these puppies
Speaker 3: on ice?
Speaker 4: You know, that's a good question. I mean, our college
Speaker 4: and the American College of Overduans just send out a
Speaker 4: whole I think it was last year that they send
Speaker 4: out a questionnaire where they asked all of us up
Speaker 4: to what extent we offer our women, our patients that
Speaker 4: are in their early thirties, up to what except we
Speaker 4: talk about fertility preservation with these patients. And it's interesting
Speaker 4: because I think that what came out is that most
Speaker 4: of us, if we had a patient who presented with
Speaker 4: cancer and was going to get a whole body of
Speaker 4: radiation that was potentially going to destroy their ovaries, we
Speaker 4: would talk to them about preserving their eggs. And we
Speaker 4: don't necessarily do that in our patients that are thirty two,
Speaker 4: that are getting their second PhD and waiting to have
Speaker 4: kids because of that reason, and we should. I mean,
Speaker 4: ever since that they that study, I have been asking people,
Speaker 4: what are your plans in terms of kids? Is this
Speaker 4: something you want? Something you don't want? I'm not you know,
Speaker 4: occasionally I've talked to people about preserving their eggs. The
Speaker 4: tricky thing in Oregon is that it's not it doesn't
Speaker 4: it's not covered under insurance. So it's pricey. Yeah, you know,
Speaker 4: us a fair amount of money. And you know people
Speaker 4: that are students don't necessarily have an extra ten to
Speaker 4: twenty thousand dollars laying around to do that.
Speaker 3: Yeah.
Speaker 4: No, So that's that's the problem. I don't think people
Speaker 4: are quite aware of how quickly, how much age, how
Speaker 4: much infertility is caused by age.
Speaker 3: So twenty or so years ago, the American Fertility Society
Speaker 3: wanted to launch an ad, very well meaning on buses
Speaker 3: that said, hey, ladies, start your families before you turn
Speaker 3: into a wizard crone paraphrasing.
Speaker 5: You know.
Speaker 4: They showed the ads to groups of women and everyone
Speaker 4: just was completely offended. Right, you know, there's it's it's
Speaker 4: hard to how do you tell women you know your
Speaker 4: clock is ticking without telling women go make a baby exactly.
Speaker 4: You know, it's it's hard, Yeah, it's hard, and the
Speaker 4: very you know, the the O site freezing has you know,
Speaker 4: we used to we used to not be that good
Speaker 4: at freezing, just unfertilized O sites. So now we've become
Speaker 4: much much better at it. So it's an option. It's
Speaker 4: a viable option now for those that can afford it.
Speaker 5: But early thirties is the time to think about it, maybe.
Speaker 4: Yeah, okay, yeah, I remember twenties, early thirties.
Speaker 3: I remember someone mentioning it to me when I was
Speaker 3: thirty four, and I was like, how dare you? And
Speaker 3: I was like, oh, yeah, okay, I see what you're
Speaker 3: talking about.
Speaker 4: Yeah, no, I mean it's just fertility starts plumbing in
Speaker 4: our late thirties and different, you know, we're we're all
Speaker 4: a different curve. Some woman I've had a patient to
Speaker 4: conceive with IVF with her own eggs at forty five.
Speaker 4: But that's the exception to the rule.
Speaker 3: Right, There's always someone that's like, I don't know, my
Speaker 3: cousin found out John accident was pregnant for forty eight
Speaker 3: and so anything's possible. And you're like, okay, whatever, good
Speaker 3: to know. Okay, have some rapid fire questions ok from listeners.
Speaker 3: But before we take questions from you, our beloved listeners,
Speaker 3: we're going to take a quick break for sponsors of
Speaker 3: the show. Sponsors. Why sponsors?
Speaker 4: You know what they do?
Speaker 3: They help us give money to different charities every week.
Speaker 3: So if you want to know where Ologies gives our money,
Speaker 3: you can go to aliwar dot com and look for
Speaker 3: the tab Ologies gives back. There's like one hundred and
Speaker 3: fifty different charities that we've given to already, with more
Speaker 3: every single week. So if you need a place to go,
Speaker 3: donate a little bit of money but you're not sure
Speaker 3: where to go. Those are all picked biologists who work
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Speaker 3: Okay your questions. Carrie Steward wants to know what are
Speaker 3: obg rants doing to reduce the maternal mortality rate in
Speaker 3: the US and during a woman's pregnancy. How do obi's
Speaker 3: balance the mom's health with the baby sealth.
Speaker 4: Well, in California, they took kind of control of the
Speaker 4: issue and they started investigating every maternal death and they
Speaker 4: came up with some really great algorithms and kind of
Speaker 4: protocols and approaches and on how to address postpartum hemorrhage,
Speaker 4: on how to recognize people at women at risk for
Speaker 4: preclimatic seizures. California maternal mortality rates have gone down ever
Speaker 4: since they started these investigating maternal deaths. Text As maternal
Speaker 4: mortality rates are have gone up, So I think it's
Speaker 4: a state by state response. It has to do with
Speaker 4: access to care.
