Ask Dr. Annie K: B12 Injections

Love+Medicine Vitamin B12
 

Should I get a B12 shot weekly @ 65 years old?

Love+Medicine

B12 injections have been popular for decades. This is the most fun part of my job as a writer – I learn new things. While researching for this article, I have learned that I am borderline B12 deficient. Enough about me (more later). Let’s get to the facts.

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HELLO JUNE

I have no plans for the weekend, perfect.

My eldest daughter and I decided to read a book together, a change from our usual shared series watching. We simultaneously downloaded The Girl Before, by JP Delaney. The reviews say it’s perfect “if you liked Gone Girl”. Oy. It’s so much less about the book than about sharing it with her – makes the 8,843 miles between us seem a bit shorter. If you’re a Gone Girl fan, definitely check it out.

After tasting a Matcha Financier- an indescribably moist cake made with matcha, white chocolate and raspberries from The Bakery in Tel Aviv, I have been obsessing over matcha.

Matcha Financier

Matcha tea preparation is a central part of tea ceremonies in Japan – I attended one in Kyoto a few years ago. Matcha is powdered green tea, carefully made from shaded, robust whole tea leaves, unlike traditional green tea. It is green tea on steroids – packed with all of the antioxidants in green tea and then some. Today I’m making matcha ice cream, I’ll let you know how that goes.

Things I have read this week:

Alone, Happily Alone, in the Tatra Mountains

Opinion I Nancy Pelosi and Facebook’s Dirty Tricks

To Reduce Travel Stress, Plan Less

Too nice outside, time to get my hands in the dirt! As Margaret Atwood says:

“In the spring, at the end of the day, you should smell like dirt”.

This pine tree started as a small twig brought home by my son when he was in 2nd grade.

Dr. Annie K

Ask Dr. Annie K: Ovulation

 

How do I know when I am ovulating?

Love+Medicine

Your question is a very good one.

There are many reasons why someone would want to know about ovulation. These can be women and their partners who are trying to get pregnant, those who are trying to avoid getting pregnant, and anyone who is curious to know more about how women’s bodies work.

Ovulation is when an egg is released from the ovary.  This happens every month in women with regular cycles. Ovulation usually happens around day 14 in women with regular 28-day cycles. But it can happen any time between day 11 to 21, day 1 being the first day of the last menstrual period. The egg lives for 12 to 24 hours after leaving the ovary, while sperm are viable for several days. If sperm enters the egg during that “fertile period” pregnancy can happen.

When you ovulate can change from month to month. It is not an exact science. Predicting when ovulation is happening is the basis for Fertility Awareness. Fertility Awareness-based methods are not reliable forms of contraception but may be helpful for women trying to get pregnant.

The body goes through changes during ovulation. Getting to know these changes can help you figure out if you are ovulating. 

Basal Body Temperature (BBT)

Prior to ovulation, body temperature falls. After ovulation, a woman’s body temperature rises as a result of an increase in progesterone. Because temperature changes can be influenced by things like stress, illness, poor sleep, inaccurate readings, etc., this alone is not a reliable method to predict ovulation.

Changes in vaginal discharge

During ovulation, the consistency and look of vaginal discharge is noticeably different in most women. Normal discharge is white, cloudy and not stretchy. During ovulation it is more like egg whites – it is clear and when stretched out, it will not break.

Mittelschmerz (German for “middle pain”)

Happens in about 20% of women. There may be a twinge or cramp in one side of the lower abdomen, close to the ovary where the egg is released. If you pay attention to your body mid-cycle, you may feel it. Sometimes it is subtle pain but for some women, it is very painful. 

The cervix never lies

“The cervix never lies” is an old medical school phrase. It can tell you a lot! In the case of ovulation, the cervix softens and opens a bit. This may be nature’s way of preparing it for the entrance of sperm. It is closed and more firm at other times. Some women can feel these changes by using their fingers. 

Increase in sex drive

Some women notice an increase in their sex drive during ovulation as a result of a surge in hormones. This may be evolution’s way of priming women to feel most aroused when they are most likely to get pregnant. 

There are apps, (many apps!) that claim to predict ovulation. Most of these apps are designed for women trying to get pregnant. 

I have done some research regarding which apps are most reliable. The American College of Obstetricians and Gynecologists (ACOG) recently published a review of cycle-tracking apps and have determined that they cannot 100% accurately predict ovulation. However, ACOG did offer suggestions of apps they comfortably recommend at this time: Clue, Glow, and Pink Pad Period Tracker Pro are the top three. 

Understanding the fascinating process of ovulation is essential for all women and their partners. The basis for most contraceptive methods is to stop ovulation – now you know why. Learning when you ovulate is part of knowing and appreciating the female body. 

How Hard Can It Be? Understanding Erectile Dysfunction

As part of my series on the Aging Male, Love and Medicine will tackle erectile dysfunction (ED) – failure of the penis to remain erect in order to reach sexual satisfaction. Most men have experienced this at one time in their lives.  Men are embarrassed, anxious and depressed when their penis isn’t working.  They report frustration because they can’t please their partner. For men in healthy relationships, their partner’s needs matter a lot.

I interned in a sleep lab in graduate school. Sleep studies were used to differentiate psychogenic ED from physiological ED. A normal man spends about two hours in a tumescent state while asleep, having three to four erections a night. A man with psychogenic ED would probably be not far from the norm; a man with physiological ED would remain soft. Diabetic men spent nights in the sleep lab while erections were recorded and it was there that the first correlation between ED and diabetes was discovered.

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Have a Peaceful Weekend


On the road again. Embracing every day, trying to get exercise, eat healthy and maintain grounding when everything is fluid.

I feel like I’m in constant alert-mode. There isn’t a bunch of chit-chat. There are few phone calls, mostly incoming texts that could be life altering at any moment. That’s my life lately. Is that how it is for everyone?

Sitting in a cafe on this cool sunny morning listening to the conversations around me: nine men and two women in their upper eighties were talking about everything from the 6 Day War, to recent hospitalizations, and on to the latest Premier league games. At the next table, a woman talking to her mom was caught saying “its me, your daughter Yael”. She then turned to her friend to report “my own mom doesn’t recognize me”. Then there were the scattering of ubiquitous Game of Thrones conversations.

I just started watching Game of Thrones, as a result of both intrigue and peer pressure. It’s popularity reminds me of The Girl With the Dragon Tattoo novels that at one time were bestsellers in 48 different countries at the same time. They are examples of entertainment that obliterate geographic, age and gender boundaries. They they make the world a smaller, more intimate place.

I’m not exactly enjoying the series. I like sex and violence, but not this kind. But I’m giving it a chance. I’m on season 2, episode 2. Admittedly, it brings me down and then I need to break it up with an episode or two of Rita ( a delightful Danish series on Netflix) before I dive back in for more GOT.

My daughter is making dinner tonight, no doubt something exotic and amazing. What a cook.

Looking forward to being nurtured, sleep, long walks and sunsets. I should be able to hit two out of the four. Maybe three.

What are your weekend plans?