Speaker 3: Texas maternal mortality rates are five times that of California,
Speaker 3: They're ten times that of some other developed nations, so
Speaker 3: access to good medical care as prevention holds true on
Speaker 3: a global scale as well. Staggeringly, ninety nine percent of
Speaker 3: global maternal mortality happens in developing countries. For me, as
Speaker 3: a non mom, I had kind of taken for granted
Speaker 3: the danger of childbirth. I mean, it's such a natural process.
Speaker 3: And on top of that, we have phones that can
Speaker 3: scan our faces now, and talking robots and soap and
Speaker 3: missions to mars. I had thought like, Oh, we've totally
Speaker 3: kicked childbirth risk. I had no idea that the statistics
Speaker 3: were still going up in some parts of the country.
Speaker 4: You know, and obstetrics, most things go fine most of
Speaker 4: the time, and occasionally things don't go fine. And when
Speaker 4: they don't go fine, they go south real quickly, and
Speaker 4: it takes a certain volume to recognize, oh, things are
Speaker 4: going south. There's also, you know, a whole kind of
Speaker 4: changing culture, and for instance, in our hospital, the way
Speaker 4: we've empowered our nurses to speak up so that if
Speaker 4: there's one person in the room that's not comfortable with
Speaker 4: what's happening, we have certain words on how to say stop.
Speaker 4: I need I think we need to change this tactic.
Speaker 4: I'm uncomfortable with what's happening here, and this is what
Speaker 4: I want to see happen, and everyone in the room
Speaker 4: has a right to speak up. And by empowering our nurses,
Speaker 4: we've also changed things. We're moving away from this model
Speaker 4: that the physician knows everything and is the captain of
Speaker 4: the ship. We're moving more to a team approach to medicine.
Speaker 4: And it's a much better approach. It's a much safer approach.
Speaker 3: It and more natural to squat and have a baby
Speaker 3: than it is to lie down and have a baby.
Speaker 4: It is, but you know, most of us don't have
Speaker 4: enough core muscle strength to actually do that. I mean,
Speaker 4: I've only had a couple of patients in my career
Speaker 4: that could actually hold their body up in a squad
Speaker 4: uh and push out a baby. One was one was exactly.
Speaker 4: One was this like Iron Iron. She was like competed
Speaker 4: in the Iron Man, and she was completely like Superwoman.
Speaker 3: She was able to She's just trail running, squat, squat,
Speaker 3: keep this baby out squatting.
Speaker 4: Most of us just don't have enough core muscle strength.
Speaker 4: I mean, it's it's different. We sit in chairs, we
Speaker 4: sit at desks, and and I've done some work in Ethiopia,
Speaker 4: and Ethiopian woman can actually squat and push a baby
Speaker 4: out because they don't sit on chairs. They sit on
Speaker 4: the floor. They work in the field all day long.
Speaker 4: They have good core muscle strength. We just don't have
Speaker 4: enough good core muscle strength to do that. Most of us.
Speaker 3: Good to know.
Speaker 5: I won't be squatting one out anytime soon, but I
Speaker 5: should work on my core sidebar.
Speaker 3: I started looking up chairs that are like really fancy
Speaker 3: balancing ones, and some are like seven hundred dollars, which
Speaker 3: seems like a really gross way to mimic just not
Speaker 3: having a chair. So then I found an article that
Speaker 3: said one thing you can do is just sit on
Speaker 3: the floor more. It's free, and it has health benefits
Speaker 3: like improved posture, it strengthens your core, and according to
Speaker 3: this article, it also keeps you humble. And it's like, dude,
Speaker 3: it's Saturday night, I'm googling, why am I a slob
Speaker 3: with atrophied abs? I got that last one covered. Rebeccaha
Speaker 3: wants to know when you say you've seen everything before,
Speaker 3: do you actually mean that or are you just saying
Speaker 3: that to make us feel better When you're like, oh man,
Speaker 3: I've seen everything knowing about it, or do you just
Speaker 3: say that.
Speaker 4: I don't think I've ever said I've seen everything before.
Speaker 4: I've seen a lot, but I don't. I don't think
Speaker 4: i'll ever have seen everything. I never ceased to be
Speaker 4: amazed at what I see. No, I mean, life is messy.
Speaker 4: Life is just messy. We're all messy. We all are
Speaker 4: like make silly mistakes. I don't know. I really don't
Speaker 4: have a lot of judgment when it comes to people's behavior.
Speaker 4: I don't. I mean, initially I think I was practicing
Speaker 4: non judgment, but eventually I just like, it's like, you know,
Speaker 4: there's so many different ways of living, and there's so
Speaker 4: many different ways of being I don't.
Speaker 3: I don't, yeah, which is funny. That leads to the
Speaker 3: follow up question.
Speaker 5: Katie Grant wants to know what's the most unexpected thing
Speaker 5: you have ever retrieved from a vagina?
Speaker 3: And I don't know if you can answer that. Set
Speaker 3: of car keys, muffin.
Speaker 4: I think across across and residency.
Speaker 3: Oh, I hope it was ironic. No ouch, Yeah, that
Speaker 3: is not ergonomic at all.
Speaker 4: Yeah.
Speaker 3: Collette Eyers wants to know why am I so irregular
Speaker 3: despite having every single form of test all coming out normal,
Speaker 3: including the one with the long stick covered in a
Speaker 3: giant condom. I think she's talking about a transfaginal I'll
Speaker 3: say that are there negative effects on the body when
Speaker 3: periods are not regular? Or are there certain chemicals your
Speaker 3: body produces during menstruation that if you're a regular your
Speaker 3: body misses out on? She asks, is contraption a good
Speaker 3: way to regulate your period? I believe she means contraceptual assumption,
Speaker 3: and that was probably autocorrect, But contraption. Maybe there's a
Speaker 3: contraption uterine cage. Yeah, what do you irregular periods? What's
Speaker 3: happening here?
Speaker 4: It is normal for the period to vary familiar from
Speaker 4: you know, every twenty four days to every thirty six days.
Speaker 4: That's normal. That's still considered regular. Okay, So I you
Speaker 4: know some woman consider that irregular, you know, and some
Speaker 4: women are blessed with having a period every twenty eight days.
Speaker 4: And even when they're not in the birth control pilt,
Speaker 4: most women have slightly irregular periods.
Speaker 3: Quick knowledge, drop about your red devil, your crimson tide,
Speaker 3: your leak, weak, et cetera. So Mensis comes from the
Speaker 3: Latin word for moon because duh. Both are twenty eight days,
Speaker 3: So of course the moon is a hollow orb that
Speaker 3: houses a period gremlin who controls us naturally. But fact
Speaker 3: check this. Several scientific studies have shown there's no correlation
Speaker 3: between moon phases and mensis. It's a dang mystery. And
Speaker 3: to repeat the dock, most women have slightly irregular periods anyway,
Speaker 3: so the moon is not a conspirator in your ruined
Speaker 3: beach plants.
Speaker 4: Skipping periods all together probably means she's not ovulating on
Speaker 4: a regular basis. And sometimes that's because you have polycysgovarian syndrome,
Speaker 4: and sometimes it's just do you have oligo aovulation, you're
Speaker 4: just not ovulating on a regular basis and you just
Speaker 4: skip a period once in a while. If you have
Speaker 4: really long intervals between periods and you don't, you know,
Speaker 4: you're menstr eight months every six months or so. The
Speaker 4: risk of that is that you're still making estrogen. The
Speaker 4: estrogen is stimulating the lining of the uterus. You're not
Speaker 4: breaking down that lining of the uterus, and so you
Speaker 4: can get an overgrowth of the lining of the uterus,
Speaker 4: or you can get worse, a cancer of the lining
Speaker 4: of the uterus. If you don't, if you're still making
Speaker 4: estrogen and you don't have progesterone to kind of break
Speaker 4: down that lining once in a while. We usually say
Speaker 4: you should have at least four periods a year. So
Speaker 4: if you're not having four periods a year, you should
Speaker 4: you should take progesterone to make yourself have a period
Speaker 4: four times a year. It's a little bit of an
Speaker 4: arbitrary number. I don't think any of us have ever
Speaker 4: studied that that's the right number. Right, the right number,
Speaker 4: and that's what's going to protect the lining of the uterus.
Speaker 4: I think if your periods are really really heavy, we're
Speaker 4: having a lot of in between your periods, you need
Speaker 4: to get the lining of your uterus evaluated. And even
Speaker 4: if you've done it two years ago, you may need
Speaker 4: to do it again because it I've I've had patients
Speaker 4: developed and a mutual cancer that I've buy up sed
Speaker 4: every two years, and every time that that lining was negative,
Speaker 4: negative and low, and behold, now it's positive and they've
Speaker 4: got an mutual cancer. So if you continue to have
Speaker 4: what's what we would call unopposed estrogen, so estrogen to
Speaker 4: the lining of the uterus and not no progesterone a
Speaker 4: kind of break down that lining of the uterus. Then
Speaker 4: you need to have the lining of your uterus evaluate it. If,
Speaker 4: on the other hand, you're having irregular periods because you're
Speaker 4: going into premature or varying failure and you don't have
Speaker 4: a lot of it estrogen around, that's and you just
Speaker 4: once in a while still kick out and you know,
Speaker 4: recruit a follicle and ovulate, then it's not. Then that's
Speaker 4: not as concerning.
Speaker 3: So irregular periods could be nothing, or they could be
Speaker 3: a sign that your lading machine is about to retire
Speaker 3: from the game early, even when you thought you had
Speaker 3: a few innings left to play. Also, buckle up for
Speaker 3: a fun fact about how low f SH or follicle
Speaker 3: stimulating hormone can be an indicator of good ovarian health
Speaker 3: and some TMI about all wards gonads. I feel very
Speaker 3: vulnerable right now.
Speaker 4: It depends on you, know, are you are you still
Speaker 4: making estrogen or your estrogen levels normal is your FSH normal,
Speaker 4: which is your forllicular stimulating hormone, which is the hormone
Speaker 4: your brain makes to tell your ovaries make estrogen. And
Speaker 4: as long as your fhilic stimulating hormone is less than ten,
Speaker 4: you're still making estrogen.
Speaker 5: But you've got to get that checked on a certain
Speaker 5: day too, write no.
Speaker 4: Yes, and no, like you know it. If it's less
Speaker 4: than ten on a random day, you're in good shape.
Speaker 3: Yeah. Mine was one thirty five last it was checked.
Speaker 4: But I you have premature, Yeah, sure you do.
Speaker 3: But I didn't. That happened started happening to be in
Speaker 3: my mid thirties, and I just was like, oh, I
Speaker 3: travel a lot. I just it's irregular. And then they
Speaker 3: didn't figure it out until it was When it came back,
Speaker 3: they were like, there's a chart and you're off of it.
Speaker 3: And it was like, oh good, But yeah, I hadn't.
Speaker 3: I didn't even think that that was the thing. I
Speaker 3: think we kind of also do get fed, like as
Speaker 3: a career woman, like don't let anyone tell you that
Speaker 3: you're losing fertility, you know what I mean. It's almost
Speaker 3: like a badge. It's fine, it's fine, it's fine. Like
Speaker 3: I'm an aunt, I'll get a dog probably baby seemed
Speaker 3: like a lot of work anyway, Fine, I am fine.
Speaker 3: See Mads wants to know how scary are pap test
Speaker 3: and obg ynn appointments, et cetera. She's like, I'm a
Speaker 3: young adult with a for guba I think she means
Speaker 3: in China, I mean, I think that's adorable, so.
Speaker 4: Many different words for I know.
Speaker 3: She's terrified of getting her bits checked out, So how
Speaker 3: scary are they she wants to know?
Speaker 4: Well, first of all, we don't do pap says until
Speaker 4: people are twenty one, So okay, Uh, if she's been
Speaker 4: sexually active, it's I mean, it depends a little bit
Speaker 4: on whether you've been sexually active before. If she's never
Speaker 4: been sexually active, she doesn't actually need a paps mare.
Speaker 4: If she's been sexually active, if she's used tampons before,
Speaker 4: it really shouldn't be it shouldn't be uncomfortable. And how
Speaker 4: scary it is depends a little bit on how comfortable
Speaker 4: she is with the physician. If she's uncomfortable with the physician,
Speaker 4: don't have them do perhaps.
Speaker 5: I Nowadays they always have a nurse in the room
Speaker 5: as well.
Speaker 3: Right, that's fairly new.
Speaker 4: There's there. Yeah, there should be someone else in the room,
Speaker 4: whether it's a nurse or a medical systant nurse. Gabe.
Speaker 3: Yeah, it's always just as a matter of you just
Speaker 3: gotta keep scooching. You think you're scooched to the edge
Speaker 3: of the table, and then they're like, can you scooch more?
Speaker 3: And you're like really, and you scooch and they're like
Speaker 3: just a little more, and you're like, damn, I gotta
Speaker 3: hang my butt off this thing for real.
Speaker 4: That's true. Yeah, that's true.
Speaker 3: Keep scooching. Lily Moss asks a question, is there an
Speaker 3: equivalent of vagino for trans women? Is it same doctors
Speaker 3: for sis women or is it a fairly new job
Speaker 3: thing that specializes in trans women's health.
Speaker 4: There? You know, there's I see some trans women, but
Speaker 4: not that many. I actually see more trans men than
Speaker 4: I see trans women. Interestingly enough, there are.
Speaker 3: Yeah.
Speaker 4: Most trans women in terms of we'll have their vagina
Speaker 4: built by someone who specializes in surgery. That's a very
Speaker 4: specific surgery. Tends to be people that are plastic surgeons.
Speaker 4: Sometimes it's gerologists. There's different groups in the country that
Speaker 4: are known for their surgery. Some of our trans woman
Speaker 4: patients will go to Thailand because the surgery is a
Speaker 4: lot more affordable there. Marcy Bauers is herself a trans woman.
Speaker 4: She used to be an over Juan. She specializes in
Speaker 4: gender reassignment surgery and she's located in the Bay Area.
Speaker 4: She used to be in a little town in Colorado.
Speaker 3: So the town of Trinidad, Colorado became known as a
Speaker 3: hub for gender reassignment surgery. When this local surgeon, doctor
Speaker 3: Stanley Biber, had come back from being a medic in
Speaker 3: the Korean War and he was asked by a patient
Speaker 3: about the possibilit for this procedure, and he was kind
Speaker 3: of stumped. He's like, I don't know how to do that.
Speaker 3: So he wrote to some colleagues at John Hopkins and Stanford.
Speaker 3: They sent some plans, like some sketches. Yeah, that's how
Speaker 3: we did it a couple times this way, and so
Speaker 3: in the late nineteen sixties he got really good at it.
Speaker 3: So this doctor in Colorado started practicing gender reassignment surgeries,
Speaker 3: and transfolks started moving to Trinidad, Colorado because his medical
Speaker 3: care was the best. So this doc kind of passed
Speaker 3: the torch to doctor Marcy Bauers. But when she left
Speaker 3: for San Francisco, Trinidad, Colorado became kind of a bit
Speaker 3: of a ghost town. The mayor himself called it an
Speaker 3: abyss of nothingness. But recently, they turned an abandoned pepsi
Speaker 3: plant into a pot dispensary, and business in Trinidad is
Speaker 3: on the rise. So for several decades, Trinidad, Colorado served
Speaker 3: as this kind of beautiful, rare gem in the middle
Speaker 3: of the wild West, but care for transpatients is now
Speaker 3: becoming a little more widespread.
Speaker 4: So there's a couple of there's sent to. San Francisco
Speaker 4: has a Center for Excellence and Chance Gender Health, hich
Speaker 4: Issue has a Center for Excellence and Chance Gender Health,
Speaker 4: And these centers kind of specialize in gender reassignment surgery,
Speaker 4: and those tend to be the places where people go.
Speaker 3: Krista Traxer wants to know how many babies have you
Speaker 3: delivered and what's the longest you've ever seen a woman
Speaker 3: be in labor.
Speaker 4: For I don't, actually, I didn't keep track of how
Speaker 4: many babies I've delivered. I've probably delivered over three thousand babies,
Speaker 4: but my god, I don't I didn't actually count them all.
Speaker 3: That's so many babies.
Speaker 4: Just based on how many years I've been in practice.
Speaker 3: What's the biggest one. My sister had a ten and
Speaker 3: a half pound baby. It's like a turkey.
Speaker 4: I helped. I kind of was supervising a midwife who
Speaker 4: delivered a thirteen pound baby. What that's like two babies, Yeah,
Speaker 4: the biggest one I've delivered. I think it was also
Speaker 4: close to thirteen pounds, but that was a C section. Oh,
Speaker 4: we knew that baby was going to be big, so
Speaker 4: we just felt like it wasn't going to be safe.
Speaker 3: Yeah. Yeah, let's get out the sun roof there. Ohive,
Speaker 3: quick question? Why are some babies giant? So doctors don't
Speaker 3: call them giant babies, but rather LGA, which stands for
Speaker 3: large for gestational age. Any baby over eight pounds thirteen ounces,
Speaker 3: it's diagnosed with fetal macro somia, which literally means baby
Speaker 3: big body. And genetics can play a part totally, as
Speaker 3: can things like maternal diabetes, which kind of messes with
Speaker 3: your insulin levels. But sometimes you just don't know. And
Speaker 3: my niece is now a lanky twelve year old, she's
Speaker 3: almost taller than me, but she will always be our
Speaker 3: beloved LGA fetal macrosomic giant turkey baby. What's the longest
Speaker 3: you've ever seen someone in labor for?
Speaker 4: Oh, it can be it can be days, like real
Speaker 4: active hard labor, probably two to three days.
Speaker 3: Ugh, But how what's the percentage of people they'd get epidurals,
Speaker 3: because that would be like Anesthscize me from the neck down,
Speaker 3: wake me up when this thing's over.
Speaker 4: It's about seventy to eighty percent.
Speaker 3: Yeah, is there any risk to them?
Speaker 4: If you get an epidura very early in labor, before
Speaker 4: you're in active labor, it may slow down your labor
Speaker 4: because it's when you first get into active labor. It's
Speaker 4: probably a good idea to walk around because kids have
Speaker 4: big heads compared to our pelvis, and in order for
Speaker 4: the head to kind of fit down the pelvis, it
Speaker 4: needs to kind of rotate to find a way to
Speaker 4: pass through the pelvis. Humans, when they evolved from being
Speaker 4: a four legged mammal to becoming bipedal, change the structure
Speaker 4: of their pelvis, and so their pelvis got a little smaller.
Speaker 4: In the meantime, heads got bigger.
Speaker 3: Listen to episode two on Primatology if you want more
Speaker 3: details on our shitty head to pelvis situation.
Speaker 4: And so hence, when the baby actually descends and leaves
Speaker 4: the body, it actually goes through these rotations to make
Speaker 4: its way through the pelvis, and those rotations work way
Speaker 4: better if you're actually walking. Oh, so that if you
Speaker 4: can walk for a part of active labor, your kit's
Speaker 4: more likely to descend and your labor is going to
Speaker 4: be a little bit faster.
Speaker 5: Okay, get on that treadmill, do some breathing exercises. Yikes.
Speaker 4: I mean, I've had people that wanted all natural deliveries
Speaker 4: and labored for twenty four hours and we're absolutely exhausted,
Speaker 4: and their muscles are tense and they're just not going
Speaker 4: anywhere in a hurry. And the epidural just allows all
Speaker 4: their muscles to relax and the baby descends and boom,
Speaker 4: they can deliver their baby and they're done. And Emmanuel,
Speaker 4: we get a lot of transfer from home deliveries, and
Speaker 4: about half of those women still deliver vangeli. And these
Speaker 4: are women that the midwife is brought in that they
Speaker 4: thought could not deliver vangeally and all they needed was
Speaker 4: some pain control and a little bit of sleep, and
Speaker 4: they still have a vangile delivery.
Speaker 3: So do you have anything about your job that you
Speaker 3: hate that just sucks or that it's difficult?
Speaker 4: You know, occasionally the sleep deprivation gets to me. Yeah,
Speaker 4: it's tough. It's sometimes really tough to I mean, typically,
Speaker 4: if it's a delivery, I can I can rally. If
Speaker 4: it's a kind of a silly phone call, yeah, or
Speaker 4: sometimes it's stuff like you know, some hospital wants to
Speaker 4: transfer patient, and that kind of stuff irritates me, and
Speaker 4: it's like, you guys can take care of this. Why
Speaker 4: are you calling me at two in the morning about this?
Speaker 4: Or an er one of my patients has gotten an
Speaker 4: ear somewhere in the air. Physician wants to just let
Speaker 4: me know that they've seen the patient. And I'm like,
Speaker 4: I'm so happy you're calling me at three to let
Speaker 4: me know that you've seen the patient and taken care
Speaker 4: of this patient, and you've just welcomed me up. I'm
Speaker 4: so happy about this.
Speaker 3: Can you get back to sleep easily?
Speaker 5: Or no?
Speaker 4: If I get irritated, no, it's hard to get back
Speaker 4: to sleep. If it's a silly thing, then I get irritated,
Speaker 4: and then it's hard to get back to sleep.
Speaker 3: But I know, what's your favorite thing about what you do?
Speaker 4: I think it's still delivering babies. It's just such a
Speaker 4: beautiful thing. I mean, I didn't I never thought I
Speaker 4: would like that this would be the thing. I always
Speaker 4: thought eventually i'd stop doing them be and I just
Speaker 4: do two an and have an easier life. But it
Speaker 4: just is such a beautiful thing. I mean, it's just
Speaker 4: so amazing that we make these little human beings and
Speaker 4: they come out. It's just it's pretty cool.
Speaker 3: I imagine. The patience vibe also is pretty great.
Speaker 4: Yeah, it's great. I mean it's especially great if it's
Speaker 4: someone that i've you know, I delivered their other kids,
Speaker 4: and it's just that's it's kind of cool.
Speaker 3: People give you a lot of cookies and baked goods,
Speaker 3: thank you.
Speaker 4: Yeah, lots of different things I actually have gotten to like.
Speaker 4: One of my most beautiful bouquet of flowers was from
Speaker 4: a patient who I who just was complaining that her
Speaker 4: she just her discharge just didn't smell right, and it
Speaker 4: had been going on for a really long time, and
Speaker 4: I told her to stop using soap and or to
Speaker 4: stop using the antibacterial soap she was using, and the
Speaker 4: smell went away and she gave me it.
Speaker 5: So with this.
Speaker 4: Beautiful bouquet of flowers, it was like, ah, it's funny.
Speaker 3: The discharge based gratitude exactly. She's like, you changed my
Speaker 3: life exactly, and my fluids exactly. So no anni bacteria soap.
Speaker 4: Don't use any antibacterial soap, and don't use detergent soap
Speaker 4: in your body, and use very little soap in your body. Really,
Speaker 4: soap is really not that especially for your vola. Don't
Speaker 4: use If you can avoid using soap, you're better off.
Speaker 3: What about vaginal steaming and douches?
Speaker 4: Don't do right? Don't, don't, don't. One of the vaginal
Speaker 4: specialists in at Kaiser in the Bay Area did a
Speaker 4: kind of had patients kind of come up with slogans
Speaker 4: for her vaginal health clinic, and one of the patients
Speaker 4: came up with a clinic with it with a slogan,
Speaker 4: the vagina is a self cleaning oven. And it's so true.
Speaker 4: It's like the vagina will keep its own balance if
Speaker 4: you don't mess with it. If you upset the balance,
Speaker 4: the anaerobic bacteria which creates smell, are going to overgrow,
Speaker 4: so the less. And the problem with soap is that
Speaker 4: a lot of soap has detergent qualities, so it's going
Speaker 4: to take away the oils, and the oils are one
Speaker 4: of the things that protect the skin. So if you
Speaker 4: take away oil from the skin, you're going to have
Speaker 4: more overgrowth of kind of bad bacteria as well. So
Speaker 4: the thing with the vagina is that, or with the
Speaker 4: vulva is that a lot of over the counter products
Speaker 4: are irritating to the vulva. Like this product vegicill that
Speaker 4: people use for irritation is actually really irritated to the vagina.
Speaker 4: Most vaginal specialists will say, vegicill makes you ill.
Speaker 3: BRB. I'm going to go drop a single called magicill
Speaker 3: makes you well.
Speaker 4: And one of the vacilline is probably very safe. Coconut
Speaker 4: oil is very safe. Those oils are safe, but creams
Speaker 4: and lotions tend to not be saved. They tend to
Speaker 4: dry out the vagina and the vulva. A lot of
Speaker 4: over the counter products have something called propellin glycol in it,
Speaker 4: which five to ten percent of people get irritated from
Speaker 4: it's drying. Ky jelly tends to dry people out, so
Speaker 4: most of us recommend against ky we. You know, either
Speaker 4: if you're using condoms, oils will dissolve the condoms, so
Speaker 4: you don't want to use an oil or a greasy
Speaker 4: substance when you're using condoms. But as an alternative, if
Speaker 4: you can use some of the silicon based lubricnts. But
Speaker 4: you don't want to get rid of the oils in
Speaker 4: the skin of evolving in the vagina because they're really
Speaker 4: there to protect you.
Speaker 3: So stay hairy, stay oily, exactly, stay greasy, and stay
Speaker 3: hair words to Luba.
Speaker 4: From the Gyro, from the gyro.
Speaker 3: Exactly good advice, Thank you so and bidazzer a great thing. Oh,
Speaker 3: days are a great thing. But I have Japanese toilets
Speaker 3: should exactly why do they have them?
Speaker 4: I know we should. They're a great thing.
Speaker 3: Do you think the kind that are like aftermarket, like
Speaker 3: putting a spoiler on your toilet, but they are a
Speaker 3: day like the kind that just hook in.
Speaker 4: They actually work? Fine? Okay, yeah, you have the days.
Speaker 4: I don't get up a day. I have a separate
Speaker 4: shower head.
Speaker 3: That's treat yourself. I tried.
Speaker 4: I tried to. It's if I have an old house.
Speaker 4: It's a it's a long story.
Speaker 3: I know. I just don't understand why we have so
Speaker 3: much technology in our cars, but our toilets are just waterholes.
Speaker 3: I know, I agree.
Speaker 4: I agree, no and all these and stay away from
Speaker 4: wipes too. That's my one other piece of advice is
Speaker 4: a lot of those wipes are drying too.
Speaker 3: And they also make fat bergs in the sewers. Have
Speaker 3: you heard of that does?
Speaker 4: Yeah? I saw that picture in the London sewer. You
Speaker 4: see it. There's a picture of these people working on
Speaker 4: this huge like blob that's like obstructing the London sewer.
Speaker 4: It's like as big as an elephant.
Speaker 3: It's the grossest thing ever picture. Okay, google fat berg
Speaker 3: and send me the invoice for the psychotherapy. It's worth it.
Speaker 3: I will tell you that in one photo, a London
Speaker 3: sewer worker is holding up this greasy chunk that's about
Speaker 3: the eyes of a small marlin where he a fisherman.
Speaker 3: I was horrified. I was traumatized to notice he was
Speaker 3: not wearing gloves. He was just raw dog and his
Speaker 3: fat berg. My mind raced and raced. I was like,
Speaker 3: why does he hate himself? How is his brain not
Speaker 3: capable of feeling fear? What is happening?
Speaker 4: Why?
Speaker 3: Why?
Speaker 4: Why?
Speaker 3: And I zoomed in on the picture and I was
Speaker 3: very relieved to see that his rubber gloves were just
Speaker 3: the same ruddy peach color as his skin. But that
Speaker 3: was a rough rough thirty seconds from a psyche. It's
Speaker 3: just like the only thing that could make I can't like.
Speaker 3: I just keep thinking of like Sisyphis having to push
Speaker 3: like a fat berg up a hill. It's just the
Speaker 3: grossest thing, a fat burg. It's a fat berg because
Speaker 3: it's yeah, I don't know, because it's grease, and wipes
Speaker 3: just clog the grossest, it's so gross. This is all
Speaker 3: really good information. You go, thank you so much for
Speaker 3: doing this. Yeah, yeah, you're good. So don't flush those
Speaker 3: wipes even though flushable ones folks, when in doubt, put
Speaker 3: it in the bin as they say. Also, go easy
Speaker 3: on the detergent. Don't get a Brazilian wax for your
Speaker 3: next pap. Your China's like no, no, what No. To
Speaker 3: find out what episodes are coming up next, you can
Speaker 3: become a patron for as little as a buck a month,
Speaker 3: y'all twenty five cents an episode, and then you can
Speaker 3: submit your questions to the ologists and I say your
Speaker 3: name and ask your question. If you want to wear
Speaker 3: an Ologies shirt or pin or tote or baby onesie,
Speaker 3: I don't know how old you are. Head over to
Speaker 3: ologiesmerch dot com. Take a look around to follow on
Speaker 3: social media. I'm Ali Ward with one L or at
Speaker 3: Ologies on both Instagram and Twitter. Also, if you like
Speaker 3: this podcast, if it's improved your life at all, tell
Speaker 3: a friend or a stranger, or leave a review on
Speaker 3: iTunes spread the word. Also, double check and make sure
Speaker 3: you're subscribed so you know the minute the next episode
Speaker 3: is out. I noticed that sometimes my Apple podcast will
Speaker 3: just unsubscribe me for my favorite things, and I'm like,
Speaker 3: what huh, even Ologies, I was like, you unsubscribe me
Speaker 3: from my own podcast Apple iTunes, What how dare you?
Speaker 5: So?
Speaker 3: Double check? Episodes coming up involve X rays, the science
Speaker 3: of hair, diabetes, Darwinism, so good stuff coming down the
Speaker 3: podcast Vagina for you. Meanwhile, ask smart people dumb questions
Speaker 3: because that's how they got smart in the first place.
Speaker 3: They love it. I want to say a quick thank
Speaker 3: you to Shannon Feltis and Bonnie Dutch for running Ologiesmarch
Speaker 3: dot com. You guys are amazing. And to Aaron Talbert
Speaker 3: and New Boston resident. How's Boston treating you? Hannah good
Speaker 3: ologit's in Boston. Say hi to Hannah Lippo online, She's amazing,
Speaker 3: Be her friend, show her your dogs. And also to
Speaker 3: Stephen Ray Morris, my amazing editor for this I could
Speaker 3: not put these out every week without you, so thank you.
Speaker 3: The theme song was written by Nick Thorburn of the
Speaker 3: band Islands. He's amazing. Now if you stick around through
Speaker 3: the credits, you know that I tell you secret each time?
Speaker 2: Is it?
Speaker 3: Thank you for sticking it out to the very end.
Speaker 3: And number one, I still haven't unpacked that Doffel bag.
Speaker 3: I'm looking at it right now. Should I unpack it
Speaker 3: while we're on I'm gonna unpack it while you guys
Speaker 3: are on Mike, Okay, let's see. Oh my god, why
Speaker 3: am I doing this this way? Okay, all right, here's
Speaker 3: the Duffel bag. This in my closet. I'm the list out.
Speaker 3: We have green card again. There's a tote bag in here.
Speaker 3: Why woolf sweater, pajama bottoms, dirty sock that has a
Speaker 3: shark on it, jewort's T shirt, bikini, and a couple
Speaker 3: of wash glass because sometimes when I go on vacation,
Speaker 3: especially if I'm sharing like an Airbnb with friends, I'm
Speaker 3: bringing a couple of wash glass to wash my face
Speaker 3: so that I don't have to use dirty hand towels
Speaker 3: on my face.
Speaker 1: Tip.
Speaker 3: Okay, guys, I unpacked the double bag. No, I just
Speaker 3: have to throw these things on the laundry. Thank you
Speaker 3: for being with me through that. Another secret I'm gonna
Speaker 3: tell you really quick is another life pack. Sometimes if
Speaker 3: you see a group on and you didn't get the
Speaker 3: deal in time or whatever, you can call the place
Speaker 3: and be like, hey, I was just about to buy
Speaker 3: a group on and they're like, don't buy the group on,
Speaker 3: just come in. We'll give you that deal because groupon
Speaker 3: takes a cut anyway. So sometimes the places like salons
Speaker 3: or gyms prefer you just pay them the group on rate,
Speaker 3: but don't do it through group on. So okay, this
Speaker 3: was this is a this is a weird secret patch.
Speaker 3: Thank you for making it through this thorny secret patch
Speaker 3: with me. Okay, borrebye pack a.
Speaker 5: Germantology, hobbiology, crypto zoology, lithology, chology, meteorology andology, nathology, seriology, theology.
Speaker 3: There you go boom, oh boy, oh boy. That's like
Speaker 3: two babies.
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